Hybrid Percolation Transition in Cluster Merging Processes: Continuously Varying Exponents

NASA Astrophysics Data System (ADS)

Cho, Y. S.; Lee, J. S.; Herrmann, H. J.; Kahng, B.

2016-01-01

Consider growing a network, in which every new connection is made between two disconnected nodes. At least one node is chosen randomly from a subset consisting of g fraction of the entire population in the smallest clusters. Here we show that this simple strategy for improving connection exhibits a more unusual phase transition, namely a hybrid percolation transition exhibiting the properties of both first-order and second-order phase transitions. The cluster size distribution of finite clusters at a transition point exhibits power-law behavior with a continuously varying exponent τ in the range 2 <τ (g )≤2.5 . This pattern reveals a necessary condition for a hybrid transition in cluster aggregation processes, which is comparable to the power-law behavior of the avalanche size distribution arising in models with link-deleting processes in interdependent networks.

Overview of Transition Programs: Policies and Programs.

ERIC Educational Resources Information Center

2003

There is recent, widespread activity in Australian education and training sectors to improve the transition of young people from initial education to further education and training and employment. Many jurisdictions have conducted high-level reviews of the institutional arrangements underpinning the transition process. The focus has been mainly on…

Use of Failure Mode and Effects Analysis to Improve Emergency Department Handoff Processes.

PubMed

Sorrentino, Patricia

2016-01-01

The purpose of this article is to describe a quality improvement process using failure mode and effects analysis (FMEA) to evaluate systems handoff communication processes, improve emergency department (ED) throughput and reduce crowding through development of a standardized handoff, and, ultimately, improve patient safety. Risk of patient harm through ineffective communication during handoff transitions is a major reason for breakdown of systems. Complexities of ED processes put patient safety at risk. An increased incidence of submitted patient safety event reports for handoff communication failures between the ED and inpatient units solidified a decision to implement the use of FMEA to identify handoff failures to mitigate patient harm through redesign. The clinical nurse specialist implemented an FMEA. Handoff failure themes were created from deidentified retrospective reviews. Weekly meetings were held over a 3-month period to identify failure modes and determine cause and effect on the process. A functional block diagram process map tool was used to illustrate handoff processes. An FMEA grid was used to list failure modes and assign a risk priority number to quantify results. Multiple areas with actionable failures were identified. A majority of causes for high-priority failure modes were specific to communications. Findings demonstrate the complexity of transition and handoff processes. The FMEA served to identify and evaluate risk of handoff failures and provide a framework for process improvement. A focus on mentoring nurses to quality handoff processes so that it becomes habitual practice is crucial to safe patient transitions. Standardizing content and hardwiring within the system are best practice. The clinical nurse specialist is prepared to provide strong leadership to drive and implement system-wide quality projects.

Challenges of Teaching Computer Science in Transition Countries: Albanian University Case

ERIC Educational Resources Information Center

Sotirofski, Kseanela; Kukeli, Agim; Kalemi, Edlira

2010-01-01

The main objective of our study is to determine the challenges faced during the process of teaching Computer Science in a university of a country in transition and make suggestions to improve this teaching process by perfecting the necessary conditions. Our survey builds on the thesis that we live in an information age; information technology is…

Project IMPACT Pilot Report: Feasibility of Implementing a Hospital-to-Home Transition Bundle.

PubMed

Mallory, Leah A; Osorio, Snezana Nena; Prato, B Stephen; DiPace, Jennifer; Schmutter, Lisa; Soung, Paula; Rogers, Amanda; Woodall, William J; Burley, Kayla; Gage, Sandra; Cooperberg, David

2017-03-01

To improve hospital to home transitions, a 4-element pediatric patient-centered transition bundle was developed, including: a transition readiness checklist; predischarge teach-back education; timely and complete written handoff to the primary care provider; and a postdischarge phone call. The objective of this study was to demonstrate the feasibility of bundle implementation and report initial outcomes at 4 pilot sites. Outcome measures included postdischarge caregiver ability to teach-back key home management information and 30-day reuse rates. A multisite, observational time series using multiple planned sequential interventions to implement bundle components with non-technology-supported and technology-supported patients. Data were collected via electronic health record reviews and during postdischarge phone calls. Statistical process control charts were used to assess outcomes. Four pilot sites implemented the bundle between January 2014 and May 2015 for 2601 patients, of whom 1394 had postdischarge telephone encounters. Improvement was noted in the implementation of all bundle elements with the transitions readiness checklist posing the greatest feasibility challenge. Phone contact connection rates were 69%. Caregiver ability to teach-back essential home management information postdischarge improved from 18% to 82%. No improvement was noted in reuse rates, which differed dramatically between technology-supported and non-technology-supported patients. A pediatric care transition bundle was successfully tested and implemented, as demonstrated by improvement in all process measures, as well as caregiver home management skills. Important considerations for successful implementation and evaluation of the discharge bundle include the role of local context, electronic health record integration, and subgroup analysis for technology-supported patients. Copyright © 2017 by the American Academy of Pediatrics.

SU-F-P-01: Changing Your Oncology Information System: A Detailed Process and Lessons Learned

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

Abing, C

Purpose: Radiation Oncology departments are faced with many options for pairing their treatment machines with record and verify systems. Recently, there is a push to have a single-vendor-solution. In order to achieve this, the department must go through an intense and rigorous transition process. Our department has recently completed this process and now offer a detailed description of the process along with lessons learned. Methods: Our cancer center transitioned from a multi-vendor department to a single-vendor department over the 2015 calendar year. Our staff was partitioned off into superuser groups, an interface team, migration team, and go-live team. Six monthsmore » after successful implementation, a detailed survey was sent to the radiation oncology department to determine areas for improvement as well as successes in the process. Results: The transition between record and verify systems was considered a complete success. The results of the survey did point out some areas for improving inefficiencies with our staff; both interactions between each other and the vendors. Conclusion: Though this process was intricate and lengthy, it can be made easier with careful planning and detailed designation of project responsibilities. Our survey results and retrospective analysis of the transition are valuable to those wishing to make this change.« less

Youth Transition from Adolescence to the World of Work.

ERIC Educational Resources Information Center

Mangum, Garth L.

Despite the fact that American society persistently separates home from workplace and extends adolescence, most American youth make the school-to-work transition with a minimum of pain and reasonable success. A substantial minority do not, however, and there is need to improve the transition process especially for those who have been economically…

Multi-Informant Assessment of Transition-Related Skills and Skill Importance in Adolescents with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Hume, Kara; Dykstra Steinbrenner, Jessica; Sideris, John; Smith, Leann; Kucharczyk, Suzanne; Szidon, Kate

2018-01-01

Adolescents with autism spectrum disorder have limited participation in the transition planning process, despite the link between active participation and an improvement in postsecondary education and employment outcomes. The Secondary School Success Checklist was designed to support transition planning for adolescents with autism spectrum…

Experience Transitioning Models and Data at the NOAA Space Weather Prediction Center

NASA Astrophysics Data System (ADS)

Berger, Thomas

2016-07-01

The NOAA Space Weather Prediction Center has a long history of transitioning research data and models into operations and with the validation activities required. The first stage in this process involves demonstrating that the capability has sufficient value to customers to justify the cost needed to transition it and to run it continuously and reliably in operations. Once the overall value is demonstrated, a substantial effort is then required to develop the operational software from the research codes. The next stage is to implement and test the software and product generation on the operational computers. Finally, effort must be devoted to establishing long-term measures of performance, maintaining the software, and working with forecasters, customers, and researchers to improve over time the operational capabilities. This multi-stage process of identifying, transitioning, and improving operational space weather capabilities will be discussed using recent examples. Plans for future activities will also be described.

A Lean Six Sigma quality improvement project to increase discharge paperwork completeness for admission to a comprehensive integrated inpatient rehabilitation program.

PubMed

Neufeld, Nathan J; Hoyer, Erik H; Cabahug, Philippines; González-Fernández, Marlís; Mehta, Megha; Walker, N Colbey; Powers, Richard L; Mayer, R Samuel

2013-01-01

Lean Six Sigma (LSS) process analysis can be used to increase completeness of discharge summary reports used as a critical communication tool when a patient transitions between levels of care. The authors used the LSS methodology as an intervention to improve systems process. Over the course of the project, 8 required elements were analyzed in the discharge paperwork. The authors analyzed the discharge paperwork of patients (42 patients preintervention and 143 patients postintervention) of a comprehensive integrated inpatient rehabilitation program (CIIRP). Prior to this LSS project, 61.8% of required discharge elements were present. The intervention improved the completeness to 94.2% of the required elements. The percentage of charts that were 100% complete increased from 11.9% to 67.8%. LSS is a well-established process improvement methodology that can be used to make significant improvements in complex health care workflow issues. Specifically, the completeness of discharge documentation required for transition of care to CIIRP can be improved.

Improving care transitions from hospital to home: standardized orders for home health nursing with remote telemonitoring.

PubMed

Heeke, Sheila; Wood, Felecia; Schuck, Jennifer

2014-01-01

A task force at a multihospital health care system partnered with home health agencies to improve gaps during the discharge transition process. A standardized order template for home health nursing and remote telemonitoring was developed to decrease discrepancies in communication between hospital health care providers and home health nurses caring for patients with heart failure. Pilot results showed significantly improved communication with no readmissions, using the order template.

Ethnographic process evaluation of a quality improvement project to improve transitions of care for older people.

PubMed

Sutton, Elizabeth; Dixon-Woods, Mary; Tarrant, Carolyn

2016-08-04

Quality improvement projects to address transitions of care across care boundaries are increasingly common but meet with mixed success for reasons that are poorly understood. We aimed to characterise challenges in a project to improve transitions for older people between hospital and care homes. Independent process evaluation, using ethnographic observations and interviews, of a quality improvement project. An English hospital and two residential care homes for older people. 32 hours of non-participant observations and 12 semistructured interviews with project members, hospital and care home staff. A hospital-based improvement team sought to reduce unplanned readmissions from residential care homes using interventions including a community-based geriatric team that could be accessed directly by care homes and a communication tool intended to facilitate transfer of information between homes and hospital. Only very modest (if any) impacts of these interventions on readmission rates could be detected. The process evaluation identified multiple challenges in implementing interventions and securing improvement. Many of these arose because of lack of consensus on the nature of the problem and the proper solutions: while the hospital team was keen to reduce readmissions and saw the problems as lying in poor communication and lack of community-based support for care homes, the care home staff had different priorities. Care home staff were unconvinced that the improvement interventions were aligned with their needs or addressed their concerns, resulting in compromised implementation. Process evaluations have a valuable role in quality improvement. Our study suggests that a key task for quality improvement projects aimed at transitions of care is that of developing a shared view of the problem to be addressed. A more participatory approach could help to surface assumptions, interpretations and interests and could facilitate the coproduction of solutions. This finding is likely to have broader applicability. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Transitions of Care in Medical Education: A Compilation of Effective Teaching Methods.

PubMed

McBryde, Meagan; Vandiver, Jeremy W; Onysko, Mary

2016-04-01

Transitioning patients safely from the inpatient environment back to an outpatient environment is an important component of health care, and multidisciplinary cooperation and formal processes are necessary to accomplish this task. This Transitions of Care (TOC) process is constantly being shaped in health care systems to improve patient safety, outcomes, and satisfaction. While there are many models that have been published on methods to improve the TOC process systematically, there is no clear roadmap for educators to teach TOC concepts to providers in training. This article reviews published data to highlight specific methods shown to effectively instill these concepts and values into medical students and residents. Formal, evidence-based, TOC curriculum should be developed within medical schools and residency programs. TOC education should ideally begin early in the education process, and its importance should be reiterated throughout the curriculum longitudinally. Curriculum should have a specific focus on recognition of common causes of hospital readmissions, such as medication errors, lack of adequate follow-up visits, and social/economic barriers. Use of didactic lectures, case-based workshops, role-playing activities, home visits, interprofessional activities, and resident-led quality improvement projects have all be shown to be effective ways to teach TOC concepts.

Transitioning adolescent and young adults with chronic disease and/or disabilities from paediatric to adult care services - an integrative review.

PubMed

Zhou, Huaqiong; Roberts, Pamela; Dhaliwal, Satvinder; Della, Phillip

2016-11-01

This paper aims to provide an updated comprehensive review of the research-based evidence related to the transitions of care process for adolescents and young adults with chronic illness/disabilities since 2010. Transitioning adolescent and young adults with chronic disease and/or disabilities to adult care services is a complex process, which requires coordination and continuity of health care. The quality of the transition process not only impacts on special health care needs of the patients, but also their psychosocial development. Inconsistent evidence was found regarding the process of transitioning adolescent and young adults. An integrative review was conducted using a five-stage process: problem identification, literature search, data evaluation, data analysis and presentation. A search was carried out using the EBSCOhost, Embase, MEDLINE, PsycINFO, and AustHealth, from 2010 to 31 October 2014. The key search terms were (adolescent or young adult) AND (chronic disease or long-term illness/conditions or disability) AND (transition to adult care or continuity of patient care or transfer or transition). A total of 5719 records were initially identified. After applying the inclusion criteria a final 61 studies were included. Six main categories derived from the data synthesis process are Timing of transition; Perceptions of the transition; Preparation for the transition; Patients' outcomes post-transition; Barriers to the transition; and Facilitating factors to the transition. A further 15 subcategories also surfaced. In the last five years, there has been improvement in health outcomes of adolescent and young adults post-transition by applying a structured multidisciplinary transition programme, especially for patients with cystic fibrosis and diabetes. However, overall patients' outcomes after being transited to adult health care services, if recorded, have remained poor both physically and psychosocially. An accurate tracking mechanism needs to be established by stakeholders as a formal channel to monitor patients' outcomes post- transition. © 2016 The Authors. Journal of Clinical Nursing Published by John Wiley & Sons Ltd.

Considerable improvement of entanglement swapping by considering multiphoton transitions via cavity quantum electrodynamics method

NASA Astrophysics Data System (ADS)

Pakniat, R.; Soltani, M.; Tavassoly, M. K.

2018-03-01

Recently we studied the effect of photon addition in the initial coherent field on the entanglement swapping which causes some improvements in the process [Soltani et al., Int. J. Mod. Phys. B 31, 1750198 (2017)]. In this paper, we investigate the influence of multiphoton transitions in the atom-field interaction based on the cavity quantum electrodynamics on the entanglement swapping and show its considerable constructive effect on this process. The presented model consists of two two-level atoms namely A1 and A2 and two distinct cavity fields F1 and F2. Initially, the atoms are prepared in a maximally entangled state and the fields in the cavities are prepared in hybrid entangled state of number and coherent states, separately. Making the atom A2 to interact with the field F1 (via the generalized Jaynes-Cummings model which allows m-photon transitions between atomic levels in the emission and absorption processes) followed by their detection allows us to arrive at the entanglement swapping from the two atoms A1, A2 and the two fields F1, F2 to the atom-field A1-F2 system. Then, we pay our attention to the time evolution of success probability of detecting processes and fidelity. Also, to determine the amount of entanglement of the generated entangled state in the swapping process, the linear entropy is evaluated and the effect of parameter m concerning the multiphoton transitions on these quantities is investigated, numerically. It is observed that, by increasing the number of photons in the transition process, one may obtain considerable improvement in the relevant quantities of the entanglement swapping. In detail, the satisfactorily acceptable values 1 and 0.5 corresponding to success probability and fidelity are obtained for most of the times during observing of the above-mentioned procedure. We concluded that the presented formalism in this paper is much more advantageous than our presentation model in our earlier work mentioned above.

Nursing perception of patient transitions from hospitals to home with home health.

PubMed

Smith, Shannon Bright; Alexander, Judith W

2012-01-01

The study's purpose was to determine nurses' opinions of sending patients from the hospital to home with home health services. The study occurred in the Charleston, South Carolina, Tricounty area (Berkeley, Charleston, and Dorchester counties). Home health agencies and hospitals were invited to participate. The study used a survey design to gather information on nursing perceptions of current practices and needed changes to improve transition of patients. The population was nurses (licensed practical nurses (LPNs) and registered nurses (RNs)) employed at inpatient hospitals or home health agencies in the area. Thirty-four RNs responded with no LPNs respondents. Agency administrators/chief nursing officers agreed for their agencies to participate and distributed the survey using a Research Electronic Data Capture (REDCap) Internet-based survey tool. Using the survey results and information from a literature review, the study developed a list of propositions, which participating administrators reviewed, for improving transitions to home. Both home health and hospital nurses reported a need to improve the process of sending patients from hospital to home with home health services. This study provides hospitals and home health agencies with propositions to facilitate the establishment of a process to communicate effectively patients care needs and streamline the discharging patients from the hospital to home health care; thus, improving patient transition. Case managers and discharge planners will need interagency collaboration along with evidence-based interventions to transition patients from the hospital to home with home health services with various populations. Direct patient care nurses in both hospital and home health settings should share the same accountability as case managers to ensure successful transitions.

Improving the Transition to University: Introducing Student Voices into the Formal Induction Process for New Geography Undergraduates

ERIC Educational Resources Information Center

Richardson, Michael J.; Tate, Simon

2013-01-01

Recently, there has been renewed interest in the area of school to university transitions within geography. This article focuses upon one aspect of these transitions, namely the induction programmes offered by universities to their new undergraduates. It argues in favour of extending the length of the induction period currently offered by many…

Getting to the Core of Transition: A Re-Assessment of Old Wine in New Bottles.

ERIC Educational Resources Information Center

Stodden, Robert A.; Leake, David W.

1994-01-01

The core of the education system must be transformed to make it supportive of exceptional students in transition. Attempts to improve the system by adding on programs rather than instituting core changes have not been effective. A "teaming" process that promotes school-community and interagency collaboration and infuses transition into the core of…

Precursors in the preparation of transition metal nitrides and transition metal carbonitrides and their reaction intermediates

DOEpatents

Maya, Leon

1991-01-01

A process for making ammonolytic precursors to nitride and carbonitride ceramics. Extreme reaction conditions are not required and the precursor is a powder-like substance that produces ceramics of improved purity and morphology upon pyrolysis.

Improving TOGAF ADM 9.1 Migration Planning Phase by ITIL V3 Service Transition

NASA Astrophysics Data System (ADS)

Hanum Harani, Nisa; Akhmad Arman, Arry; Maulana Awangga, Rolly

2018-04-01

Modification planning of business transformation involving technological utilization required a system of transition and migration planning process. Planning of system migration activity is the most important. The migration process is including complex elements such as business re-engineering, transition scheme mapping, data transformation, application development, individual involvement by computer and trial interaction. TOGAF ADM is the framework and method of enterprise architecture implementation. TOGAF ADM provides a manual refer to the architecture and migration planning. The planning includes an implementation solution, in this case, IT solution, but when the solution becomes an IT operational planning, TOGAF could not handle it. This paper presents a new model framework detail transitions process of integration between TOGAF and ITIL. We evaluated our models in field study inside a private university.

Stark County Area Transportation Study - Transportation Improvement Program 1997-2000

DOT National Transportation Integrated Search

1996-05-01

The Transportation Improvement Program (TIP) is the schedule of highway and transit improvements recommended for implementation within the next four years. It is, therefore, the end product of the transportation planning process. The TIP originates f...

Improved Tracking of an Atomic-Clock Resonance Transition

NASA Technical Reports Server (NTRS)

Prestage, John D.; Chung, Sang K.; Tu, Meirong

2010-01-01

An improved method of making an electronic oscillator track the frequency of an atomic-clock resonance transition is based on fitting a theoretical nonlinear curve to measurements at three oscillator frequencies within the operational frequency band of the transition (in other words, at three points within the resonance peak). In the measurement process, the frequency of a microwave oscillator is repeatedly set at various offsets from the nominal resonance frequency, the oscillator signal is applied in a square pulse of the oscillator signal having a suitable duration (typically, of the order of a second), and, for each pulse at each frequency offset, fluorescence photons of the transition in question are counted. As described below, the counts are used to determine a new nominal resonance frequency. Thereafter, offsets are determined with respect to the new resonance frequency. The process as described thus far is repeated so as to repeatedly adjust the oscillator to track the most recent estimate of the nominal resonance frequency.

Performance-Shaping Factors Affecting Older Adults' Hospital-to-Home Transition Success: A Systems Approach.

PubMed

Werner, Nicole E; Tong, Michelle; Borkenhagen, Amy; Holden, Richard J

2018-01-03

Facilitating older adults' successful hospital-to-home transitions remains a persistent challenge. To address this challenge, we applied a systems lens to identify and understand the performance-shaping factors (PSFs) related older adults' hospital-to-home transition success. This study was a secondary analysis of semi-structured interviews from older adults (N = 31) recently discharged from a hospital and their informal caregivers (N = 13). We used a Human Factors Engineering approach to guide qualitative thematic analysis to develop four themes concerning the system conditions shaping hospital-to-home transition success. The four themes concerning PSFs were: (a) the hospital-to-home transition was a complex multiphase process-the process unfolded over several months and required substantial, persistent investment/effort; (b) there were unmet needs for specialized tools-information and resources provided at hospital discharge were not aligned with requirements for transition success; (c) alignment of self-care routines with transition needs-pre-hospitalization routines could be supportive/disruptive and could deteriorate/be re-established; and (d) changing levels of work demand and capacity during the transition-demand often exceeded capacity leading to work overload. Our findings highlight that the transition is not an episodic event, but rather a longitudinal process extending beyond the days just after hospital discharge. Transition interventions to improve older adults' hospital-to-home transitions need to account for this complex multiphase process. Future interventions must be developed to support older adults and informal caregivers in navigating the establishment and re-establishment of routines and managing work demands and capacity during the transition process. © The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Effects of skilled nursing facility structure and process factors on medication errors during nursing home admission.

PubMed

Lane, Sandi J; Troyer, Jennifer L; Dienemann, Jacqueline A; Laditka, Sarah B; Blanchette, Christopher M

2014-01-01

Older adults are at greatest risk of medication errors during the transition period of the first 7 days after admission and readmission to a skilled nursing facility (SNF). The aim of this study was to evaluate structure- and process-related factors that contribute to medication errors and harm during transition periods at a SNF. Data for medication errors and potential medication errors during the 7-day transition period for residents entering North Carolina SNFs were from the Medication Error Quality Initiative-Individual Error database from October 2006 to September 2007. The impact of SNF structure and process measures on the number of reported medication errors and harm from errors were examined using bivariate and multivariate model methods. A total of 138 SNFs reported 581 transition period medication errors; 73 (12.6%) caused harm. Chain affiliation was associated with a reduction in the volume of errors during the transition period. One third of all reported transition errors occurred during the medication administration phase of the medication use process, where dose omissions were the most common type of error; however, dose omissions caused harm less often than wrong-dose errors did. Prescribing errors were much less common than administration errors but were much more likely to cause harm. Both structure and process measures of quality were related to the volume of medication errors.However, process quality measures may play a more important role in predicting harm from errors during the transition of a resident into an SNF. Medication errors during transition could be reduced by improving both prescribing processes and transcription and documentation of orders.

Pediatricians Transitioning Practices, Youth With Special Health Care Needs in New York State.

PubMed

Davidson, Lynn F; Chhabra, Rosy; Cohen, Hillel W; Lechuga, Claudia; Diaz, Patricia; Racine, Andrew

2015-10-01

To assess current practices of New York State pediatricians as they transition youth with special health care needs to adult-oriented medical care. A survey of New York State pediatricians included 6 critical steps from 2002 consensus statement, 11 essential steps adapted from recent literature, and questions targeting age of starting transition and availability of transition policy. Of 181 respondents, only 11% have a transition policy. Most assist patients in transition process; identify an adult provider (92%); and create portable medical summary (57%). Only 3% start planning process at recommended age. No respondents are compliant with all 6 critical steps; subspecialists were more likely to report compliance to more than 4 steps. Participating pediatricians are making gains, yet effort is needed, to incorporate the essential steps into practice for transitioning youth with special health care needs. Recognition of barriers, use of electronic tools, and clarifying subspecialist's approach, may improve compliance with transition recommendations. © The Author(s) 2015.

Comparison of the properties of tonpilz transducers fabricated with 001 fiber-textured lead magnesium niobate-lead titanate ceramic and single crystals.

PubMed

Brosnan, Kristen H; Messing, Gary L; Markley, Douglas C; Meyer, Richard J

2009-11-01

Tonpilz transducers are fabricated from 001 fiber-textured 0.72Pb(Mg(1/3)Nb(2/3))O(3)-0.28PbTiO(3) (PMN-28PT) ceramics, obtained by the templated grain growth process, and PMN-28PT ceramic and Bridgman grown single crystals of the same composition. In-water characterization of single element transducers shows higher source levels, higher in-water coupling, and more usable bandwidth for the 81 vol % textured PMN-28PT device than for the ceramic PMN-28PT element. The 81 vol % textured PMN-28PT tonpilz element measured under large signals shows linearity in sound pressure levels up to 0.23 MV/m drive field but undergoes a phase transition due to a lowered transition temperature from the SrTiO(3) template particles. Although the textured ceramic performs well in this application, it could be further improved with compositional tailoring to raise the transition temperature and better processing to improve the texture quality. With these improvements textured piezoelectric ceramics will be viable options for medical ultrasound, actuators, and sonar applications because of their ease of processing, compositional homogeneity, and potentially lower cost than single crystal.

Transitioning youth to adult healthcare: new tools from the Illinois Transition Care Project.

PubMed

Sanabria, K E; Ruch-Ross, H S; Bargeron, J L; Contri, D A; Kalichman, M A

2015-01-01

To improve youths' transition to adult healthcare, especially for youth with disabilities, The Illinois Transition Care Project created separate, yet complementary, curricula for pediatric and adult-oriented providers. Content from the curricula was tested by practicing physicians. The project created a library of skill worksheets with functional goals for patients. All methods included opportunities to teach life skills to patients to independently manage their conditions. The curricula used Maintenance of Certification (MOC) Part 4 credit as an incentive for physician participation. Pediatric pilot data indicate improvement across all sites and activities. Adult medicine results indicate increased perceived importance and feasibility of accepting young adult patients with childhood conditions. Patient/parent reviewers indicate the tools are understandable, interesting, and effective. Findings suggest the curricula, with MOC Part 4 credit for physicians, are effective in improving transition care. Project results provided new information on population management for transitioning youth and on the use of MOC Part 4 credit as an incentive. Findings have implications for primary care and specialty physicians, team-based care, teaching self-management skills to patients and methods for engaging adult-oriented physicians in the transition process.

Managing the link and strengthening transition from child to adult mental health Care in Europe (MILESTONE): background, rationale and methodology.

PubMed

Tuomainen, H; Schulze, U; Warwick, J; Paul, M; Dieleman, G C; Franić, T; Madan, J; Maras, A; McNicholas, F; Purper-Ouakil, D; Santosh, P; Signorini, G; Street, C; Tremmery, S; Verhulst, F C; Wolke, D; Singh, S P

2018-06-04

Transition from distinct Child and Adolescent Mental Health (CAMHS) to Adult Mental Health Services (AMHS) is beset with multitude of problems affecting continuity of care for young people with mental health needs. Transition-related discontinuity of care is a major health, socioeconomic and societal challenge globally. The overall aim of the Managing the Link and Strengthening Transition from Child to Adult Mental Health Care in Europe (MILESTONE) project (2014-19) is to improve transition from CAMHS to AMHS in diverse healthcare settings across Europe. MILESTONE focuses on current service provision in Europe, new transition-related measures, long term outcomes of young people leaving CAMHS, improving transitional care through 'managed transition', ethics of transitioning and the training of health care professionals. Data will be collected via systematic literature reviews, pan-European surveys, and focus groups with service providers, users and carers, and members of youth advocacy and mental health advocacy groups. A prospective cohort study will be conducted with a nested cluster randomised controlled trial in eight European Union (EU) countries (Belgium, Croatia, France, Germany, Ireland, Italy, Netherlands, UK) involving over 1000 CAMHS users, their carers, and clinicians. Improving transitional care can facilitate not only recovery but also mental health promotion and mental illness prevention for young people. MILESTONE will provide evidence of the organisational structures and processes influencing transition at the service interface across differing healthcare models in Europe and longitudinal outcomes for young people leaving CAMHS, solutions for improving transitional care in a cost-effective manner, training modules for clinicians, and commissioning and policy guidelines for service providers and policy makers. "MILESTONE study" registration: ISRCTN ISRCTN83240263 Registered 23 July 2015; ClinicalTrials.gov NCT03013595 Registered 6 January 2017.

Transition Models for Engineering Calculations

NASA Technical Reports Server (NTRS)

Fraser, C. J.

2007-01-01

While future theoretical and conceptual developments may promote a better understanding of the physical processes involved in the latter stages of boundary layer transition, the designers of rotodynamic machinery and other fluid dynamic devices need effective transition models now. This presentation will therefore center around the development of of some transition models which have been developed as design aids to improve the prediction codes used in the performance evaluation of gas turbine blading. All models are based on Narasimba's concentrated breakdown and spot growth.

Light Scattering in Exoplanet Transits

NASA Astrophysics Data System (ADS)

Robinson, Tyler D.; Fortney, Jonathan J.

2016-10-01

Transit spectroscopy is currently the leading technique for studying exoplanet atmospheric composition, and has led to the detection of molecular species, clouds, and/or hazes for numerous worlds outside the Solar System. The field of exoplanet transit spectroscopy will be revolutionized with the anticipated launch of NASA's James Webb Space Telescope (JWST) in 2018. Over the course of the design five year mission for JWST, the observatory is expected to provide in-depth observations of many tens of transiting exoplanets, including some worlds in the poorly understood 2-4 Earth-mass regime. As the quality of transit spectrum observations continues to improve, so should models of exoplanet transits. Thus, certain processes initially thought to be of second-order importance should be revisited and possibly added to modeling tools. For example, atmospheric refraction, which was commonly omitted from early transit spectrum models, has recently been shown to be of critical importance in some terrestrial exoplanet transits. Beyond refraction, another process that has seen little study with regards to exoplanet transits is light multiple scattering. In most cases, scattering opacity in exoplanet transits has been treated as equivalent to absorption opacity. However, this equivalence cannot always hold, such as in the case of a strongly forward scattering, weakly absorbing aerosol. In this presentation, we outline a theory of exoplanet transit spectroscopy that spans the geometric limit (used in most modern models) to a fully multiple scattering approach. We discuss a new technique for improving model efficiency that effectively separates photon paths, which tend to vary slowly in wavelength, from photon absorption, which can vary rapidly in wavelength. Using this newly developed approach, we explore situations where cloud or haze scattering may be important to JWST observations of gas giants, and comment on the conditions necessary for scattering to become a major influence on an exoplanet transit spectrum.

Transitions to Home Mechanical Ventilation: The Experiences of Canadian Ventilator-Assisted Adults and Their Family Caregivers.

PubMed

Dale, Craig M; King, Judy; Nonoyama, Mika; Carbone, Sarah; McKim, Douglas; Road, Jeremy; Rose, Louise

2017-12-28

Several studies have explored the experience of ventilator-assisted individual (VAIs) living at home with family caregivers. However, few explore the experiences of these individuals as they transition from a hospital setting to living at home with a view to identifying modifiable processes that could optimize transition. This descriptive, qualitative study sought to elucidate barriers to, and facilitators of, transition to home mechanical ventilation (HMV) from the perspective of Canadian VAIs and their family caregivers. Participant recruitment occurred through hospital and community respiratory clinicians based in the four Canadian provinces of Alberta, British Columbia, Ontario, and Saskatchewan. Semi-structured telephone or face-to-face interviews at home were undertaken with 33 individuals including 19 VAIs and 14 family caregivers between 3 to 24 months of transitioning to HMV. Interview data was analyzed using content analysis. Formal teaching of knowledge and skills relevant to HMV within the hospital setting prior to transition was perceived as having an immediate and enduring positive impact on transition. However, family-clinician conflict, information gaps, and persistent lack of trained personal support workers (PSWs) to provide care in the home contributed to maladjustment relating to transition. Participants strongly recommended improved transitional care in the form of respiratory health professional telephone support, home outreach, in addition to training of PSWs. Transition to HMV is a complex and demanding process. Extended HMV training and support may be helpful in mediating adjustment challenges thus reducing stress, caregiver burden and improving health related quality of life for VAIs and family caregivers.

Voluntary Teacher Leadership: Key to Sustainable Improvement

ERIC Educational Resources Information Center

Hickman, Wayne A.; Moore, Lynda C.; Torek, Tonya J.

2008-01-01

When the Burke County Board of Education mandated Burke County High School in Waynesboro, Georgia to "seek a solution" to its poor graduation rate--specifically, to change the school's schedule, teachers were given the responsibility and authority to plan and facilitate the transition. The transition process taught teachers and…

Surface water-groundwater exchange in transitional coastal environments by airborne electromagnetics: The Venice Lagoon example

NASA Astrophysics Data System (ADS)

Viezzoli, A.; Tosi, L.; Teatini, P.; Silvestri, S.

2010-01-01

A comprehensive investigation of the mixing between salt/fresh surficial water and groundwater in transitional environments is an issue of paramount importance considering the ecological, cultural, and socio-economic relevance of coastal zones. Acquiring information, which can improve the process understanding, is often logistically challenging, and generally expensive and slow in these areas. Here we investigate the capability of airborne electromagnetics (AEM) at the margin of the Venice Lagoon, Italy. The quasi-3D interpretation of the AEM outcome by the spatially constrained inversion (SCI) methodology allows us to accurately distinguish several hydrogeological features down to a depth of about 200 m. For example, the extent of the saltwater intrusion in coastal aquifers and the transition between the upper salt saturated and the underlying fresher sediments below the lagoon bottom are detected. The research highlights the AEM capability to improve the hydrogeological characterization of subsurface processes in worldwide lagoons, wetlands, deltas.

Process, outcome and experience of transition from child to adult mental healthcare: multiperspective study.

PubMed

Singh, Swaran P; Paul, Moli; Ford, Tamsin; Kramer, Tami; Weaver, Tim; McLaren, Susan; Hovish, Kimberly; Islam, Zoebia; Belling, Ruth; White, Sarah

2010-10-01

Many adolescents with mental health problems experience transition of care from child and adolescent mental health services (CAMHS) to adult mental health services (AMHS). As part of the TRACK study we evaluated the process, outcomes and user and carer experience of transition from CAMHS to AMHS. We identified a cohort of service users crossing the CAMHS/AMHS boundary over 1 year across six mental health trusts in England. We tracked their journey to determine predictors of optimal transition and conducted qualitative interviews with a subsample of users, their carers and clinicians on how transition was experienced. Of 154 individuals who crossed the transition boundary in 1 year, 90 were actual referrals (i.e. they made a transition to AMHS), and 64 were potential referrals (i.e. were either not referred to AMHS or not accepted by AMHS). Individuals with a history of severe mental illness, being on medication or having been admitted were more likely to make a transition than those with neurodevelopmental disorders, emotional/neurotic disorders and emerging personality disorder. Optimal transition, defined as adequate transition planning, good information transfer across teams, joint working between teams and continuity of care following transition, was experienced by less than 5% of those who made a transition. Following transition, most service users stayed engaged with AMHS and reported improvement in their mental health. For the vast majority of service users, transition from CAMHS to AMHS is poorly planned, poorly executed and poorly experienced. The transition process accentuates pre-existing barriers between CAMHS and AMHS.

Case management redesign in an urban facility.

PubMed

Almaden, Stefany; Freshman, Brenda; Quaye, Beverly

2011-01-01

To explore strategies for improving patient throughput and to redesign case management processes to facilitate level of care transitions and safe discharges. Large Urban Medical Center in South Los Angeles County, with 384 licensed beds that services poor, underserved communities. Both qualitative and quantitative methods were applied. Combined theoretical frameworks were used for needs assessment, intervention strategies, and change management. Observations, interviews, surveys, and database extraction methods were used. The sample consisted of case management staff members and several other staff from nursing, social work, and emergency department staff. Postintervention measures indicated improvement in reimbursements for services, reduction in length of stay, increased productivity, improved patients' access to care, and avoiding unnecessary readmission or emergency department visits. Effective change management strategies must consider multiple factors that influence daily operations and service delivery. Creating accountability by using performance measures associated with patient transitions is highlighted by the case study results. The authors developed a process model to assist in identifying and tracking outcome measures related to patient throughput, front-end assessments, and effective patient care transitions. This model can be used in future research to further investigate best case management practices.

Adolescent to Adult HIV Health Care Transition From the Perspective of Adult Providers in the United States.

PubMed

Tanner, Amanda E; Philbin, Morgan M; Ma, Alice; Chambers, Brittany D; Nichols, Sharon; Lee, Sonia; Fortenberry, J Dennis

2017-10-01

The HIV Care Continuum highlights the need for HIV-infected youth to be tested, linked, and maintained in lifelong care. Care engagement is important for HIV-infected youth in order for them to stay healthy, maintain a low viral load, and reduce further transmission. One point of potential interruption in the care continuum is during health care transition from adolescent- to adult-centered HIV care. HIV-related health care transition research focuses mainly on youth and on adolescent clinic providers; missing is adult clinic providers' perspectives. We examined health care transition processes through semi-structured interviews with 28 adult clinic staff across Adolescent Trials Network sites. We also collected quantitative data related to clinical characteristics and transition-specific strategies. Overall, participants described health care transition as a "warm handoff" and a collaborative effort across adolescent and adult clinics. Emergent transition themes included adult clinical care culture (e.g., patient responsibility), strategies for connecting youth to adult care (e.g., adolescent clinic staff attending youth's first appointment at adult clinic), and approaches to evaluating transition outcomes (e.g., data sharing). Participants provided transition improvement recommendations (e.g., formalized protocols). Using evidence-based research and a quality improvement framework to inform comprehensive and streamlined transition protocols can help enhance the capacity of adult clinics to collaborate with adolescent clinics to provide coordinated and uninterrupted HIV-related care and to improve continuum of care outcomes. Copyright © 2017 Society for Adolescent Health and Medicine. All rights reserved.

Transition Readiness in Adolescents and Emerging Adults with Diabetes: The Role of Patient-Provider Communication

PubMed Central

Hilliard, Marisa; Sweenie, Rachel; Riekert, Kristin

2013-01-01

Transition from pediatric to adult care represents a high risk period for adolescents and emerging adults with diabetes. Fundamental differences between pediatric and adult care delivery models may contribute to increased risk for poor health outcomes. This review provides a brief overview of models of care in pediatric and adult settings and focuses on patient-provider communication content and quality as potential points of intervention to improve transition-related outcomes. This review also highlights disparities in transition and communication for adolescents and emerging adults from racial/ethnic minority groups and discusses recent changes in health care legislation that have significant implications for the transition process. Intervention opportunities include programs to enhance developmentally-appropriate patient-provider interactions and increased attention to promoting transition readiness skills. Improving patient-provider communication may hasten the development of vital self-advocacy skills needed in adult health care systems and, thus, help establish a lasting pattern of positive diabetes self-care. PMID:24014075

Improving Care Transitions Management: Examining the Role of Accountable Care Organization Participation and Expanded Electronic Health Record Functionality.

PubMed

Huber, Thomas P; Shortell, Stephen M; Rodriguez, Hector P

2017-08-01

Examine the extent to which physician organization participation in an accountable care organization (ACO) and electronic health record (EHR) functionality are associated with greater adoption of care transition management (CTM) processes. A total of 1,398 physician organizations from the third National Study of Physician Organization survey (NSPO3), a nationally representative sample of medical practices in the United States (January 2012-May 2013). We used data from the third National Study of Physician Organization survey (NSPO3) to assess medical practice characteristics, including CTM processes, ACO participation, EHR functionality, practice type, organization size, ownership, public reporting, and pay-for-performance participation. Multivariate linear regression models estimated the extent to which ACO participation and EHR functionality were associated with greater CTM capabilities, controlling for practice size, ownership, public reporting, and pay-for-performance participation. Approximately half (52.4 percent) of medical practices had a formal program for managing care transitions in place. In adjusted analyses, ACO participation (p < .001) and EHR functionality (p < .001) were independently associated with greater use of CTM processes among medical practices. The growth of ACOs and similar provider risk-bearing arrangements across the country may improve the management of care transitions by physician organizations. © Health Research and Educational Trust.

Improving medication information transfer between hospitals, skilled-nursing facilities, and long-term-care pharmacies for hospital discharge transitions of care: A targeted needs assessment using the Intervention Mapping framework.

PubMed

Kerstenetzky, Luiza; Birschbach, Matthew J; Beach, Katherine F; Hager, David R; Kennelty, Korey A

2018-02-01

Patients transitioning from the hospital to a skilled nursing home (SNF) are susceptible to medication-related errors resulting from fragmented communication between facilities. Through continuous process improvement efforts at the hospital, a targeted needs assessment was performed to understand the extent of medication-related issues when patients transition from the hospital into a SNF, and the gaps between the hospital's discharge process, and the needs of the SNF and long-term care (LTC) pharmacy. We report on the development of a logic model that will be used to explore methods for minimizing patient care medication delays and errors while further improving handoff communication to SNF and LTC pharmacy staff. Applying the Intervention Mapping (IM) framework, a targeted needs assessment was performed using quantitative and qualitative methods. Using the hospital discharge medication list as reference, medication discrepancies in the SNF and LTC pharmacy lists were identified. SNF and LTC pharmacy staffs were also interviewed regarding the continuity of medication information post-discharge from the hospital. At least one medication discrepancy was discovered in 77.6% (n = 45/58) of SNF and 76.0% (n = 19/25) of LTC pharmacy medication lists. A total of 191 medication discrepancies were identified across all SNF and LTC pharmacy records. Of the 69 SNF staff interviewed, 20.3% (n = 14) reported patient care delays due to omitted documents during the hospital-to-SNF transition. During interviews, communication between the SNF/LTC pharmacy and the discharging hospital was described by facility staff as unidirectional with little opportunity for feedback on patient care concerns. The targeted needs assessment guided by the IM framework has lent to several planned process improvements initiatives to help reduce medication discrepancies during the hospital-to-SNF transition as well as improve communication between healthcare entities. Opening lines of communication along with aligning healthcare entity goals may help prevent medication-related errors. Copyright © 2017 Elsevier Inc. All rights reserved.

Understanding Atmospheric Anomalies Associated with Seasonal Pluvial-Drought Processes Using Southwest China as an Example

NASA Astrophysics Data System (ADS)

Liu, Z.; LU, G.; He, H.; Wu, Z.; He, J.

2017-12-01

Seasonal pluvial-drought transition processes are unique natural phenomena. To explore possible mechanisms, we considered Southwest China (SWC) as the study region and comprehensively investigated the temporal evolution of large-scale and regional atmospheric variables with the simple method of Standardized Anomalies (SA). Some key results include: (1) The net vertical integral of water vapour flux (VIWVF) across the four boundaries may be a feasible indicator of pluvial-drought transition processes over SWC, because its SA-based index is almost consistent with process development. (2) The vertical SA-based patterns of regional horizontal divergence (D) and vertical motion (ω) also coincides with the pluvial-drought transition processes well, and the SA-based index of regional D show relatively high correlation with the identified processes over SWC. (3) With respect to large-scale anomalies of circulation patterns, a well-organized Eurasian Pattern is one important feature during the pluvial-drought transition over SWC. (4) To explore the possibility of simulating drought development using previous pluvial anomalies, large-scale and regional atmospheric SA-based indices were used. As a whole, when SA-based indices of regional dynamic and water-vapor variables are introduced, simulated drought development only with large-scale anomalies can be improved a lot. (5) Eventually, pluvial-drought transition processes and associated regional atmospheric anomalies over nine Chinese drought study regions were investigated. With respect to regional D, vertically single or double "upper-positive-lower-negative" and "upper-negative-lower-positive" patterns are the most common vertical SA-based patterns during the pluvial and drought parts of transition processes, respectively.

Using the International Space Station (ISS) Oxygen Generation Assembly (OGA) Is Not Feasible for Mars Transit

NASA Technical Reports Server (NTRS)

Jones, Harry W.

2016-01-01

A review of two papers on improving the International Space Station (ISS) Oxygen Generation Assembly (OGA) shows that it would not save substantial mass on a Mars transit. The ISS OGA requires redesign for satisfactory operation, even for the ISS. The planned improvements of the OGA for ISS would not be sufficient to make it suitable for Mars, because Mars transit life support has significantly different requirements than ISS. The OGA for Mars should have lower mass, better reliability and maintainability, greater safety, radiation hardening, and capability for quiescent operation. NASA's methodical, disciplined systems engineering process should be used to develop the appropriate system.

The Reentry of Navy Science Assistance Program Personnel: Analysis and Recommendations for Improving the Process

DTIC Science & Technology

1986-12-01

Purpose The purposes of this project were to (1) identify organizational and personnel management practices that foster or hinder the reentry of FTMs...transition of NSAP FTMs. Latack (1984) found that individuals experiencing major career transitions experience more personal life transitions. Research...lent credibility to the claim that changes initiated in the workplace may "trigger" changes in one’s personal liife. Latack found that an individual’s

Using the Research and Development in Organisations Model to Improve Transition to High School

ERIC Educational Resources Information Center

Ashton, Rebecca

2009-01-01

This article describes the application of the Research and Development in Organisations (RADIO) model to five action research projects carried out in schools around transition processes. The RADIO model is mapped onto all five studies, and adapting the model in order to include greater stakeholder participation is suggested. Reflections are made…

The capacity fading mechanism and improvement of cycling stability in MoS2-based anode materials for lithium-ion batteries

NASA Astrophysics Data System (ADS)

Shu, Haibo; Li, Feng; Hu, Chenli; Liang, Pei; Cao, Dan; Chen, Xiaoshuang

2016-01-01

Two-dimensional (2D) layered MoS2 nanosheets possess great potential as anode materials for lithium ion batteries (LIBs), but they still suffer from poor cycling performance. Improving the cycling stability of electrode materials depends on a deep understanding of their dynamic structural evolution and reaction kinetics in the lithiation process. Herein, thermodynamic phase diagrams and the lithiation dynamics of MoS2-based nanostructures with the intercalation of lithium ions are studied by using first-principles calculations and ab initio molecular dynamics simulations. Our results demonstrate that the continuous intercalation of Li ions induces structural destruction of 2H phase MoS2 nanosheets in the discharge process that follows a layer-by-layer dissociation mechanism. Meanwhile, the intercalation of Li ions leads to a structural transition of MoS2 nanosheets from the 2H to the 1T phase due to the ultralow transition barriers (~0.1 eV). We find that the phase transition can slow down the dissociation of MoS2 nanosheets during lithiation. The result can be applied to explain extensive experimental observation of the fast capacity fading of MoS2-based anode materials between the first and the subsequent discharges. To suppress the dissociation of MoS2 nanosheets in the lithiation process, we propose a strategy by constructing a sandwich-like graphene/MoS2/graphene structure that indicates high chemical stability, superior conductivity, and high Li-ion mobility in the charge/discharge process, implying the possibility to induce an improvement in the anode cycling performance. This work opens a new route to rational design layered transition-metal disulfide (TMD) anode materials for LIBs with superior cycling stability and electrochemical performance.Two-dimensional (2D) layered MoS2 nanosheets possess great potential as anode materials for lithium ion batteries (LIBs), but they still suffer from poor cycling performance. Improving the cycling stability of electrode materials depends on a deep understanding of their dynamic structural evolution and reaction kinetics in the lithiation process. Herein, thermodynamic phase diagrams and the lithiation dynamics of MoS2-based nanostructures with the intercalation of lithium ions are studied by using first-principles calculations and ab initio molecular dynamics simulations. Our results demonstrate that the continuous intercalation of Li ions induces structural destruction of 2H phase MoS2 nanosheets in the discharge process that follows a layer-by-layer dissociation mechanism. Meanwhile, the intercalation of Li ions leads to a structural transition of MoS2 nanosheets from the 2H to the 1T phase due to the ultralow transition barriers (~0.1 eV). We find that the phase transition can slow down the dissociation of MoS2 nanosheets during lithiation. The result can be applied to explain extensive experimental observation of the fast capacity fading of MoS2-based anode materials between the first and the subsequent discharges. To suppress the dissociation of MoS2 nanosheets in the lithiation process, we propose a strategy by constructing a sandwich-like graphene/MoS2/graphene structure that indicates high chemical stability, superior conductivity, and high Li-ion mobility in the charge/discharge process, implying the possibility to induce an improvement in the anode cycling performance. This work opens a new route to rational design layered transition-metal disulfide (TMD) anode materials for LIBs with superior cycling stability and electrochemical performance. Electronic supplementary information (ESI) available: Models and energetics of Li adsorption/intercalation onto MoS2 sheets, details of the phase diagram calculations, schematic illustration for the structural evolution of lithiated MoS2 nanosheets, AIMD trajectories for lithiated silicene/MoS2/silicene composites, and movies for recording the AIMD simulation results. See DOI: 10.1039/c5nr07909h

Reducing the global burden of type 2 diabetes by improving the quality of staple foods: The Global Nutrition and Epidemiologic Transition Initiative.

PubMed

Mattei, Josiemer; Malik, Vasanti; Wedick, Nicole M; Hu, Frank B; Spiegelman, Donna; Willett, Walter C; Campos, Hannia

2015-06-04

The prevalence of type 2 diabetes has been reaching epidemic proportions across the globe, affecting low/middle-income and developed countries. Two main contributors to this burden are the reduction in mortality from infectious conditions and concomitant negative changes in lifestyles, including diet. We aimed to depict the current state of type 2 diabetes worldwide in light of the undergoing epidemiologic and nutrition transition, and to posit that a key factor in the nutrition transition has been the shift in the type and processing of staple foods, from less processed traditional foods to highly refined and processed carbohydrate sources. We showed data from 11 countries participating in the Global Nutrition and Epidemiologic Transition Initiative, a collaborative effort across countries at various stages of the nutrition-epidemiologic transition whose mission is to reduce diabetes by improving the quality of staple foods through culturally-appropriate interventions. We depicted the epidemiologic transition using demographic and mortality data from the World Health Organization, and the nutrition transition using data from the Food and Agriculture Organization food balance sheets. Main staple foods (maize, rice, wheat, pulses, and roots) differed by country, with most countries undergoing a shift in principal contributors to energy consumption from grains in the past 50 years. Notably, rice and wheat products accounted for over half of the contribution to energy consumption from staple grains, while the trends for contribution from roots and pulses generally decreased in most countries. Global Nutrition and Epidemiologic Transition Initiative countries with pilot data have documented key barriers and motivators to increase intake of high-quality staple foods. Global research efforts to identify and promote intake of culturally-acceptable high-quality staple foods could be crucial in preventing diabetes. These efforts may be valuable in shaping future research, community interventions, and public health and nutritional policies.

Improvement in self-reported confidence in nurses’ professional skills in the emergency department

PubMed Central

2013-01-01

Background The aim of this study was to assess nurses’ self-reported confidence in their professional skills before and after an extensive Emergency Department (ED) reform in Kanta-Häme Central Hospital. Methods Emergency nurses participated in transitional training commencing two years before the establishment of the new organization in 2007. Training was followed by weekly practical educational sessions in the new ED. During this process nurses improved their transition skills, defined house rules for the new clinic and improved their knowledge of new technology and instruments. The main processes involving critically ill ED patients were described and modelled with an electronic flow chart software. During the transitional training nurses compiled lists of practical skills and measures needed in the ED. These were updated after feedback from physicians in primary and secondary care and head physicians in Kanta-Häme Central Hospital. The final 189-item list comprised 15 different categories, each containing from 4 to 35 items. Based on the work described above, a questionnaire was developed to reflect ED nurses’ skills in clinical measures but also to estimate the need for professional education and practical training. Nurses working in the ED were asked to fill the questionnaire in January 2007 (response rate 97%) and in January 2011 (response rate 98%). Results Nurses’ self-reported confidence in their professional skills improved significally in eight classes out of fifteen. These classes were cannulations, urinary catheterizations, patient monitoring, cardiac patients, equipment, triage and nurse practising, psychiatric patients as well as infection risk. Best results were noted in urinary catheterizations, patient monitoring and infection risk. When studying the group of nurses participating in both surveys in 2007 and 2011, improvements were observed in all fifteen categories. All but two of these changes were significant (p<0.05). Conclusions During an extensive reform of emergency services, we noted a significant improvement in the professional skills of nurses. This improvement was especially consistent among nurses working in the ED during the whole transition process. Nurses’ education and training program in the ED may be successfully put into practice when based on co-operation between nurses and physicians dedicated to emergency services. PMID:23497683

Improvement in self-reported confidence in nurses' professional skills in the emergency department.

PubMed

Rautava, Veli-Pekka; Palomäki, Erika; Innamaa, Tapio; Perttu, Mika; Lehto, Päivi; Palomäki, Ari

2013-03-05

The aim of this study was to assess nurses' self-reported confidence in their professional skills before and after an extensive Emergency Department (ED) reform in Kanta-Häme Central Hospital. Emergency nurses participated in transitional training commencing two years before the establishment of the new organization in 2007. Training was followed by weekly practical educational sessions in the new ED. During this process nurses improved their transition skills, defined house rules for the new clinic and improved their knowledge of new technology and instruments. The main processes involving critically ill ED patients were described and modelled with an electronic flow chart software.During the transitional training nurses compiled lists of practical skills and measures needed in the ED. These were updated after feedback from physicians in primary and secondary care and head physicians in Kanta-Häme Central Hospital. The final 189-item list comprised 15 different categories, each containing from 4 to 35 items. Based on the work described above, a questionnaire was developed to reflect ED nurses' skills in clinical measures but also to estimate the need for professional education and practical training. Nurses working in the ED were asked to fill the questionnaire in January 2007 (response rate 97%) and in January 2011 (response rate 98%). Nurses' self-reported confidence in their professional skills improved significally in eight classes out of fifteen. These classes were cannulations, urinary catheterizations, patient monitoring, cardiac patients, equipment, triage and nurse practising, psychiatric patients as well as infection risk. Best results were noted in urinary catheterizations, patient monitoring and infection risk. When studying the group of nurses participating in both surveys in 2007 and 2011, improvements were observed in all fifteen categories. All but two of these changes were significant (p<0.05). During an extensive reform of emergency services, we noted a significant improvement in the professional skills of nurses. This improvement was especially consistent among nurses working in the ED during the whole transition process. Nurses' education and training program in the ED may be successfully put into practice when based on co-operation between nurses and physicians dedicated to emergency services.

The theory of organisational socialisation and its potential for improving transition experiences for new graduate nurses.

PubMed

Phillips, Craig; Esterman, Adrian; Kenny, Amanda

2015-01-01

Graduate nurse transition continues to remain a difficult time for many new graduate nurses, with significant numbers of graduates being dissatisfied, ultimately considering leaving or exiting the profession. Currently, many graduate nurse programs within Australia and internationally reflect a homogeneous nature pertaining to content and program delivery. A refinement of graduate nurse transition programs through an adaptation of a model of organisational socialisation supports a more individualised approach to transition, improving graduate outcomes and addressing attrition rates. To propose a model which supports the accommodation of new graduates within a health service improving both new graduate and health service outcomes through; greater levels of job satisfaction, increased commitment to an organisation and decreased turnover of new staff. Theoretical paper based on a program of research. An adaptation of a model of organisational socialisation was applied to the process of transition for newly qualified graduate nurses. This adaptation was informed by a larger 2012 Australian study (findings reported extensively elsewhere) with 459 newly qualified graduate nurses reporting their transition experiences of the first year of practice. Newly qualified graduate nurses reported effective socialisation with transition based on the following; enduring and continuous orientation throughout the first year of practice, allocation of patient responsibilities reflecting a level of acuity commensurate with a beginning skill set to meet care needs, and feedback of a respectful nature to improve confidence and competence in practice. Negative transition experiences were noted by many new graduates if these factors were not considered. Graduate nurse turnover is costly and destabilising for health services. One means of addressing this is the creation of positive working environments which appropriately socialise new graduates into health services. Accommodating new employees through; individual recognition, modelling of behaviours and developing positive transition outcomes will improve graduate nurse satisfaction and importantly retention. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

Psychosocial Challenges/Transition to Adulthood.

PubMed

Frederick, Carla

2016-08-01

Advances in the health care of individuals with cystic fibrosis have resulted in more than half of the population older than the age of 18 living longer, fuller lives. This success brings about the need for new areas of improvement and development including the mastery of transitioning from pediatric to adult health care and attention to psychosocial needs. This article reviews key components of the process of transitioning to adult care and some important psychosocial considerations. Copyright © 2016 Elsevier Inc. All rights reserved.

Advanced IR System For Supersonic Boundary Layer Transition Flight Experiment

NASA Technical Reports Server (NTRS)

Banks, Daniel W.

2008-01-01

Infrared thermography is a preferred method investigating transition in flight: a) Global and non-intrusive; b) Can also be used to visualize and characterize other fluid mechanic phenomena such as shock impingement, separation etc. F-15 based system was updated with new camera and digital video recorder to support high Reynolds number transition tests. Digital Recording improves image quality and analysis capability and allows for accurate quantitative (temperature) measurements and greater enhancement through image processing allows analysis of smaller scale phenomena.

Detection and Characterization of Boundary-Layer Transition in Flight at Supersonic Conditions Using Infrared Thermography

NASA Technical Reports Server (NTRS)

Banks, Daniel W.

2008-01-01

Infrared thermography is a powerful tool for investigating fluid mechanics on flight vehicles. (Can be used to visualize and characterize transition, shock impingement, separation etc.). Updated onboard F-15 based system was used to visualize supersonic boundary layer transition test article. (Tollmien-Schlichting and cross-flow dominant flow fields). Digital Recording improves image quality and analysis capability. (Allows accurate quantitative (temperature) measurements, Greater enhancement through image processing allows analysis of smaller scale phenomena).

A survey on signals and systems in ambulatory blood pressure monitoring using pulse transit time.

PubMed

Buxi, Dilpreet; Redouté, Jean-Michel; Yuce, Mehmet Rasit

2015-03-01

Blood pressure monitoring based on pulse transit or arrival time has been the focus of much research in order to design ambulatory blood pressure monitors. The accuracy of these monitors is limited by several challenges, such as acquisition and processing of physiological signals as well as changes in vascular tone and the pre-ejection period. In this work, a literature survey covering recent developments is presented in order to identify gaps in the literature. The findings of the literature are classified according to three aspects. These are the calibration of pulse transit/arrival times to blood pressure, acquisition and processing of physiological signals and finally, the design of fully integrated blood pressure measurement systems. Alternative technologies as well as locations for the measurement of the pulse wave signal should be investigated in order to improve the accuracy during calibration. Furthermore, the integration and validation of monitoring systems needs to be improved in current ambulatory blood pressure monitors.

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

Maloney, J.; Kiepper, A.F.; Simonetta, R.J.

The volume examines monitoring and reporting procedures applicable to performance and productivity. The managers of three transit systems of varying sizes discuss how productivity has been increased within their systems. The Pittsburgh discussion reviews a variety of capital projects and management improvement initiatives undertaken by Port Authority Transit, including development of maintenance manuals and an absenteeism reduction project. The Houston discussion describes how the property used a management study to identify needed organizational change and restructuring. The Ann Arbor discussion focuses on a set of service standards and performance indicators adopted to focus the management improvement process.

Patient-Centered Care Transition for Patients Admitted through the ED: Improving Patient and Employee Experience

PubMed Central

Algauer, Andrea; Rivera, Stephanie; Faurote, Robert

2015-01-01

With increasing wait times in emergency departments (ED) across America, there is a need to streamline the inpatient admission process in order to decrease wait times and more important, to increase patient and employee satisfaction. One inpatient unit at New York-Presbyterian Weill Cornell Medical Center initiated a program to help expedite the inpatient admission process from the ED. The goal of the ED Bridge program is to ease the patient's transition from the ED to an inpatient unit by visiting the patient in the ED and introducing and setting expectations for the inpatient environment (i.e. telemetry alarms, roommates, hourly comfort rounds). Along with improving the patient experience, this program intends to improve the collaboration between ED nurses and inpatient nurses. With the continued support of our nurse management, hospital administrators and most important, our staff, this concept is aimed to increase patient satisfaction scores and subsequently employee satisfaction. PMID:28725813

Laser-processing of VO2 thin films synthesized by polymer-assisted-deposition

NASA Astrophysics Data System (ADS)

Breckenfeld, Eric; Kim, Heungsoo; Gorzkowski, Edward P.; Sutto, Thomas E.; Piqué, Alberto

2017-03-01

We investigate a novel route for synthesis and laser-sintering of VO2 thin films via solution-based polymer-assisted-deposition (PAD). By replacing the traditional solvent for PAD (water) with propylene glycol, we are able to control the viscosity and improve the environmental stability of the precursor. The solution stability and ability to control the viscosity makes for an ideal solution to pattern simple or complex shapes via direct-write methods. We demonstrate the potential of our precursor for printing applications by combining PAD with laser induced forward transfer (LIFT). We also demonstrate large-area film synthesis on 4 in. diameter glass wafers. By varying the annealing temperature, we identify the optimal synthesis conditions, obtaining optical transmittance changes of 60% at a 2500 nm wavelength and a two-order-of-magnitude semiconductor-to-metal transition. We go on to demonstrate two routes for improved semiconductor-to-metal characteristics. The first method uses a multi-coating process to produce denser films with large particles. The second method uses a pulsed-UV-laser sintering step in films annealed at low temperatures (<450° C) to promote particle growth and improve the semiconductor-to-metal transition. By comparing the hysteresis width and semiconductor-to-metal transition magnitude in these samples, we demonstrate that both methods yield high quality VO2 with a three-order-of-magnitude transition.

Older Persons’ Transitions in Care (OPTIC): a study protocol

PubMed Central

2012-01-01

Background Changes in health status, triggered by events such as infections, falls, and geriatric syndromes, are common among nursing home (NH) residents and necessitate transitions between NHs and Emergency Departments (EDs). During transitions, residents frequently experience care that is delayed, unnecessary, not evidence-based, potentially unsafe, and fragmented. Furthermore, a high proportion of residents and their family caregivers report substantial unmet needs during transitions. This study is part of a program of research whose overall aim is to improve quality of care for frail older adults who reside in NHs. The purpose of this study is to identify successful transitions from multiple perspectives and to identify organizational and individual factors related to transition success, in order to inform improvements in care for frail elderly NH residents during transitions to and from acute care. Specific objectives are to: 1. define successful and unsuccessful elements of transitions from multiple perspectives; 2. develop and test a practical tool to assess transition success; 3. assess transition processes in a discrete set of transfers in two study sites over a one year period; 4. assess the influence of organizational factors in key practice locations, e.g., NHs, emergency medical services (EMS), and EDs, on transition success; and 5. identify opportunities for evidence-informed management and quality improvement decisions related to the management of NH – ED transitions. Methods/Design This is a mixed-methods observational study incorporating an integrated knowledge translation (IKT) approach. It uses data from multiple levels (facility, care unit, individual) and sources (healthcare providers, residents, health records, and administrative databases). Discussion Key to study success is operationalizing the IKT approach by using a partnership model in which the OPTIC governance structure provides for team decision-makers and researchers to participate equally in developing study goals, design, data collection, analysis and implications of findings. As preliminary and ongoing study findings are developed, their implications for practice and policy in study settings will be discussed by the research team and shared with study site administrators and staff. The study is designed to investigate the complexities of transitions and to enhance the potential for successful and sustained improvement of these transitions. PMID:23241360

High School Transition--An Intervention That Empowers Children with Special Educational Needs and Improves School Practice

ERIC Educational Resources Information Center

Bunn, Helena; Davis, Debbie; Speed, Emma

2017-01-01

This article discusses the process and results of a junior school initiative from a local authority in the East of England, to ensure that vulnerable pupils in the school experience a successful transition to high school. The resulting project is the consequence of an inter-organisational collaboration between the junior school, a secondary school…

Transitioning from Distributed and Traditional to Distributed and Agile: An Experience Report

NASA Astrophysics Data System (ADS)

Wildt, Daniel; Prikladnicki, Rafael

Global companies that experienced extensive waterfall phased plans are trying to improve their existing processes to expedite team engagement. Agile methodologies have become an acceptable path to follow because it comprises project management as part of its practices. Agile practices have been used with the objective of simplifying project control through simple processes, easy to update documentation and higher team iteration over exhaustive documentation, focusing rather on team continuous improvement and aiming to add value to business processes. The purpose of this chapter is to describe the experience of a global multinational company on transitioning from distributed and traditional to distributed and agile. This company has development centers across North America, South America and Asia. This chapter covers challenges faced by the project teams of two pilot projects, including strengths of using agile practices in a globally distributed environment and practical recommendations for similar endeavors.

Chemical analysis of extracting transition metal oxides from polymetallic ore by sulphate process

NASA Astrophysics Data System (ADS)

Enkh-Uyanga, Otgon-Uul; Munkhtsetseg, Baatar; Urangoo, Urtnasan; Tserendulam, Enkhtur; Agiimaa, Davaadorj

2017-06-01

In this research work we attempt to improve the purity of polymetallic ores in Mongolia whilst developing practical applications of its refinement processes and this paper presents the results of chemical research of extracting transition metal titanium oxides, ferrous oxide and rare earth oxides from polymetallic ore. Thereby, chemical and mineral analysis of polymetallic ore is carried out basis of responses to the support process at various degrees of water whereas transition metal sulphates solubility differ. As a result of sulphate and resulphurization process we have extracted anatase with 62.5 percent titanium dioxide and brookite mineral with 89.6 percent of titanium dioxide as well as mineral with 83.8 percent of ferrous oxide hematite and rare earth oxides with 57.6 percent of cerium oxide. These oxides are identified under various conditions in the thermal processing. The morphology structure and chemical content compound of the mineral has been verified as a result of the XRF, XRD, SEM-EDX analysis.

Parenthood in transition - Somali-born parents' experiences of and needs for parenting support programmes.

PubMed

Osman, Fatumo; Klingberg-Allvin, Marie; Flacking, Renée; Schön, Ulla-Karin

2016-02-16

Pre- and post-migration trauma due to forced migration may impact negatively on parents' ability to care for their children. Little qualitative work has examined Somali-born refugees' experiences. The aim of this study is to explore Somali-born refugees' experiences and challenges of being parents in Sweden, and the support they need in their parenting. A qualitative descriptive study was undertaken. Data were collected from four focus group discussions (FGDs) among 23 Somali-born mothers and fathers living in a county in central Sweden. Qualitative content analysis has been applied. A main category, Parenthood in Transition, emerged as a description of a process of parenthood in transition. Two generic categories were identified: Challenges, and Improved parenting. Challenges emerged from leaving the home country and being new and feeling alienated in the new country. In Improved parenting, an awareness of opportunities in the new country and ways to improve their parenting was described, which includes how to improve their communication and relationship with their children. The parents described a need for information on how to culturally adapt their parenting and obtain support from the authorities. Parents experienced a process of parenthood in transition. They were looking to the future and for ways to improve their parenting. Schools and social services can overcome barriers that prevent lack of knowledge about the new country's systems related to parenthood. Leaving the home country often means separation from the family and losing the social network. We suggest that staff in schools and social services offer parent training classes for these parents throughout their children's childhood, with benefits for the child and family.

Sleep-dependent learning and motor-skill complexity

PubMed Central

Kuriyama, Kenichi; Stickgold, Robert; Walker, Matthew P.

2004-01-01

Learning of a procedural motor-skill task is known to progress through a series of unique memory stages. Performance initially improves during training, and continues to improve, without further rehearsal, across subsequent periods of sleep. Here, we investigate how this delayed sleep-dependent learning is affected when the task characteristics are varied across several degrees of difficulty, and whether this improvement differentially enhances individual transitions of the motor-sequence pattern being learned. We report that subjects show similar overnight improvements in speed whether learning a five-element unimanual sequence (17.7% improvement), a nine-element unimanual sequence (20.2%), or a five-element bimanual sequence (17.5%), but show markedly increased overnight improvement (28.9%) with a nine-element bimanual sequence. In addition, individual transitions within the motor-sequence pattern that appeared most difficult at the end of training showed a significant 17.8% increase in speed overnight, whereas those transitions that were performed most rapidly at the end of training showed only a non-significant 1.4% improvement. Together, these findings suggest that the sleep-dependent learning process selectively provides maximum benefit to motor-skill procedures that proved to be most difficult prior to sleep. PMID:15576888

Transition to adult care for children with chronic neurological disorders.

PubMed

Camfield, Peter; Camfield, Carol

2011-03-01

Chronic neurological disorders in children have significant effects on adult medical and social function. Transition and then formal transfer of care from pediatric to adult services is a complex process, although there are virtually no objective data to inform physicians about the most effective approach. Some neurological disorders that start in children are a danger to society if poorly treated in adulthood, some disorders that were previously lethal in childhood now permit survival well into adulthood, and others are static in childhood but progressive in adulthood. Some disorders remit or are cured in childhood but continue to have serious comorbidity in adulthood, whereas others are similar and persistent in children and adults. Maturity, provision of information, and cognitive problems are confounders. We discuss several models of transition/transfer but prefer a joint pediatric/adult transition clinic. We make a series of suggestions about how to improve the transition/transfer process with the hope of better medical and social adult outcome for children with neurological disorders. Copyright © 2011 American Neurological Association.

Polyimides based on 4,4'-bis (4-aminophenoxy)-2,2'or 2,2', 6,6'-substituted biphenyl

NASA Technical Reports Server (NTRS)

Chuang, Chun-Hua K. (Inventor)

1999-01-01

This invention relates the novel diamines, the polyimide oligomers and the polyimides derived therefrom and to the method of preparing the diamines, oligomers and the polyimides. The thermoplastic polyimides derived from the aromatic diamines of this invention are characterized as having a high glass transition temperature, good mechanical properties and improved processability in the manufacture of adhesives, electronic and composite materials for use in the automotive and aerospace industry. The distinction of the novel aromatic diamines of this invention is the 2,2',6,6'-substituted biphenyl radicals which exhibit noncoplanar conformation that enhances the solubility of the diamine as well as the processability of the polyimides, while retaining a realatively high glass transition temperature and improved mechanical properties at useful temperature ranges.

Aromatic Diamines and Polyimides Based on 4,4'-Bis-(4-Aminophenoxy)-2,2' or 2,2',6,6'- Substituted Biphenyl

NASA Technical Reports Server (NTRS)

Chuang, Chun-Hua K. (Inventor)

2000-01-01

This invention relates the novel diamines. the polyimide oligomers and the polyimides derived therefrom and to the method of preparing the diamines, oligomers and the polyimides. The thermoplastic polyimides derived from the aromatic diamines of this invention are characterized as having a high glass transition temperature. good mechanical properties and improved processability in the manufacture of adhesives. electronic and composite materials for use in the automotive and aerospace industry. The distinction of the novel aromatic diamines of this invention is the 2.2',6.6substituted biphenyl radicals which exhibit noncoplanar conformation that enhances the solubility of the diamine as well as the processability of the polyimides. while retaining a relatively high glass transition temperature and improved mechanical properties at useful temperature ranges.

Digital Signal Processing Based on a Clustering Algorithm for Ir/Au TES Microcalorimeter

NASA Astrophysics Data System (ADS)

Zen, N.; Kunieda, Y.; Takahashi, H.; Hiramoto, K.; Nakazawa, M.; Fukuda, D.; Ukibe, M.; Ohkubo, M.

2006-02-01

In recent years, cryogenic microcalorimeters using their superconducting transition edge have been under development for possible application to the research for astronomical X-ray observations. To improve the energy resolution of superconducting transition edge sensors (TES), several correction methods have been developed. Among them, a clustering method based on digital signal processing has recently been proposed. In this paper, we applied the clustering method to Ir/Au bilayer TES. This method resulted in almost a 10% improvement in the energy resolution. Conversely, from the point of view of imaging X-ray spectroscopy, we applied the clustering method to pixellated Ir/Au-TES devices. We will thus show how a clustering method which sorts signals by their shapes is also useful for position identification

Changes in Efficiency and Safety Culture After Integration of an I-PASS-Supported Handoff Process.

PubMed

Sheth, Shreya; McCarthy, Elisa; Kipps, Alaina K; Wood, Matthew; Roth, Stephen J; Sharek, Paul J; Shin, Andrew Y

2016-02-01

Recent publications have shown improved outcomes associated with resident-to-resident handoff processes. However, the implementation of similar handoff processes for patients moving between units and teams with expansive responsibilities presents unique challenges. We sought to determine the impact of a multidisciplinary standardized handoff process on efficiency, safety culture, and satisfaction. A prospective improvement initiative to standardize handoffs during patient transitions from the cardiovascular ICU to the acute care unit was implemented in a university-affiliated children's hospital. Time between verbal handoff and patient transfer decreased from baseline (397 ± 167 minutes) to the postintervention period (24 ± 21 minutes) (P < .01). Percentage positive scores for the handoff/transitions domain of a national culture of safety survey improved (39.8% vs 15.2% and 38.8% vs 19.6%; P = .005 and 0.03, respectively). Provider satisfaction improved related to the information conveyed (34% to 41%; P = .03), time to transfer (5% to 34%; P < .01), and overall experience (3% to 24%; P < .01). Family satisfaction improved for several questions, including: "satisfaction with the information conveyed" (42% to 70%; P = .02), "opportunities to ask questions" (46% to 74%; P < .01), and "Acute Care team's knowledgeabout my child's issues" (50% to 73%; P = .04). No differences in rates of readmission, rapid response team calls, or mortality were observed. Implementation of a multidisciplinary I-PASS-supported handoff process for patients transferring from the cardiovascular ICU to the acute care unit resulted in improved transfer efficiency, safety culture scores, and satisfaction of providers and families. Copyright © 2016 by the American Academy of Pediatrics.

Safety threats and opportunities to improve interfacility care transitions: insights from patients and family members.

PubMed

Jeffs, Lianne; Kitto, Simon; Merkley, Jane; Lyons, Renee F; Bell, Chaim M

2012-01-01

To explore patients' and family members' perspectives on how safety threats are detected and managed across care transitions and strategies that improve care transitions from acute care hospitals to complex continuing care and rehabilitation health care organizations. Poorly executed care transitions can result in additional health care spending due to adverse outcomes and delays as patients wait to transfer from acute care to facilities providing different levels of care. Patients and their families play an integral role in ensuring they receive safe care, as they are the one constant in care transitions processes. However, patients' and family members' perspectives on how safety threats are detected and managed across care transitions from health care facility to health care facility remain poorly understood. This qualitative study used semistructured interviews with patients (15) and family members (seven) who were transferred from an acute care hospital to a complex continuing care/rehabilitation care facility. Data were analyzed using a directed content analytical approach. OUR RESULTS REVEALED THREE KEY OVERARCHING THEMES IN THE PERCEPTIONS: lacking information, getting "funneled through" too soon, and difficulty adjusting to the shift from total care to almost self-care. Several patients and families described their expectations and experiences associated with their interfacility care transitions as being uninformed about their transfer or that transfer happened too early. In addition, study participants identified the need for having a coordinated approach to care transitions that engages patients and family members. Study findings provide patients' and family members' perspectives on key safety threats and how to improve care transitions. Of particular importance is the need for patients and family members to play a more active role in their care transition planning and self-care management.

Continuous Quality Improvement: Making the Transition to Education.

ERIC Educational Resources Information Center

Hubbard, Dean L., Ed.

This book is a collection of case studies by 27 educational and industrial leaders describing the implementation of specific Total Quality Management techniques which have demonstrated their value. Essays and their authors are as follows: "Process Improvements Using Team Environments" (Scot M. Faulkner); "Team Effectiveness" (Robert S. Winter);…

Evaluation of Standardization of Transfer of Accountability between Inpatient Pharmacists.

PubMed

Tsoi, Vivian; Dewhurst, Norman; Tom, Elaine

2018-01-01

A compelling body of evidence supports the notion that transfer of accountability (TOA) improves communication, continuity of care, and patient safety. TOA involves the transmission and receipt of information between clinicians at each transition of care. Without a notification system alerting pharmacists to patient transfers, pharmacists' ability to seek out and complete TOA may be hindered. A standardized policy and process for TOA, with automated workflow, was implemented at the study hospital in 2015, to ensure consistency and timeliness of documentation by pharmacists. To evaluate pharmacists' adherence to and satisfaction with the TOA policy and process. A retrospective audit was conducted, using a random sample of individuals who were inpatients between June 2014 and February 2016. Transition points for TOA were identified, and the computerized pharmacy system was reviewed to determine whether TOA had been documented at each transition point. After the audit, an online survey was distributed to assess pharmacists' response to and satisfaction with the TOA policy and workflow. Before the TOA workflow was implemented, TOA documentation by pharmacists ranged from 11% (10/93) to 43% (48/111) of transitions. Eight months after implementation of the workflow, the rate of TOA documentation was 87% (68/78), exceeding the institution's target of 70%. Of the 32 pharmacists surveyed, most were satisfied with the TOA policy and agreed that the standardized workflow was simple to use, increased the number of TOAs provided and received, and improved the quality of completed TOAs. Respondents also indicated that the TOA workflow had improved patient care (mean score 4.09/5, standard deviation 0.64). The standardized TOA policy and process were well received by pharmacists, and resulted in consistent TOA documentation and a TOA documentation rate that exceeded the institutional target.

Transition of gastroenterological patients from paediatric to adult care: A position statement by the Italian Societies of Gastroenterology.

PubMed

Elli, Luca; Maieron, Roberto; Martelossi, Stefano; Guariso, Graziella; Buscarini, Elisabetta; Conte, Dario; di Giulio, Emilio; Staiano, Annamaria; Barp, Jacopo; Bassotti, Gabrio; Bianco, Maria Antonia; Buri, Luigi; Carrara, Maurizio; Ghidini, Benedetta; Giannini, Olivia; Knafelz, Daniela; Miele, Erasmo; Peralta, Sergio; Riccio, Elisabetta; Tomba, Carolina; Zilli, Maurizio; Guadagnini, Tiziana

2015-09-01

In 2013, four Italian Gastroenterological Societies (the Italian Society of Paediatric Gastroenterology, Hepatology and Nutrition, the Italian Society of Hospital Gastroenterologists and Endoscopists, the Italian Society of Endoscopy, and the Italian Society of Gastroenterology) formed a joint panel of experts with the aim of preparing an official statement on transition medicine in Gastroenterology. The transition of adolescents from paediatric to adult care is a crucial moment in managing chronic diseases such as celiac disease, inflammatory bowel disease, liver disease and liver transplantation. Improved medical treatment and availability of new drugs and surgical techniques have improved the prognosis of many paediatric disorders, prolonging survival, thus making the transition to adulthood possible and necessary. An inappropriate transition or the incomplete transmission of data from the paediatrician to the adult Gastroenterologist can dramatically decrease compliance to treatment and prognosis of a young patient, particularly in the case of severe disorders. For these reasons, the Italian gastroenterological societies decided to develop an official shared transition protocol. The resulting document discusses the factors influencing the transition process and highlights the main points to accomplish to optimize compliance and prognosis of gastroenterological patients during the difficult transition from childhood to adolescence and adulthood. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Adolescents with Type 1 Diabetes: transition between diabetes services.

PubMed

Visentin, Kate; Koch, Tina; Kralik, Debbie

2006-06-01

The research aimed to develop a sustainable and coordinated approach to facilitating the transition between diabetes services for adolescents. The objectives were to: (1) involve key diabetes health delivery stakeholders in expressing their concerns and issues about current service delivery and ways to improve same, and (2) reveal from the perspective of the adolescents living with Type 1 Diabetes their experiences surrounding the process of transition. This paper presents research that sought to identify the major concerns and issues that stakeholders had about transition and to reveal the experience of transition for the adolescent with Type 1 Diabetes. Key representatives from seven public diabetes services in Adelaide, South Australia worked collaboratively to answer the objectives of this inquiry. Approach. Interview data were generated and analysed using a response focus framework provided by fourth generation evaluation research. In this study, the focus was on common concerns, claims and issues raised by health care professionals (n = 21) and adolescents (n = 10) aged between 15 and 18 years about transferring from children's to adult diabetes services. Data revealed education and dietetic advice was reactive rather than proactive and that the paediatric model of care is philosophically and practically different to the adult model of diabetes care. Three phases of transition were identified: preparation, formal transition and evaluation. Our findings indicated that these stages of transition were not being fully implemented in health units. The project findings have set the scene to establish a multidisciplinary working party to work collaboratively across agencies to develop effective transition pathways. The role of diabetes nurse educators and dietitians in South Australia is under-used throughout the transition process. Diabetes nurse educators are in an ideal position to prepare, coordinate and evaluate transitional processes.

Conformer-specific microwave spectroscopy of 3-phenylpropionitrile by strong field coherence breaking

NASA Astrophysics Data System (ADS)

Fritz, Sean M.; Hernandez-Castillo, A. O.; Abeysekera, Chamara; Hays, Brian M.; Zwier, Timothy S.

2018-07-01

Strong field coherence breaking (SFCB) was used with a chirped-pulse Fourier Transform microwave spectrometer to obtain conformer-specific rotational spectra of 3-phenylpropionitrile in the 8-18 GHz region. Transitions belonging to anti and gauche conformers were identified and assigned and accurate experimental rotational constants were determined to provide insight to the molecular structure. Experimental rotational transitions provided relative abundances in the supersonic expansion. A modified line picking scheme was developed in the process to modulate more transitions and improve the overall efficiency of the SFCB multiple selective excitation technique.

Efficiently reducing transition curvature in heat-assisted magnetic recording with state-of-the-art write heads

NASA Astrophysics Data System (ADS)

Vogler, Christoph; Abert, Claas; Bruckner, Florian; Suess, Dieter

2017-05-01

Curvatures of bit transitions on granular media are a serious problem for the read-back process. We address this fundamental issue and propose a possibility to efficiently reduce transition curvatures with state-of-the-art heat-assisted magnetic recording heads. We compare footprints of conventional with those of the proposed head design on different media, consisting of exchange coupled and single phase grains. Additionally, we investigate the impact of various recording parameters, such as the full width at half maximum (FWHM) of the applied heat pulse and the coercivity gradient near the write temperature of the recording grains. The footprints are calculated with a coarse grained model, based on the Landau-Lifshitz-Bloch equation. The presented simulations show a transition curvature reduction of up to 40%, in the case of a medium with exchange coupled grains and a heat pulse with a FWHM of 40 nm. We further give the reason for the straightening of the bit transitions, by means of basic considerations with regard to the effective recording time window of the write process. Besides the transition curvature reduction, the proposed head design yields an improvement of the transition jitter in both down-track and off-track directions.

Medical Devices Transition to Information Systems: Lessons Learned

PubMed Central

Charters, Kathleen G.

2012-01-01

Medical devices designed to network can share data with a Clinical Information System (CIS), making that data available within clinician workflow. Some lessons learned by transitioning anesthesia reporting and monitoring devices (ARMDs) on a local area network (LAN) to integration of anesthesia documentation within a CIS include the following categories: access, contracting, deployment, implementation, planning, security, support, training and workflow integration. Areas identified for improvement include: Vendor requirements for access reconciled with the organizations’ security policies and procedures. Include clauses supporting transition from stand-alone devices to information integrated into clinical workflow in the medical device procurement contract. Resolve deployment and implementation barriers that make the process less efficient and more costly. Include effective field communication and creative alternatives in planning. Build training on the baseline knowledge of trainees. Include effective help desk processes and metrics. Have a process for determining where problems originate when systems share information. PMID:24199054

High-Volume Production of Lightweight Multijunction Solar Cells

NASA Technical Reports Server (NTRS)

Youtsey, Christopher

2015-01-01

MicroLink Devices, Inc., has transitioned its 6-inch epitaxial lift-off (ELO) solar cell fabrication process into a manufacturing platform capable of sustaining large-volume production. This Phase II project improves the ELO process by reducing cycle time and increasing the yield of large-area devices. In addition, all critical device fabrication processes have transitioned to 6-inch production tool sets designed for volume production. An emphasis on automated cassette-to-cassette and batch processes minimizes operator dependence and cell performance variability. MicroLink Devices established a pilot production line capable of at least 1,500 6-inch wafers per month at greater than 80 percent yield. The company also increased the yield and manufacturability of the 6-inch reclaim process, which is crucial to reducing the cost of the cells.

Strangers headed to a strange land? A pilot study of using a transition coordinator to improve transfer from pediatric to adult services.

PubMed

Annunziato, Rachel A; Baisley, Margaret C; Arrato, Nicole; Barton, Codette; Henderling, Fiona; Arnon, Ronen; Kerkar, Nanda

2013-12-01

To compare the impact of a transition coordinator on outcomes for pediatric liver transplant recipients vs a historical comparison group. To examine the utility of a transition coordinator, medication adherence, as measured by SDs of tacrolimus blood levels (Tacrolimus SD), was compared between the "transition coordinator group" (20 transplant recipients transferred between 2007 and 2012) and comparison group for 1 year before and after transfer. Measures of health care management, quality of life, and acceptability were administered to the transition coordinator group as well. A repeated measures ANOVA was used to compare adherence values between the transition coordinator group and the comparison group. During the year before transfer, for the transition coordinator group, Tacrolimus SD was 1.98 (SD = 1.05) vs 3.25 (SD = 1.19) for comparison patients, F(1,25) = 4.77, P = .04. After transfer, levels remained stable for the transition coordinator group, Tacrolimus SD = 1.88 (SD = 1.57), but increased for comparison patients, Tacrolimus SD = 4.36 (SD = 0.99), F(1,25) = 6.99, P = .01. Psychosocial outcomes remained stable during the transfer period and acceptability was high. Our findings, although limited by a small sample size, suggest that a transition coordinator is a promising method to improve this process. Copyright © 2013 Mosby, Inc. All rights reserved.

The Health Care Transition of Youth With Liver Disease Into the Adult Health System: Position Paper From ESPGHAN and EASL.

PubMed

Vajro, Pietro; Fischler, Björn; Burra, Patrizia; Debray, Dominique; Dezsofi, Antal; Guercio Nuzio, Salvatore; Hadzic, Nedim; Hierro, Loreto; Jahnel, Joerg; Lamireau, Thierry; McKiernan, Patrick; McLin, Valerie; Nobili, Valerio; Socha, Piotr; Smets, Francoise; Baumann, Ulli; Verkade, Henkjan J

2018-06-01

Medical advances have dramatically improved the long-term prognosis of children and adolescents with once-fatal hepatobiliary diseases. However, there is no generally accepted optimal pathway of care for the transition from paediatric care to the adult health system. The purpose of this position paper is to propose a transition process for young people with paediatric onset hepatobiliary diseases from child-centred to adult-centred healthcare services. Seventeen ESPGHAN/EASL physicians from 13 countries (Austria, Belgium, France, Germany, Hungary, Italy, the Netherlands, Norway, Poland, Spain, Sweden, Switzerland, and United Kingdom) formulated and answered questions after examining the currently published literature on transition from childhood to adulthood. PubMed and Google Scholar were systematically searched between 1980 and January 2018. Quality of evidence was assessed by the Grading of Recommendation Assessment, Development and Evaluation (GRADE) system. Expert opinions were used to support recommendations whenever the evidence was graded weak. All authors voted on each recommendation, using the nominal voting technique. We reviewed the literature regarding the optimal timing for the initiation of the transition process and the transfer of the patient to adult services, principal documents, transition multi-professional team components, main barriers, and goals of the general transition process. A transition plan based on available evidence was agreed focusing on the individual young people's readiness and on coordinated teamwork, with transition monitoring continuing until the first year of adult services.We further agreed on selected features of transitioning processes inherent to the most frequent paediatric-onset hepatobiliary diseases. The discussion highlights specific clinical issues that will probably present to adult gastrointestinal specialists and that should be considered, according to published evidence, in the long-term tracking of patients. Transfer of medical care of individuals with paediatric onset hepatobiliary chronic diseases to adult facilities is a complex task requiring multiple involvements of patients and both paediatric and adult care providers.

Partners at Care Transitions (PACT)—exploring older peoples’ experiences of transitioning from hospital to home in the UK: protocol for an observation and interview study of older people and their families to understand patient experience and involvement in care at transitions

PubMed Central

Birks, Yvonne; Murray, Jenni; Sheard, Laura; Hughes, Lesley; Heyhoe, Jane; Cracknell, Alison; Lawton, Rebecca

2017-01-01

Introduction Length of hospital inpatient stays have reduced. This benefits patients, who prefer to be at home, and hospitals, which can treat more people when stays are shorter. Patients may, however, leave hospital sicker, with ongoing care needs. The transition period from hospital to home can be risky, particularly for older patients with complex health and social needs. Improving patient experience, especially through greater patient involvement, may improve outcomes for patients and is a key indicator of care quality and safety. In this research, we aim to: capture the experiences of older patients and their families during the transition from hospital to home, and identify opportunities for greater patient involvement in care, particularly where this contributes to greater individual-level and organisational-level resilience. Methods and analysis A ‘focused ethnography’ comprising observations, ‘Go-Along’ and semistructured interviews will be used to capture patient and carer experiences during different points in the care transition from admission to 90 days after discharge. We will recruit 30 patients and their carers from six hospital departments across two National Health Service (NHS) Trusts. Analysis of observations and interviews will use a framework approach to identify themes to understand the experience of transitions and generate ideas about how patients could be more actively involved in their care. This will include exploring what ‘good’ care at transitions looks like and seeking out examples of success, as well as recommendations for improvement. Ethics and dissemination Ethical approval was received from the NHS Research Ethics Committee in Wales. The research findings will add to a growing body of knowledge about patient experience of transitions, in particular providing insight into the experiences of patients and carers throughout the transitions process, in ‘real time’. Importantly, the data will be used to inform the development of a patient-centred intervention to improve the quality and safety of transitions. PMID:29196483

Safety and feasibility audit of a home-based drug-transitioning approach for patients with pulmonary arterial hypertension: an observational study.

PubMed

Dawson, A; Reddecliffe, S; Coghlan, C; Schreiber, B E; Coghlan, J G

2018-04-01

Newer endothelin receptor antagonists (ERAs) used to treat patients with pulmonary arterial hypertension (PAH) are associated with fewer drug-drug interactions than bosentan and require less monitoring. This, combined with a pharmacokinetic basis for improved efficacy, means there may be a clinical rationale for changing therapies. However, this can be challenging and few data on its safety in patients with PAH are available. At the Royal Free Hospital in London, UK, home-based medication transitioning has been standard practice since 2009 to avoid unnecessary hospital visits for patients, unless there is a clinical imperative. In this audit of standard practice we evaluated the consequences of adopting such a strategy when transitioning PAH patients between ERA therapies. Using a Clinical Nurse Specialist-led, home-based transitioning strategy, 92 patients with PAH were transitioned from bosentan to macitentan or ambrisentan. Observational data were analysed retrospectively. The majority of patients were female with PAH associated with connective tissue disease and their ERA was changed in the hope of improving efficacy. The process was well tolerated with no adverse events associated with the process. Seventeen patients died during the study (macitentan, n = 5; ambrisentan, n = 12). None of the deaths was considered related to ERA treatment. The majority of patients remained clinically stable, based on WHO functional class and exercise capacity. An established home-based transitioning strategy can be adopted safely for patients with PAH changing ERA therapies. Most patients remained stable and the therapy change was well tolerated.

[Peruvian demographic transition].

PubMed

Carbajal Chirinos, C

1988-06-01

The demographic transition is conceptualized as the historic change from high to low fertility and mortality rates in a population. Peru's population was reduced by an estimated 80% as a result of new diseases, destruction of the economy, and the brutal regime of colonial exploitation after the Spanish conquest. From colonial times to the least the 1940s, Peru's principal population problem was the scarcity of manpower. The population grew at an annual rate of about .03% between 1650 and 1800, increasing to about 1.3% between 1876 and 1940. High fertility throughout the 19th century and a stabilization of mortality due to reduced incidence and deadliness of epidemics contributed to the increased growth rate. In the 1940s the process of demographic transition was initiated by abrupt declines in mortality. The crude death rate declined from 27/1000 in 1940 to 16/1000 in 1961 and 9/1000 in 1988, with the rate still declining. Fertility remained high and possibly increased slightly. The crude birth rate was estimated at 45/1000 in 1940 and 45.4/1000 in 1961. Improvements in infant and general mortality rates in developing countries like Peru result from diffusion of technological advances in prevention and control of diseases and improvement in health services rather than from changes in the economic and social structure. The 3rd phase of the demographic transition began with declines in fertility from 45.4/1000 in 1961 to 42.0/1000 in 1972 and 36.0/1000 in 1981. Despite declines, mortality and fertility continue to be elevated in Peru. The theory of demographic transition views the reduction of infant mortality, improvements in health and educational conditions and the condition of women, and more equitable income distribution as essential for a true decline in birth rates. In Peru, however, fertility has declined in a context of deteriorating living conditions and in the absence of effective family planning programs. The process of demographic transition must be accelerated, which will require improvements in education, income, and availability of sanitary services among other changes.

Kepler AutoRegressive Planet Search

NASA Astrophysics Data System (ADS)

Caceres, Gabriel Antonio; Feigelson, Eric

2016-01-01

The Kepler AutoRegressive Planet Search (KARPS) project uses statistical methodology associated with autoregressive (AR) processes to model Kepler lightcurves in order to improve exoplanet transit detection in systems with high stellar variability. We also introduce a planet-search algorithm to detect transits in time-series residuals after application of the AR models. One of the main obstacles in detecting faint planetary transits is the intrinsic stellar variability of the host star. The variability displayed by many stars may have autoregressive properties, wherein later flux values are correlated with previous ones in some manner. Our analysis procedure consisting of three steps: pre-processing of the data to remove discontinuities, gaps and outliers; AR-type model selection and fitting; and transit signal search of the residuals using a new Transit Comb Filter (TCF) that replaces traditional box-finding algorithms. The analysis procedures of the project are applied to a portion of the publicly available Kepler light curve data for the full 4-year mission duration. Tests of the methods have been made on a subset of Kepler Objects of Interest (KOI) systems, classified both as planetary `candidates' and `false positives' by the Kepler Team, as well as a random sample of unclassified systems. We find that the ARMA-type modeling successfully reduces the stellar variability, by a factor of 10 or more in active stars and by smaller factors in more quiescent stars. A typical quiescent Kepler star has an interquartile range (IQR) of ~10 e-/sec, which may improve slightly after modeling, while those with IQR ranging from 20 to 50 e-/sec, have improvements from 20% up to 70%. High activity stars (IQR exceeding 100) markedly improve. A periodogram based on the TCF is constructed to concentrate the signal of these periodic spikes. When a periodic transit is found, the model is displayed on a standard period-folded averaged light curve. Our findings to date on real-data tests of the KARPS methodology will be discussed including confirmation of some Kepler Team `candidate' planets. We also present cases of new possible planetary signals.

Exploring Parents' Perceptions and How Physiotherapy Supports Transition from Rehabilitation to School for Youth with an ABI.

PubMed

Lee, Tracy; Norton, Andrea; Hayes, Sue; Adamson, Keith; Schwellnus, Heidi; Evans, Cathy

2017-11-01

To explore parents' perceptions of their youth's transition from rehabilitation to school following an Acquired Brain Injury (ABI) and how physiotherapy influenced the youth's participation and physical function during the transition. The study utilized phenomenological qualitative methodology using semi-structured interviews with 11 parents of youth 10 to 18 years of age recruited from one pediatric rehabilitation hospital in Ontario. Each interview was audiotaped, transcribed verbatim, and thematically analyzed. Parents valued physiotherapy and highlighted potential areas of improved service delivery to promote participation in an active lifestyle during this transition. In addition to being parents, they had to assume new roles and responsibilities in order to motivate their youth to continue with therapy and physical activity and had to facilitate their participation in school, recreational and social activities. For youth following an ABI, the transition back to school is complex and strategies should be supportive and responsive. Implications for physiotherapists include improved collaboration with community partners to motivate youth and promote physical activity; engage youth with their peers early in the rehabilitation process; and ongoing support for parents.

DOD Financial Management: Challenges in Attaining Audit Readiness and Improving Business Processes and Systems

DTIC Science & Technology

2012-04-18

enterprise architecture and transition plan, and improved investment control processes. This statement is primarily based on GAO’s prior work...business system investments , they had not yet performed the key step of validating assessment results. GAO has made prior recommendations to address...be prepared no later than March 1, 1997. See 31 U.S.C. § 3515. 2An agency’s general fund accounts are those accounts in the U.S. Treasury holding

Transition from oxcarbazepine to eslicarbazepine acetate: A single center study.

PubMed

Mäkinen, Jussi; Rainesalo, Sirpa; Peltola, Jukka

2017-03-01

There is limited clinical evidence for comparison between oxcarbazepine (OXC) and eslicarbazepine acetate (ESL) in terms of tolerability, or how to execute the change from OXC to ESL. We report the process of transitioning patients with focal epilepsy from previous OXC treatment to ESL due to tolerability problems. The rationale for change from OXC is reported, and the outcome with respective to this rationale is analyzed in terms of tolerability and efficacy. The subjects were transitioned overnight from OXC to ESL in a hospital inpatient setting. An evaluation of the effects of the transition was made after 1 and 3 months. All adverse events (AEs) were recorded following the transition period. Subjects were classified by outcome in terms of AEs. Twenty-three subjects were transitioned from OXC to ESL. Fifteen patients OXC-related AEs reduced significantly after transition. Particularly, most of (93%) the AEs presented in the morning resolved after transition to ESL. No patient had an increase in seizure frequency following the transition. The incidence of ESL-related AEs was 39% at 1 month and 13% at 3 month follow-up; however, all patients continued ESL throughout the study period. This study demonstrates that patients suffering from OXC-related AEs improve in terms of tolerability after a switch to ESL with maintaining seizure control. This improvement is more pronounced if the OXC-related AEs are most evident following morning dosing of OXC. Transition can be safely executed in an outpatient setting.

Understanding Atmospheric Anomalies Associated With Seasonal Pluvial-Drought Processes Using Southwest China as an Example

NASA Astrophysics Data System (ADS)

Liu, Zhenchen; Lu, Guihua; He, Hai; Wu, Zhiyong; He, Jian

2017-11-01

Seasonal pluvial-drought transition processes are unique natural phenomena. To explore possible mechanisms, we considered Southwest China (SWC) as the study region and comprehensively investigated the temporal evolution or spatial patterns of large-scale and regional atmospheric variables with the simple method of Standardized Anomalies (SA). Some key procedures and results include the following: (1) Because regional atmospheric variables are more directly responsible for the transition processes, we investigate it in detail. The temporal evolution of net vertical integral water vapor flux (net VIWVF) across SWC, together with vertical SA-based patterns of regional horizontal divergence (D) and vertical motion (ω), coincides well with pluvial-drought transition processes. (2) With respect to large-scale circulation patterns, a well-organized Eurasian (EU) Pattern is one important feature during the pluvial-drought transitions over SWC. (3) Based on these large-scale and regional atmospheric anomalous features, relevant SA-based indices were built, to explore the possibility of simulating drought development using previous pluvial anomalies. As a whole, simulated drought development only with SA-based indices of large-scale circulation patterns does not perform well. Further, it can be improved a lot when SA-based indices of regional D and net VIWVF are introduced. (4) In addition, the potential drought prediction using pluvial anomalies, together with the deep understanding of physical mechanisms responsible for pluvial-drought transitions, need to be further explored.

From adolescents to adults with congenital heart disease: the role of transition.

PubMed

Moceri, Pamela; Goossens, Eva; Hascoet, Sebastien; Checler, Carine; Bonello, Béatrice; Ferrari, Emile; Acar, Philippe; Fraisse, Alain

2015-07-01

Improved surgical care during the last decades, together with advances in medical management, led to a remarkable increase in survival of patients with congenital heart disease (CHD). However, aging of the CHD population brings new challenges, and loss of follow-up of adolescents and adults with CHD is a major concern. It is crucial to optimize the transfer of patients with CHD from paediatric to adult health care services to prevent loss to follow-up. The transition process plays a central role in the future health and follow-up of the patient. The aim of this review is to explain and discuss the clinical impact of the transition process in adolescents with CHD. We will also discuss specific CHD adolescents' problems. Adolescence is a crucial phase for the formation of the personality. Understanding and acceptance of the responsibility for health at this stage through a transition process with a multidisciplinary team will determine the quality of future medical follow-up and probably limit psychosocial issues in their adult life. • Aging of the congenital heart disease population brings new challenges to the organisation of care. • Loss of follow-up is a major concern for patients with congenital heart disease. What is new: • The quality of a formal transition process during adolescence will determine future outcomes in patients with congenital heart disease.

[Role transition and working adaption in new nursing graduates: a qualitative study].

PubMed

Ho, Hsueh-Hua; Liu, Pei-Fen; Hu, Hsiao-Chen; Huang, Su-Fei; Chen, Hsiao-Lien

2010-12-01

The role transition process is full of stresses and challenges for nurses. Between 35-61% nurses leave their job within the first year. Past cross-sectional quantitative studies have not provided deep descriptions of either the dynamic role transition or work adaption processes of new nurses. The purpose of this study was to understand the role transition experience of new nurses as they transitioned into clinical practice during their first three months on the job. A qualitative approach was used. Data were collected through a semi-structured interview from 50 new nurses. Data were analyzed using category-content analysis. Three stages were identified in the new nurse work adaption process over the first three-month period. These included (1) Understanding: New nurse knowledge and skills are insufficient to handle routine work, adapting to the role transition is difficult, feelings of anxiety emerge related to fears of incompetence, communication difficulties must be faced in the handover process, new nurses adopt feelings of attachment to their preceptors, they must work to adopt appropriate attitudes and approaches to nursing practice, and support is sought from family, teachers and friends; (2) Acclimation: Learning to care for patients independently, seeking role models, learning to adapt to night shifts, trying to identify with co-workers, and seeking support from colleagues, preceptors and head nurses; (3) Acceptance: Managing nursing work better in terms of time and organization, feeling gradual acceptance from co-workers, restoring personal enthusiasm for work, starting to consider other, non-work related matters, experiencing and appreciating the support of co-workers and head nurses. CONCLUSIONS/IMPLICATION: New nurses face a critical role transition process through their first three months on the job. Guidance and leadership from experienced nurses and multiple support systems can assist new nurses to acclimate to their role. Research results provide information for educators and administrators to better understand the adaption process of new nurses, and offer a reference for developing future strategies to improve nurse competency in handling their work.

Temperature-Controlled High-Speed AFM: Real-Time Observation of Ripple Phase Transitions.

PubMed

Takahashi, Hirohide; Miyagi, Atsushi; Redondo-Morata, Lorena; Scheuring, Simon

2016-11-01

With nanometer lateral and Angstrom vertical resolution, atomic force microscopy (AFM) has contributed unique data improving the understanding of lipid bilayers. Lipid bilayers are found in several different temperature-dependent states, termed phases; the main phases are solid and fluid phases. The transition temperature between solid and fluid phases is lipid composition specific. Under certain conditions some lipid bilayers adopt a so-called ripple phase, a structure where solid and fluid phase domains alternate with constant periodicity. Because of its narrow regime of existence and heterogeneity ripple phase and its transition dynamics remain poorly understood. Here, a temperature control device to high-speed atomic force microscopy (HS-AFM) to observe dynamics of phase transition from ripple phase to fluid phase reversibly in real time is developed and integrated. Based on HS-AFM imaging, the phase transition processes from ripple phase to fluid phase and from ripple phase to metastable ripple phase to fluid phase could be reversibly, phenomenologically, and quantitatively studied. The results here show phase transition hysteresis in fast cooling and heating processes, while both melting and condensation occur at 24.15 °C in quasi-steady state situation. A second metastable ripple phase with larger periodicity is formed at the ripple phase to fluid phase transition when the buffer contains Ca 2+ . The presented temperature-controlled HS-AFM is a new unique experimental system to observe dynamics of temperature-sensitive processes at the nanoscopic level. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Uranium redox transition pathways in acetate-amended sediments

USGS Publications Warehouse

Bargar, John R.; Williams, Kenneth H.; Campbell, Kate M.; Long, Philip E.; Stubbs, Joanne E.; Suvorova, Elenal I.; Lezama-Pacheco, Juan S.; Alessi, Daniel S.; Stylo, Malgorzata; Webb, Samuel M.; Davis, James A.; Giammar, Daniel E.; Blue, Lisa Y.; Bernier-Latmani, Rizlan

2013-01-01

Redox transitions of uranium [from U(VI) to U(IV)] in low-temperature sediments govern the mobility of uranium in the environment and the accumulation of uranium in ore bodies, and inform our understanding of Earth’s geochemical history. The molecular-scale mechanistic pathways of these transitions determine the U(IV) products formed, thus influencing uranium isotope fractionation, reoxidation, and transport in sediments. Studies that improve our understanding of these pathways have the potential to substantially advance process understanding across a number of earth sciences disciplines. Detailed mechanistic information regarding uranium redox transitions in field sediments is largely nonexistent, owing to the difficulty of directly observing molecular-scale processes in the subsurface and the compositional/physical complexity of subsurface systems. Here, we present results from an in situ study of uranium redox transitions occurring in aquifer sediments under sulfate-reducing conditions. Based on molecular-scale spectroscopic, pore-scale geochemical, and macroscale aqueous evidence, we propose a biotic–abiotic transition pathway in which biomass-hosted mackinawite (FeS) is an electron source to reduce U(VI) to U(IV), which subsequently reacts with biomass to produce monomeric U(IV) species. A species resembling nanoscale uraninite is also present, implying the operation of at least two redox transition pathways. The presence of multiple pathways in low-temperature sediments unifies apparently contrasting prior observations and helps to explain sustained uranium reduction under disparate biogeochemical conditions. These findings have direct implications for our understanding of uranium bioremediation, ore formation, and global geochemical processes.

Obstructive sleep apnea alters sleep stage transition dynamics.

PubMed

Bianchi, Matt T; Cash, Sydney S; Mietus, Joseph; Peng, Chung-Kang; Thomas, Robert

2010-06-28

Enhanced characterization of sleep architecture, compared with routine polysomnographic metrics such as stage percentages and sleep efficiency, may improve the predictive phenotyping of fragmented sleep. One approach involves using stage transition analysis to characterize sleep continuity. We analyzed hypnograms from Sleep Heart Health Study (SHHS) participants using the following stage designations: wake after sleep onset (WASO), non-rapid eye movement (NREM) sleep, and REM sleep. We show that individual patient hypnograms contain insufficient number of bouts to adequately describe the transition kinetics, necessitating pooling of data. We compared a control group of individuals free of medications, obstructive sleep apnea (OSA), medical co-morbidities, or sleepiness (n = 374) with mild (n = 496) or severe OSA (n = 338). WASO, REM sleep, and NREM sleep bout durations exhibited multi-exponential temporal dynamics. The presence of OSA accelerated the "decay" rate of NREM and REM sleep bouts, resulting in instability manifesting as shorter bouts and increased number of stage transitions. For WASO bouts, previously attributed to a power law process, a multi-exponential decay described the data well. Simulations demonstrated that a multi-exponential process can mimic a power law distribution. OSA alters sleep architecture dynamics by decreasing the temporal stability of NREM and REM sleep bouts. Multi-exponential fitting is superior to routine mono-exponential fitting, and may thus provide improved predictive metrics of sleep continuity. However, because a single night of sleep contains insufficient transitions to characterize these dynamics, extended monitoring of sleep, probably at home, would be necessary for individualized clinical application.

16 CFR 802.80 - Transitional rule for transactions investigated by the agencies.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., REGULATIONS, STATEMENTS AND INTERPRETATIONS UNDER THE HART-SCOTT-RODINO ANTITRUST IMPROVEMENTS ACT OF 1976... compulsory process from all parties that would be required to submit a Notification and Report Form for...

Mode transition coordinated control for a compound power-split hybrid car

NASA Astrophysics Data System (ADS)

Wang, Chen; Zhao, Zhiguo; Zhang, Tong; Li, Mengna

2017-03-01

With a compound power-split transmission directly connected to the engine in hybrid cars, dramatic fluctuations in engine output torque result in noticeable jerks when the car is in mode transition from electric drive mode to hybrid drive mode. This study designed a mode transition coordinated control strategy, and verified that strategy's effectiveness with both simulations and experiments. Firstly, the mode transition process was analyzed, and ride comfort issues during the mode transition process were demonstrated. Secondly, engine ripple torque was modeled using the measured cylinder pumping pressure when the engine was not in operation. The complete dynamic plant model of the power-split hybrid car was deduced, and its effectiveness was validated by a comparison of experimental and simulation results. Thirdly, a coordinated control strategy was designed to determine the desired engine torque, motor torque, and the moment of fuel injection. Active damping control with two degrees of freedom, based on reference output shaft speed estimation, was designed to mitigate driveline speed oscillations. Carrier torque estimation based on transmission kinematics and dynamics was used to suppress torque disturbance during engine cranking. The simulation and experimental results indicate that the proposed strategy effectively suppressed vehicle jerks and improved ride comfort during mode transition.

Acoustic waves and the detectability of first-order phase transitions by eLISA

NASA Astrophysics Data System (ADS)

Weir, David J.

2017-05-01

In various extensions of the Standard Model it is possible that the electroweak phase transition was first order. This would have been a violent process, involving the formation of bubbles and associated shock waves. Not only would the collision of these bubbles and shock waves be a detectable source of gravitational waves, but persistent acoustic waves could enhance the signal and improve prospects of detection by eLISA. I summarise the results of a recent campaign to model such a phase transition based on large-scale hydrodynamical simulations, and its implications for the eLISA mission.

Guide for Transitioning Army Missile Systems From Development to Production.

DTIC Science & Technology

1981-07-01

cost reduction ideas. 3 e! M. atumtion0 !eM . One missile system currently In fall *"I* develoluft, MM9 bee foregone the traditional engineering... costs , delivery schedules and deployment dates. Because of these difficulties and a desire to improve the weapon systems acquisition process, the...tered during the transition of new missile systems into production include: 1. High production unit costs - Occasionally the number of systems to be

The clinical impact of a brief transition programme for young people with juvenile idiopathic arthritis: results of the DON'T RETARD project.

PubMed

Hilderson, Deborah; Moons, Philip; Van der Elst, Kristien; Luyckx, Koen; Wouters, Carine; Westhovens, René

2016-01-01

To investigate the clinical impact of a brief transition programme for young people with JIA. The Devices for Optimization of Transfer and Transition of Adolescents with Rheumatic Disorders (DON'T RETARD) project is a mixed method project in which we first conducted a quasi-experimental study employing a one-group pre-test-post-test with a non-equivalent post-test-only comparison group design. In this quantitative study, we investigated clinical outcomes in patients with JIA and their parents who participated in the transition programme (longitudinal analyses). The post-test scores of this intervention group were compared with those of patients who received usual care (comparative analyses). Second, a qualitative study was conducted to explore the experiences of adolescents with JIA and their parents regarding their participation in the transition programme. The primary hypothesis of improved physical (effect size 0.11), psychosocial (effect size 0.46) and rheumatic-specific health status (effect size ranging from 0.21 to 0.33), was confirmed. With respect to the secondary outcomes, improved quality of life (effect size 0.51) and an optimized parenting climate (effect size ranging from 0.21 to 0.28) were observed. No effect was measured in medication adherence (odds ratio 1.46). Implementation of a transition programme as a brief intervention can improve the perceived health and quality of life of adolescents with JIA during the transition process, as well as the parenting behaviours of their parents. Based on the present study, a randomized controlled trial can be designed to evaluate the effectiveness of the transition programme. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Institutional change to support regime transformation: Lessons from Australia's water sector

NASA Astrophysics Data System (ADS)

Werbeloff, Lara; Brown, Rebekah; Cocklin, Chris

2017-07-01

Institutional change is fundamental to regime transformation, and a necessary part of moving toward integrated water management. However, insight into the role of institutional change processes in such transitions is currently limited. A more nuanced understanding of institutional frameworks is necessary, both to advance understanding of institutional change in the context of transitions toward improved water management and to inform strategies for guiding such processes. To this end, we examine two contemporary cases of transformative change in Australia's urban water sector, exploring the evolution of institutional change in each city. This paper offers insights into regime transformation, providing guidance on types of institutional structures and the ways structure-change initiatives can be sequenced to support a transition. The results reveal the importance of regulation in embedding regime change and suggest that engagement with structural frameworks should begin early in transition processes to ensure the timely introduction of supporting regulation. Our findings also highlight the inextricable link between culture-based and structure-based change initiatives, and the importance of using a diverse range of institutional change mechanisms in a mutually reinforcing way to provide a strong foundation for change. These findings provide a foundation for further scholarly examination of institutional change mechanisms, while also serving to inform the strategic activities of transition-oriented organizations and actors.

'Struggling to be an insider': a phenomenological design of new nurses' transition.

PubMed

Lee, Huei Ying; Hsu, Min-Tao; Li, Pei-Ling; Sloan, Rebecca S

2013-03-01

To obtain a comprehensive understanding of the transition process of new nurses in Taiwan. Background.  The transition period for new nurses can be a daunting and traumatic experience. The large number of newly graduated Taiwanese nurses who resign from their jobs within three months indicates that this process can be complicated. However, the problems associated with the experiences of new nurses have not yet been recognised. We adopted a phenomenological design using focus group interviews. Sixteen new nurses (less than one year working experience) participated in eight weekly group interviews lasting two hours each to grasp their experience of 'being new'. Interview data were analysed according to Sloan's (2002) three moments, and the whole process of analysis followed the suggestions of Agar (1986), which was performed in a close collaboration between researchers until the consensus about the findings could be reached. The overarching pattern of the transition process of new nurses becoming experienced members of the clinical nursing team was revealed as a journey of 'struggling to be an insider'. This phenomenon was characterised by four themes, including (1) 'being new as being weak', (2) 'masking myself', (3) 'internalising the unreasonable' and (4) 'transforming myself to get a position'. While Western culture view abusive indoctrination of new nurses as toxic behaviour, under the Chinese traditions of yield, tolerance and self-oppression, following the power hierarchy and seeking harmony, the transition of new nurses is interpreted differently. Recognition of the journey of 'struggling to be an insider' helps nurse administrators to (1) gain a better understanding of what new nurses encounter in their transition process, (2) help new nurses without harm, (3) improve in-service training programmes and (4) retain future nurses. © 2012 Blackwell Publishing Ltd.

Improving the Transition of Care in Patients Transferred Through the Ochsner Medical Center Transfer Center

PubMed Central

Amedee, Ronald G.; Maronge, Genevieve F.; Pinsky, William W.

2012-01-01

Background Patient transfers from other hospitals within the Ochsner Health System to the main campus are coordinated through a Transfer Center that was established in fall 2008. We analyzed the transfer process to assess distinct opportunities to enhance the overall transition of patient care. Methods We surveyed internal medicine residents and nocturnists to determine their satisfaction with transfers in terms of safety, efficiency, and usefulness of information provided at the time of transfer. After a kaizen event at which complementary goals for the institution and members of the study team were recognized and implemented, we resurveyed the group to evaluate improvement in the transfer process. Results The preintervention average satisfaction score was 1.18 (SD=0.46), while the postintervention score was 3.7 (SD=1.01). A t test showed a significant difference in the average scores between the preintervention and postintervention surveys (P<0.0001). Conclusions By including residents in the transfer calls (a result of the kaizen event), data were collected that facilitated fewer and higher quality handoffs that were performed in less time. In addition, the process resulted in increased awareness of the value of resident participation in institutional quality improvement projects. PMID:23267257

Improving the transition of care in patients transferred through the ochsner medical center transfer center.

PubMed

Amedee, Ronald G; Maronge, Genevieve F; Pinsky, William W

2012-01-01

Patient transfers from other hospitals within the Ochsner Health System to the main campus are coordinated through a Transfer Center that was established in fall 2008. We analyzed the transfer process to assess distinct opportunities to enhance the overall transition of patient care. We surveyed internal medicine residents and nocturnists to determine their satisfaction with transfers in terms of safety, efficiency, and usefulness of information provided at the time of transfer. After a kaizen event at which complementary goals for the institution and members of the study team were recognized and implemented, we resurveyed the group to evaluate improvement in the transfer process. The preintervention average satisfaction score was 1.18 (SD=0.46), while the postintervention score was 3.7 (SD=1.01). A t test showed a significant difference in the average scores between the preintervention and postintervention surveys (P<0.0001). By including residents in the transfer calls (a result of the kaizen event), data were collected that facilitated fewer and higher quality handoffs that were performed in less time. In addition, the process resulted in increased awareness of the value of resident participation in institutional quality improvement projects.

Understanding and shifting drug-related decisions: Contributions of automatic decision-making processes

PubMed Central

Carpenter, Kenneth M.; Bedi, Gillinder; Vadhan, Nehal P.

2015-01-01

While substance use is common, only a minority of individuals who use drugs or alcohol develop problematic use. An understanding of the factors underlying the transition from substance use to misuse may improve prevention and intervention efforts. A key feature of substance misuse is ongoing decisions to use drugs or alcohol despite escalating negative consequences. Research findings highlight the importance of both relatively automatic, associative cognitive processes and relatively controlled, deliberative, and rational-analytic cognitive processes, for understanding situational decisions to use drugs. In this review, we discuss several cognitive component processes that may contribute to decision-making that promotes substance use and misuse, with a focus on more automatic processes. A growing body of evidence indicates that relative differences in the strength of these component processes can account for individual differences in the transition from substance use to misuse, and may offer important avenues for developing novel intervention strategies. PMID:26084667

Understanding and shifting drug-related decisions: contributions of automatic decision-making processes.

PubMed

Carpenter, Kenneth M; Bedi, Gillinder; Vadhan, Nehal P

2015-08-01

While substance use is common, only a minority of individuals who use drugs or alcohol develop problematic use. An understanding of the factors underlying the transition from substance use to misuse may improve prevention and intervention efforts. A key feature of substance misuse is ongoing decisions to use drugs or alcohol despite escalating negative consequences. Research findings highlight the importance of both relatively automatic, associative cognitive processes and relatively controlled, deliberative, and rational-analytic cognitive processes, for understanding situational decisions to use drugs. In this review, we discuss several cognitive component processes that may contribute to decision-making that promotes substance use and misuse, with a focus on more automatic processes. A growing body of evidence indicates that relative differences in the strength of these component processes can account for individual differences in the transition from substance use to misuse and may offer important avenues for developing novel intervention strategies.

Toward a process-level view of distributed healthcare tasks: Medication management as a case study.

PubMed

Werner, Nicole E; Malkana, Seema; Gurses, Ayse P; Leff, Bruce; Arbaje, Alicia I

2017-11-01

We aim to highlight the importance of using a process-level view in analyzing distributed healthcare tasks through a case study analysis of medication management (MM). MM during older adults' hospital-to-skilled-home-healthcare (SHHC) transitions is a healthcare process with tasks distributed across people, organizations, and time. MM has typically been studied at the task level, but a process-level is needed to fully understand and improve MM during transitions. A process-level view allows for a broader investigation of how tasks are distributed throughout the work system through an investigation of interactions and the resultant emergent properties. We studied MM during older adults' hospital-to-SHHC transitions through interviews and observations with 60 older adults, their 33 caregivers, and 79 SHHC providers at 5 sites associated with 3 SHHC agencies. Study findings identified key cross-system characteristics not observable at the task-level: (1) identification of emergent properties (e.g., role ambiguity, loosely-coupled teams performing MM) and associated barriers; and (2) examination of barrier propagation across system boundaries. Findings highlight the importance of a process-level view of healthcare delivery occurring across system boundaries. Copyright © 2017 Elsevier Ltd. All rights reserved.

Speech perception in individuals with auditory dys-synchrony.

PubMed

Kumar, U A; Jayaram, M

2011-03-01

This study aimed to evaluate the effect of lengthening the transition duration of selected speech segments upon the perception of those segments in individuals with auditory dys-synchrony. Thirty individuals with auditory dys-synchrony participated in the study, along with 30 age-matched normal hearing listeners. Eight consonant-vowel syllables were used as auditory stimuli. Two experiments were conducted. Experiment one measured the 'just noticeable difference' time: the smallest prolongation of the speech sound transition duration which was noticeable by the subject. In experiment two, speech sounds were modified by lengthening the transition duration by multiples of the just noticeable difference time, and subjects' speech identification scores for the modified speech sounds were assessed. Subjects with auditory dys-synchrony demonstrated poor processing of temporal auditory information. Lengthening of speech sound transition duration improved these subjects' perception of both the placement and voicing features of the speech syllables used. These results suggest that innovative speech processing strategies which enhance temporal cues may benefit individuals with auditory dys-synchrony.

Transition support for new graduate and novice nurses in critical care settings: An integrative review of the literature.

PubMed

Innes, Tiana; Calleja, Pauline

2018-05-01

Transition into critical care areas for new graduate nurses may be more difficult than transitioning into other areas due to the specialised knowledge needed. It is unknown which aspects of transition programs best support new graduate nurses improve competence and confidence to transition into critical care nursing specialties. Identifying these aspects would assist to design and implement best practice transition programs for new graduates in critical care areas. Themes identified in the literature include; having a designated resource person, workplace culture, socialisation, knowledge and skill acquisition, orientation, and rotation. Allocation of a quality resource person/s, supportive workplace culture, positive socialisation experiences, knowledge and skill acquisition and structured orientation based on new graduates' learning needs all positively supported increased confidence, competence and transition into nursing practice. Rotations between areas within graduate programs can potentially have both positive and negative impacts on the transition process. Negative impacts of including a rotation component in a transition program should be carefully considered alongside perceived benefits when designing new graduate nurse transition programs. Copyright © 2018. Published by Elsevier Ltd.

Quality transitivity and traceability system of herbal medicine products based on quality markers.

PubMed

Liu, Changxiao; Guo, De-An; Liu, Liang

2018-05-15

Due to a variety of factors to affect the herb quality, the existing quality management model is unable to evaluate the process control. The development of the concept of "quality marker" (Q-marker) lays basis for establishing an independent process quality control system for herbal products. To ensure the highest degree of safety, effectiveness and quality process control of herbal products, it is aimed to establish a quality transitivity and traceability system of quality and process control from raw materials to finished herbal products. Based on the key issues and challenges of quality assessment, the current status of quality and process controls from raw materials to herbal medicinal products listed in Pharmacopoeia were analyzed and the research models including discovery and identification of Q-markers, analysis and quality management of risk evaluation were designed. Authors introduced a few new technologies and methodologies, such as DNA barcoding, chromatographic technologies, fingerprint analysis, chemical markers, bio-responses, risk management and solution for quality process control. The quality and process control models for herbal medicinal products were proposed and the transitivity and traceability system from raw materials to the finished products was constructed to improve the herbal quality from the entire supply and production chain. The transitivity and traceability system has been established based on quality markers, especially on how to control the production process under Good Engineering Practices, as well as to implement the risk management for quality and process control in herbal medicine production. Copyright © 2018 Elsevier GmbH. All rights reserved.

Assessing the need for a medical respite: perceptions of service providers and homeless persons.

PubMed

Biederman, Donna J; Gamble, Julia; Manson, Marigny; Taylor, Destry

2014-01-01

For homeless persons, posthospitalization care is increasingly provided in formal medical respite programs, and their success is now reported in the literature. However, there is a dearth of literature on posthospitalization transitional care for homeless persons in the absence of a respite program. Through this formative study, we sought to understand the process of securing posthospitalization care in the absence of a formal homeless medical respite. Results demonstrated a de facto patchwork respite process that has emerged. We describe both human and monetary costs associated with patchwork respite and demonstrate opportunities for improvement in homeless health care transitions.

Transition experiences of mental health service users, parents, and professionals in the United Kingdom: a qualitative study.

PubMed

Hovish, Kimberly; Weaver, Tim; Islam, Zoebia; Paul, Moli; Singh, Swaran P

2012-01-01

The aim of this study was to describe the experiences of child and adolescent mental health service (CAMHS) users, parents and professionals in relation to transition between CAMHS and adult mental health services (AMHS) in the United Kingdom. Young people were sampled from an observational study population of people reaching the transition boundary between CAMHS and AMHS. We thematically analyzed qualitative interviews with service users, parents and clinicians. Eleven service users were interviewed and linked interviews were completed with parents (n=6), and responsible clinicians in CAMHS (n=3) and AMHS (n=6). Informal and gradual preparation, transfer planning meetings, periods of parallel care, and consistency in key-workers promoted positive experiences of transition. Transfers between AMHS, changes of key-worker and waiting lists were viewed negatively. Other life transitions, including changes in housing, pregnancy, physical illness, and the involvement of parents or other services were sometimes powerful extraneous influences on transition experiences. The cumulative effect of multiple transitions is a complex and unsettling experience for many service users. Service user experiences are more likely to be positive if healthcare transition is a gradual process, tailored to the young person's needs and managed in the context of the other simultaneous practical, developmental and psychosocial transitions. Transfer planning meetings and parallel care were valued by all parties and should be standard practice at transition. CAMHS and AMHS need to work jointly to improve the transition process in these ways in order to enhance the outcomes for young people.

Development of rapid continuous dyeing process for heavy-weight nylon 6,6 carpet

USDA-ARS?s Scientific Manuscript database

An improved continuous dyeing process for coloration of heavy-weight (60-70 oz/yd2), residential nylon 6,6 carpet is reported. By inserting a slot steam applicator after the dye pad and before the box steamer to preheat the carpet to around 180°F (greater than the nylon wet glass transition temperat...

Advanced Satellite-Derived Wind Observations, Assimilation, and Targeting Strategies during TCS-08 for Developing Improved Operational Analysis and Prediction of Western Pacific Tropical Cyclones

DTIC Science & Technology

2012-09-30

influences on TC structure evolve up to landfall or extratropical transition. In particular, winds derived from geostationary satellites have been shown... extratropical transition, it is clear that a dedicated research effort is needed to optimize the satellite data processing strategies, assimilation...and applications to better understand the behavior of the near- storm environmental flow fields during these evolutionary TC stages. To our knowledge

Advanced Satellite-Derived Wind Observations, Assimilation, and Targeting Strategies during TCS-08 for Developing Improved Operational Analysis and Prediction of Western Pacific Tropical Cyclones

DTIC Science & Technology

2011-09-30

influences on TC structure evolve up to landfall or extratropical transition. In particular, winds derived from geostationary satellites have been...and extratropical transition, it is clear that a dedicated research effort is needed to optimize the satellite data processing strategies...assimilation, and applications to better understand the behavior of the near- storm environmental flow fields during these evolutionary TC stages. To our

Improving care coordination for community-dwelling older Australians: a longitudinal qualitative study.

PubMed

Harvey, Desley; Foster, Michele; Strivens, Edward; Quigley, Rachel

2017-05-01

Objective The aim of the present study was to describe the care transition experiences of older people who transfer between subacute and primary care, and to identify factors that influence these experiences. A further aim of the study was to identify ways to enhance the Geriatric Evaluation and Management (GEM) model of care and improve local coordination of services for older people. Methods The present study was an exploratory, longitudinal case study involving repeat interviews with 19 patients and carers, patient chart audits and three focus groups with service providers. Interview transcripts were coded and synthesised to identify recurring themes. Results Patients and carers experienced care transitions as dislocating and unpredictable within a complex and turbulent service context. The experience was characterised by precarious self-management in the community, floundering with unmet needs and holistic care within the GEM service. Patient and carer attitudes to seeking help, quality and timeliness of communication and information exchange, and system pressure affected care transition experiences. Conclusion Further policy and practice attention, including embedding early intervention and prevention, strengthening links between levels of care by building on existing programs and educative and self-help initiatives for patients and carers is recommended to improve care transition experiences and optimise the impact of the GEM model of care. What is known about the topic? Older people with complex care needs experience frequent care transitions because of fluctuating health and fragmentation of aged care services in Australia. The GEM model of care promotes multidisciplinary, coordinated care to improve care transitions and outcomes for older people with complex care needs. What does this paper add? The present study highlights the crucial role of the GEM service, but found there is a lack of systemised linkages within and across levels of care that disrupts coordinated care and affects care transition experiences. There are underutilised opportunities for early intervention and prevention across the system, including the emergency department and general practice. What are the implications for practitioners? Comprehensive screening, assessment and intervention in primary and acute care, formalised transition processes and enhanced support for patients and carers to access timely, appropriate care is required to achieve quality, coordinated care transitions for older people.

A qualitative study of innovations implemented to improve transition of care from maternity to child and family health (CFH) services in Australia.

PubMed

Psaila, Kim; Fowler, Cathrine; Kruske, Sue; Schmied, Virginia

2014-12-01

The transition of care (ToC) from maternity services, particularly from midwifery care to child and family health (CFH) nursing services, is a critical time in the support of women as they transition into early parenting. However significant issues in service provision exist, particularly meeting the needs of women with social and emotional health risk factors. These include insufficient resources, poor communication and information transfer, limited interface between private and public health systems and tension around role boundaries. In response some services are implementing strategies to improve the transition of care from maternity to CFH services. This paper describes a range of innovations developed to improve transition of care between maternity and child and family health services and identifies the characteristics common to all innovations. Data reported were collected in phase three of a mixed methods study investigating the feasibility of implementing a national approach to child and family health services in Australia (CHoRUS study). Data were collected from 33 professionals including midwives, child and family health nurses, allied health staff and managers, at seven sites across four Australian states. Data were analysed thematically, guided by Braun and Clarke's six-step process of thematic analysis. The range of innovations implemented included those which addressed; information sharing, the efficient use of funding and resources, development of new roles to improve co-ordination of care, the co-location of services and working together. Four of the seven sites implemented innovations that specifically targeted families with additional needs. Successful implementation was dependent on the preliminary work undertaken which required professionals and/or organisations to work collaboratively. Improving the transition of care requires co-ordination and collaboration to ensure families are adequately supported. Collaboration between professionals and services facilitated innovative practice and was core to successful change. Copyright © 2014 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Survival tactics for managing the hospital marketing effort.

PubMed

Schaupp, D L; Ponzurick, T G; Schaupp, F W

1994-01-01

Hospital marketing is an intricate and complex process. Especially difficult is the transition the hospital marketer must make from designing marketing strategies to implementing those strategies. This transition usually causes the marketer to call upon a different set of skills. These skills involve managing the personnel needed to implement the designed marketing strategy. Unfortunately, little in the way of formal training is provided the marketer for developing these management skills. Therefore, the authors have comprised a series of tactical procedures designed to assist the hospital marketer to survive this transition. Using these tactics for decision-making guidelines may help to improve the management of the hospital's marketing effort.

Optimizing the TESS Planet Finding Pipeline

NASA Astrophysics Data System (ADS)

Chitamitara, Aerbwong; Smith, Jeffrey C.; Tenenbaum, Peter; TESS Science Processing Operations Center

2017-10-01

The Transiting Exoplanet Survey Satellite (TESS) is a new NASA planet finding all-sky survey that will observe stars within 200 light years and 10-100 times brighter than that of the highly successful Kepler mission. TESS is expected to detect ~1000 planets smaller than Neptune and dozens of Earth size planets. As in the Kepler mission, the Science Processing Operations Center (SPOC) processing pipeline at NASA Ames Research center is tasked with calibrating the raw pixel data, generating systematic error corrected light curves and then detecting and validating transit signals. The Transiting Planet Search (TPS) component of the pipeline must be modified and tuned for the new data characteristics in TESS. For example, due to each sector being viewed for as little as 28 days, the pipeline will be identifying transiting planets based on a minimum of two transit signals rather than three, as in the Kepler mission. This may result in a significantly higher false positive rate. The study presented here is to measure the detection efficiency of the TESS pipeline using simulated data. Transiting planets identified by TPS are compared to transiting planets from the simulated transit model using the measured epochs, periods, transit durations and the expected detection statistic of injected transit signals (expected MES). From the comparisons, the recovery and false positive rates of TPS is measured. Measurements of recovery in TPS are then used to adjust TPS configuration parameters to maximize the planet recovery rate and minimize false detections. The improvements in recovery rate between initial TPS conditions and after various adjustments will be presented and discussed.

Experiences with Transitioning Science Data Production from a Symmetric Multiprocessor Platform to a Linux Cluster Environment

NASA Astrophysics Data System (ADS)

Walter, R. J.; Protack, S. P.; Harris, C. J.; Caruthers, C.; Kusterer, J. M.

2008-12-01

NASA's Atmospheric Science Data Center at the NASA Langley Research Center performs all of the science data processing for the Multi-angle Imaging SpectroRadiometer (MISR) instrument. MISR is one of the five remote sensing instruments flying aboard NASA's Terra spacecraft. From the time of Terra launch in December 1999 until February 2008, all MISR science data processing was performed on a Silicon Graphics, Inc. (SGI) platform. However, dramatic improvements in commodity computing technology coupled with steadily declining project budgets during that period eventually made transitioning MISR processing to a commodity computing environment both feasible and necessary. The Atmospheric Science Data Center has successfully ported the MISR science data processing environment from the SGI platform to a Linux cluster environment. There were a multitude of technical challenges associated with this transition. Even though the core architecture of the production system did not change, the manner in which it interacted with underlying hardware was fundamentally different. In addition, there are more potential throughput bottlenecks in a cluster environment than there are in a symmetric multiprocessor environment like the SGI platform and each of these had to be addressed. Once all the technical issues associated with the transition were resolved, the Atmospheric Science Data Center had a MISR science data processing system with significantly higher throughput than the SGI platform at a fraction of the cost. In addition to the commodity hardware, free and open source software such as S4PM, Sun Grid Engine, PostgreSQL and Ganglia play a significant role in the new system. Details of the technical challenges and resolutions, software systems, performance improvements, and cost savings associated with the transition will be discussed. The Atmospheric Science Data Center in Langley's Science Directorate leads NASA's program for the processing, archival and distribution of Earth science data in the areas of radiation budget, clouds, aerosols, and tropospheric chemistry. The Data Center was established in 1991 to support NASA's Earth Observing System and the U.S. Global Change Research Program. It is unique among NASA data centers in the size of its archive, cutting edge computing technology, and full range of data services. For more information regarding ASDC data holdings, documentation, tools and services, visit http://eosweb.larc.nasa.gov

Evolution of weighted complex bus transit networks with flow

NASA Astrophysics Data System (ADS)

Huang, Ailing; Xiong, Jie; Shen, Jinsheng; Guan, Wei

2016-02-01

Study on the intrinsic properties and evolutional mechanism of urban public transit networks (PTNs) has great significance for transit planning and control, particularly considering passengers’ dynamic behaviors. This paper presents an empirical analysis for exploring the complex properties of Beijing’s weighted bus transit network (BTN) based on passenger flow in L-space, and proposes a bi-level evolution model to simulate the development of transit routes from the view of complex network. The model is an iterative process that is driven by passengers’ travel demands and dual-controlled interest mechanism, which is composed of passengers’ spatio-temporal requirements and cost constraint of transit agencies. Also, the flow’s dynamic behaviors, including the evolutions of travel demand, sectional flow attracted by a new link and flow perturbation triggered in nearby routes, are taken into consideration in the evolutional process. We present the numerical experiment to validate the model, where the main parameters are estimated by using distribution functions that are deduced from real-world data. The results obtained have proven that our model can generate a BTN with complex properties, such as the scale-free behavior or small-world phenomenon, which shows an agreement with our empirical results. Our study’s results can be exploited to optimize the real BTN’s structure and improve the network’s robustness.

TESS Follow-up Observing Program (TFOP) Working Group:A Mission-led Effort to Coordinate Community Resources to Confirm TESS Planets

NASA Astrophysics Data System (ADS)

Collins, Karen; Quinn, Samuel N.; Latham, David W.; Christiansen, Jessie; Ciardi, David; Dragomir, Diana; Crossfield, Ian; Seager, Sara

2018-01-01

The Transiting Exoplanet Survey Satellite (TESS) will observe most of the sky over a period of two years. Observations will be conducted in 26 sectors of sky coverage and each sector will be observed for ~27 days. Data from each sector is expected to produce hundreds of transiting planet candidates (PCs) per month and thousands over the two year nominal mission. The TFOP Working Group (WG) is a mission-led effort organized to efficiently provide follow-up observations to confirm candidates as planets or reject them as false positives. The primary goal of the TFOP WG is to facilitate achievement of the Level One Science Requirement to measure masses for 50 transiting planets smaller than 4 Earth radii. Secondary goals are to serve any science coming out of TESS and to foster communication and coordination both within the TESS Science Team and with the community at large. The TFOP WG is organized as five Sub Groups (SGs). SG1 will provide seeing-limited imaging to measure blending within a candidate's aperture and time-series photometry to identify false positives and in some cases to improve ephemerides, light curves, and/or transit time variation (TTV) measurements. SG2 will provide reconnaissance spectroscopy to identify astrophysical false positives and to contribute to improved host star parameters. SG3 will provide high-resolution imaging with adaptive optics, speckle imaging, and lucky imaging to detect nearby objects. SG4 will provide precise radial velocities to derive orbits of planet(s) and measure their mass(es) relative to the host star. SG5 will provide space-based photometry to confirm and/or improve the TESS photometric ephemerides, and will also provide improved light curves for transit events or TTV measurements. We describe the TFOP WG observing and planet confirmation process, the five SGs that comprise the TFOP WG, ExoFOP-TESS and other web-based tools being developed to support TFOP WG observers, other advantages of joining the TFOP WG, the TFOP WG charter and publication policy, preferred capabilities of SG team members, and the TFOP WG application process.

Do state-and-transition models derived from vegetation succession also represent avian succession in restored mine pits?

PubMed

Craig, Michael D; Stokes, Vicki L; Fontaine, Joseph B; Hardy, Giles E StJ; Grigg, Andrew H; Hobbs, Richard J

2015-10-01

State-and-transition models are increasingly used as a tool to inform management of post-disturbance succession and effective conservation of biodiversity in production landscapes. However, if they are to do this effectively, they need to represent faunal, as well as vegetation, succession. We assessed the congruence between vegetation and avian succession by sampling avian communities in each state of a state-and-transition model used to inform management of post-mining restoration in a production landscape in southwestern Australia. While avian communities differed significantly among states classified as on a desirable successional pathway, they did not differ between desirable and deviated states of the same post-mining age. Overall, we concluded there was poor congruence between vegetation and avian succession in this state-and-transition model. We identified four factors that likely contributed to this lack of congruence, which were that long-term monitoring of succession in restored mine pits was not used to update and improve models, states were not defined based on ecological processes and thresholds, states were not defined by criteria that were important in structuring the avian community, and states were not based on criteria that related to values in the reference community. We believe that consideration of these four factors in the development of state-and-transition models should improve their ability to accurately represent faunal, as well as vegetation, succession. Developing state-and-transition models that better incorporate patterns of faunal succession should improve the ability to manage post-disturbance succession across a range of ecosystems for biodiversity conservation.

A Review of Interventions Aimed at Facilitating Successful Transition Planning and Transfer to Adult Care Among Youth with Chronic Illness.

PubMed

Weissberg-Benchell, Jill; Shapiro, Jenna B

2017-05-01

This article reviews studies that developed interventions aimed at facilitating the transition process and/or the transfer of youth with chronic illness to adult programs during the past decade. Three key intervention approaches have been studied. Data assessing the impact of transition coordinators suggest that the most successful outcomes occur when coordinators meet with patients prior to the transfer of care, support them as they negotiate the adult programs, and facilitate appointment keeping. Data assessing the impact of transition clinics suggest that the key to positive outcomes is helping patients develop a trusting relationship with the adult providers before fully transferring their care to the adult clinic. Similar conclusions can be drawn for transition programs, where it appears that the opportunity to discuss and plan transition with a pediatric provider over time and to meet with both the pediatric and adult providers simultaneously are beneficial for facilitating successful transfer to adult care. Although aspects of these care processes appear promising for improving transition success, this review identifies areas that need further study. We argue that studies are needed that examine individual patient and family-focused interventions as well as looking at other potential interventions in the health care system. [Pediatr Ann. 2017;46(5):e182-e187.]. Copyright 2017, SLACK Incorporated.

Problem-Solving Phase Transitions During Team Collaboration.

PubMed

Wiltshire, Travis J; Butner, Jonathan E; Fiore, Stephen M

2018-01-01

Multiple theories of problem-solving hypothesize that there are distinct qualitative phases exhibited during effective problem-solving. However, limited research has attempted to identify when transitions between phases occur. We integrate theory on collaborative problem-solving (CPS) with dynamical systems theory suggesting that when a system is undergoing a phase transition it should exhibit a peak in entropy and that entropy levels should also relate to team performance. Communications from 40 teams that collaborated on a complex problem were coded for occurrence of problem-solving processes. We applied a sliding window entropy technique to each team's communications and specified criteria for (a) identifying data points that qualify as peaks and (b) determining which peaks were robust. We used multilevel modeling, and provide a qualitative example, to evaluate whether phases exhibit distinct distributions of communication processes. We also tested whether there was a relationship between entropy values at transition points and CPS performance. We found that a proportion of entropy peaks was robust and that the relative occurrence of communication codes varied significantly across phases. Peaks in entropy thus corresponded to qualitative shifts in teams' CPS communications, providing empirical evidence that teams exhibit phase transitions during CPS. Also, lower average levels of entropy at the phase transition points predicted better CPS performance. We specify future directions to improve understanding of phase transitions during CPS, and collaborative cognition, more broadly. Copyright © 2017 Cognitive Science Society, Inc.

A stochastic estimation procedure for intermittently-observed semi-Markov multistate models with back transitions.

PubMed

Aralis, Hilary; Brookmeyer, Ron

2017-01-01

Multistate models provide an important method for analyzing a wide range of life history processes including disease progression and patient recovery following medical intervention. Panel data consisting of the states occupied by an individual at a series of discrete time points are often used to estimate transition intensities of the underlying continuous-time process. When transition intensities depend on the time elapsed in the current state and back transitions between states are possible, this intermittent observation process presents difficulties in estimation due to intractability of the likelihood function. In this manuscript, we present an iterative stochastic expectation-maximization algorithm that relies on a simulation-based approximation to the likelihood function and implement this algorithm using rejection sampling. In a simulation study, we demonstrate the feasibility and performance of the proposed procedure. We then demonstrate application of the algorithm to a study of dementia, the Nun Study, consisting of intermittently-observed elderly subjects in one of four possible states corresponding to intact cognition, impaired cognition, dementia, and death. We show that the proposed stochastic expectation-maximization algorithm substantially reduces bias in model parameter estimates compared to an alternative approach used in the literature, minimal path estimation. We conclude that in estimating intermittently observed semi-Markov models, the proposed approach is a computationally feasible and accurate estimation procedure that leads to substantial improvements in back transition estimates.

[Process of land use transition and its impact on regional ecological quality in the Middle Reaches of Heihe River, China].

PubMed

Wang, Fu Hong; Zhao, Rui Feng; Zhang, Li Hua; Li, Hong Wei

2017-12-01

Land use transition is one of the main drivers of regional ecosystem change in arid area, which directly affects human well-being. Based on the satellite images of 1987, 2001 and 2016, the change detection assessment model and ecological response model were used to analyze the process of land use transition and response of ecological quality during 1987-2016 in the ecologically fragile middle reaches of the Heihe River. The results showed that the land use change was significant during 1987-2016 and the total change increased significantly, as well as the continuous increase of the cultivated land and construction land. There was a strong tendency of transform from grassland to cultivated land, while the tendency of transforming unused land to other land classes was not strong under a random process of gain or loss. During 1987-2016, the ecological quality of the study area displayed a decreasing trend as a whole and the ecological land decreased by 2.8%. The land use transition with the greatest impact on the ecological environment degradation was the transition of the grassland to the cultivated land and unused land. Therefore, in order to promote the sustainable use of regional land resources and to improve the regional ecological quality, it is necessary to allocate the proportion of production land and ecological land according to the regional water resources.

Changes in cognitive functions of students in the transitional period from elementary school to junior high school.

PubMed

Mizuno, Kei; Tanaka, Masaaki; Fukuda, Sanae; Sasabe, Tetsuya; Imai-Matsumura, Kyoko; Watanabe, Yasuyoshi

2011-05-01

When students proceed to junior high school from elementary school, rapid changes in the environment occur, which may cause various behavioral and emotional problems. However, the changes in cognitive functions during this transitional period have rarely been studied. In 158 elementary school students from 4th- to 6th-grades and 159 junior high school students from 7th- to 9th-grades, we assessed various cognitive functions, including motor processing, spatial construction ability, semantic fluency, immediate memory, delayed memory, spatial and non-spatial working memory, and selective, alternative, and divided attention. Our findings showed that performance on spatial and non-spatial working memory, alternative attention, divided attention, and semantic fluency tasks improved from elementary to junior high school. In particular, performance on alternative and divided attention tasks improved during the transitional period from elementary to junior high school. Our finding suggests that development of alternative and divided attention is of crucial importance in the transitional period from elementary to junior high school. Copyright © 2010 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

Electronic Two-Transition-Induced Enhancement of Emission Efficiency in Polymer Light-Emitting Diodes

PubMed Central

Chen, Ren-Ai; Wang, Cong; Li, Sheng; George, Thomas F.

2013-01-01

With the development of experimental techniques, effective injection and transportation of electrons is proven as a way to obtain polymer light-emitting diodes (PLEDs) with high quantum efficiency. This paper reveals a valid mechanism for the enhancement of quantum efficiency in PLEDs. When an external electric field is applied, the interaction between a negative polaron and triplet exciton leads to an electronic two-transition process, which induces the exciton to emit light and thus improve the emission efficiency of PLEDs. PMID:28809346

Advanced Satellite-Derived Wind Observations, Assimilation, and Targeting Strategies during TCS-08 for Developing Improved Operational Analysis and Prediction of Western Pacific Tropical Cyclones

DTIC Science & Technology

2013-09-30

TC structure evolve up to landfall or extratropical transition. In particular, winds derived from geostationary satellites have been shown to be an... extratropical transition, it is clear that a dedicated research effort is needed to optimize the satellite data processing strategies, assimilation, and...applications to better understand the behavior of the near- storm environmental flow fields during these evolutionary TC stages. To our knowledge, this

Transition Metal Switchable Mirror

ScienceCinema

None

2017-12-09

The switchable-mirrors technology was developed by Tom Richardson and Jonathan Slack of Berkeley Lab's Environmental Energy Technologies Division. By using transition metals rather than the rare earth metals used in the first metal-hydride switchable mirrors, Richardson and Slack were able to lower the cost and simplify the manufacturing process. Energy performance is improved as well, because the new windows can reflect or transmit both visible and infrared light. Besides windows for offices and homes, possible applications include automobile sunroofs, signs and displays, aircraft windows, and spacecraft.

Transition Metal Switchable Mirror

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

None

2009-08-21

The switchable-mirrors technology was developed by Tom Richardson and Jonathan Slack of Berkeley Lab's Environmental Energy Technologies Division. By using transition metals rather than the rare earth metals used in the first metal-hydride switchable mirrors, Richardson and Slack were able to lower the cost and simplify the manufacturing process. Energy performance is improved as well, because the new windows can reflect or transmit both visible and infrared light. Besides windows for offices and homes, possible applications include automobile sunroofs, signs and displays, aircraft windows, and spacecraft.

Femtosecond crystallography with ultrabright electrons and x-rays: capturing chemistry in action.

PubMed

Miller, R J Dwayne

2014-03-07

With the recent advances in ultrabright electron and x-ray sources, it is now possible to extend crystallography to the femtosecond time domain to literally light up atomic motions involved in the primary processes governing structural transitions. This review chronicles the development of brighter and brighter electron and x-ray sources that have enabled atomic resolution to structural dynamics for increasingly complex systems. The primary focus is on achieving sufficient brightness using pump-probe protocols to resolve the far-from-equilibrium motions directing chemical processes that in general lead to irreversible changes in samples. Given the central importance of structural transitions to conceptualizing chemistry, this emerging field has the potential to significantly improve our understanding of chemistry and its connection to driving biological processes.

Polyestercarbonates which exhibit improved processibility

DOEpatents

Krabbenhoft, Herman Otto

1999-01-01

The invention relates to a polyestercarbonate polymer which comprises repeating units of a mono-unsaturated aliphatic dicarboxylic acid having about 12 to about 20 carbon atoms. Preferred dicarboxylic acids for incorporation into the polymer are cis-octadec-9-enedioic acid or trans-octadec-9-enedioic acid. The use of these mono-unsaturated acids results in polymers with lower glass transition temperatures, and enhances processibility.

Trauma patient discharge and care transition experiences: Identifying opportunities for quality improvement in trauma centres.

PubMed

Gotlib Conn, Lesley; Zwaiman, Ashley; DasGupta, Tracey; Hales, Brigette; Watamaniuk, Aaron; Nathens, Avery B

2018-01-01

Challenges delivering quality care are especially salient during hospital discharge and care transitions. Severely injured patients discharged from a trauma centre will go either home, to rehabilitation or another acute care hospital with complex management needs. This purpose of this study was to explore the experiences of trauma patients and families treated in a regional academic trauma centre to better understand and improve their discharge and care transition experiences. A qualitative study using inductive thematic analysis was conducted between March and October 2016. Telephone interviews were conducted with trauma patients and/or a family member after discharge from the trauma centre. Data collection and analysis were completed inductively and iteratively consistent with a qualitative approach. Twenty-four interviews included 19 patients and 7 family members. Participants' experiences drew attention to discharge and transfer processes that either (1) Fostered quality discharge or (2) Impeded quality discharge. Fostering quality discharge was ward staff preparation efforts; establishing effective care continuity; and, adequate emotional support. Impeding discharge quality was perceived pressure to leave the hospital; imposed transfer decisions; and, sub-optimal communication and coordination around discharge. Patient-provider communication was viewed to be driven by system, rather than patient need. Inter-facility information gaps raised concern about receiving facilities' ability to care for injured patients. The quality of trauma patient discharge and transition experiences is undermined by system- and ward-level processes that compete, rather than align, in producing high quality patient-centred discharge. Local improvement solutions focused on modifiable factors within the trauma centre include patient-oriented discharge education and patient navigation; however, these approaches alone may be insufficient to enhance patient experiences. Trauma patients encounter complex barriers to quality discharge that likely require a comprehensive, multimodal intervention. Copyright © 2017 Elsevier Ltd. All rights reserved.

High Quantum Efficiency OLED Lighting Systems

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

Shiang, Joseph

The overall goal of the program was to apply improvements in light outcoupling technology to a practical large area plastic luminaire, and thus enable the product vision of an extremely thin form factor high efficiency large area light source. The target substrate was plastic and the baseline device was operating at 35 LPW at the start of the program. The target LPW of the program was a >2x improvement in the LPW efficacy and the overall amount of light to be delivered was relatively high 900 lumens. Despite the extremely difficult challenges associated with scaling up a wet solution processmore » on plastic substrates, the program was able to make substantial progress. A small molecule wet solution process was successfully implemented on plastic substrates with almost no loss in efficiency in transitioning from the laboratory scale glass to large area plastic substrates. By transitioning to a small molecule based process, the LPW entitlement increased from 35 LPW to 60 LPW. A further 10% improvement in outcoupling efficiency was demonstrated via the use of a highly reflecting cathode, which reduced absorptive loss in the OLED device. The calculated potential improvement in some cases is even larger, ~30%, and thus there is considerable room for optimism in improving the net light coupling efficacy, provided absorptive loss mechanisms are eliminated. Further improvements are possible if scattering schemes such as the silver nanowire based hard coat structure are fully developed. The wet coating processes were successfully scaled to large area plastic substrate and resulted in the construction of a 900 lumens luminaire device.« less

Multi-informant assessment of transition-related skills and skill importance in adolescents with autism spectrum disorder.

PubMed

Hume, Kara; Dykstra Steinbrenner, Jessica; Sideris, John; Smith, Leann; Kucharczyk, Suzanne; Szidon, Kate

2018-01-01

Adolescents with autism spectrum disorder have limited participation in the transition planning process, despite the link between active participation and an improvement in postsecondary education and employment outcomes. The Secondary School Success Checklist was designed to support transition planning for adolescents with autism spectrum disorder by incorporating their own assessments of strengths, skill deficits, and prioritization for instruction along with those of their parents and teachers across multiple skill domains. Findings from more than 500 adolescents with autism spectrum disorder across the United States indicate discrepancies between adolescent, teacher, and parent ratings of skills highlighting the importance of the inclusion of multiple perspectives in transition planning. Although ratings varied, agreement between adolescents with autism spectrum disorder, parents, and teachers across the highest and lowest rated skills suggests the need to broaden the focus on critical transition skills to include problem-solving, planning for life after high school, and self-advocacy.

Impact of transaction costs on healthcare outcomes.

PubMed

Stiles, Renée A; So, Stephanie A

2003-06-01

This article reviews transaction cost economics to frame a discussion of how inefficiencies in healthcare delivery processes affect clinical outcomes and differentiate between inefficiencies that are tractable from those that are transitional or intractable. Recognizing and quantifying these effects improves the ability of organizations to calculate returns on investment in quality improvement, research and development and related value enhancing, but it is subject to high-risk undertakings.

Promoting Local Ownership: Lessons Learned from Process of Transitioning Clinical Mentoring of HIV Care and Treatment in Ethiopia.

PubMed

Kassie, Getnet M; Belay, Teklu; Sharma, Anjali; Feleke, Getachew

2018-01-01

Focus on improving access and quality of HIV care and treatment gained acceptance in Ethiopia through the work of the International Training and Education Center for Health. The initiative deployed mobile field-based teams and capacity building teams to mentor health care providers on clinical services and program delivery in three regions, namely Tigray, Amhara, and Afar. Transitioning of the clinical mentoring program (CMP) began in 2012 through capacity building and transfer of skills and knowledge to local health care providers and management. The initiative explored the process of transitioning a CMP on HIV care and treatment to local ownership and documented key lessons learned. A mixed qualitative design was used employing focus group discussions, individual in-depth interviews, and review of secondary data. The participants included regional focal persons, mentors, mentees, multidisciplinary team members, and International Training and Education Center for Health (I-TECH) staff. Three facilities were selected in each region. Data were collected by trained research assistants using customized guides for interviews and with data extraction format. The interviews were recorded and fully transcribed. Open Code software was used for coding and categorizing the data. A total of 16 focus group discussions and 20 individual in-depth interviews were conducted. The critical processes for transitioning a project were: establishment of a mentoring transition task force, development of a roadmap to define steps and directions for implementing the transition, and signing of a memorandum of understanding (MOU) between the respective regional health bureaus and I-TECH Ethiopia to formalize the transition. The elements of implementation included mentorship and capacity building, joint mentoring, supportive supervision, review meetings, and independent mentoring supported by facility-based mechanisms: multidisciplinary team meetings, case-based discussions, and catchment area meetings. The process of transitioning the CMP to local ownership involved signing an MOU, training of mentors, and building capacity of mentoring in each region. The experience shed light on how to transition donor-supported work to local country ownership, with key lessons related to strengthening the structures of regional health bureaus, and other facilities addressing critical issues and ensuring continuity of the facility-based activities.

Transitional care challenges of rehospitalized veterans: listening to patients and providers.

PubMed

Stephens, Caroline; Sackett, Nathan; Pierce, Read; Schopfer, David; Schmajuk, Gabriela; Moy, Nicholas; Bachhuber, Melissa; Wallhagen, Margaret I; Lee, Sei J

2013-10-01

Readmissions to the hospital are common and costly, often resulting from poor care coordination. Despite increased attention given to improving the quality and safety of care transitions, little is known about patient and provider perspectives of the transitional care needs of rehospitalized Veterans. As part of a larger quality improvement initiative to reduce hospital readmissions, the authors conducted semi-structured interviews with 25 patients and 14 of their interdisciplinary health care providers to better understand their perspectives of the transitional care needs and challenges faced by rehospitalized Veterans. Patients identified 3 common themes that led to rehospitalization: (1) knowledge gaps and deferred power; (2) difficulties navigating the health care system; and (3) complex psychiatric and social needs. Providers identified different themes that led to rehospitalization: (1) substance abuse and mental illness; (2) lack of social or financial support and homelessness; (3) premature discharge and poor communication; and (4) nonadherence with follow-up. Results underscore that rehospitalized Veterans have a complex overlapping profile of real and perceived physical, mental, and social needs. A paradigm of disempowerment and deferred responsibility appears to exist between patients and providers that contributes to ineffective care transitions, resulting in readmissions. These results highlight the cultural constraints on systems of care and suggest that process improvements should focus on increasing the sense of partnership between patients and providers, while simultaneously creating a culture of empowerment, ownership, and engagement, to achieve success in reducing hospital readmissions.

The NASA Short-term Prediction Research and Transition (SPoRT) Center: A Collaborative Model for Accelerating Research into Operations

NASA Technical Reports Server (NTRS)

Goodman, S. J.; Lapenta, W.; Jedlovec, G.; Dodge, J.; Bradshaw, T.

2003-01-01

The NASA Short-term Prediction Research and Transition (SPoRT) Center in Huntsville, Alabama was created to accelerate the infusion of NASA earth science observations, data assimilation and modeling research into NWS forecast operations and decision-making. The principal focus of experimental products is on the regional scale with an emphasis on forecast improvements on a time scale of 0-24 hours. The SPoRT Center research is aligned with the regional prediction objectives of the US Weather Research Program dealing with 0-1 day forecast issues ranging from convective initiation to 24-hr quantitative precipitation forecasting. The SPoRT Center, together with its other interagency partners, universities, and the NASA/NOAA Joint Center for Satellite Data Assimilation, provides a means and a process to effectively transition NASA Earth Science Enterprise observations and technology to National Weather Service operations and decision makers at both the global/national and regional scales. This paper describes the process for the transition of experimental products into forecast operations, current products undergoing assessment by forecasters, and plans for the future.

Improved functionality of graphene and carbon nanotube hybrid foam architecture by UV-ozone treatment

NASA Astrophysics Data System (ADS)

Wang, Wei; Ruiz, Isaac; Lee, Ilkeun; Zaera, Francisco; Ozkan, Mihrimah; Ozkan, Cengiz S.

2015-04-01

Optimization of the electrode/electrolyte double-layer interface is a key factor for improving electrode performance of aqueous electrolyte based supercapacitors (SCs). Here, we report the improved functionality of carbon materials via a non-invasive, high-throughput, and inexpensive UV generated ozone (UV-ozone) treatment. This process allows precise tuning of the graphene and carbon nanotube hybrid foam (GM) transitionally from ultrahydrophobic to hydrophilic within 60 s. The continuous tuning of surface energy can be controlled by simply varying the UV-ozone exposure time, while the ozone-oxidized carbon nanostructure maintains its integrity. Symmetric SCs based on the UV-ozone treated GM foam demonstrated enhanced rate performance. This technique can be readily applied to other CVD-grown carbonaceous materials by taking advantage of its ease of processing, low cost, scalability, and controllability.Optimization of the electrode/electrolyte double-layer interface is a key factor for improving electrode performance of aqueous electrolyte based supercapacitors (SCs). Here, we report the improved functionality of carbon materials via a non-invasive, high-throughput, and inexpensive UV generated ozone (UV-ozone) treatment. This process allows precise tuning of the graphene and carbon nanotube hybrid foam (GM) transitionally from ultrahydrophobic to hydrophilic within 60 s. The continuous tuning of surface energy can be controlled by simply varying the UV-ozone exposure time, while the ozone-oxidized carbon nanostructure maintains its integrity. Symmetric SCs based on the UV-ozone treated GM foam demonstrated enhanced rate performance. This technique can be readily applied to other CVD-grown carbonaceous materials by taking advantage of its ease of processing, low cost, scalability, and controllability. Electronic supplementary information (ESI) available. See DOI: 10.1039/c4nr06795a

Applying an ecological framework to understand transition pathways to post-secondary education for youth with physical disabilities.

PubMed

Lindsay, Sally; Duncanson, Michelle; Niles-Campbell, Nadia; McDougall, Carolyn; Diederichs, Sara; Menna-Dack, Dolly

2018-02-01

The purpose of this study was to explore the experiences of youth with physical disabilities and clinicians who support them in their transition to post-secondary education (PSE). Most research on transition to PSE has focused on youth with intellectual disabilities while there is a lack of research on youth with physical disabilities. This study drew on 30 interviews with 20 youth with disabilities and 10 clinicians. We used Bronfrenbrenner's ecological framework to inform our analysis. Our results showed that there are several important individual skills that youth need to be successful in transitioning to PSE. Youth with disabilities experienced supports from peers and family that influence their transition to PSE. Several disability-specific issues (e.g., coping, self-care, disclosure, and accommodations) were often a barrier to transitioning to PSE. Clinicians and youth both reported that improved inter-professional collaboration and inter-agency partnerships were needed to enhance the transition experience. Societal attitudes (stigma and discrimination), policies, and the timing of transitions also influence youth's transition. Applying an ecological approach helped to provide a more holistic perspective of the PSE transitions and emphasizes the need to consider more than just preparing individuals but also where they are transitioned. Implications for rehabilitation Clinicians and educators should continue to promote the development of relevant life skills (e.g., self-advocacy, disclosure, and navigating public transportation) that youth need to succeed in post-secondary education. Clinicians should continue to educate and support youth regarding the process for disclosing their condition and how to request and set up accommodations in PSE. Clinicians should connect youth with disabilities to appropriate resources that can support them and continue to help them to set career goals and develop career plans. There is a critical need for improved inter-professional collaboration among clinicians providing transition services and inter-agency partnerships among high schools, disability organizations, and PSEs to enhance transition experiences for youth with disabilities.

Socio-technical transition as a co-evolutionary process: Innovation and the role of niche markets in the transition to motor vehicles

NASA Astrophysics Data System (ADS)

Birky, Alicia K.

2008-10-01

Significant reductions in greenhouse emissions from personal transportation will require a transition to an alternative technology regime based on renewable energy sources. Two bodies of research, the quasi-evolutionary (QE) model and the multi-level perspective (MLP) assert that processes within niches play a fundamental role in such transitions. This research asks whether the description of transitions based on this niche hypothesis and its underlying assumptions is consistent with the historical U.S. transition to motor vehicles at the beginning of the 20th century. Unique to this dissertation is the combination of the perspective of the entrepreneur with co-evolutionary approaches to socio-technical transitions. This approach is augmented with concepts from the industry life-cycle model and with a taxonomy of mechanisms of learning. Using this analytic framework, I examine specifically the role of entrepreneurial behavior and processes within and among firms in the co-evolution of technologies and institutions during the transition to motor vehicles. I find that niche markets played an important role in the development of the technology, institutions, and the industry. However, I also find that the diffusion of the automobile is not consistent with the niche hypothesis in the following ways: (1) product improvements and cost reductions were not realized in niche markets, but were achieved simultaneously with diffusion into mass markets; (2) in addition to learning-by-doing and learning-by-interacting with users, knowledge spillovers and interacting with suppliers were critical in this process; (3) cost reductions were not automatic results of expanding markets, but rather arose from the strategies of entrepreneurs based on personal perspectives and values. This finding supports the use of a behavioral approach with a micro-focus in the analysis of socio-technical change. I also find that the emergence and diffusion of the motor vehicle can only be understood by considering the combination of developments and processes in multiple regimes, within niches, and within the wider technical, institutional, and ecological complex (TIEC). For the automobile, the process of regime development was more consistent with a fit-stretch pattern of gradual unfolding and adaptation than one of niche proliferation and rapid regime renewal described in the literature.

A pragmatic randomized comparative effectiveness trial of transitional care for a socioeconomically diverse population: Design, rationale and baseline characteristics.

PubMed

Schaeffer, Christine; Teter, Caroline; Finch, Emily A; Hurt, Courtney; Keeter, Mary Kate; Liss, David T; Rogers, Angela; Sheth, Avani; Ackermann, Ronald

2018-02-01

Transitional care programs have been widely used to reduce readmissions and improve the quality and safety of the handoff process between hospital and outpatient providers. Very little is known about effective transitional care interventions among patients who are uninsured or with Medicaid. This paper describes the design and baseline characteristics of a pragmatic randomized comparative effectiveness trial of transitional care. Northwestern Medical Group- Transitional Care (NMG-TC) care model was developed to address the needs of patients with multiple medical problems that required lifestyle changes and were amenable to office-based management. We present the design, evaluation methods and baseline characteristics of NMG-TC trial patients. Baseline demographic characteristics indicate that our patient population is predominantly male, Medicaid insured and non-white. This study will evaluate two methods for implementing an effective transitional care model in a medically complex and socioeconomically diverse population. Copyright © 2017 Elsevier Inc. All rights reserved.

A Qualitative Study of Patient and Provider Experiences during Preoperative Care Transitions

PubMed Central

MALLEY, ANN; YOUNG, GARY J.

2017-01-01

Aims To explore the issues and challenges of care transitions in the preoperative environment. Background Ineffective transitions play a role in a majority of serious medical errors. There is a paucity of research related to the preoperative arena and the multiple inherent transitions in care that occur there. Design Qualitative descriptive design was used. Methods Semi-structured interviews were conducted in a 975 bed academic medical center. Results 30 providers and 10 preoperative patients participated. Themes that arose were: (1) Need for clarity of purpose of preoperative care (2) Care coordination (3) Inter-professional boundaries of care (4) Inadequate time and resources. Conclusion Effective transitions in the preoperative environment require that providers bridge scope of practice barriers to promote good teamwork. Preoperative care that is a product of well-informed providers and patients can improve the entire perioperative care process and potentially influence post-operative patient outcomes. Relevance to Clinical Practice Nurses are well positioned to bridge the gaps within transitions of care and accordingly affect health outcomes. PMID:27706872

Seismics-electrics Joint Interpretation in a gypsiferous context.

NASA Astrophysics Data System (ADS)

Marzan, Ignacio; Marti, David; Lobo, Agustin; Alvarez-Marron, Joaquina; Carbonell, Ramon

2016-04-01

The main objective of this study is to improve the geophysical characterization resulting from a shallow 3D high resolution travel-time tomography survey (500x500m). This survey was acquired in Villar de Cañas (Cuenca, Spain) in late 2013 and early 2014. Lithology down to 150 m depth in this site is characterized by endorheic sediments, mainly siltstone and gypsum. After processing the tomography data, the velocity model showed a good correlation with geology models and borehole data except for the siltstone-gypsum transition. The model involves two lithological limits: the "transition layer - massive gypsum layer" (well resolved by a relatively high velocity contrast) and the "siltstone layer - transition layer" (constrained only in the central part of the model by a relatively low velocity contrast). As electrical resistivity is able to characterize shale-gypsum transitions, we complemented the seismic data with results from a collection of 2D ERT surveys, for which we build a new 3D grid with 2 parameters by node: velocity and resistivity. In order to derive a geological interpretation, we apply a statistical classification method (Linear Discriminant Analysis) to the new bi-parametric grid, using reference classes from well logs. This process results on a final 3D lithological model with less ambiguity and thus with a better definition of the two limits under discussion. Our study shows that the integration of seismic and electric methods significantly improves geological characterization in a gypsiferous context.

Planning Programs for Transescents.

ERIC Educational Resources Information Center

Eichhorn, Donald H.

"Transescents" -- the prefix "trans" meaning "to go across" and the suffix "escent" meaning "to become something" -- are young people in transition from childhood to adolescence. The middle school organization presents educators with an opportunity for improved educational processes uniquely suited to students of this age group. Transescents are…

Coordinating patient care within radiology and across the enterprise.

PubMed

McEnery, Kevin W

2014-12-01

For the practice of radiology, the transition to filmless imaging operations has resulted in a fundamental transition to more efficient clinical operations. In addition, the electronic delivery of diagnostic studies to the bedside has had a great impact on the care process throughout the health care enterprise. The radiology information system (RIS) has been at the core of the transition to filmless patient care. In a similar manner, the electronic medical record (EMR) is fundamentally and rapidly transforming the clinical enterprise into paperless/digital coordination of care. The widespread availability of EMR systems can be predicted to continue to increase the level of coordination of clinical care within the EMR framework. For the radiologist, readily available clinical information at the point of interpretation will continue to drive the evolution of the interpretation process, leading to improved patient outcomes. Regardless of practice size, efficient workflow processes are required to best leverage the functionality of IT systems. The radiologist should be aware of the scope of the RIS capabilities that allow for maximizing clinical benefit, and of the EMR system capabilities for improving = clinical imaging practice and care coordination across the enterprise. Radiology departments should be actively involved in forming practice patterns that allow efficient EMR-based clinical practice. This summary article is intended to assist radiologists in becoming active participants in the evolving role of both the RIS and EMR systems in coordinating efficient and effective delivery across the clinical enterprise. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Addressing cancer patient and caregiver role transitions during home hospice nursing care.

PubMed

Hudson, Janella; Reblin, Maija; Clayton, Margaret F; Ellington, Lee

2018-05-15

Many family caregivers and hospice patients experience role changes resulting from advancing illness and the need for increased caregiver responsibility. Successful navigation of conflicts that arise because of these role transitions has been linked to higher quality of patient care and improved caregiver bereavement adjustment. Nursing communication with patients and their caregivers plays an important role in facilitating these transitions. Our objective is to describe patient-caregiver-nurse communication during transitions at end of life. A secondary, qualitative analysis was conducted on transcripts. Using an iterative process of constant comparison, coders inductively categorized nurse, caregiver, and patient communication behavior into overarching themes. Participants were home hospice nurses and cancer patient/spouse caregiver dyads; participants were >45 years of age, English speaking, and cognitively able to participate. Research took place in the home during nurse visits.ResultNineteen unique home hospice visits were analyzed. Patient-caregiver conflict occurred in two major content themes (1) negotiating transitions in patient independence and (2) navigating caregiver/patient emotions (e.g., frustration, sadness). Nurse responses to transition conflict included problem-solving, mediating, or facilitating discussions about conflicts. Nurse responses to emotional conflict included validation and reassurance.Significance of resultsOur findings provide insight into the topics and processes involved in patient and caregiver transitions in home hospice and the role hospice nursing communication plays in mediating potential conflict. Nurses are often asked to take on the role of mediator, often with little conflict resolution communication education; results can be used for nursing education.

Improvements in Low-cost Ultrasonic Measurements of Blood Flow in "by-passes" Using Narrow & Broad Band Transit-time Procedures

NASA Astrophysics Data System (ADS)

Ramos, A.; Calas, H.; Diez, L.; Moreno, E.; Prohías, J.; Villar, A.; Carrillo, E.; Jiménez, A.; Pereira, W. C. A.; Von Krüger, M. A.

The cardio-pathology by ischemia is an important cause of death, but the re-vascularization of coronary arteries (by-pass operation) is an useful solution to reduce associated morbidity improving quality of life in patients. During these surgeries, the flow in coronary vessels must be measured, using non-invasive ultrasonic methods, known as transit time flow measurements (TTFM), which are the most accurate option nowadays. TTFM is a common intra-operative tool, in conjunction with classic Doppler velocimetry, to check the quality of these surgery processes for implanting grafts in parallel with the coronary arteries. This work shows important improvements achieved in flow-metering, obtained in our research laboratories (CSIC, ICIMAF, COPPE) and tested under real surgical conditions in Cardiocentro-HHA, for both narrowband NB and broadband BB regimes, by applying results of a CYTED multinational project (Ultrasonic & computational systems for cardiovascular diagnostics). mathematical models and phantoms were created to evaluate accurately flow measurements, in laboratory conditions, before our new electronic designs and low-cost implementations, improving previous ttfm systems, which include analogic detection, acquisition & post-processing, and a portable PC. Both regimes (NB and BB), with complementary performances for different conditions, were considered. Finally, specific software was developed to offer facilities to surgeons in their interventions.

Transitions in Care from Pediatric to Adult Health Care Providers: Ongoing Challenges and Opportunities for Young Persons with Diabetes.

PubMed

Garvey, Katharine; Laffel, Lori

2018-01-01

Adolescence and young adulthood are times of multiple developmental changes, including physiological, social, emotional, cognitive, and behavioral transformations. The adolescent or young adult living with type 1 or type 2 diabetes must navigate the vicissitudes of these developmental stages while managing the rigors and self-care demands of these conditions. Diabetes in children is managed by adults, mainly by parents. As the child matures, diabetes management tasks transition from parents to the developing teen. This transition in care is a process that generally begins in early adolescence and culminates when the older teen successfully accepts and manages diabetes self-care tasks. Along with the transitions in diabetes management tasks, older teens and young adults must be prepared for transfer from the pediatric diabetes care team to an adult-focused health care team. Numerous publications have described the challenges associated with both the process of transition and the act of transfer. Lack of preparation during transition followed by unsuccessful transfer often results in gaps in diabetes care exceeding 6 months, deterioration in glycemic control, increase in emergency room use and hospitalization, and emergence of diabetes complications among older teens and young adults. There is need for ongoing research internationally to address these deficiencies in order to improve the short- and long-term health of young persons with diabetes. © 2018 S. Karger AG, Basel.

On the deflagration-to-detonation transition (DDT) process with added energetic solid particles for pulse detonation engines (PDE)

NASA Astrophysics Data System (ADS)

Nguyen, V. B.; Li, J.; Chang, P.-H.; Phan, Q. T.; Teo, C. J.; Khoo, B. C.

2018-01-01

In this paper, numerical simulations are performed to study the dynamics of the deflagration-to-detonation transition (DDT) in pulse detonation engines (PDE) using energetic aluminum particles. The DDT process and detonation wave propagation toward the unburnt hydrogen/air mixture containing solid aluminum particles is numerically studied using the Eulerian-Lagrangian approach. A hybrid numerical methodology combined with appropriate sub-models is used to capture the gas dynamic characteristics, particle behavior, combustion characteristics, and two-way solid-particle-gas flow interactions. In our approach, the gas mixture is expressed in the Eulerian frame of reference, while the solid aluminum particles are tracked in the Lagrangian frame of reference. The implemented computer code is validated using published benchmark problems. The obtained results show that the aluminum particles not only shorten the DDT length but also reduce the DDT time. The improvement of DDT is primarily attributed to the heat released from surface chemical reactions on the aluminum particles. The temperatures associated with the DDT process are greater than the case of non-reacting particles added, with an accompanying rise in the pressure. For an appropriate range of particle volume fraction, particularly in this study, the higher volume fraction of the micro-aluminum particles added in the detonation chamber can lead to more heat energy released and more local instabilities in the combustion process (caused by the local high temperature), thereby resulting in a faster DDT process. In essence, the aluminum particles contribute to the DDT process of successfully transitioning to detonation waves for (failure) cases in which the fuel gas mixture can be either too lean or too rich. With a better understanding of the influence of added aluminum particles on the dynamics of the DDT and detonation process, we can apply it to modify the geometry of the detonation chamber (e.g., the length of the detonation tube) accordingly to improve the operational performance of the PDE.

Exploring the effect of at-risk case management compensation on hospital pay-for-performance outcomes: tools for change.

PubMed

Granata, Randy L; Hamilton, Karen

2015-01-01

Acute care nurse case managers are charged with compliance oversight, managing throughput, and ensuring safe care transitions. Leveraging the roles of nurse case managers and social workers during care transitions translates into improved fiscal performance under the Affordable Care Act. This article aims to equip leaders in the field of case management with tools to facilitate the alignment of case management systems with hospital pay-for-performance measures. A quality improvement project was implemented at a hospital in south Alabama to examine the question: for acute care case managers, what is the effect of key performance indictors using an at-risk compensation model in comparison to past nonincentive models on hospital readmissions, lengths of stay, and patient satisfaction surrounding the discharge process. Inpatient acute care hospital. The implementation of an at-risk compensation model using key performance indicators, Lean Six Sigma methodology, and Creative Health Care Management's Relationship-Based Care framework demonstrated reduced length of stay, hospital readmissions, and improved patient experiences. Regulatory changes and new models of reimbursement in the acute care environment have created the perfect storm for case management leaders. Hospital fiscal performance is dependent on effective case management processes and the ability to optimize scarce resources. The quality improvement project aimed to further align case management systems and structures with hospital pay-for-performance measures. Tools for change were presented to assist leaders with the change acceleration process.

Novel mathematic models for quantitative transitivity of quality-markers in extraction process of the Buyanghuanwu decoction.

PubMed

Zhang, Yu-Tian; Xiao, Mei-Feng; Deng, Kai-Wen; Yang, Yan-Tao; Zhou, Yi-Qun; Zhou, Jin; He, Fu-Yuan; Liu, Wen-Long

2018-06-01

Nowadays, to research and formulate an efficiency extraction system for Chinese herbal medicine, scientists have always been facing a great challenge for quality management, so that the transitivity of Q-markers in quantitative analysis of TCM was proposed by Prof. Liu recently. In order to improve the quality of extraction from raw medicinal materials for clinical preparations, a series of integrated mathematic models for transitivity of Q-markers in quantitative analysis of TCM were established. Buyanghuanwu decoction (BYHWD) was a commonly TCMs prescription, which was used to prevent and treat the ischemic heart and brain diseases. In this paper, we selected BYHWD as an extraction experimental subject to study the quantitative transitivity of TCM. Based on theory of Fick's Rule and Noyes-Whitney equation, novel kinetic models were established for extraction of active components. Meanwhile, fitting out kinetic equations of extracted models and then calculating the inherent parameters in material piece and Q-marker quantitative transfer coefficients, which were considered as indexes to evaluate transitivity of Q-markers in quantitative analysis of the extraction process of BYHWD. HPLC was applied to screen and analyze the potential Q-markers in the extraction process. Fick's Rule and Noyes-Whitney equation were adopted for mathematically modeling extraction process. Kinetic parameters were fitted and calculated by the Statistical Program for Social Sciences 20.0 software. The transferable efficiency was described and evaluated by potential Q-markers transfer trajectory via transitivity availability AUC, extraction ratio P, and decomposition ratio D respectively. The Q-marker was identified with AUC, P, D. Astragaloside IV, laetrile, paeoniflorin, and ferulic acid were studied as potential Q-markers from BYHWD. The relative technologic parameters were presented by mathematic models, which could adequately illustrate the inherent properties of raw materials preparation and affection of Q-markers transitivity in equilibrium processing. AUC, P, D for potential Q-markers of AST-IV, laetrile, paeoniflorin, and FA were obtained, with the results of 289.9 mAu s, 46.24%, 22.35%; 1730 mAu s, 84.48%, 1.963%; 5600 mAu s, 70.22%, 0.4752%; 7810 mAu s, 24.29%, 4.235%, respectively. The results showed that the suitable Q-markers were laetrile and paeoniflorin in our study, which exhibited acceptable traceability and transitivity in the extraction process of TCMs. Therefore, these novel mathematic models might be developed as a new standard to control TCMs quality process from raw medicinal materials to product manufacturing. Copyright © 2018 Elsevier GmbH. All rights reserved.

Short-Term Change in Couples’ Conflict Following a Transition to Parenthood Intervention

PubMed Central

Shapiro, Alyson F.; Gottman, John M.; Fink, Brandi C.

2016-01-01

Conflict among couples was examined following a transition to parenthood intervention to determine both short-term efficacy of the program and elucidate the process of change postintervention. A randomized clinical trial design was used to examine conflict in couples who participated in a transition to parenthood psycho-educational workshop compared with controls. The beginnings of improved communication in conflict were evident at 3 months postbirth through decreased husband contempt and increased husband positive affect during conflict in a sample that demonstrated more substantial improvement at 1 year postintervention. Increases in husband positive affect in the workshop group at 3 months postbirth predicted more positive and less negative wife affect during conflict at 1 year postbirth. Results suggest that some indicators of intervention efficacy were evident, postintervention change can be gradual, husbands may be more receptive to implementing change shortly after birth, and early changes can be associated with later positive outcomes. Findings have implications for preparing couples for the gradual and complex nature of change associated with intervention. PMID:27375959

On-the-fly transition search and applications to temperature-accelerated dynamics

NASA Astrophysics Data System (ADS)

Shim, Yunsic; Amar, Jacques

2015-03-01

Temperature-accelerated dynamics (TAD) is a powerful method to study non-equilibrium processes and has been providing surprising insights for a variety of systems. While serial TAD simulations have been limited by the roughly N3 increase in the computational cost as a function of the number of atoms N in the system, recently we have shown that by carrying out parallel TAD simulations which combine spatial decomposition with our semi-rigorous synchronous sublattice algorithm, significantly improved scaling is possible. However, in this approach the size of activated events is limited by the processor size while the dynamics is not exact. Here we discuss progress in improving the scaling of serial TAD by combining the use of on-the-fly transition searching with our previously developed localized saddle-point method. We demonstrate improved performance for the cases of Ag/Ag(100) annealing and Cu/Cu(100) growth. Supported by NSF DMR-1410840.

Twin-induced phase transition from β-Ga2O3 to α-Ga2O3 in Ga2O3 thin films

NASA Astrophysics Data System (ADS)

Choi, Byeongdae; Allabergenov, Bunyod; Lyu, Hong-Kun; Lee, Seong Eui

2018-06-01

We deposited a 300-nm-thick Ga2O3 thin film on an amorphous SiO2/Si substrate via pulsed laser deposition. X-ray diffraction patterns revealed the formation of β-Ga2O3 phase at a substrate temperature of 700 °C. X-ray photoelectron spectra indicated that the degree of oxidation increased after annealing at 700 °C. Further annealings at higher temperatures led to a transition of the β-Ga2O3 phase to the α-Ga2O3 phase; this transition was caused by the twin structure formed during the crystallinity improvement process. In addition, we discuss the mechanism of the transition from the β phase to the α phase in the β-Ga2O3 thin films.

23 CFR 450.306 - Scope of the metropolitan transportation planning process.

Code of Federal Regulations, 2011 CFR

2011-04-01

... transportation improvements and State and local planned growth and economic development patterns; (6) Enhance the... transportation system development, land use, employment, economic development, human and natural environment, and... CFR part 940. (g) Preparation of the coordinated public transit-human services transportation plan, as...

Development of a MASH TL-2 guardrail-to-bridge rail transition compatible with 31-inch guardrail.

DOT National Transportation Integrated Search

2011-12-01

The TxDOT Design Division is in the process of developing new guardrail standards that comply with the AASHTO Manual for Assessing Safety Hardware (MASH). The new guardrail system will provide increased capacity and improved impact performance relati...

Evaluation of Roadway Reallocation Projects: Analysis of Before-and-After Travel Speeds and Congestion Utilizing High-Resolution Bus Transit Data

DOT National Transportation Integrated Search

2017-11-01

The traditional process of identifying corridors for road diet improvements involves selecting potential corridors (mostly based on identifying fourlane roads) and conducting a traffic impact analysis of proposed changes on a selected roadway before ...

Transition Metal Switchable Mirror

ScienceCinema

None

2017-12-29

The switchable-mirrors technology was developed by Tom Richardson and Jonathan Slack of Berkeley Lab's Environmental Energy Technologies Division. By using transition metals rather than the rare earth metals used in the first metal-hydride switchable mirrors, Richardson and Slack were able to lower the cost and simplify the manufacturing process. Energy performance is improved as well, because the new windows can reflect or transmit both visible and infrared light. Besides windows for offices and homes, possible applications include automobile sunroofs, signs and displays, aircraft windows, and spacecraft. More information at: http://windows.lbl.gov/materials/chromogenics/default.htm

Transition Metal Switchable Mirror

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

None

2009-08-21

The switchable-mirrors technology was developed by Tom Richardson and Jonathan Slack of Berkeley Lab's Environmental Energy Technologies Division. By using transition metals rather than the rare earth metals used in the first metal-hydride switchable mirrors, Richardson and Slack were able to lower the cost and simplify the manufacturing process. Energy performance is improved as well, because the new windows can reflect or transmit both visible and infrared light. Besides windows for offices and homes, possible applications include automobile sunroofs, signs and displays, aircraft windows, and spacecraft. More information at: http://windows.lbl.gov/materials/chromogenics/default.htm

Development and testing of a superconducting link for an IR detector

NASA Technical Reports Server (NTRS)

Caton, R.; Selim, R.

1991-01-01

The development and testing of a ceramic superconducting link for an infrared detector is summarized. Areas of study included the materials used, the electrical contacts, radiation and temperature cycling effects, aging, thermal conductivity, and computer models of an ideal link. Materials' samples were processed in a tube furnace at temperatures of 840 C to 865 C for periods up to 17 days and transition temperatures and critical current densities were recorded. The project achieved better quality high superconducting transition temperature material through improved processing and also achieved high quality electrical contacts. Studies on effects of electron irradiation, temperature cycling, and aging on superconducting properties indicate that the materials will be suitable for space applications. Various presentations and publications on the study's results are reported.

Superresolution fluorescence imaging by pump-probe setup using repetitive stimulated transition process

NASA Astrophysics Data System (ADS)

Dake, Fumihiro; Fukutake, Naoki; Hayashi, Seri; Taki, Yusuke

2018-02-01

We proposed superresolution nonlinear fluorescence microscopy with pump-probe setup that utilizes repetitive stimulated absorption and stimulated emission caused by two-color laser beams. The resulting nonlinear fluorescence that undergoes such a repetitive stimulated transition is detectable as a signal via the lock-in technique. As the nonlinear fluorescence signal is produced by the multi-ply combination of incident beams, the optical resolution can be improved. A theoretical model of the nonlinear optical process is provided using rate equations, which offers phenomenological interpretation of nonlinear fluorescence and estimation of the signal properties. The proposed method is demonstrated as having the scalability of optical resolution. Theoretical resolution and bead image are also estimated to validate the experimental result.

The Role of Intraseasonal Variability in Supporting the Shallow-to-Deep Transition in the Amazon

NASA Astrophysics Data System (ADS)

Serra, Y. L.; Rowe, A.; Adams, D. K.; Barbosa, H. M.; Kiladis, G. N.

2016-12-01

The shallow-to-deep convective transition over land typically refers to the growth of the convective boundary layer after sunrise, followed by the development of cumulus congestus clouds in the late morning/early afternoon and transitioning to deep convective clouds in the late afternoon and early evening. Under favorable conditions, this diurnal convection can result in organized mesoscale convective systems (MCSs) that last through the following morning. While many studies have focused on improving this process in models, the shallow-to-deep transition remains poorly represented especially over land. The recent DOE ARM mobile facility deployment in the Amazon, launched as part of GOAmazon, along with a dense GNSS network supported by Universidade do Estado do Amazonas (UEA)/Instituto Nacional de Pesquisas Espaciais (INPE) and co-located with the CHUVA Project sites for GOAmazon, are used here to examine land-based convective processes in the tropics. In particular, this aspect of a larger study of the shallow-to-deep transition explores the role of large-scale intraseasonal wave activity in supporting the growth of MCSs over the GoAmazon region. These results will be placed in the context of local forcing mechanisms for convective growth over the region in ongoing work.

Deducing the Kinetics of Protein Synthesis In Vivo from the Transition Rates Measured In Vitro

PubMed Central

Rudorf, Sophia; Thommen, Michael; Rodnina, Marina V.; Lipowsky, Reinhard

2014-01-01

The molecular machinery of life relies on complex multistep processes that involve numerous individual transitions, such as molecular association and dissociation steps, chemical reactions, and mechanical movements. The corresponding transition rates can be typically measured in vitro but not in vivo. Here, we develop a general method to deduce the in-vivo rates from their in-vitro values. The method has two basic components. First, we introduce the kinetic distance, a new concept by which we can quantitatively compare the kinetics of a multistep process in different environments. The kinetic distance depends logarithmically on the transition rates and can be interpreted in terms of the underlying free energy barriers. Second, we minimize the kinetic distance between the in-vitro and the in-vivo process, imposing the constraint that the deduced rates reproduce a known global property such as the overall in-vivo speed. In order to demonstrate the predictive power of our method, we apply it to protein synthesis by ribosomes, a key process of gene expression. We describe the latter process by a codon-specific Markov model with three reaction pathways, corresponding to the initial binding of cognate, near-cognate, and non-cognate tRNA, for which we determine all individual transition rates in vitro. We then predict the in-vivo rates by the constrained minimization procedure and validate these rates by three independent sets of in-vivo data, obtained for codon-dependent translation speeds, codon-specific translation dynamics, and missense error frequencies. In all cases, we find good agreement between theory and experiment without adjusting any fit parameter. The deduced in-vivo rates lead to smaller error frequencies than the known in-vitro rates, primarily by an improved initial selection of tRNA. The method introduced here is relatively simple from a computational point of view and can be applied to any biomolecular process, for which we have detailed information about the in-vitro kinetics. PMID:25358034

Runaway and Homeless Youth Grants: Improvements Needed in the Grant Award Process. Report to Congressional Committees. GAO-10-335

ERIC Educational Resources Information Center

Brown, Kay E.

2010-01-01

The Department of Health and Human Services (HHS) awards grants to provide shelter and services to runaway and homeless youth through the Basic Center, Transitional Living and Street Outreach Programs. In response to a mandate for a review of the grant award process for these programs in the Reconnecting Homeless Youth Act of 2008 (Pub. L. No.…

Understanding Transitions to Promote Student Success: A Concept Analysis.

PubMed

Hart, Julie A; Swenty, Constance F

2016-07-01

The purpose of this analysis is to provide an extensive exploration of the concept of transitions, specifically within the context of nursing students. Transitions are a universal part of life. The concept of transitions is rooted in disciplines such as anthropology, sociology, psychology, and business. Transitions are also a central theme in nursing. While various definitions of the concept exist, most agree that transitions involve a process, which over time results in transformation of self. Walker and Avant's eight-step method of concept analysis served as the framework for exploration of the concept. The databases Cumulative Index to Nursing and Allied Health Literature, MEDLINE, Education Resources Information Center, ProQuest, and Academic Search Premiere were searched using the search terms transition, transitions, transformation, nursing students, anxiety, and clinical education. Quantitative and qualitative studies, published concept analysis, and transition theory articles were included. During a transition, people experience stress and anxiety. This applies to nursing students as well, who often report much stress and anxiety upon entering the initial clinical experience. However, consequences of a successful transition include increased knowledge, attainment of new skills, and identify reformation. By understanding the concept, nurse educators can develop effective teaching strategies to facilitate successful transitions, which will improve the educational experience, support student retention, and promote graduation of competent practitioners. Hart Swenty. © 2015 Wiley Periodicals, Inc.

Milestoning with coarse memory

NASA Astrophysics Data System (ADS)

Hawk, Alexander T.

2013-04-01

Milestoning is a method used to calculate the kinetics of molecular processes occurring on timescales inaccessible to traditional molecular dynamics (MD) simulations. In the method, the phase space of the system is partitioned by milestones (hypersurfaces), trajectories are initialized on each milestone, and short MD simulations are performed to calculate transitions between neighboring milestones. Long trajectories of the system are then reconstructed with a semi-Markov process from the observed statistics of transition. The procedure is typically justified by the assumption that trajectories lose memory between crossing successive milestones. Here we present Milestoning with Coarse Memory (MCM), a generalization of Milestoning that relaxes the memory loss assumption of conventional Milestoning. In the method, milestones are defined and sample transitions are calculated in the standard Milestoning way. Then, after it is clear where trajectories sample milestones, the milestones are broken up into distinct neighborhoods (clusters), and each sample transition is associated with two clusters: the cluster containing the coordinates the trajectory was initialized in, and the cluster (on the terminal milestone) containing trajectory's final coordinates. Long trajectories of the system are then reconstructed with a semi-Markov process in an extended state space built from milestone and cluster indices. To test the method, we apply it to a process that is particularly ill suited for Milestoning: the dynamics of a polymer confined to a narrow cylinder. We show that Milestoning calculations of both the mean first passage time and the mean transit time of reversal—which occurs when the end-to-end vector reverses direction—are significantly improved when MCM is applied. Finally, we note the overhead of performing MCM on top of conventional Milestoning is negligible.

Evaluating Innovation and Navigating Unseen Boundaries: Systems, Processes and People

ERIC Educational Resources Information Center

Fleet, Alma; De Gioia, Katey; Madden, Lorraine; Semann, Anthony

2018-01-01

This paper illustrates an evaluation model emerging from Australian research. With reference to a range of contexts, its usefulness is demonstrated through application to two professional development initiatives designed to improve continuity of learning in the context of the transition to school. The model reconceptualises approaches to…

Problems and Trends Regarding Vocational Teachers in China

ERIC Educational Resources Information Center

Kuang, Ying

2014-01-01

At present, China's vocational education system is undergoing a transition process from growing in size to improving in quality. Teacher and teaching force issues are a bottleneck and critical factor that will determine whether the transformation will be successful. The real-world problems of the number, deployment, capacity, and training systems…

Building Enterprise Transition Plans Through the Development of Collapsing Design Structure Matrices

DTIC Science & Technology

2015-09-17

processes from the earliest input to the final output to evaluate where change is needed to reduce costs, reduce waste, and improve the flow of information...from) integrating a large complex enterprise? • How should firms/enterprises evaluate systems prior to integration? What are some valid taxonomies

The Family Perspective on Hospital to Home Transitions: A Qualitative Study.

PubMed

Solan, Lauren G; Beck, Andrew F; Brunswick, Stephanie A; Sauers, Hadley S; Wade-Murphy, Susan; Simmons, Jeffrey M; Shah, Samir S; Sherman, Susan N

2015-12-01

Transitions from the hospital to home can be difficult for patients and families. Family-informed characterization of this vulnerable period may facilitate the identification of interventions to improve transitions home. Our objective was to develop a comprehensive understanding of hospital-to-home transitions from the family perspective. Using qualitative methods, focus groups and individual interviews were held with caregivers of children discharged from the hospital in the preceding 30 days. Focus groups were stratified based upon socioeconomic status. The open-ended, semistructured question guide included questions about communication and understanding of care plans, transition home, and postdischarge events. Using inductive thematic analysis, investigators coded the transcripts, resolving differences through consensus. Sixty-one caregivers participated across 11 focus groups and 4 individual interviews. Participants were 87% female and 46% nonwhite; 38% were the only adult in their household, and 56% resided in census tracts with ≥15% of residents living in poverty. Responses from participants yielded a conceptual model depicting key elements of families' experiences with hospital-to-home transitions. Four main concepts resulted: (1) "In a fog" (barriers to processing and acting on information), (2) "What I wish I had" (desired information and suggestions for improvement), (3) "Am I ready to go home?" (discharge readiness), and (4) "I'm home, now what?" (confidence and postdischarge care). Transitions from hospital to home affect the lives of families in ways that may affect patient outcomes postdischarge. The caregiver is key to successful transitions, and the family perspective can inform interventions that support families and facilitate an easier re-entry to the home. Copyright © 2015 by the American Academy of Pediatrics.

Fabrication and Improvement of Lmsc's All-silica RSI

NASA Technical Reports Server (NTRS)

Beasley, R. M.; Izu, Y. D.; Nakano, H. N.; Ozolin, A. A.; Peachman, A.

1973-01-01

The LI-1500 and LI-900 all silica RSI materials have made the transition from laboratory to manufacturing operation. Improvements in both quality and reproducibility have been achieved. The LI-1500 material has displayed superior reliability in evaluations conducted at various facilities. The dependable performance of the material is attributed to the adherence to the stringent requirements of the numerous material, process, and product control evaluations and inspection points performed during manufacture.

Effects of running with backpack loads during simulated gravitational transitions: Improvements in postural control

NASA Astrophysics Data System (ADS)

Brewer, Jeffrey David

The National Aeronautics and Space Administration is planning for long-duration manned missions to the Moon and Mars. For feasible long-duration space travel, improvements in exercise countermeasures are necessary to maintain cardiovascular fitness, bone mass throughout the body and the ability to perform coordinated movements in a constant gravitational environment that is six orders of magnitude higher than the "near weightlessness" condition experienced during transit to and/or orbit of the Moon, Mars, and Earth. In such gravitational transitions feedback and feedforward postural control strategies must be recalibrated to ensure optimal locomotion performance. In order to investigate methods of improving postural control adaptation during these gravitational transitions, a treadmill based precision stepping task was developed to reveal changes in neuromuscular control of locomotion following both simulated partial gravity exposure and post-simulation exercise countermeasures designed to speed lower extremity impedance adjustment mechanisms. The exercise countermeasures included a short period of running with or without backpack loads immediately after partial gravity running. A novel suspension type partial gravity simulator incorporating spring balancers and a motor-driven treadmill was developed to facilitate body weight off loading and various gait patterns in both simulated partial and full gravitational environments. Studies have provided evidence that suggests: the environmental simulator constructed for this thesis effort does induce locomotor adaptations following partial gravity running; the precision stepping task may be a helpful test for illuminating these adaptations; and musculoskeletal loading in the form of running with or without backpack loads may improve the locomotor adaptation process.

Advanced ACTPol Multichroic Polarimeter Array Fabrication Process for 150 mm Wafers

NASA Astrophysics Data System (ADS)

Duff, S. M.; Austermann, J.; Beall, J. A.; Becker, D.; Datta, R.; Gallardo, P. A.; Henderson, S. W.; Hilton, G. C.; Ho, S. P.; Hubmayr, J.; Koopman, B. J.; Li, D.; McMahon, J.; Nati, F.; Niemack, M. D.; Pappas, C. G.; Salatino, M.; Schmitt, B. L.; Simon, S. M.; Staggs, S. T.; Stevens, J. R.; Van Lanen, J.; Vavagiakis, E. M.; Ward, J. T.; Wollack, E. J.

2016-08-01

Advanced ACTPol (AdvACT) is a third-generation cosmic microwave background receiver to be deployed in 2016 on the Atacama Cosmology Telescope (ACT). Spanning five frequency bands from 25 to 280 GHz and having just over 5600 transition-edge sensor (TES) bolometers, this receiver will exhibit increased sensitivity and mapping speed compared to previously fielded ACT instruments. This paper presents the fabrication processes developed by NIST to scale to large arrays of feedhorn-coupled multichroic AlMn-based TES polarimeters on 150-mm diameter wafers. In addition to describing the streamlined fabrication process which enables high yields of densely packed detectors across larger wafers, we report the details of process improvements for sensor (AlMn) and insulator (SiN_x) materials and microwave structures, and the resulting performance improvements.

Advanced ACTPol Multichroic Polarimeter Array Fabrication Process for 150 mm Wafers

NASA Technical Reports Server (NTRS)

Duff, S. M.; Austermann, J.; Beall, J. A.; Becker, D.; Datta, R.; Gallardo, P. A.; Henderson, S. W.; Hilton, G. C.; Ho, S. P.; Hubmayr, J.;

ISS-Experiments of Columnar-to-Equiaxed Transition in Solidification Processing

NASA Technical Reports Server (NTRS)

Sturz, Laszlo; Zimmermann, Gerhard; Gandin, Charles, Andre; Billia, Bernard; Magelinck, Nathalie; Nguyen-Thi, Henry; Browne, David John; Mirihanage, Wajira U.; Voss, Daniela; Beckermann, Christoph;

Version 2 of the Protuberance Correlations for the Shuttle-Orbiter Boundary Layer Transition Tool

NASA Technical Reports Server (NTRS)

King, Rudolph A.; Kegerise, Michael A.; Berry, Scott A.

2009-01-01

Orbiter-specific transition data, acquired in four ground-based facilities (LaRC 20-Inch Mach 6 Air Tunnel, LaRC 31-Inch Mach 10 Air Tunnel, LaRC 20-Inch Mach 6 CF4 Tunnel, and CUBRC LENS-I Shock Tunnel) with three wind tunnel model scales (0.75, 0.90, and 1.8%) and from Orbiter historical flight data, have been analyzed to improve a pre-existing engineering tool for reentry transition prediction on the windward side of the Orbiter. Boundary layer transition (BLT) engineering correlations for transition induced by isolated protuberances are presented using a laminar Navier-Stokes (N-S) database to provide the relevant boundary-layer properties. It is demonstrated that the earlier version of the BLT correlation that had been developed using parameters derived from an engineering boundary-layer code has improved data collapse when developed with the N-S database. Of the new correlations examined, the proposed correlation 5, based on boundary-layer edge and wall properties, was found to provide the best overall correlation metrics when the entire database is employed. The second independent correlation (proposed correlation 7) selected is based on properties within the boundary layer at the protuberance height. The Aeroheating Panel selected a process to derive the recommended coefficients for Version 2 of the BLT Tool. The assumptions and limitations of the recommended protuberance BLT Tool V.2 are presented.

Transition to adult care in pediatric solid-organ transplant: development of a practice guideline.

PubMed

Gold, Anna; Martin, Kathy; Breckbill, Katie; Avitzur, Yaron; Kaufman, Miriam

2015-06-01

Transition to adult-centered care is becoming an increasingly important area of practice in pediatric organ transplant. Standardized, best-practice guidelines are needed to assist transplant practitioners in providing optimal transitional care for this population of patients. To describe the development and implementation of a practice guideline for the transitional care of pediatric transplant recipients. A quality improvement project was undertaken in a pediatric multiorgan transplant program setting. Strategies employed included (1) creation of an interdisciplinary working group, (2) survey of transition-related practices and learning needs of transplant practitioners, (3) review of the literature and existing transition-related materials, and (4) creation of transition guidelines. An interdisciplinary survey of transplant practitioners at our institution identified practice strengths related to transitional care and learning needs. Review of relevant literature and other materials revealed limited but emerging research related to the transition of pediatric transplant recipients from pediatric to adult care. Existing transition tools were examined and applicable items identified. A practice guideline for use with pediatric transplant recipients transitioning to adult care was developed. Strategies to educate staff about the guideline and promote ongoing guideline use were implemented. Preparing pediatric transplant recipients and their families for transition to adult-centered care is an emerging challenge for transplant teams. These guidelines provide practitioners with a developmentally sensitive overview of important transition-related domains and strategies directed toward patients and their caregivers, who may experience the process of transition differently. Dissemination of the pediatric transplant transition guideline will make transition information more widely available to transplant practitioners.

Kilogram-scale prexasertib monolactate monohydrate synthesis under continuous-flow CGMP conditions.

PubMed

Cole, Kevin P; Groh, Jennifer McClary; Johnson, Martin D; Burcham, Christopher L; Campbell, Bradley M; Diseroad, William D; Heller, Michael R; Howell, John R; Kallman, Neil J; Koenig, Thomas M; May, Scott A; Miller, Richard D; Mitchell, David; Myers, David P; Myers, Steven S; Phillips, Joseph L; Polster, Christopher S; White, Timothy D; Cashman, Jim; Hurley, Declan; Moylan, Robert; Sheehan, Paul; Spencer, Richard D; Desmond, Kenneth; Desmond, Paul; Gowran, Olivia

2017-06-16

Advances in drug potency and tailored therapeutics are promoting pharmaceutical manufacturing to transition from a traditional batch paradigm to more flexible continuous processing. Here we report the development of a multistep continuous-flow CGMP (current good manufacturing practices) process that produced 24 kilograms of prexasertib monolactate monohydrate suitable for use in human clinical trials. Eight continuous unit operations were conducted to produce the target at roughly 3 kilograms per day using small continuous reactors, extractors, evaporators, crystallizers, and filters in laboratory fume hoods. Success was enabled by advances in chemistry, engineering, analytical science, process modeling, and equipment design. Substantial technical and business drivers were identified, which merited the continuous process. The continuous process afforded improved performance and safety relative to batch processes and also improved containment of a highly potent compound. Copyright © 2017, American Association for the Advancement of Science.

Reconciling patient and provider priorities for improving the care of critically ill patients: A consensus method and qualitative analysis of decision making.

PubMed

McKenzie, Emily; Potestio, Melissa L; Boyd, Jamie M; Niven, Daniel J; Brundin-Mather, Rebecca; Bagshaw, Sean M; Stelfox, Henry T

2017-12-01

Providers have traditionally established priorities for quality improvement; however, patients and their family members have recently become involved in priority setting. Little is known about how to reconcile priorities of different stakeholder groups into a single prioritized list that is actionable for organizations. To describe the decision-making process for establishing consensus used by a diverse panel of stakeholders to reconcile two sets of quality improvement priorities (provider/decision maker priorities n=9; patient/family priorities n=19) into a single prioritized list. We employed a modified Delphi process with a diverse group of panellists to reconcile priorities for improving care of critically ill patients in the intensive care unit (ICU). Proceedings were audio-recorded, transcribed and analysed using qualitative content analysis to explore the decision-making process for establishing consensus. Nine panellists including three providers, three decision makers and three family members of previously critically ill patients. Panellists rated and revised 28 priorities over three rounds of review and reached consensus on the "Top 5" priorities for quality improvement: transition of patient care from ICU to hospital ward; family presence and effective communication; delirium screening and management; early mobilization; and transition of patient care between ICU providers. Four themes were identified as important for establishing consensus: storytelling (sharing personal experiences), amalgamating priorities (negotiating priority scope), considering evaluation criteria and having a priority champion. Our study demonstrates the feasibility of incorporating families of patients into a multistakeholder prioritization exercise. The approach described can be used to guide consensus building and reconcile priorities of diverse stakeholder groups. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

The transition of young adults with lifelong urological needs from pediatric to adult services: An international children's continence society position statement.

PubMed

Bower, Wendy F; Christie, Deborah; DeGennaro, Mario; Latthe, Pallavi; Raes, Ann; Romao, Rodrigo L P; Taghizadeh, Arash; Wood, Dan; Woodhouse, Christopher R J; Bauer, Stuart B

2017-03-01

Children with urinary tract disorders managed by teams, or individual pediatricians, urologists, nephrologists, gastroenterologists, neurologists, psychologists, and nurses at some point move from child-centered to adult-centered health systems. The actual physical change is referred to as the transfer whilst the process preceding this move constitutes transition of care. Our aims are twofold: to identify management and health-service problems related to children with congenital or acquired urological conditions who advance into adulthood and the clinical implications this has for long-term health and specialist care; and, to understand the issues facing both pediatric and adult-care clinicians and to develop a systems-approach model that meets the needs of young adults, their families and the clinicians working within adult services. Information was gleaned from presentations at an International Children's Continence Society meeting with collaboration from the International Continence Society, that discussed problems of transfer and transitioning such children. Several specialists attending this conference finalized this document identifying issues and highlighting ways to ease this transition and transfer of care for both patients and practitioners. The consensus was, urological patients with congenital or other lifelong care needs, are now entering adulthood in larger numbers than previously, necessitating new planning processes for tailored transfer of management. Adult teams must become familiar with new clinical problems in multiple organ systems and anticipate issues provoked by adolescence and physical growth. During this period of transitional care the clinician or team assists young patients to build attitudes, skills and understanding of processes needed to maximize function of their urinary tract-thus taking responsibility for their own healthcare needs. Preparation must also address, negotiating adult health care systems, psychosocial, educational or vocational issues, and mental wellbeing. Transitioning and transfer of children with major congenital anomalies to clinicians potentially unfamiliar with their conditions requires improved education both for receiving doctors and children's families. Early initiation of the transition process should allow the transference to take place at appropriate times based on the child's development, and environmental and financial factors. Neurourol. Urodynam. 36:811-819, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

The ED-inpatient dashboard: Uniting emergency and inpatient clinicians to improve the efficiency and quality of care for patients requiring emergency admission to hospital.

PubMed

Staib, Andrew; Sullivan, Clair; Jones, Matt; Griffin, Bronwyn; Bell, Anthony; Scott, Ian

2017-06-01

Patients who require emergency admission to hospital require complex care that can be fragmented, occurring in the ED, across the ED-inpatient interface (EDii) and subsequently, in their destination inpatient ward. Our hospital had poor process efficiency with slow transit times for patients requiring emergency care. ED clinicians alone were able to improve the processes and length of stay for the patients discharged directly from the ED. However, improving the efficiency of care for patients requiring emergency admission to true inpatient wards required collaboration with reluctant inpatient clinicians. The inpatient teams were uninterested in improving time-based measures of care in isolation, but they were motivated by improving patient outcomes. We developed a dashboard showing process measures such as 4 h rule compliance rate coupled with clinically important outcome measures such as inpatient mortality. The EDii dashboard helped unite both ED and inpatient teams in clinical redesign to improve both efficiencies of care and patient outcomes. © 2016 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Atomizing nozzle and process

DOEpatents

Anderson, I.E.; Figliola, R.S.; Molnar, H.M.

1993-07-20

High pressure atomizing nozzle includes a high pressure gas manifold having a divergent expansion chamber between a gas inlet and arcuate manifold segment to minimize standing shock wave patterns in the manifold and thereby improve filling of the manifold with high pressure gas for improved melt atomization. The atomizing nozzle is especially useful in atomizing rare earth-transition metal alloys to form fine powder particles wherein a majority of the powder particles exhibit particle sizes having near-optimum magnetic properties.

Atomizing nozzle and process

DOEpatents

Anderson, Iver E.; Figliola, Richard S.; Molnar, Holly M.

1992-06-30

High pressure atomizing nozzle includes a high pressure gas manifold having a divergent expansion chamber between a gas inlet and arcuate manifold segment to minimize standing shock wave patterns in the manifold and thereby improve filling of the manifold with high pressure gas for improved melt atomization. The atomizing nozzle is especially useful in atomizing rare earth-transition metal alloys to form fine powder particles wherein a majority of the powder particles exhibit particle sizes having near-optimum magnetic properties.

International education and reflection: transition of Swedish and American nursing students to authenticity.

PubMed

Lepp, Margret; Zorn, CeCelia R; Duffy, Patricia R; Dickson, Rana J

2003-01-01

Reflection, a process grounded in distancing from the self to enhance self-awareness, can be used as a pedagogic activity to promote students' transition to a greater authenticity and professionalism and, therefore, improve patient care and nursing practice. In this international educational project (implemented in 2001) using interactive videoconferencing technology (IVC), Swedish and U.S. nursing students and faculty incorporated reflective journaling, drama in education, photolanguage, and off-air meeting discussions to enhance personal and professional development. Highlights from the literature, a description of the project, and student and faculty appraisals are presented.

Paradox of integration-A computational model

NASA Astrophysics Data System (ADS)

Krawczyk, Małgorzata J.; Kułakowski, Krzysztof

2017-02-01

The paradoxical aspect of integration of a social group has been highlighted by Blau (1964). During the integration process, the group members simultaneously compete for social status and play the role of the audience. Here we show that when the competition prevails over the desire of approval, a sharp transition breaks all friendly relations. However, as was described by Blau, people with high status are inclined to bother more with acceptance of others; this is achieved by praising others and revealing her/his own weak points. In our model, this action smooths the transition and improves interpersonal relations.

Benefits of Using the "NADE Self-Evaluation Guides" for Program Development, Improvement, and Evaluation

ERIC Educational Resources Information Center

Neuburger, Jane

2018-01-01

The "NADE Self-Evaluation Guides" are a compendium of best practices in four areas: (1) Tutoring Services; (2) Course-based Learning Assistance; (3) the Teaching & Learning Process; and (4) Developmental Coursework, also recently known as transitional, co-requisite, accelerated, or bridge programs, all of which are…

Deflagration to Detonation Transition Processes in Pulsed Detonation Engines

DTIC Science & Technology

2002-08-03

which subsequently leads to DDT. The modelling approach taken here is as outlined by Arntzen et al. [9] and features a fractal based eddy-breakup... Arntzen , B.J., Hjertager, B., Lindstedt, R.P., Mercx, W.P.M. and Popat, N. “Investigations to Improve and Assess the Accuracy of Computational Fluid

An Analysis of Gateway Technical College Instructors' Opinions on Secondary and Postsecondary Program Alignment

ERIC Educational Resources Information Center

Albrecht, Bryan D.

2011-01-01

The purpose of this study was to determine what opinions Gateway Technical College instructors had toward secondary and postsecondary program alignment. Student transition is critical to supporting the mission and vision of Gateway Technical College. The impetus for this study was twofold. First, the quality improvement process established at…

Preparation and modification of VO2 thin film on R-sapphire substrate by rapid thermal process

NASA Astrophysics Data System (ADS)

Zhu, Nai-Wei; Hu, Ming; Xia, Xiao-Xu; Wei, Xiao-Ying; Liang, Ji-Ran

2014-04-01

The VO2 thin film with high performance of metal-insulator transition (MIT) is prepared on R-sapphire substrate for the first time by magnetron sputtering with rapid thermal process (RTP). The electrical characteristic and THz transmittance of MIT in VO2 film are studied by four-point probe method and THz time domain spectrum (THz-TDS). X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), atomic force microscopy (AFM), and search engine marketing (SEM) are employed to analyze the crystalline structure, valence state, surface morphology of the film. Results indicate that the properties of VO2 film which is oxidized from the metal vanadium film in oxygen atmosphere are improved with a follow-up RTP modification in nitrogen atmosphere. The crystallization and components of VO2 film are improved and the film becomes compact and uniform. A better phase transition performance is shown that the resistance changes nearly 3 orders of magnitude with a 2-°C hysteresis width and the THz transmittances are reduced by 64% and 60% in thermal and optical excitation respectively.

Assessing and Adapting Scientific Results for Space Weather Research to Operations (R2O)

NASA Astrophysics Data System (ADS)

Thompson, B. J.; Friedl, L.; Halford, A. J.; Mays, M. L.; Pulkkinen, A. A.; Singer, H. J.; Stehr, J. W.

2017-12-01

Why doesn't a solid scientific paper necessarily result in a tangible improvement in space weather capability? A well-known challenge in space weather forecasting is investing effort to turn the results of basic scientific research into operational knowledge. This process is commonly known as "Research to Operations," abbreviated R2O. There are several aspects of this process: 1) How relevant is the scientific result to a particular space weather process? 2) If fully utilized, how much will that result improve the reliability of the forecast for the associated process? 3) How much effort will this transition require? Is it already in a relatively usable form, or will it require a great deal of adaptation? 4) How much burden will be placed on forecasters? Is it "plug-and-play" or will it require effort to operate? 5) How can robust space weather forecasting identify challenges for new research? This presentation will cover several approaches that have potential utility in assessing scientific results for use in space weather research. The demonstration of utility is the first step, relating to the establishment of metrics to ensure that there will be a clear benefit to the end user. The presentation will then move to means of determining cost vs. benefit, (where cost involves the full effort required to transition the science to forecasting, and benefit concerns the improvement of forecast reliability), and conclude with a discussion of the role of end users and forecasters in driving further innovation via "O2R."

Perspectives of Youth in Foster Care on Essential Ingredients for Promoting Self-determination and Successful Transition to Adult Life: My Life Model.

PubMed

Powers, Laurie E; Fullerton, Ann; Schmidt, Jessica; Geenen, Sarah; Oberweiser-Kennedy, Molly; Dohn, JoAnn; Nelson, May; Iavanditti, Rosemary; Blakeslee, Jennifer

2018-02-01

Research clearly documents the serious challenges and poor outcomes experienced by many young people exiting foster care, as well as compounded disparities for the high percentage of youth in care who are identified with disabilities and/or mental health challenges. However, very little research has been conducted to specify or validate effective models for improving the transition trajectories of youth exiting care. Evidence suggests the My Life self-determination enhancement model offers a promising approach for supporting youths' self-determined and positive transition to adulthood. The model includes youth-directed, experientially oriented coaching in the application of self-determination skills to achieve youth-identified transition goals, coupled with peer mentoring workshops that provide opportunities for learning, networking and fun. This in depth qualitative study of 10 youth who completed the My Life intervention focused on investigating coaching and mentoring elements and processes that youth participants identify as most important to their success, with the intention of informing the further development of youth-directed approaches to supporting young people who are transitioning to adulthood. Themes emerged around the centrality of youth self-direction, important processes in the coaching relationship, the essential value of experiential activities and self-determination skill development, and peer mentoring experiences that youth identified as fostering their success. Implications are discussed for research and practice in supporting youth exiting foster care.

“Don't let the world become too small” – How patients with advanced cancer and their significant others cope with transitions during the last year of life. A qualitative study

PubMed

Chabloz-Süssenbach, Christiane; Sailer Schramm, Monique; Stoll, Hansruedi; Spirig, Rebecca

2016-07-01

Background: In the last year of life, persons with advanced cancer and their significant others are affected by several transitions. They perform psychological adjustment processes during transformation. This requires strategies for patients and their significant others. Research in German about this theme is missing. Aim: We explored the experiences with illness management during transitions in the last year of life of patients with advanced cancer and their significant others. Method: In this qualitative study, we conducted structured interviews with five dyads, consisting of persons with Karnofsky Index ≥ 60 % and life expectancy of six to twelve months as well as their significant others. To interpret the interviews, we used qualitative content analysis according to Mayring. Results: The main theme “Don't let the world become too small” expresses that limitations diminished the lifeworld and the participants struggled against this process. This is revealed in three categories: “Being shocked by diagnosis – realigning again”, “Bearing limitations and loss – finding new ways in daily life”, “Living in uncertainty – holding out together”. Conclusions: Patients and significant others live in changing lifeworlds caused by transitions. Health care professionals should be attentive and may gain deeper knowledge about transitions. Further research in German-speaking contexts will help to improve nursing care and psychooncological interventions.

Benefits of a transfer clinic in adolescent and young adult kidney transplant patients.

PubMed

McQuillan, Rory F; Toulany, Alene; Kaufman, Miriam; Schiff, Jeffrey R

2015-01-01

Adolescent and young adult kidney transplant recipients have worse graft outcomes than older and younger age groups. Difficulties in the process of transition, defined as the purposeful, planned movement of adolescents with chronic health conditions from child to adult-centered health care systems, may contribute to this. Improving the process of transition may improve adherence post-transfer to adult care services. The purpose of this study is to investigate whether a kidney transplant transfer clinic for adolescent and young adult kidney transplant recipients transitioning from pediatric to adult care improves adherence post-transfer. We developed a joint kidney transplant transfer clinic between a pediatric kidney transplant program, adult kidney transplant program, and adolescent medicine at two academic health centers. The transfer clinic facilitated communication between the adult and pediatric transplant teams, a face-to-face meeting of the patient with the adult team, and a meeting with the adolescent medicine physician. We compared the outcomes of 16 kidney transplant recipients transferred before the clinic was established with 16 patients who attended the clinic. The primary outcome was a composite measure of non-adherence. Non-adherence was defined as either self-reported medication non-adherence or displaying two of the following three characteristics: non-attendance at clinic, non-attendance for blood work appointments, or undetectable calcineurin inhibitor levels within 1 year post-transfer. The two groups were similar at baseline, with non-adherence identified in 43.75 % of patients. Non-adherent behavior in the year post-transfer, which included missing clinic visits, missing regular blood tests, and undetectable calcineurin inhibitor levels, was significantly lower in the cohort which attended the transfer clinic (18.8 versus 62.5 %, p = 0.03). The median change in estimated glomerular filtration rate (eGFR) in the year following transfer was smaller in the group that attended the transition clinic (-0.9 ± 13.2 ml/min/1.73 m(2)) compared to those who did not (-12.29 ± 14.9 ml/min/1.73 m(2)), p = 0.045. Attendance at a single kidney transplant transfer clinic was associated with improved adherence and renal function in the year following transfer to adult care. If these changes are sustained, they may improve long-term graft outcomes for adolescent kidney transplant recipients.

The pros and cons of code validation

NASA Technical Reports Server (NTRS)

Bobbitt, Percy J.

1988-01-01

Computational and wind tunnel error sources are examined and quantified using specific calculations of experimental data, and a substantial comparison of theoretical and experimental results, or a code validation, is discussed. Wind tunnel error sources considered include wall interference, sting effects, Reynolds number effects, flow quality and transition, and instrumentation such as strain gage balances, electronically scanned pressure systems, hot film gages, hot wire anemometers, and laser velocimeters. Computational error sources include math model equation sets, the solution algorithm, artificial viscosity/dissipation, boundary conditions, the uniqueness of solutions, grid resolution, turbulence modeling, and Reynolds number effects. It is concluded that, although improvements in theory are being made more quickly than in experiments, wind tunnel research has the advantage of the more realistic transition process of a right turbulence model in a free-transition test.

Improved tabletability after a polymorphic transition of delta-mannitol during twin screw granulation.

PubMed

Vanhoorne, V; Bekaert, B; Peeters, E; De Beer, T; Remon, J-P; Vervaet, C

2016-06-15

In most formulations processed via continuous twin screw granulation microcrystalline cellulose (MCC) and/or lactose are used as excipients, but mannitol is also a preferred excipient for wet granulation and tableting due to its non-hygroscopicity and inertness. Therefore, the aim of the current study was to investigate the influence of process parameters on critical quality attributes of granules (moisture content, solid state, morphology, size distribution, specific surface area, friability, flowability and hygroscopicity) and tablets (tensile strength and friability) after twin screw granulation of δ-mannitol. The δ-polymorph was selected since a moisture-induced transformation to β-mannitol was observed during batch wet granulation, which exhibited a unique morphology with a large surface area and improved tabletability. A full factorial experimental design was performed, varying screw speed (400-900rpm), granulation temperature (25-40°C), number of kneading elements (6 or 12) and liquid-to-solid (L/S) ratio, on the granulation unit of a ConsiGma™-25 line (a continuous powder-to-tablet manufacturing system). After tray drying the granules were milled and tableted. The results showed that the polymorphic transition from δ- to β-mannitol also occurred during twin screw granulation, although the residence time and L/S ratios were much lower in continuous twin screw granulation compared to batch processing. However, the polymorphic transition was not complete in all experiments and depended on the L/S ratio, screw speed and number of kneading elements. Nevertheless all granules exhibited the unique morphology linked to the polymorphic transition and had a superior tabletability compared to granules produced with β-mannitol as starting material. This was attributed to enhanced plastic deformation of the granules manufactured using δ-mannitol as starting material. In addition, it was concluded that mannitol was granulated via a different mechanism than other, less-soluble, excipients (e.g. lactose, microcrystalline cellulose) due to its high solubility and dissolution rate as the influence of process parameters on the mannitol granule characteristics was different. Copyright © 2016 Elsevier B.V. All rights reserved.

A Multi-Encoding Approach for LTL Symbolic Satisfiability Checking

NASA Technical Reports Server (NTRS)

Rozier, Kristin Y.; Vardi, Moshe Y.

2011-01-01

Formal behavioral specifications written early in the system-design process and communicated across all design phases have been shown to increase the efficiency, consistency, and quality of the system under development. To prevent introducing design or verification errors, it is crucial to test specifications for satisfiability. Our focus here is on specifications expressed in linear temporal logic (LTL). We introduce a novel encoding of symbolic transition-based Buchi automata and a novel, "sloppy," transition encoding, both of which result in improved scalability. We also define novel BDD variable orders based on tree decomposition of formula parse trees. We describe and extensively test a new multi-encoding approach utilizing these novel encoding techniques to create 30 encoding variations. We show that our novel encodings translate to significant, sometimes exponential, improvement over the current standard encoding for symbolic LTL satisfiability checking.

An innovative model for achieving breast-feeding success in infants with complex surgical anomalies.

PubMed

Edwards, Taryn M; Spatz, Diane L

2010-01-01

This manuscript describes an innovative nurse-driven continuous quality improvement project. Infants born with congenital surgical anomalies face significant challenges within the newborn period and human milk/breast-feeding may not be viewed as a priority. In many hospitals, nurses refer families to lactation consultants for all breast-feeding assistance and support. The Transition to Breast Pathway was developed on the basis of the evidence-based standards and protocols at The Children's Hospital of Philadelphia. The pathway consists of (1) initiation of pumping and maintenance of milk supply, (2) mouth care with human milk, (3) skin-to-skin care, (4) nonnutritive sucking at the breast, (5) transitioning to at breast feeds. A sample of 80 infants were enrolled in this project. Major results of the project are as follows: (1) mother's average milk supply was approximately 603 mL/d, (2) 71% (57/80) of the infants received mouth care with human milk, (3) 48% (38/80) mother/infant dyads performed skin-to-skin care, (4) 60% (35/58) of mother/infant dyads performed nonnutritive sucking at the breast, (5) 100% (58/58) of mother-infant dyads transitioned to breast prior to discharge. This continuous quality improvement project demonstrates that nurses can and should lead the process of transitioning infants to at breast feeds.

Fundamental Physics

NASA Image and Video Library

2003-01-22

Still photographs taken over 16 hours on Nov. 13, 2001, on the International Space Station have been condensed into a few seconds to show the de-mixing -- or phase separation -- process studied by the Experiment on Physics of Colloids in Space. Commanded from the ground, dozens of similar tests have been conducted since the experiment arrived on ISS in 2000. The sample is a mix of polymethylmethacrylate (PMMA or acrylic) colloids, polystyrene polymers and solvents. The circular area is 2 cm (0.8 in.) in diameter. The phase separation process occurs spontaneously after the sample is mechanically mixed. The evolving lighter regions are rich in colloid and have the structure of a liquid. The dark regions are poor in colloids and have the structure of a gas. This behavior carnot be observed on Earth because gravity causes the particles to fall out of solution faster than the phase separation can occur. While similar to a gas-liquid phase transition, the growth rate observed in this test is different from any atomic gas-liquid or liquid-liquid phase transition ever measured experimentally. Ultimately, the sample separates into colloid-poor and colloid-rich areas, just as oil and vinegar separate. The fundamental science of de-mixing in this colloid-polymer sample is the same found in the annealing of metal alloys and plastic polymer blends. Improving the understanding of this process may lead to improving processing of these materials on Earth.

Pharmacist Advancement of Transitions of Care to Home (PATCH) Service.

PubMed

Trang, Joseph; Martinez, Amanda; Aslam, Sadaf; Duong, Minh-Tri

2015-11-01

There is a paucity of literature on a well-defined role of a pharmacist in different aspects of transition of care service (TCS). Although health care institutions have specific details on the discharge process, there is a need for a sustainable TCS with a well-defined role of pharmacists. To describe the impact of a pharmacist-led TCS on acute health care utilization, clinic quality indicators, and identification and resolution of medication-related problems (MRPs). A pharmacist-managed TCS service, referred to as the Pharmacist Advancement of Transitions of Care to Home (PATCH) service, was established at an academic medical center, where high-risk patients received a postdischarge phone call from a pharmacist followed by a face-to-face meeting with the pharmacist and the patient's primary care provider (PCP). In a prospective transitions of care group (n = 74), outcomes of patients such as acute health care utilization (an emergency department visit or an inpatient readmission, within 30 days post discharge), clinic quality indicators, and identification and resolution of MRPs were compared to a retrospective control group (n = 87) who received the standard of care. Utilization of acute health care services was significantly lower in the prospective group compared to the retrospective control group (23% vs 41.4%; P = .013). A total of 49 MRPs were discovered in patients who received the TCS. Pharmacists play an integral role in improving the transitions of care to reduce acute health care utilization. In addition, they may improve care transitions by optimizing clinic quality indicators and by identifying and resolving MRPs.

Turner syndrome: transition from pediatrics to adulthood.

PubMed

Rubin, Karen R

2008-09-01

To highlight the importance of an improved, seamless, and effective transition from pediatric to adult care, especially for medically complex conditions such as Turner syndrome (TS). The morbidities in adult patients with TS are reviewed, including features of the metabolic syndrome, congenital and acquired cardiovascular conditions, osteopenia and osteoporosis, autoimmune thyroid disease, and obesity, and psychobehavioral issues are addressed, in terms of promoting the development of independent self-care and autonomy in adolescent patients. An essential component of high-quality health care, transition for adolescents with TS needs to be reengineered as a staged process initiated during early-stage adolescence (about age 12 years), when exogenous estrogen therapy is begun in coordination with the final phase of growth hormone therapy. At this time, the focus of care shifts from the parent to the adolescent and from maximizing final adult height to inducing puberty with gradually increasing doses of estrogen. During this transition, the development of healthful and independent healthcare behaviors should be promoted to prepare patients with TS for the adult responsibility of self-care. During the final phase of transition, an adult care plan should be formulated in collaboration with the adolescent with TS and her providers of adult care to improve the likelihood that she will continue to be carefully monitored in a way that optimizes her adult health and longevity. The transitional period from pediatrics to adulthood is the ideal time for patients with TS to be made aware of their health history and health needs and of the evolving impact of TS into adulthood.

Era of hospitalists

PubMed Central

Palabindala, Venkataraman; Abdul Salim, Sohail

2018-01-01

ABSTRACT Hospitalists, known as physicians, are an emerging group in the medical field that is focused on the general medical care of hospitalized patients. Specializing in hospital medicine, they often attract a mix of appreciation and criticism. In the present manuscript, we review the pros and cons of a hospitalist in the health-care system. Although experts agree that hospitalists add value to the health-care system by reducing costs, streamlining administrative processes, and contributing to improved health-care outcomes, there is a large degree of disagreement regarding the extent of hospitalist contribution to overall improvements on health-care outcomes. In this paper, new strategies to overcome reported shortcomings and to further improve the quality of health care are discussed. Abbreviations: SHM: Society of Hospital Medicine; BOOST: Better Outcomes by Optimizing Safe Transitions; RED: Re-Engineered Discharge; CHF: chronic heart failure; MI: myocardial infarction; ICU: intensive care unit; PACT: post-acute care transitions; MRSA: methicillin-resistant Staphylococcus aureus; CINAHL: The Cumulative Index to Nursing and Allied Health Literature; PCP: primary care physician. PMID:29441160

Transitioning Communication Education to an Interactive Online Module Format.

PubMed

Williams, Kristine; Abd-Hamid, Nor Hashidah; Perkhounkova, Yelena

2017-07-01

The Changing Talk intervention improves nursing home staff communication by reducing elderspeak. To facilitate dissemination, interactive online modules were created, maintaining the original content. This article reports on the process of transitioning and the results of pilot testing the modules. Interactive online modules were developed, pilot tested, and the evaluated in comparison to outcomes from the classroom format training. Online participants (N = 9) demonstrated pre to posttest knowledge gain (scores improved from M = 82.4% to M = 91.2%). Rating of a staff-resident interaction showed improved recognition of elderspeak and person-centered communication after training. Online and original participants reported similar intentions to use learned skills and rated the program highly. Evidence-based interventions can be translated from traditional classroom to online format maintaining effects on increasing staff knowledge and intentions to use learned skills in practice. However, the modules should be tested in a larger and more representative sample. J Contin Educ Nurs. 2017;48(7):320-328. Copyright 2017, SLACK Incorporated.

Business Process Design Method Based on Business Event Model for Enterprise Information System Integration

NASA Astrophysics Data System (ADS)

Kobayashi, Takashi; Komoda, Norihisa

The traditional business process design methods, in which the usecase is the most typical, have no useful framework to design the activity sequence with. Therefore, the design efficiency and quality vary widely according to the designer’s experience and skill. In this paper, to solve this problem, we propose the business events and their state transition model (a basic business event model) based on the language/action perspective, which is the result in the cognitive science domain. In the business process design, using this model, we decide event occurrence conditions so that every event synchronizes with each other. We also propose the design pattern to decide the event occurrence condition (a business event improvement strategy). Lastly, we apply the business process design method based on the business event model and the business event improvement strategy to the credit card issue process and estimate its effect.

Speech perception in individuals with auditory dys-synchrony: effect of lengthening of voice onset time and burst duration of speech segments.

PubMed

Kumar, U A; Jayaram, M

2013-07-01

The purpose of this study was to evaluate the effect of lengthening of voice onset time and burst duration of selected speech stimuli on perception by individuals with auditory dys-synchrony. This is the second of a series of articles reporting the effect of signal enhancing strategies on speech perception by such individuals. Two experiments were conducted: (1) assessment of the 'just-noticeable difference' for voice onset time and burst duration of speech sounds; and (2) assessment of speech identification scores when speech sounds were modified by lengthening the voice onset time and the burst duration in units of one just-noticeable difference, both in isolation and in combination with each other plus transition duration modification. Lengthening of voice onset time as well as burst duration improved perception of voicing. However, the effect of voice onset time modification was greater than that of burst duration modification. Although combined lengthening of voice onset time, burst duration and transition duration resulted in improved speech perception, the improvement was less than that due to lengthening of transition duration alone. These results suggest that innovative speech processing strategies that enhance temporal cues may benefit individuals with auditory dys-synchrony.

Microstructure examination of Fe-14Cr ODS ferritic steels produced through different processing routes

NASA Astrophysics Data System (ADS)

Oksiuta, Z.; Hosemann, P.; Vogel, S. C.; Baluc, N.

2014-08-01

Various thermo-mechanical treatments were applied to refine and homogenise grain size and improve mechanical properties of hot-isostatically pressed (HIP) 14%Cr ODS ferritic steel. The grain size was reduced, improving mechanical properties, tensile strength and Charpy impact, however bimodal-like distribution was also observed. As a result, larger, frequently elongated grains with size above 1 μm and refined, equiaxed grains with a diameter ranging from 250 to 500 nm. Neutron diffraction measurements revealed that for HIP followed by hydrostatic extrusion material the strongest fiber texture was observed oriented parallel to the extrusion direction. In comparison with hot rolling and hot pressing methods, this material exhibited promising mechanical properties: the ultimate tensile strength of 1350 MPa, yield strength of 1280 MPa, total elongation of 21.7% and Charpy impact energy of 5.8 J. Inferior Charpy impact energy of ∼3.0 J was measured for HIP and hot rolled material, emphasising that parameters of this manufacturing process still have to be optimised. As an alternative manufacturing route, due to the uniform microstructure and simplicity of the process, hot pressing might be a promising method for production of smaller parts of ODS ferritic steels. Besides, the ductile-to-brittle transition temperature of all thermo-mechanically treated materials, in comparison with as-HIPped ODS steel, was improved by more than 50%, the transition temperature ranging from 50 to 70 °C (323 and 343 K) remains still unsatisfactory.

Dynamic coordinated control during mode transition process for a compound power-split hybrid electric vehicle

NASA Astrophysics Data System (ADS)

Su, Yanzhao; Hu, Minghui; Su, Ling; Qin, Datong; Zhang, Tong; Fu, Chunyun

2018-07-01

The fuel economy of the hybrid electric vehicles (HEVs) can be effectively improved by the mode transition (MT). However, for a power-split powertrain whose power-split transmission is directly connected to the engine, the engine ripple torque (ERT), inconsistent dynamic characteristics (IDC) of engine and motors, model estimation inaccuracies (MEI), system parameter uncertainties (SPU) can cause jerk and vibration of transmission system during the MT process, which will reduce the driving comfort and the life of the drive parts. To tackle these problems, a dynamic coordinated control strategy (DCCS), including a staged engine torque feedforward and feedback estimation (ETFBC) and an active damping feedback compensation (ADBC) based on drive shaft torque estimation (DSTE), is proposed. And the effectiveness of this strategy is verified using a plant model. Firstly, the powertrain plant model is established, and the MT process and problems are analyzed. Secondly, considering the characteristics of the engine torque estimation (ETE) model before and after engine ignition, a motor torque compensation control based on the staged ERT estimation is developed. Then, considering the MEI, SPU and the load change, an ADBC based on a real-time nonlinear reduced-order robust observer of the DSTE is designed. Finally, the simulation results show that the proposed DCCS can effectively improve the driving comfort.

Impact of 5 years of lean six sigma in a University Medical Center.

PubMed

Niemeijer, Gerard C; Trip, Albert; de Jong, Laura J; Wendt, Klaus W; Does, Ronald J M M

2012-01-01

Lean Six Sigma (LSS) is an originally industry-based methodology for cost reduction and quality improvement. In more recent years, LSS was introduced in health care as well. This article describes the experiences of the University Medical Center Groningen, the second largest hospital in the Netherlands, with LSS. It was introduced in 2007 to create the financial possibility to develop innovations. In this article, we describe how LSS was introduced, and how it developed in the following years. We zoom in at the traumatology department, where all main processes have been analyzed and improved. An evaluation after 5 years shows that LSS helped indeed reducing cost and improving quality. Moreover, it aided the transition of the organization from purely problem oriented to more process oriented, which in turn is helpful in eliminating waste and finding solutions for difficult problems. A major benefit of the program is that own employees are trained to become project leaders for improvement. Several people from the primary process were thus stimulated and equipped to become role models for continuous improvement.

General Synthesis of Transition-Metal Oxide Hollow Nanospheres/Nitrogen-Doped Graphene Hybrids by Metal-Ammine Complex Chemistry for High-Performance Lithium-Ion Batteries.

PubMed

Chen, Jiayuan; Wu, Xiaofeng; Gong, Yan; Wang, Pengfei; Li, Wenhui; Mo, Shengpeng; Peng, Shengpan; Tan, Qiangqiang; Chen, Yunfa

2018-02-09

We present a general and facile synthesis strategy, on the basis of metal-ammine complex chemistry, for synthesizing hollow transition-metal oxides (Co 3 O 4 , NiO, CuO-Cu 2 O, and ZnO)/nitrogen-doped graphene hybrids, potentially applied in high-performance lithium-ion batteries. The oxygen-containing functional groups of graphene oxide play a prerequisite role in the formation of hollow transition-metal oxides on graphene nanosheets, and a significant hollowing process occurs only when forming metal (Co 2+ , Ni 2+ , Cu 2+ , or Zn 2+ )-ammine complex ions. Moreover, the hollowing process is well correlated with the complexing capacity between metal ions and NH 3 molecules. The significant hollowing process occurs for strong metal-ammine complex ions including Co 2+ , Ni 2+ , Cu 2+ , and Zn 2+ ions, and no hollow structures formed for weak and/or noncomplex Mn 2+ and Fe 3+ ions. Simultaneously, this novel strategy can also achieve the direct doping of nitrogen atoms into the graphene framework. The electrochemical performance of two typical hollow Co 3 O 4 or NiO/nitrogen-doped graphene hybrids was evaluated by their use as anodic materials. It was demonstrated that these unique nanostructured hybrids, in contrast with the bare counterparts, solid transition-metal oxides/nitrogen-doped graphene hybrids, perform with significantly improved specific capacity, superior rate capability, and excellent capacity retention. © 2018 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

The use of transition region characteristics to improve the numerical simulation of heat transfer in bypass transitional flows

NASA Technical Reports Server (NTRS)

Simon, Frederick F.

1993-01-01

A method is presented for improving the numerical prediction of bypass transition heat transfer on a flat plate in a high-disturbance environment with zero or favorable pressure gradient. The method utilizes low Reynolds number k-epsilon turbulence models in combination with the characteristic parameters of the transition region. The parameters representing the characteristics of the transition region used are the intermittency, transition length and turbulent spot properties. An analysis is made of the transition length in terms of turbulent spot variables. The nondimensional spot formation rate, required for the prediction of the transition length, is shown by the analysis to be a function of the spot spreading angle, the dimensionless spot velocity ratio and the dimensionless spot area ratio. The intermittency form of the k-epsilon equations were derived from conditionally averaged equations which have been shown to be an improvement over global-time-averaged equations for the numerical calculation of the transition region. The numerical predictions are in general good agreement with the experimental data and indicate the potential use of the method in accelerating flows. Turbulence models of the k-epsilon type are known to underpredict the transition length. The present work demonstrates how incorporating transition region characteristics improves the ability of two-equation turbulence models to simulate bypass transition for flat plates with potential application to turbine vanes and blades.

Connectedness Is Key: The Evolution of a Process-Driven High School Program

ERIC Educational Resources Information Center

Nitza, Amy; Dobias, Brian

2015-01-01

This article discusses a collaborative project to improve freshman transition into a high school and to increase connectedness among high school students. What started out for the authors, a high school guidance counselor and a counselor educator, as two independent projects on similar topics, evolved in a scholarly partnership that seeks to link…

Reorganizing the General Clinical Research Center to improve the clinical and translational research enterprise.

PubMed

Allen, David; Ripley, Elizabeth; Coe, Antoinette; Clore, John

2013-12-01

In 2010, Virginia Commonwealth University (VCU) was granted a Clinical and Translational Science Award which prompted reorganization and expansion of their clinical research infrastructure. A case study approach is used to describe the implementation of a business and cost recovery model for clinical and translational research and the transformation of VCU's General Clinical Research Center and Clinical Trials Office to a combined Clinical Research Services entity. We outline the use of a Plan, Do, Study, Act cycle that facilitated a thoughtful transition process, which included the identification of required changes and cost recovery processes for implementation. Through this process, the VCU Center for Clinical and Translational Research improved efficiency, increased revenue recovered, reduced costs, and brought a high level of fiscal responsibility through financial reporting.

High-Speed Boundary-Layer Transition: Study of Stationary Crossflow Using Spectral Analysis

NASA Astrophysics Data System (ADS)

McGuire, Patrick Joseph

Crossflow instability is primary cause of boundary-layer transition on swept wings used in high-speed applications. Delaying the downstream location of transition would drastically reduce the viscous drag over the wing surface, and subsequently improves the overall aircraft efficiency. By studying the development of instability growth rates and how they interact with the surroundings, researchers can control the crossflow transition location. Experiments on the 35° swept-wing model were performed in the NASA Langley 20-Inch Supersonic Wind Tunnel with Mach 2.0 flow conditions and 20 μm tall discrete roughness elements (DRE) with varying spacing placed along the leading edge. Fluorene was used as the sublimating chemical in the surface flow visualization technique to observe the transition front and stationary crossflow vortex patterns in the laminar flow region. Spatial spectral decomposition was completed on high-resolution images of sublimating chemical runs using a newly developed image processing technique. Streamwise evolution of the vortex track wavelengths within the laminar boundary-layer region was observed. The spectral information was averaged to produce dominant modes present throughout the laminar region.

Phase Transitions in Antibody Solutions: from Pharmaceuticals to Human Disease

NASA Astrophysics Data System (ADS)

Wang, Ying; Lomakin, Aleksey; Benedek, George; Dana Farber Cancer Institute Collaboration; Amgen Inc. Collaboration

2014-03-01

Antibodies are very important proteins. Natural antibodies play essential role in the immune system of human body. Pharmaceutical antibodies are used as drugs. Antibodies are also indispensable tools in biomedical research and diagnostics. Recently, a number of observations of phase transitions of pharmaceutical antibodies have been reported. These phase transitions are undesirable from the perspective of colloid stability of drug solutions in processing and storage, but can be used for protein purification, X-ray crystallography, and improving pharmokinetics of drugs. Phase transitions of antibodies can also take place in human body, particularly in multiple myeloma patients who overproduce monoclonal antibodies. These antibodies, in some cases, crystallize at body temperature and cause severe complications called cryoglobulinemia. I will present the results of our current studies on phase transitions of both pharmaceutical antibodies and cryoglobulinemia-associated antibodies. These studies have shown that different antibodies have different propensity to undergo phase transitions, but their phase behavior has universal features which are remarkably different from those of spherical proteins. I will discuss how studies of phase behavior can be useful in assessing colloid stability of pharmaceutical antibodies and in early diagnostics of cryoglobulinemia, as well as general implications of the fact that some antibodies can precipitate at physiological conditions.

RECENT TRANSITS OF THE SUPER-EARTH EXOPLANET GJ 1214b

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

Sada, Pedro V.; Deming, Drake; Jackson, Brian

We report recent ground-based photometry of the transiting super-Earth exoplanet GJ 1214b at several wavelengths, including the infrared near 1.25 {mu}m (J band). We observed a J-band transit with the FLAMINGOS infrared imager and the 2.1 m telescope on Kitt Peak, and we observed several optical transits using a 0.5 m telescope on Kitt Peak and the 0.36 m Universidad de Monterrey Observatory telescope. Our high-precision J-band observations exploit the brightness of the M dwarf host star at this infrared wavelength as compared with the optical and are significantly less affected by stellar activity and limb darkening. We fit themore » J-band transit to obtain an independent determination of the planetary and stellar radii. Our radius for the planet (2.61{sup +0.30} {sub -0.11} R {sub +}) is in excellent agreement with the discovery value reported by Charbonneau et al. based on optical data. We demonstrate that the planetary radius is insensitive to degeneracies in the fitting process. We use all of our observations to improve the transit ephemeris, finding P = 1.5804043 {+-} 0.0000005 days and T {sub 0} = 2454964.94390 {+-} 0.00006 BJD.« less

Recent Transits of the Super-Earth Exoplanet GJ 1214B

NASA Technical Reports Server (NTRS)

Sada, Pedro V.; Deming, Drake; Jackson, Brian; Jennings, Donald E.; Peterson, Steven W.; Haase, Flynn; Bays, Kevin; OGorman, Eamon; Lundsford, Alan

2001-01-01

We report recent ground-based photometry of the transiting super-Earth exoplanet GJ1214b at several wavelengths, including the infrared near 1.25 microns (J-band). We observed a J-band transit with the FLAMINGOS infrared imager and the 2.1-meter telescope on Kitt Peak, and we observed several optical transits using a 0.5-meter telescope on Kitt Peak and the 0.36-meter Universidad de Monterrey Observatory telescope. Our high-precision J-band observations exploit the brightness of the M-dwarf host star at this infrared wavelength as compared to the optical, as well as being significantly less affected by stellar activity and limb darkening. We fit the J-band transit to obtain an independent determination of the planetary and stellar radii. Our radius for the planet (2.61 +0.30 / -0.11 Earth radii) is in excellent agreement with the discovery value reported by Charbonneau et al. based on optical data. We demonstrate that the planetary radius is insensitive to degeneracies in the fitting process. We use all of our observations to improve the transit ephemeris, finding P=1.5804043 +/- 0.0000005 days, and T0=2454964.94390 +/- 0.00006 BJD.

Recent Transits of the Super-Earth Exoplanet GJ 1214b

NASA Astrophysics Data System (ADS)

Sada, Pedro V.; Deming, Drake; Jackson, Brian; Jennings, Donald E.; Peterson, Steven W.; Haase, Flynn; Bays, Kevin; O'Gorman, Eamon; Lundsford, Alan

2010-09-01

We report recent ground-based photometry of the transiting super-Earth exoplanet GJ 1214b at several wavelengths, including the infrared near 1.25 μm (J band). We observed a J-band transit with the FLAMINGOS infrared imager and the 2.1 m telescope on Kitt Peak, and we observed several optical transits using a 0.5 m telescope on Kitt Peak and the 0.36 m Universidad de Monterrey Observatory telescope. Our high-precision J-band observations exploit the brightness of the M dwarf host star at this infrared wavelength as compared with the optical and are significantly less affected by stellar activity and limb darkening. We fit the J-band transit to obtain an independent determination of the planetary and stellar radii. Our radius for the planet (2.61+0.30 -0.11 R ⊕) is in excellent agreement with the discovery value reported by Charbonneau et al. based on optical data. We demonstrate that the planetary radius is insensitive to degeneracies in the fitting process. We use all of our observations to improve the transit ephemeris, finding P = 1.5804043 ± 0.0000005 days and T 0 = 2454964.94390 ± 0.00006 BJD.

Becoming an Air Force Nurse: The Experience of Transition A New Perspective of a Known Phenomenon.

PubMed

Chargualaf, Katie A; Tse, Alice M

2017-10-01

Transitions in nursing have consistently been described as complex and stressful. While the literature is replete with studies investigating role transitions in civilian healthcare settings, there is no known research that explores the role transition of experienced nurses who move from civilian to military nursing practice. Using nurses in the U.S. Air Force as an exemplar, this study serves as a starting point to understand the transition process and challenges likely encountered by nurses new to the military. The outcomes of this study could influence future efforts to recruit and retain qualified nurses. A hermeneutic, phenomenologic approach was used to explore and describe the lived experience of transition from civilian staff nurse to Air Force staff nurse. The results indicated that new Air Force nurses encounter challenges related to a lack of knowledge and role preparedness, which led to feelings of stress and frustration. Support from peers, mentors, and managers helped the new Air Force nurses bridge the gap in knowledge and successfully integrate into the military culture. Efforts to reduce the perceived lack of knowledge through improvements to the Commissioned Officer Training program and the clinical orientation period are recommended. © 2016 Wiley Periodicals, Inc.

Automated detection of inaccurate and imprecise transitions in peptide quantification by multiple reaction monitoring mass spectrometry.

PubMed

Abbatiello, Susan E; Mani, D R; Keshishian, Hasmik; Carr, Steven A

2010-02-01

Multiple reaction monitoring mass spectrometry (MRM-MS) of peptides with stable isotope-labeled internal standards (SISs) is increasingly being used to develop quantitative assays for proteins in complex biological matrices. These assays can be highly precise and quantitative, but the frequent occurrence of interferences requires that MRM-MS data be manually reviewed, a time-intensive process subject to human error. We developed an algorithm that identifies inaccurate transition data based on the presence of interfering signal or inconsistent recovery among replicate samples. The algorithm objectively evaluates MRM-MS data with 2 orthogonal approaches. First, it compares the relative product ion intensities of the analyte peptide to those of the SIS peptide and uses a t-test to determine if they are significantly different. A CV is then calculated from the ratio of the analyte peak area to the SIS peak area from the sample replicates. The algorithm identified problematic transitions and achieved accuracies of 94%-100%, with a sensitivity and specificity of 83%-100% for correct identification of errant transitions. The algorithm was robust when challenged with multiple types of interferences and problematic transitions. This algorithm for automated detection of inaccurate and imprecise transitions (AuDIT) in MRM-MS data reduces the time required for manual and subjective inspection of data, improves the overall accuracy of data analysis, and is easily implemented into the standard data-analysis work flow. AuDIT currently works with results exported from MRM-MS data-processing software packages and may be implemented as an analysis tool within such software.

Automated Detection of Inaccurate and Imprecise Transitions in Peptide Quantification by Multiple Reaction Monitoring Mass Spectrometry

PubMed Central

Abbatiello, Susan E.; Mani, D. R.; Keshishian, Hasmik; Carr, Steven A.

2010-01-01

BACKGROUND Multiple reaction monitoring mass spectrometry (MRM-MS) of peptides with stable isotope–labeled internal standards (SISs) is increasingly being used to develop quantitative assays for proteins in complex biological matrices. These assays can be highly precise and quantitative, but the frequent occurrence of interferences requires that MRM-MS data be manually reviewed, a time-intensive process subject to human error. We developed an algorithm that identifies inaccurate transition data based on the presence of interfering signal or inconsistent recovery among replicate samples. METHODS The algorithm objectively evaluates MRM-MS data with 2 orthogonal approaches. First, it compares the relative product ion intensities of the analyte peptide to those of the SIS peptide and uses a t-test to determine if they are significantly different. A CV is then calculated from the ratio of the analyte peak area to the SIS peak area from the sample replicates. RESULTS The algorithm identified problematic transitions and achieved accuracies of 94%–100%, with a sensitivity and specificity of 83%–100% for correct identification of errant transitions. The algorithm was robust when challenged with multiple types of interferences and problematic transitions. CONCLUSIONS This algorithm for automated detection of inaccurate and imprecise transitions (AuDIT) in MRM-MS data reduces the time required for manual and subjective inspection of data, improves the overall accuracy of data analysis, and is easily implemented into the standard data-analysis work flow. AuDIT currently works with results exported from MRM-MS data-processing software packages and may be implemented as an analysis tool within such software. PMID:20022980

Transitioning from caregiver to visitor in a long-term care facility: the experience of caregivers of people with dementia.

PubMed

Crawford, K; Digby, R; Bloomer, M; Tan, H; Williams, A

2015-01-01

Transitioning from the primary caregiver to the visitor in a long-term care facility may be challenging for the caregiver; they are required to surrender their caring duties to the medical and nursing staff. The aim of this study was to explore the experiences of caregivers during their transition from day-to-day caregiver of a person with dementia to a visitor in a long-term care facility. This study utilised a qualitative descriptive design. Twenty caregivers of people with dementia were recruited from the one Aged Rehabilitation and Geriatric Evaluation and Management facility, located in Victoria, Australia. Semi-structured interviews were used to explore the caregiver's experiences. Interviews were analysed using thematic analysis. The interview data revealed that the participants were undergoing similar experiences. The findings revealed that it was difficult for the caregiver to transition to their new role of visitor; negative reactions of grief, loss of motivation and loneliness were also coupled with positive feelings of relief and the reassurance that their relative or friend would be well cared for and safe within the long-term care facility. The findings offer insight into the experiences felt by caregivers when their relative or friend with dementia is admitted to hospital. Implications of this study include the need to improve the transition process for the caregiver by allowing them to be involved in the decision-making process, keeping them informed of care decisions, and importantly, providing emotional support to help the caregiver positively adapt to this transition.

Enhancing success in transition service coordinators: use of transformational leadership.

PubMed

Rearick, Ellen

2007-01-01

The lifespan of children with special healthcare needs has been extended because of improved technology and medical advances. Successful transition to the adult arena of healthcare, social services, and education by adolescents with special healthcare needs (ASHCN) is lacking. The transition service coordinator (TSC) is a multifaceted role of advanced practice nursing that provides highly specialized transition services to adolescents with special healthcare needs. The use of key concepts from the transformational leadership theory may improve healthcare outcomes. This article applies to pediatric and adult primary care and case management services that serve adolescents with special healthcare needs. Employing key concepts of transformational leadership theory will enhance the success of the TSC to improve both collaboration among stakeholders in the transitional team and young adults' transition to the world of adult services. Enhanced communication resulting in improved sharing of information, understanding of the stakeholder roles, and provision of formal linkages between pediatric and adult medical providers is a significant outcome affecting the ASHCN. Improved collaboration will produce a smooth transition for the ASHCN to the world of adult social services education, and employment. Incorporating the transformational leadership dimensions of idealized influence, inspirational motivation intellectual stimulation, and individualized consideration will enhance the ability of the TSC to improve collaboration among stakeholders in the transitional team and the quality of services for the ASHCN.

77 FR 21541 - Notice of Submission for OMB Review; Office of Innovation and Improvement; Transition to Teaching...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-10

... DEPARTMENT OF EDUCATION Notice of Submission for OMB Review; Office of Innovation and Improvement; Transition to Teaching Evaluation SUMMARY: The Transition to Teaching (TTT) grant program provides five- year... records. Title of Collection: Transition to Teaching Evaluation. OMB Control Number: 1855-0018. Type of...

Research on the control strategy of distributed energy resources inverter based on improved virtual synchronous generator.

PubMed

Gao, Changwei; Liu, Xiaoming; Chen, Hai

2017-08-22

This paper focus on the power fluctuations of the virtual synchronous generator(VSG) during the transition process. An improved virtual synchronous generator(IVSG) control strategy based on feed-forward compensation is proposed. Adjustable parameter of the compensation section can be modified to achieve the goal of reducing the order of the system. It can effectively suppress the power fluctuations of the VSG in transient process. To verify the effectiveness of the proposed control strategy for distributed energy resources inverter, the simulation model is set up in MATLAB/SIMULINK platform and physical experiment platform is established. Simulation and experiment results demonstrate the effectiveness of the proposed IVSG control strategy.

Unique variable polarity plasma arc welding for space shuttle

NASA Technical Reports Server (NTRS)

Schwinghamer, R. J.

1985-01-01

Since the introduction of the Plasma Arc Torch in 1955 and subsequent to the work at Boeing in the 1960's, significant improvements crucial to success have been made in the Variable Polarity Plasma Arc (VPPA) Process at the Marshall Space Flight Center. Several very important advantages to this process are given, and the genesis of PA welding, the genesis of VPPA welding, special equiment requirements, weld property development, results with other aluminum alloys, and the eventual successful VPPA transition to production operations are discussed.

The interface between child/adolescent and adult mental health services: results from a European 28-country survey.

PubMed

Signorini, Giulia; Singh, Swaran P; Marsanic, Vlatka Boricevic; Dieleman, Gwen; Dodig-Ćurković, Katarina; Franic, Tomislav; Gerritsen, Suzanne E; Griffin, James; Maras, Athanasios; McNicholas, Fiona; O'Hara, Lesley; Purper-Ouakil, Diane; Paul, Moli; Russet, Frederick; Santosh, Paramala; Schulze, Ulrike; Street, Cathy; Tremmery, Sabine; Tuomainen, Helena; Verhulst, Frank; Warwick, Jane; de Girolamo, Giovanni

2018-04-01

Transition-related discontinuity of care is a major socioeconomic and societal challenge for the EU. The current service configuration, with distinct Child and Adolescent Mental Health (CAMHS) and Adult Mental Health Services (AMHS), is considered a weak link where the care pathway needs to be most robust. Our aim was to delineate transitional policies and care across Europe and to highlight current gaps in care provision at the service interface. An online mapping survey was conducted across all 28 European Countries using a bespoke instrument: The Standardized Assessment Tool for Mental Health Transition (SATMEHT). The survey was directed at expert(s) in each of the 28 EU countries. The response rate was 100%. Country experts commonly (12/28) reported that between 25 and 49% of CAMHS service users will need transitioning to AMHS. Estimates of the percentage of AMHS users aged under 30 years who had has previous contact with CAMHS were most commonly in the region 20-30% (33% on average).Written policies for managing the interface were available in only four countries and half (14/28) indicated that no transition support services were available. This is the first survey of CAMHS transitional policies and care carried out at a European level. Policymaking on transitional care clearly needs special attention and further elaboration. The Milestone Study on transition should provide much needed data on transition processes and outcomes that could form the basis for improving policy and practice in transitional care.

A comprehensive literature review of guidelines facilitating transition of newly graduated nurses to professional nurses.

PubMed

van Rooyen, Dalena R M; Jordan, Portia J; Ten Ham-Baloyi, Wilma; Caka, Ernestina M

2018-05-01

Literature shows that successful transition of newly graduate nurses to professional nurses is imperative but does not always take place, resulting in difficulty in performance, cognizance or behaviour of a role as a nurse, affecting the quality of patient care negatively. No integrative literature review could be found to summarize available guidelines facilitating transition of final year nursing students to professional nurses. An extensive search of the literature by means of an integrative literature review was conducted in 2014 and updated in June 2017, following a five-step process. All relevant studies were subsequently appraised for rigour and quality using the AGREE II tool by two independent reviewers. Eight (n = 8) guidelines on transitions were independently extracted. After thematic analysis was done, three factors to facilitate transition of final year nursing students to professional nurses were found: 1) support for new graduates, 2) the graduate's need for socialization and belonging, and 3) a positive clinical learning environment. The availability and implementation of guidelines on transition of final year nursing students by educational institutions and healthcare facilities could ease the transition from being final year nursing students to becoming professional nurses as well as improve retention of newly qualified professional nurses. Copyright © 2018. Published by Elsevier Ltd.

An aggregate method to calibrate the reference point of cumulative prospect theory-based route choice model for urban transit network

NASA Astrophysics Data System (ADS)

Zhang, Yufeng; Long, Man; Luo, Sida; Bao, Yu; Shen, Hanxia

2015-12-01

Transit route choice model is the key technology of public transit systems planning and management. Traditional route choice models are mostly based on expected utility theory which has an evident shortcoming that it cannot accurately portray travelers' subjective route choice behavior for their risk preferences are not taken into consideration. Cumulative prospect theory (CPT), a brand new theory, can be used to describe travelers' decision-making process under the condition of uncertainty of transit supply and risk preferences of multi-type travelers. The method to calibrate the reference point, a key parameter to CPT-based transit route choice model, determines the precision of the model to a great extent. In this paper, a new method is put forward to obtain the value of reference point which combines theoretical calculation and field investigation results. Comparing the proposed method with traditional method, it shows that the new method can promote the quality of CPT-based model by improving the accuracy in simulating travelers' route choice behaviors based on transit trip investigation from Nanjing City, China. The proposed method is of great significance to logical transit planning and management, and to some extent makes up the defect that obtaining the reference point is solely based on qualitative analysis.

Neuronal excitability level transition induced by electrical stimulation

NASA Astrophysics Data System (ADS)

Florence, G.; Kurths, J.; Machado, B. S.; Fonoff, E. T.; Cerdeira, H. A.; Teixeira, M. J.; Sameshima, K.

2014-12-01

In experimental studies, electrical stimulation (ES) has been applied to induce neuronal activity or to disrupt pathological patterns. Nevertheless, the underlying mechanisms of these activity pattern transitions are not clear. To study these phenomena, we simulated a model of the hippocampal region CA1. The computational simulations using different amplitude levels and duration of ES revealed three states of neuronal excitability: burst-firing mode, depolarization block and spreading depression wave. We used the bifurcation theory to analyse the interference of ES in the cellular excitability and the neuronal dynamics. Understanding this process would help to improve the ES techniques to control some neurological disorders.

Femtosecond laser pulse induced phase transition of Cr-doped Sb2Te1 films studied with a pump-probe system

NASA Astrophysics Data System (ADS)

Jiang, Minghui; Wang, Qing; Lei, Kai; Wang, Yang; Liu, Bo; Song, Zhitang

2016-10-01

The Femtosecond laser pulse induced phase transition dynamics of Cr-doped Sb2Te1 films was studied by real-time reflectivity measurements with a pump-probe system. It was found that crystallization of the as-deposited CrxSb2Te1 phase-change thin films exhibits a multi-stage process lasting for about 40ns.The time required for the multi-stage process seems to be not related to the contents of Cr element. The durations of the crystallization and amorphization processes are approximately the same. Doping Cr into Sb2Te1 thin film can improve its photo-thermal stability without obvious change in the crystallization rate. Optical images and image intensity cross sections are used to visualize the transformed regions. This work may provide further insight into the phase-change mechanism of CrxSb2Te1 under extra-non-equilibrium conditions and aid to develop new ultrafast phase-change memory materials.

Trade and the nutrition transition: strengthening policy for health in the Pacific.

PubMed

Thow, Anne Marie; Heywood, Peter; Schultz, Jimaima; Quested, Christine; Jan, Stephen; Colagiuri, Stephen

2011-01-01

This article describes pathways through which trade policy change in two Pacific Island countries has contributed to changes in the food supply, and thereby to the nutrition transition. The effect of various trade policies from 1960 to 2005 on trends in food imports and availability is described, and case studies are presented for four foods associated with the nutrition transition and chronic disease in the Pacific. Trade policies (including liberalization, export promotion, protection of the domestic meat industry and support for foreign direct investment) have contributed to a reduced availability of traditional staples, and increased availability of foods associated with the nutrition transition, including refined cereals (particularly polished rice and white flour), meat, fats and oils, and processed food products. This study suggests that promoting healthier imports and increasing production of healthier traditional foods, in both of which trade policy has an important effect, has the potential to improve diets and health, in conjunction with other public health intervention.

Detecting critical state before phase transition of complex systems by hidden Markov model

NASA Astrophysics Data System (ADS)

Liu, Rui; Chen, Pei; Li, Yongjun; Chen, Luonan

Identifying the critical state or pre-transition state just before the occurrence of a phase transition is a challenging task, because the state of the system may show little apparent change before this critical transition during the gradual parameter variations. Such dynamics of phase transition is generally composed of three stages, i.e., before-transition state, pre-transition state, and after-transition state, which can be considered as three different Markov processes. Thus, based on this dynamical feature, we present a novel computational method, i.e., hidden Markov model (HMM), to detect the switching point of the two Markov processes from the before-transition state (a stationary Markov process) to the pre-transition state (a time-varying Markov process), thereby identifying the pre-transition state or early-warning signals of the phase transition. To validate the effectiveness, we apply this method to detect the signals of the imminent phase transitions of complex systems based on the simulated datasets, and further identify the pre-transition states as well as their critical modules for three real datasets, i.e., the acute lung injury triggered by phosgene inhalation, MCF-7 human breast cancer caused by heregulin, and HCV-induced dysplasia and hepatocellular carcinoma.

Transitioning from parenteral to inhaled prostacyclin therapy in pulmonary arterial hypertension.

PubMed

Ataya, Ali; Somoracki, Angelina; Cope, Jessica; Alnuaimat, Hassan

2016-10-01

Parenteral prostacyclin therapy for PAH has allowed for improvements in functional status, quality of life and mortality. Parenteral therapies however carry an increased risk of line-associated complications. Inhaled prostacyclins are an attractive alternative therapy; however, limited data exists supporting the safety and outcomes after transition. We describe a retrospective observational analysis of adults with PAH who were transitioned from a parenteral prostacyclin to inhaled treprostinil at our institution. Endpoints include duration of transition, hospital length of stay, adverse effects during transition, and cardiopulmonary function post transition. Eight patients were included, all of which were on triple therapy. Seven patients receiving intravenous prostacyclin therapy were transitioned in an ICU setting, while one patient was transitioned from subcutaneous treprostinil as an outpatient. The average ICU and hospital length of stay was 4.1 ± 0.7 days. Patient preference was the most common reason for transition (n = 5), followed by line complication (n = 2), and intolerance to parenteral therapy (n = 1). One adverse event was observed while initiating inhaled treprostinil that only required slowing of the transition process. On follow-up (19.6 ± 11.1 months) functional class did not change, and non-parametric test showed no change in 6MWD after transition (p = 0.62). One patient failed inhaled therapy necessitating transition back to intravenous therapy. Transitioning patients from parenteral to inhaled prostacyclin therapy can be safely accomplished in specialized centers over a 48-72 h period. Patient preference was overwhelming the most prevalent reason for transition. Copyright © 2016 Elsevier Ltd. All rights reserved.

Nonlinear process in the mode transition in typical strut-based and cavity-strut based scramjet combustors

NASA Astrophysics Data System (ADS)

Yan, Li; Liao, Lei; Huang, Wei; Li, Lang-quan

2018-04-01

The analysis of nonlinear characteristics and control of mode transition process is the crucial issue to enhance the stability and reliability of the dual-mode scramjet engine. In the current study, the mode transition processes in both strut-based combustor and cavity-strut based combustor are numerically studied, and the influence of the cavity on the transition process is analyzed in detail. The simulations are conducted by means of the Reynolds averaged Navier-Stokes (RANS) equations coupled with the renormalization group (RNG) k-ε turbulence model and the single-step chemical reaction mechanism, and this numerical approach is proved to be valid by comparing the predicted results with the available experimental shadowgraphs in the open literature. During the mode transition process, an obvious nonlinear property is observed, namely the unevenly variations of pressure along the combustor. The hysteresis phenomenon is more obvious upstream of the flow field. For the cavity-strut configuration, the whole flow field is more inclined to the supersonic state during the transition process, and it is uneasy to convert to the ramjet mode. In the scram-to-ram transition process, the process would be more stable, and the hysteresis effect would be reduced in the ram-to-scram transition process.

Evaluation of oesophageal transit velocity using the improved Demons technique.

PubMed

De Souza, Michele N; Xavier, Fernando E B; Secaf, Marie; Troncon, Luiz E A; de Oliveira, Ricardo B; Moraes, Eder R

2016-01-01

This paper presents a novel method to compute oesophageal transit velocity in a direct and automatized manner by the registration of scintigraphy images. A total of 36 images from nine healthy volunteers were processed. Four dynamic image series per volunteer were acquired after a minimum 8 h fast. Each acquisition was made following the ingestion of 5 ml saline labelled with about 26 MBq (700 µCi) technetium-99m phytate in a single swallow. Between the acquisitions, another two swallows of 5 ml saline were performed to clear the oesophagus. The composite acquired files were made of 240 frames of anterior and posterior views. Each frame is the accumulate count for 250 ms.At the end of acquisitions, the images were corrected for radioactive decay, the geometric mean was computed between the anterior and posterior views and the registration of a set of subsequent images was performed. Utilizing the improved Demons technique, we obtained from the deformation field the regional resultant velocity, which is directly related to the oesophagus transit velocity. The mean regional resulting velocities decreases progressively from the proximal to the distal oesophageal portions and, at the proximal portion, is virtually identical to the primary peristaltic pump typical velocity. Comparison between this parameter and 'time-activity' curves reveals consistency in velocities obtained using both methods, for the proximal portion. Application of the improved Demons technique, as an easy and automated method to evaluate velocities of oesophageal bolus transit, is feasible and seems to yield consistent data, particularly for the proximal oesophagus.

Transportation and Aging: An Updated Research Agenda to Advance Safe Mobility among Older Adults Transitioning From Driving to Non-driving.

PubMed

Dickerson, Anne E; Molnar, Lisa J; Bédard, Michel; Eby, David W; Berg-Weger, Marla; Choi, Moon; Grigg, Jenai; Horowitz, Amy; Meuser, Thomas; Myers, Anita; O'Connor, Melissa; Silverstein, Nina M

2017-07-29

Engagement in civic, social, and community life plays an important role in health, well-being, and quality of life, and requires individuals to be mobile in their environment. In this article, we review what is currently known about 2 areas relevant to safe mobility for older drivers and identify future research in these areas. Using a framework for transportation and safe mobility, 2 key areas were selected for review: the process of transitioning to non-driving and the maintenance of mobility after driving has ceased. This article serves as a companion to another article that used the same approach to explore safe mobility issues for older adults who are still driving. We found that although there has been progress in supporting transitioning process to non-driving and improving mobility options for older adults following driving cessation, many knowledge gaps still exist. We identified several research topics that would benefit from continued scientific inquiry. In addition, several themes emerged from the review, including the need for: multidisciplinary, community-wide solutions; large-scale, longitudinal studies; improved education and training for older adults and the variety of stakeholders involved in older adult transportation; and the need for programs and interventions that are flexible and responsive to individual needs and situational differences. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Regulation of Pituitary Stem Cells by Epithelial to Mesenchymal Transition Events and Signaling Pathways

PubMed Central

Cheung, Leonard Y. M.; Davis, Shannon W.; Brinkmeier, Michelle L.; Camper, Sally A.; Pérez-Millán, María Inés

2017-01-01

The anterior pituitary gland is comprised of specialized cell-types that produce and secrete polypeptide hormones in response to hypothalamic input and feedback from target organs. These specialized cells arise from stem cells that express SOX2 and the pituitary transcription factor PROP1, which is necessary to establish the stem cell pool and promote an epithelial to mesenchymal-like transition, releasing progenitors from the niche. The adult anterior pituitary responds to physiological challenge by mobilizing the SOX2-expressing progenitor pool and producing additional hormone-producing cells. Knowledge of the role of signaling pathways and extracellular matrix components in these processes may lead to improvements in the efficiency of differentiation of embryonic stem cells or induced pluripotent stem cells into hormone producing cells in vitro. Advances in our basic understanding of pituitary stem cell regulation and differentiation may lead to improved diagnosis and treatment for patients with hypopituitarism. PMID:27650955

A methodology for stochastic analysis of share prices as Markov chains with finite states.

PubMed

Mettle, Felix Okoe; Quaye, Enoch Nii Boi; Laryea, Ravenhill Adjetey

2014-01-01

Price volatilities make stock investments risky, leaving investors in critical position when uncertain decision is made. To improve investor evaluation confidence on exchange markets, while not using time series methodology, we specify equity price change as a stochastic process assumed to possess Markov dependency with respective state transition probabilities matrices following the identified state pace (i.e. decrease, stable or increase). We established that identified states communicate, and that the chains are aperiodic and ergodic thus possessing limiting distributions. We developed a methodology for determining expected mean return time for stock price increases and also establish criteria for improving investment decision based on highest transition probabilities, lowest mean return time and highest limiting distributions. We further developed an R algorithm for running the methodology introduced. The established methodology is applied to selected equities from Ghana Stock Exchange weekly trading data.

Evolution and Initial Experience of a Statewide Care Transitions Quality Improvement Collaborative: Preventing Avoidable Readmissions Together.

PubMed

Axon, R Neal; Cole, Laura; Moonan, Aunyika; Foster, Richard; Cawley, Patrick; Long, Laura; Turley, Christine B

2016-02-01

Increasing scrutiny of hospital readmission rates has spurred a wide variety of quality improvement initiatives. The Preventing Avoidable Readmissions Together (PART) initiative is a statewide quality improvement learning collaborative organized by stakeholder organizations in South Carolina. This descriptive report focused on initial interventions with hospitals. Eligible participants included all acute care hospitals plus home health organizations, nursing facilities, hospices, and other health care organizations. Measures were degree of statewide participation, curricular engagement, adoption of evidence-based improvement strategies, and readmission rate changes. Fifty-nine of 64 (92%) acute care hospitals and 9 of 10 (90%) hospital systems participated in collaborative events. Curricular engagement included: webinars and coaching calls (49/59, 83%), statewide in-person meetings (35/59, 59%), regional in-person meetings (44/59, 75%), and individualized consultations (46/59, 78%). Among 34 (58%) participating hospitals completing a survey at the completion of Year 1, respondents indicated complete implementation of multidisciplinary rounding (58%), post-discharge telephone calls (58%), and teach-back (32%), and implementation in process of high-quality transition records (52%), improved discharge summaries (45%), and timely follow-up appointments (39%). A higher proportion of hospitals had significant decreases (≥10% relative change) in all-cause readmission rates for acute myocardial infarction (55.6% vs. 30.4%, P=0.01), heart failure (54.2% vs. 31.7%, P=0.09), and chronic obstructive pulmonary disease (41.7% vs. 33.3%, P=0.83) between 2011-2013 compared to earlier (2009-2011) trends. Focus on reducing readmissions is driving numerous, sometimes competing, quality improvement initiatives. PART successfully engaged the majority of acute care facilities in one state to harmonize and accelerate adoption of evidence-based care transitions strategies.

Exploring Asperger's Syndrome, Schlossberg's Transition Theory and Federally Mandated Transition Planning: Seeking Improvements

ERIC Educational Resources Information Center

Spencer, Tracy Lynne Wright Lyons

2013-01-01

Federally mandated transition planning has done little to improve the postsecondary outcomes of people with Asperger's syndrome. Current high school transition planning for students with Asperger's attempts to address some of these areas through family involvement, community inclusion, and the active participation of the student in…

Reducing bottlenecks: professionals’ and adolescents’ experiences with transitional care delivery

PubMed Central

2014-01-01

Background The purpose of this study was to describe the interventions implemented in a quality improvement programme to improve transitional care and evaluate its effectiveness in reducing bottlenecks as perceived by professionals and improving chronically ill adolescents’ experiences with care delivery. Methods This longitudinal study was undertaken with adolescents and professionals who participated in the Dutch ‘On Your Own Feet Ahead!’ quality improvement programme. This programme followed the Breakthrough Series improvement and implementation strategy. A total of 102/128 (79.7%) professionals from 21 hospital teams filled out a questionnaire at the start of the programme (T0), and 79/123 (64.2%; five respondents had changed jobs) professionals completed the same questionnaire 1 year later (T1). Seventy-two (58.5%) professionals from 21 teams returned questionnaires at both time points. Of 389 and 430 participating adolescents, 36% and 41% returned questionnaires at T0 and T1, respectively. We used descriptive statistics and two-tailed, paired t-tests to investigate improvements in bottlenecks in transitional care (perceived by professionals) and care delivery (perceived by adolescents). Results Professionals observed improvement in all bottlenecks at T1 (vs. T0; p < 0.05), especially in the organisation of care, such as the presence of a joint mission between paediatric and adult care, coordination of care, and availability of more resources for joint care services. Within a 1-year period, the transition programme improved some aspects of patients’ experiences with care delivery, such as the provision of opportunities for adolescents to visit the clinic alone (p < 0.001) and to decide who should be present during consultations (p < 0.05). Conclusions This study demonstrated that transitional care interventions may improve the organisation and coordination of transitional care and better prepare adolescents for the transition to adult care within a 1-year period. By setting specific goals based on experiences with bottlenecks, the breakthrough approach helped to improve transitional care delivery for adolescents with chronic conditions. PMID:24485282

Decreasing handoff-related care failures in children's hospitals.

PubMed

Bigham, Michael T; Logsdon, Tina R; Manicone, Paul E; Landrigan, Christopher P; Hayes, Leslie W; Randall, Kelly H; Grover, Purva; Collins, Susan B; Ramirez, Dana E; O'Guin, Crystal D; Williams, Catherine I; Warnick, Robin J; Sharek, Paul J

2014-08-01

Patient handoffs in health care require transfer of information, responsibility, and authority between providers. Suboptimal patient handoffs pose a serious safety risk. Studies demonstrating the impact of improved patient handoffs on care failures are lacking. The primary objective of this study was to evaluate the effect of a multihospital collaborative designed to decrease handoff-related care failures. Twenty-three children's hospitals participated in a quality improvement collaborative aimed at reducing handoff-related care failures. The improvement was guided by evidence-based recommendations regarding handoff intent and content, standardized handoff tools/methods, and clear transition of responsibility. Hospitals tailored handoff elements to locally important handoff types. Handoff-related care failures were compared between baseline and 3 intervention periods. Secondary outcomes measured compliance to specific change package elements and balancing measure of staff satisfaction. Twenty-three children's hospitals evaluated 7864 handoffs over the 12-month study period. Handoff-related care failures decreased from baseline (25.8%) to the final intervention period (7.9%) (P < .05). Significant improvement was observed in every handoff type studied. Compliance to change package elements improved (achieving a common understanding about the patient from 86% to 96% [P < .05]; clear transition of responsibility from 92% to 96% [P < .05]; and minimized interruptions and distractions from 84% to 90% [P < .05]) as did overall satisfaction with the handoff (from 55% to 70% [P < .05]). Implementation of a standardized evidence-based handoff process across 23 children's hospitals resulted in a significant decrease in handoff-related care failures, observed over all handoff types. Compliance to critical components of the handoff process improved, as did provider satisfaction. Copyright © 2014 by the American Academy of Pediatrics.

Optimizing Transitions of Care - Hospital to Community.

PubMed

Sheridan, Emily; Thompson, Christine; Pinheiro, Tania; Robinson, Nicole; Davies, Karen; Whitmore, Nancy

2017-01-01

Discharging patients from the hospital is a complex process, and preventing avoidable readmissions has the potential to improve both the quality of life for patients and the financial sustainability of the healthcare system (Alper et al. 2016). Improving the discharge process is one method to mitigate readmission to the hospital. Historically, St. Thomas Elgin General Hospital (STEGH) consistently experienced higher-than-expected readmission rates, and only 41% of discharge summaries were sent from the hospital to the community primary care within 48 hours. In addition, the overall percentage of patients attending a follow-up appointment with a primary care physician within seven days of discharge from hospital was lower than the provincial average. Through engagement with primary care providers (PCPs) and clinical associates (CAs) and with the use of standard work and monitoring organizational metrics, STEGH has achieved significant improvements.

Health-illness transition among persons using advanced medical technology at home.

PubMed

Fex, Angelika; Flensner, Gullvi; Ek, Anna-Christina; Söderhamn, Olle

2011-06-01

This study aimed to elucidate meanings of health-illness transition experiences among adult persons using advanced medical technology at home. As an increasing number of persons perform self-care while using different sorts of advanced medical technology at home, knowledge about health-illness transition experiences in this situation may be useful to caregivers in supporting these patients. A qualitative design was used. Five women and five men, all of whom performed self-care at home, either using long-term oxygen therapy from a ventilator or oxygen cylinder, or performing peritoneal or haemodialysis, were interviewed. Ethics committee approval was obtained. Informed consent was received from all participants, and ethical issues concerning their rights in research were raised. The interviews were analysed using a phenomenological hermeneutical methodology, including both an inductive and a deductive structural analysis. This method offers possibilities to obtain an increased understanding by uncovering a deeper meaning of lived experiences through interviews transcribed as texts. The health-illness transition for adult persons in this context was found to mean a learning process of accepting, managing, adjusting and improving daily life with technology, facilitated by realizing the gain from technology at home. Further, the meaning of the health-illness transition experience was interpreted as contentment with being part of the active and conscious process towards transcending into a new state of living, in which the individual and the technology were in tune. The healthy transition experience was characterized by human growth and becoming. This study elucidates one meaning of health-illness transition experiences in relation to the use of advanced medical technology on a more generic level, independent of the specific type of technology used. A positive attitude towards technology at home facilitates the transition. © 2010 The Authors. Scandinavian Journal of Caring Sciences © 2010 Nordic College of Caring Science.

AFRL Nanoscience Technologies: Applications, Transitions and Innovations

DTIC Science & Technology

2010-01-01

other electromagnetic energy; they can interact with magnetic domains for improved superconductivity; they strengthen metals by resisting the motion of...thick platinum silicide (PtSi) layer on a silicon substrate. The basic research to establish the process of internal photoemission responsible for...pulses, saving 150 lbs per aircraft over the current metal shielding. Electrically conductive coatings using nickel nanostrands are now fielded in other

The Rationale for a Wider Concept of Inclusive Education for Teacher Education: A Case Study of Serbia

ERIC Educational Resources Information Center

Macura-Milovanovic, Suncica; Pantic, Natasa; Closs, Alison

2012-01-01

Teacher education for inclusive education (IE) is recognized as vital for improving quality and equity in education globally. In the Western Balkan countries it is also part of the transition process towards joining the European Union and has attracted international funding for IE-related projects. A key finding from research funded by the…

Student and Early Career Mobility Patterns among Highly Educated People in Germany, Finland, Italy, and the United Kingdom

ERIC Educational Resources Information Center

Lindberg, Matti E.

2009-01-01

This article addresses the question of how great are higher education students' incentives to change study programs or institutions to improve one's personal employability in the course of the higher education-to-work transition process. The posed question is addressed at a system level. Students' mobility between programs and institutions is…

LARC-TPI and new thermoplastic polyimides

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

Yamaguchi, A.; Ohta, M.

1987-02-01

The LARC-TPI linear thermoplastic polyimide has been developed by NASA for high temperature adhesive applications in aerospace structures in the forms of varnish, films, powders, and prepregs. LARC-TPI improves adhesive processability and lowers glass transition temperature, while retaining mechanical, thermal and electrical properties inherent in the polyimides. It may be used as a structural adhesive for metals, composites, ceramics, and films. 8 references.

[The basis of modern technologies in management of health care system].

PubMed

Nemytin, Iu V

2014-12-01

For the development of national heaIth care it is required to implement modern and effective methods and forms of governance. It is necessary to clearly identify transition to process management followed by an introduction of quality management care. It is necessary to create a complete version of the three-level health care system based on the integration into the system "Clinic - Hospital - Rehabilitation", which will ensure resource conservation in general throughout the industry. The most important task is purposeful comprehensive management training for health care--statesmen who have the potential ability to manage. The leader must possess all forms of management and apply them on a scientific basis. Standards and other tools of health management should constantly improve. Standards should be a teaching tool and help to improve the quality and effectiveness of treatment processes, the transition to the single-channel financing--the most advanced form of payment for the medical assistance. This type of financing requires managers to new management approaches, knowledge of business economics. One of the breakthrough objectives is the creation of a new type of health care organizations, which as lead locomotives for a rest.

Leading change: evidence-based transition.

PubMed

Lewis, Brennan; Allen, Stephanie

2015-01-01

The purpose of this article was to provide a framework for evidence-based transition of patient populations within an acute care pediatric institution. Transition within a hospital is foreseeable, given the ever-changing needs of the patients within an evolving healthcare system. These changes include moving patient populations because of expansion, renovation, or cohorting similar patient diagnoses to provide care across a continuum. Over the past 1 to 2 years, Children's Health Children's Medical Center Dallas has experienced a wide variety of transition. To provide a smooth transition for patients and families into new care areas resulting in a healthy work environment for all team members. The planning phase for patient population moves, and transition should address key aspects to include physical location and care flow, supplies and equipment, staffing model and human resources (HR), education and orientation, change process and integrating teams, and family preparation. It is imperative to consider these aspects in order for transitions within a healthcare system to be successful. During a time of such transitions, the clinical nurse specialist (CNS) is a highly valuable team member offering a unique perspective and methodological approach, which is central to the new initiative's overall success. The themes addressed in this article on evidence-based transition are organized according to the CNS spheres of influence: system/organization, patient/family, and nursing. An evidence-based transition plan was developed and implemented successfully with the support from the CNS for 3 patient populations. Organizational leadership gained an increased awareness of the CNS role at the conclusion of each successful transition. The CNS plays a pivotal role as clinical experts and proponents of evidence-based practice and effects change in the system/organization, nursing, and patient/family spheres of influence. While transitions can be a source of stress for leaders and bedside staff, it is also a time that allows for growth and new opportunities for staff and may result in development of a healthier work environment. The CNS is able to provide leadership while working collaboratively to oversee the moves with a forward-thinking approach. There are key components to consider during times of transition. These include (1) organize, plan, and improve work efficiencies during a construction build; (2) identify the key elements for improvement in nurse and patient satisfaction; (3) develop or maintain healthy work environment standards; (4) establish adequate staffing levels and staff education to successfully care for patient populations following transition; and (5) support the staff and patients during transition.

Thermal-hydraulic behavior of a mixed chevron single-pass plate-and-frame heat exchanger

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

Manglik, R.M.; Muley, A.

1995-12-31

Effective heat exchange is very critical for improving the process efficiency and operating economy of chemical and process plants. Here, experimental friction factor and heat transfer data for single-phase water flows in a plate-and-frame heat exchanger are presented. A mixed chevron plate arrangement with {beta} = 30{degree}/60{degree} in a single-pass U-type, counterflow configuration is employed. The friction factor and heat transfer data are for isothermal flow and cooling conditions, respectively, and the flow rates correspond to transition and turbulent flow regimes (300 < Re < 6,000 and 2.4 < Pr < 4.5). Based on these data, Nusselt number and frictionmore » factor correlations for fully developed turbulent flows (Re {ge} 1,000) are presented. The results highlight the effects of {beta} on the thermal-hydraulic performance, transition to turbulent flows, and the relative impact of using symmetric or mixed chevron plate arrangements.« less

Energy-efficient biomass processing with pulsed electric fields for bioeconomy and sustainable development.

PubMed

Golberg, Alexander; Sack, Martin; Teissie, Justin; Pataro, Gianpiero; Pliquett, Uwe; Saulis, Gintautas; Stefan, Töpfl; Miklavcic, Damijan; Vorobiev, Eugene; Frey, Wolfgang

2016-01-01

Fossil resources-free sustainable development can be achieved through a transition to bioeconomy, an economy based on sustainable biomass-derived food, feed, chemicals, materials, and fuels. However, the transition to bioeconomy requires development of new energy-efficient technologies and processes to manipulate biomass feed stocks and their conversion into useful products, a collective term for which is biorefinery. One of the technological platforms that will enable various pathways of biomass conversion is based on pulsed electric fields applications (PEF). Energy efficiency of PEF treatment is achieved by specific increase of cell membrane permeability, a phenomenon known as membrane electroporation. Here, we review the opportunities that PEF and electroporation provide for the development of sustainable biorefineries. We describe the use of PEF treatment in biomass engineering, drying, deconstruction, extraction of phytochemicals, improvement of fermentations, and biogas production. These applications show the potential of PEF and consequent membrane electroporation to enable the bioeconomy and sustainable development.

Movie of phase separation during physics of colloids in space experiment

NASA Technical Reports Server (NTRS)

2002-01-01

Still photographs taken over 16 hours on Nov. 13, 2001, on the International Space Station have been condensed into a few seconds to show the de-mixing -- or phase separation -- process studied by the Experiment on Physics of Colloids in Space. Commanded from the ground, dozens of similar tests have been conducted since the experiment arrived on ISS in 2000. The sample is a mix of polymethylmethacrylate (PMMA or acrylic) colloids, polystyrene polymers and solvents. The circular area in the video is 2 cm (0.8 in.) in diameter. The phase separation process occurs spontaneously after the sample is mechanically mixed. The evolving lighter regions are rich in colloid and have the structure of a liquid. The dark regions are poor in colloids and have the structure of a gas. This behavior carnot be observed on Earth because gravity causes the particles to fall out of solution faster than the phase separation can occur. While similar to a gas-liquid phase transition, the growth rate observed in this test is different from any atomic gas-liquid or liquid-liquid phase transition ever measured experimentally. Ultimately, the sample separates into colloid-poor and colloid-rich areas, just as oil and vinegar separate. The fundamental science of de-mixing in this colloid-polymer sample is the same found in the annealing of metal alloys and plastic polymer blends. Improving the understanding of this process may lead to improving processing of these materials on Earth.

Phase separation during the Experiment on Physics of Colloids in Space

NASA Technical Reports Server (NTRS)

2003-01-01

Still photographs taken over 16 hours on Nov. 13, 2001, on the International Space Station have been condensed into a few seconds to show the de-mixing -- or phase separation -- process studied by the Experiment on Physics of Colloids in Space. Commanded from the ground, dozens of similar tests have been conducted since the experiment arrived on ISS in 2000. The sample is a mix of polymethylmethacrylate (PMMA or acrylic) colloids, polystyrene polymers and solvents. The circular area is 2 cm (0.8 in.) in diameter. The phase separation process occurs spontaneously after the sample is mechanically mixed. The evolving lighter regions are rich in colloid and have the structure of a liquid. The dark regions are poor in colloids and have the structure of a gas. This behavior carnot be observed on Earth because gravity causes the particles to fall out of solution faster than the phase separation can occur. While similar to a gas-liquid phase transition, the growth rate observed in this test is different from any atomic gas-liquid or liquid-liquid phase transition ever measured experimentally. Ultimately, the sample separates into colloid-poor and colloid-rich areas, just as oil and vinegar separate. The fundamental science of de-mixing in this colloid-polymer sample is the same found in the annealing of metal alloys and plastic polymer blends. Improving the understanding of this process may lead to improving processing of these materials on Earth.

Imide Oligomers Containing Pendent and Terminal Phenylethynyl Groups-2

NASA Technical Reports Server (NTRS)

Connell, J. W.; Smith, J. G., Jr.; Hergenrother, P. M.

1998-01-01

As part of a program to develop high-performance/high-temperature structural resins for aeronautical applications, imide oligomers containing pendent and terminal phenylethynyl groups were prepared, characterized and the cured resins evaluated as composite matrices. The oligomers were prepared at a calculated number-average molecular weight of 5000 g/mol and contained 15-20 mol% pendent phenylethynyl groups. In previous work, an oligomer containing pendent and terminal phenylethynyl groups exhibited a high glass transition temperature (approximately 313 C), and laminates therefrom exhibited high compressive properties, but processability, fracture toughness, microcrack resistance and damage tolerance were less than desired. In an attempt to improve these deficiencies, modifications in the oligomeric backbone involving the incorporation of 1,3-bis(3-aminophenoxy)benzene were investigated as a means of improving processability and toughness without detracting from the high glass transition temperature and high compressive properties. The amide acid oligomeric solutions were prepared in N-methyl-2-pyrrolidinone and were subsequently processed into imide powder, thin films, adhesive tape and carbon fiber prepreg. Neat resin plaques were fabricated from imide powder by compression moulding. The maximum processing pressure was 1.4 MPa and the cure temperature ranged from 350 to 371 C for 1 h for the mouldings, adhesives, films and composites. The properties of the 1,3-bis(3-aniinophenoxy)benzene modified cured imide oligomers containing pendent and terminal phenylethynyl groups are compared with those of previously prepared oligomers containing pendent and terminal phenylethynyl groups of similar composition and molecular weight.

Implementation of a Transition Model in a NASA Code and Validation Using Heat Transfer Data on a Turbine Blade

NASA Technical Reports Server (NTRS)

Ameri, Ali A.

2012-01-01

The purpose of this report is to summarize and document the work done to enable a NASA CFD code to model laminar-turbulent transition process on an isolated turbine blade. The ultimate purpose of the present work is to down-select a transition model that would allow the flow simulation of a variable speed power turbine to be accurately performed. The flow modeling in its final form will account for the blade row interactions and their effects on transition which would lead to accurate accounting for losses. The present work only concerns itself with steady flows of variable inlet turbulence. The low Reynolds number k- model of Wilcox and a modified version of the same model will be used for modeling of transition on experimentally measured blade pressure and heat transfer. It will be shown that the k- model and its modified variant fail to simulate the transition with any degree of accuracy. A case is thus made for the adoption of more accurate transition models. Three-equation models based on the work of Mayle on Laminar Kinetic Energy were explored. The three-equation model of Walters and Leylek was thought to be in a relatively mature state of development and was implemented in the Glenn-HT code. Two-dimensional heat transfer predictions of flat plate flow and two-dimensional and three-dimensional heat transfer predictions on a turbine blade were performed and reported herein. Surface heat transfer rate serves as sensitive indicator of transition. With the newly implemented model, it was shown that the simulation of transition process is much improved over the baseline k- model for the single Reynolds number and pressure ratio attempted; while agreement with heat transfer data became more satisfactory. Armed with the new transition model, total-pressure losses of computed three-dimensional flow of E3 tip section cascade were compared to the experimental data for a range of incidence angles. The results obtained, form a partial loss bucket for the chosen blade. In time the loss bucket will be populated with losses at additional incidences. Results obtained thus far will be discussed herein.

Towards a voxel-based geographic automata for the simulation of geospatial processes

NASA Astrophysics Data System (ADS)

Jjumba, Anthony; Dragićević, Suzana

2016-07-01

Many geographic processes evolve in a three dimensional space and time continuum. However, when they are represented with the aid of geographic information systems (GIS) or geosimulation models they are modelled in a framework of two-dimensional space with an added temporal component. The objective of this study is to propose the design and implementation of voxel-based automata as a methodological approach for representing spatial processes evolving in the four-dimensional (4D) space-time domain. Similar to geographic automata models which are developed to capture and forecast geospatial processes that change in a two-dimensional spatial framework using cells (raster geospatial data), voxel automata rely on the automata theory and use three-dimensional volumetric units (voxels). Transition rules have been developed to represent various spatial processes which range from the movement of an object in 3D to the diffusion of airborne particles and landslide simulation. In addition, the proposed 4D models demonstrate that complex processes can be readily reproduced from simple transition functions without complex methodological approaches. The voxel-based automata approach provides a unique basis to model geospatial processes in 4D for the purpose of improving representation, analysis and understanding their spatiotemporal dynamics. This study contributes to the advancement of the concepts and framework of 4D GIS.

Wheeled mobility device transportation safety in fixed route and demand-responsive public transit vehicles within the United States.

PubMed

Frost, Karen L; van Roosmalen, Linda; Bertocci, Gina; Cross, Douglas J

2012-01-01

An overview of the current status of wheelchair transportation safety in fixed route and demand-responsive, non-rail, public transportation vehicles within the US is presented. A description of each mode of transportation is provided, followed by a discussion of the primary issues affecting safety, accessibility, and usability. Technologies such as lifts, ramps, securement systems, and occupant restraint systems, along with regulations and voluntary industry standards have been implemented with the intent of improving safety and accessibility for individuals who travel while seated in their wheeled mobility device (e.g., wheelchair or scooter). However, across both fixed route and demand-responsive transit systems a myriad of factors such as nonuse and misuse of safety systems, oversized wheeled mobility devices, vehicle space constraints, and inadequate vehicle operator training may place wheeled mobility device (WhMD) users at risk of injury even under non-impact driving conditions. Since WhMD-related incidents also often occur during the boarding and alighting process, the frequency of these events, along with factors associated with these events are described for each transit mode. Recommendations for improving WhMD transportation are discussed given the current state of

Economic transition and health transition: comparing China and Russia.

PubMed

Liu, Y; Rao, K; Fei, J

1998-05-01

Drawing on experiences from China and Russia (the world's two largest transitional economies), this paper empirically examines the impact of economic reforms on health status. While China's overall health status continued to improve after the economic reform, Russia experienced a serious deterioration in its population health. The observed differences in health performance between China and Russia can be explained by the different impacts of economic reforms on three major socioeconomic determinants of health. Depending on whether or not the reform improves physical environment (as reflected in income level and nutritional status), social environment (including social stability and security system), and health care, we would observe either a positive or a negative net effect on health. Despite remarkable differences in overall health development, China and Russia share some common problems. Mental and social health problems such as suicides and alcohol poisoning have been on the rise in both countries. These problems were much more serious in Russia, where political and social instability was more pronounced, associated with Russia's relatively radical reform process. With their economies moving toward a free market system, health sectors in China and Russia are undergoing marketization, which has had serious detrimental effect on the public health services.

New graduate nurse transition programs: Relationships with bullying and access to support.

PubMed

Rush, Kathy L; Adamack, Monica; Gordon, Jason; Janke, Robert

2014-01-01

Abstract New graduate nurses are often targets of bullying and horizontal violence. The support offered by new graduate nurse transition programs may moderate the effects of bullying and limit its negative impact on new graduate nurse transition. This study examined the relationships between access to support, workplace bullying and new graduate nurse transition within the context of new graduate transition programs. As part of a mixed methods study, an online survey was administered to new graduates (N = 245) approximately a year from starting employment. Bullied new graduate nurses were less able to access support when needed and had poorer transition experiences than their non-bullied peers. Participation in a formal transition program improved access to support and transition for bullied new graduate nurses. People supports within transition programs positively influenced the new graduate nurse transition experience. Formal transition programs provide support that attenuates the impact of bullying on new graduate nurses and improves transition.

New Graduate Transition Programs: Relationships With Access to Support and Bullying.

PubMed

Rush, Kathy L; Adamack, Monica; Gordon, Jason; Janke, Robert

2014-02-03

Abstract New graduate nurses are often targets of bullying and horizontal violence. The support offered by new graduate nurse transition programs may moderate the effects of bullying and limit its negative impact on new graduate nurse transition. This study examined the relationships between access to support, workplace bullying and new graduate nurse transition within the context of New Graduate Transition programs. As part of a mixed methods study, an online survey was administered to new graduates (n=245) approximately a year from starting employment. Bullied new graduate nurses were less able to access support when needed and had poorer transition experiences than their non-bullied peers. Participation in a formal transition program improved access to support and transition for bullied new graduate nurses. People supports within transition programs positively influenced the new graduate nurse transition experience. Formal transition programs provide support that attenuates the impact of bullying on new graduate nurses and improves transition.

Genetic evaluation of mastitis liability and recovery through longitudinal analysis of transition probabilities

PubMed Central

2012-01-01

Background Many methods for the genetic analysis of mastitis use a cross-sectional approach, which omits information on, e.g., repeated mastitis cases during lactation, somatic cell count fluctuations, and recovery process. Acknowledging the dynamic behavior of mastitis during lactation and taking into account that there is more than one binary response variable to consider, can enhance the genetic evaluation of mastitis. Methods Genetic evaluation of mastitis was carried out by modeling the dynamic nature of somatic cell count (SCC) within the lactation. The SCC patterns were captured by modeling transition probabilities between assumed states of mastitis and non-mastitis. A widely dispersed SCC pattern generates high transition probabilities between states and vice versa. This method can model transitions to and from states of infection simultaneously, i.e. both the mastitis liability and the recovery process are considered. A multilevel discrete time survival model was applied to estimate breeding values on simulated data with different dataset sizes, mastitis frequencies, and genetic correlations. Results Correlations between estimated and simulated breeding values showed that the estimated accuracies for mastitis liability were similar to those from previously tested methods that used data of confirmed mastitis cases, while our results were based on SCC as an indicator of mastitis. In addition, unlike the other methods, our method also generates breeding values for the recovery process. Conclusions The developed method provides an effective tool for the genetic evaluation of mastitis when considering the whole disease course and will contribute to improving the genetic evaluation of udder health. PMID:22475575

A role for social workers in improving care setting transitions: a case study.

PubMed

Barber, Ruth D; Coulourides Kogan, Alexis; Riffenburgh, Anne; Enguidanos, Susan

2015-01-01

High 30-day readmission rates are a major burden to the American medical system. Much attention is on transitional care to decrease financial costs and improve patient outcomes. Social workers may be uniquely qualified to improve care transitions and have not previously been used in this role. We present a case study of an older, dually eligible Latina woman who received a social work-driven transition intervention that included in-home and telephone contacts. The patient was not readmitted during the six-month study period, mitigated her high pain levels, and engaged in social outings once again. These findings suggest the value of a social worker in a transitional care role.

Planning ahead for livable communities along the Powell–Division Bus Rapid Transit : neighborhood conditions and change.

DOT National Transportation Integrated Search

2017-07-04

New transit investments can be a double-edged sword for disadvantaged communities (e.g., those included in environmental justice and Title VI protected classes). Transit investments improve communities mobility and access, and may improve health w...

Clinicians’ views on improving inter-organizational care transitions

PubMed Central

2013-01-01

Background Patients with complex health conditions frequently require care from multiple providers and are particularly vulnerable to poorly executed transitions from one healthcare setting to another. Poorly executed care transitions can result in negative patient outcomes (e.g. medication errors, delays in treatment) and increased healthcare spending due to re-hospitalization or emergency room visits by patients. Little is known about care transitions from acute care to complex continuing care and rehabilitation settings. Thus, a qualitative study was undertaken to explore clinicians’ perceptions of strategies aimed at improving patient care transitions from acute care hospitals to complex continuing care and rehabilitation healthcare organizations. Methods A qualitative study using semi-structured interviews was conducted with clinicians employed at two selected healthcare facilities: an acute care hospital and a complex continuing care/rehabilitation organization, respectively. Analysis of the transcripts involved the creation of a coding schema using the content analyses outlined by Ryan and Bernard. In total, 31 interviews were conducted with clinicians at the participating study sites. Results Three themes emerged from the data to delineate what study participants described as strategies to ensure quality inter-organizational transitions of patients transferred from acute care to the complex continuing care and rehabilitation hospital. These themes are: 1) communicating more effectively; 2) being vigilant around the patients’ readiness for transfer and care needs; and 3) documenting more accurately and completely in the patient transfer record. Conclusion Our study provides insights from the perspectives of multiple clinicians that have important implications for health care leaders and clinicians in their efforts to enhance inter-organizational care transitions. Of particular importance is the need to have a collective and collaborative approach amongst clinicians during the inter-organizational care transition process. Study findings also suggest that the written patient transfer record needs to be augmented with a verbal report whereby the receiving clinician has an opportunity to discuss with a clinician from the acute care hospital the patient’s status on discharge and plan of care. Integral to future research efforts is designing and testing out interventions to optimize inter-organizational care transitions and feedback loops for complex medical patients. PMID:23899326

Transition in Education: Policy Making and the Key Educational Policy Areas in the Central-European and Baltic Countries.

ERIC Educational Resources Information Center

Rado, Peter

This report examines transition in educational systems and identifies key policy areas in Central-Eastern European countries. It summarizes policy implications of the transition process within the educational context of these countries. Chapter 1, "Transition and Education," outlines key characteristics of the transition process and…

Real-time video compressing under DSP/BIOS

NASA Astrophysics Data System (ADS)

Chen, Qiu-ping; Li, Gui-ju

2009-10-01

This paper presents real-time MPEG-4 Simple Profile video compressing based on the DSP processor. The programming framework of video compressing is constructed using TMS320C6416 Microprocessor, TDS510 simulator and PC. It uses embedded real-time operating system DSP/BIOS and the API functions to build periodic function, tasks and interruptions etcs. Realize real-time video compressing. To the questions of data transferring among the system. Based on the architecture of the C64x DSP, utilized double buffer switched and EDMA data transfer controller to transit data from external memory to internal, and realize data transition and processing at the same time; the architecture level optimizations are used to improve software pipeline. The system used DSP/BIOS to realize multi-thread scheduling. The whole system realizes high speed transition of a great deal of data. Experimental results show the encoder can realize real-time encoding of 768*576, 25 frame/s video images.

Analyzing power measurements of (d,/sup 2/He) reactions on light nuclei

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

Motobayashi, T.; Sakai, H.; Matsuoka, N.

1986-12-01

Spin-flip charge-exchange (d,/sup 2/He) reactions on /sup 12/C, /sup 13/C, and /sup 14/N were measured at E/sub d/ = 70 MeV. At forward angles, negative vector analyzing powers of -0.2 to -0.6 were observed for ..delta..L = 0 transitions for all targets studied, whereas a positive value was obtained for the transition to the 4.4 MeV excited state of /sup 12/B in the /sup 12/C(d,/sup 2/He) reaction for which ..delta..L = 1 is the main component. Distorted-wave Born-approximation calculations reproduce this ..delta..L dependence of the analyzing power. The fits to the data for ..delta..L = 0 transitions are improved ifmore » the two-step processes via d-p-/sup 2/He and d-/sup 3/He-/sup 2/He channels are taken into account.« less

Sensitive periods in fear learning and memory.

PubMed

King, Elizabeth C; Pattwell, Siobhan S; Glatt, Charles E; Lee, Francis S

2014-01-01

Adolescence represents a uniquely sensitive developmental stage in the transition from childhood to adulthood. During this transition, neuronal circuits are particularly susceptible to modification by experience. In addition, adolescence is a stage in which the incidence of anxiety disorders peaks in humans and over 75% of adults with fear-related disorders met diagnostic criteria as children and adolescents. While postnatal critical periods of plasticity for primary sensory processes, such as in the visual system are well established, less is known about potential critical or sensitive periods for fear learning and memory. Here, we review the non-linear developmental aspects of fear learning and memory during a transition period into and out of adolescence. We also review the literature on the non-linear development of GABAergic neurotransmission, a key regulator of critical period plasticity. We provide a model that may inform improved treatment strategies for children and adolescents with fear-related disorders.

Sensitive periods in fear learning and memory

PubMed Central

King, Elizabeth C.; Pattwell, Siobhan S.; Glatt, Charles E.; Lee, Francis S.

2015-01-01

Adolescence represents a uniquely sensitive developmental stage in the transition from childhood to adulthood. During this transition, neuronal circuits are particularly susceptible to modification by experience. In addition, adolescence is a stage in which the incidence of anxiety disorders peaks in humans and over 75% of adults with fear-related disorders met diagnostic criteria as children and adolescents. While postnatal critical periods of plasticity for primary sensory processes, such as in the visual system are well established, less is known about potential critical or sensitive periods for fear learning and memory. Here, we review the nonlinear developmental aspects of fear learning and memory during a transition period into and out of adolescence. We also review the literature on the non-linear development of GABAergic neurotransmission, a key regulator of critical period plasticity. We provide a model that may inform improved treatment strategies for children and adolescents with fear-related disorders. PMID:23611461

Key Value Considerations for Consultant Pharmacists.

PubMed

Meyer, Lee; Perry, Ronald G; Rhodus, Susan M; Stearns, Wendy

2016-07-01

Managing the efficiency and costs of residents' drug regimens outside the acute-care hospital and through transitions of care requires a toolbox filled with cost-control tools and careful collaboration among the pharmacy provider(s), facility staff, and the consultant/senior care pharmacist. This article will provide the reader with key long-term care business strategies that affect the profitability of the pharmacy provider in various care settings while, at the same time, ensuring optimal therapy for residents as they transition across levels of care. Readers can take away ideas on how to access critical information, what they can do with this information, and how they can improve the overall care process. Four experts in various aspects of pharmacy management share their insights on pharmacy practice issues including formulary management, performance metrics, short-cycle dispensing challenges/solutions, cost-control measures, facility surveys, billing practices, medication reconciliation, prospective medication reviews, and transitions of care.

Advances in the Kepler Transit Search Engine

NASA Astrophysics Data System (ADS)

Jenkins, Jon M.

2016-10-01

Twenty years ago, no planets were known outside our own solar system. Since then, the discoveries of ~1500 exoplanets have radically altered our views of planets and planetary systems. This revolution is due in no small part to the Kepler Mission, which has discovered >1000 of these planets and >4000 planet candidates. While Kepler has shown that small rocky planets and planetary systems are quite common, the quest to find Earth's closest cousins and characterize their atmospheres presses forward with missions such as NASA Explorer Program's Transiting Exoplanet Survey Satellite (TESS) slated for launch in 2017 and ESA's PLATO mission scheduled for launch in 2024. These future missions pose daunting data processing challenges in terms of the number of stars, the amount of data, and the difficulties in detecting weak signatures of transiting small planets against a roaring background. These complications include instrument noise and systematic effects as well as the intrinsic stellar variability of the subjects under scrutiny. In this paper we review recent developments in the Kepler transit search pipeline improving both the yield and reliability of detected transit signatures. Many of the phenomena in light curves that represent noise can also trigger transit detection algorithms. The Kepler Mission has expended great effort in suppressing false positives from its planetary candidate catalogs. Over 18,000 transit-like signatures can be identified for a search across 4 years of data. Most of these signatures are artifacts, not planets. Vetting all such signatures historically takes several months' effort by many individuals. We describe the application of machine learning approaches for the automated vetting and production of planet candidate catalogs. These algorithms can improve the efficiency of the human vetting effort as well as quantifying the likelihood that each candidate is truly a planet. This information is crucial for obtaining valid planet occurrence rates. Machine learning approaches may prove to be critical to the success of future missions such as TESS and PLATO.

Transit signal priority systems application and technology investigation : final report, March 2009.

DOT National Transportation Integrated Search

2009-03-01

This report describes the process and results of research to develop an evaluation process that will : assist NJ Transit in quickly determining which intersections are good candidates for Transit Signal : Priority (TSP). This evaluation process is ap...

An evaluation of transit procurement training.

PubMed

Noland, Robert B; Weiner, Marc D; Klein, Nicholas J; Puniello, Orin D

2017-04-01

We evaluated a training course called "Orientation to Transit Procurement", designed and conducted by the National Transit Institute. This course is designed to provide Federal Transit Administration (FTA) grantees an overview of regulations and best practices related to the procurement process. Our objective in conducting the evaluation was to understand how transit agency staff made changes in procurement practices in response to the course training. The evaluation was mixed mode: an Internet survey followed by in-depth interviews with a small group of respondents. Survey respondents were also provided with an open-ended question providing us with additional context for our evaluation. Results show that the training is substantially successful at meeting the goal of improving procurement practices at transit agencies; indeed, most respondents report making changes at their agencies as the proximate result of the training. This was at odds with our exploration of knowledge of procurement topics, as most respondents gave inaccurate answers on multiple-choice "knowledge questions". This may have been due to question structure or, more likely, the nature of online surveys. Suitable training on the procurement of information technology was also a main concern. The lack of training in this area is indicative of the broader challenge facing public transit agencies in how to incorporate new forms of technology into their existing practices and bureaucratic structures. Copyright © 2016 Elsevier Ltd. All rights reserved.

Transition from the Lactational Amenorrhea Method to other modern family planning methods in rural Bangladesh: barrier analysis and implications for behavior change communication program intervention design.

PubMed

Kouyaté, Robin Anthony; Ahmed, Salahuddin; Haver, Jaime; McKaig, Catharine; Akter, Nargis; Nash-Mercado, Angela; Baqui, Abdullah

2015-06-01

The timely transition from Lactational Amenorrhea Method (LAM)(2) to another modern family planning method contributes to healthy spacing of pregnancies by increasing the adoption of family planning during the first year postpartum. Yet, literature suggests challenges in completing a timely LAM transition. To guide program implementation in Bangladesh, this study identified factors influencing women's transition decisions. Eighty postpartum women, comprising 40 who transitioned from LAM(3) and 40 who did not,(4) participated. Half of each group participated in in-depth interviews to explore the decision-making process. All participants responded to a "Barrier Analysis" questionnaire to identify differences in eight behavioral determinants. More than half of transitioners switched to another modern method before or within the same month that LAM ended. Of the 18 transitioners who delayed,(5) 15 waited for menses to return. For non-transitioners, key barriers included waiting for menses to return, misconceptions on return to fertility, and perceived lack of familial support. The LAM transition can help women prevent unintended pregnancy during the first year postpartum. Increased emphasis on counseling women about the risk of pregnancy, and misconceptions about personal fertility patterns are critical for facilitating the transition. Strategies should also include interventions that train health workers and improve social support. Copyright © 2015. Published by Elsevier Ltd.

Characterization of Hybrid Epoxy Nanocomposites

PubMed Central

Simcha, Shelly; Dotan, Ana; Kenig, Samuel; Dodiuk, Hanna

2012-01-01

This study focused on the effect of Multi Wall Carbon Nanotubes (MWCNT) content and its surface treatment on thermo-mechanical properties of epoxy nanocomposites. MWCNTs were surface treated and incorporated into two epoxy systems. MWCNT's surface treatments were based on: (a) Titania coating obtained by sol-gel process and (b) a nonionic surfactant. Thermo-mechanical properties improvement was obtained following incorporation of treated MWCNT. It was noticed that small amounts of titania coated MWCNT (0.05 wt %) led to an increase in the glass transition temperature and stiffness. The best performance was achieved adding 0.3 wt % titania coated MWCNT where an increase of 10 °C in the glass transition temperature and 30% in storage modulus were obtained. PMID:28348313

Production of Transitional Diffused Layers by Electrospark Coating

NASA Astrophysics Data System (ADS)

Smolentsev, Vladislav P.; Boldyrev, Alexander I.; Smolentsev, Evgeniy V.; Boldyrev, Alexander A.; Mozgalin, Vladislav L.

2018-03-01

The article presents a new method for production of diffused transitional layers with nano- and microthickness by local removal of nanofilms on aluminum alloys. This allows procuring of high-quality coatings on fusible alloys (for example, on aluminum ones) by materials, the melting point of which is 2-3 times higher than that of the basis (for example, of cast iron). This permits imparting new useful properties to workpieces made from light alloys with decent values for electrochemical working. The authors show that application of coatings provides minimum heating of workpieces. This enables the regulation in temperature condition of operating environment and permits efficiency improving during the process of electrochemical working by means of higher density current supply.

Automation and Process Improvement Enables a Small Team to Operate a Low Thrust Mission in Orbit Around the Asteroid Vesta

NASA Technical Reports Server (NTRS)

Weise, Timothy M

2012-01-01

NASA's Dawn mission to the asteroid Vesta and dwarf planet Ceres launched September 27, 2007 and arrived at Vesta in July of 2011. This mission uses ion propulsion to achieve the necessary delta-V to reach and maneuver at Vesta and Ceres. This paper will show how the evolution of ground system automation and process improvement allowed a relatively small engineering team to transition from cruise operations to asteroid operations while maintaining robust processes. The cruise to Vesta phase lasted almost 4 years and consisted of activities that were built with software tools, but each tool was open loop and required engineers to review the output to ensure consistency. Additionally, this same time period was characterized by the evolution from manually retrieved and reviewed data products to automatically generated data products and data value checking. Furthermore, the team originally took about three to four weeks to design and build about four weeks of spacecraft activities, with spacecraft contacts only once a week. Operations around the asteroid Vesta increased the tempo dramatically by transitioning from one contact a week to three or four contacts a week, to fourteen contacts a week (every 12 hours). This was accompanied by a similar increase in activity complexity as well as very fast turn around activity design and build cycles. The design process became more automated and the tools became closed loop, allowing the team to build more activities without sacrificing rigor. Additionally, these activities were dependent on the results of flight system performance, so more automation was added to analyze the flight data and provide results in a timely fashion to feed the design cycle. All of this automation and process improvement enabled up the engineers to focus on other aspects of spacecraft operations, including spacecraft health monitoring and anomaly resolution.

Health transition in Brazil: regional variations and divergence/convergence in mortality.

PubMed

Borges, Gabriel Mendes

2017-08-21

This study analyzes the main characteristics of the health transition in Brazil and its five major regions, using a framework that accounts for regional inequalities in mortality trends. The regional mortality divergence/convergence process is described and discussed by considering the specific contributions of age groups and causes of death in life expectancy variations. Results show that mortality change in Brazil has follow the epidemiologic transition theory to some extent during the period under analysis - for instance, the sharp decline in infant mortality in all regions (first from infectious and parasitic diseases and then from causes associated with the perinatal period) and the increase in the participation of chronic and degenerative diseases as the main cause of death. However, some features of Brazilian transition have not followed the linear and unidirectional pattern proposed by the epidemiologic transition theory, which helps to understand the periods of regional divergence in life expectancy, despite the long-term trends showing reducing regional inequalities. The emergence of HIV/AIDS, the persistence of relatively high levels of other infections and parasitic diseases, the regional differences in the unexpected mortality improvements from cardiovascular diseases, and the rapid and strong variations in mortality from external causes are some of the examples.

Rate Constants for Fine-Structure Excitations in O - H Collisions with Error Bars Obtained by Machine Learning

NASA Astrophysics Data System (ADS)

Vieira, Daniel; Krems, Roman

2017-04-01

Fine-structure transitions in collisions of O(3Pj) with atomic hydrogen are an important cooling mechanism in the interstellar medium; knowledge of the rate coefficients for these transitions has a wide range of astrophysical applications. The accuracy of the theoretical calculation is limited by inaccuracy in the ab initio interaction potentials used in the coupled-channel quantum scattering calculations from which the rate coefficients can be obtained. In this work we use the latest ab initio results for the O(3Pj) + H interaction potentials to improve on previous calculations of the rate coefficients. We further present a machine-learning technique based on Gaussian Process regression to determine the sensitivity of the rate coefficients to variations of the underlying adiabatic interaction potentials. To account for the inaccuracy inherent in the ab initio calculations we compute error bars for the rate coefficients corresponding to 20% variation in each of the interaction potentials. We obtain these error bars by fitting a Gaussian Process model to a data set of potential curves and rate constants. We use the fitted model to do sensitivity analysis, determining the relative importance of individual adiabatic potential curves to a given fine-structure transition. NSERC.

A matter of time: improvement of visual temporal processing during training-induced restoration of light detection performance

PubMed Central

Poggel, Dorothe A.; Treutwein, Bernhard; Sabel, Bernhard A.; Strasburger, Hans

2015-01-01

The issue of how basic sensory and temporal processing are related is still unresolved. We studied temporal processing, as assessed by simple visual reaction times (RT) and double-pulse resolution (DPR), in patients with partial vision loss after visual pathway lesions and investigated whether vision restoration training (VRT), a training program designed to improve light detection performance, would also affect temporal processing. Perimetric and campimetric visual field tests as well as maps of DPR thresholds and RT were acquired before and after a 3 months training period with VRT. Patient performance was compared to that of age-matched healthy subjects. Intact visual field size increased during training. Averaged across the entire visual field, DPR remained constant while RT improved slightly. However, in transition zones between the blind and intact areas (areas of residual vision) where patients had shown between 20 and 80% of stimulus detection probability in pre-training visual field tests, both DPR and RT improved markedly. The magnitude of improvement depended on the defect depth (or degree of intactness) of the respective region at baseline. Inter-individual training outcome variability was very high, with some patients showing little change and others showing performance approaching that of healthy controls. Training-induced improvement of light detection in patients with visual field loss thus generalized to dynamic visual functions. The findings suggest that similar neural mechanisms may underlie the impairment and subsequent training-induced functional recovery of both light detection and temporal processing. PMID:25717307

Implementation and impact of ICD-10 (Part II).

PubMed

Rahmathulla, Gazanfar; Deen, H Gordon; Dokken, Judith A; Pirris, Stephen M; Pichelmann, Mark A; Nottmeier, Eric W; Reimer, Ronald; Wharen, Robert E

2014-01-01

The transition from the International Classification of Disease-9(th) clinical modification to the new ICD-10 was all set to occur on 1 October 2015. The American Medical Association has previously been successful in delaying the transition by over 10 years and has been able to further postpone its introduction to 2015. The new system will overcome many of the limitations present in the older version, thus paving the way to more accurate capture of clinical information. The benefits of the new ICD-10 system include improved quality of care, potential cost savings, reduction of unpaid claims, and improved tracking of healthcare data. The areas where challenges will be evident include planning and implementation, the cost to transition, a shortage of qualified coders, training and education of the healthcare workforce, and a loss of productivity when this occurs. The impacts include substantial costs to the healthcare system, but the projected long-term savings and benefits will be significant. Improved fraud detection, accurate data entry, ability to analyze cost benefits with procedures, and enhanced quality outcome measures are the most significant beneficial factors with this change. The present Current Procedural Terminology and Healthcare Common Procedure Coding System code sets will be used for reporting ambulatory procedures in the same manner as they have been. ICD-10-PCS will replace ICD-9 procedure codes for inpatient hospital services. The ICD-10-CM will replace the clinical code sets. Our article will focus on the challenges to execution of an ICD change and strategies to minimize risk while transitioning to the new system. With the implementation deadline gradually approaching, spine surgery practices that include multidisciplinary health specialists have to anticipate and prepare for the ICD change in order to mitigate risk. Education and communication is the key to this process in spine practices.

Transition to Adult Life for People with Disabilities. Bulletin No. 3.

ERIC Educational Resources Information Center

Fish, John

This document describes and discusses aspects of the transition to adult life for people with disabilities in Great Britain and sets it in an international context. The first three sections describe the transition process, the difficulties of implementing a framework for transition, and the aims of the transition process. The aims are the…

Quantum-enhanced Sensing and Efficient Quantum Computation

DTIC Science & Technology

2015-07-27

accuracy. The system was used to improve quantum boson sampling tests. 15. SUBJECT TERMS EOARD, Quantum Information Processing, Transition Edge Sensors...quantum  boson  sampling (QBS) problem are reported in Ref. [7]. To substantially  increase the scale of feasible tests, we developed a new variation

Noise Enhanced Sensory Signal Processing

DTIC Science & Technology

2012-01-31

Moreover, a contrast sensitivity function (CSF), as an object feature enhancer , was employed for further improving the segmentation performance, which...Digital mammography work appeared in ACM Tech News on Feb. 3, 2010. 8. Interactions/Transitions Invited talks: • P.K. Varshney, “Noise Enhanced ... mammography machines with regard to our work on image enhancement based on SR. • Lectures at Lockheed Martin in Syracuse and SRC that included discussion

Improving your four-dimensional image: traveling through a decade of light-sheet-based fluorescence microscopy research.

PubMed

Strobl, Frederic; Schmitz, Alexander; Stelzer, Ernst H K

2017-06-01

Light-sheet-based fluorescence microscopy features optical sectioning in the excitation process. This reduces phototoxicity and photobleaching by up to four orders of magnitude compared with that caused by confocal fluorescence microscopy, simplifies segmentation and quantification for three-dimensional cell biology, and supports the transition from on-demand to systematic data acquisition in developmental biology applications.

An investigation of transition boiling mechanisms of subcooled water under forced convective conditions

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

Kwang-Won, Lee; Sang-Yong, Lee

1995-09-01

A mechanistic model for forced convective transition boiling has been developed to investigate transition boiling mechanisms and to predict transition boiling heat flux realistically. This model is based on a postulated multi-stage boiling process occurring during the passage time of the elongated vapor blanket specified at a critical heat flux (CHF) condition. Between the departure from nucleate boiling (DNB) and the departure from film boiling (DFB) points, the boiling heat transfer is established through three boiling stages, namely, the macrolayer evaporation and dryout governed by nucleate boiling in a thin liquid film and the unstable film boiling characterized by themore » frequent touches of the interface and the heated wall. The total heat transfer rates after the DNB is weighted by the time fractions of each stage, which are defined as the ratio of each stage duration to the vapor blanket passage time. The model predictions are compared with some available experimental transition boiling data. The parametric effects of pressure, mass flux, inlet subcooling on the transition boiling heat transfer are also investigated. From these comparisons, it can be seen that this model can identify the crucial mechanisms of forced convective transition boiling, and that the transition boiling heat fluxes including the maximum heat flux and the minimum film boiling heat flux are well predicted at low qualities/high pressures near 10 bar. In future, this model will be improved in the unstable film boiling stage and generalized for high quality and low pressure situations.« less

Health Care Transition in Patients With Type 1 Diabetes

PubMed Central

Garvey, Katharine C.; Wolpert, Howard A.; Rhodes, Erinn T.; Laffel, Lori M.; Kleinman, Ken; Beste, Margaret G.; Wolfsdorf, Joseph I.; Finkelstein, Jonathan A.

2012-01-01

OBJECTIVE To examine characteristics of the transition from pediatric to adult care in emerging adults with type 1 diabetes and evaluate associations between transition characteristics and glycemic control. RESEARCH DESIGN AND METHODS We developed and mailed a survey to evaluate the transition process in emerging adults with type 1 diabetes, aged 22 to 30 years, receiving adult diabetes care at a single center. Current A1C data were obtained from the medical record. RESULTS The response rate was 53% (258 of 484 eligible). The mean transition age was 19.5 ± 2.9 years, and 34% reported a gap >6 months in establishing adult care. Common reasons for transition included feeling too old (44%), pediatric provider suggestion (41%), and college (33%). Less than half received an adult provider recommendation and <15% reported having a transition preparation visit or receiving written transition materials. The most recent A1C was 8.1 ± 1.3%. Respondents who felt mostly/completely prepared for transition had lower likelihood of a gap >6 months between pediatric and adult care (adjusted odds ratio 0.47 [95% CI 0.25–0.88]). In multivariate analysis, pretransition A1C (β = 0.49, P < 0.0001), current age (β = −0.07, P = 0.03), and education (β = −0.55, P = 0.01) significantly influenced current posttransition A1C. There was no independent association of transition preparation with posttransition A1C (β = −0.17, P = 0.28). CONCLUSIONS Contemporary transition practices may help prevent gaps between pediatric and adult care but do not appear to promote improvements in A1C. More robust preparation strategies and handoffs between pediatric and adult care should be evaluated. PMID:22699289

450mm wafer patterning with jet and flash imprint lithography

NASA Astrophysics Data System (ADS)

Thompson, Ecron; Hellebrekers, Paul; Hofemann, Paul; LaBrake, Dwayne L.; Resnick, Douglas J.; Sreenivasan, S. V.

2013-09-01

The next step in the evolution of wafer size is 450mm. Any transition in sizing is an enormous task that must account for fabrication space, environmental health and safety concerns, wafer standards, metrology capability, individual process module development and device integration. For 450mm, an aggressive goal of 2018 has been set, with pilot line operation as early as 2016. To address these goals, consortiums have been formed to establish the infrastructure necessary to the transition, with a focus on the development of both process and metrology tools. Central to any process module development, which includes deposition, etch and chemical mechanical polishing is the lithography tool. In order to address the need for early learning and advance process module development, Molecular Imprints Inc. has provided the industry with the first advanced lithography platform, the Imprio® 450, capable of patterning a full 450mm wafer. The Imprio 450 was accepted by Intel at the end of 2012 and is now being used to support the 450mm wafer process development demands as part of a multi-year wafer services contract to facilitate the semiconductor industry's transition to lower cost 450mm wafer production. The Imprio 450 uses a Jet and Flash Imprint Lithography (J-FILTM) process that employs drop dispensing of UV curable resists to assist high resolution patterning for subsequent dry etch pattern transfer. The technology is actively being used to develop solutions for markets including NAND Flash memory, patterned media for hard disk drives and displays. This paper reviews the recent performance of the J-FIL technology (including overlay, throughput and defectivity), mask development improvements provided by Dai Nippon Printing, and the application of the technology to a 450mm lithography platform.

Effects of ward rotation on subsequent transition processes of Japanese clinical nurses.

PubMed

Fujino, Mitsuku; Nojima, Yoshiko

2005-03-01

The purpose of this study was to examine the experience of Japanese clinical nurses undertaking a ward rotation in a general hospital, and its effects on subsequent processes relating to: (i) perception of ward rotation; (ii) reactions to the ward transition process; and (iii) outcomes of ward rotation. In-depth interviews were conducted with 21 Japanese clinical nurses who had an average of 8.8 years (SD = 5.50) clinical experience. Findings indicated that participants experienced role overload, role incongruity and/or role underload, role overqualification, or role ambiguity in the new environment. These role stresses created critical emotional distress during the transition process. The high desire for career development facilitated the transition process, while lack of preparation inhibited the transition process. To facilitate smooth transition, well-prepared and structured supports based on reliable interpersonal relationships are necessary. The findings offer significant cues for effective ward rotation programs. The implication for nursing administrators is that appropriate ward rotations enhance confidence and promote effective role development in the new clinical setting.

A Framework for Supporting Organizational Transition Processes Towards Sustainable Energy Systems

NASA Astrophysics Data System (ADS)

Buch, Rajesh

Economic development over the last century has driven a tripling of the world's population, a twenty-fold increase in fossil fuel consumption, and a tripling of traditional biomass consumption. The associated broad income and wealth inequities are retaining over 2 billion people in poverty. Adding to this, fossil fuel combustion is impacting the environment across spatial and temporal scales and the cost of energy is outpacing all other variable costs for most industries. With 60% of world energy delivered in 2008 consumed by the commercial and industrial sector, the fragmented and disparate energy-related decision making within organizations are largely responsible for the inefficient and impacting use of energy resources. The global transition towards sustainable development will require the collective efforts of national, regional, and local governments, institutions, the private sector, and a well-informed public. The leadership role in this transition could be provided by private and public sector organizations, by way of sustainability-oriented organizations, cultures, and infrastructure. The diversity in literature exemplifies the developing nature of sustainability science, with most sustainability assessment approaches and frameworks lacking transformational characteristics, tending to focus on analytical methods. In general, some shortfalls in sustainability assessment processes include lack of: · thorough stakeholder participation in systems and stakeholder mapping, · participatory envisioning of future sustainable states, · normative aggregation of results to provide an overall measure of sustainability, and · influence within strategic decision-making processes. Specific to energy sustainability assessments, while some authors aggregate results to provide overall sustainability scores, assessments have focused solely on energy supply scenarios, while including the deficits discussed above. This paper presents a framework for supporting organizational transition processes towards sustainable energy systems, using systems and stakeholder mapping, participatory envisioning, and sustainability assessment to prepare the development of transition strategies towards realizing long-term energy sustainability. The energy system at Arizona State University's Tempe campus (ASU) in 2008 was used as a baseline to evaluate the sustainability of the current system. From interviews and participatory workshops, energy system stakeholders provided information to map the current system and measure its performance. Utilizing operationalized principles of energy sustainability, stakeholders envisioned a future sustainable state of the energy system, and then developed strategies to begin transition of the current system to its potential future sustainable state. Key findings include stakeholders recognizing that the current energy system is unsustainable as measured against principles of energy sustainability and an envisioned future sustainable state of the energy system. Also, insufficient governmental stakeholder engagement upstream within the current system could lead to added risk as regulations affect energy supply. Energy demand behavior and consumption patterns are insufficiently understood by current stakeholders, limiting participation and accountability from consumers. In conclusion, although this research study focused on the Tempe campus, ASU could apply this process to other campuses thereby improving overall ASU energy system sustainability. Expanding stakeholder engagement upstream within the energy system and better understanding energy consumption behavior can also improve long-term energy sustainability. Finally, benchmarking ASU's performance against its peer universities could expand the current climate commitment of participants to broader sustainability goals.

Kepler AutoRegressive Planet Search: Motivation & Methodology

NASA Astrophysics Data System (ADS)

Caceres, Gabriel; Feigelson, Eric; Jogesh Babu, G.; Bahamonde, Natalia; Bertin, Karine; Christen, Alejandra; Curé, Michel; Meza, Cristian

2015-08-01

The Kepler AutoRegressive Planet Search (KARPS) project uses statistical methodology associated with autoregressive (AR) processes to model Kepler lightcurves in order to improve exoplanet transit detection in systems with high stellar variability. We also introduce a planet-search algorithm to detect transits in time-series residuals after application of the AR models. One of the main obstacles in detecting faint planetary transits is the intrinsic stellar variability of the host star. The variability displayed by many stars may have autoregressive properties, wherein later flux values are correlated with previous ones in some manner. Auto-Regressive Moving-Average (ARMA) models, Generalized Auto-Regressive Conditional Heteroskedasticity (GARCH), and related models are flexible, phenomenological methods used with great success to model stochastic temporal behaviors in many fields of study, particularly econometrics. Powerful statistical methods are implemented in the public statistical software environment R and its many packages. Modeling involves maximum likelihood fitting, model selection, and residual analysis. These techniques provide a useful framework to model stellar variability and are used in KARPS with the objective of reducing stellar noise to enhance opportunities to find as-yet-undiscovered planets. Our analysis procedure consisting of three steps: pre-processing of the data to remove discontinuities, gaps and outliers; ARMA-type model selection and fitting; and transit signal search of the residuals using a new Transit Comb Filter (TCF) that replaces traditional box-finding algorithms. We apply the procedures to simulated Kepler-like time series with known stellar and planetary signals to evaluate the effectiveness of the KARPS procedures. The ARMA-type modeling is effective at reducing stellar noise, but also reduces and transforms the transit signal into ingress/egress spikes. A periodogram based on the TCF is constructed to concentrate the signal of these periodic spikes. When a periodic transit is found, the model is displayed on a standard period-folded averaged light curve. We also illustrate the efficient coding in R.

Improving mental health service users' with medical co-morbidity transition between tertiary medical hospital and primary care services: a qualitative study.

PubMed

Cranwell, Kate; Polacsek, Meg; McCann, Terence V

2016-07-26

Mental health service users have high rates of medical co-morbidity but frequently experience problems accessing and transitioning between tertiary medical and primary care services. The aim of this study was to identify ways to improve service users' with medical co-morbidity care and experience during their transition between tertiary medical hospitals and primary care services. Experience-based co-design (EBCD) qualitative study incorporating a focus group discussion. The study took place in a large tertiary medical service, incorporating three medical hospitals, and primary care services, in Melbourne, Australia. A purposive sample of service users and their caregivers and tertiary medical and primary care clinicians participated in the focus group discussion, in August 2014. A semi-structured interview guide was used to inform data collection. A thematic analysis of the data was undertaken. Thirteen participants took part in the focus group interview, comprising 5 service users, 2 caregivers and 6 clinicians. Five themes were abstracted from the data, illustrating participants' perspectives about factors that facilitated (clinicians' expertise, engagement and accessibility enhancing transition) and presented as barriers (improving access pathways; enhancing communication and continuity of care; improving clinicians' attitudes; and increasing caregiver participation) to service users' progress through tertiary medical and primary care services. A sixth theme, enhancing service users' transition, incorporated three strategies to enhance their transition through tertiary medical and primary care services. EBCD is a useful approach to collaboratively develop strategies to improve service users' with medical co-morbidity and their caregivers' transition between tertiary medical and primary care services. A whole-of-service approach, incorporating policy development and implementation, change of practice philosophy, professional development education and support for clinicians, and acceptance of the need for caregiver participation, is required to improve service users' transition.

49 CFR 659.31 - Hazard management process.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., operational changes, or other changes within the rail transit environment. (b) The hazard management process must, at a minimum: (1) Define the rail transit agency's approach to hazard management and the... Agency § 659.31 Hazard management process. (a) The oversight agency must require the rail transit agency...

49 CFR 659.31 - Hazard management process.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., operational changes, or other changes within the rail transit environment. (b) The hazard management process must, at a minimum: (1) Define the rail transit agency's approach to hazard management and the... Agency § 659.31 Hazard management process. (a) The oversight agency must require the rail transit agency...

Development of a Logic Model for a Physical Activity–Based Employee Wellness Program for Mass Transit Workers

PubMed Central

Petruzzello, Steven J.; Ryan, Katherine E.

2014-01-01

Transportation workers, who constitute a large sector of the workforce, have worksite factors that harm their health. Worksite wellness programs must target this at-risk population. Although physical activity is often a component of worksite wellness logic models, we consider it the cornerstone for improving the health of mass transit employees. Program theory was based on in-person interviews and focus groups of employees. We identified 4 short-term outcome categories, which provided a chain of responses based on the program activities that should lead to the desired end results. This logic model may have significant public health impact, because it can serve as a framework for other US mass transit districts and worksite populations that face similar barriers to wellness, including truck drivers, railroad employees, and pilots. The objective of this article is to discuss the development of a logic model for a physical activity–based mass-transit employee wellness program by describing the target population, program theory, the components of the logic model, and the process of its development. PMID:25032838

Influence of Nb doping on the phase transition properties of VO2 thin films prepared by ion beam co-sputtering deposition

NASA Astrophysics Data System (ADS)

Zhu, Huiqun; Li, Pengfei; Zhao, Lite; Liu, Jiahuan

2016-03-01

The Nb-doped VO2 thin films were successfully prepared on the glass substrates by ion beam co-sputtering at room temperature and post annealing under the air condition. The effects of the preparation processing and Nb doping on the thermal hysteresis loop and phase transition temperature of the VO2 thin films were analyzed by resistancetemperature measurement. The results show that Nb doping significantly changes the surface morphologies of VO2 thin films, and Nb-doped VO2 thin films exhibit VO2(002) preferred orientation growth with greatly improved crystallinity and orientation. Compared with pure VO2, the phase transition temperature of Nb-doped VO2 thin films drops to 40 ºC, and the width of thermal hysteresis loop narrows to 8 ºC. It is demonstrated that Nb-doped VO2 thin films prepared by ion beam co-sputtered at room temperature have an obvious thermal sensitive effect, and keep a good characteristic from metal to semiconductor phase transition.

Transition dynamics of generalized multiple epileptic seizures associated with thalamic reticular nucleus excitability: A computational study

NASA Astrophysics Data System (ADS)

Liu, Suyu; Wang, Qingyun

2017-11-01

Presently, we improve a computational framework of thalamocortical circuits related to the Taylor's model to investigate the relationship between thalamic reticular nucleus (RE) excitability and epilepsy. By using bifurcation analysis, we explore the RE's excitability dynamics mechanism in the processes of seizure generation, development and transition. Results show that the seizure-free state, absence seizures, clonic seizures and tonic seizures can be formed as the RE excitability is changed in this established model. Importantly, it is verified that physiological changing GABAA inhibition in RE can elicit absence seizures and clonic seizures and the pathological transitions between these two seizures. Furthermore, when the level of AMPA connection is decreased or increased, this proposed model embraces absence seizures and clonic seizures, and tonic seizures, respectively. Except that, bifurcation mechanisms of dynamical transition of different seizures are analyzed in detail. In addition, hybrid regulations of the reticular nucleus excitability for epileptic seizures are proven to be valid within the suitable levels of AMPA and GABAA connection. Hopefully, the obtained results could be helpful for effective control of epileptic activities with additional pharmacological interference.

Development of a logic model for a physical activity-based employee wellness program for mass transit workers.

PubMed

Das, Bhibha M; Petruzzello, Steven J; Ryan, Katherine E

2014-07-17

Transportation workers, who constitute a large sector of the workforce, have worksite factors that harm their health. Worksite wellness programs must target this at-risk population. Although physical activity is often a component of worksite wellness logic models, we consider it the cornerstone for improving the health of mass transit employees. Program theory was based on in-person interviews and focus groups of employees. We identified 4 short-term outcome categories, which provided a chain of responses based on the program activities that should lead to the desired end results. This logic model may have significant public health impact, because it can serve as a framework for other US mass transit districts and worksite populations that face similar barriers to wellness, including truck drivers, railroad employees, and pilots. The objective of this article is to discuss the development of a logic model for a physical activity-based mass-transit employee wellness program by describing the target population, program theory, the components of the logic model, and the process of its development.

NURSING 911: an orientation program to improve retention of online RN-BSN students.

PubMed

Gilmore, Melanie; Lyons, Evadna M

2012-01-01

This article describes the implementation and evaluation of an eight-hour, comprehensive, face-to-face orientation program designed to improve student retention in a newly developed online RN to BSN program. A total of 179 newly enrolled RN to BSN students participated in the orientation program and evaluated the process. Student attrition decreased from 20 percent to less than 1 percent after the orientation program was extended and improved to include a technology assessment and an online practice course. A quality online program requires a well-designed orientation that includes technological assessments and hands-on, active participation by the learner. The newly improved and designed course has become effective in student retention and transition into the online learning environment.

Managing Transition with Support: Experiences of Transition from Child and Adolescent Psychiatry to General Adult Psychiatry Narrated by Young Adults and Relatives

PubMed Central

Söderberg, Siv; Skär, Lisa

2014-01-01

Young adults with mental illness who need continuing care when they turn 18 are referred from child and adolescent psychiatry to general adult psychiatry. During this process, young adults are undergoing multiple transitions as they come of age while they transfer to another unit in healthcare. The aim of this study was to explore expectations and experiences of transition from child and adolescent psychiatry to general adult psychiatry as narrated by young adults and relatives. Individual interviews were conducted with three young adults and six relatives and analysed according to grounded theory. The analysis resulted in a core category: managing transition with support, and three categories: being of age but not mature, walking out of security and into uncertainty, and feeling omitted and handling concerns. The young adults' and relatives' main concerns were that they might be left out and feel uncertainty about the new situation during the transition process. To facilitate the transition process, individual care planning is needed. It is essential that young adults and relatives are participating in the process to be prepared for the changes and achieve a successful transition. Knowledge about the simultaneous processes seems to be an important issue for facilitating transition. PMID:24829900

Exploring business process modelling paradigms and design-time to run-time transitions

NASA Astrophysics Data System (ADS)

Caron, Filip; Vanthienen, Jan

2016-09-01

The business process management literature describes a multitude of approaches (e.g. imperative, declarative or event-driven) that each result in a different mix of process flexibility, compliance, effectiveness and efficiency. Although the use of a single approach over the process lifecycle is often assumed, transitions between approaches at different phases in the process lifecycle may also be considered. This article explores several business process strategies by analysing the approaches at different phases in the process lifecycle as well as the various transitions.

The timing resolution of scintillation-detector systems: Monte Carlo analysis

NASA Astrophysics Data System (ADS)

Choong, Woon-Seng

2009-11-01

Recent advancements in fast scintillating materials and fast photomultiplier tubes (PMTs) have stimulated renewed interest in time-of-flight (TOF) positron emission tomography (PET). It is well known that the improvement in the timing resolution in PET can significantly reduce the noise variance in the reconstructed image resulting in improved image quality. In order to evaluate the timing performance of scintillation detectors used in TOF PET, we use Monte Carlo analysis to model the physical processes (crystal geometry, crystal surface finish, scintillator rise time, scintillator decay time, photoelectron yield, PMT transit time spread, PMT single-electron response, amplifier response and time pick-off method) that can contribute to the timing resolution of scintillation-detector systems. In the Monte Carlo analysis, the photoelectron emissions are modeled by a rate function, which is used to generate the photoelectron time points. The rate function, which is simulated using Geant4, represents the combined intrinsic light emissions of the scintillator and the subsequent light transport through the crystal. The PMT output signal is determined by the superposition of the PMT single-electron response resulting from the photoelectron emissions. The transit time spread and the single-electron gain variation of the PMT are modeled in the analysis. Three practical time pick-off methods are considered in the analysis. Statistically, the best timing resolution is achieved with the first photoelectron timing. The calculated timing resolution suggests that a leading edge discriminator gives better timing performance than a constant fraction discriminator and produces comparable results when a two-threshold or three-threshold discriminator is used. For a typical PMT, the effect of detector noise on the timing resolution is negligible. The calculated timing resolution is found to improve with increasing mean photoelectron yield, decreasing scintillator decay time and decreasing transit time spread. However, only substantial improvement in the timing resolution is obtained with improved transit time spread if the first photoelectron timing is less than the transit time spread. While the calculated timing performance does not seem to be affected by the pixel size of the crystal, it improves for an etched crystal compared to a polished crystal. In addition, the calculated timing resolution degrades with increasing crystal length. These observations can be explained by studying the initial photoelectron rate. Experimental measurements provide reasonably good agreement with the calculated timing resolution. The Monte Carlo analysis developed in this work will allow us to optimize the scintillation detectors for timing and to understand the physical factors limiting their performance.

The timing resolution of scintillation-detector systems: Monte Carlo analysis.

PubMed

Choong, Woon-Seng

2009-11-07

Recent advancements in fast scintillating materials and fast photomultiplier tubes (PMTs) have stimulated renewed interest in time-of-flight (TOF) positron emission tomography (PET). It is well known that the improvement in the timing resolution in PET can significantly reduce the noise variance in the reconstructed image resulting in improved image quality. In order to evaluate the timing performance of scintillation detectors used in TOF PET, we use Monte Carlo analysis to model the physical processes (crystal geometry, crystal surface finish, scintillator rise time, scintillator decay time, photoelectron yield, PMT transit time spread, PMT single-electron response, amplifier response and time pick-off method) that can contribute to the timing resolution of scintillation-detector systems. In the Monte Carlo analysis, the photoelectron emissions are modeled by a rate function, which is used to generate the photoelectron time points. The rate function, which is simulated using Geant4, represents the combined intrinsic light emissions of the scintillator and the subsequent light transport through the crystal. The PMT output signal is determined by the superposition of the PMT single-electron response resulting from the photoelectron emissions. The transit time spread and the single-electron gain variation of the PMT are modeled in the analysis. Three practical time pick-off methods are considered in the analysis. Statistically, the best timing resolution is achieved with the first photoelectron timing. The calculated timing resolution suggests that a leading edge discriminator gives better timing performance than a constant fraction discriminator and produces comparable results when a two-threshold or three-threshold discriminator is used. For a typical PMT, the effect of detector noise on the timing resolution is negligible. The calculated timing resolution is found to improve with increasing mean photoelectron yield, decreasing scintillator decay time and decreasing transit time spread. However, only substantial improvement in the timing resolution is obtained with improved transit time spread if the first photoelectron timing is less than the transit time spread. While the calculated timing performance does not seem to be affected by the pixel size of the crystal, it improves for an etched crystal compared to a polished crystal. In addition, the calculated timing resolution degrades with increasing crystal length. These observations can be explained by studying the initial photoelectron rate. Experimental measurements provide reasonably good agreement with the calculated timing resolution. The Monte Carlo analysis developed in this work will allow us to optimize the scintillation detectors for timing and to understand the physical factors limiting their performance.

Bethe Ansatz for the Weakly Asymmetric Simple Exclusion Process and Phase Transition in the Current Distribution

NASA Astrophysics Data System (ADS)

Simon, Damien

2011-03-01

The probability distribution of the current in the asymmetric simple exclusion process is expected to undergo a phase transition in the regime of weak asymmetry of the jumping rates. This transition was first predicted by Bodineau and Derrida using a linear stability analysis of the hydrodynamical limit of the process and further arguments have been given by Mallick and Prolhac. However it has been impossible so far to study what happens after the transition. The present paper presents an analysis of the large deviation function of the current on both sides of the transition from a Bethe Ansatz approach of the weak asymmetry regime of the exclusion process.

Synthesis of Individual Transition Plans: Format and Process.

ERIC Educational Resources Information Center

La Mar, Kathleen; Rosenberg, Bill

This document presents a prototype Individual Transition Plan (ITP) process and format for students receiving special education services. Following an overview of the role of transition, a section on the ITP process discusses pre-meeting activities, conducting an ITP meeting, monitoring and evaluating the ITP meeting, and a rationale for the…

Learning through Transitions: The Role of Institutions

ERIC Educational Resources Information Center

Zittoun, Tania

2008-01-01

In this paper two models are proposed for analysing transitions in education. Firstly, transitions are the processes that follow ruptures perceived by people. They include learning, identity change, and meaning making processes. Secondly, processes of change are observed through a semiotic prism, articulating self-other-object-sense of the object…

Best practices of formal new graduate nurse transition programs: an integrative review.

PubMed

Rush, Kathy L; Adamack, Monica; Gordon, Jason; Lilly, Meredith; Janke, Robert

2013-03-01

The aim of this review was to identify best practices of formal new graduate nurse transition programs. This information would be useful for organizations in their support and development of formal transition programs for newly hired nurses. An integrative review of the nursing research literature (2000-2011). The literature search included PubMed (MEDLINE), the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and the Excerpta Medica Database (Embase). Studies that dealt with programs geared toward pre-registration nursing students were removed. At least two researchers evaluated the literature to determine if the article met the inclusion and exclusion criteria. The final number of articles included in this review is 47. Cooper's (1989) five-stage approach to integrative review guided the process: problem formulation, data collection, evaluation of data points, data analysis and interpretation, presentation of results. Transition program literature was examined according to four major themes: Education (pre-registration and practice), Support/Satisfaction, Competency and Critical Thinking, and Workplace Environment. This included new graduates' retrospective accounts of their undergraduate education and examination of orientation and formal supports provided beyond the traditional unit orientation period. Transition programs included residencies, internships, mentorships, extended preceptorships, and generic programs. Common elements of programs were a specified resource person(s) for new graduates, mentor (mentorship), formal education, and peer support opportunities. The length, type of education, and supports provided varied considerably among programs, yet the presence of a transition program resulted in improved new graduate nurse retention and cost benefits. The variability in research designs limits the conclusions that can be drawn about best practices in transition programs for new graduate nurses. The presence of a formal new graduate transition program resulted in good retention and improved competency. The stronger evidence suggests that new graduate education should focus on practical skill development, preceptors should receive a level of formal training, formal support should be available at least through the difficult six to nine month post-hire period, opportunities for connection with their peers should be provided, and organizations should strive to ensure clinical units with healthy work environments. Copyright © 2012 Elsevier Ltd. All rights reserved.

Advances in the Kepler Transit Search Engine and Automated Approaches to Identifying Likely Planet Candidates in Transit Surveys

NASA Astrophysics Data System (ADS)

Jenkins, Jon Michael

2015-08-01

Twenty years ago, no planets were known outside our own solar system. Since then, the discoveries of ~1500 exoplanets have radically altered our views of planets and planetary systems. This revolution is due in no small part to the Kepler Mission, which has discovered >1000 of these planets and >4000 planet candidates. While Kepler has shown that small rocky planets and planetary systems are quite common, the quest to find Earth’s closest cousins and characterize their atmospheres presses forward with missions such as NASA Explorer Program’s Transiting Exoplanet Survey Satellite (TESS) slated for launch in 2017 and ESA’s PLATO mission scheduled for launch in 2024.These future missions pose daunting data processing challenges in terms of the number of stars, the amount of data, and the difficulties in detecting weak signatures of transiting small planets against a roaring background. These complications include instrument noise and systematic effects as well as the intrinsic stellar variability of the subjects under scrutiny. In this paper we review recent developments in the Kepler transit search pipeline improving both the yield and reliability of detected transit signatures.Many of the phenomena in light curves that represent noise can also trigger transit detection algorithms. The Kepler Mission has expended great effort in suppressing false positives from its planetary candidate catalogs. While over 18,000 transit-like signatures can be identified for a search across 4 years of data, most of these signatures are artifacts, not planets. Vetting all such signatures historically takes several months’ effort by many individuals. We describe the application of machine learning approaches for the automated vetting and production of planet candidate catalogs. These algorithms can improve the efficiency of the human vetting effort as well as quantifying the likelihood that each candidate is truly a planet. This information is crucial for obtaining valid planet occurrence rates. Machine learning approaches may prove to be critical to the success of future missions such as TESS and PLATO.

Short-distance probes for protein backbone structure based on energy transfer between bimane and transition metal ions

PubMed Central

Taraska, Justin W.; Puljung, Michael C.; Zagotta, William N.

2009-01-01

The structure and dynamics of proteins underlies the workings of virtually every biological process. Existing biophysical methods are inadequate to measure protein structure at atomic resolution, on a rapid time scale, with limited amounts of protein, and in the context of a cell or membrane. FRET can measure distances between two probes, but depends on the orientation of the probes and typically works only over long distances comparable with the size of many proteins. Also, common probes used for FRET can be large and have long, flexible attachment linkers that position dyes far from the protein backbone. Here, we improve and extend a fluorescence method called transition metal ion FRET that uses energy transfer to transition metal ions as a reporter of short-range distances in proteins with little orientation dependence. This method uses a very small cysteine-reactive dye monobromobimane, with virtually no linker, and various transition metal ions bound close to the peptide backbone as the acceptor. We show that, unlike larger fluorophores and longer linkers, this donor–acceptor pair accurately reports short-range distances and changes in backbone distances. We further extend the method by using cysteine-reactive metal chelators, which allow the technique to be used in protein regions of unknown secondary structure or when native metal ion binding sites are present. This improved method overcomes several of the key limitations of classical FRET for intramolecular distance measurements. PMID:19805285

Bridge to shared governance: developing leadership of frontline nurses.

PubMed

Dearmon, Valorie A; Riley, Bettina H; Mestas, Lisa G; Buckner, Ellen B

2015-01-01

Transforming health care systems to improve quality is the responsibility of nurse executives and frontline nurses alike, yet frontline nurses are often ill-prepared to share leadership and accountability needed for transformation. The aim of this qualitative study was to describe the process used to build leadership capacity of frontline nurses engaged in resolving operational failures interrupting nursing care. The leadership development process served to bridge staff transition to shared governance. This institutional review board-approved qualitative research was designed to identify the effects of mentoring by the chief nursing officer and faculty partners on leadership development of frontline nurses working to find solutions to operational failures. Twelve nurses from 4 medical surgical units participated in a Frontline Innovations' nurse-led interdisciplinary group, which met over 18 months. Transcriptions of audiotaped meetings were analyzed for emerging process and outcome themes. The transcripts revealed a robust leadership development journey of frontline nurses engaged in process improvement. Themes that emerged from the mentoring process included engagement, collaboration, empowerment, confidence, and lifelong learning. The mentoring process provided frontline nurses the leadership foundation necessary to initiate shared governance.

Statewide Transportation Improvement Program - FY 1998-2000 - Proposed Highway & Transit Improvement Program - Draft

DOT National Transportation Integrated Search

1997-10-01

The FY 1998-2000 Statewide Transportation Improvement Program (STIP) is a three-year program of highway and transit projects developed to fulfill the requirements set forth in the Intermodal Surface Transportation Efficiency Act of 1991 (ISTEA). The ...

Crustal structure of Central Sicily

NASA Astrophysics Data System (ADS)

Giustiniani, Michela; Tinivella, Umberta; Nicolich, Rinaldo

2018-01-01

We processed crustal seismic profile SIRIPRO, acquired across Central Sicily. To improve the seismic image we utilized the wave equation datuming technique, a process of upward or downward continuation of the wave-field between two arbitrarily shaped surfaces. Wave equation datuming was applied to move shots and receivers to a given datum plane, removing time shifts related to topography and to near-surface velocity variations. The datuming procedure largely contributed to attenuate ground roll, enhance higher frequencies, increase resolution and improve the signal/noise ratio. Processed data allow recognizing geometries of crust structures differentiating seismic facies and offering a direct image of ongoing tectonic setting within variable lithologies characterizing the crust of Central Sicily. Migrated sections underline distinctive features of Hyblean Plateau foreland and above all a crustal thinning towards the Caltanissetta trough, to the contact with a likely deep Permo-Triassic rifted basin or rather a zone of a continent to oceanic transition. Inhomogeneity and fragmentation of Sicily crust, with a distinct separation of Central Sicily basin from western and eastern blocks, appear to have guided the tectonic transport inside the Caltanissetta crustal scale syncline and the accumulation of allochthonous terrains with south and north-verging thrusts. Major tectonic stack operated on the construction of a wide anticline of the Maghrebian chain in northern Sicily. Sequential south-verging imbrications of deep elements forming the anticline core denote a crust wedge indenting foreland structures. Deformation processes involved multiple detachment planes down to decoupling levels located near crust/mantle transition, supporting a presence of high-density lenses beneath the chain, interrelated to a southwards push of Tyrrhenian mantle and asthenosphere.

The effect of various metallurgical parameters on the flow and fracture behavior of polycrystalline NiAl near the brittle-to-ductile transition

NASA Technical Reports Server (NTRS)

Noebe, Ronald D.

1994-01-01

An investigation of the effect of various metallurgical parameters such as interfaces, allowing additions, test temperature, and strain rate on the flow and fracture behavior of polycrystalline NiAl is summarized. From this study, a more complete understanding of the deformation and fracture behavior of polycrystalline NiAl near the brittle-to-ductile transition temperature has been developed. A mechanism for the BDTT is proposed that is based on the operation of localized dislocation climb processes that operate within the vicinity of the grain boundaries and provide the additional deformation mechanisms necessary for grain-to-grain compatibility during plastic deformation. Finally, methods for improving the low temperature mechanical behavior of NiAl were considered and reviewed within the context of the present knowledge of NiAl-based materials and the operative deformation and fracture mechanisms determined in this study. Special emphasis was placed on the use of second phases for improving low temperature properties.

Association of Transition Readiness to Intentional Self-Regulation and Hopeful Future Expectations in Youth With Illness.

PubMed

Hart, Laura C; Pollock, McLean; Hill, Sherika; Maslow, Gary

Little is known about how transition readiness relates to other developmental skills of adolescence in youth with chronic illness. Better understanding of how transition readiness relates to these other developmental skills could lead to a broader array of tools to improve transition readiness. Intentional self-regulation (ISR) and hopeful future expectations (HFE) are 2 developmental skills of adolescence that improve with participation in developmental programming and thus are modifiable. We explored associations between transition readiness, as measured by the Transition Readiness Assessment Questionnaire 29 (TRAQ-29) and ISR and HFE in youth with chronic illness recruited from a variety of subspecialty clinics from a major southeast medical center. A total of 71 adolescents with chronic illness were included in the analysis. The TRAQ-29 Self-Advocacy domain showed positive associations to both ISR (P = .03) and HFE (P = .009). In addition, the TRAQ-29 overall had positive associations to HFE (P = .04). The significant associations between TRAQ-29 Self-Advocacy domain scores and ISR and HFE suggest that transition readiness is developing within the context of other developmental areas in adolescence. More work is needed to see if the programming that improves these other developmental skills might also improve transition readiness. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Transit Security Procedures Guide

DOT National Transportation Integrated Search

1994-12-01

To protect passenger, employees, revenue, and property, transit systems are encouraged to take a proactive, prevention-oriented systems approach to transit security. This guide is a compilation of materials for planning and improving transit security...

Improving the Transition of Earth Satellite Observations from Research to Operations

NASA Technical Reports Server (NTRS)

Goodman, Steven J.; Lapenta, William M.; Jedlovec, Gary J.

2004-01-01

There are significant gaps between the observations, models, and decision support tools that make use of new data. These challenges include: 1) Decreasing the time to incorporate new satellite data into operational forecast assimilation systems, 2) Blending in-situ and satellite observing systems to produce the most accurate and comprehensive data products and assessments, 3) Accelerating the transition from research to applications through national test beds, field campaigns, and pilot demonstrations, and 4) Developing the partnerships and organizational structures to effectively transition new technology into operations. At the Short-term Prediction Research and Transition (SPORT) Center in Huntsville, Alabama, a NASA-NOAA-University collaboration has been developed to accelerate the infusion of NASA Earth science observations, data assimilation and modeling research into NWS forecast operations and decision-making. The SPoRT Center research focus is to improve forecasts through new observation capability and the regional prediction objectives of the US Weather Research Program dealing with 0-1 day forecast issues such as convective initiation and 24-hr quantitative precipitation forecasting. The near real-time availability of high-resolution experimental products of the atmosphere, land, and ocean from the Moderate Resolution Imaging Spectroradiometer (MODIS), the Advanced Infrared Spectroradiometer (AIRS), and lightning mapping systems provide an opportunity for science and algorithm risk reduction, and for application assessment prior to planned observations from the next generation of operational low Earth orbiting and geostationary Earth orbiting satellites. This paper describes the process for the transition of experimental products into forecast operations, current products undergoing assessment by forecasters, and plans for the future. The SPoRT Web page is at (http://www.ghcc.msfc.nasa.gov/sport).

Starting where I am: a grounded theory exploration of mindfulness as a facilitator of transition in living with a long-term condition.

PubMed

Long, Jaqui; Briggs, Michelle; Long, Andrew; Astin, Felicity

2016-10-01

To explore how practising mindfulness affects people's experiences of living with a long-term condition. Increasing evidence suggest that mindfulness meditation-based interventions benefit people with long-term conditions, particularly in terms of psychological well-being. Most evidence, however, relates to short-term outcomes and limited information exists about how people use mindfulness in the longer term and how this affects their experience of living with their condition. A qualitative study using constructivist-informed grounded theory. Using interviews, diaries and focus groups, data were collected between 2011 - 2012 from participants and/or trainers of Breathworks' mindfulness intervention. Phased recruitment enabled theoretical sampling, with data analysed concurrently using Charmaz's two-stage coding strategy. The final sample comprised 41 adults with diverse physical and/or mental health conditions. Participants reported predominantly positive experiences, almost all identifying significant changes in thinking and behaviour. A core process of 'Starting where I am' was formulated, highlighting how people became more aware and accepting of their condition and thus able to self-care more effectively. The process was encapsulated in five themes: Getting a new perspective; Feeling equipped to cope; Doing life differently; Seeing a change; and Finding mindfulness difficult. Strong resonances were identified between participants' experiences and the process of transition through which people come to terms with challenging life events. Mindfulness can be conceptualized as a facilitator of transition, enabling people to adapt to living with a long-term condition. Transition is associated with improved, self-directed self-management, which is significant to both people with long-term conditions and healthcare providers. © 2016 John Wiley & Sons Ltd.

PKSOI Bulletin. Volume 2, Issue 3. April 2010

DTIC Science & Technology

2010-04-01

and understand "transitions" as a crucial process during recovery from crisis and conflict. It is an opportunity for aca - demics, civil society...education is conducted at the level that can be sustained. Often, medical devices that are utilized for training (i.e. de- fibrillators) are not...location where they can utilize their improved skill set for a better monetary reward. Metrics for success: Oversight of engagements is vital; and

Task Force to Improve Timeliness of Senior Official Administrative Investigations

DTIC Science & Technology

2014-11-04

from FY 2013. Prior to FY 2014, the Director, ISO, read and reviewed every senior official complaint received through the DoD Hotline. Beginning...files all documentary evidence into D-CATS for seamless transition to the ISO investigator. ODIG-AI Investigative Process ODIG-AI conducts...availability of potential witnesses, and the volume of documentary evidence. Key investigative milestones for a lower priority case of typical complexity

Hydrogen sulfide conversion with nanophase titania

DOEpatents

Beck, Donald D.; Siegel, Richard W.

1996-01-01

A process for disassociating H.sub.2 S in a gaseous feed using an improved catalytic material in which the feed is contacted at a temperature of at least about 275.degree. C. with a catalyst of rutile nanocrystalline titania having grain sizes in the range of from about 1 to about 100 nanometers. Other transition metal catalysts are disclosed, each of nanocrystalline material with grain sizes in the 1-100 nm range.

Quality assurance, an administrative means to a managerial end: Part IV.

PubMed

Clark, G B

1992-01-01

This is the fourth and final part of a series of articles on laboratory quality surveillance. Part I addressed the historical background of medical quality assurance. Part II covered surveillance guidelines of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and the College of American Pathologists with emphasis on quality assurance (QA) and the ten-step process. Part III focused on the JCAHO transition from QA to quality assessment and improvement. Part IV concludes the series by discussing the systematic identification of quality indicators in the total quality management and continuous quality improvement environment.

Modification of epoxy-reinforced glass-cloth composites with a perfluorinated alkyl ether elastomer

NASA Technical Reports Server (NTRS)

Rosser, R. W.; Chen, T. S.; Taylor, M.

1984-01-01

A perfluorinated alkyl ether diacyl fluoride prepolymer (molecular weight about 1500) was coreacted with Epon 828 epoxy resin and diamino diphenyl sulfone to obtain an elastomer-toughened, glass-cloth composite. Improvements in flexural toughness, impact resistance, and water resistance, without loss of strength, modulus of elasticity or a lowering of the glass-transition temperature, were realized over those of the unmodified composite. Factors concerning optimization of the process are discussed. Results suggest that a simultaneously interpenetrating polymer network may be formed which gives rise to a measured improvement in composite mechanical properties.

Potential impacts of changing supply-water quality on drinking water distribution: A review.

PubMed

Liu, Gang; Zhang, Ya; Knibbe, Willem-Jan; Feng, Cuijie; Liu, Wentso; Medema, Gertjan; van der Meer, Walter

2017-06-01

Driven by the development of water purification technologies and water quality regulations, the use of better source water and/or upgraded water treatment processes to improve drinking water quality have become common practices worldwide. However, even though these elements lead to improved water quality, the water quality may be impacted during its distribution through piped networks due to the processes such as pipe material release, biofilm formation and detachment, accumulation and resuspension of loose deposits. Irregular changes in supply-water quality may cause physiochemical and microbiological de-stabilization of pipe material, biofilms and loose deposits in the distribution system that have been established over decades and may harbor components that cause health or esthetical issues (brown water). Even though it is clearly relevant to customers' health (e.g., recent Flint water crisis), until now, switching of supply-water quality is done without any systematic evaluation. This article reviews the contaminants that develop in the water distribution system and their characteristics, as well as the possible transition effects during the switching of treated water quality by destabilization and the release of pipe material and contaminants into the water and the subsequent risks. At the end of this article, a framework is proposed for the evaluation of potential transition effects. Copyright © 2017 Elsevier Ltd. All rights reserved.

A Problem-Solving Intervention Using iPads to Improve Transition-Related Task Performance of Students with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Yakubova, Gulnoza; Zeleke, Waganesh A.

2016-01-01

In this study, the effectiveness of teaching problem-solving to improve transition-related task performance of three students with autism spectrum disorder (ASD) was examined using a multiple probe across students design. Target behaviors included various transition-related tasks individualized for each student based on their individual…

Improving Transition Behaviors in Students with Autism Spectrum Disorders: A Comprehensive Evaluation of Interventions in Educational Settings

ERIC Educational Resources Information Center

Lequia, Jenna; Wilkerson, Kimber L.; Kim, Sunyoung; Lyons, Gregory L.

2015-01-01

Students with autism spectrum disorders (ASD) often exhibit rigidity, which can lead to difficulties with transitions. Such difficulties can explain why students with ASD are placed in more restrictive educational environments. This review offers a quantitative synthesis of effects of interventions aimed to improve transitions of students with ASD…

TransQUAL Online User's Guide: Improving Student Transitions to Life after School. Version 3.0

ERIC Educational Resources Information Center

Brewer, David

2006-01-01

TransQUAL Online is designed to assist school districts collaborate with others and continuously improve their transition practices for youth. TransQUAL incorporates New York State Education Department Transition Quality Indicators (TQI), based on the work of Paula Kolher from Western Michigan University. The TQI assesses program structure,…

Factors Related to Successful Transition Planning for Adolescents on the Autism Spectrum

ERIC Educational Resources Information Center

Hatfield, Megan; Ciccarelli, Marina; Falkmer, Torbjörn; Falkmer, Marita

2018-01-01

Adolescents on the autism spectrum often have difficulties with the transition from high school to post-school activities. Despite this, little is known about the transition planning processes for this group. This study explored predisposing, reinforcing and enabling factors related to the transition planning processes for adolescents on the…

Transition Process of Procedural to Conceptual Understanding in Solving Mathematical Problems

ERIC Educational Resources Information Center

Fatqurhohman

2016-01-01

This article aims to describe the transition process from procedural understanding to conceptual understanding in solving mathematical problems. Subjects in this study were three students from 20 fifth grade students of SDN 01 Sumberberas Banyuwangi selected based on the results of the students' answers. The transition process from procedural to…

Motivators and hygiene factors among physicians responding to explicit incentives to improve the value of care.

PubMed

Waddimba, Anthony C; Burgess, James F; Young, Gary J; Beckman, Howard B; Meterko, Mark

2013-01-01

Physician's dissatisfaction is reported to be increasing, especially in primary care. The transition from fee-for-service to outcome-based reimbursements may make matters worse. To investigate influences of provider attitudes and practice settings on job satisfaction/dissatisfaction during transition to quality-based payment models, we assessed self-reported satisfaction/dissatisfaction with practice in a Rochester (New York)-area physician practice association in the process of implementing pay-for-performance. We linked cross-sectional data for 215 survey respondents on satisfaction ratings and behavioral attitudes with medical record data on their clinical behavior and practices, and census data on their catchment population. Factors associated with the odds of being satisfied or dissatisfied were determined via predictive multivariable logistic regression modeling. Dissatisfied physicians were more likely to have larger-than-average patient panels, lower autonomy and/or control, and beliefs that quality incentives were hindering patient care. Satisfied physicians were more likely to have a higher sense of autonomy and control, smaller patient volumes, and a less complex patient mix. Efforts to maintain or improve satisfaction among physicians should focus on encouraging professional autonomy during transitions from volume-based to quality/outcomes-based payment systems. An optimum balance between accountability and autonomy/control might maximize both health care quality and job satisfaction.

Monitoring and Evaluating the Transition of Large-Scale Programs in Global Health

PubMed Central

Bao, James; Rodriguez, Daniela C; Paina, Ligia; Ozawa, Sachiko; Bennett, Sara

2015-01-01

Purpose: Donors are increasingly interested in the transition and sustainability of global health programs as priorities shift and external funding declines. Systematic and high-quality monitoring and evaluation (M&E) of such processes is rare. We propose a framework and related guiding questions to systematize the M&E of global health program transitions. Methods: We conducted stakeholder interviews, searched the peer-reviewed and gray literature, gathered feedback from key informants, and reflected on author experiences to build a framework on M&E of transition and to develop guiding questions. Findings: The conceptual framework models transition as a process spanning pre-transition and transition itself and extending into sustained services and outcomes. Key transition domains include leadership, financing, programming, and service delivery, and relevant activities that drive the transition in these domains forward include sustaining a supportive policy environment, creating financial sustainability, developing local stakeholder capacity, communicating to all stakeholders, and aligning programs. Ideally transition monitoring would begin prior to transition processes being implemented and continue for some time after transition has been completed. As no set of indicators will be applicable across all types of health program transitions, we instead propose guiding questions and illustrative quantitative and qualitative indicators to be considered and adapted based on the transition domains identified as most important to the particular health program transition. The M&E of transition faces new and unique challenges, requiring measuring constructs to which evaluators may not be accustomed. Many domains hinge on measuring “intangibles” such as the management of relationships. Monitoring these constructs may require a compromise between rigorous data collection and the involvement of key stakeholders. Conclusion: Monitoring and evaluating transitions in global health programs can bring conceptual clarity to the transition process, provide a mechanism for accountability, facilitate engagement with local stakeholders, and inform the management of transition through learning. Further investment and stronger methodological work are needed. PMID:26681706

Facilitating specialist to primary care transfer with tools for transition: a quality of care improvement initiative for patients with type 2 diabetes.

PubMed

Maranger, Julie; Malcolm, Janine; Liddy, Clare; Izzi, Sheryl; Brez, Sharon; LaBrecque, Kerri; Taljaard, Monica; Reid, Robert; Keely, Erin; Ooi, Teik Chye

2013-01-01

The epidemic of diabetes has increased pressure on the whole spectrum of the healthcare system including specialist centres. The authors' own specialist centre at The Ottawa Hospital has 20,000 annual visits for diabetes, 80% of which are follow-up visits. Since it is a tertiary facility, managers, administrators and clinicians would like to increase their ability to see newly referred patients and decrease the number of follow-up visits. In order to discharge appropriate diabetes patients, the authors decided it was essential to strengthen the transition process to decrease both the pressure on the centre and the risk for discontinuity of diabetes care after discharge.

Inelastic collision processes in ozone and their relation to atmospheric pressure broadening

NASA Technical Reports Server (NTRS)

Steinfeld, J. I.; Flannery, C.; Klaassen, J.; Mizugai, Y.; Spencer, M.

1990-01-01

The research task employs infrared double-resonance to determine rotational energy transfer rates and pathways, in both the ground and vibrationally excited states of ozone. The resulting data base will then be employed to test inelastic scattering theories and to assess intermolecular potential models, both of which are necessary for the systematization and prediction of infrared pressure-broadening coefficients, which are in turn required by atmospheric ozone monitoring techniques based on infrared remote sensing. In addition, observation of excited-state absorption transitions will permit us to improve the determination of the 2 nu(sub 3), nu(sub 1) + nu(sub 2), and 2 nu(sub 1) rotational constants and to derive band strengths for hot-band transitions involving these levels.

A Longitudinal Study in Learning Preferences and Academic Performance in First Year Medical School.

PubMed

Hu, Yenya; Gao, Hong; Wofford, Marcia M; Violato, Claudio

2017-12-18

This is a longitudinal study of first year medical students that investigates the relationship between the pattern change of the learning preferences and academic performance. Using the visual, auditory, reading-writing, and kinesthetic inventory at the beginning of the first and second year for the same class, it was found that within the first year, 36% of the class remained unimodal (single) modality learners (SS), 14% changed from unimodal to multimodality learners (SM), 27% changed from multimodality to unimodal modality learners (MS) and 21% remained as multimodality learners (MM). Among the academic performance through subsequent didactic blocks from Clinical Anatomy, Cell and Subcellular Processes to Medical Neuroscience during first year, the SM group made more significant improvement compared to the SS group. Semi-structured interview results from the SM group showed that students made this transition between the Clinical Anatomy course and the middle of the Medical Neuroscience course, in an effort to improve their performance. This study suggests that the transition from unimodal to multimodality learning among academically struggling students improved their academic performance in the first year of medical school. Therefore, this may be considered as part of academic advising tools for struggling students to improve their academic performances. Anat Sci Educ. © 2017 American Association of Anatomists. © 2017 American Association of Anatomists.

Patient experiences of transitioning from hospital to home: an ethnographic quality improvement project.

PubMed

Cain, Carol H; Neuwirth, Estee; Bellows, Jim; Zuber, Christi; Green, Jennifer

2012-01-01

Little is known about patient perspectives of the transition from hospital to home. To develop a richly detailed, patient-centered view of patient and caregiver needs in the hospital-to-home transition. An ethnographic approach including participant observation and in-depth, semi-structured video recorded interviews. Kaiser Permanente's Southern California, Colorado, and Hawaii regions. Twenty-four adult inpatients hospitalized for a range of acute and chronic conditions and characterized by variety in diagnoses, illness severity, planned or unplanned hospitalization, age, and ability to self manage. During the hospital-to-home transition, patients and caregivers expressed or demonstrated experiences in 6 domains: 1) translating knowledge into safe, health-promoting actions at home; 2) inclusion of caregivers at every step of the transition process; 3) having readily available problem-solving resources; 4) feeling connected to and trusting providers; 5) transitioning from illness-defined experience to "normal" life; and 6) anticipating needs after discharge and making arrangements to meet them. The work of transitioning occurs for patients and caregivers in the hours and days after they return home and is fraught with challenges. Reducing readmissions will remain challenging without a broadened understanding of the types of support and coaching patients need after discharge. We are piloting strategies such as risk stratification and tailoring of care, a specialized phone number for recently discharged patients, standardized same-day discharge summaries to primary care providers, medication reconciliation, follow-up phone calls, and scheduling appointments before discharge. Copyright © 2012 Society of Hospital Medicine.

Evolution of ribozymes in the presence of a mineral surface

PubMed Central

Stephenson, James D.; Popović, Milena; Bristow, Thomas F.

2016-01-01

Mineral surfaces are often proposed as the sites of critical processes in the emergence of life. Clay minerals in particular are thought to play significant roles in the origin of life including polymerizing, concentrating, organizing, and protecting biopolymers. In these scenarios, the impact of minerals on biopolymer folding is expected to influence evolutionary processes. These processes include both the initial emergence of functional structures in the presence of the mineral and the subsequent transition away from the mineral-associated niche. The initial evolution of function depends upon the number and distribution of sequences capable of functioning in the presence of the mineral, and the transition to new environments depends upon the overlap between sequences that evolve on the mineral surface and sequences that can perform the same functions in the mineral's absence. To examine these processes, we evolved self-cleaving ribozymes in vitro in the presence or absence of Na-saturated montmorillonite clay mineral particles. Starting from a shared population of random sequences, RNA populations were evolved in parallel, along separate evolutionary trajectories. Comparative sequence analysis and activity assays show that the impact of this clay mineral on functional structure selection was minimal; it neither prevented common structures from emerging, nor did it promote the emergence of new structures. This suggests that montmorillonite does not improve RNA's ability to evolve functional structures; however, it also suggests that RNAs that do evolve in contact with montmorillonite retain the same structures in mineral-free environments, potentially facilitating an evolutionary transition away from a mineral-associated niche. PMID:27793980

Electric field-triggered metal-insulator transition resistive switching of bilayered multiphasic VOx

NASA Astrophysics Data System (ADS)

Won, Seokjae; Lee, Sang Yeon; Hwang, Jungyeon; Park, Jucheol; Seo, Hyungtak

2018-01-01

Electric field-triggered Mott transition of VO2 for next-generation memory devices with sharp and fast resistance-switching response is considered to be ideal but the formation of single-phase VO2 by common deposition techniques is very challenging. Here, VOx films with a VO2-dominant phase for a Mott transition-based metal-insulator transition (MIT) switching device were successfully fabricated by the combined process of RF magnetron sputtering of V metal and subsequent O2 annealing to form. By performing various material characterizations, including scanning transmission electron microscopy-electron energy loss spectroscopy, the film is determined to have a bilayer structure consisting of a VO2-rich bottom layer acting as the Mott transition switching layer and a V2O5/V2O3 mixed top layer acting as a control layer that suppresses any stray leakage current and improves cyclic performance. This bilayer structure enables excellent electric field-triggered Mott transition-based resistive switching of Pt-VOx-Pt metal-insulator-metal devices with a set/reset current ratio reaching 200, set/reset voltage of less than 2.5 V, and very stable DC cyclic switching upto 120 cycles with a great set/reset current and voltage distribution less than 5% of standard deviation at room temperature, which are specifications applicable for neuromorphic or memory device applications. [Figure not available: see fulltext.

Active magnetic refrigerants based on Gd-Si-Ge material and refrigeration apparatus and process

DOEpatents

Gschneidner, Jr., Karl A.; Pecharsky, Vitalij K.

1998-04-28

Active magnetic regenerator and method using Gd.sub.5 (Si.sub.x Ge.sub.1-x).sub.4, where x is equal to or less than 0.5, as a magnetic refrigerant that exhibits a reversible ferromagnetic/antiferromagnetic or ferromagnetic-II/ferromagnetic-I first order phase transition and extraordinary magneto-thermal properties, such as a giant magnetocaloric effect, that renders the refrigerant more efficient and useful than existing magnetic refrigerants for commercialization of magnetic regenerators. The reversible first order phase transition is tunable from approximately 30 K to approximately 290 K (near room temperature) and above by compositional adjustments. The active magnetic regenerator and method can function for refrigerating, air conditioning, and liquefying low temperature cryogens with significantly improved efficiency and operating temperature range from approximately 10 K to 300 K and above. Also an active magnetic regenerator and method using Gd.sub.5 (Si.sub.x Ge.sub.1-x).sub.4, where x is equal to or greater than 0.5, as a magnetic heater/refrigerant that exhibits a reversible ferromagnetic/paramagnetic second order phase transition with large magneto-thermal properties, such as a large magnetocaloric effect that permits the commercialization of a magnetic heat pump and/or refrigerant. This second order phase transition is tunable from approximately 280 K (near room temperature) to approximately 350 K by composition adjustments. The active magnetic regenerator and method can function for low level heating for climate control for buildings, homes and automobile, and chemical processing.

Active magnetic refrigerants based on Gd-Si-Ge material and refrigeration apparatus and process

DOEpatents

Gschneidner, K.A. Jr.; Pecharsky, V.K.

1998-04-28

Active magnetic regenerator and method using Gd{sub 5} (Si{sub x}Ge{sub 1{minus}x}){sub 4}, where x is equal to or less than 0.5, as a magnetic refrigerant that exhibits a reversible ferromagnetic/antiferromagnetic or ferromagnetic-II/ferromagnetic-I first order phase transition and extraordinary magneto-thermal properties, such as a giant magnetocaloric effect, that renders the refrigerant more efficient and useful than existing magnetic refrigerants for commercialization of magnetic regenerators. The reversible first order phase transition is tunable from approximately 30 K to approximately 290 K (near room temperature) and above by compositional adjustments. The active magnetic regenerator and method can function for refrigerating, air conditioning, and liquefying low temperature cryogens with significantly improved efficiency and operating temperature range from approximately 10 K to 300 K and above. Also an active magnetic regenerator and method using Gd{sub 5} (Si{sub x} Ge{sub 1{minus}x}){sub 4}, where x is equal to or greater than 0.5, as a magnetic heater/refrigerant that exhibits a reversible ferromagnetic/paramagnetic second order phase transition with large magneto-thermal properties, such as a large magnetocaloric effect that permits the commercialization of a magnetic heat pump and/or refrigerant. This second order phase transition is tunable from approximately 280 K (near room temperature) to approximately 350 K by composition adjustments. The active magnetic regenerator and method can function for low level heating for climate control for buildings, homes and automobile, and chemical processing. 27 figs.

Simulation of surface processes

PubMed Central

Jónsson, Hannes

2011-01-01

Computer simulations of surface processes can reveal unexpected insight regarding atomic-scale structure and transitions. Here, the strengths and weaknesses of some commonly used approaches are reviewed as well as promising avenues for improvements. The electronic degrees of freedom are usually described by gradient-dependent functionals within Kohn–Sham density functional theory. Although this level of theory has been remarkably successful in numerous studies, several important problems require a more accurate theoretical description. It is important to develop new tools to make it possible to study, for example, localized defect states and band gaps in large and complex systems. Preliminary results presented here show that orbital density-dependent functionals provide a promising avenue, but they require the development of new numerical methods and substantial changes to codes designed for Kohn–Sham density functional theory. The nuclear degrees of freedom can, in most cases, be described by the classical equations of motion; however, they still pose a significant challenge, because the time scale of interesting transitions, which typically involve substantial free energy barriers, is much longer than the time scale of vibrations—often 10 orders of magnitude. Therefore, simulation of diffusion, structural annealing, and chemical reactions cannot be achieved with direct simulation of the classical dynamics. Alternative approaches are needed. One such approach is transition state theory as implemented in the adaptive kinetic Monte Carlo algorithm, which, thus far, has relied on the harmonic approximation but could be extended and made applicable to systems with rougher energy landscape and transitions through quantum mechanical tunneling. PMID:21199939

An analysis of the wear behavior of SiC whisker reinforced alumina from 25 to 1200 C

NASA Technical Reports Server (NTRS)

Dellacorte, Christopher

1991-01-01

A model is described for predicting the wear behavior of whisker reinforced ceramics. The model was successfully applied to a silicon carbide whisker reinforced alumina ceramic composite subjected to sliding contact. The model compares the friction forces on the whiskers due to sliding, which act to pull or push them out of the matrix, to the clamping or compressive forces on the whiskers due to the matrix, which act to hold the whiskers in the composite. At low temperatures, the whiskers are held strongly in the matrix and are fractured into pieces during the wear process along with the matrix. At elevated temperatures differential thermal expansion between the whiskers and matrix can cause loosening of the whiskers and lead to pullout during the wear process and to higher wear. The model, which represents the combination of elastic stress analysis and a friction heating analysis, predicts a transition temperature at which the strength of the whiskers equals the clamping force holding them in the matrix. Above the transition the whiskers are pulled out of the matrix during sliding, and below the transition the whiskers are simply fractured. The existence of the transition gives rise to a dual wear mode or mechanism behavior for this material which was observed in laboratory experiments. The results from this model correlate well with experimentally observed behavior indicating that the model may be useful in obtaining a better understanding of material behavior and in making material improvements.

An analysis of the wear behavior of SiC whisker-reinforced alumina from 25 to 1200 C

NASA Technical Reports Server (NTRS)

Dellacorte, Christopher

1993-01-01

A model is described for predicting the wear behavior of whisker reinforced ceramics. The model was successfully applied to a silicon carbide whisker reinforced alumina ceramic composite subjected to sliding contact. The model compares the friction forces on the whiskers due to sliding, which act to pull or push them out of the matrix, to the clamping or compressive forces on the whiskers due to the matrix, which act to hold the whiskers in the composite. At low temperatures, the whiskers are held strongly in the matrix and are fractured into pieces during the wear process along with the matrix. At elevated temperatures differential thermal expansion between the whiskers and matrix can cause loosening of the whiskers and lead to pullout during the wear process and to higher wear. The model, which represents the combination of elastic stress analysis and a friction heating analysis, predicts a transition temperature at which the strength of the whiskers equals the clamping force holding them in the matrix. Above the transition the whiskers are pulled out of the matrix during sliding, and below the transition the whiskers are simply fractured. The existence of the transition gives rise to a dual wear mode or mechanism behavior for this material which was observed in laboratory experiments. The results from this model correlate well with experimentally observed behavior indicating that the model may be useful in obtaining a better understanding of material behavior and in making material improvements.

Passenger reactions to transit safety measures

DOT National Transportation Integrated Search

1999-10-01

Safety and security are important considerations for the transit operator, but few empirical studies exist that measure the effectiveness of measures taken to improve transit safety on either actual crime (or other incident) data or transit passenger...

Cryogenic two-phase flow during chilldown: Flow transition and nucleate boiling heat transfer

NASA Astrophysics Data System (ADS)

Jackson, Jelliffe Kevin

The recent interest in space exploration has placed a renewed focus on rocket propulsion technology. Cryogenic propellants are the preferred fuel for rocket propulsion since they are more energetic and environmentally friendly compared with other storable fuels. Voracious evaporation occurs while transferring these fluids through a pipeline that is initially in thermal equilibrium with the environment. This phenomenon is referred to as line chilldown. Large temperature differences, rapid transients, pressure fluctuations and the transition from the film boiling to the nucleate boiling regime characterize the chilldown process. Although the existence of the chilldown phenomenon has been known for decades, the process is not well understood. Attempts have been made to model the chilldown process; however the results have been fair at best. A major shortcoming of these models is the use of correlations that were developed for steady, non-cryogenic flows. The development of reliable correlations for cryogenic chilldown has been hindered by the lack of experimental data. An experimental facility was constructed that allows the flow structure, the temperature history and the pressure history to be recorded during the line chilldown process. The temperature history is then utilized in conjunction with an inverse heat conduction procedure that was developed, which allows the unsteady heat transfer coefficient on the interior of the pipe wall to be extracted. This database is used to evaluate present predictive models and correlations for flow regime transition and nucleate boiling heat transfer. It is found that by calibrating the transition between the stratified-wavy and the intermittent/annular regimes of the Taitel and Dukler flow regime map, satisfactory predictions are obtained. It is also found that by utilizing a simple model that includes the effect of flow structure and incorporating the enhancement provided by the local heat flux, significant improvement in the predictive capabilities of the Muller-Steinhagen and Jamialahmadi correlation for nucleate flow boiling is achieved.

Health system strengthening in Cambodia-a case study of health policy response to social transition.

PubMed

Grundy, John; Khut, Qiu Yi; Oum, Sophal; Annear, Peter; Ky, Veng

2009-10-01

Cambodia, following decades of civil conflict and social and economic transition, has in the last 10 years developed health policy innovations in the areas of health contracting, health financing and health planning. This paper aims to outline recent social, epidemiological and demographic health trends in Cambodia, and on the basis of this outline, to analyse and discuss these policy responses to social transition. Sources of information included a literature review, participant observation in health planning development in Cambodia between 1993 and 2008, and comparative analysis of demographic health surveys between 2000 and 2005. In Cambodia there have been sharp but unequal improvements in child mortality, and persisting high maternal mortality rates. Data analysis demonstrates associations between location, education level and access to facility based care, suggesting the dominant role of socio-economic factors in determining access to facility based health care. These events are taking place against a background of rapid social transition in Cambodian history, including processes of decentralization, privatization and the development of open market economic systems. Primary policy responses of the Ministry of Health to social transition and associated health inequities include the establishment of health contracting, hospital health equity funds and public-private collaborations. Despite the internationally recognized health policy flexibility and innovation demonstrated in Cambodia, policy response still lags well behind the reality of social transition. In order to minimize the delay between transition and response, new policy making tactics are required in order to provide more flexible and timely responses to the ongoing social transition and its impacts on population health needs in the lowest socio-economic quintiles.

Ten Steps to Establishing an e-Consultation Service to Improve Access to Specialist Care

PubMed Central

Maranger, Julie; Afkham, Amir; Keely, Erin

2013-01-01

Abstract There is dissatisfaction among primary care physicians, specialists, and patients with respect to the consultation process. Excessive wait times for receiving specialist services and inefficient communication between practitioners result in decreased access to care and jeopardize patient safety. We created and implemented an electronic consultation (e-consultation) system in Eastern Ontario to address these problems and improve the consultation process. The e-consultation system has passed through the proof-of-concept and pilot study stages and has effectively reduced unnecessary referrals while receiving resoundingly positive feedback from physician-users. Using our experience, we have outlined the 10 steps to developing an e-consultation service. We detail the technical, administrative, and strategic considerations with respect to (1) identifying your partners, (2) choosing your platform, (3) starting as a pilot project, (4) designing your product, (5) ensuring patient privacy, (6) thinking through the process, (7) fostering relationships with your participants, (8) being prepared to provide physician payment, (9) providing feedback, and (10) planning the transition from pilot to permanency. In following these 10 steps, we believe that the e-consultation system and its associated improvements on the consultation process can be effectively implemented in other healthcare settings. PMID:24073898

Innovative approach to improving the care of acute decompensated heart failure.

PubMed

Merhaut, Shawn; Trupp, Robin

2011-06-01

The care of patients presenting to hospitals with acute decompensated heart failure remains a challenging and multifaceted dilemma across the continuum of care. The combination of improved survival rates for and rising incidence of heart failure has created both a clinical and economic burden for hospitals of epidemic proportion. With limited clinical resources, hospitals are expected to provide efficient, comprehensive, and quality care to a population laden with multiple comorbidities and social constraints. Further, this care must be provided in the setting of a volatile economic climate heavily affected by prolonged length of stays, high readmission rates, and changing healthcare policy. Although problems continue to mount, solutions remain scarce. In an effort to help hospitals identify gaps in care, control costs, streamline processes, and ultimately improve outcomes for these patients, the Society of Chest Pain Centers launched Heart Failure Accreditation in July 2009. Rooted in process improvement science, the Society's approach includes utilization of a tiered Accreditation tool to identify best practices, facilitate an internal gap analysis, and generate opportunities for improvement. In contrast to other organizations that require compliance with predetermined specifications, the Society's Heart Failure Accreditation focuses on the overall process including the continuum of care from emergency medical services, emergency department care, inpatient management, transition from hospital to home, and community outreach. As partners in the process, the Society strives to build relationships with facilities and share best practices with the ultimate goal to improve outcomes for heart failure patients.

Ionization equilibrium and radiative energy loss rates for C, N, and O ions in low-density plasmas

NASA Technical Reports Server (NTRS)

Jacobs, V. L.; Davis, J.; Rogerson, J. E.; Blaha, M.

1978-01-01

The results of calculations of the ionization equilibrium and radiative energy loss rates for C, N and O ions in low-density plasmas are presented for electron temperatures in the range 10,000-10,000,000 K. The ionization structure is determined by using the steady-state corona model, in which electron impact ionization from the ground states is balanced by direct radiative and dielectronic recombination. With an improved theory, detailed calculations are carried out for the dielectronic recombination rates in which account is taken of all radiative and autoionization processes involving a single-electron electric-dipole transition of the recombining ion. The radiative energy loss processes considered are electron-impact excitation of resonance line emission, direct radiative recombination, dielectronic recombination, and electron-ion bremsstrahlung. For all three elements, resonance line emission resulting from 2s-2p transitions produces a broad maximum in the energy loss rate near 100,000 K.

Phase Restructuring in Transition Metal Dichalcogenides for Highly Stable Energy Storage.

PubMed

Leng, Kai; Chen, Zhongxin; Zhao, Xiaoxu; Tang, Wei; Tian, Bingbing; Nai, Chang Tai; Zhou, Wu; Loh, Kian Ping

2016-09-28

Achieving homogeneous phase transition and uniform charge distribution is essential for good cycle stability and high capacity when phase conversion materials are used as electrodes. Herein, we show that chemical lithiation of bulk 2H-MoS 2 distorts its crystalline domains in three primary directions to produce mosaic-like 1T' nanocrystalline domains, which improve phase and charge uniformity during subsequent electrochemical phase conversion. 1T'-Li x MoS 2 , a macroscopic dense material with interconnected nanoscale grains, shows excellent cycle stability and rate capability in a lithium rechargeable battery compared to bulk or exfoliated-restacked MoS 2 . Transmission electron microscopy studies reveal that the interconnected MoS 2 nanocrystals created during the phase change process are reformable even after multiple cycles of galvanostatic charging/discharging, which allows them to play important roles in the long term cycling performance of the chemically intercalated TMD materials. These studies shed light on how bulk TMDs can be processed into quasi-2D nanophase material for stable energy storage.

Cellular migration, transition and interaction during regeneration of the sponge Hymeniacidon heliophila.

PubMed

Coutinho, Cristiano C; Rosa, Ivone de Andrade; Teixeira, John Douglas de Oliveira; Andrade, Leonardo R; Costa, Manoel Luis; Mermelstein, Claudia

2017-01-01

Sponges have a high capacity for regeneration and this process improves biomass production in some species, thus contributing to a solution for the biomass supply problem for biotechnological applications. The aim of this work is to characterize the dynamics of cell behavior during the initial stages of sponge regeneration, using bright-field microscopy, confocal microscopy and SEM. We focused on the first 20 h of regeneration, during which blastema formation and epithelium initialization occur. An innovative sponge organotypic culture of the regenerating internal region is described and investigated by confocal microscopy, cell transplantation and vital staining. Cell-cell interaction and cell density are shown to affect events in morphogenesis such as epithelial/mesenchymal and mesenchymal/epithelial transitions as well as distinct cell movements required for regeneration. Extracellular matrix was organized according to the morphogenetic process observed, with evidence for cell-signaling instructions and remodeling. These data and the method of organotypic culture described here provide support for the development of viable sponge biomass production.

Providing Transition Planning for the Secondary Student through the Community Based Inservice Model.

ERIC Educational Resources Information Center

Glasenapp, Gary

This paper provides an overview of the transition process for students with severe handicaps. For secondary age youths with severe handicaps, explicit and intensive transition planning is necessary to bridge the gap between school experiences and adult life. The transition planning process is designed to build the skills necessary for an…

Training directionally selective motion pathways can significantly improve reading efficiency

NASA Astrophysics Data System (ADS)

Lawton, Teri

2004-06-01

This study examined whether perceptual learning at early levels of visual processing would facilitate learning at higher levels of processing. This was examined by determining whether training the motion pathways by practicing leftright movement discrimination, as found previously, would improve the reading skills of inefficient readers significantly more than another computer game, a word discrimination game, or the reading program offered by the school. This controlled validation study found that practicing left-right movement discrimination 5-10 minutes twice a week (rapidly) for 15 weeks doubled reading fluency, and significantly improved all reading skills by more than one grade level, whereas inefficient readers in the control groups barely improved on these reading skills. In contrast to previous studies of perceptual learning, these experiments show that perceptual learning of direction discrimination significantly improved reading skills determined at higher levels of cognitive processing, thereby being generalized to a new task. The deficits in reading performance and attentional focus experienced by the person who struggles when reading are suggested to result from an information overload, resulting from timing deficits in the direction-selectivity network proposed by Russell De Valois et al. (2000), that following practice on direction discrimination goes away. This study found that practicing direction discrimination rapidly transitions the inefficient 7-year-old reader to an efficient reader.

Comparison of active-set method deconvolution and matched-filtering for derivation of an ultrasound transit time spectrum.

PubMed

Wille, M-L; Zapf, M; Ruiter, N V; Gemmeke, H; Langton, C M

2015-06-21

The quality of ultrasound computed tomography imaging is primarily determined by the accuracy of ultrasound transit time measurement. A major problem in analysis is the overlap of signals making it difficult to detect the correct transit time. The current standard is to apply a matched-filtering approach to the input and output signals. This study compares the matched-filtering technique with active set deconvolution to derive a transit time spectrum from a coded excitation chirp signal and the measured output signal. The ultrasound wave travels in a direct and a reflected path to the receiver, resulting in an overlap in the recorded output signal. The matched-filtering and deconvolution techniques were applied to determine the transit times associated with the two signal paths. Both techniques were able to detect the two different transit times; while matched-filtering has a better accuracy (0.13 μs versus 0.18 μs standard deviations), deconvolution has a 3.5 times improved side-lobe to main-lobe ratio. A higher side-lobe suppression is important to further improve image fidelity. These results suggest that a future combination of both techniques would provide improved signal detection and hence improved image fidelity.

The Brittle-Ductile Transition in Crystal and Bubble-bearing Magmas

NASA Astrophysics Data System (ADS)

Caricchi, L.; Pistone, M.; Cordonnier, B.; Tripoli, B.; Ulmer, P.; Reusser, E.; Marone, F.; Burlini, L.

2011-12-01

The strain response of magma is critically dependent upon its viscosity, the magnitude of the applied stress and the experimental time-scale. The brittle-ductile transition in pure silicate melts is expected for an applied stress approaching 108±0.5 Pa (Dingwell, 1997). However, magmas are mostly mixture of crystal and bubble-bearing silicate melts. To date, there are no data to constrain the ductile-brittle transition for three-phase magmas. Thus, we conducted consistent torsion experiments at high temperature (673-973 K) and high pressure (200 MPa), in the strain rate range 1*10-5-4*10-3 s-1, using a HT-HP internally-heated Paterson-type rock deformation apparatus. The samples are composed of hydrous haplogranitic glass, quartz crystals (24-65 vol%) and CO2-rich gas-pressurized bubbles (9-12 vol%). The applied strain rate was increased until brittle failure occurred; micro-fracturing and healing processes commonly occurred before sample macroscopic fracturing. The experimental results highlight a clear relationship between the effective viscosity of the three-phase magmas, strain rate, temperature and the onset of brittle-ductile behavior. Crystal- and bubble-free melts at high viscosity (1011-1011.6 Pa*s at 673 K) show brittle behavior in the strain rate range between 1*10-4 and 5*10-4 s-1. For comparable viscosities crystal and bubble-bearing magmas show a transition to brittle behavior at lower strain rates. Synchrotron-based 3D imaging of fractured samples, show the presence of fractures with an antithetic trend with respect to shear strain directions. The law found in this study expresses the transition from ductile to brittle behavior for real magmas and could significantly improve our understanding of the control of brittle processes on extrusion of high-viscosity magmas and degassing at silicic volcanoes.

Innovating team-based outpatient mental health care in the Veterans Health Administration: Staff-perceived benefits and challenges to pilot implementation of the Behavioral Health Interdisciplinary Program (BHIP).

PubMed

Barry, Catherine N; Abraham, Kristen M; Weaver, Kendra R; Bowersox, Nicholas W

2016-05-01

In the past decade, the demand for Veterans Health Administration (VHA) mental health care has increased rapidly. In response to the increased demand, the VHA developed the Behavioral Health Interdisciplinary Program (BHIP) team model as an innovative approach to transform VHA general outpatient mental health delivery. The present formative evaluation gathered information about pilot implementation of BHIP to understand the struggles and successes that staff experienced during facility transitions to the BHIP model. Using a purposive, nonrandom sampling approach, we conducted 1-on-1, semistructured interviews with 37 licensed and nonlicensed clinical providers and 13 clerical support staff assigned to BHIP teams in 21 facilities across the VHA. Interviews revealed that having actively involved facility mental health leaders, obtaining adequate staffing for teams to meet the requirements of the BHIP model, creating clear descriptions and expectations for team member roles within the BHIP framework, and allocating designated time for BHIP team meetings challenged many VHA sites but are crucial for successful BHIP implementation. Despite the challenges, staff reported that the transition to BHIP improved team work and improved patient care. Staff specifically highlighted the potential for the BHIP model to improve staff working relationships and enhance communication, collaboration, morale, and veteran treatment consistency. Future evaluations of the BHIP implementation process and BHIP team functioning focusing on patient outcomes, organizational outcomes, and staff functioning are recommended for fully understanding effects of transitioning to the BHIP model within VHA general mental health clinics and to identify best practices and areas for improvement. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Transition to school for children with autism spectrum disorder: A systematic review

PubMed Central

Marsh, Annabel; Spagnol, Vanessa; Grove, Rachel; Eapen, Valsamma

2017-01-01

AIM To identify factors that promote a positive start to school for children with autism spectrum disorder (ASD). METHODS Web of Science, MEDLINE, Scopus, and PsychINFO searches were conducted to identify literature published after 1991 and relevant to school transition processes in children with ASD. Twenty studies were deemed eligible for inclusion. These studies evaluated a range of factors including school readiness, parent and teacher perspectives on transition practices, characteristics of children with ASD that are associated with successful transition to school and the impact of school based intervention programs. RESULTS A review of these studies showed that children with ASD are less school ready emotionally than their peers and those children with ASD appear to have more externalising behaviours and self-regulation difficulties that affect their school engagement and their relationships with their teachers. There was a paucity of research looking at interventions targeting school readiness. However, school-based behavioural interventions appear to improve cognitive, language and daily living skills, but have less impact on socialisation and peer inclusion. CONCLUSION Children with ASD face more challenges transitioning to school, particularly with social interaction. Further development and implementation of specific school-based interventions is needed in order to assist children with autism to maximise their success in starting school. PMID:29043156

Phase transition of a cobalt-free perovskite as a high-performance cathode for intermediate-temperature solid oxide fuel cells.

PubMed

Jiang, Shanshan; Zhou, Wei; Niu, Yingjie; Zhu, Zhonghua; Shao, Zongping

2012-10-01

It is generally recognized that the phase transition of a perovskite may be detrimental to the connection between cathode and electrolyte. Moreover, certain phase transitions may induce the formation of poor electronic and ionic conducting phase(s), thereby lowering the electrochemical performance of the cathode. Here, we present a study on the phase transition of a cobalt-free perovskite (SrNb(0.1)Fe(0.9)O(3-δ), SNF) and evaluate its effect on the electrochemical performance of the fuel cell. SNF exists as a primitive perovskite structure with space group P4mm (99) at room temperature. As evidenced by in situ high-temperature X-ray diffraction measurements over the temperature range of 600 to 1000 °C, SNF undergoes a transformation to a tetragonal structure with a space group I4/m (87). This phase transition is accompanied by a moderate change in the volume, allowing a good cathode/electrolyte interface on thermal cycling. According to the electrochemical impedance spectroscopy evaluation, the I4/m phase exhibits positive effects on the cathode's performance, showing the highest oxygen reduction reaction activity of cobalt-free cathodes reported so far. This activity improvement is attributed to enhanced oxygen surface processes. Copyright © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Integrating evolutionary game theory into epigenetic study of embryonic development. Comment on ;Epigenetic game theory: How to compute the epigenetic control of maternal-to-zygotic transition; by Qian Wang et al.

NASA Astrophysics Data System (ADS)

Wang, Zuoheng

2017-03-01

DNA methylation is an essential component in the epigenetic regulation of embryonic development, and plays a crucial role in various biological processes, including repression of gene transcription, parent-of-origin genomic imprinting, and X-chromosome inactivation [1-5]. Understanding the epigenetic processes in different stages of embryo development has become an important research topic in the field. It has potential to offer new insight into reproductive medicine and contribute to the improvement of long-term health outcomes.

Effect of Ultra-Fast Cooling on Microstructure and Properties of High Strength Steel for Shipbuilding

NASA Astrophysics Data System (ADS)

Zhou, Cheng; Ye, Qibin; Yan, Ling

The effect of ultra-fast cooling(UFC) and conventional accelerated cooling(AcC) on the mechanical properties and microstructure of controlled rolled AH32 grade steel plates on industrial scale were compared using tensile test, Charpy impact test, welding thermal simulation, and microscopic analysis. The results show that the properties of the plate produced by UFC are improved considerably comparing to that by AcC. The yield strength is increased with 54 MPa without deterioration in the ductility and the impact energy is improved to more than 260 J at -60 °C with much lower ductile-to-brittle transition temperature(DBTT). The ferrite grain size is refined to ASTM No. 11.5 in the UFC steel with uniform microstructure throughout the thickness direction, while that of the AcC steel is ASTM No. 9.5. The analysis of nucleation kinetics of α-ferrite indicates that the microstructure is refined due to the increased nucleation rate of α-ferrite by much lower γ→α transition temperature through the UFC process. The Hall-Petch effect is quantified for the improvement of the strength and toughness of the UFC steel attributed to the grain refinement.

Improvement Research Priorities: USA Survey and Expert Consensus

PubMed Central

Stevens, Kathleen R.; Ovretveit, John

2013-01-01

The purpose of this study was to identify stakeholder views about national priorities for improvement science and build agreement for action in a national improvement and implementation research network in the USA. This was accomplished using three stages of identification and consensus. (1) Topics were identified through a multipronged environmental scan of the literature and initiatives. (2) Based on this scan, a survey was developed, and stakeholders (n = 2,777) were invited to rate the resulting 33-topic, 9-category list, via an online survey. Data from 560 respondents (20% response) were analyzed. (3) An expert panel used survey results to further refine the research priorities through a Rand Delphi process. Priorities identified were within four categories: care coordination and transitions, high-performing clinical systems and microsystems improvement approaches, implementation of evidence-based improvements and best practices, and culture of quality and safety. The priorities identified were adopted by the improvement science research network as the research agenda to guide strategy. The process and conclusions may be of value to quality improvement research funding agencies, governments, and research units seeking to concentrate their resources on improvement topics where research is capable of yielding timely and actionable answers as well as contributing to the knowledge base for improvement. PMID:24024029

77 FR 27854 - Agency Information Collection Activity Under OMB Review

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-11

... will provide FTA with the opportunity to establish a proactive safety research agenda that will improve... survey will be used to improve transit safety research with long-term goals of improving public transit... 20503, Attention: FTA Desk Officer. Comments are Invited On: Whether the proposed collection of...

Perspectives of Post-Acute Transition of Care for Cardiac Surgery Patients

PubMed Central

Stoicea, Nicoleta; You, Tian; Eiterman, Andrew; Hartwell, Clifton; Davila, Victor; Marjoribanks, Stephen; Florescu, Cristina; Bergese, Sergio Daniel; Rogers, Barbara

2017-01-01

Post-acute care (PAC) facilities improve patient recovery, as measured by activities of daily living, rehabilitation, hospital readmission, and survival rates. Seamless transitions between discharge and PAC settings continue to be challenges that hamper patient outcomes, specifically problems with effective communication and coordination between hospitals and PAC facilities at patient discharge, patient adherence and access to cardiac rehabilitation (CR) services, caregiver burden, and the financial impact of care. The objective of this review is to examine existing models of cardiac transitional care, identify major challenges and social factors that affect PAC, and analyze the impact of current transitional care efforts and strategies implemented to improve health outcomes in this patient population. We intend to discuss successful methods to address the following aspects: hospital-PAC linkages, improved discharge planning, caregiver burden, and CR access and utilization through patient-centered programs. Regular home visits by healthcare providers result in decreased hospital readmission rates for patients utilizing home healthcare while improved hospital-PAC linkages reduced hospital readmissions by 25%. We conclude that widespread adoption of improvements in transitional care will play a key role in patient recovery and decrease hospital readmission, morbidity, and mortality. PMID:29230400

Perspectives of Post-Acute Transition of Care for Cardiac Surgery Patients.

PubMed

Stoicea, Nicoleta; You, Tian; Eiterman, Andrew; Hartwell, Clifton; Davila, Victor; Marjoribanks, Stephen; Florescu, Cristina; Bergese, Sergio Daniel; Rogers, Barbara

2017-01-01

Post-acute care (PAC) facilities improve patient recovery, as measured by activities of daily living, rehabilitation, hospital readmission, and survival rates. Seamless transitions between discharge and PAC settings continue to be challenges that hamper patient outcomes, specifically problems with effective communication and coordination between hospitals and PAC facilities at patient discharge, patient adherence and access to cardiac rehabilitation (CR) services, caregiver burden, and the financial impact of care. The objective of this review is to examine existing models of cardiac transitional care, identify major challenges and social factors that affect PAC, and analyze the impact of current transitional care efforts and strategies implemented to improve health outcomes in this patient population. We intend to discuss successful methods to address the following aspects: hospital-PAC linkages, improved discharge planning, caregiver burden, and CR access and utilization through patient-centered programs. Regular home visits by healthcare providers result in decreased hospital readmission rates for patients utilizing home healthcare while improved hospital-PAC linkages reduced hospital readmissions by 25%. We conclude that widespread adoption of improvements in transitional care will play a key role in patient recovery and decrease hospital readmission, morbidity, and mortality.

A single activity with a practice quality improvement project for faculty and a quality improvement project for residents.

PubMed

Kim, Hyun; Malatesta, Theresa M; Simone, Nicole L; Den, Robert B; McAna, John; Dicker, Adam P; Bar Ad, Voichita

2016-01-01

The Next Accreditation System (NAS) requires radiation oncology residents to do a formal quality improvement project during their residency. The American Board of Radiology (ABR) Maintenance of Certification (MOC) program requires certified physicians to complete a Practice Quality Improvement (PQI) project approximately every 3 years. The purpose of our project was to develop a clinical transition of care policy via a process that resulted in quality improvement project credit for residents and PQI credit for participating faculty. Approval for project implementation was obtained from the ABR MOC committee. The PQI project consisted of an initial survey to assess resident perception on resident transition of care in our department, formal sign-out training, and 2 postintervention surveys after 1 and 11 months. The primary endpoint was the percentage of questions with ≤1 unfavorable responses. Sign-test was used to determine response difference from neutral. One hundred percent of surveyed residents completed the preintervention (n = 6), postintervention 1 (n = 7), and postintervention 2 (n = 8) surveys. In the preintervention, postintervention 1, and postintervention 2 surveys, 71.4%, 57.1%, and 57.1% of questions were answered with ≤1 unfavorable response, respectively. The number of questions with ≥75% favorable response was 7 (50%), 7 (50%), and 11 (78.5%) in the preintervention, postintervention 1, and postintervention 2 surveys, respectively (P = .13). A written sign-out template and monthly protected sign-out meetings were instituted. One resident and 3 attending physicians received credit for Accreditation Council of Graduate Medical Education NAS quality improvement and ABR MOC PQI projects, respectively. This project shows the feasibility of a combined attending and resident physician effort to improve patient care and fulfill his or her respective ABR MOC PQI and Accreditation Council of Graduate Medical Education NAS requirements. Attending and resident physicians can tailor collaborative projects to fulfill MOC and NAS requirements unique to their subspecialty. Written sign-out templates and protected sign-out time may improve transition of care. Copyright © 2016 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

Is there a role for organic trace element supplements in transition cow health?

PubMed

Andrieu, S

2008-04-01

Optimal transition cow health is the key to success of the subsequent lactation, and increasing attention has been focused on management and nutritional practices that support it. Physiological stress during the transition period alters the efficiency of the immune system, making the lactating dairy cow more susceptible to infectious diseases, such as mastitis and metritis, with subsequent impairment of reproductive performance. Trace elements have a specific role in free radical control at the cellular level and influence the anti-oxidant/free radical balance. Dietary trace elements must be available for absorption throughout the whole of the digestive process until they reach the final site of absorption in the small intestine. Negative interactions between minerals can occur and, as the intestinal environment lowers the absorption of ionic minerals, chelation technology has been developed to increase mineral bioavailability. Organic trace elements have been used in dairy cow experiments, resulting in significant improvements in udder health, lameness and reproductive performance.

The Applied Meteorology Unit: Nineteen Years Successfully Transitioning Research Into Operations for America's Space Program

NASA Technical Reports Server (NTRS)

Madura, John T.; Bauman, William H., III; Merceret, Francis J.; Roeder, William P.; Brody, Frank C.; Hagemeyer, Bartlett C.

2011-01-01

The Applied Meteorology Unit (AMU) provides technology development and transition services to improve operational weather support to America's space program . The AMU was founded in 1991 and operates under a triagency Memorandum of Understanding (MOU) between the National Aeronautics and Space Administration (NASA), the United States Air Force (USAF) and the National Weather Service (NWS) (Ernst and Merceret, 1995). It is colocated with the 45th Weather Squadron (45WS) at Cape Canaveral Air Force Station (CCAFS) and funded by the Space Shuttle Program . Its primary customers are the 45WS, the Spaceflight Meteorology Group (SMG) operated for NASA by the NWS at the Johnson Space Center (JSC) in Houston, TX, and the NWS forecast office in Melbourne, FL (MLB). The gap between research and operations is well known. All too frequently, the process of transitioning research to operations fails for various reasons. The mission of the AMU is in essence to bridge this gap for America's space program.

More accurate depiction of adsorption energy on transition metals using work function as one additional descriptor.

PubMed

Shen, Xiaochen; Pan, Yanbo; Liu, Bin; Yang, Jinlong; Zeng, Jie; Peng, Zhenmeng

2017-05-24

The reaction mechanism and properties of a catalytic process are primarily determined by the interactions between reacting species and catalysts. However, the interactions are often challenging to be experimentally measured, especially for unstable intermediates. Therefore, it is of significant importance to establish an exact relationship between chemical-catalyst interactions and catalyst parameters, which will allow calculation of these interactions and thus advance their mechanistic understanding. Herein we report the description of adsorption energy on transition metals by considering both ionic bonding and covalent bonding contributions and introduce the work function as one additional responsible parameter. We find that the adsorption energy can be more accurately described using a two-dimensional (2D) polynomial model, which shows a significant improvement compared with the current adsorption energy-d-band center linear correlation. We also demonstrate the utilization of this new 2D polynomial model to calculate oxygen binding energy of different transition metals to help understand their catalytic properties in oxygen reduction reactions.

User Experience and Care Integration in Transitional Care for Older People From Hospital to Home: A Meta-Synthesis.

PubMed

Allen, Jacqueline; Hutchinson, Alison M; Brown, Rhonda; Livingston, Patricia M

2017-01-01

This meta-synthesis aimed to improve understanding of user experience of older people, carers, and health providers; and care integration in the care of older people transitioning from hospital to home. Following our systematic search, we identified and synthesized 20 studies, and constructed a comprehensive framework. We derived four themes: (1) 'Who is taking care of what? Trying to work together"; (2) 'Falling short of the mark'; (3) 'A proper discharge'; and (4) 'You adjust somehow.' The themes that emerged from the studies reflected users' experience of discharge and transitional care as a social process of 'negotiation and navigation of independence (older people/carers), or dependence (health providers).' Users engaged in negotiation and navigation through the interrogative strategies of questioning, discussion, information provision, information seeking, assessment, and translation. The derived themes reflected care integration that facilitated, or a lack of care integration that constrained, users' experiences of negotiation and navigation of independence/dependence. © The Author(s) 2016.

First-principles Study of Phonons in Structural Phase Change of Ge-Sb-Te Compounds

NASA Astrophysics Data System (ADS)

Song, Young-Sun; Kim, Jeongwoo; Kim, Minjae; Jhi, Seung-Hoon

Ge-Sb-Te (GST) compounds, exhibiting substantial electrical and optical contrast at extremely fast switching modes, have attracted great attention for application as non-volatile memory devices. Despite extensive studies of GST compounds, the underlying mechanism for fast transitions between amorphous and crystalline phases is yet to be revealed. We study the vibrational property of various GST compounds and the role of nitrogen doping on phase-change processes using first-principles calculations. We find that a certain vibrational mode (Eu) plays a crucial role to determine transition temperatures, and that its frequency depends on the amount of Ge in GST. We also find that the nitrogen doping drives crystalline-amorphous transition at low power consumption modes. In addition, we discuss the effect of the spin-orbit coupling on vibration modes, which is known essential for correct description of the electrical property of GST. Our understanding of phonon modes in GST compounds paves the way for the improving the device performance especially in terms of switching speed and operating voltage.

Glass-Transition Temperature of the β-Relaxation as the Major Predictive Parameter for Recrystallization of Neat Amorphous Drugs.

PubMed

Kissi, Eric Ofosu; Grohganz, Holger; Löbmann, Korbinian; Ruggiero, Michael T; Zeitler, J Axel; Rades, Thomas

2018-03-15

Recrystallization of amorphous drugs is currently limiting the simple approach to improve solubility and bioavailability of poorly water-soluble drugs by amorphization of a crystalline form of the drug. In view of this, molecular mobility, α-relaxation and β-relaxation processes with the associated transition temperatures T gα and T gβ , was investigated using dynamic mechanical analysis (DMA). The correlation between the transition temperatures and the onset of recrystallization for nine amorphous drugs, stored under dry conditions at a temperature of 296 K, was determined. From the results obtained, T gα does not correlate with the onset of recrystallization under the experimental storage conditions. However, a clear correlation between T gβ and the onset of recrystallization was observed. It is shown that at storage temperature below T gβ , amorphous nifedipine retains its amorphous form. On the basis of the correlation, an empirical correlation is proposed for predicting the onset of recrystallization for drugs stored at 0% RH and 296 K.

Linking user and staff perspectives in the evaluation of innovative transition projects for youth with disabilities.

PubMed

McAnaney, Donal F; Wynne, Richard F

2016-06-01

A key challenge in formative evaluation is to gather appropriate evidence to inform the continuous improvement of initiatives. In the absence of outcome data, the programme evaluator often must rely on the perceptions of beneficiaries and staff in generating insight into what is making a difference. The article describes the approach adopted in an evaluation of 15 innovative projects supporting school-leavers with disabilities in making the transition to education, work and life in community settings. Two complementary processes provided an insight into what project staff and leadership viewed as the key project activities and features that facilitated successful transition as well as the areas of quality of life (QOL) that participants perceived as having been impacted positively by the projects. A comparison was made between participants' perceptions of QOL impact with the views of participants in services normally offered by the wider system. This revealed that project participants were significantly more positive in their views than participants in traditional services. In addition, the processes and activities of the more highly rated projects were benchmarked against less highly rated projects and also with usually available services. Even in the context of a range of intervening variables such as level and complexity of participant needs and variations in the stage of development of individual projects, the benchmarking process indicated a number of project characteristics that were highly valued by participants. © The Author(s) 2016.

Automation Improves Schedule Quality and Increases Scheduling Efficiency for Residents.

PubMed

Perelstein, Elizabeth; Rose, Ariella; Hong, Young-Chae; Cohn, Amy; Long, Micah T

2016-02-01

Medical resident scheduling is difficult due to multiple rules, competing educational goals, and ever-evolving graduate medical education requirements. Despite this, schedules are typically created manually, consuming hours of work, producing schedules of varying quality, and yielding negative consequences for resident morale and learning. To determine whether computerized decision support can improve the construction of residency schedules, saving time and improving schedule quality. The Optimized Residency Scheduling Assistant was designed by a team from the University of Michigan Department of Industrial and Operations Engineering. It was implemented in the C.S. Mott Children's Hospital Pediatric Emergency Department in the 2012-2013 academic year. The 4 metrics of schedule quality that were compared between the 2010-2011 and 2012-2013 academic years were the incidence of challenging shift transitions, the incidence of shifts following continuity clinics, the total shift inequity, and the night shift inequity. All scheduling rules were successfully incorporated. Average schedule creation time fell from 22 to 28 hours to 4 to 6 hours per month, and 3 of 4 metrics of schedule quality significantly improved. For the implementation year, the incidence of challenging shift transitions decreased from 83 to 14 (P < .01); the incidence of postclinic shifts decreased from 72 to 32 (P < .01); and the SD of night shifts dropped by 55.6% (P < .01). This automated shift scheduling system improves the current manual scheduling process, reducing time spent and improving schedule quality. Embracing such automated tools can benefit residency programs with shift-based scheduling needs.

Improving Access to Transit Through Crowdsourced Information

DOT National Transportation Integrated Search

2017-11-01

The purpose of this research was to facilitate the ongoing collection of information from the public about potential areas of multimodal service and infrastructure improvements and easily share these problems with transit agencies, departments of tra...

Travlink Operational Test Evaluation Report; Final Report

DOT National Transportation Integrated Search

1996-08-01

">THE OBJECTIVES OF THE TRAVLINK OPERATIONAL TEST WERE TO IMPROVE TRANSIT FLEET MANAGEMENT, IMPROVE THE TIMELINESS AND ACCURACY OF TRAVEL INFORMATION, AND ENCOURAGE TRANSIT RIDERSHIP. THE PROJECT'S CORRIDOR WAS A NEWLY RECONSTRUCTED FREEWAY THAT WAS ...

Hydrogen sulfide conversion with nanophase titania

DOEpatents

Beck, D.D.; Siegel, R.W.

1996-08-20

A process is described for disassociating H{sub 2}S in a gaseous feed using an improved catalytic material in which the feed is contacted at a temperature of at least about 275 C with a catalyst of rutile nanocrystalline titania having grain sizes in the range of from about 1 to about 100 nanometers. Other transition metal catalysts are disclosed, each of nanocrystalline material with grain sizes in the 1-100 nm range. 5 figs.

Multiple Case Comparison of the In-Transit Visibility Business Process

DTIC Science & Technology

2003-03-01

therefore we give it the highest levels of development , testing, training, continuous improvement (lessons learned ) with all of the staff. b. How do you... the Air Force. Results from this study indicate that a lack of emphasis on policy development and management practices, rather than poor system...frequently require information on what they will receive, not just when they will receive it (Gilmore, 2002). This shift in strategy makes the study

Aligning Transition Services with Secondary Educational Reform: A Position Statement of the Division on Career Development and Transition

PubMed Central

Morningstar, Mary E.; Bassett, Diane S.; Cashman, Joanne; Kochhar-Bryant, Carol; Wehmeyer, Michael L.

2014-01-01

Society has witnessed significant improvements in the lives of students receiving transition services over the past 30 years. The field of transition has developed an array of evidence-based interventions and promising practices, however, secondary school reform efforts have often overlooked these approaches for youth without disabilities. If we are to see improvements in postsecondary outcomes for all youth, reform efforts must begin with active participation of both general and special educators and critical home, school, and community stakeholders. In the Division on Career Development for Exceptional Individuals’ position paper, we discuss the evolution of transition in light of reform efforts in secondary education. We review and identify secondary educational initiatives that embrace transition principles. Finally, recommendations are provided for advancing alignment of transition services with secondary education reforms. PMID:25221733

Transition of care for acute stroke and myocardial infarction patients: from hospitalization to rehabilitation, recovery, and secondary prevention.

PubMed

Olson, DaiWai M; Bettger, Janet Prvu; Alexander, Karen P; Kendrick, Amy S; Irvine, Julian R; Wing, Liz; Coeytaux, Remy R; Dolor, Rowena J; Duncan, Pamela W; Graffagnino, Carmelo

2011-10-01

To review the available published literature to assess whether evidence supports a beneficial role for coordinated transition of care services for the postacute care of patients hospitalized with first or recurrent stroke or myocardial infarction (MI). This review was framed around five areas of investigation: (1) key components of transition of care services, (2) evidence for improvement in functional outcomes, morbidity, mortality, and quality of life, (3) associated risks or potential harms, (4) evidence for improvement in systems of care, and (5) evidence that benefits and harms vary by patient-based or system-based characteristics. MEDLINE(®), CINAHL(®), Cochrane Database of Systematic Reviews, and Embase(®). We included studies published in English from 2000 to 2011 that specified postacute hospitalization transition of care services as well as prevention of recurrent stroke or MI. A total of 62 articles representing 44 studies were included for data abstraction. Transition of care interventions were grouped into four categories: (1) hospital -initiated support for discharge was the initial stage in the transition of care process, (2) patient and family education interventions were started during hospitalization but were continued at the community level, (3) community-based models of support followed hospital discharge, and (4) chronic disease management models of care assumed the responsibility for long-term care. Early supported discharge after stroke was associated with reduced total hospital length of stay without adverse effects on functional recovery, and specialty care after MI was associated with reduced mortality. Because of several methodological shortcomings, most studies did not consistently demonstrate that any specific intervention resulted in improved patient-or system -based outcomes. Some studies included more than one intervention, which made it difficult to determine the effect of individual components on clinical outcomes. There was inconsistency in the definition of what constituted a component of transition of care compared to "standard care." Standard care was poorly defined, and nearly all studies were underpowered to demonstrate a statistical benefit. The endpoints varied greatly from study to study. Nearly all the studies were single-site based, and most (26 of 44) were conducted in countries with national health care systems quite different from that of the U.S., therefore limiting their generalizability. Although a basis for the definition of transition of care exists, more consensus is needed on the definition of the interventions and the outcomes appropriate to those interventions. There was limited evidence that two components of hospital-initiated support for discharge (early supported discharge after stroke and specialty care followup after MI)were associated with beneficial effects. No other interventions had sufficient evidence of benefit based on the findings of this systematic review. The adoption of a standard set of definitions, a refinement in the methodology used to study transition of care, and appropriate selection of patient-centered and policy-relevant outcomes should be employed to draw valid conclusions pertaining to specific components of transition of care.

Process for preparing high-transition-temperature superconductors in the Nb-Al-Ge system

DOEpatents

Giorgi, A.L.; Szklarz, E.G.

1973-01-30

The patent describes a process for preparing superconducting materials in the Nb-Al-Ge system having transition temperatures in excess of 19K. The process comprises premixing powdered constituents, pressing them into a plug, heating the plug to 1,450-1,800C for 30 minutes to an hour under vacuum or an inert atmosphere, and annealing at moderate temperatures for reasonably long times (approximately 50 hours). High transition-temperature superconductors, including those in the Nb3(Al,Ge) system, prepared in accordance with this process exhibit little degradation in the superconducting transition temperature on being ground to -200 mesh powder. (GRA)

Pharmacist managed diabetes and cardiovascular risk reduction clinic in kidney transplant recipients: bridging the gap in care transition.

PubMed

Pinelli, Nicole R; Clark, Lindsey M; Carrington, Anne C; Carrington, Julia L; Malinzak, Lauren; Patel, Anita

2014-12-01

The purpose was to assess the feasibility of a care transition intervention for kidney transplant recipients (KTRs) with diabetes. Results document improved quality indicators and reduced resource utilization. These findings imply that a care transition intervention for KTRs with diabetes is feasible and associated with improved patient outcomes. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Framework for developing a spatial walkability index (SWI) for the light-rail transit (LRT) stations in Kuala Lumpur city centre using analytical network process (ANP) and GIS

NASA Astrophysics Data System (ADS)

Naharudin, Nabilah; Ahamad, Mohd Sanusi S.; Sadullah, Ahmad Farhan Mohd

2017-10-01

In support to the nation's goal of developing a liveable city, Malaysian government aims to improve the mobility in Kuala Lumpur by providing good quality transit services across the city. However, the public starts to demand for more than just a connectivity between two points. They want their transit journey to be comfortable and pleasant from the very first mile. The key here is the first and last mile (FLM) of the transit service which defines their journey to access the station itself. The question is, does the existing transit services' FLM satisfy public's needs? Therefore, many studies had emerged in attempt to assess the pedestrian-friendliness. While most of them did base on the pedestrian's perceptions, there were also studies that spatially measured the connectivity and accessibility to various landuses and point of interests. While both can be a good method, their integration could actually produce a better assessment. However, till date, only a few studies had attempted to do so. This paper proposes a framework to develop a Spatial Walkability Index (SWI) by integrating a multicriteria evaluation technique, Analytical Network Process (ANP) and network analysis on geographical information system (GIS) platform. First, ANP will aggregate the degree of importance for each walkability criteria based on the pedestrian's perceptions. Then, the network analysis will use the weighted criteria as attributes to find the walkable routes within half mile radius from each station. The index will be calculated by rationing the total length of walkable routes in respect to the available footpath. The final outcome is a percentage of walkable FLM transit routes for each station which will be named as the SWI. It is expected that the developed framework can be applied in other cities across the globe. It can also be improvised to suit the demand and purpose there.

Transition from children's to adult services for young adults with life-limiting conditions: A realist review of the literature.

PubMed

Kerr, Helen; Price, Jayne; Nicholl, Honor; O'Halloran, Peter

2017-11-01

Improvements in care and treatment have led to more young adults with life-limiting conditions living beyond childhood, which means they must make the transition from children's to adult services. This has proved a challenging process for both young adults and service providers, with complex transition interventions interacting in unpredictable ways with local contexts. To explain how intervention processes interact with contextual factors to help transition from children's to adult services for young adults with life-limiting conditions. Systematic realist review of the literature. Literature was sourced from four electronic databases: Embase, MEDLINE, Science Direct and Cochrane Library from January 1995 to April 2016. This was supplemented with a search in Google Scholar and articles sourced from reference lists of included papers. Data were extracted using an adapted standardised data extraction tool which included identifying information related to interventions, mechanisms, contextual influences and outcomes. Two reviewers assessed the relevance of papers based on the inclusion criteria. Methodological rigor was assessed using the relevant Critical Appraisal Skills Programme tools. 78 articles were included in the review. Six interventions were identified related to an effective transition to adult services. Contextual factors include the need for children's service providers to collaborate with adult service providers to prepare an environment with knowledgeable staff and adequate resources. Mechanisms triggered by the interventions include a sense of empowerment and agency amongst all stakeholders. Early planning, collaboration between children's and adult service providers, and a focus on increasing the young adults' confidence in decision-making and engaging with adult services, are vital to a successful transition. Interventions should be tailored to their context and focused not only on organisational procedures but on equipping young adults, parents/carers and staff to engage with each other effectively. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Design for success: Identifying a process for transitioning to an intensive online course delivery model in health professions education.

PubMed

McDonald, Paige L; Harwood, Kenneth J; Butler, Joan T; Schlumpf, Karen S; Eschmann, Carson W; Drago, Daniela

2018-12-01

Intensive courses (ICs), or accelerated courses, are gaining popularity in medical and health professions education, particularly as programs adopt e-learning models to negotiate challenges of flexibility, space, cost, and time. In 2014, the Department of Clinical Research and Leadership (CRL) at the George Washington University School of Medicine and Health Sciences began the process of transitioning two online 15-week graduate programs to an IC model. Within a year, a third program also transitioned to this model. A literature review yielded little guidance on the process of transitioning from 15-week, traditional models of delivery to IC models, particularly in online learning environments. Correspondingly, this paper describes the process by which CRL transitioned three online graduate programs to an IC model and details best practices for course design and facilitation resulting from our iterative redesign process. Finally, we present lessons-learned for the benefit of other medical and health professions' programs contemplating similar transitions. CRL: Department of Clinical Research and Leadership; HSCI: Health Sciences; IC: Intensive course; PD: Program director; QM: Quality Matters.

Design for success: Identifying a process for transitioning to an intensive online course delivery model in health professions education

PubMed Central

McDonald, Paige L.; Harwood, Kenneth J.; Butler, Joan T.; Schlumpf, Karen S.; Eschmann, Carson W.; Drago, Daniela

2018-01-01

ABSTRACT Intensive courses (ICs), or accelerated courses, are gaining popularity in medical and health professions education, particularly as programs adopt e-learning models to negotiate challenges of flexibility, space, cost, and time. In 2014, the Department of Clinical Research and Leadership (CRL) at the George Washington University School of Medicine and Health Sciences began the process of transitioning two online 15-week graduate programs to an IC model. Within a year, a third program also transitioned to this model. A literature review yielded little guidance on the process of transitioning from 15-week, traditional models of delivery to IC models, particularly in online learning environments. Correspondingly, this paper describes the process by which CRL transitioned three online graduate programs to an IC model and details best practices for course design and facilitation resulting from our iterative redesign process. Finally, we present lessons-learned for the benefit of other medical and health professionsʼ programs contemplating similar transitions. Abbreviations: CRL: Department of Clinical Research and Leadership; HSCI: Health Sciences; IC: Intensive course; PD: Program director; QM: Quality Matters PMID:29277143

Demographic transition and the dynamics of measles in six provinces in China: A modeling study

PubMed Central

Su, Qiru; An, Zhijie; Ma, Fubao; Xie, Shuyun; Xu, Aiqiang; Zhang, Yanyang; Ding, Zhengrong; Li, Hui; Wang, Huaqing; Luo, Huiming; Wang, Ning; Li, Li; Ferrari, Matthew J.

2017-01-01

Background Industrialization and demographic transition generate nonstationary dynamics in human populations that can affect the transmission and persistence of infectious diseases. Decades of increasing vaccination and development have led to dramatic declines in the global burden of measles, but the virus remains persistent in much of the world. Here we show that a combination of demographic transition, as a result of declining birth rates, and reduced measles prevalence, due to improved vaccination, has shifted the age distribution of susceptibility to measles throughout China. Methods and findings We fit a novel time-varying catalytic model to three decades of age-specific measles case reporting in six provinces in China to quantify the change in the age-specific force of infection for measles virus over time. We further quantified the impact of supplemental vaccination campaigns on the reduction of susceptible individuals. The force of infection of measles has declined dramatically (90%–97% reduction in transmission rate) in three industrialized eastern provinces during the last decade, driving a concomitant increase in both the relative proportion and absolute number of adult cases, while three central and western provinces exhibited dynamics consistent with endemic persistence (24%–73% reduction in transmission rate). The reduction in susceptible individuals due to supplemental vaccination campaigns is frequently below the nominal campaign coverage, likely because campaigns necessarily vaccinate those who may already be immune. The impact of these campaigns has significantly improved over time: campaigns prior to 2005 were estimated to have achieved less than 50% reductions in the proportion susceptible in the target age classes, but campaigns from 2005 onwards reduced the susceptible proportion by 32%–87%. A limitation of this study is that it relies on case surveillance, and thus inference may be biased by age-specific variation in measles reporting. Conclusions The age distribution of measles cases changes in response to both demographic and vaccination processes. Combining both processes in a novel catalytic model, we illustrate that age-specific incidence patterns reveal regional differences in the progress to measles elimination and the impact of vaccination controls in China. The shift in the age distribution of measles susceptibility in response to demographic and vaccination processes emphasizes the importance of progressive control strategies and measures to evaluate program success that anticipate and react to this transition in observed incidence. PMID:28376084

A systematic review of the effectiveness of strategies and interventions to improve the transition from student to newly qualified nurse.

PubMed

Edwards, Deborah; Hawker, Clare; Carrier, Judith; Rees, Colin

2015-07-01

The transition from student to newly qualified nurse can be stressful for many newly qualified nurses who feel inadequately prepared. A variety of support strategies to improve the transition process have been reported across the international literature but the effectiveness of such strategies is unknown. To determine the effectiveness of the main strategies used to support newly qualified nurses during the transition into the clinical workplace and, where identified, evaluate the impact of these on individual and organisational outcomes. Systematic review. A search of electronic databases to identify published studies (CINAHL, MEDLINE, British Nursing Index, Cochrane Library, EMBASE, PsychLit, PsychINFO, PsychARTICLES, Web Of Science, EBM Reviews, BioMed, TRIP, ERIC, SCOPUS (January 2000-April 2011) was conducted. Relevant journals were hand-searched and reference lists from retrieved studies were reviewed to identify any further studies. The search was restricted to English language papers. The key words used were words that described new graduate nurses and support strategies (e.g. internship, residency, orientation programmes). The inclusion criteria were quantitative studies that investigated the effectiveness of support strategies for newly qualified graduate nurses. Studies that involved students in their final year of graduate study were excluded (for example extern programmes). Extraction of data was undertaken independently by two reviewers. A further two reviewers assessed the methodological quality against agreed criteria. A total of 8199 studies were identified from the database search and 30 met the inclusion criteria for the review. The evidence suggests that transition interventions/strategies do lead to improvements in confidence and competence, job satisfaction, critical thinking and reductions in stress and anxiety for the newly qualified nurse. This systematic review demonstrates the beneficial effects of transitional support strategies for newly qualified nurses from the perspective of the new nurse and their employer. The overall impact of support strategies appears positive, irrespective of the type of support provided. This may suggest that it is the organisations' focus on new graduate nurses that is important, rather than simply leaving them to acclimatise to their new role themselves. Future research should involve well designed randomised controlled trials with larger sample sizes, using more objective and reliable outcome measures. Copyright © 2015 Elsevier Ltd. All rights reserved.

Mathematical modeling for optimizing skip-stop rail transit operation strategy using genetic algorithm.

DOT National Transportation Integrated Search

2012-03-01

"With skip-stop rail transit operation, transit agencies can reduce their operating costs and fleet size, : and passengers can experience reduced in-transit travel times without extra track and technological : improvement. However, since skip-stop op...

Improving transit equity, streamlining operations : technologies that benefit the transportation disadvantaged

DOT National Transportation Integrated Search

2006-01-01

This illustrates some of the ways in which technology has improved the ability of transportation disadvantaged individuals to use public transit. Some benefits offered include more efficient coordination among service providers, system flexibility, t...

Mask data processing in the era of multibeam writers

NASA Astrophysics Data System (ADS)

Abboud, Frank E.; Asturias, Michael; Chandramouli, Maesh; Tezuka, Yoshihiro

2014-10-01

Mask writers' architectures have evolved through the years in response to ever tightening requirements for better resolution, tighter feature placement, improved CD control, and tolerable write time. The unprecedented extension of optical lithography and the myriad of Resolution Enhancement Techniques have tasked current mask writers with ever increasing shot count and higher dose, and therefore, increasing write time. Once again, we see the need for a transition to a new type of mask writer based on massively parallel architecture. These platforms offer a step function improvement in both dose and the ability to process massive amounts of data. The higher dose and almost unlimited appetite for edge corrections open new windows of opportunity to further push the envelope. These architectures are also naturally capable of producing curvilinear shapes, making the need to approximate a curve with multiple Manhattan shapes unnecessary.

Exploring the need for Transition Readiness Scales within cystic fibrosis services: A qualitative descriptive study.

PubMed

Bourke, Mary; Houghton, Catherine

2018-07-01

To explore healthcare professionals' and patients' perceptions of the potential use of a Transition Readiness Scale in cystic fibrosis care. This included an examination of barriers and facilitators to its implementation along with the identification of key items to include in a Transition Readiness Scale. Due to increasing life expectancy and improved quality of life, more adolescents with cystic fibrosis are transitioning from paediatric to adult health care. To assess and correctly manage this transition, a more structured approach to transition is advocated. This can be achieved using a Transition Readiness Scale to potentially identify or target areas of care in which the adolescent may have poor knowledge. These key items include education, developmental readiness taking into account relationships, reproduction, future plans and self-management skills. Existing tools to gauge readiness concentrate mainly on education and self-care needs assessment as their key items. Currently, there is no specific cystic fibrosis Transition Readiness Scale in use in Ireland or internationally. The study used a descriptive qualitative design. Data were collected using semi-structured interviews (n = 8) and analysed using a thematic approach. The findings identified the potential benefits of this tool and second the resources which need to be in place before its development and implementation into cystic fibrosis services. Transition Readiness Scales have substantial relevance with cystic fibrosis services emphasising the importance of establishing the necessary resources prior to its implementation. These were identified as more staff, a dedicated private space and staff training and education. Significant resources are needed to fully integrate Transition Readiness Scales in practice. The study findings suggest multidisciplinary collaborations, and patient engagement is pivotal in planning and easing the transition process for adolescents with cystic fibrosis. © 2018 The Authors. Journal of Clinical Nursing Published by John Wiley & Sons Ltd.

Safe transition to surgery: working differently to make blood transfusion process safer for elective surgery.

PubMed

Badjie, Karafa S W; Rogers, James C; Jenkins, Sarah M; Bundy, Kevin L; Stubbs, James R; Cima, Robert R

2015-09-01

Our institutional policy allows patients who are scheduled for elective surgery with no history of a pregnancy or blood transfusion in the preceding 3 months to have a presurgical sample (PSS) collected and tested up to 56 days before their scheduled surgery; however, our PSS TS completion rate in eligible patients before the morning of surgery was 83%. In 2011, a team was charged to develop a standardized process along with other process improvements while ensuring no increase in transfusion-related events. The team followed the DMAIC framework in appraising the effectiveness and efficiency of the current state process including baseline data collection such as PSS TS completion rate, number of eligible patients needing a PSS TS on the day of surgery, benchmarking, SSBO utilization, and future state mapping. First quarter (Q1) 2011 versus Q1 2012 postimplementation results showed significant improvements of the process including a 53% decrease in PSS TS on the day of surgery; a 13% increase in PSS TS completion before the morning of surgery; a 26% reduction in total XM RBCs; and a 58.8% reduction in XM RBCs not issued, plus a 47% decrease in RBC wastage. Q1 2011 versus Q1 2013 showed a 41% reduction in total XM RBCs and an 88.4% reduction in XM RBCs not issued but overall RBCs issued versus returned increased slightly and represents a future opportunity for improvement. The redesigned, transformational process eliminated SSBO and improved ordering process and PSS TS completion rate as well as blood product ordering and utilization. © 2015 AABB.

Computer graphic visualization of orbiter lower surface boundary-layer transition

NASA Technical Reports Server (NTRS)

Throckmorton, D. A.; Hartung, L. C.

1984-01-01

Computer graphic techniques are applied to the processing of Shuttle Orbiter flight data in order to create a visual presentation of the extent and movement of the boundary-layer transition front over the orbiter lower surface during entry. Flight-measured surface temperature-time histories define the onset and completion of the boundary-layer transition process at any measurement location. The locus of points which define the spatial position of the boundary-layer transition front on the orbiter planform is plotted at each discrete time for which flight data are available. Displaying these images sequentially in real-time results in an animated simulation of the in-flight boundary-layer transition process.

Global CALIPSO Observations of Aerosol Changes Near Clouds

NASA Technical Reports Server (NTRS)

Varnai, Tamas; Marshak, Alexander

2011-01-01

Several recent studies have found that clouds are surrounded by a transition zone of rapidly changing aerosol optical properties and particle size. Characterizing this transition zone is important for better understanding aerosol-cloud interactions and aerosol radiative effects, and also for improving satellite retrievals of aerosol properties. This letter presents a statistical analysis of a monthlong global data set of Cloud-Aerosol Lidar and Infrared Pathfinder Satellite Observation (CALIPSO) lidar observations over oceans. The results show that the transition zone is ubiquitous over all oceans and extends up to 15 km away from clouds. They also show that near-cloud enhancements in backscatter and particle size are strongest at low altitudes, slightly below the top of the nearest clouds. Also, the enhancements are similar near illuminated and shadowy cloud sides, which confirms that the asymmetry of Moderate Resolution Imaging Spectroradiometer reflectances found in an earlier study comes from 3-D radiative processes and not from differences in aerosol properties. Finally, the effects of CALIPSO aerosol detection and cloud identification uncertainties are discussed. The findings underline the importance of accounting for the transition zone to avoid potential biases in studies of satellite aerosol products, aerosol-cloud interactions, and aerosol direct radiative effects.

Experimental Identification of Electric Field Excitation Mechanisms in a Structural Transition of Tokamak Plasmas

PubMed Central

Kobayashi, T.; Itoh, K.; Ido, T.; Kamiya, K.; Itoh, S.-I.; Miura, Y.; Nagashima, Y.; Fujisawa, A.; Inagaki, S.; Ida, K.; Hoshino, K.

2016-01-01

Self-regulation between structure and turbulence, which is a fundamental process in the complex system, has been widely regarded as one of the central issues in modern physics. A typical example of that in magnetically confined plasmas is the Low confinement mode to High confinement mode (L-H) transition, which is intensely studied for more than thirty years since it provides a confinement improvement necessary for the realization of the fusion reactor. An essential issue in the L-H transition physics is the mechanism of the abrupt “radial” electric field generation in toroidal plasmas. To date, several models for the L-H transition have been proposed but the systematic experimental validation is still challenging. Here we report the systematic and quantitative model validations of the radial electric field excitation mechanism for the first time, using a data set of the turbulence and the radial electric field having a high spatiotemporal resolution. Examining time derivative of Poisson’s equation, the sum of the loss-cone loss current and the neoclassical bulk viscosity current is found to behave as the experimentally observed radial current that excites the radial electric field within a few factors of magnitude. PMID:27489128

A Novel In-situ Electrochemical Cell for Neutron Diffraction Studies of Phase Transitions in Small Volume Electrodes of Li-ion Batteries

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

Vadlamani, Bhaskar S; An, Ke; Jagannathan, M.

2014-01-01

The design and performance of a novel in-situ electrochemical cell that greatly facilitates the neutron diffraction study of complex phase transitions in small volume electrodes of Li-ion cells, is presented in this work. Diffraction patterns that are Rietveld-refinable could be obtained simultaneously for all the electrodes, which demonstrates that the cell is best suited to explore electrode phase transitions driven by the lithiation and delithiation processes. This has been facilitated by the use of single crystal (100) Si sheets as casing material and the planar cell configuration, giving improved signal-to-noise ratio relative to other casing materials. The in-situ cell hasmore » also been designed for easy assembly and to facilitate rapid experiments. The effectiveness of cell is demonstrated by tracking the neutron diffraction patterns during the charging of graphite/LiCoO2 and graphite/LiMn2O4 cells. It is shown that good quality neutron diffraction data can be obtained and that most of the finer details of the phase transitions, and the associated changes in crystallographic parameters in these electrodes, can be captured.« less

Iowa in motion : transit system plan : implementing Iowa's state transportation plan

DOT National Transportation Integrated Search

1999-09-14

The Iowa Transit System Plan was developed as a result of the on-going long-range transportation planning process known as Iowa In Motion This planning document, the 1999 Iowa Transit System Plan, is the result of this continuing planning process and...

Improved transition path sampling methods for simulation of rare events

NASA Astrophysics Data System (ADS)

Chopra, Manan; Malshe, Rohit; Reddy, Allam S.; de Pablo, J. J.

2008-04-01

The free energy surfaces of a wide variety of systems encountered in physics, chemistry, and biology are characterized by the existence of deep minima separated by numerous barriers. One of the central aims of recent research in computational chemistry and physics has been to determine how transitions occur between deep local minima on rugged free energy landscapes, and transition path sampling (TPS) Monte-Carlo methods have emerged as an effective means for numerical investigation of such transitions. Many of the shortcomings of TPS-like approaches generally stem from their high computational demands. Two new algorithms are presented in this work that improve the efficiency of TPS simulations. The first algorithm uses biased shooting moves to render the sampling of reactive trajectories more efficient. The second algorithm is shown to substantially improve the accuracy of the transition state ensemble by introducing a subset of local transition path simulations in the transition state. The system considered in this work consists of a two-dimensional rough energy surface that is representative of numerous systems encountered in applications. When taken together, these algorithms provide gains in efficiency of over two orders of magnitude when compared to traditional TPS simulations.

Modeling and evaluating user behavior in exploratory visual analysis

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

Reda, Khairi; Johnson, Andrew E.; Papka, Michael E.

Empirical evaluation methods for visualizations have traditionally focused on assessing the outcome of the visual analytic process as opposed to characterizing how that process unfolds. There are only a handful of methods that can be used to systematically study how people use visualizations, making it difficult for researchers to capture and characterize the subtlety of cognitive and interaction behaviors users exhibit during visual analysis. To validate and improve visualization design, however, it is important for researchers to be able to assess and understand how users interact with visualization systems under realistic scenarios. This paper presents a methodology for modeling andmore » evaluating the behavior of users in exploratory visual analysis. We model visual exploration using a Markov chain process comprising transitions between mental, interaction, and computational states. These states and the transitions between them can be deduced from a variety of sources, including verbal transcripts, videos and audio recordings, and log files. This model enables the evaluator to characterize the cognitive and computational processes that are essential to insight acquisition in exploratory visual analysis, and reconstruct the dynamics of interaction between the user and the visualization system. We illustrate this model with two exemplar user studies, and demonstrate the qualitative and quantitative analytical tools it affords.« less

Improving Sickle Cell Transitions of Care Through Health Information Technology.

PubMed

Frost, Jennifer R; Cherry, Rebecca K; Oyeku, Suzette O; Faro, Elissa Z; Crosby, Lori E; Britto, Maria; Tuchman, Lisa K; Horn, Ivor B; Homer, Charles J; Jain, Anjali

2016-07-01

Transitions between inpatient and outpatient care and pediatric to adult care are associated with increased mortality for sickle cell disease (SCD) patients. As accurate and timely sharing of health information is essential during transitions, a health information technology (HIT)-enabled tool holds promise to improve care transitions. From 2012 through 2014, the team conducted and analyzed data from an environmental scan, key informant interviews, and focus groups to inform the development of an HIT-enabled tool for SCD patients' use during care transitions. The scan included searches of peer-reviewed and gray literature to understand SCD patient needs, transition concerns, and best practices in mobile health applications, and searches of websites and online stores to identify existing transition tools and their features. Eleven focus groups consisted of four groups of SCD patients of varying ages (≥9 years); three groups of parents/caregivers of SCD patients; three groups of providers; and one with IT developers. In focus groups, patients and caregivers reported that the transition from home to the emergency department (ED) was the most challenging; the ED was also where transitions from pediatric to adult care usually occurred. Patients felt they were not taken seriously by unfamiliar ED providers, and their inability to convey their diagnosis, pain regimen, and detailed medical history while in significant pain hindered care. The environmental scan did not reveal an existing suitable transition tool, but patients, parents, providers, and IT experts saw the potential and appeal of creating a tool to meet ED health information needs to improve care transitions. Copyright © 2016 American Journal of Preventive Medicine. All rights reserved.

Biotechnological Strategies to Improve Plant Biomass Quality for Bioethanol Production

PubMed Central

del Moral, Sandra; Núñez-López, Lizeth; Barrera-Figueroa, Blanca E.; Amaya-Delgado, Lorena

2017-01-01

The transition from an economy dependent on nonrenewable energy sources to one with higher diversity of renewables will not be a simple process. It requires an important research effort to adapt to the dynamics of the changing energy market, sort costly processes, and avoid overlapping with social interest markets such as food and livestock production. In this review, we analyze the desirable traits of raw plant materials for the bioethanol industry and the molecular biotechnology strategies employed to improve them, in either plants already under use (as maize) or proposed species (large grass families). The fundamentals of these applications can be found in the mechanisms by which plants have evolved different pathways to manage carbon resources for reproduction or survival in unexpected conditions. Here, we review the means by which this information can be used to manipulate these mechanisms for commercial uses, including saccharification improvement of starch and cellulose, decrease in cell wall recalcitrance through lignin modification, and increase in plant biomass. PMID:28951875

The Image Gently pediatric digital radiography safety checklist: tools for improving pediatric radiography.

PubMed

John, Susan D; Moore, Quentin T; Herrmann, Tracy; Don, Steven; Powers, Kevin; Smith, Susan N; Morrison, Greg; Charkot, Ellen; Mills, Thalia T; Rutz, Lois; Goske, Marilyn J

2013-10-01

Transition from film-screen to digital radiography requires changes in radiographic technique and workflow processes to ensure that the minimum radiation exposure is used while maintaining diagnostic image quality. Checklists have been demonstrated to be useful tools for decreasing errors and improving safety in several areas, including commercial aviation and surgical procedures. The Image Gently campaign, through a competitive grant from the FDA, developed a checklist for technologists to use during the performance of digital radiography in pediatric patients. The checklist outlines the critical steps in digital radiography workflow, with an emphasis on steps that affect radiation exposure and image quality. The checklist and its accompanying implementation manual and practice quality improvement project are open source and downloadable at www.imagegently.org. The authors describe the process of developing and testing the checklist and offer suggestions for using the checklist to minimize radiation exposure to children during radiography. Copyright © 2013 American College of Radiology. All rights reserved.

SNR improvement by variation of recording and media parameters for a HAMR exchange coupled composite media

NASA Astrophysics Data System (ADS)

Natekar, N. A.; Liu, Zengyuan; Hernandez, Stephanie; Victora, R. H.

2018-05-01

An exchange coupled composite media structure proposed previously seems to address both the issue of Tc variation in FePt as well as poor SNR/User Density during the HAMR process. Here we examine a thinner 3-6 nm structure that is likely easier to fabricate than the previous 13.5 nm thick structure. We find that increasing the damping within the write (superparamagnetic) layer and introducing intergranular exchange within the grains in the write layer are both successful approaches to improve the recorded SNR. Ensemble waveform analysis that allows the breakdown of the total SNR into transition SNR (due to AC noise) and remanence SNR (due to DC noise) helps identify the leading causes for this SNR improvement. Further studies indicate that varying the peak heat spot temperature in the HAMR write process is also a successful approach for improving the recorded SNR. This lends credence to the idea that a thinner composite media may still be used successfully to realize significant enhancements of SNR and the corresponding user density.

Future Directions for Transit Pricing : Proceedings of the September 1980 Conference on Transit Pricing Innovations

DOT National Transportation Integrated Search

1981-04-01

The purpose of the conference was to provide practical guidance to policy makers and transit operators on improved pricing policies and strategies. Topics covered include: trends and policies in future transit pricing; conventional and paratransit in...

Design & development of the LCO-140H series hydraulic hybrid low floor transit bus.

DOT National Transportation Integrated Search

2012-09-01

Automation Alley, Altair, and the Federal Transit Administration (FTA), in a public-private partnership, teamed up to advance a new transit bus initiative that would improve Americas local and regional transit systems while requiring no infrastruc...

Transit Marketing : A Program of Research, Demonstration and Communication

DOT National Transportation Integrated Search

1985-04-01

This report recommends a five-year program of research, demonstration, and communication to improve the effectiveness of marketing practice in the U.S. transit industry. The program is oriented toward the development of improved market research tools...

UAB UTC transit related activities

DOT National Transportation Integrated Search

2011-01-25

The ITS Strategic Plan outlines a strategy for improving the efficiency of the Region's existing highway and transit systems. The Region's overall goal is to improve the efficiency and effectiveness of existing systems so as to reduce the need to bui...

TEACHER TRAINING: How to Produce Better Math and Science Teachers.

PubMed

Mervis, J

2000-09-01

Two National Research Council panels have released new reports on improving science and math education in the United States. One panel says that the best way to improve teacher education is to make it a continuum, with school districts taking more responsibility for the initial preparation of new teachers and university faculty playing a bigger role in ongoing professional development. The other panel says that more recent science Ph.D.s would be willing to teach high school science and math if the government helped with the transition, if the certification process were compressed, and if they could retain ties to research.

Adiabatic leakage elimination operator in an experimental framework

NASA Astrophysics Data System (ADS)

Wang, Zhao-Ming; Byrd, Mark S.; Jing, Jun; Wu, Lian-Ao

2018-06-01

Adiabatic evolution is used in a variety of quantum information processing tasks. However, the elimination of errors is not as well developed as it is for circuit model processing. Here, we present a strategy to improve the performance of a quantum adiabatic process by adding leakage elimination operators (LEOs) to the evolution. These are a sequence of pulse controls acting in an adiabatic subspace to eliminate errors by suppressing unwanted transitions. Using the Feshbach P Q partitioning technique, we obtain an analytical solution for a set of pulse controls. The effectiveness of the LEO is independent of the specific form of the pulse but depends on the average frequency of the control function. By observing that the evolution of the target eigenstate is governed by a periodic function appearing in the integral of the control function, we show that control parameters can be chosen in such a way that the instantaneous eigenstates of the system are unchanged, yet a speedup can be achieved by suppressing transitions. Furthermore, we give the exact expression of the control function for a counter unitary transformation to be used in experiments which provides a clear physical meaning for the LEO, aiding in the implementation.

Visualizing redox orbitals and their potentials in advanced lithium-ion battery materials using high-resolution x-ray Compton scattering

PubMed Central

Hafiz, Hasnain; Suzuki, Kosuke; Barbiellini, Bernardo; Orikasa, Yuki; Callewaert, Vincent; Kaprzyk, Staszek; Itou, Masayoshi; Yamamoto, Kentaro; Yamada, Ryota; Uchimoto, Yoshiharu; Sakurai, Yoshiharu; Sakurai, Hiroshi; Bansil, Arun

2017-01-01

Reduction-oxidation (redox) reactions are the key processes that underlie the batteries powering smartphones, laptops, and electric cars. A redox process involves transfer of electrons between two species. For example, in a lithium-ion battery, current is generated when conduction electrons from the lithium anode are transferred to the redox orbitals of the cathode material. The ability to visualize or image the redox orbitals and how these orbitals evolve under lithiation and delithiation processes is thus of great fundamental and practical interest for understanding the workings of battery materials. We show that inelastic scattering spectroscopy using high-energy x-ray photons (Compton scattering) can yield faithful momentum space images of the redox orbitals by considering lithium iron phosphate (LiFePO4 or LFP) as an exemplar cathode battery material. Our analysis reveals a new link between voltage and the localization of transition metal 3d orbitals and provides insight into the puzzling mechanism of potential shift and how it is connected to the modification of the bond between the transition metal and oxygen atoms. Our study thus opens a novel spectroscopic pathway for improving the performance of battery materials. PMID:28845452

Visualizing redox orbitals and their potentials in advanced lithium-ion battery materials using high-resolution x-ray Compton scattering.

PubMed

Hafiz, Hasnain; Suzuki, Kosuke; Barbiellini, Bernardo; Orikasa, Yuki; Callewaert, Vincent; Kaprzyk, Staszek; Itou, Masayoshi; Yamamoto, Kentaro; Yamada, Ryota; Uchimoto, Yoshiharu; Sakurai, Yoshiharu; Sakurai, Hiroshi; Bansil, Arun

2017-08-01

Reduction-oxidation (redox) reactions are the key processes that underlie the batteries powering smartphones, laptops, and electric cars. A redox process involves transfer of electrons between two species. For example, in a lithium-ion battery, current is generated when conduction electrons from the lithium anode are transferred to the redox orbitals of the cathode material. The ability to visualize or image the redox orbitals and how these orbitals evolve under lithiation and delithiation processes is thus of great fundamental and practical interest for understanding the workings of battery materials. We show that inelastic scattering spectroscopy using high-energy x-ray photons (Compton scattering) can yield faithful momentum space images of the redox orbitals by considering lithium iron phosphate (LiFePO 4 or LFP) as an exemplar cathode battery material. Our analysis reveals a new link between voltage and the localization of transition metal 3d orbitals and provides insight into the puzzling mechanism of potential shift and how it is connected to the modification of the bond between the transition metal and oxygen atoms. Our study thus opens a novel spectroscopic pathway for improving the performance of battery materials.

Effect of SiC particle impact nano-texturing on tribological performance of 304L stainless steel

NASA Astrophysics Data System (ADS)

Lorenzo-Martin, C.; Ajayi, O. O.

2014-10-01

Topographical features on sliding contact surfaces are known to have a significant impact on friction and wear. Indeed, various forms of surface texturing are being used to improve and/or control the tribological performance of sliding surfaces. In this paper, the effect of random surface texturing produced by a mechanical impact process is studied for friction and wear behavior of 304L stainless steel (SS) under dry and marginal oil lubrication. The surface processing was applied to 304L SS flat specimens and tested under reciprocating ball-on-flat sliding contact, with a 440C stainless steel ball. Under dry contact, the impact textured surface exhibited two order of magnitude lower wear than the isotropically ground surface of the same material. After 1500 s of sliding and wearing through of the processed surface layer following occurring of scuffing, the impact textured surface underwent a transition in wear and friction behavior. Under marginal oil lubrication, however, no such transition occurred, and the wear for the impact textured surface was consistently two orders of magnitude lower than that for the ground material. Mechanisms for the tribological performance enhancement are proposed.

The department chair position in academic nursing.

PubMed

Kirkpatrick, M K

1994-01-01

There is a dearth of information on the role of the department chairperson in the nursing literature. As defined in this article, a chairperson is the middle manager and interface between the dean and the faculty. Chairperson refers to the leader of an adult health, maternal/parent child, community, or mental health department who reports to the dean of the School of Nursing. Using transitional theories as the undergirding framework, this article describes the transition from faculty to a chairperson position and the roles and responsibilities of the position. The chairperson must facilitate positive relationships, increase faculty productivity, and empower faculty. This constitutes the foundation for chairperson to facilitate greater faculty development, teaching excellence, and relationships. Implications for ways that nursing leaders may improve this position through the evaluative process are explored.

Dynamics of a Landau-Zener non-dissipative system with fluctuating energy levels

NASA Astrophysics Data System (ADS)

Fai, L. C.; Diffo, J. T.; Ateuafack, M. E.; Tchoffo, M.; Fouokeng, G. C.

2014-12-01

This paper considers a Landau-Zener (two-level) system influenced by a three-dimensional Gaussian and non-Gaussian coloured noise and finds a general form of the time dependent diabatic quantum bit (qubit) flip transition probabilities in the fast, intermediate and slow noise limits. The qubit flip probability is observed to mimic (for low-frequencies noise) that of the standard LZ problem. The qubit flip probability is also observed to be the measure of quantum coherence of states. The transition probability is observed to be tailored by non-Gaussian low-frequency noise and otherwise by Gaussian low-frequency coloured noise. Intermediate and fast noise limits are observed to alter the memory of the system in time and found to improve and control quantum information processing.

Simulating the Thermal Response of High Explosives on Time Scales of Days to Microseconds

NASA Astrophysics Data System (ADS)

Yoh, Jack J.; McClelland, Matthew A.

2004-07-01

We present an overview of computational techniques for simulating the thermal cookoff of high explosives using a multi-physics hydrodynamics code, ALE3D. Recent improvements to the code have aided our computational capability in modeling the response of energetic materials systems exposed to extreme thermal environments, such as fires. We consider an idealized model process for a confined explosive involving the transition from slow heating to rapid deflagration in which the time scale changes from days to hundreds of microseconds. The heating stage involves thermal expansion and decomposition according to an Arrhenius kinetics model while a pressure-dependent burn model is employed during the explosive phase. We describe and demonstrate the numerical strategies employed to make the transition from slow to fast dynamics.

Transitioning Adolescents and Young Adults With HIV Infection to Adult Care: Pilot Testing the "Movin' Out" Transitioning Protocol.

PubMed

Maturo, Donna; Powell, Alexis; Major-Wilson, Hannah; Sanchez, Kenia; De Santis, Joseph P; Friedman, Lawrence B

2015-01-01

Advances in care and treatment of adolescents/young adults with HIV infection have made survival into adulthood possible, requiring transition to adult care. Researchers have documented that the transition process is challenging for adolescents/young adults. To ensure successful transition, a formal transition protocol is needed. Despite existing research, little quantitative evaluation of the transition process has been conducted. The purpose of the study was to pilot test the "Movin' Out" Transitioning Protocol, a formalized protocol developed to assist transition to adult care. A retrospective medical/nursing record review was conducted with 38 clients enrolled in the "Movin' Out" Transitioning Protocol at a university-based adolescent medicine clinic providing care to adolescents/young adults with HIV infection. Almost half of the participants were able to successfully transition to adult care. Reasons for failure to transition included relocation, attrition, lost to follow-up, and transfer to another adult service. Failure to transition to adult care was not related to adherence issues, X(2) (1, N=38)=2.49, p=.288; substance use, X(2) (1, N=38)=1.71, p=.474; mental health issues, X(2) (1, N=38)=2.23, p=.322; or pregnancy/childrearing, X(2) (1, N=38)=0.00, p=.627). Despite the small sample size, the "Movin' Out" Transitioning Protocol appears to be useful in guiding the transition process of adolescents/young adults with HIV infection to adult care. More research is needed with a larger sample to fully evaluate the "Movin' Out" Transitioning Protocol. Copyright © 2015 Elsevier Inc. All rights reserved.

A stress-induced phase transition model for semi-crystallize shape memory polymer

NASA Astrophysics Data System (ADS)

Guo, Xiaogang; Zhou, Bo; Liu, Liwu; Liu, Yanju; Leng, Jinsong

2014-03-01

The developments of constitutive models for shape memory polymer (SMP) have been motivated by its increasing applications. During cooling or heating process, the phase transition which is a continuous time-dependent process happens in semi-crystallize SMP and the various individual phases form at different temperature and in different configuration. Then, the transformation between these phases occurred and shape memory effect will emerge. In addition, stress applied on SMP is an important factor for crystal melting during phase transition. In this theory, an ideal phase transition model considering stress or pre-strain is the key to describe the behaviors of shape memory effect. So a normal distributed model was established in this research to characterize the volume fraction of each phase in SMP during phase transition. Generally, the experiment results are partly backward (in heating process) or forward (in cooling process) compared with the ideal situation considering delay effect during phase transition. So, a correction on the normal distributed model is needed. Furthermore, a nonlinear relationship between stress and phase transition temperature Tg is also taken into account for establishing an accurately normal distributed phase transition model. Finally, the constitutive model which taking the stress as an influence factor on phase transition was also established. Compared with the other expressions, this new-type model possesses less parameter and is more accurate. For the sake of verifying the rationality and accuracy of new phase transition and constitutive model, the comparisons between the simulated and experimental results were carried out.

Preparing childhood cancer survivors for transition to adult care: The young adult perspective.

PubMed

Frederick, Natasha N; Bober, Sharon L; Berwick, Lexie; Tower, Mary; Kenney, Lisa B

2017-10-01

Childhood cancer survivors (CCSs) remain at risk for developing treatment-associated health conditions as they age; however, many do not obtain recommended follow-up, putting them at unnecessary risk for morbidity. Educational interventions targeted at providing survivors with the knowledge and skills necessary for healthcare independence might improve adherence and outcomes as they transition care to the adult medical system. To identify informational needs, educational preferences, and support that young adult CCSs perceive as beneficial for transition from pediatric to adult medical care. Sixteen young adult CCSs (ages 22-39 years) who have transitioned to adult care participated in focus groups led by a trained moderator and analyzed using a thematic analysis approach. Four major themes emerged: (1) education preferences-pediatric oncology provider as the primary source of information and guidance, enhanced by other formats, and early and ongoing engagement in education; (2) family role in transition-desire for independence and acknowledgement of need for ongoing parental support; (3) expectations for adult providers, such as close relationships, open communication, and care coordination; and (4) knowledge deficits regarding disease/treatment history, risk for long-term complications, and navigation of the adult medical system. Transition education as described by young adult CCSs should be a developmentally appropriate process beginning in early adolescents, primarily administered by pediatric oncology providers, and delivered in multiple formats. While healthcare independence is a goal for young adult CCSs, all stakeholders must recognize that families and providers continue to have an important role supporting survivors with transition logistics and medical decision-making. © 2017 Wiley Periodicals, Inc.

Accurate treatment of total photoabsorption cross sections by an ab initio time-dependent method

NASA Astrophysics Data System (ADS)

Daud, Mohammad Noh

2014-09-01

A detailed discussion of parallel and perpendicular transitions required for the photoabsorption of a molecule is presented within a time-dependent view. Total photoabsorption cross sections for the first two ultraviolet absorption bands of the N2O molecule corresponding to transitions from the X1 A' state to the 21 A' and 11 A'' states are calculated to test the reliability of the method. By fully considering the property of the electric field polarization vector of the incident light, the method treats the coupling of angular momentum and the parity differently for two kinds of transitions depending on the direction of the vector whether it is: (a) situated parallel in a molecular plane for an electronic transition between states with the same symmetry; (b) situated perpendicular to a molecular plane for an electronic transition between states with different symmetry. Through this, for those transitions, we are able to offer an insightful picture of the dynamics involved and to characterize some new aspects in the photoabsorption process of N2O. Our calculations predicted that the parallel transition to the 21 A' state is the major dissociation pathway which is in qualitative agreement with the experimental observations. Most importantly, a significant improvement in the absolute value of the total cross section over previous theoretical results [R. Schinke, J. Chem. Phys. 134, 064313 (2011), M.N. Daud, G.G. Balint-Kurti, A. Brown, J. Chem. Phys. 122, 054305 (2005), S. Nanbu, M.S. Johnson, J. Phys. Chem. A 108, 8905 (2004)] was obtained.

A Pilot Study Exploring the Role of Physical Therapists and Transition in Care of Pediatric Patients with Cystic Fibrosis to the Adult Setting

PubMed Central

Packel, Lora; Sood, Megha; Gormley, Michelle; Hayden, Rebecca

2013-01-01

Background Cystic fibrosis (CF) is a disease that requires intensive multidisciplinary care, including care by physical therapists (PTs). People with CF are now living well into adulthood, necessitating a transfer of care from the pediatric setting to an adult one. Physical therapists play a large role in the care of the person with CF; however, there is little known about the PT role in transition of care. Purpose To explore transition issues for people with CF from the perspective of PTs. Methods An 18-question online survey was sent to PTs via an electronic CF listserv. Questions were derived from an analysis of transition literature in CF and other chronic childhood conditions. Physical therapists who reported treating people with CF gave their opinions on issues impacting transition from their perspective as well as their perception of patient and parent concerns. Descriptive statistics were used for data analysis. Results A total of 26 PTs completed the survey. A majority, 61.5%, reported that there was a transition program at their facility, with 42.3% involving physical therapy. Common themes for patients and parents included feeling uncertain about: knowledge of the adult physician, acquiring pulmonary infections in the adult setting, and pace of the adult clinic. Physical therapists were concerned about adherence with airway clearance and exercise following transfer to the adult clinic. Conclusions The role of PT in transition programs is quite varied. Physical therapists should address common concerns of their patients and families to improve the transition process and possibly impact adherence to the PT plan of care. PMID:23754936

Implementation and impact of ICD-10 (Part II)

PubMed Central

Rahmathulla, Gazanfar; Deen, H. Gordon; Dokken, Judith A.; Pirris, Stephen M.; Pichelmann, Mark A.; Nottmeier, Eric W.; Reimer, Ronald; Wharen, Robert E.

2014-01-01

Background: The transition from the International Classification of Disease-9th clinical modification to the new ICD-10 was all set to occur on 1 October 2015. The American Medical Association has previously been successful in delaying the transition by over 10 years and has been able to further postpone its introduction to 2015. The new system will overcome many of the limitations present in the older version, thus paving the way to more accurate capture of clinical information. Methods: The benefits of the new ICD-10 system include improved quality of care, potential cost savings, reduction of unpaid claims, and improved tracking of healthcare data. The areas where challenges will be evident include planning and implementation, the cost to transition, a shortage of qualified coders, training and education of the healthcare workforce, and a loss of productivity when this occurs. The impacts include substantial costs to the healthcare system, but the projected long-term savings and benefits will be significant. Improved fraud detection, accurate data entry, ability to analyze cost benefits with procedures, and enhanced quality outcome measures are the most significant beneficial factors with this change. Results: The present Current Procedural Terminology and Healthcare Common Procedure Coding System code sets will be used for reporting ambulatory procedures in the same manner as they have been. ICD-10-PCS will replace ICD-9 procedure codes for inpatient hospital services. The ICD-10-CM will replace the clinical code sets. Our article will focus on the challenges to execution of an ICD change and strategies to minimize risk while transitioning to the new system. Conclusion: With the implementation deadline gradually approaching, spine surgery practices that include multidisciplinary health specialists have to anticipate and prepare for the ICD change in order to mitigate risk. Education and communication is the key to this process in spine practices. PMID:25184098

Markov-chain model of classified atomistic transition states for discrete kinetic Monte Carlo simulations.

PubMed

Numazawa, Satoshi; Smith, Roger

2011-10-01

Classical harmonic transition state theory is considered and applied in discrete lattice cells with hierarchical transition levels. The scheme is then used to determine transitions that can be applied in a lattice-based kinetic Monte Carlo (KMC) atomistic simulation model. The model results in an effective reduction of KMC simulation steps by utilizing a classification scheme of transition levels for thermally activated atomistic diffusion processes. Thermally activated atomistic movements are considered as local transition events constrained in potential energy wells over certain local time periods. These processes are represented by Markov chains of multidimensional Boolean valued functions in three-dimensional lattice space. The events inhibited by the barriers under a certain level are regarded as thermal fluctuations of the canonical ensemble and accepted freely. Consequently, the fluctuating system evolution process is implemented as a Markov chain of equivalence class objects. It is shown that the process can be characterized by the acceptance of metastable local transitions. The method is applied to a problem of Au and Ag cluster growth on a rippled surface. The simulation predicts the existence of a morphology-dependent transition time limit from a local metastable to stable state for subsequent cluster growth by accretion. Excellent agreement with observed experimental results is obtained.

Quantifying Anthropogenic Dust Emissions

NASA Astrophysics Data System (ADS)

Webb, Nicholas P.; Pierre, Caroline

2018-02-01

Anthropogenic land use and land cover change, including local environmental disturbances, moderate rates of wind-driven soil erosion and dust emission. These human-dust cycle interactions impact ecosystems and agricultural production, air quality, human health, biogeochemical cycles, and climate. While the impacts of land use activities and land management on aeolian processes can be profound, the interactions are often complex and assessments of anthropogenic dust loads at all scales remain highly uncertain. Here, we critically review the drivers of anthropogenic dust emission and current evaluation approaches. We then identify and describe opportunities to: (1) develop new conceptual frameworks and interdisciplinary approaches that draw on ecological state-and-transition models to improve the accuracy and relevance of assessments of anthropogenic dust emissions; (2) improve model fidelity and capacity for change detection to quantify anthropogenic impacts on aeolian processes; and (3) enhance field research and monitoring networks to support dust model applications to evaluate the impacts of disturbance processes on local to global-scale wind erosion and dust emissions.

Being a Female Veteran: A Grounded Theory of Coping With Transitions

PubMed Central

Burkhart, Lisa; Hogan, Nancy

2015-01-01

Female veterans, the fastest growing segment in the military, have unique pre-military histories and military experiences that are associated with post-military physical and mental health service needs. Successful treatment is contingent on a clearer understanding of the processes underlying these experiences. Data from 20 female veterans who served post–Gulf War were analyzed to generate a substantive theory of the process of women who entered, served in, and transitioned out of the military. Coping with transitions emerged as the basic psychosocial process used by female veterans. The Coping with transitions process is comprised of seven categories: Choosing the Military, Adapting to the Military, Being in the Military, Being a Female in the Military, Departing the Military, Experiencing Stressors of Being a Civilian, and Making Meaning of Being a Veteran-Civilian. The results of this study provide a theoretical description of the process female veterans experience when transitioning from a civilian identity, through military life stressors and adaptations, toward gaining a dual identity of being a veteran-civilian. PMID:25745366

Political commitment for vulnerable populations during donor transition.

PubMed

Rodríguez, Daniela C; Whiteside, Alan; Bennett, Sara

2017-02-01

The responsibilities for the programmatic, technical and financial support of health programmes are increasingly being passed from external donors to governments. Programmes for family planning, human immunodeficiency virus, immunization, malaria and tuberculosis have already faced such donor transition, which is a difficult and often political process. Wherever programmes and services aimed at vulnerable populations are primarily supported by donors, the post-transition future is uncertain. Overreliance on donor support is often a reflection of limited domestic political commitment. Limited commitment, which is frequently expressed as the persecution of vulnerable groups, poses a risk to individuals as well as to the effectiveness and sustainability of health programmes. We argue that, for reasons linked to human rights, the social contract and the cost-effectiveness of health promotion, prevention and treatment programmes, it is critical that governments sustain health services for vulnerable populations during and after donor transition. Although civil society organizations could help by engaging with government stakeholders, pushing to change social norms and supporting mechanisms that demand accountability, they may be constrained by economic, political and social factors. Vulnerable populations need to be actively involved in the planning and implementation of donor transition - to ensure that their voice and needs are taken into account and to establish a platform that improves visibility and accountability. As transitions spread across all aspects of global health, transparent conversations about the building and sustainment of political commitment for health services for vulnerable populations become a critical human rights issue.

The direct liquefaction proof of concept program

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

Comolli, A.G.; Lee, L.K.; Pradhan, V.R.

1995-12-31

The goal of the Proof of Concept (POC) Program is to develop Direct Coal Liquefaction and associated transitional technologies towards commercial readiness for economically producing premium liquid fuels from coal in an environmentally acceptable manner. The program focuses on developing the two-stage liquefaction (TSL) process by utilizing geographically strategic feedstocks, commercially feasible catalysts, new prototype equipment, and testing co-processing or alternate feedstocks and improved process configurations. Other high priority objectives include dispersed catalyst studies, demonstrating low rank coal liquefaction without solids deposition, improving distillate yields on a unit reactor volume basis, demonstrating ebullated bed operations while obtaining scale-up data, demonstratingmore » optimum catalyst consumption using new concepts (e.g. regeneration, cascading), producing premium products through on-line hydrotreating, demonstrating improved hydrogen utilization for low rank coals using novel heteroatom removal methods, defining and demonstrating two-stage product properties for upgrading; demonstrating efficient and economic solid separation methods, examining the merits of integrated coal cleaning, demonstrating co-processing, studying interactions between the preheater and first and second-stage reactors, improving process operability by testing and incorporating advanced equipment and instrumentation, and demonstrating operation with alternate coal feedstocks. During the past two years major PDU Proof of Concept runs were completed. POC-1 with Illinois No. 6 coal and POC-2 with Black Thunder sub-bituminous coal. Results from these operations are continuing under review and the products are being further refined and upgraded. This paper will update the results from these operations and discuss future plans for the POC program.« less

Trajectory description of the quantum–classical transition for wave packet interference

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

Chou, Chia-Chun, E-mail: ccchou@mx.nthu.edu.tw

2016-08-15

The quantum–classical transition for wave packet interference is investigated using a hydrodynamic description. A nonlinear quantum–classical transition equation is obtained by introducing a degree of quantumness ranging from zero to one into the classical time-dependent Schrödinger equation. This equation provides a continuous description for the transition process of physical systems from purely quantum to purely classical regimes. In this study, the transition trajectory formalism is developed to provide a hydrodynamic description for the quantum–classical transition. The flow momentum of transition trajectories is defined by the gradient of the action function in the transition wave function and these trajectories follow themore » main features of the evolving probability density. Then, the transition trajectory formalism is employed to analyze the quantum–classical transition of wave packet interference. For the collision-like wave packet interference where the propagation velocity is faster than the spreading speed of the wave packet, the interference process remains collision-like for all the degree of quantumness. However, the interference features demonstrated by transition trajectories gradually disappear when the degree of quantumness approaches zero. For the diffraction-like wave packet interference, the interference process changes continuously from a diffraction-like to collision-like case when the degree of quantumness gradually decreases. This study provides an insightful trajectory interpretation for the quantum–classical transition of wave packet interference.« less

Fiber-Reinforced Reactive Nano-Epoxy Composites

NASA Technical Reports Server (NTRS)

Zhong, Wei-Hong

2011-01-01

An ultra-high-molecular-weight polyethylene/ matrix interface based on the fabrication of a reactive nano-epoxy matrix with lower surface energy has been improved. Enhanced mechanical properties versus pure epoxy on a three-point bend test include: strength (25 percent), modulus (20 percent), and toughness (30 percent). Increased thermal properties include higher Tg (glass transition temperature) and stable CTE (coefficient of thermal expansion). Improved processability for manufacturing composites includes faster wetting rates on macro-fiber surfaces, lower viscosity, better resin infusion rates, and improved rheological properties. Improved interfacial adhesion properties with Spectra fibers by pullout tests include initial debonding force of 35 percent, a maximum pullout force of 25 percent, and energy to debond at 65 percent. Improved mechanical properties of Spectra fiber composites (tensile) aging resistance properties include hygrothermal effects. With this innovation, high-performance composites have been created, including carbon fibers/nano-epoxy, glass fibers/nano-epoxy, aramid fibers/ nano-epoxy, and ultra-high-molecularweight polyethylene fiber (UHMWPE).

Influence of Disability and Gender on Transition Assessment and Goal Generator (TAGG) Scores

ERIC Educational Resources Information Center

El-Kazimi, Nidal

2012-01-01

Legislators mandated transition education for students with disabilities to improve their post-school outcomes. Each student with an IEP should have an annual transition plan at or before his or her 16th birthday. IDEA mandated the utilization of age appropriate transition assessment to develop students' post-secondary transition goals based on…

Applications for improved inventory management for public transit systems

DOT National Transportation Integrated Search

2001-01-01

This report documents and presents the results of a Testing and Demonstration (T&D) Project on applications for improved inventory management for public transit systems. This project is a follow-up to an earlier study on inventory management for bus ...

Design and evaluation of a prelicensure interprofessional course on improving care transitions.

PubMed

Heflin, Mitchell T; Pinheiro, Sandro O; Konrad, Thomas R; Egerton, Emily O; Thornlow, Deirdre K; White, Heidi K; McConnell, Eleanor J

2014-01-01

Effective management of care transitions for older adults require the coordinated expertise of an interprofessional team. Unfortunately, different health care professions are rarely educated together or trained in teamwork skills. To address this issue, a team of professionally diverse faculty from the Duke University Geriatric Education Center designed an interprofessional course focused on improving transitions of care for older adults. This innovative prelicensure course provided interactive teaching sessions designed to promote critical thinking and foster effective communication among health care professionals, caregivers, and patients. Students were assessed by in-class and online participation, performance on individual assignments, and team-based proposals to improve care transitions for older patients with congestive heart failure. Twenty students representing six professions completed the course; 18 completed all self-efficacy and course evaluation surveys. Students rated their self-efficacy in several domains before and after the course and reported gains in teamwork skills (p < .001), transitions of care (p < .001), quality improvement (p < .001) and cultural competence (p < .001). Learner feedback emphasized the importance of enthusiastic and well-prepared faculty, interactive learning experiences, and engagement in relevant work. This course offers a promising approach to shifting the paradigm of health professions education to empower graduates to promote quality improvement through team-based care.

Using Storyboarding Techniques to Identify Design Opportunities: When Students Employ Storyboards, They Are Better Able to Understand the Complexity of a Products's Use and Visualize Areas for Improvement

ERIC Educational Resources Information Center

Reeder, Kevin

2005-01-01

The movie industry heavily relies on storyboards as an effective way to visually describe the process of a movie. The storyboard visually describes how the movie flows from beginning to end, how the characters are interacting, and where transitions and/or gaps exist in the storyline. The storyboard is an effective tool in industrial design as…

Tough, Microcracking-Resistant, High-Temperature Polymer

NASA Technical Reports Server (NTRS)

Pater, Ruth H.; Razon, Pert; Smith, Ricky; Working, Dennis; Chang, Alice; Gerber, Margaret

1990-01-01

Simultaneous synthesis from thermosetting and thermoplastic components yields polyimide with outstanding properties. Involves process in which one polymer cross-linked in immediate presence of other, undergoing simultaneous linear chain extension. New material, LaRC-RP40 synthesized from high-temperature thermosetting imide prepolymer and from thermoplastic monomer. Three significantly improved properties: toughness, resistance to microcracking, and glass-transition temperature. Shows promise as high-temperature matrix resin for variety of components of aircraft engines and for use in other aerospace structures.

Transitional analysis of organic thin color filter layers in displays during baking process using multi-speckle diffusing wave spectroscopy

NASA Astrophysics Data System (ADS)

Park, Baek Sung; Hyung, Kyung Hee; Oh, Gwi Jeong; Jung, Hyun Wook

2018-02-01

The color filter (CF) is one of the key components for improving the performance of TV displays such as liquid crystal display (LCD) and white organic light emitting diodes (WOLED). The profile defects like undercut during the fine fabrication processes for CF layers are inevitably generated through the UV exposure and development processes, however, these can be controlled through the baking process. In order to resolve the profile defects of CF layers, in this study, the real-time dynamic changes of CF layers are monitored during the baking process by changing components such as polymeric binder and acrylate. The motion of pigment particles in CF layers during baking is quantitatively interpreted using multi-speckle diffusing wave spectroscopy (MSDWS), in terms of the autocorrelation function and the characteristic time of α-relaxation.

Kinetic synergistic transitions in the Ostwald ripening processes

NASA Astrophysics Data System (ADS)

Sachkov, I. N.; Turygina, V. F.; Dolganov, A. N.

2018-01-01

There is proposed approach to mathematical description of the kinetic transitions in Ostwald ripening processes of volatile substance in nonuniformly heated porous materials. It is based upon the finite element method. There are implemented computer software. The main feature of the software is to calculate evaporation and condensation fluxes on the walls of a nonuniformly heated cylindrical capillary. Kinetic transitions are detected for three modes of volatile substances migration which are different by condensation zones location. There are controlling dimensionless parameters of the kinetic transition which are revealed during research. There is phase diagram of the Ostwald ripening process modes realization.

Modeling the gain of inner-shell X-ray laser transitions in neon, argon, and copper driven by X-ray free electron laser radiation using photo-ionization and photo-excitation processes

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

Nilsen, Joseph

2015-12-16

Using an X-ray free electron laser (XFEL) at 960 eV to photo-ionize the 1s electron in neutral neon followed by lasing on the 2p-1s transition in singly-ionized neon, an inner-shell X-ray laser was demonstrated at 849 eV in singly-ionized neon gas several years ago. It took decades to demonstrate this scheme, because it required a very strong X-ray source that could photo-ionize the 1s (K shell) electron in neon on a timescale comparable to the intrinsic Auger lifetime in neon of 2 fs. In this paper, we model the neon inner shell X-ray laser under similar conditions to those usedmore » in the XFEL experiments at the SLAC Linac Coherent Light Source (LCLS), and show how we can improve the efficiency of the neon laser and reduce the drive requirements by tuning the XFEL to the 1s-3p transition in neutral neon in order to create gain on the 2p-1s line in neutral neon. We also show how the XFEL could be used to photo-ionize L-shell electrons to drive gain on n = 3–2 transitions in singly-ionized Ar and Cu plasmas. Furthermore, these bright, coherent, and monochromatic X-ray lasers may prove very useful for doing high-resolution spectroscopy and for studying non-linear process in the X-ray regime.« less

[The transition process from paediatric to adult services: A perspective from hospitalised adolescent sufferers of chronic diseases].

PubMed

Inostroza Quezada, Carolina; Correa Venegas, María Loreto; Besoain Arrau, Carolina; Reinoso Medinelli, Alejandro; Velarde Lizama, Macarena; Valenzuela Mujica, María Teresa; Bedregal García, Paula; Zubarew Gurtchin, Tamara

2016-01-01

Chronic illnesses during adolescence are a big challenge for the patient, his or her family, and health care providers. The transition from paediatric health services to adult health services involves a programmed and planned transfer process of adolescent sufferers of chronic illnesses, in order to maintain a high quality of life and bio-psycho-social development. There is currently no transition model. The objective of the study is to understand the transition process from the perspective of hospitalised adolescents to collaborate towards the design of a model that meets the needs studied. Semi-structured interviews with 13 adolescent sufferers of chronic illnesses, hospitalised in two healthcare centres in Santiago, Chile, in one analytical-relational study, supported by qualitative methodology. In the analysis, 5 major themes stand out: experience of living with the illness, the importance of the doctor-patient relationship, the concept of limited autonomy to the pharmacology, the absence of the transition process as such, and the identification of barriers and needs for an adequate transition. This study is new in Chile in that it explores the phenomenom of the transition of adolescents with chronic illnesses. It emphasises the need to reinforce the concept of self-care and autonomy from early stages of care, and the importance of early planning of a healthy transition process, in accordance to the detected needs of the adolescents themselves. Copyright © 2015. Publicado por Elsevier España, S.L.U.

Land use impacts of rapid transit: implications of recent experience. Final report

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

Knight, R.L.; Trygg, L.L.

Evidence of land use impacts of recent major rapid transit improvements are reviewed and conclusions drawn concerning the extent and nature of such impacts and the conditions under which they have occurred. Transit improvements studied are primarily post-World War II in origin. American and Canadian examples are stressed, although European experience is teated briefly. Virtually all major modern American and Canadian rapid transit investments are included, covering conventional rapid rail, commuter rail, light rail and bus/busway. In addition to conclusions on general patterns of land use impact and causes, research recommendations and Federal policy implications are drawn.

Implementation of a web-based medication tracking system in a large academic medical center.

PubMed

Calabrese, Sam V; Williams, Jonathan P

2012-10-01

Pharmacy workflow efficiencies achieved through the use of an electronic medication-tracking system are described. Medication dispensing turnaround times at the inpatient pharmacy of a large hospital were evaluated before and after transition from manual medication tracking to a Web-based tracking process involving sequential bar-code scanning and real-time monitoring of medication status. The transition was carried out in three phases: (1) a workflow analysis, including the identification of optimal points for medication scanning with hand-held wireless devices, (2) the phased implementation of an automated solution and associated hardware at a central dispensing pharmacy and three satellite locations, and (3) postimplementation data collection to evaluate the impact of the new tracking system and areas for improvement. Relative to the manual tracking method, electronic medication tracking allowed the capture of far more data points, enabling the pharmacy team to delineate the time required for each step of the medication dispensing process and to identify the steps most likely to involve delays. A comparison of baseline and postimplementation data showed substantial reductions in overall medication turnaround times with the use of the Web-based tracking system (time reductions of 45% and 22% at the central and satellite sites, respectively). In addition to more accurate projections and documentation of turnaround times, the Web-based tracking system has facilitated quality-improvement initiatives. Implementation of an electronic tracking system for monitoring the delivery of medications provided a comprehensive mechanism for calculating turnaround times and allowed the pharmacy to identify bottlenecks within the medication distribution system. Altering processes removed these bottlenecks and decreased delivery turnaround times.

Current practice and views of neurologists on the transition from pediatric to adult care.

PubMed

Oskoui, Maryam; Wolfson, Christina

2012-12-01

To describe the current practice and views of neurologists on transitioning patients from pediatric to adult care, a cross-sectional study of all pediatric and adult neurologists in the province of Quebec, Canada, was conducted. The response rate was 73% for pediatric and 49% for adult neurologists. Most pediatric neurologists do not have a patient transition program or policy in place. Although a transfer summary is commonly provided, critical information is often lacking. Nearly half of neurologists believed that patients experience a gap in care during the transition process, and most agreed that the transition process is often poorly coordinated, highlighting patient, family, and health care factors. Current practice does not follow existing consensus statements for transition of care with respect to timing, communication, and preparation, and many pediatric neurologists experience difficulty in finding an appropriate adult health care provider for their patients. Neurologists reported many challenges in the current transition of care process.

Improving Parolees' Participation in Drug Treatment and Other Services through Strengths Case Management.

PubMed

Prendergast, Michael; Cartier, Jerome J

2008-01-01

In an effort to increase participation in community aftercare treatment for substance-abusing parolees, an intervention based on a transitional case management (TCM) model that focuses mainly on offenders' strengths has been developed and is under testing. This model consists of completion, by the inmate, of a self-assessment of strengths that informs the development of the continuing care plan, a case conference call shortly before release, and strengths case management for three months post-release to promote retention in substance abuse treatment and support the participant's access to designated services in the community. The post-release component consists of a minimum of one weekly client/case manager meeting (in person or by telephone) for 12 weeks. The intervention is intended to improve the transition process from prison to community at both the individual and systems level. Specifically, the intervention is designed to improve outcomes in parolee admission to, and retention in, community-based substance-abuse treatment, parolee access to other needed services, and recidivism rates during the first year of parole. On the systems level, the intervention is intended to improve the communication and collaboration between criminal justice agencies, community-based treatment organizations, and other social and governmental service providers. The TCM model is being tested in a multisite study through the Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) research cooperative funded by the National Institute of Drug Abuse.

Percolation transition in dynamical traffic network with evolving critical bottlenecks.

PubMed

Li, Daqing; Fu, Bowen; Wang, Yunpeng; Lu, Guangquan; Berezin, Yehiel; Stanley, H Eugene; Havlin, Shlomo

2015-01-20

A critical phenomenon is an intrinsic feature of traffic dynamics, during which transition between isolated local flows and global flows occurs. However, very little attention has been given to the question of how the local flows in the roads are organized collectively into a global city flow. Here we characterize this organization process of traffic as "traffic percolation," where the giant cluster of local flows disintegrates when the second largest cluster reaches its maximum. We find in real-time data of city road traffic that global traffic is dynamically composed of clusters of local flows, which are connected by bottleneck links. This organization evolves during a day with different bottleneck links appearing in different hours, but similar in the same hours in different days. A small improvement of critical bottleneck roads is found to benefit significantly the global traffic, providing a method to improve city traffic with low cost. Our results may provide insights on the relation between traffic dynamics and percolation, which can be useful for efficient transportation, epidemic control, and emergency evacuation.

Hillslope to fluvial process domain transitions in headwater catchments

NASA Astrophysics Data System (ADS)

Williams, Karen Mary

The landscape is partitioned into hillslopes and unchanneled valleys (hollows), and colluvial (hillslope controlled) and alluvial (self-formed) channels. The key issue for any study of headwater catchments is the rational distinction between these elements. Accurate identification of process domain transitions from hillslopes to hollows, hollows to colluvial channels and colluvial to alluvial channels, are not obvious either in the field or from topographic data derived from remotely sensed data such as laser derived (LIDAR) digital elevation models. The research in this dissertation investigates the spatial arrangement of these landforms and how hillslope and fluvial process domains interact in two pairs of headwater catchments in southwest and central Montana, using LIDAR data. This dissertation uses digital terrain analysis of LIDAR-derived topography and field studies to investigate methods of detection, modeling, and prediction of process transitions from the hillslope to fluvial domains and within the fluvial domain, from colluvial to alluvial channel reaches. Inflections in the scaling relationships between landscape parameters such as flowpath length, unit stream power (a metric of the energy expended by the channel in doing work), and drainage area were used to detect transitions in flow regimes characteristic of hillslope, unchanneled valleys, and channeled landforms. Using the scale-invariant properties of fluvial systems as a threshold condition, magnitude-frequency distributions of curvature and the derivative of aspect were also used to detect hillslope, fluvial, and transitional process domains. Finally, within the classification of channeled landforms, the transition from colluvial to alluvial channels was detected using the presence/absence of repeating patterns in the power spectra of fluvial energy and channel form parameters. LIDAR-derived scaling relations and magnitude-frequency distributions successfully detected and predicted locations of mapped channel heads and hollows and spatial regions of process transitions. Subreaches of arguably alluvial channel conditions were also identified in power spectra. However, extrinsic forcing limits ability to detect a clear transition from colluvial to fully alluvial conditions. Headwater catchments present a mosaic of process domains, in large determined by local structure and lithology. However, process domain transitions appear detectable and statistically, though not deterministically, predictable, irrespective of setting.

Improvement of resist profile roughness in bilayer resist process

NASA Astrophysics Data System (ADS)

Jeong, Chang-Young; Ryu, Sang-Wook; Park, Ki-Yeop; Lee, Won-Kyu; Lee, Seung-Woog; Lee, Dai-Hoon

2000-06-01

The bi-layer resist (BLR) process, which first accomplish imaging on a thin top layer and transfer it down to a thick organic layer, is one of newly emerging patterning techniques in silicon processing. In this work, we studied the lithographic performance of the BLR process adopting FK- SPTM (Fujifilm Olin Co.) as top layer material and various organic material as bottom layer. Generally, considerable advantages of planarization, reduced substrate reflection, improved process latitude, and of enhanced resolution are achieved. However, the resolution and the process latitude are highly affected by surface interaction between the top resist and the bottom material. Moreover, the BLR process has a sidewall roughness problem related to the material factors of the resist and the degraded aerial image contrast, which can affect the reliability of the device. We found that thermal curing treatment applied after development with the consideration of the glass transition temperature are very effective in reducing the line edge roughness. More smooth and steep patterning is achieved by the thermal treatment. The linewidth controllability is below 10 nm and the k1 value is reduced from 0.5 down to 0.32 in this process. The reactive ion etching adopting O2 gas demonstrated selectivity of the top resist over bottom material more than 15:1, together with residue-free and vertical wall profile.

Tradeoffs between costs and greenhouse gas emissions in the design of urban transit systems

NASA Astrophysics Data System (ADS)

Griswold, Julia B.; Madanat, Samer; Horvath, Arpad

2013-12-01

Recent investments in the transit sector to address greenhouse gas emissions have concentrated on purchasing efficient replacement vehicles and inducing mode shift from the private automobile. There has been little focus on the potential of network and operational improvements, such as changes in headways, route spacing, and stop spacing, to reduce transit emissions. Most models of transit system design consider user and agency cost while ignoring emissions and the potential environmental benefit of operational improvements. We use a model to evaluate the user and agency costs as well as greenhouse gas benefit of design and operational improvements to transit systems. We examine how the operational characteristics of urban transit systems affect both costs and greenhouse gas emissions. The research identifies the Pareto frontier for designing an idealized transit network. Modes considered include bus, bus rapid transit (BRT), light rail transit (LRT), and metro (heavy) rail, with cost and emissions parameters appropriate for the United States. Passenger demand follows a many-to-many travel pattern with uniformly distributed origins and destinations. The approaches described could be used to optimize the network design of existing bus service or help to select a mode and design attributes for a new transit system. The results show that BRT provides the lowest cost but not the lowest emissions for our large city scenarios. Bus and LRT systems have low costs and the lowest emissions for our small city scenarios. Relatively large reductions in emissions from the cost-optimal system can be achieved with only minor increases in user travel time.

Resident Dyads Providing Transition Care to Adolescents and Young Adults With Chronic Illnesses and Neurodevelopmental Disabilities

PubMed Central

Jasien, Joan; Maslow, Gary R.

2017-01-01

Background Youth with special health care needs often experience difficulty transitioning from pediatric to adult care. These difficulties may derive in part from lack of physician training in transition care and the challenges health care providers experience establishing interdisciplinary partnerships to support these patients. Objective This educational innovation sought to improve pediatrics and adult medicine residents' interdisciplinary communication and collaboration. Methods Residents from pediatrics, medicine-pediatrics, and internal medicine training programs participated in a transitions clinic for patients with chronic health conditions aged 16 to 26 years. Residents attended 1 to 4 half-day clinic sessions during 1-month ambulatory rotations. Pediatrics/adult medicine resident dyads collaboratively performed psychosocial and medical transition consultations that addressed health care navigation, self-care, and education and vocation topics. Two to 3 attending physicians supervised each clinic session (4 hours) while concurrently seeing patients. Residents completed a preclinic survey about baseline attitudes and experiences, and a postclinic survey about their transitions clinic experiences, changes in attitudes, and transition care preparedness. Results A total of 46 residents (100% of those eligible) participated in the clinic and completed the preclinic survey, and 25 (54%) completed the postclinic survey. A majority of respondents to the postclinic survey reported positive experiences. Residents in both pediatrics and internal medicine programs reported improved preparedness for providing transition care to patients with chronic health conditions and communicating effectively with colleagues in other disciplines. Conclusions A dyadic model of collaborative transition care training was positively received and yielded improvements in immediate self-assessed transition care preparedness. PMID:28439357

Resident Dyads Providing Transition Care to Adolescents and Young Adults With Chronic Illnesses and Neurodevelopmental Disabilities.

PubMed

Chung, Richard J; Jasien, Joan; Maslow, Gary R

2017-04-01

Youth with special health care needs often experience difficulty transitioning from pediatric to adult care. These difficulties may derive in part from lack of physician training in transition care and the challenges health care providers experience establishing interdisciplinary partnerships to support these patients. This educational innovation sought to improve pediatrics and adult medicine residents' interdisciplinary communication and collaboration. Residents from pediatrics, medicine-pediatrics, and internal medicine training programs participated in a transitions clinic for patients with chronic health conditions aged 16 to 26 years. Residents attended 1 to 4 half-day clinic sessions during 1-month ambulatory rotations. Pediatrics/adult medicine resident dyads collaboratively performed psychosocial and medical transition consultations that addressed health care navigation, self-care, and education and vocation topics. Two to 3 attending physicians supervised each clinic session (4 hours) while concurrently seeing patients. Residents completed a preclinic survey about baseline attitudes and experiences, and a postclinic survey about their transitions clinic experiences, changes in attitudes, and transition care preparedness. A total of 46 residents (100% of those eligible) participated in the clinic and completed the preclinic survey, and 25 (54%) completed the postclinic survey. A majority of respondents to the postclinic survey reported positive experiences. Residents in both pediatrics and internal medicine programs reported improved preparedness for providing transition care to patients with chronic health conditions and communicating effectively with colleagues in other disciplines. A dyadic model of collaborative transition care training was positively received and yielded improvements in immediate self-assessed transition care preparedness.

Managing railcar maintenance : a primer on practices and improvement opportunities for the U.S. transit industry.

DOT National Transportation Integrated Search

2013-09-01

This report surveys the state-of-practice of transit railcar maintenance management and fleet management practices. It emphasizes a lifecycle management approach to fleet management. It also emphasizes the role of performance improvement programs and...

Atomic processes and equation of state of high Z plasmas for EUV sources and their effects on the spatial and temporal evolution of the plasmas

NASA Astrophysics Data System (ADS)

Sasaki, Akira; Sunahara, Atushi; Furukawa, Hiroyuki; Nishihara, Katsunobu; Nishikawa, Takeshi; Koike, Fumihiro

2016-03-01

Laser-produced plasma (LPP) extreme ultraviolet (EUV) light sources have been intensively investigated due to potential application to next-generation semiconductor technology. Current studies focus on the atomic processes and hydrodynamics of plasmas to develop shorter wavelength sources at λ = 6.x nm as well as to improve the conversion efficiency (CE) of λ = 13.5 nm sources. This paper examines the atomic processes of mid-z elements, which are potential candidates for λ = 6.x nm source using n=3-3 transitions. Furthermore, a method to calculate the hydrodynamics of the plasmas in terms of the initial interaction between a relatively weak prepulse laser is presented.

The Manufacturing of High Porosity Iron with an Ultra-Fine Microstructure via Free Pressureless Spark Plasma Sintering

PubMed Central

Cui, Guodong; Wei, Xialu; Olevsky, Eugene A.; German, Randall M.; Chen, Junying

2016-01-01

High porosity (>40 vol %) iron specimens with micro- and nanoscale isotropic pores were fabricated by carrying out free pressureless spark plasma sintering (FPSPS) of submicron hollow Fe–N powders at 750 °C. Ultra-fine porous microstructures are obtained by imposing high heating rates during the preparation process. This specially designed approach not only avoids the extra procedures of adding and removing space holders during the formation of porous structures, but also triggers the continued phase transitions of the Fe–N system at relatively lower processing temperatures. The compressive strength and energy absorption characteristics of the FPSPS processed specimens are examined here to be correspondingly improved as a result of the refined microstructure. PMID:28773617

AllAboard: Visual Exploration of Cellphone Mobility Data to Optimise Public Transport.

PubMed

Di Lorenzo, G; Sbodio, M; Calabrese, F; Berlingerio, M; Pinelli, F; Nair, R

2016-02-01

The deep penetration of mobile phones offers cities the ability to opportunistically monitor citizens' mobility and use data-driven insights to better plan and manage services. With large scale data on mobility patterns, operators can move away from the costly, mostly survey based, transportation planning processes, to a more data-centric view, that places the instrumented user at the center of development. In this framework, using mobile phone data to perform transit analysis and optimization represents a new frontier with significant societal impact, especially in developing countries. In this paper we present AllAboard, an intelligent tool that analyses cellphone data to help city authorities in visually exploring urban mobility and optimizing public transport. This is performed within a self contained tool, as opposed to the current solutions which rely on a combination of several distinct tools for analysis, reporting, optimisation and planning. An interactive user interface allows transit operators to visually explore the travel demand in both space and time, correlate it with the transit network, and evaluate the quality of service that a transit network provides to the citizens at very fine grain. Operators can visually test scenarios for transit network improvements, and compare the expected impact on the travellers' experience. The system has been tested using real telecommunication data for the city of Abidjan, Ivory Coast, and evaluated from a data mining, optimisation and user prospective.

New nurse transition: success through aligning multiple identities.

PubMed

Leong, Yee Mun Jessica; Crossman, Joanna

2015-01-01

The purpose of this paper is to explore the perceptions of new nurses in Singapore of their experiences of role transition and to examine the implications for managers in terms of employee training, development and retention. This qualitative study was conducted using a constructivist grounded theory approach. In total 26 novice nurses and five preceptors (n=31) from five different hospitals participated in the study. Data were collected from semi-structured interviews and reflective journal entries and analysed using the constant comparative method. The findings revealed that novice nurses remained emotionally and physically challenged when experiencing role transition. Two major constructs appear to play an important part in the transition process; learning how to Fit in and aligning personal with professional and organisational identities. The findings highlight factors that facilitate or impede Fitting in and aligning these identities. Although the concept of Fitting in and its relation to the attrition of novice nurses has been explored in global studies, that relationship has not yet been theorised as the dynamic alignment of multiple identities. Also, whilst most research around Fitting in, identity and retention has been conducted in western countries, little is known about these issues and their interrelationship in the context of Singapore. The study should inform decision making by healthcare organisations, nurse managers and nursing training institutions with respect to improving the transition experience of novice nurses.

Structure and properties of composite films formed by cellulose nanocrystals and charged latex nanoparticles

NASA Astrophysics Data System (ADS)

Thérien-Aubin, Héloïse; Lukach, Ariella; Pitch, Natalie; Kumacheva, Eugenia

2015-04-01

We report the structural and optical properties of composite films formed from mixed suspensions of cellulose nanocrystals (CNCs) and fluorescent latex nanoparticles (NPs). We explored the effect of NP concentration, size, surface charge, glass transition temperature and film processing conditions on film structure and properties. The chiral nematic order, typical of CNC films, was preserved in films with up to 50 wt% of negatively-charged latex NPs. Composite films were characterized by macroscopically close-to-uniform fluorescence, birefringence, and circular dichroism properties. In contrast, addition of positively charged latex NPs led to gelation of CNC-latex suspensions and disruption of the chiral nematic order in the composite films. Large latex NPs disrupted the chiral nematic order to a larger extend than small NPs. Furthermore, the glass transition of latex NPs had a dramatic effect on the structure of CNC-latex films. Latex particles in the rubbery state were easily incorporated in the ordered CNC matrix and improved the structural integrity of its chiral nematic phase.We report the structural and optical properties of composite films formed from mixed suspensions of cellulose nanocrystals (CNCs) and fluorescent latex nanoparticles (NPs). We explored the effect of NP concentration, size, surface charge, glass transition temperature and film processing conditions on film structure and properties. The chiral nematic order, typical of CNC films, was preserved in films with up to 50 wt% of negatively-charged latex NPs. Composite films were characterized by macroscopically close-to-uniform fluorescence, birefringence, and circular dichroism properties. In contrast, addition of positively charged latex NPs led to gelation of CNC-latex suspensions and disruption of the chiral nematic order in the composite films. Large latex NPs disrupted the chiral nematic order to a larger extend than small NPs. Furthermore, the glass transition of latex NPs had a dramatic effect on the structure of CNC-latex films. Latex particles in the rubbery state were easily incorporated in the ordered CNC matrix and improved the structural integrity of its chiral nematic phase. Electronic supplementary information (ESI) available: Detailed latex synthesis. Additional characterization of the nanoparticles and films. See DOI: 10.1039/c5nr00660k

Segmental and local dynamics of stacked thin films of poly(methyl methacrylate)

NASA Astrophysics Data System (ADS)

Hayashi, Tatsuhiko; Fukao, Koji

2014-02-01

The glass transition temperature and the dynamics of the α and β processes have been investigated using differential scanning calorimetry and dielectric relaxation spectroscopy during successive annealing processes above the glass transition temperature for stacked thin films of poly(methyl methacrylate) (PMMA) of various thicknesses. The glass transition temperature and the dynamics of the α process (segmental motion) of as-stacked PMMA thin films exhibit thin-film-like behavior, insofar as the glass transition temperature is depressed and the dynamics of the α process are faster than those of the bulk system. Annealing at high temperature causes the glass transition temperature to increase from the reduced value and causes the dynamics of the α process to become slower approaching those of the bulk. Contrary to the segmental motion, the relaxation time of the β process (local motion) of the stacked PMMA thin films is almost equal to that of the bulk PMMA and is unaffected by the annealing process. However, the relaxation strengths of both the α process and β process show a strong correlation between each other. The sum of the relaxation strengths remains almost unchanged, while the individual relaxation strengths change during the annealing process. The fragility index of the stacked PMMA thin films increases with annealing, which suggests that the glassy state of the stacked thin films changes from strong to fragile.

Transition to adult-oriented health care: perspectives of youth and adults with complex physical disabilities.

PubMed

Young, Nancy L; Barden, Wendy S; Mills, Wendy A; Burke, Tricia A; Law, Mary; Boydell, Katherine

2009-01-01

The transition to adulthood is extremely difficult for individuals with disabilities. We sought to explore the specific issue of transition to adult-oriented health care in a Canadian context. We conducted semi-structured individual interviews with 15 youth and 15 adults with cerebral palsy, spina bifida, and acquired brain injuries of childhood, and their parents (n = 30). Respondents discussed their health care services, their experience with clinical transition, and contributing factors. We analyzed the transcripts using qualitative methods. All participants identified challenges in transition, including: lack of access to health care; lack of professionals' knowledge; lack of information and uncertainty regarding the transition process. Two solutions were identified: early provision of detailed information and more extensive support throughout the clinical transition process. The challenges of clinical transition were universal. More extensive information and support is needed during transition to ensure an efficient move to appropriate adult-oriented health care.

Clinician and educator experiences of facilitating students' transition back to school following acquired brain injury: A qualitative systematic review.

PubMed

Hartman, Laura R; Duncanson, Michelle; Farahat, Sarah Marie; Lindsay, Sally

2015-01-01

Transition back to school following paediatric acquired brain injury (ABI) is complex. It must be facilitated by healthcare and educational professionals, who need to work together to return affected students to learning. This qualitative systematic review synthesizes qualitative studies on clinicians' and educators' experiences of facilitating hospital-to-school transitions following ABI. A search was conducted using seven electronic databases (CINAHL, Cochrane, EMBASE, ERIC, HealthSTAR, MEDLINE, PsycINFO) and key resources were manually reviewed. Publications selected for inclusion had a sample of clinicians and/or educators who worked with children/youth with ABI and focused on hospital-to-school transition processes from the professionals' perspectives. The initial search returned 4761 publications. Of those, 10 met the inclusion criteria. Six main themes emerged across those publications. Three related to transition barriers: (1) lack of training and education regarding transition processes; (2) lack of communication between stakeholders; and (3) lack of preparation for transition. The remaining three presented items that both facilitate and/or impede the transition process: (4) supports available; (5) linking agents; and (6) policies and procedures guiding transition. Clinicians and educators called for collaboration and communication to support students' transition back to school. Further inquiry into designated linking agents and policies that facilitate hospital-to-school transitions for students following ABI may address these lacking areas.

The Occupational Transition Process to Upper Secondary School, Further Education and/or Work in Sweden: As Described by Young Adults with Asperger Syndrome and Attention Deficit Hyperactivity Disorder.

PubMed

Baric, Vedrana Bolic; Hemmingsson, Helena; Hellberg, Kristina; Kjellberg, Anette

2017-03-01

The aim was to describe the occupational transition process to upper secondary school, further education and/or work, and to discover what support influences the process from the perspectives of young adults with Asperger syndrome or attention deficit/hyperactivity disorder. This qualitative study was performed in Sweden and comprised interviews with 15 young adults recruited from community based day centres. Support influencing the process included: occupational transition preparation in compulsory school, practical work experience in a safe environment, and support beyond the workplace. The overall understanding shows that the occupational transition process was a longitudinal one starting as early as in middle school, and continuing until the young adults obtained and were able to remain in employment or further education.

Towards a Sufficient Theory of Transition in Cognitive Development.

ERIC Educational Resources Information Center

Wallace, J. G.

The work reported aims at the construction of a sufficient theory of transition in cognitive development. The method of theory construction employed is computer simulation of cognitive process. The core of the model of transition presented comprises self-modification processes that, as a result of continuously monitoring an exhaustive record of…

Theories of Human Development that Enhance an Understanding of the College Transition Process

ERIC Educational Resources Information Center

Guiffrida, Douglas A.

2009-01-01

Background/Context: Although theories of human development often play a central role in K-12 pedagogical practices, evidence suggests that developmental theories have not been used extensively to understand the college transition process or to develop programs to support students during these transitions. Purpose/Objective/Research Question/Focus…

Materials Development for Auxiliary Components for Large Compact Mo/Au TES Arrays

NASA Technical Reports Server (NTRS)

Finkbeiner, F. m.; Chervenak, J. A.; Bandler, S. R.; Brekosky, R.; Brown, A. D.; Figueroa-Feliciano, E.; Iyomoto, N.; Kelley, R. L.; Kilbourne, C. A.; Porter, F. S.;

Application of Raman Spectroscopy and Univariate Modelling As a Process Analytical Technology for Cell Therapy Bioprocessing

PubMed Central

Baradez, Marc-Olivier; Biziato, Daniela; Hassan, Enas; Marshall, Damian

2018-01-01

Cell therapies offer unquestionable promises for the treatment, and in some cases even the cure, of complex diseases. As we start to see more of these therapies gaining market authorization, attention is turning to the bioprocesses used for their manufacture, in particular the challenge of gaining higher levels of process control to help regulate cell behavior, manage process variability, and deliver product of a consistent quality. Many processes already incorporate the measurement of key markers such as nutrient consumption, metabolite production, and cell concentration, but these are often performed off-line and only at set time points in the process. Having the ability to monitor these markers in real-time using in-line sensors would offer significant advantages, allowing faster decision-making and a finer level of process control. In this study, we use Raman spectroscopy as an in-line optical sensor for bioprocess monitoring of an autologous T-cell immunotherapy model produced in a stirred tank bioreactor system. Using reference datasets generated on a standard bioanalyzer, we develop chemometric models from the Raman spectra for glucose, glutamine, lactate, and ammonia. These chemometric models can accurately monitor donor-specific increases in nutrient consumption and metabolite production as the primary T-cell transition from a recovery phase and begin proliferating. Using a univariate modeling approach, we then show how changes in peak intensity within the Raman spectra can be correlated with cell concentration and viability. These models, which act as surrogate markers, can be used to monitor cell behavior including cell proliferation rates, proliferative capacity, and transition of the cells to a quiescent phenotype. Finally, using the univariate models, we also demonstrate how Raman spectroscopy can be applied for real-time monitoring. The ability to measure these key parameters using an in-line Raman optical sensor makes it possible to have immediate feedback on process performance. This could help significantly improve cell therapy bioprocessing by allowing proactive decision-making based on real-time process data. Going forward, these types of in-line sensors also open up opportunities to improve bioprocesses further through concepts such as adaptive manufacturing. PMID:29556497

Application of Raman Spectroscopy and Univariate Modelling As a Process Analytical Technology for Cell Therapy Bioprocessing.

PubMed

Baradez, Marc-Olivier; Biziato, Daniela; Hassan, Enas; Marshall, Damian

2018-01-01

Cell therapies offer unquestionable promises for the treatment, and in some cases even the cure, of complex diseases. As we start to see more of these therapies gaining market authorization, attention is turning to the bioprocesses used for their manufacture, in particular the challenge of gaining higher levels of process control to help regulate cell behavior, manage process variability, and deliver product of a consistent quality. Many processes already incorporate the measurement of key markers such as nutrient consumption, metabolite production, and cell concentration, but these are often performed off-line and only at set time points in the process. Having the ability to monitor these markers in real-time using in-line sensors would offer significant advantages, allowing faster decision-making and a finer level of process control. In this study, we use Raman spectroscopy as an in-line optical sensor for bioprocess monitoring of an autologous T-cell immunotherapy model produced in a stirred tank bioreactor system. Using reference datasets generated on a standard bioanalyzer, we develop chemometric models from the Raman spectra for glucose, glutamine, lactate, and ammonia. These chemometric models can accurately monitor donor-specific increases in nutrient consumption and metabolite production as the primary T-cell transition from a recovery phase and begin proliferating. Using a univariate modeling approach, we then show how changes in peak intensity within the Raman spectra can be correlated with cell concentration and viability. These models, which act as surrogate markers, can be used to monitor cell behavior including cell proliferation rates, proliferative capacity, and transition of the cells to a quiescent phenotype. Finally, using the univariate models, we also demonstrate how Raman spectroscopy can be applied for real-time monitoring. The ability to measure these key parameters using an in-line Raman optical sensor makes it possible to have immediate feedback on process performance. This could help significantly improve cell therapy bioprocessing by allowing proactive decision-making based on real-time process data. Going forward, these types of in-line sensors also open up opportunities to improve bioprocesses further through concepts such as adaptive manufacturing.

76 FR 207 - Intent To Prepare an Environmental Impact Statement for Proposed Transit Improvements to the...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-03

.... ADDRESSES: Comments will be accepted at the public scoping meetings or they may be sent to Mr. Steve Hands... crucial transit asset into a state of good repair, while reducing travel times, improving access to job...

49 CFR 659.31 - Hazard management process.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 7 2014-10-01 2014-10-01 false Hazard management process. 659.31 Section 659.31... Agency § 659.31 Hazard management process. (a) The oversight agency must require the rail transit agency..., operational changes, or other changes within the rail transit environment. (b) The hazard management process...

49 CFR 659.31 - Hazard management process.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 7 2013-10-01 2013-10-01 false Hazard management process. 659.31 Section 659.31... Agency § 659.31 Hazard management process. (a) The oversight agency must require the rail transit agency..., operational changes, or other changes within the rail transit environment. (b) The hazard management process...

49 CFR 659.31 - Hazard management process.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 7 2012-10-01 2012-10-01 false Hazard management process. 659.31 Section 659.31... Agency § 659.31 Hazard management process. (a) The oversight agency must require the rail transit agency..., operational changes, or other changes within the rail transit environment. (b) The hazard management process...

NASA Trapezoidal Wing Computations Including Transition and Advanced Turbulence Modeling

NASA Technical Reports Server (NTRS)

Rumsey, C. L.; Lee-Rausch, E. M.

2012-01-01

Flow about the NASA Trapezoidal Wing is computed with several turbulence models by using grids from the first High Lift Prediction Workshop in an effort to advance understanding of computational fluid dynamics modeling for this type of flowfield. Transition is accounted for in many of the computations. In particular, a recently-developed 4-equation transition model is utilized and works well overall. Accounting for transition tends to increase lift and decrease moment, which improves the agreement with experiment. Upper surface flap separation is reduced, and agreement with experimental surface pressures and velocity profiles is improved. The predicted shape of wakes from upstream elements is strongly influenced by grid resolution in regions above the main and flap elements. Turbulence model enhancements to account for rotation and curvature have the general effect of increasing lift and improving the resolution of the wing tip vortex as it convects downstream. However, none of the models improve the prediction of surface pressures near the wing tip, where more grid resolution is needed.

What can artefact analysis tell us about patient transitions between the hospital and primary care? Lessons from the HANDOVER project.

PubMed

Johnson, Julie K; Arora, Vineet M; Barach, Paul R

2013-09-01

Hospital discharge often faces breakdowns in information, communication, and coordination. The European Union FP7 Health Research Programme commissioned the European HANDOVER Project in 2008, a three year, 3.5 million Euro programme to examine transitions of patient care from the hospital to the community care settings. Six European countries--Italy, the Netherlands, Poland, United Kingdom, Spain, and Sweden--participated in this collaborative study. This paper highlights a multi-centre, multi-national research programme. We describe how HANDOVER participants conducted an 'artefact analysis' as one element of the mixed methods study to inform opportunities to make patient handovers between hospital and community care more effective. The artefact analysis consisted of a four-step process to assess different tools used in communication and treatment and their effects on the communication processes between the hospital and general practice settings. Four themes emerged from our analysis: (a) The inpatient care of a patient is 'hospital centric' whereby the hospital 'pulls' information regarding a patient's family physician (b) There are rich cognitive artefacts that support the patient clinician encounter; c) The use of information technology does not necessarily improve the communication process; and (d) There is a role for the patient, albeit not particularly well-defined or explicit, as a conduit for essential information communication. Cognitive artefact analysis is an innovative method to provide insights into transitions of patient care. It may be most useful to think about interventions at both the individual patient and the system levels that more fully address and overcome the system issues at work.

Sixth national stakeholder workshop summary report

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

NONE

On June 17--18, 1998, the Department of Energy`s (DOE) Office of Worker and Community Transition convened its sixth National Stakeholder Workshop at the Ramada Plaza Hotel Old Town in Alexandria, Virginia. Approximately 325 stakeholders attended representing DOE headquarters and field offices, contractors, labor organizations, state and local government, education and community interest groups. The meeting addressed the progress made on the issues and challenges identified at the last stakeholder`s meeting in Oakland, California on April 9--11, 1997. Also discussed were the full range of the Department`s work force issues and creative solutions to the inherent challenges of simultaneously implementing themore » Department`s post Cold-War mission, work force restructuring guidance, contract reform objectives, asset disposition, performance-based management requirements, and business process improvement policies. The format of the Workshop included several plenary sessions and a number of small group discussion sessions. The small group sessions focused on topics related to labor issues, work force restructuring, work force planning, community transition, and employee concerns. The sessions provided a wide range of views on worker and community transition issues. The plenary sessions of the Workshop included presentations on the following topics: welcome and introductions; opening remarks; building a better labor-management relationship; keynote speech from Secretary of Energy Federico Pena; meeting tomorrow`s challenges (early site closures); harnessing the contracting process to encourage local growth; and, the British experience in economic conversion.« less

Vitrification of organics-containing wastes

DOEpatents

Bickford, D.F.

1995-01-01

A process for stabilizing organics-containing waste materials and recovery metals therefrom, and a waste glass product made according to the process are described. Vitrification of wastes such as organic ion exchange resins, electronic components and the like can be accomplished by mixing at least one transition metal oxide with the wastes, and, if needed, glass formers to compensate for a shortage of silicates or other glass formers in the wastes. The transition metal oxide increases the rate of oxidation of organic materials in the wastes to improve the composition of the glass-forming mixture: at low temperatures, the oxide catalyzes oxidation of a portion of the organics in the waste; at higher temperatures, the oxide dissolves and the resulting oxygen ions oxidize more of the organics; and at vitrification temperatures, the metal ions conduct oxygen into the melt to oxidize the remaining organics. In addition, the transition metal oxide buffers the redox potential of the glass melt so that metals such as Au, Pt, Ag, and Cu separate form the melt in the metallic state and can be recovered. After the metals are recovered, the remainder of the melt is allowed to cool and may subsequently be disposed of. The product has good leaching resistance and can be disposed of in an ordinary landfill, or, alternatively, used as a filler in materials such as concrete, asphalt, brick and tile.

Vitrification of organics-containing wastes

DOEpatents

Bickford, Dennis F.

1997-01-01

A process for stabilizing organics-containing waste materials and recovering metals therefrom, and a waste glass product made according to the process. Vitrification of wastes such as organic ion exchange resins, electronic components and the like can be accomplished by mixing at least one transition metal oxide with the wastes, and, if needed, glass formers to compensate for a shortage of silicates or other glass formers in the wastes. The transition metal oxide increases the rate of oxidation of organic materials in the wastes to improve the composition of the glass-forming mixture: at low temperatures, the oxide catalyzes oxidation of a portion of the organics in the waste; at higher temperatures, the oxide dissolves and the resulting oxygen ions oxidize more of the organics; and at vitrification temperatures, the metal ions conduct oxygen into the melt to oxidize the remaining organics. In addition, the transition metal oxide buffers the redox potential of the glass melt so that metals such as Au, Pt, Ag, and Cu separate from the melt in the metallic state and can be recovered. After the metals are recovered, the remainder of the melt is allowed to cool and may subsequently be disposed of. The product has good leaching resistance and can be disposed of in an ordinary landfill, or, alternatively, used as a filler in materials such as concrete, asphalt, brick and tile.

Vitrification of organics-containing wastes

DOEpatents

Bickford, D.F.

1997-09-02

A process is described for stabilizing organics-containing waste materials and recovering metals therefrom, and a waste glass product made according to the process is also disclosed. Vitrification of wastes such as organic ion exchange resins, electronic components and the like can be accomplished by mixing at least one transition metal oxide with the wastes, and, if needed, glass formers to compensate for a shortage of silicates or other glass formers in the wastes. The transition metal oxide increases the rate of oxidation of organic materials in the wastes to improve the composition of the glass-forming mixture: at low temperatures, the oxide catalyzes oxidation of a portion of the organics in the waste; at higher temperatures, the oxide dissolves and the resulting oxygen ions oxidize more of the organics; and at vitrification temperatures, the metal ions conduct oxygen into the melt to oxidize the remaining organics. In addition, the transition metal oxide buffers the redox potential of the glass melt so that metals such as Au, Pt, Ag, and Cu separate from the melt in the metallic state and can be recovered. After the metals are recovered, the remainder of the melt is allowed to cool and may subsequently be disposed of. The product has good leaching resistance and can be disposed of in an ordinary landfill, or, alternatively, used as a filler in materials such as concrete, asphalt, brick and tile. 1 fig.

Transition of care for acute stroke and myocardial infarction patients: from hospitalization to rehabilitation, recovery, and secondary prevention.

PubMed Central

Olson, DaiWai M; Bettger, Janet Prvu; Alexander, Karen P; Kendrick, Amy S; Irvine, Julian R; Wing, Liz; Coeytaux, Remy R; Dolor, Rowena J; Duncan, Pamela W; Graffagnino, Carmelo

2011-01-01

OBJECTIVES To review the available published literature to assess whether evidence supports a beneficial role for coordinated transition of care services for the postacute care of patients hospitalized with first or recurrent stroke or myocardial infarction (MI). This review was framed around five areas of investigation: (1) key components of transition of care services, (2) evidence for improvement in functional outcomes, morbidity, mortality, and quality of life, (3) associated risks or potential harms, (4) evidence for improvement in systems of care, and (5) evidence that benefits and harms vary by patient-based or system-based characteristics. DATA SOURCES MEDLINE(®), CINAHL(®), Cochrane Database of Systematic Reviews, and Embase(®). REVIEW METHODS We included studies published in English from 2000 to 2011 that specified postacute hospitalization transition of care services as well as prevention of recurrent stroke or MI. RESULTS A total of 62 articles representing 44 studies were included for data abstraction. Transition of care interventions were grouped into four categories: (1) hospital -initiated support for discharge was the initial stage in the transition of care process, (2) patient and family education interventions were started during hospitalization but were continued at the community level, (3) community-based models of support followed hospital discharge, and (4) chronic disease management models of care assumed the responsibility for long-term care. Early supported discharge after stroke was associated with reduced total hospital length of stay without adverse effects on functional recovery, and specialty care after MI was associated with reduced mortality. Because of several methodological shortcomings, most studies did not consistently demonstrate that any specific intervention resulted in improved patient-or system -based outcomes. Some studies included more than one intervention, which made it difficult to determine the effect of individual components on clinical outcomes. There was inconsistency in the definition of what constituted a component of transition of care compared to "standard care." Standard care was poorly defined, and nearly all studies were underpowered to demonstrate a statistical benefit. The endpoints varied greatly from study to study. Nearly all the studies were single-site based, and most (26 of 44) were conducted in countries with national health care systems quite different from that of the U.S., therefore limiting their generalizability. CONCLUSIONS Although a basis for the definition of transition of care exists, more consensus is needed on the definition of the interventions and the outcomes appropriate to those interventions. There was limited evidence that two components of hospital-initiated support for discharge (early supported discharge after stroke and specialty care followup after MI)were associated with beneficial effects. No other interventions had sufficient evidence of benefit based on the findings of this systematic review. The adoption of a standard set of definitions, a refinement in the methodology used to study transition of care, and appropriate selection of patient-centered and policy-relevant outcomes should be employed to draw valid conclusions pertaining to specific components of transition of care. PMID:23126647

Adding structure to the transition process to advanced mathematical activity

NASA Astrophysics Data System (ADS)

Engelbrecht, Johann

2010-03-01

The transition process to advanced mathematical thinking is experienced as traumatic by many students. Experiences that students had of school mathematics differ greatly to what is expected from them at university. Success in school mathematics meant application of different methods to get an answer. Students are not familiar with logical deductive reasoning, required in advanced mathematics. It is necessary to assist students in this transition process, in moving from general to mathematical thinking. In this article some structure is suggested for this transition period. This essay is an argumentative exposition supported by personal experience and international literature. This makes this study theoretical rather than empirical.

The effects of a lean transition on process times, patients and employees.

PubMed

Simons, Pascale; Backes, Huub; Bergs, Jochen; Emans, Davy; Johannesma, Madelon; Jacobs, Maria; Marneffe, Wim; Vandijck, Dominique

2017-03-13

Purpose Treatment delays must be avoided, especially in oncology, to assure sustainable high-quality health care and increase the odds of survival. The purpose of this paper is to hypothesize that waiting times would decrease and patients and employees would benefit, when specific lean interventions are incorporated in an organizational improvement approach. Design/methodology/approach In 2013, 15 lean interventions were initiated to improve flow in a single radiotherapy institute. Process/waiting times, patient satisfaction, safety, employee satisfaction, and absenteeism were evaluated using a mixed methods methodology (2010-2014). Data from databases, surveys, and interviews were analyzed by time series analysis, χ 2 , multi-level regression, and t-tests. Findings Median waiting/process times improved from 20.2 days in 2012 to 16.3 days in 2014 ( p<0.001). The percentage of palliative patients for which waiting times had exceeded Dutch national norms (ten days) improved from 35 (six months in 2012: pre-intervention) to 16 percent (six months in 2013-2014: post-intervention; p<0.01), and the percentage exceeding national objectives (seven days) from 22 to 17 percent ( p=0.44). For curative patients, exceeding of norms (28 days) improved from 17 (2012) to 8 percent (2013-2014: p=0.05), and for the objectives (21 days) from 18 to 10 percent ( p<0.01). Reported safety incidents decreased 47 percent from 2009 to 2014, whereas safety culture, awareness, and intention to solve problems improved. Employee satisfaction improved slightly, and absenteeism decreased from 4.6 (2010) to 2.7 percent (2014; p<0.001). Originality/value Combining specific lean interventions with an organizational improvement approach improved waiting times, patient safety, employee satisfaction, and absenteeism on the short term. Continuing evaluation of effects should study the improvements sustainability.

Rethinking the relationship between medicine and media: two examples from Croatia.

PubMed

Jergović, Blanka

2004-08-01

The communication between medicine and media is an important component within the complex process of changes in post-communist transition countries. It reflects not only organizational and legislative state of the society but its cultural adaptability and character. In that respect, media communication could be a tool for shifting the existing attitudes to innovative evaluation of physician's responsibility. Adapting to the democratic society necessitates more effective communication and improvement of all components of communication process: medicine, media, and the public sphere. Existing communication strategies in Croatia were recognized as inefficient and proved damaging for the health care system and society in general. As a demonstration, two representative examples were analyzed in this paper: the case of deaths related to Baxter dialyzers, and the case of pediatric cardiac surgery at the Zagreb University Hospital Center. The cases illustrate the lack of communication within the medical profession and physicians with the executive government, and the public. There is a great need for more effective communication and skillful professionals in transition countries. The future concept of the communication should be characterized by contextual and "cross-talk' approach.

Mobil lube dewaxing technologies

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

Baker, C.L.; McGuiness, M.P.

1995-09-01

Currently, the lube refining industry is in a period of transition, with both hydroprocessing and catalytic dewaxing gathering momentum as replacements for solvent extraction and solvent dewaxing. In addition, lube product quality requirements have been increasing, both in the US and abroad. Mobil has developed a broad array of dewaxing catalytic technologies which can serve refiners throughout the stages of this transition. In the future, lube feedstocks which vary in source and wax content will become increasingly important, requiring an optimized system for highest performance. The Mobil Lube Dewaxing (MLDW) process is the work-horse of the catalytic dewaxing technologies, beingmore » a robust, low cost technology suitable for both solvent extracted and hydrocracked feeds. The Mobil Selective Dewaxing (MSDW) process has been recently introduced in response to the growth of hydroprocessing. MSDW requires either severely hydrotreated or hydrocracked feeds and provides improved lube yields and VI. For refiners with hydrocrackers and solvent dewaxing units, Mobil Wax Isomerization (MWI) technology can make higher VI base stocks to meet the growing demand for very high quality lube products. A review of these three technologies is presented in this paper.« less

On the road toward formal reasoning: reasoning with factual causal and contrary-to-fact causal premises during early adolescence.

PubMed

Markovits, Henry

2014-12-01

Understanding the development of conditional (if-then) reasoning is critical for theoretical and educational reasons. Here we examined the hypothesis that there is a developmental transition between reasoning with true and contrary-to-fact (CF) causal conditionals. A total of 535 students between 11 and 14 years of age received priming conditions designed to encourage use of either a true or CF alternatives generation strategy and reasoning problems with true causal and CF causal premises (with counterbalanced order). Results show that priming had no effect on reasoning with true causal premises. By contrast, priming with CF alternatives significantly improved logical reasoning with CF premises. Analysis of the effect of order showed that reasoning with CF premises reduced logical responding among younger students but had no effect among older students. Results support the idea that there is a transition in the reasoning processes in this age range associated with the nature of the alternatives generation process required for logical reasoning with true and CF causal conditionals. Copyright © 2014 Elsevier Inc. All rights reserved.

Ethnic and gender earning gaps in a liberalized economy: The case of Israel.

PubMed

Bental, Benjamin; Kraus, Vered; Yonay, Yuval

2017-03-01

During the 1990s and the 2000s Israel, a country ethnically divided into a dominant Jewish majority and a disadvantaged mostly Muslim Palestinian minority, underwent a transition from a heavily regulated to a neo-liberal economy. This paper makes use of the Israeli case to shed light on the effect of liberalization on earning gaps in the public and private sectors across dominant and disadvantaged population groups. The data, drawn from the 1995 and 2008 censuses-years that encompass the transition period, enable a dynamic investigation of the liberalization process by comparing labor market outcomes for Israeli Jews and Muslims of both genders working in the public or private sector. Liberalization reduced the protective role of the public sector, especially hurting women of both ethnic groups. In the private sector this process improved the position of the strongest group of Jewish men and of the weakest group of Muslim women. Discrimination against Jewish women and Muslim men in the private sector increased. Copyright © 2016 Elsevier Inc. All rights reserved.

Phase restructuring in transition metal dichalcogenides for highly stable energy storage

DOE PAGES

Leng, Kai; Chen, Zhongxin; Zhao, Xiaoxu; ...

2016-09-16

Achieving homogeneous phase transition and uniform charge distribution is essential for good cycle stability and high capacity when phase conversion materials are used as electrodes. Herein, we show that chemical lithiation of bulk 2H-MoS 2 distorts its crystalline domains in three primary directions to produce mosaic-like 1T' nanocrystalline domains, which improve phase and charge uniformity during subsequent electrochemical phase conversion. 1T'-Li xMoS 2, a macroscopic dense material with interconnected nanoscale grains, shows excellent cycle stability and rate capability in a lithium rechargeable battery compared to bulk or exfoliated-restacked MoS 2. Transmission electron microscopy studies reveal that the interconnected MoS 2more » nanocrystals created during the phase change process are reformable even after multiple cycles of galvanostatic charging/discharging, which allows them to play important roles in the long term cycling performance of the chemically intercalated TMD materials. Finally, these studies shed light on how bulk TMDs can be processed into quasi-2D nanophase material for stable energy storage.« less

Nutritional challenges for children in societies in transition.

PubMed

Cai, Wei

2014-05-01

This review is to explore the childhood nutrition and health in relation to socioeconomic changes in transitional countries, and to describe the good experiences and policies in these countries to combat childhood nutritional challenges. Double burden of malnutrition - the coexistence of under-nutrition and over-nutrition in the same population - is a prominent public health concern in transitional countries. With rapid industrialization, these countries are facing a growing epidemic of overweight/obesity in children and adolescents. The increasing prevalence of childhood overweight/obesity is a likely consequence of behavioral changes, and accompanied with an increasing incidence of noncommunicable chronic diseases. Although remarkable improvement of childhood nutrition was achieved, the stunting growth and micronutrient deficiency remain to be child health issues in transitional countries. The social transition caused a broad range of nutrition-associated problems. Previous successful experiences indicated that if appropriate action is undertaken, the child nutritional problems accompanied with economic transition could be controlled to some extent. However, greater efforts are needed to improve the status of childhood nutrition in transitional countries.

Modelling the transitional boundary layer

NASA Technical Reports Server (NTRS)

Narasimha, R.

1990-01-01

Recent developments in the modelling of the transition zone in the boundary layer are reviewed (the zone being defined as extending from the station where intermittency begins to depart from zero to that where it is nearly unity). The value of using a new non-dimensional spot formation rate parameter, and the importance of allowing for so-called subtransitions within the transition zone, are both stressed. Models do reasonably well in constant pressure 2-dimensional flows, but in the presence of strong pressure gradients further improvements are needed. The linear combination approach works surprisingly well in most cases, but would not be so successful in situations where a purely laminar boundary layer would separate but a transitional one would not. Intermittency-weighted eddy viscosity methods do not predict peak surface parameters well without the introduction of an overshooting transition function whose connection with the spot theory of transition is obscure. Suggestions are made for further work that now appears necessary for developing improved models of the transition zone.

Answering Aggregation Questions in Contingency Valuation of Rural Transit Benefits

DOT National Transportation Integrated Search

2001-08-01

While the qualitative benefits of transit are relatively well known, quantifying the benefits of transit is still a developing methodology. Quantifying benefits offers improved operational management and planning as well as better information for pol...