A Systems Approach to Evaluating Ionizing Radiation: Six Focus Areas to Improve Quality, Efficiency, and Patient Safety

PubMed Central

Mower, Laura; Bushe, Chris

2015-01-01

Abstract: Ionizing radiation is an essential component of the care process. However, providers and patients may not be fully aware of the risks involved, the level of ionizing radiation delivered with various procedures, or the potential for harm through incidental overexposure or cumulative dose. Recent high-profile incidents demonstrating the devastating short-term consequences of radiation overexposure have drawn attention to these risks, but applicable solutions are lacking. Although various recommendations and guidelines have been proposed, organizational variability challenges providers to identify their own practical solutions. To identify potential failure modes and develop solutions to preserve patient safety within a large, national healthcare system, we assembled a multidisciplinary team to conduct a comprehensive analysis of practices surrounding the delivery of ionizing radiation. Workgroups were developed to analyze existing culture, processes, and technology to identify deficiencies and propose solutions. Six focus areas were identified: competency and certification; equipment; monitoring and auditing; education; clinical pathways; and communication and marketing. This manuscript summarizes this comprehensive, multidisciplinary, and systemic analysis of risk and provides examples to illustrate how these focus areas can be used to improve the use of ionizing radiation. The proposed solutions, once fully implemented, may advance patient safety and care. PMID:26042626

Group Work Education in Social Work: A Review of the Literature Reveals Possible Solutions

ERIC Educational Resources Information Center

LaRocque, Sarah E.

2017-01-01

This article examines the growing concerns in the literature that traditional group work education in social work is not providing the foundational knowledge, skills, evidence-based practice, professional uses of self, and adherence to practice standards necessary for effective group practice. An exploration of the best available evidence on group…

Capturing the Diversity of Transition from a Multidisciplinary Perspective

ERIC Educational Resources Information Center

Burns, Edgar

2010-01-01

The broad utility of the concept of transition in many disciplines provides career educators and career advisory personnel with expanded opportunities to explore fresh solutions to problems they meet in the course of their work. Further practical solutions become available by continuing to seek applications of the concept. Career transition…

Practical Tools for Foster Parents. Foster Care Solutions.

ERIC Educational Resources Information Center

Temple-Plotz, Lana, Ed.; Stricklett, Ted P., Ed.; Baker, Christena B., Ed.; Sterba, Michael N., Ed.

Based on the Girls and Boys Town's "Common Sense Parenting" approach, this book presents an approach to foster parenting focusing on building relationships with children, teaching them skills, and empowering them by teaching self-discipline and self-control. Research-based solutions are provided for common concerns, including building a…

Applications of isotopes to tracing sources of solutes and water in shallow systems

USGS Publications Warehouse

Kendall, Carol; Krabbenhoft, David P.

1995-01-01

New awareness of the potential danger to water supplies posed by the use of agricultural chemicals has focused attention on the nature of groundwater recharge and the mobility of various solutes, especially nitrate and pesticides, in shallow systems. A better understanding of hydrologic flowpaths and solute sources is required to determine the potential impact of sources of contamination on water supplies, to develop management practices for preserving water quality, and to develop remediation plans for sites that are already contaminated. In many cases, environmental isotopes can be employed as 'surgical tools' for answering very specific questions about water and solute sources. Isotopic data can often provide more accurate information about the system than hydrologic measurements or complicated hydrologic models. This note focuses on practical and cost-effective examples of how naturally-occurring isotopes can be used to track water and solutes as they move through shallow systems.

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

PubMed

Cronise, Rita

2016-09-01

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

Building Alliances Series: Workforce Development

ERIC Educational Resources Information Center

Brady, Cecilia

2009-01-01

Public-private partnerships done right are a powerful tool for development, providing enduring solutions to some of the greatest challenges. To help familiarize readers with the art of alliance building, the Global Development Alliance (GDA) office has created a series of practical guides that highlight proven practices in partnerships,…

Leveraging Technology to Reduce Patient Transaction Costs.

PubMed

Edlow, Richard C

2015-01-01

Medical practices are under significant pressure to provide superior customer service in an environment of declining or flat reimbursement. The solution for many practices involves the integration of a variety of third-party technologies that conveniently interface with one's electronic practice management and medical records systems. Typically, the applications allow the practice to reduce the cost of each patient interaction. Drilling down to quantify the cost of each individual patient interaction helps to determine the practicality of implementation.

A thematic analysis of the experience of UK mental health nurses who have trained in Solution Focused Brief Therapy.

PubMed

Smith, S; Macduff, C

2017-03-01

WHAT IS KNOWN ON THE SUBJECT?: Solution Focused Brief Therapy (SFBT) is an effective model of brief psychotherapy. Evidence suggests that nurses can be trained to deliver SFBT with only a few days training. It has been argued that SFBT reflects the core values of nursing practice, but no empirical research has been undertaken to validate this assertion. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: This is the first time the impact of such training on nurses' sense of professional and personal identity has been explored. Drawing upon data derived from twenty interviews, this paper explores the key themes reported by nurses in relation to their personal experience of training in SFBT. This paper extends our understanding of the lived experience of mental health nurses and facilitates discussion on the preparation and practice of their role. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Training in SFBT can provide a framework for nurses to empower their clients/patients to take control of their own recovery in a shared and trusting relationship. Training in SFBT can enhance nurses' sense of trust in their clients. Training in solution-focused interactions may provide a framework for many nurses to provide the type of collaborative, patient-led care they aspire to. Introduction SFBT is a psychotherapeutic model that aims to 'build solutions' rather than 'solve problems'. It has evolved into a structured communication framework utilized across a range of disciplines, focusing on the future, as opposed to the past, and on participant's strengths and abilities, as opposed to their problems and deficits. There have been no studies exploring the experience of training in SFBT from the perspective of the nurses being trained. Aim This study sought to explore the experience of nurses who had completed a six-month training course in SFBT. Methods Using a qualitative methodology, 20 nurses who had undertaken SFBT training were interviewed at various locations across Scotland. Results Five main themes emerged from analysis of the 20 interviews. Many of the participants reported increased trust in their clients and enhanced role satisfaction. Implications for Practice Training in SFBT provides nurses with an alternative model of practice to the dominant 'medical' and 'psychological' models of contemporary practice. The experiences of the participants in this study suggest that SFBT can be a useful intervention in nursing practice and that nurses can easily incorporate SFBT into their practice. © 2017 John Wiley & Sons Ltd.

Military Interoperable Digital Hospital Testbed (MIDHT)

DTIC Science & Technology

2010-07-01

solutions to optimize healthcare resources for rural communities and identify lessons learned and best practices that benefit both the global MHS...providers and three CHS facilities on their business practices and process flows. Research initiatives will focus on the impact of an electronic...strategic goals and the Nationwide Health Information Network (NHIN). The MIDHT will continue to identify lessons learned/best practices that benefit

The OCHIN community information network: bringing together community health centers, information technology, and data to support a patient-centered medical village.

PubMed

Devoe, Jennifer E; Sears, Abigail

2013-01-01

Creating integrated, comprehensive care practices requires access to data and informatics expertise. Information technology (IT) resources are not readily available to individual practices. One model of shared IT resources and learning is a "patient-centered medical village." We describe the OCHIN Community Health Information Network as an example of this model; community practices have come together collectively to form an organization that leverages shared IT expertise, resources, and data, providing members with the means to fully capitalize on new technologies that support improved care. This collaborative facilitates the identification of "problem sheds" through surveillance of network-wide data, enables shared learning regarding best practices, and provides a "community laboratory" for practice-based research. As an example of a community of solution, OCHIN uses health IT and data-sharing innovations to enhance partnerships between public health leaders, clinicians in community health centers, informatics experts, and policy makers. OCHIN community partners benefit from the shared IT resource (eg, a linked electronic health record, centralized data warehouse, informatics, and improvement expertise). This patient-centered medical village provides (1) the collective mechanism to build community-tailored IT solutions, (2) "neighbors" to share data and improvement strategies, and (3) infrastructure to support innovations based on electronic health records across communities, using experimental approaches.

Selection and placement of best management practices used to reduce water quality degradation in Lincoln Lake watershed

NASA Astrophysics Data System (ADS)

Rodriguez, Hector German; Popp, Jennie; Maringanti, Chetan; Chaubey, Indrajeet

2011-01-01

An increased loss of agricultural nutrients is a growing concern for water quality in Arkansas. Several studies have shown that best management practices (BMPs) are effective in controlling water pollution. However, those affected with water quality issues need water management plans that take into consideration BMPs selection, placement, and affordability. This study used a nondominated sorting genetic algorithm (NSGA-II). This multiobjective algorithm selects and locates BMPs that minimize nutrients pollution cost-effectively by providing trade-off curves (optimal fronts) between pollutant reduction and total net cost increase. The usefulness of this optimization framework was evaluated in the Lincoln Lake watershed. The final NSGA-II optimization model generated a number of near-optimal solutions by selecting from 35 BMPs (combinations of pasture management, buffer zones, and poultry litter application practices). Selection and placement of BMPs were analyzed under various cost solutions. The NSGA-II provides multiple solutions that could fit the water management plan for the watershed. For instance, by implementing all the BMP combinations recommended in the lowest-cost solution, total phosphorous (TP) could be reduced by at least 76% while increasing cost by less than 2% in the entire watershed. This value represents an increase in cost of 5.49 ha-1 when compared to the baseline. Implementing all the BMP combinations proposed with the medium- and the highest-cost solutions could decrease TP drastically but will increase cost by 24,282 (7%) and $82,306 (25%), respectively.

Proposal of a Roundabout Solution within a Particular Traflc Operation

NASA Astrophysics Data System (ADS)

Ližbetin, Ján; Stopka, Ondrej

2016-11-01

This paper presents the practical solution of the transport telematics elements within a particular traffic operation when providing a transport and logistics services. A roundabout helps to increase the fluency and safety of transport and logistics services in cities and urban areas, however, the positive effect can be achieved only after determining the proper intersection parameters. Based on a survey performed in a real traffic situation, the practical application of roundabout in the city of Pilsen is processed in the most important part of the paper.

Nursing Portal; a Nursing Informatics Solution for Iran, Lessons Learned from a Comparative Study

PubMed Central

Safdari, Reza; Masoori, Niloufar; Torabi, Mashaallah; Cheraghi, Mohammad A.; farzananejad, Ahmadreza; Azadmanjir, Zahra

2012-01-01

The nursing portal is an informatics solution in which services and capabilities supports the nursing staff in their practices and professional development with respect to the existing challenges for use of Internet by nurses at work. It can be considered as a creditable gateway for quick access to research-based evidence provided by reliable resources. Also it provide interactive virtual environment for knowledge exchange with experts or colleagues in different geographical area. Through a comparative study on specialized nursing portals in Iran and other three countries, the aim of this paper is defining desired content and structural specifications of nursing portals which support the practice of nurses in the workplace. Based on results of the present study, a set of recommendations provide for development of a comprehensive nursing portal in Iran. PMID:24199117

Nursing portal; a nursing informatics solution for iran, lessons learned from a comparative study.

PubMed

Safdari, Reza; Masoori, Niloufar; Torabi, Mashaallah; Cheraghi, Mohammad A; Farzananejad, Ahmadreza; Azadmanjir, Zahra

2012-01-01

The nursing portal is an informatics solution in which services and capabilities supports the nursing staff in their practices and professional development with respect to the existing challenges for use of Internet by nurses at work. It can be considered as a creditable gateway for quick access to research-based evidence provided by reliable resources. Also it provide interactive virtual environment for knowledge exchange with experts or colleagues in different geographical area. Through a comparative study on specialized nursing portals in Iran and other three countries, the aim of this paper is defining desired content and structural specifications of nursing portals which support the practice of nurses in the workplace. Based on results of the present study, a set of recommendations provide for development of a comprehensive nursing portal in Iran.

Early Warning Signs. A Solution-Finding Report

ERIC Educational Resources Information Center

Sullivan, Robert, Comp.

2017-01-01

This Solution-Finding Report provides information, requested by Tara Zuber with the Great Lakes Comprehensive Center (GLCC) at American Institutes for Research (AIR), for resources with evidence-based practices that look at the social and emotional causes that impact the lack of student learning and engagement, for GLCC's Early Warning Signs work.…

Practice Consolidation: Forces Not of Nature, but of Government, Demographics, Economics, and Technology.

PubMed

Edlow, Richard C

2016-01-01

The demand for healthcare services is increasing more rapidly than the supply of providers, while reimbursement levels ignore the free market law of supply and demand. The regulated healthcare environment in the United States fails to increase prices (i.e., reimbursement rates) as demand outstrips supply. Healthcare practitioners must find alternative methods in order to continue providing excellent patient care while at the same time maintaining an economically viable practice. Practice consolidation with the assistance of private equity healthcare investment is an extremely attractive solution to this imbalance.

Compliance with AAPM Practice Guideline 1.a: CT Protocol Management and Review — from the perspective of a university hospital

PubMed Central

Bour, Robert K.; Pozniak, Myron; Ranallo, Frank N.

2015-01-01

The purpose of this paper is to describe our experience with the AAPM Medical Physics Practice Guideline 1.a: “CT Protocol Management and Review Practice Guideline”. Specifically, we will share how our institution's quality management system addresses the suggestions within the AAPM practice report. We feel this paper is needed as it was beyond the scope of the AAPM practice guideline to provide specific details on fulfilling individual guidelines. Our hope is that other institutions will be able to emulate some of our practices and that this article would encourage other types of centers (e.g., community hospitals) to share their methodology for approaching CT protocol optimization and quality control. Our institution had a functioning CT protocol optimization process, albeit informal, since we began using CT. Recently, we made our protocol development and validation process compliant with a number of the ISO 9001:2008 clauses and this required us to formalize the roles of the members of our CT protocol optimization team. We rely heavily on PACS‐based IT solutions for acquiring radiologist feedback on the performance of our CT protocols and the performance of our CT scanners in terms of dose (scanner output) and the function of the automatic tube current modulation. Specific details on our quality management system covering both quality control and ongoing optimization have been provided. The roles of each CT protocol team member have been defined, and the critical role that IT solutions provides for the management of files and the monitoring of CT protocols has been reviewed. In addition, the invaluable role management provides by being a champion for the project has been explained; lack of a project champion will mitigate the efforts of a CT protocol optimization team. Meeting the guidelines set forth in the AAPM practice guideline was not inherently difficult, but did, in our case, require the cooperation of radiologists, technologists, physicists, IT, administrative staff, and hospital management. Some of the IT solutions presented in this paper are novel and currently unique to our institution. PACS number: 87.57.Q PMID:26103176

Dialysis Cannot be Dosed

PubMed Central

Meyer, Timothy W.; Sirich, Tammy L.; Hostetter, Thomas H.

2014-01-01

Adequate dialysis is difficult to define because we have not identified the toxic solutes that contribute most to uremic illness. Dialysis prescriptions therefore cannot be adjusted to control the levels of these solutes. The current solution to this problem is to define an adequate dose of dialysis on the basis of fraction of urea removed from the body. This has provided a practical guide to treatment as the dialysis population has grown over the past 25 years. Indeed, a lower limit to Kt/Vurea (or the related urea reduction ratio) is now established as a quality indicator by the Centers for Medicare and Medicaid for chronic hemodialysis patients in the United States. For the present, this urea-based standard provides a useful tool to avoid grossly inadequate dialysis. Dialysis dosing, however, based on measurement of a single, relatively nontoxic solute can provide only a very limited guide toward improved treatment. Prescriptions which have similar effects on the index solute can have widely different effects on other solutes. The dose concept discourages attempts to increase the removal of such solutes independent of the index solute. The dose concept further assumes that important solutes are produced at a constant rate relative to body size, and discourages attempts to augment dialysis treatment by reducing solute production. Identification of toxic solutes would provide a more rational basis for the prescription of dialysis and ultimately for improved treatment of patients with renal failure. PMID:21929590

Food parenting practices for 5 to 12 year old children: a concept map analysis of parenting and nutrition experts input.

PubMed

O'Connor, Teresia M; Mâsse, Louise C; Tu, Andrew W; Watts, Allison W; Hughes, Sheryl O; Beauchamp, Mark R; Baranowski, Tom; Pham, Truc; Berge, Jerica M; Fiese, Barbara; Golley, Rebecca; Hingle, Melanie; Kremers, Stef P J; Rhee, Kyung E; Skouteris, Helen; Vaughn, Amber

2017-09-11

Parents are an important influence on children's dietary intake and eating behaviors. However, the lack of a conceptual framework and inconsistent assessment of food parenting practices limits our understanding of which food parenting practices are most influential on children. The aim of this study was to develop a food parenting practice conceptual framework using systematic approaches of literature reviews and expert input. A previously completed systematic review of food parenting practice instruments and a qualitative study of parents informed the development of a food parenting practice item bank consisting of 3632 food parenting practice items. The original item bank was further reduced to 110 key food parenting concepts using binning and winnowing techniques. A panel of 32 experts in parenting and nutrition were invited to sort the food parenting practice concepts into categories that reflected their perceptions of a food parenting practice conceptual framework. Multi-dimensional scaling produced a point map of the sorted concepts and hierarchical cluster analysis identified potential solutions. Subjective modifications were used to identify two potential solutions, with additional feedback from the expert panel requested. The experts came from 8 countries and 25 participated in the sorting and 23 provided additional feedback. A parsimonious and a comprehensive concept map were developed based on the clustering of the food parenting practice constructs. The parsimonious concept map contained 7 constructs, while the comprehensive concept map contained 17 constructs and was informed by a previously published content map for food parenting practices. Most of the experts (52%) preferred the comprehensive concept map, while 35% preferred to present both solutions. The comprehensive food parenting practice conceptual map will provide the basis for developing a calibrated Item Response Modeling (IRM) item bank that can be used with computerized adaptive testing. Such an item bank will allow for more consistency in measuring food parenting practices across studies to better assess the impact of food parenting practices on child outcomes and the effect of interventions that target parents as agents of change.

Great Assistant Principals and the (Great) Principals Who Mentor Them: A Practical Guide

ERIC Educational Resources Information Center

Goodman, Carole C.; Berry, Christopher S.

2011-01-01

Written for principals and assistant principals to read and reflect on together, this book describes the most common challenges facing today's assistant principals--and provides practical solutions. Authors Carole Goodman and Christopher Berry examine how principals and assistant principals can develop the kinds of relationships that serve to meet…

Viewing equitable practices through the lens of intersecting identities

NASA Astrophysics Data System (ADS)

Lyons, Renée; Dsouza, Nikeetha; Quigley, Cassie

2016-12-01

This review explores Archer, Dawson, Seakins, and Wong's "Disorienting, fun or meaningful? Disadvantaged families' experiences of a science museum visit" by examining the analytic frameworks guiding this study. To expand on Archer et al.'s use of feminist post-structuralist theories of identity we draw from the theory of intersectionality to provide a more robust framework for analyzing barriers to engagement within an informal learning space. Our response to this work ends by exploring the types of solutions generated from an intersectionality framework—solutions aimed at transforming institutional programs and practices to create more equitable spaces for learning.

The right of women in property sharing in Bangladesh: Can the islamic inheritance system eliminate discrimination?

PubMed

Khan, Issa; Abdullah, Md Faruk; Rahman, Noor Naemah Abdul; Nor, Mohd Roslan Bin Mohd; Yusoff, Mohd Yakub Zulkifli Bin Mohd

2016-01-01

This study seeks to discover the best solution for women's property sharing between Islamic and current social practices in Bangladesh. A qualitative method has been adopted to achieve this goal. It is found that the majority of the women are marginalised from their property in the social practice. On the other hand, in the Islamic solution, the property is fixed for all classes of women and is based on a property sharing system called fara'id that takes into account the roles and responsibilities of man and woman in the society. Men are responsible for providing maintenance to their wives and children. Men in Islamic society should bear expenditure related to marriage. The research concludes that the Islamic solution is fair and ensures just property sharing rights for women. It suggests that the Islamic solution for property sharing should be implemented to empower women in Bangladesh.

Comply with regulations or risk paying hefty fines: ten tips for choosing call recording to help ensure compliance.

PubMed

Johnson, Bill

2014-01-01

Medical practices are paying hundreds of thousands of dollars in fines for not complying with various governmental regulations, including a variety of HIPAA rules and credit card compliance. One solution to help reduce this risk and avoid fines is to use call recording to help ensure compliance. This article provides readers with key considerations for choosing and implementing a call recording solution for their medical practices to ensure that it will be compliant with key regulations. These tips include being able to customize call recording policies and procedures for their unique needs; providing secure, private storage; allowing easy access for authorized users; secure sharing of call recordings; regulatory compliance training; disaster recovery; and maintaining an audit-ready and compliant-evident state at all times.

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

PubMed Central

2013-01-01

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

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

PubMed

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

2013-08-07

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

Taking a traditional web site to patient portal technology.

PubMed

Labow, Kimberly

2010-01-01

In this era of consumer-driven healthcare, consumers (your current and potential patients) seek healthcare information on the Internet. If your practice doesn't have a Web site, or has one that's static and uninformative, you won't be found, and the patient will move on to the next practice Web site. Why? Because only the most graphically appealing, informative, and patient-centered Web sites will drive patients to your practice. Patients are demanding improved communication with their physician. A practice Web site is a start, but the adoption of a fully functional, interactive Web site with patient portal solutions will not only improve patient-to-provider relationships but will also give the patient access to your practice from anywhere, at any time of the day. Furthermore, these solutions can help practices increase efficiencies and revenue, while reducing operating costs. With the American Recovery and Reinvestment Act of 2009 and other incentives for healthcare information technology adoption, the time is right for your practice to consider implementing technology that will bring considerable value to your practice and also increase patient satisfaction.

Dynamic Undergraduate Climate Change Affinity Program: University of Delaware Climate Program for Undergraduates (CPUG)

NASA Astrophysics Data System (ADS)

Merrill, J.

2017-12-01

Multidisciplinary undergraduate climate change education is critical for students entering any sector of the workforce. The University of Delaware has developed a new interdisciplinary affinity program—UD Climate Program for Undergraduates (CPUG)—open to undergraduate students of all majors to provide a comprehensive educational experience designed to educate skilled climate change problem-solvers for a wide range of professional careers. The program is designed to fulfill all General Education requirements, and includes a residential community commitment and experiential learning in community outreach and problem solving. Seminars will introduce current popular press and research materials and provide practice in confirming source credibility, communications training, and psychological support, as well as team building. As undergraduates, members of the UD CPUG team will define, describe, and develop a solution or solutions for a pressing local climate challenge that has the potential for global impact. The choice of a challenge and approach to addressing it will be guided by the student's advisor. Students are expected to develop a practical, multidisciplinary solution to address the challenge as defined, using their educational and experiential training. Solutions will be presented to the UD community during the spring semester of their senior year, as a collaborative team solution, with enhancement through individual portfolios from each team member. The logic model, structure, curricular and co-curricular supports for the CPUG will be provided. Mechanisms of support available through University administration will also be discussed.

Dermatology practice management assures practice development and efficiency.

PubMed

Wagener, D L

2000-09-01

This article provides an overview of the disciplines involved in managing a dermatology practice today. Several key management processes, including strategic planning, financial analysis, advertising and public relations, information systems management, and compliance program development and monitoring are addressed. This article explores several possible tactics that can be used to help guide your practice in the right direction without overtaxing your resources. Also offered are possible solutions for creating an organization that is poised for success, and a management team capable of steering the practice through the sea of change ahead.

Wilderness visitor management practices: a benchmark and an assessment of progress

Treesearch

Alan E. Watson

1989-01-01

In the short time that wilderness visitor management practices have been monitored, some obvious trends have developed. The managing agencies, however, have appeared to provide different solutions to similar problems. In the early years, these problems revolved around concern about overuse of the resource and crowded conditions. Some of those concerns exist today, but...

Closing the research to practice gap in children's mental health: structures, solutions, and strategies.

PubMed

Jensen, Peter S; Foster, Michael

2010-03-01

Failure to apply research on effective interventions spans all areas of medicine, including children's mental health services. This article examines the policy, structural, and economic problems in which this gap originates. We identify four steps to close this gap. First, the field should develop scientific measures of the research-practice gap. Second, payors should link incentives to outcomes-based performance measures. Third, providers and others should develop improved understanding and application of effective dissemination and business models. Fourth, efforts to link EBP to clinical practice should span patient/consumers, providers, practices, plans, and purchasers. The paper discusses each of these in turn and relates them to fundamental problems of service delivery.

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

PubMed

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

2017-01-01

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

General practice integration in Australia. Primary health services provider and consumer perceptions of barriers and solutions.

PubMed

Appleby, N J; Dunt, D; Southern, D M; Young, D

1999-08-01

To identify practical examples of barriers and possible solutions to improve general practice integration with other health service providers. Twelve focus groups, including one conducted by teleconference, were held across Australia with GPs and non GP primary health service providers between May and September, 1996. Focus groups were embedded within concept mapping sessions, which were used to conceptually explore the meaning of integration in general practice. Data coding, organising and analysis were based on the techniques documented by Huberman and Miles. Barriers to integration were perceived to be principally due to the role and territory disputes between the different levels of government and their services, the manner in which the GP's role is currently defined, and the system of GP remuneration. Suggestions on ways to improve integration involved two types of strategies. The first involves initiatives implemented 'top down' through major government reform to service structures, including the expansion of the role of divisions of general practice, and structural changes to the GP remuneration systems. The second type of strategy suggested involves initiatives implemented from the 'bottom up' involving services such as hospitals (e.g. additional GP liaison positions) and the use of information technology to link services and share appropriate patient data. The findings support the need for further research and evaluation of initiatives aimed at achieving general practice integration at a systems level. There is little evidence to suggest which types of initiatives improve integration. However, general practice has been placed in the centre of the health care debate and is likely to remain central to the success of such initiatives. Clarification of the future role and authority of general practice will therefore be required if such integrative strategies are to be successful at a wider health system level.

Energy Efficient Cryogenics

NASA Technical Reports Server (NTRS)

Meneghelli, Barry J.; Notardonato, William; Fesmire, James E.

2016-01-01

The Cryogenics Test Laboratory, NASA Kennedy Space Center, works to provide practical solutions to low-temperature problems while focusing on long-term technology targets for the energy-efficient use of cryogenics on Earth and in space.

See More, Do More, Teach More: Surgical Resident Autonomy and the Transition to Independent Practice.

PubMed

Hashimoto, Daniel A; Bynum, William E; Lillemoe, Keith D; Sachdeva, Ajit K

2016-06-01

The graduate medical education system is tasked with training competent and autonomous health care providers while also improving patient safety, delivering more efficient care, and cutting costs. Concerns about resident autonomy and preparation for independent and safe practice appear to be growing, and the field of surgery faces unique challenges in preparing graduates for independent practice. Multiple factors are contributing to an erosion of resident autonomy and decreased operative experience, including differing views of autonomy, financial forces, duty hours regulations, and diverse community health care needs. Identifying these barriers and developing solutions to overcome them are vital first steps in reversing the trend of diminishing autonomy in surgical residency training. This Commentary highlights the problem of decreasing autonomy, outlines specific threats to resident autonomy, and discusses potential solutions to mitigate their impact on the successful transition to independent practice.

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

PubMed

Petosa, R L; Smith, L

2017-01-01

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

Inverse kinematic solution for near-simple robots and its application to robot calibration

NASA Technical Reports Server (NTRS)

Hayati, Samad A.; Roston, Gerald P.

1986-01-01

This paper provides an inverse kinematic solution for a class of robot manipulators called near-simple manipulators. The kinematics of these manipulators differ from those of simple-robots by small parameter variations. Although most robots are by design simple, in practice, due to manufacturing tolerances, every robot is near-simple. The method in this paper gives an approximate inverse kinematics solution for real time applications based on the nominal solution for these robots. The validity of the results are tested both by a simulation study and by applying the algorithm to a PUMA robot.

Ten tips for successful electronic health records deployment.

PubMed

Gasch, Art

2012-01-01

As healthcare providers are increasingly compelled to adopt electronic health records (EHRs) and paper records migrate to electronic files provided to dozens of healthcare intermediaries, breeches of protected health information are skyrocketing, and so are dissatisfaction rates with EHR solutions. This article provides 10 practical tips to ensure a successful EHR system deployment an circumvent EHR land mines.

What students learn when studying physics practice exam problems

NASA Astrophysics Data System (ADS)

Fakcharoenphol, Witat; Potter, Eric; Stelzer, Timothy

2011-06-01

We developed a web-based tool to provide students with access to old exam problems and solutions. By controlling the order in which students saw the problems, as well as their access to solutions, we obtained data about student learning by studying old exam problems. Our data suggest that in general students learn from doing old exam problems, and that having access to the problem solutions increases their learning. However, the data also suggest the depth of learning may be relatively shallow. In addition, the data show that doing old exam problems provides important formative assessment about the student’s overall preparedness for the exam and their particular areas of strength and weakness.

Energy Efficient Cryogenics on Earth and in Space

NASA Technical Reports Server (NTRS)

Fesmire, James E.

2012-01-01

The Cryogenics Test Laboratory, NASA Kennedy Space Center, works to provide practical solutions to low-temperature problems while focusing on long-term technology targets for energy-efficient cryogenics on Earth and in space.

Data Presentation on Transportation Agency Websites: Trends and Best Practices

DOT National Transportation Integrated Search

2017-05-01

The Division of Research, Innovation and System Information (DRISI) within Californias Department of Transportation (Caltrans) provides solutions and knowledge that improves Californias transportation system. The Division recently sought to det...

Serials Solutions and LinkFinderPlus at the University of Wales Swansea

ERIC Educational Resources Information Center

Brown, Andrew; Smyth, Neil

2005-01-01

Purpose: To provide practical information on two electronic journal-related products implemented in Library and Information Services at University of Wales Swansea. Design/methodology/approach: An overview is provided of the evaluation of electronic journal management products undertaken and subsequent implementation. Findings: Serials Solutions…

Basic Skills Support in Business and Industry.

ERIC Educational Resources Information Center

Byatt, Janet; Davies, Karen

This guide is designed as a tool for English and Welsh businesses wanting to provide basic skills training for their employees. It provides practical solutions to the problems of identifying employees' basic skills needs and selecting the best model of training delivery to address identified training needs. The introductory section discusses basic…

Honorary Authorship Practices in Environmental Science Teams: Structural and Cultural Factors and Solutions.

PubMed

Elliott, Kevin C; Settles, Isis H; Montgomery, Georgina M; Brassel, Sheila T; Cheruvelil, Kendra Spence; Soranno, Patricia A

2017-01-01

Overinclusive authorship practices such as honorary or guest authorship have been widely reported, and they appear to be exacerbated by the rise of large interdisciplinary collaborations that make authorship decisions particularly complex. Although many studies have reported on the frequency of honorary authorship and potential solutions to it, few have probed how the underlying dynamics of large interdisciplinary teams contribute to the problem. This article reports on a qualitative study of the authorship standards and practices of six National Science Foundation-funded interdisciplinary environmental science teams. Using interviews of the lead principal investigator and an early-career member on each team, our study explores the nature of honorary authorship practices as well as some of the motivating factors that may contribute to these practices. These factors include both structural elements (policies and procedures) and cultural elements (values and norms) that cross organizational boundaries. Therefore, we provide recommendations that address the intersection of these factors and that can be applied at multiple organizational levels.

Patient safety problem identification and solution sharing among rural community pharmacists.

PubMed

Galt, Kimberly A; Fuji, Kevin T; Faber, Jennifer

2013-01-01

To implement a communication network for safety problem identification and solution sharing among rural community pharmacists and to report participating pharmacists' perceived value and impact of the network on patient safety after 1 year of implementation. Action research study. Rural community pharmacies in Nebraska from January 2010 to April 2011. Rural community pharmacists who voluntarily agreed to join the Pharmacists for Patient Safety Network in Nebraska. Pharmacists reported errors, near misses, and safety concerns through Web-based event reporting. A rapid feedback process was used to provide patient safety solutions to consider implementing across the network. Qualitative interviews were conducted 1 year after program implementation with participating pharmacists to assess use of the reporting system, value of the disseminated safety solutions, and perceived impact on patient safety in pharmacies. 30 of 38 pharmacists participating in the project completed the interviews. The communication network improved pharmacist awareness, promoted open discussion and knowledge sharing, contributed to practice vigilance, and led to incorporation of proactive safety prevention practices. Despite low participation in error and near-miss reporting, a dynamic communication network designed to rapidly disseminate evidence-based patient safety strategies to reduce risk was valued and effective at improving patient safety practices in rural community pharmacies.

Activist engineering: changing engineering practice by deploying praxis.

PubMed

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

2015-02-01

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

Increasing the Roles and Significance of Teachers in Policymaking for K-12 Engineering Education: Proceedings of a Convocation

ERIC Educational Resources Information Center

Olson, Steve

2017-01-01

Engineering is a small but growing part of K-12 education. Curricula that use the principles and practices of engineering are providing opportunities for elementary, middle, and high school students to design solutions to problems of immediate practical and societal importance. Professional development programs are showing teachers how to use…

Re-wilding Europe's traditional agricultural landscapes: Values and the link between science and practice

Treesearch

Paul H. Gobster

2014-01-01

Landscape and Urban Planning encourages multiple perspectives and approaches to help understand landscapes as social-ecological systems, with the goal that by building a robust science of landscape we can provide sustainable solutions for guiding its change. But the link between science and practice, or more simply put, between knowledge and action, is not always clear...

The testing effect and analogical problem-solving.

PubMed

Peterson, Daniel J; Wissman, Kathryn T

2018-06-25

Researchers generally agree that retrieval practice of previously learned material facilitates subsequent recall of same material, a phenomenon known as the testing effect. There is debate, however, about when such benefits transfer to related (though not identical) material. The current study examines the phenomenon of transfer in the domain of analogical problem-solving. In Experiments 1 and 2, learners were presented a source text describing a problem and solution to read which was subsequently either restudied or recalled. Following a short (Experiment 1) or long (Experiment 2) delay, learners were given a new target text and asked to solve a problem. The two texts shared a common structure such that the provided solution for the source text could be applied to solve the problem in the target text. In a combined analysis of both experiments, learners in the retrieval practice condition were more successful at solving the problem than those in the restudy condition. Experiment 3 explored the degree to which retrieval practice promotes cued versus spontaneous transfer by manipulating whether participants were provided with an explicit hint that the source and target texts were related. Results revealed no effect of retrieval practice.

Regulation of gene expression by yoga, meditation and related practices: a review of recent studies.

PubMed

Saatcioglu, Fahri

2013-02-01

Integrative medicine (IM) approaches have gained significant interest in recent years to provide a solution for the health care challenges we face today. Yogic cognitive-behavioral practices are among the most widely used IM approaches and include diverse practices such as yoga asanas, meditation, breathing exercises, Qi Gong, Tai Chi Chih, and various others. Studies to date suggest that these yogic/meditative practices have significant positive effects on the mind-body system and thereby can increase wellness and support the healing process from disease. Previous work has provided evidence for both psychological and physiological effects of these practices; however, the mechanisms of these effects, especially at the molecular level, have largely been missing. Three recent studies started to provide some of this information through gene expression profiling in circulating immune cells, which support the hypothesis that yogic/meditative practices have a measurable effect at the molecular level. These studies are reviewed herein and some future perspectives are considered. Copyright © 2012 Elsevier B.V. All rights reserved.

Values-based practice in mental health and psychiatry.

PubMed

Woodbridge-Dodd, Kim

2012-11-01

Values-based practice (VBP) challenges traditions of clinical practice and moral decision-making and the literature published over the last 18 months demonstrates a growing momentum for its use. The VBP model has become part of the narrative of health and social care practice. It features in a range of publications and has been subject to philosophical analysis in relation to its theoretical rigour, and applied to clinical practice through education and training, implementation in the field and policy development. From a philosophical perspective the model faces several challenges; from a practice perspective it is welcomed as a necessary partner to Evidence-Based Practice. Both perspectives suggest VBP requires significant adjustment to professional ideas of good practice, expectations of the clinician service user relationship and notions of what constitutes good care. VBP is both a solution and a problem for clinicians. Whether VBP is seen as providing a much needed clinical skill for working with the complexity of mental health and psychiatry which is steeped in values or a solution to a dominant sociopolitical neoliberal ideology demand for choice and personalization of care, VBP will require clinicians to make personal changes to their values base that reach to the depths of their professional identity.

An American and Dutch partnership for psychiatric mental health advance nursing practice: nurturing a relationship across the ocean.

PubMed

Maas, Lillian; Ezeobele, I Ezebuiro; Tetteroo, Marieke

2012-07-01

The purpose of this article is to discuss the challenges and rewards of developing and nurturing an international clinical psychiatric mental health advanced nursing practice exchange between the Netherlands and the United States. Since 1997, Rotterdam University of Applied Sciences in the Netherlands has been participating in international clinical experiences for their psychiatric mental health (PMH) advanced practice nursing students. The international experience is mandatory prior to graduation and is the first of its kind in Europe to mandate such a unique experience. This study sample included eight Dutch PMH advanced practice nursing students enrolled in a full-time master's in advanced nursing practice program. The descriptive study included reflective reports and one-on-one discussions over a 3-year period. With proper planning, an international nursing experience provides a unique opportunity for nurses to think beyond their own culture and healthcare system. Solving problems together through different perspectives creates opportunities for creative solutions. International partnerships within PMH advanced practice nursing promotes sharing of knowledge and solutions as patients and diseases have no border. © 2011 Wiley Periodicals, Inc.

Beyond individualism: Is there a place for relational autonomy in clinical practice and research?

PubMed

Dove, Edward S; Kelly, Susan E; Lucivero, Federica; Machirori, Mavis; Dheensa, Sandi; Prainsack, Barbara

2017-09-01

The dominant, individualistic understanding of autonomy that features in clinical practice and research is underpinned by the idea that people are, in their ideal form, independent, self-interested and rational gain-maximising decision-makers. In recent decades, this paradigm has been challenged from various disciplinary and intellectual directions. Proponents of 'relational autonomy' in particular have argued that people's identities, needs, interests - and indeed autonomy - are always also shaped by their relations to others. Yet, despite the pronounced and nuanced critique directed at an individualistic understanding of autonomy, this critique has had very little effect on ethical and legal instruments in clinical practice and research so far. In this article, we use four case studies to explore to what extent, if at all, relational autonomy can provide solutions to ethical and practical problems in clinical practice and research. We conclude that certain forms of relational autonomy can have a tangible and positive impact on clinical practice and research. These solutions leave the ultimate decision to the person most affected, but encourage and facilitate the consideration of this person's care and responsibility for connected others.

Analytic regularization of uniform cubic B-spline deformation fields.

PubMed

Shackleford, James A; Yang, Qi; Lourenço, Ana M; Shusharina, Nadya; Kandasamy, Nagarajan; Sharp, Gregory C

2012-01-01

Image registration is inherently ill-posed, and lacks a unique solution. In the context of medical applications, it is desirable to avoid solutions that describe physically unsound deformations within the patient anatomy. Among the accepted methods of regularizing non-rigid image registration to provide solutions applicable to medical practice is the penalty of thin-plate bending energy. In this paper, we develop an exact, analytic method for computing the bending energy of a three-dimensional B-spline deformation field as a quadratic matrix operation on the spline coefficient values. Results presented on ten thoracic case studies indicate the analytic solution is between 61-1371x faster than a numerical central differencing solution.

Ordinary differential equations.

PubMed

Lebl, Jiří

2013-01-01

In this chapter we provide an overview of the basic theory of ordinary differential equations (ODE). We give the basics of analytical methods for their solutions and also review numerical methods. The chapter should serve as a primer for the basic application of ODEs and systems of ODEs in practice. As an example, we work out the equations arising in Michaelis-Menten kinetics and give a short introduction to using Matlab for their numerical solution.

Asperger Syndrome and the Elementary School Experience: Practical Solutions for Academic & Social Difficulties.

ERIC Educational Resources Information Center

Moore, Susan Thompson.

This book provides educators with an understanding of Asperger syndrome (AS) and how it affects a student academically and socially, and provides specific strategies for helping elementary school students with AS function successfully. Following an introductory chapter, chapter 2 presents the major areas of difficulty for individuals with AS with…

Photography in Dermatologic Surgery: Selection of an Appropriate Lighting Solution for a Particular Clinical Application.

PubMed

Chen, Brian R; Poon, Emily; Alam, Murad

2018-01-01

Lighting is an important component of consistent, high-quality dermatologic photography. There are different types of lighting solutions available. To evaluate currently available lighting equipment and methods suitable for procedural dermatology. Overhead lighting, built-in camera flashes, external flash units, studio strobes, and light-emitting diode (LED) light panels were evaluated with regard to their utility for dermatologic surgeons. A set of ideal lighting characteristics was used to examine the capabilities and limitations of each type of lighting solution. Recommendations regarding lighting solutions and optimal usage configurations were made in terms of the context of the clinical environment and the purpose of the image. Overhead lighting may be a convenient option for general documentation. An on-camera lighting solution using a built-in camera flash or a camera-mounted external flash unit provides portability and consistent lighting with minimal training. An off-camera lighting solution with studio strobes, external flash units, or LED light panels provides versatility and even lighting with minimal shadows and glare. The selection of an optimal lighting solution is contingent on practical considerations and the purpose of the image.

MANDATING DISCLOSURE OF CONSCIENCE-BASED LIMITATIONS ON MEDICAL PRACTICE.

PubMed

Sawicki, Nadia N

2016-01-01

Stakeholders in law, medicine, and religion are unable to reach consensus about how best to address conflicts between healthcare providers' conscientious objections to treatment and patients' rights to access medical care. Conscience laws that protect objecting providers and institutions from liability are criticized as too broad by patient advocates and as too narrow by defenders of religious freedom. This Article posits that some of the tension between these stakeholders could be mitigated by statutory recognition of a duty on the part of healthcare institutions or providers to disclose conscientiously motivated limitations on practice. While this solution would not guarantee a patient's access to treatment, referral, or information from any given provider, it would prevent some of the more egregious cases of denial of treatment--those where patients are not made aware that a legal and clinically defensible treatment option is excluded from a provider's or institution's scope of practice and so have no opportunity to seek care elsewhere.

On computing the geoelastic response to a disk load

NASA Astrophysics Data System (ADS)

Bevis, M.; Melini, D.; Spada, G.

2016-06-01

We review the theory of the Earth's elastic and gravitational response to a surface disk load. The solutions for displacement of the surface and the geoid are developed using expansions of Legendre polynomials, their derivatives and the load Love numbers. We provide a MATLAB function called diskload that computes the solutions for both uncompensated and compensated disk loads. In order to numerically implement the Legendre expansions, it is necessary to choose a harmonic degree, nmax, at which to truncate the series used to construct the solutions. We present a rule of thumb (ROT) for choosing an appropriate value of nmax, describe the consequences of truncating the expansions prematurely and provide a means to judiciously violate the ROT when that becomes a practical necessity.

Improving the management of chronic diseases using web-based technologies: an application in hemophilia care.

PubMed

Teixeira, Leonor; Saavedra, Vasco; Ferreira, Carlos; Sousa Santos, Beatriz

2010-01-01

Modern methods of information and communication that use web technologies provide an opportunity to facilitate closer communication between patients and healthcare providers, allowing a joint management of chronic diseases. This paper describes a web-based technological solution to support the management of inherited bleeding disorders integrating, diffusing and archiving large sets of data relating to the clinical practice of hemophilia care, more specifically the clinical practice at the Hematology Service of Coimbra Hospital Center (a Hemophilia Treatment Center located in Portugal).

Magnetic radiation shielding - An idea whose time has returned?

NASA Technical Reports Server (NTRS)

Landis, Geoffrey A.

1991-01-01

One solution to the problem of shielding crew from particulate radiation in space is to use active electromagnetic shielding. Practical types of shield include the magnetic shield, in which a strong magnetic field diverts charged particles from the crew region, and the magnetic/electrostatic plasma shield, in which an electrostatic field shields the crew from positively charged particles, while a magnetic field confines electrons from the space plasma to provide charge neutrality. Advances in technology include high-strength composite materials, high-temperature superconductors, numerical computational solutions to particle transport in electromagnetic fields, and a technology base for construction and operation of large superconducting magnets. These advances make electromagnetic shielding a practical alternative for near-term future missions.

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

PubMed

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

2018-02-05

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

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

PubMed

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

2009-04-01

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

Practical Use Of It In Traceability In Food Value Chains

NASA Astrophysics Data System (ADS)

Ratcliff, Jon; Boddington, Michael

Traceability is today considered an essential requirement for the food value chain due to the need to provide consumers with accurate information in the event of food safety recalls, to provide assurance with regard the source and production systems for food products and in certain countries to comply with government legislation. Within an individual business traceability can be quite simple to implement, however, in a global trading market, traceability of the entire supply chain, including logistics is extremely complex. For this reason IT solutions such as TraceTracker have been developed which not only provide electronic solutions for complete traceability but also allow products to be tracked at any point in the supply chain.

A focus on the asthma HEDIS measure and its implications for clinical practice.

PubMed

Davies, Thomas J; Bunn, William B; Fromer, Leonard; Gelfand, Erwin W; Colice, Gene L

2006-02-01

With more than $16.1 billion in annual costs, the asthma management system is inadequate and needs revision to improve health and financial outcomes. Solutions may be found in the National Committee for Quality Assurance's guidelines and in such programs as Pay for Performance that financially reward providers for adherence to standards of practice based on Health Plan Employer Data and Information Set measures.

Reprint Filing: A Profile-Based Solution

PubMed Central

Gass, David A.; Putnam, R. Wayne

1983-01-01

A reprint filing system based on practice profiles can give family physicians easy access to relevant medical information. The use of the ICHPPC classification and some supplemental categories provides a more practical coding mechanism than organ systems, textbook chapter titles or even Index Medicus subject headings. The system can be simply maintained, updated and improved, but users must regularly weed out unused information, and read widely to keep the reprints current. PMID:21283301

Data-Driven Diffusion Of Innovations: Successes And Challenges In 3 Large-Scale Innovative Delivery Models

PubMed Central

Dorr, David A.; Cohen, Deborah J.; Adler-Milstein, Julia

2018-01-01

Failed diffusion of innovations may be linked to an inability to use and apply data, information, and knowledge to change perceptions of current practice and motivate change. Using qualitative and quantitative data from three large-scale health care delivery innovations—accountable care organizations, advanced primary care practice, and EvidenceNOW—we assessed where data-driven innovation is occurring and where challenges lie. We found that implementation of some technological components of innovation (for example, electronic health records) has occurred among health care organizations, but core functions needed to use data to drive innovation are lacking. Deficits include the inability to extract and aggregate data from the records; gaps in sharing data; and challenges in adopting advanced data functions, particularly those related to timely reporting of performance data. The unexpectedly high costs and burden incurred during implementation of the innovations have limited organizations’ ability to address these and other deficits. Solutions that could help speed progress in data-driven innovation include facilitating peer-to-peer technical assistance, providing tailored feedback reports to providers from data aggregators, and using practice facilitators skilled in using data technology for quality improvement to help practices transform. Policy efforts that promote these solutions may enable more rapid uptake of and successful participation in innovative delivery system reforms. PMID:29401031

Data-Driven Diffusion Of Innovations: Successes And Challenges In 3 Large-Scale Innovative Delivery Models.

PubMed

Dorr, David A; Cohen, Deborah J; Adler-Milstein, Julia

2018-02-01

Failed diffusion of innovations may be linked to an inability to use and apply data, information, and knowledge to change perceptions of current practice and motivate change. Using qualitative and quantitative data from three large-scale health care delivery innovations-accountable care organizations, advanced primary care practice, and EvidenceNOW-we assessed where data-driven innovation is occurring and where challenges lie. We found that implementation of some technological components of innovation (for example, electronic health records) has occurred among health care organizations, but core functions needed to use data to drive innovation are lacking. Deficits include the inability to extract and aggregate data from the records; gaps in sharing data; and challenges in adopting advanced data functions, particularly those related to timely reporting of performance data. The unexpectedly high costs and burden incurred during implementation of the innovations have limited organizations' ability to address these and other deficits. Solutions that could help speed progress in data-driven innovation include facilitating peer-to-peer technical assistance, providing tailored feedback reports to providers from data aggregators, and using practice facilitators skilled in using data technology for quality improvement to help practices transform. Policy efforts that promote these solutions may enable more rapid uptake of and successful participation in innovative delivery system reforms.

Mastery-style exercises in physics

NASA Astrophysics Data System (ADS)

Schroeder, Noah D.

Mastery learning employs repeated cycles of instructional support and formative assessment to help students achieve desired skills. Instructional objectives are broken into small pieces, and students master those pieces in successive order by performing to a set standard on an assessment for each objective. If a student cannot master an objective, instructional support is provided, and the student is reassessed. Mastery learning has been proved effective in many subject areas, but comparatively little research has been done on applying it in physics instruction. This dissertation details the path taken that culminated in the use of mastery-inspired exercises to teach students basic skills in introductory physics courses. The path that led to our choice of mastery began with an attempt to provide students with extra practice and formative assessment through weekly practice tests with corresponding solutions, with the goal of helping them better prepare for summative exams in an introductory physics course. No effect was seen, and participation was very low. Investigating how students learn from solutions revealed that they are poor evaluators of their understanding of provided solutions and struggle to retain the skills taught in those solutions. In a follow-up clinical experiment that provided students with solutions, required them to recall the solutions from memory, and re-presented the solutions for restudy, students showed strong retention as well as the ability to transfer information from the solutions to new situations. These results inspired the formal use of mastery learning as an instructional paradigm due to its requirement that students repeatedly recall information from solutions and apply it to new situations. Mastery-style exercises were first created and tested in clinical trials, followed by two in-course implementations. In the clinical trials, students completed a set of questions on a particular skill, and if they failed to master that skill, they were given support in the form of narrated animated solution videos followed by a new version of the question set. On mastering a skill, students moved on to the next skill level. Students mastered all provided skill levels and then took a post-test. Those clinical trials demonstrated that students can use provided solutions to quickly progress through successive levels of mastery exercises and that mastery-style exercises had a larger impact on the post-test than traditional multi-try immediate feedback homework exercises. Following these strong results, mastery-style exercises were implemented over an entire semester in an introductory course, replacing the existing homework. Participation was much poorer than in the clinical experiments due to frustration with the difficulty of the provided exercises. As a result the implementation had a comparatively small impact on student performance. Frustrated students circumvented the system by ignoring provided solutions and skipping assessments, choosing instead to cycle through the provided versions until they could reattempt an already seen version of an assessment. A follow-up implementation covering a single week had a larger impact on a quiz, yet students were still frustrated with the exercises and displayed behaviors similar to those seen in the semester-long implementation. Moving forward, frustration must be overcome to return participation to levels seen in the clinical trials. A preliminary development mode is suggested to ensure proper calibration of difficulty to student skills. Other changes involving how the mechanics of the system work as well as how its benefits are communicated to students are also suggested. If frustration is overcome and participation increases, the incredible potential of mastery-inspired exercises can be realized. Mastery is a powerful addition to physics instruction.

Incorporation of Hands-On Sterile Technique Instruction in an Introductory Pharmacy Practice Experience

PubMed Central

Cruthirds, Danielle; Coward, Lori

2015-01-01

Objective. To examine sterile technique and basic sterile compounding procedures among third-year pharmacy students. Design. Third year pharmacy students participating in an introductory pharmacy practice experience (IPPE) in 2012 (n=126) and 2013 (n=119) performed a modified low-risk compounded sterile product (CSP) media fill challenge test, then prepared a 5 mg/mL vancomycin solution that was subsequently analyzed for accuracy. Assessment. To identify deficiencies in sterile procedures, students were observed while performing a modified low-risk CSP media fill challenge test. In the first year of conducting the challenge test (2012), 3 deficiencies were identified: hand washing before compounding, cleaning items with alcohol prior to start, and cleaning work area upon completion. In 2013, significant improvements were observed in these 3 areas after students watched a demonstration video. Examination of CSPs revealed less than 1% contamination in both years. Analysis of compounded vancomycin solutions showed that 84% and 71% of students prepared solutions in 2012 and 2013, respectively, were within 10% of the targeted final concentration. Conclusion. Hands-on sterile compounding exercises are typically delivered early in the pharmacy professional curriculum with minimal reinforcement in subsequent years. Providing opportunities for advanced pharmacy students to refresh and practice sterile compounding procedures allows students to refine their skills before entering pharmacy practice. PMID:25861109

Neural dynamic programming and its application to control systems

NASA Astrophysics Data System (ADS)

Seong, Chang-Yun

There are few general practical feedback control methods for nonlinear MIMO (multi-input-multi-output) systems, although such methods exist for their linear counterparts. Neural Dynamic Programming (NDP) is proposed as a practical design method of optimal feedback controllers for nonlinear MIMO systems. NDP is an offspring of both neural networks and optimal control theory. In optimal control theory, the optimal solution to any nonlinear MIMO control problem may be obtained from the Hamilton-Jacobi-Bellman equation (HJB) or the Euler-Lagrange equations (EL). The two sets of equations provide the same solution in different forms: EL leads to a sequence of optimal control vectors, called Feedforward Optimal Control (FOC); HJB yields a nonlinear optimal feedback controller, called Dynamic Programming (DP). DP produces an optimal solution that can reject disturbances and uncertainties as a result of feedback. Unfortunately, computation and storage requirements associated with DP solutions can be problematic, especially for high-order nonlinear systems. This dissertation presents an approximate technique for solving the DP problem based on neural network techniques that provides many of the performance benefits (e.g., optimality and feedback) of DP and benefits from the numerical properties of neural networks. We formulate neural networks to approximate optimal feedback solutions whose existence DP justifies. We show the conditions under which NDP closely approximates the optimal solution. Finally, we introduce the learning operator characterizing the learning process of the neural network in searching the optimal solution. The analysis of the learning operator provides not only a fundamental understanding of the learning process in neural networks but also useful guidelines for selecting the number of weights of the neural network. As a result, NDP finds---with a reasonable amount of computation and storage---the optimal feedback solutions to nonlinear MIMO control problems that would be very difficult to solve with DP. NDP was demonstrated on several applications such as the lateral autopilot logic for a Boeing 747, the minimum fuel control of a double-integrator plant with bounded control, the backward steering of a two-trailer truck, and the set-point control of a two-link robot arm.

Understanding the effect of resident duty hour reform: a qualitative study.

PubMed

Wu, Peter E; Stroud, Lynfa; McDonald-Blumer, Heather; Wong, Brian M

2014-04-01

Concern surrounding the effect of resident fatigue on patient care recently led the National Steering Committee on Resident Duty Hours to publish Canadian recommendations suggesting that duty periods of 24 or more consecutive hours without restorative sleep should be avoided. We sought to characterize how different training programs are preparing for the effect of such changes on education, patient care and provider well-being. Using constructivist grounded theory methodology, we conducted 18 one-on-one semistructured interviews with program directors, division directors and department chiefs from 11 residency programs affiliated with one Canadian medical school. We gathered and analyzed data iteratively until we reached theoretical saturation. The key theme articulated by our participants was that changes in resident duty hours would potentially lead to gaps in the provision of clinical care. These changes affect acute care specialties based primarily in the inpatient setting (e.g., medicine, surgery) more than primarily ambulatory (e.g., family medicine) or shift-model based (e.g., emergency) specialties. Potential strategies to address gaps in clinical care include resident-based solutions, faculty-based solutions and solutions based on other providers (e.g., nonacademic physicians, physician extenders). Each solution has unique advantages and disadvantages in terms of education, continuity of care, preparedness for practice and provider well-being. Our data-driven framework serves as a guide for programs to anticipate challenges of satisfying clinical care needs in the face of changes to resident duty hours, while balancing education, care continuity, preparedness for practice and provider well-being. Our findings challenge the "one-size-fits-all" approach to changes to resident duty hours and endorse flexibility in enacting duty hour regulations based on specialty-specific factors.

No programming required. Mobile PCs can help physicians work more efficiently, especially when the application is designed to fit the practice.

PubMed

Campbell, J

2000-09-01

The Jacobson Medical Group San Antonio Jacobson Medical Group (JMG) needed a way to effectively and efficiently coordinate referral information between their hospitalist physicians and specialists. JMG decided to replace paper-based binders with something more convenient and easily updated. The organization chose to implement a mobile solution that would provide its physicians with convenient access to a database of information via a hand-held computer. The hand-held solution provides physicians with full demographic profiles of primary care givers for each area where the group operates. The database includes multiple profiles based on different healthcare plans, along with details about preferred and authorized specialists. JMG adopted a user-friendly solution that the hospitalists and specialists would embrace and actually use.

Beyond individualism: Is there a place for relational autonomy in clinical practice and research?

PubMed Central

Kelly, Susan E; Lucivero, Federica; Machirori, Mavis; Dheensa, Sandi; Prainsack, Barbara

2017-01-01

The dominant, individualistic understanding of autonomy that features in clinical practice and research is underpinned by the idea that people are, in their ideal form, independent, self-interested and rational gain-maximising decision-makers. In recent decades, this paradigm has been challenged from various disciplinary and intellectual directions. Proponents of ‘relational autonomy’ in particular have argued that people’s identities, needs, interests – and indeed autonomy – are always also shaped by their relations to others. Yet, despite the pronounced and nuanced critique directed at an individualistic understanding of autonomy, this critique has had very little effect on ethical and legal instruments in clinical practice and research so far. In this article, we use four case studies to explore to what extent, if at all, relational autonomy can provide solutions to ethical and practical problems in clinical practice and research. We conclude that certain forms of relational autonomy can have a tangible and positive impact on clinical practice and research. These solutions leave the ultimate decision to the person most affected, but encourage and facilitate the consideration of this person’s care and responsibility for connected others. PMID:28989327

Species tree inference by minimizing deep coalescences.

PubMed

Than, Cuong; Nakhleh, Luay

2009-09-01

In a 1997 seminal paper, W. Maddison proposed minimizing deep coalescences, or MDC, as an optimization criterion for inferring the species tree from a set of incongruent gene trees, assuming the incongruence is exclusively due to lineage sorting. In a subsequent paper, Maddison and Knowles provided and implemented a search heuristic for optimizing the MDC criterion, given a set of gene trees. However, the heuristic is not guaranteed to compute optimal solutions, and its hill-climbing search makes it slow in practice. In this paper, we provide two exact solutions to the problem of inferring the species tree from a set of gene trees under the MDC criterion. In other words, our solutions are guaranteed to find the tree that minimizes the total number of deep coalescences from a set of gene trees. One solution is based on a novel integer linear programming (ILP) formulation, and another is based on a simple dynamic programming (DP) approach. Powerful ILP solvers, such as CPLEX, make the first solution appealing, particularly for very large-scale instances of the problem, whereas the DP-based solution eliminates dependence on proprietary tools, and its simplicity makes it easy to integrate with other genomic events that may cause gene tree incongruence. Using the exact solutions, we analyze a data set of 106 loci from eight yeast species, a data set of 268 loci from eight Apicomplexan species, and several simulated data sets. We show that the MDC criterion provides very accurate estimates of the species tree topologies, and that our solutions are very fast, thus allowing for the accurate analysis of genome-scale data sets. Further, the efficiency of the solutions allow for quick exploration of sub-optimal solutions, which is important for a parsimony-based criterion such as MDC, as we show. We show that searching for the species tree in the compatibility graph of the clusters induced by the gene trees may be sufficient in practice, a finding that helps ameliorate the computational requirements of optimization solutions. Further, we study the statistical consistency and convergence rate of the MDC criterion, as well as its optimality in inferring the species tree. Finally, we show how our solutions can be used to identify potential horizontal gene transfer events that may have caused some of the incongruence in the data, thus augmenting Maddison's original framework. We have implemented our solutions in the PhyloNet software package, which is freely available at: http://bioinfo.cs.rice.edu/phylonet.

Solution-focused conversations: a new therapeutic strategy in well child health nursing telephone consultations.

PubMed

Polaschek, Linda; Polaschek, Nick

2007-07-01

This paper is a report of a study to explore well child nurses' perceptions of outcomes resulting from the use of solution-focused conversations in their telephone consultations with clients. Well child nurses (health visitors) in some services provide a separate telephone consultation service for parents who need immediate advice or are unable to visit the clinic. As well as purely physical issues suggesting infant pathology, these consultations address a range of other concerns relating to parenting and child behaviour. The standard problem-solving approach used to address physical issues is less effective for various non-physical concerns, where different communication strategies may be helpful. In this qualitative, action-oriented study, a small group of well child telenurses in New Zealand was introduced to a specific communication strategy, called 'solution-focused conversations', during 2005. They applied this approach in their practice and then reflected together on their experiences in focus groups. The nurses considered that the solution-focused conversations enabled clients to: recognize the nature of the parenting issue of concern that had motivated their call; identify more effective parenting practices to address specific issues with their child; increase their confidence in their own parenting capabilities. This study suggested the value of learning a specific communication strategy for the practice of a group of well child telenurses. Solution-focused conversation is a suitable approach for the single, relatively short, interactions involved in telephone nursing. Other communication strategies could be appropriate for nurses in different clinical situations.

Facilitation Standards: A Mixed Methods Study

ERIC Educational Resources Information Center

Hunter, Jennifer

2017-01-01

Online education is increasing as a solution to manage ever increasing enrollment numbers at higher education institutions. Intentionally and thoughtfully constructed courses allow students to improve performance through practice and self-assessment and instructors benefit from improving consistency in providing content and assessing process,…

To the Best Solution in Education.

ERIC Educational Resources Information Center

Klepko, Serhiy

This booklet presents two papers on educational quality and reform. "Pedagogical Practice and the Philosophy of Education: The Experience of Ukrainian In-Service Teacher Education," explains that most Ukrainian inservice teacher education is provided through regional institutes. It focuses on the Poltava Ostrogradsky Teachers'…

Novel pH-sensitive photopolymer hydrogel and its holographic sensing response for solution characterization

NASA Astrophysics Data System (ADS)

Liu, Hongpeng; Yu, Dan; Zhou, Ke; Wang, Shichan; Luo, Suhua; Li, Li; Wang, Weibo; Song, Qinggong

2018-05-01

Optical sensor based on pH-sensitive hydrogel has important practical applications in medical diagnosis and bio-sensor areas. This report details the experimental and theoretical results from a novel photosensitive polymer hydrogel holographic sensor, which formed by thermal polymerization of 2-hydroxyethyl methacrylate, for the detection of pH in buffer. Volume grating recorded in the polymer hydrogel was employed in response to the performance of solution. Methacrylic acid with carboxyl groups was selected as the primary co-monomer to functionalize the matrix. Peak diffraction spectrum of holographic grating determined as a primary sensing parameter was characterized to reflect the change in pH. The extracted linear relation between peak wavelength and pH value provided a probability for the practical application of holographic sensor. To explore the sensing mechanism deeply, a theoretical model was used to describe the relevant holographic processes, including grating formation, dark diffusional enhancement, and final fringe swelling. Numerical result further showed all of the dynamic processes and internal sensing physical mechanism. These experimental and numerical results provided a significant foundation for the development of novel holographic sensor based on polymer hydrogel and improvement of its practical applicability.

GP Networks as enablers of quality of care: implementing a practice engagement framework in a General Practice Network.

PubMed

Pearce, Christopher; Shearer, Marianne; Gardner, Karina; Kelly, Jill; Xu, Tony Baixian

2012-01-01

This paper describes how the Melbourne East General Practice Network supports general practice to enable quality of care, it describes the challenges and enablers of change, and the evidence of practice capacity building and improved quality of care. Primary care is well known as a place where quality, relatively inexpensive medical care occurs. General practice is made up of multiple small sites with fragmented systems and a funding system that challenges a whole-of-practice approach to clinical care. General Practice Networks support GPs to synthesise complexity and crystallise solutions that enhance general practice beyond current capacity. Through a culture of change management, GP Networks create the link between the practice and the big picture of the whole health system and reduce the isolation of general practice. They distribute information (evidence-based learning and resources) and provide individualised support, responding to practice need and capacity.

Practical Considerations for Determination of Glass Transition Temperature of a Maximally Freeze Concentrated Solution.

PubMed

Pansare, Swapnil K; Patel, Sajal Manubhai

2016-08-01

Glass transition temperature is a unique thermal characteristic of amorphous systems and is associated with changes in physical properties such as heat capacity, viscosity, electrical resistance, and molecular mobility. Glass transition temperature for amorphous solids is referred as (T g), whereas for maximally freeze concentrated solution, the notation is (T g'). This article is focused on the factors affecting determination of T g' for application to lyophilization process design and frozen storage stability. Also, this review provides a perspective on use of various types of solutes in protein formulation and their effect on T g'. Although various analytical techniques are used for determination of T g' based on the changes in physical properties associated with glass transition, the differential scanning calorimetry (DSC) is the most commonly used technique. In this article, an overview of DSC technique is provided along with brief discussion on the alternate analytical techniques for T g' determination. Additionally, challenges associated with T g' determination, using DSC for protein formulations, are discussed. The purpose of this review is to provide a practical industry perspective on determination of T g' for protein formulations as it relates to design and development of lyophilization process and/or for frozen storage; however, a comprehensive review of glass transition temperature (T g, T g'), in general, is outside the scope of this work.

Evidence-based dentistry: a clinician's perspective.

PubMed

Bauer, Janet; Spackman, Sue; Chiappelli, Francesco; Prolo, Paolo; Stevenson, Richard

2006-07-01

Evidence-based dentistry is a discipline that provides best, explicit-based evidence to dentists and their patients in shared decision-making. Currently, dentists are being trained and directed to adopt the role of translational researchers in developing evidence-based dental practices. Practically, evidence-based dentistry is not usable in its current mode for the provision of labor-intensive services that characterize current dental practice. The purpose of this article is to introduce a model of evidence-based dental practice. This model conceptualizes a team approach in explaining problems and solutions to change current dental practice. These changes constitute an evidence-based dental practice that involves the electronic chart, centralized database, knowledge management software, and personnel in optimizing effective oral health care to dental patients.

Patient and provider perspectives on uptake of a shared decision making intervention for asthma in primary care practices.

PubMed

Welch, Madelyn; Ludden, Tom; Mottus, Kathleen; Bray, Paul; Hendrickson, Lori; Rees, Jennifer; Halladay, Jacqueline; Tapp, Hazel

2018-06-21

Poor outcomes and health disparities related to asthma result in part from difficulty disseminating new evidence such as shared decision making (SDM) into clinical practice. As part of a three-arm cluster randomized dissemination study, evaluation of the impact of different dissemination methods was studied. Here we evaluate themes from patient and provider focus groups to assess the impact of a facilitated, traditional dissemination approach, or no intervention, on patient and provider perspectives of asthma care. Using semi-structured questions, twenty-four pre- and post-intervention focus groups with patients and providers took place across primary care practices. Discussions were held in all three arms both before and after the time of intervention rollout. Audio recordings were transcribed and analyzed for themes. Across all sites patients and providers discussed themes of communication, asthma self-management, barriers, education, and patient awareness. After the intervention, compared to traditional sites, facilitated practices were more likely to discuss themes related to SDM, such as patient-centered communication, patient-provider negotiation on treatment plan, planning, goal-setting, and solutions to barriers. Emergent themes allowed for further understanding of how the SDM implementation was perceived at the patient and provider level. The facilitated implementation was associated with higher adoption of the SDM intervention. These themes and supporting quotes add to knowledge of best practices associated with implementing an evidence-based SDM intervention for asthma into primary care and will inform researchers, practices, and providers as they work to improve adoption of evidence-based interventions into practice.

Integrated Platform for Automated Sustainable Demand Response in Smart Grids

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

Zois, Vassilis; Frincu, Marc; Prasanna, Viktor K.

2014-10-08

Demand Response(DR) is a common practice used by utility providers to regulate energy demand. It is used at periods of high demand to minimize the peak to average consumption ratio. Several methods have been Demand Response(DR) is a common praon using information about the baseline consumption and the consumption during DR. Our goal is to provide a sustainable reduction to ensure the elimination of peaks in demand. The proposed system includes an adaptation mechanism for when the provided solution does not meet the DR requirements. We conducted a series of experiments using consumption data from a real life micro gridmore » to evaluate the efficiency as well as the robustness of our solution.« less

Energy Digest.

ERIC Educational Resources Information Center

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

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

Reading and Spelling Difficulties in the ELT Classroom

ERIC Educational Resources Information Center

Gerlach, David

2017-01-01

Learners with reading and/or spelling difficulties (RSD) generally also show severe problems in learning EFL. Taking into consideration several observational and interventional studies, this article illustrates some practical and pragmatic means of identifying RSD, and provides possible solutions when addressing these difficulties in ELT…

Just Solutions.

ERIC Educational Resources Information Center

Update on Law-Related Education: Student Edition, 1994

1994-01-01

Written by students for students, this collection of articles contains students' perspectives on justice, fairness and equity in the lives of young people. The issue provides a vision of the future, strategies for individual involvement, and practical suggestions for initiating change. Specific issues include the rights of minors, discrimination,…

On long-time instabilities in staggered finite difference simulations of the seismic acoustic wave equations on discontinuous grids

NASA Astrophysics Data System (ADS)

Gao, Longfei; Ketcheson, David; Keyes, David

2018-02-01

We consider the long-time instability issue associated with finite difference simulation of seismic acoustic wave equations on discontinuous grids. This issue is exhibited by a prototype algebraic problem abstracted from practical application settings. Analysis of this algebraic problem leads to better understanding of the cause of the instability and provides guidance for its treatment. Specifically, we use the concept of discrete energy to derive the proper solution transfer operators and design an effective way to damp the unstable solution modes. Our investigation shows that the interpolation operators need to be matched with their companion restriction operators in order to properly couple the coarse and fine grids. Moreover, to provide effective damping, specially designed diffusive terms are introduced to the equations at designated locations and discretized with specially designed schemes. These techniques are applied to simulations in practical settings and are shown to lead to superior results in terms of both stability and accuracy.

Problems in the fingerprints based polycyclic aromatic hydrocarbons source apportionment analysis and a practical solution.

PubMed

Zou, Yonghong; Wang, Lixia; Christensen, Erik R

2015-10-01

This work intended to explain the challenges of the fingerprints based source apportionment method for polycyclic aromatic hydrocarbons (PAH) in the aquatic environment, and to illustrate a practical and robust solution. The PAH data detected in the sediment cores from the Illinois River provide the basis of this study. Principal component analysis (PCA) separates PAH compounds into two groups reflecting their possible airborne transport patterns; but it is not able to suggest specific sources. Not all positive matrix factorization (PMF) determined sources are distinguishable due to the variability of source fingerprints. However, they constitute useful suggestions for inputs for a Bayesian chemical mass balance (CMB) analysis. The Bayesian CMB analysis takes into account the measurement errors as well as the variations of source fingerprints, and provides a credible source apportionment. Major PAH sources for Illinois River sediments are traffic (35%), coke oven (24%), coal combustion (18%), and wood combustion (14%). Copyright © 2015. Published by Elsevier Ltd.

Storage system architectures and their characteristics

NASA Technical Reports Server (NTRS)

Sarandrea, Bryan M.

1993-01-01

Not all users storage requirements call for 20 MBS data transfer rates, multi-tier file or data migration schemes, or even automated retrieval of data. The number of available storage solutions reflects the broad range of user requirements. It is foolish to think that any one solution can address the complete range of requirements. For users with simple off-line storage requirements, the cost and complexity of high end solutions would provide no advantage over a more simple solution. The correct answer is to match the requirements of a particular storage need to the various attributes of the available solutions. The goal of this paper is to introduce basic concepts of archiving and storage management in combination with the most common architectures and to provide some insight into how these concepts and architectures address various storage problems. The intent is to provide potential consumers of storage technology with a framework within which to begin the hunt for a solution which meets their particular needs. This paper is not intended to be an exhaustive study or to address all possible solutions or new technologies, but is intended to be a more practical treatment of todays storage system alternatives. Since most commercial storage systems today are built on Open Systems concepts, the majority of these solutions are hosted on the UNIX operating system. For this reason, some of the architectural issues discussed focus around specific UNIX architectural concepts. However, most of the architectures are operating system independent and the conclusions are applicable to such architectures on any operating system.

Hyperspectral imaging in medicine: image pre-processing problems and solutions in Matlab.

PubMed

Koprowski, Robert

2015-11-01

The paper presents problems and solutions related to hyperspectral image pre-processing. New methods of preliminary image analysis are proposed. The paper shows problems occurring in Matlab when trying to analyse this type of images. Moreover, new methods are discussed which provide the source code in Matlab that can be used in practice without any licensing restrictions. The proposed application and sample result of hyperspectral image analysis. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Maximizing the business value of information technology in home care and hospice.

PubMed

2012-08-01

Health care technology provides the key to becoming the high performing efficient organization you want to be. But how do you sift through the many available solutions and determine which technology to acquire? Do you fully understand the best practices for choosing and using technology and measuring the value gained once your new solutions are in place? Get a map to the digital road from Suzanne Sblendorio, director of Healthcare Information Technology Consulting at Simione Healthcare Consultants.

Suite of Benchmark Tests to Conduct Mesh-Convergence Analysis of Nonlinear and Non-constant Coefficient Transport Codes

NASA Astrophysics Data System (ADS)

Zamani, K.; Bombardelli, F. A.

2014-12-01

Verification of geophysics codes is imperative to avoid serious academic as well as practical consequences. In case that access to any given source code is not possible, the Method of Manufactured Solution (MMS) cannot be employed in code verification. In contrast, employing the Method of Exact Solution (MES) has several practical advantages. In this research, we first provide four new one-dimensional analytical solutions designed for code verification; these solutions are able to uncover the particular imperfections of the Advection-diffusion-reaction equation, such as nonlinear advection, diffusion or source terms, as well as non-constant coefficient equations. After that, we provide a solution of Burgers' equation in a novel setup. Proposed solutions satisfy the continuity of mass for the ambient flow, which is a crucial factor for coupled hydrodynamics-transport solvers. Then, we use the derived analytical solutions for code verification. To clarify gray-literature issues in the verification of transport codes, we designed a comprehensive test suite to uncover any imperfection in transport solvers via a hierarchical increase in the level of tests' complexity. The test suite includes hundreds of unit tests and system tests to check vis-a-vis the portions of the code. Examples for checking the suite start by testing a simple case of unidirectional advection; then, bidirectional advection and tidal flow and build up to nonlinear cases. We design tests to check nonlinearity in velocity, dispersivity and reactions. The concealing effect of scales (Peclet and Damkohler numbers) on the mesh-convergence study and appropriate remedies are also discussed. For the cases in which the appropriate benchmarks for mesh convergence study are not available, we utilize symmetry. Auxiliary subroutines for automation of the test suite and report generation are designed. All in all, the test package is not only a robust tool for code verification but it also provides comprehensive insight on the ADR solvers capabilities. Such information is essential for any rigorous computational modeling of ADR equation for surface/subsurface pollution transport. We also convey our experiences in finding several errors which were not detectable with routine verification techniques.

General linear methods and friends: Toward efficient solutions of multiphysics problems

NASA Astrophysics Data System (ADS)

Sandu, Adrian

2017-07-01

Time dependent multiphysics partial differential equations are of great practical importance as they model diverse phenomena that appear in mechanical and chemical engineering, aeronautics, astrophysics, meteorology and oceanography, financial modeling, environmental sciences, etc. There is no single best time discretization for the complex multiphysics systems of practical interest. We discuss "multimethod" approaches that combine different time steps and discretizations using the rigourous frameworks provided by Partitioned General Linear Methods and Generalize-structure Additive Runge Kutta Methods..

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

PubMed

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

2007-01-01

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

Numerical simulation of air hypersonic flows with equilibrium chemical reactions

NASA Astrophysics Data System (ADS)

Emelyanov, Vladislav; Karpenko, Anton; Volkov, Konstantin

2018-05-01

The finite volume method is applied to solve unsteady three-dimensional compressible Navier-Stokes equations on unstructured meshes. High-temperature gas effects altering the aerodynamics of vehicles are taken into account. Possibilities of the use of graphics processor units (GPUs) for the simulation of hypersonic flows are demonstrated. Solutions of some test cases on GPUs are reported, and a comparison between computational results of equilibrium chemically reacting and perfect air flowfields is performed. Speedup of solution on GPUs with respect to the solution on central processor units (CPUs) is compared. The results obtained provide promising perspective for designing a GPU-based software framework for practical applications.

Reflective practice and its implications for pharmacy education.

PubMed

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

2014-02-12

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

Reflective Practice and Its Implications for Pharmacy Education

PubMed Central

Bosnic-Anticevich, Sinthia; Smith, Lorraine

2014-01-01

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

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

PubMed

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

2014-01-01

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

Classroom Acoustics: A Resource for Creating Environments with Desirable Listening Conditions.

ERIC Educational Resources Information Center

Seep, Benjamin; Glosemeyer, Robin; Hulce, Emily; Linn, Matt; Aytar, Pamela

This booklet provides a general overview of classroom acoustic problems and their solutions for both new school construction and renovation. Practical explanations and examples are discussed on topics including reverberation, useful and undesirable reflections, mechanical equipment noise, interior noise sources, and sound reinforcement. Examples…

Collaboration for Diverse Learners: Viewpoints and Practices.

ERIC Educational Resources Information Center

Risko, Victoria J., Ed.; Bromley, Karen, Ed.

This book suggests that a solution to schools' lack of comprehensive literacy programs may be found through innovations in collaborative decision making about curriculum and instruction. It provides analyses of collaborative efforts, multiple ways to think about collaboration and its implementation, and examples of collaborative projects. After an…

A University Admissions System

ERIC Educational Resources Information Center

Ittig, Peter T.

1977-01-01

Presents a mathematical programming model that will make admit/reject decisions for freshman university applicants. The model is intended to aid reviewers in producing better, more consistent decisions. The author shows that a linear programming formulation will provide an efficient and practical solution for all but a very few applicants.…

Electronic Health Record Challenges, Workarounds, and Solutions Observed in Practices Integrating Behavioral Health and Primary Care.

PubMed

Cifuentes, Maribel; Davis, Melinda; Fernald, Doug; Gunn, Rose; Dickinson, Perry; Cohen, Deborah J

2015-01-01

This article describes the electronic health record (EHR)-related experiences of practices striving to integrate behavioral health and primary care using tailored, evidenced-based strategies from 2012 to 2014; and the challenges, workarounds and initial health information technology (HIT) solutions that emerged during implementation. This was an observational, cross-case comparative study of 11 diverse practices, including 8 primary care clinics and 3 community mental health centers focused on the implementation of integrated care. Practice characteristics (eg, practice ownership, federal designation, geographic area, provider composition, EHR system, and patient panel characteristics) were collected using a practice information survey and analyzed to report descriptive information. A multidisciplinary team used a grounded theory approach to analyze program documents, field notes from practice observation visits, online diaries, and semistructured interviews. Eight primary care practices used a single EHR and 3 practices used 2 different EHRs, 1 to document behavioral health and 1 to document primary care information. Practices experienced common challenges with their EHRs' capabilities to 1) document and track relevant behavioral health and physical health information, 2) support communication and coordination of care among integrated teams, and 3) exchange information with tablet devices and other EHRs. Practices developed workarounds in response to these challenges: double documentation and duplicate data entry, scanning and transporting documents, reliance on patient or clinician recall for inaccessible EHR information, and use of freestanding tracking systems. As practices gained experience with integration, they began to move beyond workarounds to more permanent HIT solutions ranging in complexity from customized EHR templates, EHR upgrades, and unified EHRs. Integrating behavioral health and primary care further burdens EHRs. Vendors, in cooperation with clinicians, should intentionally design EHR products that support integrated care delivery functions, such as data documentation and reporting to support tracking patients with emotional and behavioral problems over time and settings, integrated teams working from shared care plans, template-driven documentation for common behavioral health conditions such as depression, and improved registry functionality and interoperability. This work will require financial support and cooperative efforts among clinicians, EHR vendors, practice assistance organizations, regulators, standards setters, and workforce educators. © Copyright 2015 by the American Board of Family Medicine.

Assessment of current cybersecurity practices in the public domain : cyber indications and warnings domain.

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

Hamlet, Jason R.; Keliiaa, Curtis M.

This report assesses current public domain cyber security practices with respect to cyber indications and warnings. It describes cybersecurity industry and government activities, including cybersecurity tools, methods, practices, and international and government-wide initiatives known to be impacting current practice. Of particular note are the U.S. Government's Trusted Internet Connection (TIC) and 'Einstein' programs, which are serving to consolidate the Government's internet access points and to provide some capability to monitor and mitigate cyber attacks. Next, this report catalogs activities undertaken by various industry and government entities. In addition, it assesses the benchmarks of HPC capability and other HPC attributes thatmore » may lend themselves to assist in the solution of this problem. This report draws few conclusions, as it is intended to assess current practice in preparation for future work, however, no explicit references to HPC usage for the purpose of analyzing cyber infrastructure in near-real-time were found in the current practice. This report and a related SAND2010-4766 National Cyber Defense High Performance Computing and Analysis: Concepts, Planning and Roadmap report are intended to provoke discussion throughout a broad audience about developing a cohesive HPC centric solution to wide-area cybersecurity problems.« less

Towards efficient backward-in-time adjoint computations using data compression techniques

DOE PAGES

Cyr, E. C.; Shadid, J. N.; Wildey, T.

2014-12-16

In the context of a posteriori error estimation for nonlinear time-dependent partial differential equations, the state-of-the-practice is to use adjoint approaches which require the solution of a backward-in-time problem defined by a linearization of the forward problem. One of the major obstacles in the practical application of these approaches, we found, is the need to store, or recompute, the forward solution to define the adjoint problem and to evaluate the error representation. Our study considers the use of data compression techniques to approximate forward solutions employed in the backward-in-time integration. The development derives an error representation that accounts for themore » difference between the standard-approach and the compressed approximation of the forward solution. This representation is algorithmically similar to the standard representation and only requires the computation of the quantity of interest for the forward solution and the data-compressed reconstructed solution (i.e. scalar quantities that can be evaluated as the forward problem is integrated). This approach is then compared with existing techniques, such as checkpointing and time-averaged adjoints. Lastly, we provide numerical results indicating the potential efficiency of our approach on a transient diffusion–reaction equation and on the Navier–Stokes equations. These results demonstrate memory compression ratios up to 450×450× while maintaining reasonable accuracy in the error-estimates.« less

Preparing registrants for mentor roles: the chicken or egg conundrum.

PubMed

McGuinness, Claire; McCallum, Jacqueline; Duffy, Kathleen

2016-12-01

The Nursing and Midwifery Council's (NMC) Standards to Support Learning and Assessment in Practice ( 2008 ) outline requirements for the preparation of those who support nursing and midwifery pre-registration students in practice, formally known as mentors. Pre-registration nursing and midwifery programme providers, and practice learning environments (PLEs), work collaboratively to prepare registrants to undertake this role, and to help them maintain mentor status. An important NMC requirement is that registrants, when undertaking mentor preparation programmes, must be supported by experienced mentors in their workplace. This is challenging for programme providers and PLEs if there is lack of experienced mentors in the area concerned. This article discusses support for registrants when preparing to become mentors, suggests some alternative solutions and makes recommendations for the future of mentor preparation in the UK.

Ethical practice under fire: deployed physicians in the global war on terrorism.

PubMed

Sessums, Laura L; Collen, Jacob F; O'Malley, Patrick G; Jackson, Jeffery L; Roy, Michael J

2009-05-01

The Global War on Terrorism brings significant ethical challenges for military physicians. From Abu Ghraib to Guantanamo Bay, the actions of health care providers have come under considerable scrutiny. Military providers have dual roles as military officers and medical professionals, which have the potential to come into conflict. Often they are inadequately prepared to manage this conflict. We review pertinent historical precedents, applicable laws, ethical guidelines, and military regulations. We also present examples of ethical challenges deployed clinicians have faced and their ethical solution. Finally, we propose a practical strategy to educate physicians on how to manage complex ethical dilemmas in war time settings.

Cloud-Based Applications for Organizing and Reviewing Plastic Surgery Content

PubMed Central

Luan, Anna; Momeni, Arash; Lee, Gordon K.

2015-01-01

Cloud-based applications including Box, Dropbox, Google Drive, Evernote, Notability, and Zotero are available for smartphones, tablets, and laptops and have revolutionized the manner in which medical students and surgeons read and utilize plastic surgery literature. Here we provide an overview of the use of Cloud computing in practice and propose an algorithm for organizing the vast amount of plastic surgery literature. Given the incredible amount of data being produced in plastic surgery and other surgical subspecialties, it is prudent for plastic surgeons to lead the process of providing solutions for the efficient organization and effective integration of the ever-increasing data into clinical practice. PMID:26576208

Investigating Pathways from the Earth Science Knowledge Base to Candidate Solutions

NASA Astrophysics Data System (ADS)

Anderson, D. J.; Johnson, E.; Mita, D.; Dabbiru, L.; Katragadda, S.; Lewis, D.; O'Hara, C.

2007-12-01

A principle objective of the NASA Applied Sciences Program is to support the transition of scientific research results into decisions which benefit society. One of the Solutions Network activities supporting this goal is the generation of Candidate Solutions derived from NASA Earth Science research results that have the potential to enhance future operational systems for societal benefit. In short, the program seeks to fill gaps between Earth Science results and operational needs. The Earth Science Knowledge Base (ESKB) is being developed to provide connectivity and deliver content for the research information needs of the NASA Applied Science Program and related scientific communities of practice. Data has been collected which will permit users to identify and analyze the current network of interactions between organizations within the community of practice, harvest research results fixed to those interactions, examine the individual components of that research, and assist in developing strategies for furthering research. The ESKB will include information about organizations that conduct NASA-funded Earth Science research, NASA research solicitations, principal investigators, research publications and other project reports, publication authors, inter-agency agreements like memoranda-of-understanding, and NASA assets, models, decision support tools, and data products employed in the course of or developed as a part of the research. The generation of candidate solutions is the first step in developing rigorously tested applications for operational use from the normal yet chaotic process of natural discovery. While the process of 'idea generation' cannot be mechanized, the ESKB serves to provide a resource for testing theories about advancing research streams into the operational realm. Formulation Reports are the documents which outline a Candidate Solution. The reports outline the essential elements, most of which are detailed in the ESKB, which must be analyzed when assessing the value of the solution. Through developmental testing of the ESKB, several pathways to Candidate Solutions have been discovered.

A duality framework for stochastic optimal control of complex systems

DOE PAGES

Malikopoulos, Andreas A.

2016-01-01

In this study, we address the problem of minimizing the long-run expected average cost of a complex system consisting of interactive subsystems. We formulate a multiobjective optimization problem of the one-stage expected costs of the subsystems and provide a duality framework to prove that the control policy yielding the Pareto optimal solution minimizes the average cost criterion of the system. We provide the conditions of existence and a geometric interpretation of the solution. For practical situations having constraints consistent with those studied here, our results imply that the Pareto control policy may be of value when we seek to derivemore » online the optimal control policy in complex systems.« less

ACR Imaging IT Reference Guide: Image Sharing: Evolving Solutions in the Age of Interoperability

PubMed Central

Erickson, Bradley J.; Choy, Garry

2014-01-01

Interoperability is a major focus of the quickly evolving world of Health Information Technology. Easy, yet secure and confidential exchange of imaging exams and the associated reports must be a part of the solutions that are implemented. The availability of historical exams is essential in providing a quality interpretation and reducing inappropriate utilization of imaging services. Today exchange of imaging exams is most often achieved via a CD. We describe the virtues of this solution as well as challenges that have surfaced. Internet and cloud based technologies employed for many consumer services can provide a better solution. Vendors are making these solutions available. Standards for internet based exchange are emerging. Just as Radiology converged on DICOM as a standard to store and view images we need a common exchange standard. We will review the existing standards, and how they are organized into useful workflows through Integrating the Healthcare Enterprise (IHE) profiles. IHE and standards development processes are discussed. Healthcare and the domain of Radiology must stay current with quickly evolving internet standards. The successful use of the “cloud” will depend upon both the technologies we discuss and the policies put into place around these technologies. We discuss both aspects. The Radiology community must lead the way and provide a solution that works for radiologists and clinicians in the Electronic Medical Record (EMR). Lastly we describe the features we believe radiologists should consider when considering adding internet based exchange solutions to their practice. PMID:25467903

Nested Logit Models for Multiple-Choice Item Response Data

ERIC Educational Resources Information Center

Suh, Youngsuk; Bolt, Daniel M.

2010-01-01

Nested logit item response models for multiple-choice data are presented. Relative to previous models, the new models are suggested to provide a better approximation to multiple-choice items where the application of a solution strategy precedes consideration of response options. In practice, the models also accommodate collapsibility across all…

A Solution in Search of a Problem: Bibliometrics and Libraries.

ERIC Educational Resources Information Center

Wallace, Danny P.

1987-01-01

The literature of bibliometrics suggests that the results of bibliometric studies can be of practical use in libraries by providing a scientific basis for collection management decisions. Reports on the application of these studies are virtually nonexistent and a number of reasons for this are suggested. (EM)

Working Together? Partnership Approaches to 14-19 Education in England

ERIC Educational Resources Information Center

Higham, Jeremy; Yeomans, David

2010-01-01

Partnership working between institutions and organisations is currently commonly seen as providing solutions to meeting multiple, interrelated needs in areas of social policy including health, social welfare and education. This article examines and discusses the policy and practice of such collaboration in an educational context. Drawing on…

Disseminating Educational Research with IT.

ERIC Educational Resources Information Center

Davis, Niki

Teachers and researchers need to use the research produced in education to improve their practice. However, the current modes of dissemination through journals and papers are often written for the expert community. The Telematics Centre at the University of Exeter (United Kingdom), School of Education provides creative solutions for the effective…

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

ERIC Educational Resources Information Center

Blase, Joseph; Blase, Jo

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

Raising Kids Who Read: What Parents and Teachers Can Do

ERIC Educational Resources Information Center

Willingham, Daniel T.

2015-01-01

Everyone agrees that reading is important, but kids today tend to lose interest in reading before adolescence. In "Raising Kids Who Read", bestselling author and psychology professor Daniel T. Willingham explains this phenomenon and provides practical solutions for engendering a love of reading that lasts into adulthood. Like…

Impact of Policy Change on US Army Combat Transfusion Practices

DTIC Science & Technology

2010-07-01

We believe that a patient who is bleeding to death should have the best resuscitation we can provide. Right now, evidence - based medicine suggests that...for improvement and, through evidence based medicine , create and implement a solution that had a tangible impact on the patient half a world away

Project-Based Learning: Differentiating Instruction for the 21st Century

ERIC Educational Resources Information Center

Bender, William N.

2012-01-01

Project-based learning has emerged as one of today's most effective instructional practices. In PBL, students confront real-world issues and problems, collaborate to create solutions, and present their results. This exciting new book describes how PBL fosters 21st century skills and innovative thinking. The author provides instructional…

On a Non-Reflecting Boundary Condition for Hyperbolic Conservation Laws

NASA Technical Reports Server (NTRS)

Loh, Ching Y.

2003-01-01

A non-reflecting boundary condition (NRBC) for practical computations in fluid dynamics and aeroacoustics is presented. The technique is based on the hyperbolicity of the Euler equation system and the first principle of plane (simple) wave propagation. The NRBC is simple and effective, provided the numerical scheme maintains locally a C(sup 1) continuous solution at the boundary. Several numerical examples in ID, 2D and 3D space are illustrated to demonstrate its robustness in practical computations.

Application of temporal LNC logic in artificial intelligence

NASA Astrophysics Data System (ADS)

Adamek, Marek; Mulawka, Jan

2016-09-01

This paper presents the temporal logic inference engine developed in our university. It is an attempt to demonstrate implementation and practical application of temporal logic LNC developed in Cardinal Stefan Wyszynski University in Warsaw.1 The paper describes the fundamentals of LNC logic, architecture and implementation of inference engine. The practical application is shown by providing the solution for popular in Artificial Intelligence problem of Missionaries and Cannibals in terms of LNC logic. Both problem formulation and inference engine are described in details.

On a Non-Reflecting Boundary Condition for Hyperbolic Conservation Laws

NASA Technical Reports Server (NTRS)

Loh, Ching Y.

2003-01-01

A non-reflecting boundary condition (NRBC) for practical computations in fluid dynamics and aeroacoustics is presented. The technique is based on the first principle of non-reflecting, plane wave propagation and the hyperbolicity of the Euler equation system. The NRBC is simple and effective, provided the numerical scheme maintains locally a C(sup 1) continuous solution at the boundary. Several numerical examples in 1D, 2D, and 3D space are illustrated to demonstrate its robustness in practical computations.

Evidence-based integrated environmental solutions for secondary lead smelters: pollution prevention and waste minimization technologies and practices.

PubMed

Genaidy, A M; Sequeira, R; Tolaymat, T; Kohler, J; Rinder, M

2009-05-01

An evidence-based methodology was adopted in this research to establish strategies to increase lead recovery and recycling via a systematic review and critical appraisal of the published literature. In particular, the research examines pollution prevention and waste minimization practices and technologies that meet the following criteria: (a) reduce/recover/recycle the largest quantities of lead currently being disposed of as waste, (b) technically and economically viable, that is, ready to be diffused and easily transferable, and (c) strong industry interest (i.e., industry would consider implementing projects with higher payback periods). The following specific aims are designed to achieve the study objectives: Aim 1 - To describe the recycling process of recovering refined lead from scrap; Aim 2 - To document pollution prevention and waste management technologies and practices adopted by US stakeholders along the trajectory of LAB and lead product life cycle; Aim 3 - To explore improved practices and technologies which are employed by other organizations with an emphasis on the aforementioned criteria; Aim 4 - To demonstrate the economic and environmental costs and benefits of applying improved technologies and practices to existing US smelting operations; and Aim 5 - To evaluate improved environmental technologies and practices using an algorithm that integrates quantitative and qualitative criteria. The process of identifying relevant articles and reports was documented. The description of evidence was presented for current practices and technologies used by US smelters as well as improved practices and technologies. Options for integrated environmental solutions for secondary smelters were introduced and rank ordered on the basis of costs (i.e., capital investment) and benefits (i.e., production increases, energy and flux savings, and reduction of SO(2) and slag). An example was provided to demonstrate the utility of the algorithm by detailing the costs and benefits associated with different combinations of practices and technologies. The evidence-based methodology documented in this research reveals that it is technically and economically feasible to implement integrated environmental solutions to increase lead recovery and recycling among US smelters. The working example presented in this research can be confirmed with US stakeholders and form the basis for implementable solutions in the lead smelter and product industries to help reverse the overall trend of declining life-cycle recycling rates.

Cox process representation and inference for stochastic reaction-diffusion processes

NASA Astrophysics Data System (ADS)

Schnoerr, David; Grima, Ramon; Sanguinetti, Guido

2016-05-01

Complex behaviour in many systems arises from the stochastic interactions of spatially distributed particles or agents. Stochastic reaction-diffusion processes are widely used to model such behaviour in disciplines ranging from biology to the social sciences, yet they are notoriously difficult to simulate and calibrate to observational data. Here we use ideas from statistical physics and machine learning to provide a solution to the inverse problem of learning a stochastic reaction-diffusion process from data. Our solution relies on a non-trivial connection between stochastic reaction-diffusion processes and spatio-temporal Cox processes, a well-studied class of models from computational statistics. This connection leads to an efficient and flexible algorithm for parameter inference and model selection. Our approach shows excellent accuracy on numeric and real data examples from systems biology and epidemiology. Our work provides both insights into spatio-temporal stochastic systems, and a practical solution to a long-standing problem in computational modelling.

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

USGS Publications Warehouse

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

2006-01-01

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

In situ bioinspired synthesis of silver chloride nanocrystals on silk fibroin fibers

NASA Astrophysics Data System (ADS)

Su, Huilan; Han, Jie; Dong, Qun; Xu, Jia; Chen, Ying; Gu, Yu; Song, Weiqiang; Zhang, Di

2011-02-01

Silver chloride (AgCl) nanocrystals were formed and grown on silk fibroin fibers (SFFs) by a room-temperature process. Practically, the degummed SFFs were immersed into silver nitrate solution and sodium chloride solution in turn. The amino acids on the SFF surface were negatively charged in alkaline impregnant, providing locations to immobilize silver ions and form silver chloride seeds. AgCl nanocrystals can further grow into cubic AgCl nanocrystals with an edge of about 100 nm. The morphologies of the AgCl nanocrystals were mostly influenced by the concentration of sodium chloride solution and the special configurations of the SFFs. The target AgCl/SFF nanocomposites constructed by AgCl nanocrystals and substrate SFFs could be used as photocatalysts in water splitting and antibacterial agents. This work provides an important example in the introduction of natural biofibers to the synthesis of functional hybrid nanocomposites by a green and mild technique.

Applications of Automation Methods for Nonlinear Fracture Test Analysis

NASA Technical Reports Server (NTRS)

Allen, Phillip A.; Wells, Douglas N.

2013-01-01

Using automated and standardized computer tools to calculate the pertinent test result values has several advantages such as: 1. allowing high-fidelity solutions to complex nonlinear phenomena that would be impractical to express in written equation form, 2. eliminating errors associated with the interpretation and programing of analysis procedures from the text of test standards, 3. lessening the need for expertise in the areas of solid mechanics, fracture mechanics, numerical methods, and/or finite element modeling, to achieve sound results, 4. and providing one computer tool and/or one set of solutions for all users for a more "standardized" answer. In summary, this approach allows a non-expert with rudimentary training to get the best practical solution based on the latest understanding with minimum difficulty.Other existing ASTM standards that cover complicated phenomena use standard computer programs: 1. ASTM C1340/C1340M-10- Standard Practice for Estimation of Heat Gain or Loss Through Ceilings Under Attics Containing Radiant Barriers by Use of a Computer Program 2. ASTM F 2815 - Standard Practice for Chemical Permeation through Protective Clothing Materials: Testing Data Analysis by Use of a Computer Program 3. ASTM E2807 - Standard Specification for 3D Imaging Data Exchange, Version 1.0 The verification, validation, and round-robin processes required of a computer tool closely parallel the methods that are used to ensure the solution validity for equations included in test standard. The use of automated analysis tools allows the creation and practical implementation of advanced fracture mechanics test standards that capture the physics of a nonlinear fracture mechanics problem without adding undue burden or expense to the user. The presented approach forms a bridge between the equation-based fracture testing standards of today and the next generation of standards solving complex problems through analysis automation.

Biological Small Angle Scattering: Techniques, Strategies and Tips

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

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

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

A review of some exact solutions to the planar equations of motion of a thrusting spacecraft

NASA Technical Reports Server (NTRS)

Petropoulos, A. E.; Sims, J. A.

2002-01-01

With the complexities in computing optimal low thrust trajectories, easily-computed, good sub-optimal trajectories provide both a practical alternative for mission designers and a starting point for optimisation. The present paper collects in one place for easy reference and comparison several exact solutions that have been obtained in the literature over the last few decades: the logarithmic spiral, Pinkham's variant thereof, Forbes spiral, the exponential sinusoid, the case of constant radial thrust, Markopoulos's Keplerian thrust arcs, Lawden's spiral, and the analogous Bishop and Azimov spiral.

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

PubMed

Kronberg, S L; Schauer, C S

2013-10-01

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

A Service Brokering and Recommendation Mechanism for Better Selecting Cloud Services

PubMed Central

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

2014-01-01

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

Practices of research data curation in institutional repositories: A qualitative view from repository staff

PubMed Central

Stvilia, Besiki

2017-01-01

The importance of managing research data has been emphasized by the government, funding agencies, and scholarly communities. Increased access to research data increases the impact and efficiency of scientific activities and funding. Thus, many research institutions have established or plan to establish research data curation services as part of their Institutional Repositories (IRs). However, in order to design effective research data curation services in IRs, and to build active research data providers and user communities around those IRs, it is essential to study current data curation practices and provide rich descriptions of the sociotechnical factors and relationships shaping those practices. Based on 13 interviews with 15 IR staff members from 13 large research universities in the United States, this paper provides a rich, qualitative description of research data curation and use practices in IRs. In particular, the paper identifies data curation and use activities in IRs, as well as their structures, roles played, skills needed, contradictions and problems present, solutions sought, and workarounds applied. The paper can inform the development of best practice guides, infrastructure and service templates, as well as education in research data curation in Library and Information Science (LIS) schools. PMID:28301533

Practices of research data curation in institutional repositories: A qualitative view from repository staff.

PubMed

Lee, Dong Joon; Stvilia, Besiki

2017-01-01

The importance of managing research data has been emphasized by the government, funding agencies, and scholarly communities. Increased access to research data increases the impact and efficiency of scientific activities and funding. Thus, many research institutions have established or plan to establish research data curation services as part of their Institutional Repositories (IRs). However, in order to design effective research data curation services in IRs, and to build active research data providers and user communities around those IRs, it is essential to study current data curation practices and provide rich descriptions of the sociotechnical factors and relationships shaping those practices. Based on 13 interviews with 15 IR staff members from 13 large research universities in the United States, this paper provides a rich, qualitative description of research data curation and use practices in IRs. In particular, the paper identifies data curation and use activities in IRs, as well as their structures, roles played, skills needed, contradictions and problems present, solutions sought, and workarounds applied. The paper can inform the development of best practice guides, infrastructure and service templates, as well as education in research data curation in Library and Information Science (LIS) schools.

Learning together for effective collaboration in school-based occupational therapy practice.

PubMed

Villeneuve, Michelle A; Shulha, Lyn M

2012-12-01

School-based occupational therapy (SBOT) practice takes place within a complex system that includes service recipients, service providers, and program decision makers across health and education sectors. Despite the promotion of collaborative consultation at a policy level, there is little practical guidance about how to coordinate multi-agency service and interprofessional collaboration among these stakeholders. This paper reports on a process used to engage program administrators in an examination of SBOT collaborative consultation practice in one region of Ontario to provide an evidence-informed foundation for decision making about implementation of these services. Within an appreciative inquiry framework (Cooperrider, Whitney, & Stavros, 2008), Developmental Work Research methods (Engeström, 2000) were used to facilitate shared learning for improved SBOT collaborative consultation. Program administrators participated alongside program providers and service recipients in a series of facilitated workshops to develop principles that will guide future planning and decision making about the delivery of SBOT services. Facilitated discussion among stakeholders led to the articulation of 12 principles for effective collaborative practice. Program administrators used their shared understanding to propose a new model for delivering SBOT services. Horizontal and vertical learning across agency and professional boundaries led to the development of powerful solutions for program improvement.

Methods for the practical determination of the mechanical strength of tablets--from empiricism to science.

PubMed

Podczeck, Fridrun

2012-10-15

This review aims to awake an interest in the determination of the tensile strength of tablets of various shapes using a variety of direct and indirect test methods. The United States Pharmacopoeia monograph 1217 (USP35/NF30, 2011) has provided a very good approach to the experimental determination of and standards for the mechanical strength of tablets. Building on this monograph, it is hoped that the detailed account of the various methods provided in this review will encourage industrial and academic scientists involved in the development and manufacture of tablet formulations to take a step forward and determine the tensile strength of tablets, even if these are not simply flat disc-shaped or rectangular. To date there are a considerable number of valid test configurations and stress equations available, catering for many of the various shapes of tablets on the market. The determination of the tensile strength of tablets should hence replace the sole determination of a breaking force, because tensile strength values are more comparable and suggestions for minimum and/or maximum values are available. The review also identifies the gaps that require urgent filling. There is also a need for further analysis using, for example, Finite Element Method, to provide correct stress solutions for tablets of differing shapes, but this also requires practical experiments to find the best loading conditions, and theoretical stress solutions should be verified with practical experiments. Copyright © 2012 Elsevier B.V. All rights reserved.

Efficient Privacy-Aware Record Integration.

PubMed

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

2013-01-01

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

Australasian Society for Parenteral and Enteral Nutrition guidelines for supplementation of trace elements during parenteral nutrition.

PubMed

Osland, Emma J; Ali, Azmat; Isenring, Elizabeth; Ball, Patrick; Davis, Melvyn; Gillanders, Lyn

2014-01-01

This work represents the first part of a progressive review of AuSPEN's 1999 Guidelines for Provision of Micronutrient Supplementation in Adult Patients receiving Parenteral Nutrition, in recognition of the developments in the literature on this topic since that time. A systematic literature review was undertaken and recommendations were made based on the available evidence and with consideration to specific elements of the Australian and New Zealand practice environment. The strength of evidence underpinning each recommendation was assessed. External reviewers provided feedback on the guidelines using the AGREE II tool. Reduced doses of manganese, copper, chromium and molybdenum, and an increased dose of selenium are recommended when compared with the 1999 guidelines. Currently the composition of available multi-trace element formulations is recognised as an obstacle to aligning these guidelines with practice. A paucity of available literature and limitations with currently available methods of monitoring trace element status are acknowledged. The currently unknown clinical impact of changes to trace element contamination of parenteral solutions with contemporary practices highlights need for research and clinical vigilance in this area of nutrition support practice. Trace elements are essential and should be provided daily to patients receiving parenteral nutrition. Monitoring is generally only required in longer term parenteral nutrition, however should be determined on an individual basis. Industry is encouraged to modify existing multi-trace element solutions available in Australia and New Zealand to reflect changes in the literature outlined in these guidelines. Areas requiring research are highlighted.

Selected problems associated with the treatment and care for patients with colostomy - part 2.

PubMed

Muzyczka, Katarzyna; Kachaniuk, Hanna; Szadowska-Szlachetka, Zdzisława; Charzyńska-Gula, Marianna; Kocka, Katarzyna; Bartoszek, Agnieszka; Celej-Szuster, Jolanta

2013-01-01

Generally, ostomy is a purposeful connection of the lumen of the intestine with abdominal integuments by surgery. The study presents practical solutions related to care for the colostomy patient, i.e. an ostomy on the large intestine. The following issues will be discussed: regulating the defecation cycle, risk connected with improper selection of ostomy equipment, instruction on colostomy irrigation with practical advice and irrigation equipment supply. The knowledge of these rules and mastering them in practice is to provide ostomy patients not only with highest-standard care and help but also to prepare them for dealing with problems independently, i.e. for self-care.

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

PubMed

Hubbard, Jessie Marie; Gattman, Kindsey Rae

2017-03-01

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

A nurse led model of chronic disease care - an interim report.

PubMed

Eley, Diann S; Del Mar, Chris B; Patterson, Elizabeth; Synnott, Robyn L; Baker, Peter G; Hegney, Desley

2008-12-01

Chronic condition management in general practice is projected to account for 50% of all consultations by 2051. General practices under present workforce conditions will be unable to meet this demand. Nurse led collaborative care models of chronic disease management have been successful overseas and are proposed as one solution. This article provides an interim report on a prospective randomised trial to investigate the acceptability, cost effectiveness and feasibility of a nurse led model of care for chronic conditions in Australian general practice. A qualitative study focused on the impact of this model of care through the perceptions of practice staff from one urban and one regional practice in Queensland, and one Victorian rural practice. Primary benefits of the collaborative care model focused on increased efficiency and communication between practice staff and patients. The increased degree of patient self responsibility was noted by all and highlights the motivational aspect of chronic disease management.

Advanced Placement Academy: Case Study of a Program within a School

ERIC Educational Resources Information Center

Swanson, Julie Dingle; Nagy, Steven

2014-01-01

The focus of this study was the first year of implementation of the Advanced Placement Academy (APA), a program within a high school providing honors and Advanced Placement coursework for high-ability African American students with previously limited access to rigorous courses. The qualitative investigation explores practical solutions from…

Five Ideas for 21st Century Math Classrooms

ERIC Educational Resources Information Center

Gasser, Kenneth W.

2011-01-01

This article draws on the 21st Century Skills Movement and the successful teaching practices of Asian schools in order to provide five suggestions that secondary math teachers can incorporate into their classrooms in order to promote the skill set necessary for an ever-changing global economy. Problem-based instruction, student-led solutions, risk…

Evaluation of holonomic quantum computation: adiabatic versus nonadiabatic.

PubMed

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

2003-04-11

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

Creativity and Innovation: Theory, Research, and Practice

ERIC Educational Resources Information Center

Plucker, Jonathan A., Ed.

2016-01-01

Creativity and innovation are frequently mentioned as key 21st-century skills for career and life success. Indeed, recent research provides evidence that the jobs of the future will increasingly require the ability to bring creative solutions to complex problems. And creativity is often the spice of life, that little extra something that makes the…

3-2-1 Ignition*: Making Science Creative, Accessible and Fun

ERIC Educational Resources Information Center

Reichardt, Oliver

2013-01-01

For over 250 years, the RSA (Royal Society for the Encouragement of Arts, Manufactures and Commerce) has been committed to finding practical solutions to today's social challenges. The Society's way of working consists of providing a platform for critical debate and new ideas; working with partners to translate knowledge and progressive thinking…

Perceived Communication Skill Needs for Small Work Groups.

ERIC Educational Resources Information Center

Hawkins, Katherine; Fillion, Bryant

A study examined communication skills essential for small work groups and whether the quality of small group teaching and research is in decline. The study reviewed small group research done previously by others and the problem of existing pedagogy and research in small group communication which does not provide practical solutions to real life…

Introducing Scale Analysis by Way of a Pendulum

ERIC Educational Resources Information Center

Lira, Ignacio

2007-01-01

Empirical correlations are a practical means of providing approximate answers to problems in physics whose exact solution is otherwise difficult to obtain. The correlations relate quantities that are deemed to be important in the physical situation to which they apply, and can be derived from experimental data by means of dimensional and/or scale…

Injury Prevention in Physical Education: Scenarios and Solutions

ERIC Educational Resources Information Center

Merrie, Michael D.; Shewmake, Cole; Calleja, Paul

2016-01-01

The purpose of this article is to provide physical educators with practical strategies that can assist in preventing injuries in the classroom. The dynamic nature of physical education and the numerous tasks physical educators must complete daily can be challenging. Embedded in these challenges is the constant risk of student injury. Fortunately,…

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

ERIC Educational Resources Information Center

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

2012-01-01

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

Preparing Students for Front-Line Management: Non-Routine Day-to-Day Decisions

ERIC Educational Resources Information Center

Clydesdale, Greg; Tan, John

2009-01-01

Purpose: This paper attempts to reduce the gap between management education and practice. It emphasises day-to-day decisions that middle and lower level managers make. The purpose is to provide an education framework embodying a flexible approach to interpretation and solution creation, suitable for situations of ambiguity and uncertainty.…

Math Thinkercises. A Good Apple Math Activity Book for Students. Grades 4-8.

ERIC Educational Resources Information Center

Daniel, Becky

This booklet designed for students in grades 4-8 provides 52 activities, including puzzles and problems. Activities range from simple to complex, giving learners practice in finding patterns, numeration, permutation, and problem solving. Calculators should be available, and students should be encouraged to discuss solutions with classmates,…

The Recycle Team.

ERIC Educational Resources Information Center

Scott, Roger; And Others

This guide provides lessons that enable students to learn how important it is for each of us to take care of the environment by minimizing the problems caused by too much trash. In the 10 lessons included here, students and their families learn how they can be part of the solution by practicing source reduction and by reusing, recycling, and…

Nature: a new paradigm for well-being and ergonomics.

PubMed

Richardson, Miles; Maspero, Marta; Golightly, David; Sheffield, David; Staples, Vicki; Lumber, Ryan

2017-02-01

Nature is presented as a new paradigm for ergonomics. As a discipline concerned with well-being, the importance of natural environments for wellness should be part of ergonomics knowledge and practice. This position is supported by providing a concise summary of the evidence of the value of the natural environment to well-being. Further, an emerging body of research has found relationships between well-being and a connection to nature, a concept that reveals the integrative character of human experience which can inform wider practice and epistemology in ergonomics. Practitioners are encouraged to bring nature into the workplace, so that ergonomics keeps pace with the move to nature-based solutions, but also as a necessity in the current ecological and social context. Practitioner Summary: Nature-based solutions are coming to the fore to address societal challenges such as well-being. As ergonomics is concerned with well-being, there is a need for a paradigm shift in the discipline. This position is supported by providing a concise summary of the evidence of the value of the natural environment to well-being.

Empowering clinical supervisors to flourish though critical companionship.

PubMed

Mackay, Maria; Stephens, Moira; Wragg, Siobhan; Ebejer, Saskia; Bourgeois, Sharon

2018-01-01

Education for professional nursing practice has undergone a significant shift over the last few decades impacting nursing practice and the relationship between nurses. Enhancing professional practice and acting as a conduit for empowering nurses to be active participants in their learning and development is Practice Development. This action research project with philosophical premises of critical companionship and human flourishing aimed to develop the knowledge and skills of registered nurses in their ability to provide clinical supervision of nursing students in practice. The overall project consisted of two action research cycles in two different health facilities. Participants in both projects identified similar issues and common learning needs including; how to better understand and develop skills in reflective practice; how to provide a positive learning and enabling environment; and how to provide effective solution focused feedback. Workshop facilitators witnessed the flourishing of participants as they were enabled to negotiate their learning requirements; grow and develop in their roles over the workshop series. Participants themselves identified personal growth in skills, knowledge and confidence in being a preceptor as a result of the workshops in the study. Overall, this study has resulted in the development and capacity building of the nursing workforce clinical placement capacity through the development of clinical supervisors. Copyright © 2017 Elsevier Ltd. All rights reserved.

Public Health Information Systems: Priorities and Practices for Successful Deployments.

PubMed

Pearce, Martin

2016-01-01

A fast paced workshop designed for senior public health decision makers and clinical leaders implementing information systems to support delivery of public health programs. The tutorial will introduce public health information systems and provide best practices for implementing solutions related to immunization, communicable disease case management and outbreak management. Using a combination of formats, the tutorial will: • Highlight key functionality of public health information systems. • Review global crises currently exposing gaps and deficiencies in public health information. • Examine governance, planning, and implementation priorities. • Highlight considerations supporting implementations nationally and in special populations. • Provide real, actionable lessons learned to take away and apply in the real world.

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

DTIC Science & Technology

1980-05-01

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

A new and inexpensive non-bit-for-bit solution reproducibility test based on time step convergence (TSC1.0)

NASA Astrophysics Data System (ADS)

Wan, Hui; Zhang, Kai; Rasch, Philip J.; Singh, Balwinder; Chen, Xingyuan; Edwards, Jim

2017-02-01

A test procedure is proposed for identifying numerically significant solution changes in evolution equations used in atmospheric models. The test issues a fail signal when any code modifications or computing environment changes lead to solution differences that exceed the known time step sensitivity of the reference model. Initial evidence is provided using the Community Atmosphere Model (CAM) version 5.3 that the proposed procedure can be used to distinguish rounding-level solution changes from impacts of compiler optimization or parameter perturbation, which are known to cause substantial differences in the simulated climate. The test is not exhaustive since it does not detect issues associated with diagnostic calculations that do not feedback to the model state variables. Nevertheless, it provides a practical and objective way to assess the significance of solution changes. The short simulation length implies low computational cost. The independence between ensemble members allows for parallel execution of all simulations, thus facilitating fast turnaround. The new method is simple to implement since it does not require any code modifications. We expect that the same methodology can be used for any geophysical model to which the concept of time step convergence is applicable.

Anonymous Transactions in Computer Networks

NASA Astrophysics Data System (ADS)

Dolev, Shlomi; Kopeetsky, Marina

We present schemes for providing anonymous transactions while privacy and anonymity are preserved, providing user anonymous authentication in distributed networks such as the Internet. We first present a practical scheme for anonymous transactions while the transaction resolution is assisted by a Trusted Authority. This practical scheme is extended to a theoretical scheme where a Trusted Authority is not involved in the transaction resolution. Given an authority that generates for each player hard to produce evidence EVID (e. g., problem instance with or without a solution) to each player, the identity of a user U is defined by the ability to prove possession of said evidence. We use Zero-Knowledge proof techniques to repeatedly identify U by providing a proof that U has evidence EVID, without revealing EVID, therefore avoiding identity theft.

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

PubMed

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

2016-02-01

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

Method for the recovery of silver from waste photographic fixer solutions

DOEpatents

Posey, F.A.; Palko, A.A.

The method of the present invention is directed to the recovery of silver from spent photographic fixer solutions and for providing an effluent essentially silver-free that is suitable for discharge into commercial sewage systems. The present method involves the steps of introducing the spent photographic fixer solution into an alkaline hypochlorite solution. The oxidizing conditions of the alkaline hypochlorite solution are maintained during the addition of the fixer solution so that the silver ion complexing agents of thiosulfate and sulfite ions are effectively destroyed. Hydrazine monohydrate is then added to the oxidizing solution to form a reducing solution to effect the formation of a precipitate of silver which can be readily removed by filtration of decanting. Experimental tests indicate that greater than 99.99% of the original silver in the spent photographic fixer can be efficiently removed by practicing the present method. Also, the chemical and biological oxygen demand of the remaining effluent is significantly reduced so as to permit the discharge thereof into sewage systems at levels in compliance with federal and state environmental standards.

Method for the recovery of silver from waste photographic fixer solutions

DOEpatents

Posey, Franz A.; Palko, Aloysius A.

1984-01-01

The method of the present invention is directed to the recovery of silver from spent photographic fixer solutions and for providing an effluent essentially silver-free that is suitable for discharge into commercial sewage systems. The present method involves the steps of introducing the spent photographic fixer solution into an alkaline hypochlorite solution. The oxidizing conditions of the alkaline hypochlorite solution are maintained during the addition of the fixer solution so that the silver ion complexing agents of thiosulfate and sulfite ions are effectively destroyed. Hydrazine monohydrate is then added to the oxidizing solution to form a reducing solution to effect the formation of a precipitate of silver which can be readily removed by filtration or decanting. Experimental tests indicate that greater than 99.99% of the original silver in the spent photographic fixer can be efficiently removed by practicing the present method. Also, the chemical and biological oxygen demand of the remaining effluent is significantly reduced so as to permit the discharge thereof into sewage systems at levels in compliance with federal and state environmental standards.

Biosimilars: Opportunities to Promote Optimization Through Payer and Provider Collaboration.

PubMed

Manolis, Chronis H; Rajasenan, Kiran; Harwin, William; McClelland, Scott; Lopes, Maria; Farnum, Carolyn

2016-09-01

A panel was convened that consisted of 1 medical director, 2 pharmacy directors, and 2 oncologists, who represented the University of Pittsburgh Medical Center Health Plan, an integrated delivery network, and Florida Blue, a progressive regional health plan. This panel met in order to share ideas, discuss challenges, and develop practical solutions to promote optimal utilization in order to encourage collaboration between payers and providers to help ensure the success of biosimilar entrants into the marketplace. Live meetings were conducted in Orlando, Florida, and Pittsburgh, Pennsylvania, and were followed by virtual meetings to solidify ideas and concepts for this supplement. It is important for biosimilar manufacturers to identify potential payer, provider, and patient obstacles in order to develop strategic and tactical plans to preemptively address these potential obstacles. Gathering payer and provider insights will shed light on various issues such as access and reimbursement. Biosimilar manufacturers must be proactive in the education of payers, providers, and patients to ensure access to biosimilars. A strong factor emphasized among this group was that the assumption surrounding biosimilar development and use is the potential for health care cost savings. According to the panel, payers and providers must carefully consider economic implications and potential cost-effectiveness in order to increase the acceptance or understanding of biosimilars in clinical practice. The group identified 3 major challenges surrounding biosimilar adoption: (1) provider confidence in biosimilar education and clinical value, (2) provider confidence in reimbursement for new biosimilars, and (3) creating shared payer and provider cost-savings. After identification of the 3 challenges, the group posed potential solutions to help with biosimilar adoption.

Constructing conceptual knowledge and promoting "number sense" from computer-managed practice in rounding whole numbers

NASA Astrophysics Data System (ADS)

Hativa, Nira

1993-12-01

This study sought to identify how high achievers learn and understand new concepts in arithmetic from computer-based practice which provides full solutions to examples but without verbal explanations. Four high-achieving second graders were observed in their natural school settings throughout all their computer-based practice sessions which involved the concept of rounding whole numbers, a concept which was totally new to them. Immediate post-session interviews inquired into students' strategies for solutions, errors, and their understanding of the underlying mathematical rules. The article describes the process through which the students construct their knowledge of the rounding concepts and the errors and misconceptions encountered in this process. The article identifies the cognitive abilities that promote student self-learning of the rounding concepts, their number concepts and "number sense." Differences in the ability to generalise, "mathematical memory," mindfulness of work and use of cognitive strategies are shown to account for the differences in patterns of, and gains in, learning and in maintaining knowledge among the students involved. Implications for the teaching of estimation concepts and of promoting students' "number sense," as well as for classroom use of computer-based practice are discussed.

Phynx: an open source software solution supporting data management and web-based patient-level data review for drug safety studies in the general practice research database and other health care databases.

PubMed

Egbring, Marco; Kullak-Ublick, Gerd A; Russmann, Stefan

2010-01-01

To develop a software solution that supports management and clinical review of patient data from electronic medical records databases or claims databases for pharmacoepidemiological drug safety studies. We used open source software to build a data management system and an internet application with a Flex client on a Java application server with a MySQL database backend. The application is hosted on Amazon Elastic Compute Cloud. This solution named Phynx supports data management, Web-based display of electronic patient information, and interactive review of patient-level information in the individual clinical context. This system was applied to a dataset from the UK General Practice Research Database (GPRD). Our solution can be setup and customized with limited programming resources, and there is almost no extra cost for software. Access times are short, the displayed information is structured in chronological order and visually attractive, and selected information such as drug exposure can be blinded. External experts can review patient profiles and save evaluations and comments via a common Web browser. Phynx provides a flexible and economical solution for patient-level review of electronic medical information from databases considering the individual clinical context. It can therefore make an important contribution to an efficient validation of outcome assessment in drug safety database studies.

The science, policy and practice of nature-based solutions: An interdisciplinary perspective.

PubMed

Nesshöver, Carsten; Assmuth, Timo; Irvine, Katherine N; Rusch, Graciela M; Waylen, Kerry A; Delbaere, Ben; Haase, Dagmar; Jones-Walters, Lawrence; Keune, Hans; Kovacs, Eszter; Krauze, Kinga; Külvik, Mart; Rey, Freddy; van Dijk, Jiska; Vistad, Odd Inge; Wilkinson, Mark E; Wittmer, Heidi

2017-02-01

In this paper, we reflect on the implications for science, policy and practice of the recently introduced concept of Nature-Based Solutions (NBS), with a focus on the European context. First, we analyse NBS in relation to similar concepts, and reflect on its relationship to sustainability as an overarching framework. From this, we derive a set of questions to be addressed and propose a general framework for how these might be addressed in NBS projects by funders, researchers, policy-makers and practitioners. We conclude that: To realise their full potential, NBS must be developed by including the experience of all relevant stakeholders such that 'solutions' contribute to achieving all dimensions of sustainability. As NBS are developed, we must also moderate the expectations placed on them since the precedent provided by other initiatives whose aim was to manage nature sustainably demonstrates that we should not expect NBS to be cheap and easy, at least not in the short-term. Copyright © 2016 British Geological Survey, NERC. Published by Elsevier B.V. All rights reserved.

Phase function of a spherical particle when scattering an inhomogeneous electromagnetic plane wave.

PubMed

Frisvad, Jeppe Revall

2018-04-01

In absorbing media, electromagnetic plane waves are most often inhomogeneous. Existing solutions for the scattering of an inhomogeneous plane wave by a spherical particle provide no explicit expressions for the scattering components. In addition, current analytical solutions require evaluation of the complex hypergeometric function F 1 2 for every term of a series expansion. In this work, I develop a simpler solution based on associated Legendre functions with argument zero. It is similar to the solution for homogeneous plane waves but with new explicit expressions for the angular dependency of the far-field scattering components, that is, the phase function. I include recurrence formulas for practical evaluation and provide numerical examples to evaluate how well the new expressions match previous work in some limiting cases. The predicted difference in the scattering phase function due to inhomogeneity is not negligible for light entering an absorbing medium at an oblique angle. The presented theory could thus be useful for predicting scattering behavior in dye-based random lasing and in solar cell absorption enhancement.

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

NASA Technical Reports Server (NTRS)

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

2012-01-01

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

Addressing the paradox of the team innovation process: A review and practical considerations.

PubMed

Thayer, Amanda L; Petruzzelli, Alexandra; McClurg, Caitlin E

2018-01-01

Facilitating team innovation is paramount to promoting progress in the science, technology, engineering, and math fields, as well as advancing national health, safety, prosperity, and welfare. However, innovation teams face a unique set of challenges due to the novelty and uncertainty that is core to the definition of innovation, as well as the paradoxical nature of idea generation and idea implementation processes. These and other challenges must be overcome for innovation teams to realize their full potential for producing change. The purpose of this review is, thus, to provide insight into the unique context that these teams function within and provide an integrative, evidence-based, and practically useful, organizing heuristic that focuses on the most important considerations for facilitating team innovation. Finally, we provide practical guidance for psychologists, organizations, practitioners, scientists, educators, policymakers, and others who employ teams to produce novel, innovative solutions to today's problems. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

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

NASA Astrophysics Data System (ADS)

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

2017-12-01

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

Information system evolution at the French National Network of Seismic Survey (BCSF-RENASS)

NASA Astrophysics Data System (ADS)

Engels, F.; Grunberg, M.

2013-12-01

The aging information system of the French National Network of Seismic Survey (BCSF-RENASS), located in Strasbourg (EOST), needed to be updated to satisfy new practices from Computer science world. The latter means to evolve our system at different levels : development method, datamining solutions, system administration. The new system had to provide more agility for incoming projects. The main difficulty was to maintain old system and the new one in parallel the time to validate new solutions with a restricted team. Solutions adopted here are coming from standards used by the seismological community and inspired by the state of the art of devops community. The new system is easier to maintain and take advantage of large community to find support. This poster introduces the new system and choosen solutions like Puppet, Fabric, MongoDB and FDSN Webservices.

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

PubMed Central

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

2016-01-01

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

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

PubMed

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

2016-12-01

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

Developing Effective Collaboration Between Primary Care and Mental Health Providers

PubMed Central

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

2006-01-01

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

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.

The Prepared Mind.

PubMed

Garber, Susan L

Every day, in clinics and hospitals around the world, occupational therapists care for patients with serious problems requiring viable solutions. Each patient is unique, and his or her problem does not necessarily correspond to existing practice models. Practitioners must adapt standard approaches to provide effective outcomes, yet problems exist for which few or no beneficial approaches have been identified. Such clinical issues require solutions to be generated de novo from the practitioner's body of knowledge and past experience. Yet, no single new intervention can be used without prior validation of its efficacy. Only a therapist with a prepared mind can accept such challenges, recognize what is known and not yet known, design studies to acquire that needed knowledge, and translate it into successful clinical treatment strategies. The occupational therapist with a prepared mind is one willing to seize unexpected opportunities and construct new paradigms of practice. Innovation through scientific inquiry requires a prepared mind. Copyright © 2016 by the American Occupational Therapy Association, Inc.

Utilization of municipal solid and liquid wastes for bioenergy and bioproducts production.

PubMed

Chen, Paul; Xie, Qinglong; Addy, Min; Zhou, Wenguang; Liu, Yuhuan; Wang, Yunpu; Cheng, Yanling; Li, Kun; Ruan, Roger

2016-09-01

Municipal wastes, be it solid or liquid, are rising due to the global population growth and rapid urbanization and industrialization. Conventional management practice involving recycling, combustion, and treatment/disposal is deemed unsustainable. Solutions must be sought to not only increase the capacity but also improve the sustainability of waste management. Research has demonstrated that the non-recyclable waste materials and bio-solids can be converted into useable heat, electricity, or fuel and chemical through a variety of processes, including gasification, pyrolysis, anaerobic digestion, and landfill gas in addition to combustion, and wastewater streams have the potential to support algae growth and provide other energy recovery options. The present review is intended to assess and analyze the current state of knowledge in the municipal solid wastes and wastewater treatment and utilization technologies and recommend practical solution options and future research and development needs. Copyright © 2016 Elsevier Ltd. All rights reserved.

Practical Bayesian tomography

NASA Astrophysics Data System (ADS)

Granade, Christopher; Combes, Joshua; Cory, D. G.

2016-03-01

In recent years, Bayesian methods have been proposed as a solution to a wide range of issues in quantum state and process tomography. State-of-the-art Bayesian tomography solutions suffer from three problems: numerical intractability, a lack of informative prior distributions, and an inability to track time-dependent processes. Here, we address all three problems. First, we use modern statistical methods, as pioneered by Huszár and Houlsby (2012 Phys. Rev. A 85 052120) and by Ferrie (2014 New J. Phys. 16 093035), to make Bayesian tomography numerically tractable. Our approach allows for practical computation of Bayesian point and region estimators for quantum states and channels. Second, we propose the first priors on quantum states and channels that allow for including useful experimental insight. Finally, we develop a method that allows tracking of time-dependent states and estimates the drift and diffusion processes affecting a state. We provide source code and animated visual examples for our methods.

Portfolio theory and the alternative decision rule of cost-effectiveness analysis: theoretical and practical considerations.

PubMed

Sendi, Pedram; Al, Maiwenn J; Gafni, Amiram; Birch, Stephen

2004-05-01

Bridges and Terris (Soc. Sci. Med. (2004)) critique our paper on the alternative decision rule of economic evaluation in the presence of uncertainty and constrained resources within the context of a portfolio of health care programs (Sendi et al. Soc. Sci. Med. 57 (2003) 2207). They argue that by not adopting a formal portfolio theory approach we overlook the optimal solution. We show that these arguments stem from a fundamental misunderstanding of the alternative decision rule of economic evaluation. In particular, the portfolio theory approach advocated by Bridges and Terris is based on the same theoretical assumptions that the alternative decision rule set out to relax. Moreover, Bridges and Terris acknowledge that the proposed portfolio theory approach may not identify the optimal solution to resource allocation problems. Hence, it provides neither theoretical nor practical improvements to the proposed alternative decision rule.

Understanding dental CAD/CAM for restorations--the digital workflow from a mechanical engineering viewpoint.

PubMed

Tapie, L; Lebon, N; Mawussi, B; Fron Chabouis, H; Duret, F; Attal, J-P

2015-01-01

As digital technology infiltrates every area of daily life, including the field of medicine, so it is increasingly being introduced into dental practice. Apart from chairside practice, computer-aided design/computer-aided manufacturing (CAD/CAM) solutions are available for creating inlays, crowns, fixed partial dentures (FPDs), implant abutments, and other dental prostheses. CAD/CAM dental solutions can be considered a chain of digital devices and software for the almost automatic design and creation of dental restorations. However, dentists who want to use the technology often do not have the time or knowledge to understand it. A basic knowledge of the CAD/CAM digital workflow for dental restorations can help dentists to grasp the technology and purchase a CAM/CAM system that meets the needs of their office. This article provides a computer-science and mechanical-engineering approach to the CAD/CAM digital workflow to help dentists understand the technology.

New perspectives in plastic biodegradation.

PubMed

Sivan, Alex

2011-06-01

During the past 50 years new plastic materials, in various applications, have gradually replaced the traditional metal, wood, leather materials. Ironically, the most preferred property of plastics--durability--exerts also the major environmental threat. Recycling has practically failed to provide a safe solution for disposal of plastic waste (only 5% out of 1 trillion plastic bags, annually produced in the US alone, are being recycled). Since the most utilized plastic is polyethylene (PE; ca. 140 million tons/year), any reduction in the accumulation of PE waste alone would have a major impact on the overall reduction of the plastic waste in the environment. Since PE is considered to be practically inert, efforts were made to isolate unique microorganisms capable of utilizing synthetic polymers. Recent data showed that biodegradation of plastic waste with selected microbial strains became a viable solution. Copyright © 2011 Elsevier Ltd. All rights reserved.

Reasoning and Data Representation in a Health and Lifestyle Support System.

PubMed

Hanke, Sten; Kreiner, Karl; Kropf, Johannes; Scase, Marc; Gossy, Christian

2017-01-01

Case-based reasoning and data interpretation is an artificial intelligence approach that capitalizes on past experience to solve current problems and this can be used as a method for practical intelligent systems. Case-based data reasoning is able to provide decision support for experts and clinicians in health systems as well as lifestyle systems. In this project we were focusing on developing a solution for healthy ageing considering daily activities, nutrition as well as cognitive activities. The data analysis of the reasoner followed state of the art guidelines from clinical practice. Guidelines provide a general framework to guide clinicians, and require consequent background knowledge to become operational, which is precisely the kind of information recorded in practice cases; cases complement guidelines very well and helps to interpret them. It is expected that the interest in case-based reasoning systems in the health.

06. Facilitating Collection of Research and Quality Data in Integrative Medicine Clinical Settings: Views From Academic, Health System and Private Clinics

PubMed Central

Dolor, Rowena; Victorson, David; Amoils, Steve

2013-01-01

Focus Areas: Integrative Approaches to Care The purpose of this panel discussion is to share successful efforts from a practice-based research network (PBRN) including ten integrative medicine clinics. The BraveNet PBRN includes integrative medicine clinics with academic health centers, large health systems, and a stand-alone private practice clinic. While clinical care is prioritized across all of these centers, introducing research into clinical sites oriented to providing care poses challenges that vary by clinic environment. We will highlight some of the unique issues encountered when trying to standardize data collection in sites practicing a patient-centered, whole-systems approach to healing as well as the solutions used to overcome these issues. We will present some operational solutions and data collected from the PBRN's ongoing data registry, entitled PRIMIER. The panel will engage attendees in a dialogue centering on potential for future analyses of existing results, ideas for possible upcoming studies, and creative ways to expand the PBRN data registry to include additional sites that may have expertise and interest in participating.

Assessment of Perceived Barriers to Herpes Zoster Vaccination among Geriatric Primary Care Providers.

PubMed

Montag Schafer, Katherine; Reidt, Shannon

2016-10-18

The herpes zoster vaccine is recommended for use in adults 60 years of age and older to reduce the incidence and morbidity associated with infection. Its limited uptake has been attributed to logistical barriers, but uncertain efficacy and safety in subsets of this patient population could also be contributing. The purpose of this study was to evaluate the current vaccination practices, barriers to vaccination, knowledge of vaccination reimbursement and strategies to evaluate for insurance coverage among an urban, safety net, teaching hospital, geriatric primary care provider group through a survey administered via paper and online platforms. Survey participants ( n = 10) reported lack of availability of the vaccine in their practice settings (6/10), with half of providers (5/10) referring patients to outside pharmacies or to other practice settings (2/10) for vaccine administration. Reimbursement issues and storage requirements were perceived as major barriers by 40% (4/10) of providers, whereas 80% (8/10) of providers reported that concerns about safety and effectiveness of the vaccine were not major barriers to vaccination. Logistical barriers, rather than concerns about safety and effectiveness of the vaccine, were reported as major barriers to vaccination by a significant portion of providers. Lack of availability and reimbursement problems for practice sites allow for gaps in care. Partnership with community and long-term care pharmacies could serve as a possible solution.

Maintaining physical therapy standards in an emergency situation: solutions after the Bali bombing disaster.

PubMed

Edgar, D; Wood, F; Goodwin-Walters, A

2005-08-01

In a mass casualty event, treatment is traditionally provided in a 'best for the most' fashion. This paper examines the challenges encountered by physical therapists while providing rehabilitation to 28 survivors who suffered burns after the terrorist bombing in Bali, Indonesia. Individual patient input was achieved with routine outcome measures and workload statistics. Workforce expansion, maintenance of treatment quality, and other practical initiatives used in order to achieve this goal are discussed.

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

ERIC Educational Resources Information Center

Tetteris, Belinda Christine

2006-01-01

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

Shaping the Future with Math, Science, and Technology: Solutions and Lesson Plans to Prepare Tomorrow's Innovators

ERIC Educational Resources Information Center

Adams, Dennis; Hamm, Mary

2011-01-01

"Shaping the Future with Math, Science, and Technology" examines how ingenuity, creativity, and teamwork skills are part of an intellectual toolbox associated with math, science, and technology. The book provides new ideas, proven processes, practical tools, and examples useful to educators who want to encourage students to solve problems and…

Collaborative Practitioner Inquiry: Providing Leadership and Action Research for Teacher Professional Development

ERIC Educational Resources Information Center

von Gnechten, Mitchell P.

2011-01-01

Professional development is best when embedded in one's practice and linked directly to the classroom. Opportunities for teachers to identify specific areas of concern in their classroom and problem solve solutions via action research promotes a culture of inquiry. This culture of inquiry is enhanced when teams of teachers collaborate and share…

Beyond Technology...Learning with the Wired Curriculum. 1998 Yearbook of the Massachusetts Association for Supervision and Curriculum Development.

ERIC Educational Resources Information Center

Zimmerman, Isa Kaftal, Ed.; Hayes, Mary Forte, Ed.

This yearbook for the Massachusetts Association for Supervision and Curriculum Development (MASCD) provides educators with models of successful practices and raises questions and potential solutions to issues of accountability, policy, long-term planning, funding, and student motivation for learning. This 1998 yearbook assists educators at all…

A Win-Win Solution: The Empirical Evidence on School Choice. Third Edition

ERIC Educational Resources Information Center

Forster, Greg

2013-01-01

This report surveys the empirical research on school choice. It provides a thorough overview of what the research has found on five key topics: (1) Academic outcomes of choice participants; (2) Academic outcomes of public schools; (3) Fiscal impact on taxpayers; (4) Racial segregation in schools; and (5) Civic values and practices. The evidence…

The Rise of the Teleworker: False Promises and Responsive Solutions

ERIC Educational Resources Information Center

Kanuka, Heather; Jugdev, Kam; Heller, Robert; West, Dan

2008-01-01

The purpose of this exploratory study was to gain a better understanding of how to provide learning opportunities to improve teaching practices for the increasing numbers of academics who are choosing to work online from remote offices, sometimes called e-academics, remote workers, or teleworkers. The objectives of the study were twofold: (1) to…

New Training Approaches for Drivers--A Practical Experience

ERIC Educational Resources Information Center

Catenazzi, Nadia; Sommaruga, Lorenzo; De Angelis, Kylene; Gabbianelli, Giulio

2018-01-01

In the context of the road transport there is the need to provide new training opportunities for million of truck and bus drivers who are often on the road. The C95-Challenge EU Erasmus+ project aims to meet this need by introducing new training methodologies and solutions that support compulsory periodic courses. The main project result is the…

Teaching Search Engine Marketing through the Google Ad Grants Program

ERIC Educational Resources Information Center

Clarke, Theresa B.; Murphy, Jamie; Wetsch, Lyle R.; Boeck, Harold

2018-01-01

Instructors may find it difficult to stay abreast of the rapidly changing nature of search engine marketing (SEM) and to incorporate hands-on, practical classroom experiences. One solution is Google Ad Grants, a nonprofit edition of Google AdWords that provides up to $10,000 monthly in free advertising. A quasi-experiment revealed no differences…

Marketing and Promotion of Library Services

NASA Astrophysics Data System (ADS)

Nicholas, Julie

As librarians we should be actively marketing and promoting our library services. This paper aims to demystify marketing for librarians. Practical solutions are provided on how to implement a marketing strategy, with particular emphasis on the value of using electronic information resources. It also shows the link between promoting library services and raising the profile of the library.

Reuse of hydroponic waste solution.

PubMed

Kumar, Ramasamy Rajesh; Cho, Jae Young

2014-01-01

Attaining sustainable agriculture is a key goal in many parts of the world. The increased environmental awareness and the ongoing attempts to execute agricultural practices that are economically feasible and environmentally safe promote the use of hydroponic cultivation. Hydroponics is a technology for growing plants in nutrient solutions with or without the use of artificial medium to provide mechanical support. Major problems for hydroponic cultivation are higher operational cost and the causing of pollution due to discharge of waste nutrient solution. The nutrient effluent released into the environment can have negative impacts on the surrounding ecosystems as well as the potential to contaminate the groundwater utilized by humans for drinking purposes. The reuse of non-recycled, nutrient-rich hydroponic waste solution for growing plants in greenhouses is the possible way to control environmental pollution. Many researchers have successfully grown several plant species in hydroponic waste solution with high yield. Hence, this review addresses the problems associated with the release of hydroponic waste solution into the environment and possible reuse of hydroponic waste solution as an alternative resource for agriculture development and to control environmental pollution.

Solving nursing shortages: a common priority

PubMed Central

Buchan, James; Aiken, Linda

2009-01-01

Aims and objectives This paper provides a context for this special edition. It highlights the scale of the challenge of nursing shortages, but also makes the point that there is a policy agenda that provides workable solutions. Results An overview of nurse:population ratios in different countries and regions of the world, highlighting considerable variations, with Africa and South East Asia having the lowest average ratios. The paper argues that the ‘shortage’ of nurses is not necessarily a shortage of individuals with nursing qualifications, it is a shortage of nurses willing to work in the present conditions. The causes of shortages are multi-faceted, and there is no single global measure of their extent and nature, there is growing evidence of the impact of relatively low staffing levels on health care delivery and outcomes. The main causes of nursing shortages are highlighted: inadequate workforce planning and allocation mechanisms, resource constrained undersupply of new staff, poor recruitment, retention and ‘return’ policies, and ineffective use of available nursing resources through inappropriate skill mix and utilisation, poor incentive structures and inadequate career support. Conclusions What now faces policy makers in Japan, Europe and other developed countries is a policy agenda with a core of common themes. First, themes related to addressing supply side issues: getting, keeping and keeping in touch with relatively scarce nurses. Second, themes related to dealing with demand side challenges. The paper concludes that the main challenge for policy makers is to develop a co-ordinated package of policies that provide a long term and sustainable solution. Relevance to clinical practice This paper highlights the impact that nursing shortages has on clinical practice and in health service delivery. It outlines scope for addressing shortage problems and therefore for providing a more positive staffing environment in which clinical practice can be delivered. PMID:19146584

Estimating Aquifer Properties Using Sinusoidal Pumping Tests

NASA Astrophysics Data System (ADS)

Rasmussen, T. C.; Haborak, K. G.; Young, M. H.

2001-12-01

We develop the theoretical and applied framework for using sinusoidal pumping tests to estimate aquifer properties for confined, leaky, and partially penetrating conditions. The framework 1) derives analytical solutions for three boundary conditions suitable for many practical applications, 2) validates the analytical solutions against a finite element model, 3) establishes a protocol for conducting sinusoidal pumping tests, and 4) estimates aquifer hydraulic parameters based on the analytical solutions. The analytical solutions to sinusoidal stimuli in radial coordinates are derived for boundary value problems that are analogous to the Theis (1935) confined aquifer solution, the Hantush and Jacob (1955) leaky aquifer solution, and the Hantush (1964) partially penetrated confined aquifer solution. The analytical solutions compare favorably to a finite-element solution of a simulated flow domain, except in the region immediately adjacent to the pumping well where the implicit assumption of zero borehole radius is violated. The procedure is demonstrated in one unconfined and two confined aquifer units near the General Separations Area at the Savannah River Site, a federal nuclear facility located in South Carolina. Aquifer hydraulic parameters estimated using this framework provide independent confirmation of parameters obtained from conventional aquifer tests. The sinusoidal approach also resulted in the elimination of investigation-derived wastes.

Reviewing education challenges and solutions for health professionals in community care.

PubMed

Kirk, Mary

2015-10-01

The biggest asset of the NHS is its staff. Health professionals working in the community are faced with a number of challenges to maintain and develop their knowledge and skills in their clinical practice. NHS England's Five Year Forward View describes the need for change, identifying the necessity to reshape care delivery, harnessing technology, and driving down variations in quality and safety of care. This article explores some of the challenges faced by community health-care providers and reviews possible solutions to meet community health-care needs for now as well as the future.

Correlation Relation for the Membrane Transport ParametersL(p), σ, and ω.

PubMed

Kargol, A; Kargol, M; Przestalski, S

1997-12-01

We derive a formula for the correlation of the three practical transportparameters L(p), σ, and ω appearing in Kedem-Katchalskyequations. It has a form ω = KL(p)/v(s)(1-σ), where K = 0.0306 is a universal constant independent ofthe choice of a membrane and a solute. It can be used to calculate the valueof any of these parameters, provided the other two and the molar volume[Formula: see text] of the solute are known. The formula couldbe very useful, in particular when measurements of the parameters aredifficult or even impossible.

Political Science: Building relationships and trust with lawmakers (Invited)

NASA Astrophysics Data System (ADS)

Unruh Cohen, A. L.

2013-12-01

Energy and climate policies are important drivers of domestic and international politics. They are also sources of controversy and polarization. Input from scientists is critical to identifying problems and their solutions for our domestic and international energy and climate challenges. I will discuss how issues come to the attention of lawmakers, how they determine the solutions they wish to pursue and how scientists can meaningfully engage in that process. Based on my experience working on energy and climate legislation in Congress for the last decade, I will provide practical advice on establishing trust and developing relationships with lawmakers.

Interlaminar stresses in composite laminates: A perturbation analysis

NASA Technical Reports Server (NTRS)

Hsu, P. W.; Herakovich, C. T.

1976-01-01

A general method of solution for an elastic balanced symmetric composite laminate subject to a uniaxial extension was developed based upon a perturbation analysis of a limiting free body containing an interfacial plane. The solution satisfies more physical requirements and boundary conditions than previous investigations, and predicts smooth continuous interlaminar stresses with no instabilities. It determines the finite maximum intensity for the interlaminar normal stress in all laminates, provides mathematical evidences for the singular stresses in angle-ply laminates, suggests the need for the experimental determination of an important problem parameter, and introduces a viable means for solving related problems of practical interest.

The Biopsychosocial-Digital Approach to Health and Disease: Call for a Paradigm Expansion

PubMed Central

2018-01-01

Digital health is an advancing phenomenon in modern health care systems. Currently, numerous stakeholders in various countries are evaluating the potential benefits of digital health solutions at the individual, population, and/or organizational levels. Additionally, driving factors are being created from the customer-side of the health care systems to push health care providers, policymakers, or researchers to embrace digital health solutions. However, health care providers may differ in their approach to adopt these solutions. Health care providers are not assumed to be appropriately trained to address the requirements of integrating digital health solutions into daily everyday practices and procedures. To adapt to the changing demands of health care systems, it is necessary to expand relevant paradigms and to train human resources as required. In this article, a more comprehensive paradigm will be proposed, based on the ‘biopsychosocial model’ of assessing health and disease, originally introduced by George L Engel. The “biopsychosocial model” must be leveraged to include a “digital” component, thus suggesting a ‘biopsychosocial-digital’ approach to health and disease. Modifications to the “biopsychosocial” model and transition to the “biopsychosocial-digital” model are explained. Furthermore, the emerging implications of understanding health and disease are clarified pertaining to their relevance in training human resources for health care provision and research. PMID:29776900

Meteoroid/Debris Shielding

NASA Technical Reports Server (NTRS)

Christiansen, Eric L.

2003-01-01

This report provides innovative, low-weight shielding solutions for spacecraft and the ballistic limit equations that define the shield's performance in the meteoroid/debris environment. Analyses and hypervelocity impact testing results are described that have been used in developing the shields and equations. Spacecraft shielding design and operational practices described in this report are used to provide effective spacecraft protection from meteoroid and debris impacts. Specific shield applications for the International Space Station (ISS), Space Shuttle Orbiter and the CONTOUR (Comet Nucleus Tour) space probe are provided. Whipple, Multi-Shock and Stuffed Whipple shield applications are described.

The big hurt: Trauma system funding in today's health care environment.

PubMed

Geehan, Douglas

2010-01-01

Trauma systems provide effective care of the injured patient but require major financial costs in readiness and availability of the extensive trauma team and specialized equipment. Traditional billing and collection practices do not fully recoup these costs. Effective use of the standard billing system is vital to the stability of a trauma system; however, a system wide funding mechanism provides an optimal, stable foundation. Efforts to provide sustainable trauma system funding are ongoing. Numerous state initiatives have been successful in funding trauma systems but a universal solution has yet to be found.

Selected problems associated with the treatment and care for patients with colostomy – part 2

PubMed Central

Kachaniuk, Hanna; Szadowska-Szlachetka, Zdzisława; Charzyńska-Gula, Marianna; Kocka, Katarzyna; Bartoszek, Agnieszka; Celej-Szuster, Jolanta

2013-01-01

Generally, ostomy is a purposeful connection of the lumen of the intestine with abdominal integuments by surgery. The study presents practical solutions related to care for the colostomy patient, i.e. an ostomy on the large intestine. The following issues will be discussed: regulating the defecation cycle, risk connected with improper selection of ostomy equipment, instruction on colostomy irrigation with practical advice and irrigation equipment supply. The knowledge of these rules and mastering them in practice is to provide ostomy patients not only with highest-standard care and help but also to prepare them for dealing with problems independently, i.e. for self-care. PMID:24596509

Artificial intelligence in medicine: the challenges ahead.

PubMed

Coiera, E W

1996-01-01

The modern study of artificial intelligence in medicine (AIM) is 25 years old. Throughout this period, the field has attracted many of the best computer scientists, and their work represents a remarkable achievement. However, AIM has not been successful-if success is judged as making an impact on the practice of medicine. Much recent work in AIM has been focused inward, addressing problems that are at the crossroads of the parent disciplines of medicine and artificial intelligence. Now, AIM must move forward with the insights that it has gained and focus on finding solutions for problems at the heart of medical practice. The growing emphasis within medicine on evidence-based practice should provide the right environment for that change.

Formative assessment as a vehicle for changing classroom practice in a specific cultural context

NASA Astrophysics Data System (ADS)

Chen, Jingping

2015-09-01

In this commentary, I interpret Xinying Yin and Gayle Ann Buck's collaborative action research from a social-cultural perspective. Classroom implementation of formative assessment is viewed as interaction between this assessment method and the local learning culture. I first identify Yin and Buck's definition of the formative assessment, and then analyze the role of formative assessment in the change of local learning culture. Based on the practice of Yin and Buck I emphasize the significance of their "bottom up" strategy to the teachers' epistemological change. I believe that this strategy may provide practicable solutions to current Chinese educational problems as well as a means for science educators to shift toward systematic professional development.

Integrated Concentration in Science (iCons): Undergraduate Education Through Interdisciplinary, Team-Based, Real-World Problem Solving

NASA Astrophysics Data System (ADS)

Tuominen, Mark

2013-03-01

Attitude, Skills, Knowledge (ASK) - In this order, these are fundamental characteristics of scientific innovators. Through first-hand practice in using science to unpack and solve complex real-world problems, students can become self-motivated scientific leaders. This presentation describes the pedagogy of a recently developed interdisciplinary undergraduate science education program at the University of Massachusetts Amherst focused on addressing global challenges with scientific solutions. Integrated Concentration in Science (iCons) is an overarching concentration program that supplements the curricula provided within each student's chosen major. iCons is a platform for students to perform student-led research in interdisciplinary collaborative teams. With a schedule of one course per year over four years, the cohort of students move through case studies, analysis of real-world problems, development of potential solutions, integrative communication, laboratory practice, and capstone research projects. In this presentation, a track emphasizing renewable energy science is used to illustrate the iCons pedagogical methods. This includes discussion of a third-year laboratory course in renewable energy that is educationally scaffolded: beginning with a boot camp in laboratory techniques and culminating with student-designed research projects. Among other objectives, this course emphasizes the practice of using reflection and redesign, as a means of generating better solutions and embedding learning for the long term. This work is supported in part by NSF grant DUE-1140805.

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

NASA Astrophysics Data System (ADS)

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

1997-01-01

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

A corrosion control manual for rail rapid transit

NASA Technical Reports Server (NTRS)

Gilbert, L. O.; Fitzgerald, J. F., II; Menke, J. T.

1982-01-01

In 1979, during the planning stage of the Metropolitan Dade County Transit System, the need was expressed for a corrosion control manual oriented to urban rapid transit system use. This manual responds to that need. The objective of the manual is to aid rail rapid transit agencies by providing practical solutions to selected corrosion problems. The scope of the manual encompasses corrosion problems of the facilities of rapid transit systems: structures and tracks, platforms and stations, power and signals, and cars. It also discusses stray electric current corrosion. Both design and maintenance solutions are provided for each problem. Also included are descriptions of the types of corrosion and their causes, descriptions of rapid transit properties, a list of corrosion control committees and NASA, DOD, and ASTM specifications and design criteria to which reference is made in the manual. A bibliography of papers and excerpts of reports and a glossary of frequency used terms are provided.

Understanding facilitators and barriers to reengineering the clinical research enterprise in community-based practice settings.

PubMed

Kukafka, Rita; Allegrante, John P; Khan, Sharib; Bigger, J Thomas; Johnson, Stephen B

2013-09-01

Solutions are employed to support clinical research trial tasks in community-based practice settings. Using the IT Implementation Framework (ITIF), an integrative framework intended to guide the synthesis of theoretical perspectives for planning multi-level interventions to enhance IT use, we sought to understand the barriers and facilitators to clinical research in community-based practice settings preliminary to implementing new informatics solutions for improving clinical research infrastructure. The studies were conducted in practices within the Columbia University Clinical Trials Network. A mixed-method approach, including surveys, interviews, time-motion studies, and observations was used. The data collected, which incorporates predisposing, enabling, and reinforcing factors in IT use, were analyzed according to each phase of ITIF. Themes identified in the first phase of ITIF were 1) processes and tools to support clinical trial research and 2) clinical research peripheral to patient care processes. Not all of the problems under these themes were found to be amenable to IT solutions. Using the multi-level orientation of the ITIF, we set forth strategies beyond IT solutions that can have an impact on reengineering clinical research tasks in practice-based settings. Developing strategies to target enabling and reinforcing factors, which focus on organizational factors, and the motivation of the practice at large to use IT solutions to integrate clinical research tasks with patient care processes, is most challenging. The ITIF should be used to consider both IT and non-IT solutions concurrently for reengineering of clinical research in community-based practice settings. © 2013.

Capacity planning for waste management systems: an interval fuzzy robust dynamic programming approach.

PubMed

Nie, Xianghui; Huang, Guo H; Li, Yongping

2009-11-01

This study integrates the concepts of interval numbers and fuzzy sets into optimization analysis by dynamic programming as a means of accounting for system uncertainty. The developed interval fuzzy robust dynamic programming (IFRDP) model improves upon previous interval dynamic programming methods. It allows highly uncertain information to be effectively communicated into the optimization process through introducing the concept of fuzzy boundary interval and providing an interval-parameter fuzzy robust programming method for an embedded linear programming problem. Consequently, robustness of the optimization process and solution can be enhanced. The modeling approach is applied to a hypothetical problem for the planning of waste-flow allocation and treatment/disposal facility expansion within a municipal solid waste (MSW) management system. Interval solutions for capacity expansion of waste management facilities and relevant waste-flow allocation are generated and interpreted to provide useful decision alternatives. The results indicate that robust and useful solutions can be obtained, and the proposed IFRDP approach is applicable to practical problems that are associated with highly complex and uncertain information.

Branding an anatomic pathology practice to build revenue.

PubMed

Johnson, Paul

2004-01-01

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

Hawai'i Island Health Workforce Assessment 2008.

PubMed

Withy, Kelley; Andaya, January; Vitousek, Sharon; Sakamoto, David

2009-12-01

Anecdotal reports of a doctor shortage on the Big Island have been circulating for years, but a detailed assessment of the health care workforce had not previously been accomplished. The Hawai'i Island Health Workforce Assessment used licensure data, focus groups, telephone follow up to provider offices, national estimates of average provider supply and analysis of insurance claims data to assess the extent of the existing medical and mental health workforce, approximate how many additional providers might be effectively utilized, develop a population-based estimate of future demand and identify causes and potential solutions for the challenges faced. As of February 2008, the researchers were able to locate 310 practicing physicians, 36 nurse practitioners, 6 physician assistants, 51 psychologists, 57 social workers and 42 other mental health providers. Based on national averages, claims analysis and focus groups, the Island could use approximately 45 additional medical professionals to care for the 85% of the population that is medically insured; a larger number to care for the entire population. Ascertaining a complete roster of mental health professionals was not possible using this methodology. The researchers compared the current supply of physicians with the national average of physicians to population and the number of visits to different specialists for the year 2006 and found specific regional shortages of providers. The focus groups concentrated on solutions to the workforce crisis that include the formation of a well-organized, broad collaboration to coordinate recruitment efforts, expand and strengthen retention and renewal activities, and reinvigorate the health profession pipeline and training opportunities. The researchers recommend collaboration between the community, government, business, health center care providers, hospitals and centers to develop a plan before the tenuous state of healthcare on the Big Island worsens. In addition, continued surveillance of the health workforce is vital to tracking the impact of interventions. This could be accomplished through community informants and data collected at the time of professional relicensure to include practice location and practice intensions for future planning estimates.

RISQy business (Relationships, Incentives, Supports, and Quality): evolution of the British Columbia Model of Primary Care (patient-centered medical home).

PubMed

MacCarthy, Dan; Hollander, Marcus J

2014-01-01

In 2002, the British Columbia Ministry of Health and the British Columbia Medical Association (now Doctors of BC) came together to form the British Columbia General Practice Services Committee to bring about transformative change in primary care in British Columbia, Canada. This committee's approach to primary care was to respond to an operational problem--the decline of family practice in British Columbia--with an operational solution--assist general practitioners to provide better care by introducing new incentive fees into the fee-for-service payment schedule, and by providing additional training to general practitioners. This may be referred to as a "soft power" approach, which can be summarized in the abbreviation RISQ: focus on Relationships; provide Incentives for general practitioners to spend more time with their patients and provide guidelines-based care; Support general practitioners by developing learning modules to improve their practices; and, through the incentive payments and learning modules, provide better Quality care to patients and improved satisfaction to physicians. There are many similarities between the British Columbian approach to primary care and the US patient-centered medical home.

Medicine for the City: Perspective and Solidarity as Tools for Making Urban Health.

PubMed

Fullilove, Mindy Thompson; Cantal-Dupart, Michel

2016-06-01

The United States has pursued policies of urban upheaval that have undermined social organization, dispersed people, particularly African Americans, and increased rates of disease and disorder. Healthcare institutions have been, and can be, a part of this problem or a part of the solution. This essay addresses two tools that healthcare providers can use to repair the urban ecosystem-perspective and solidarity. Perspective addresses both our ability to envision solutions and our ability to see in the space in which we move. Solidarity is our ability to appreciate our fellowship with other people, a mindset that is at the heart of medical practice. These two tools lay the foundation for structurally competent healthcare providers to act in a restorative manner to create a health-giving built environment.

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

NASA Astrophysics Data System (ADS)

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

2005-04-01

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

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

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

Shah, Monisha; Burr, Andrew; Schulte, Andrew

2016-08-26

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

Investigation of hydrophobic substrates for solution residue analysis utilizing an ambient desorption liquid sampling-atmospheric pressure glow discharge microplasma.

PubMed

Paing, Htoo W; Marcus, R Kenneth

2018-03-12

A practical method for preparation of solution residue samples for analysis utilizing the ambient desorption liquid sampling-atmospheric pressure glow discharge optical emission spectroscopy (AD-LS-APGD-OES) microplasma is described. Initial efforts involving placement of solution aliquots in wells drilled into copper substrates, proved unsuccessful. A design-of-experiment (DOE) approach was carried out to determine influential factors during sample deposition including solution volume, solute concentration, number of droplets deposited, and the solution matrix. These various aspects are manifested in the mass of analyte deposited as well as the size/shape of the product residue. Statistical analysis demonstrated that only those initial attributes were significant factors towards the emission response of the analyte. Various approaches were investigated to better control the location/uniformity of the deposited sample. Three alternative substrates, a glass slide, a poly(tetrafluoro)ethylene (PTFE) sheet, and a polydimethylsiloxane (PDMS)-coated glass slide, were evaluated towards the microplasma analytical performance. Co-deposition with simple organic dyes provided an accurate means of determining the location of the analyte with only minor influence on emission responses. The PDMS-coated glass provided the best performance by virtue of its providing a uniform spatial distribution of the residue material. This uniformity yielded an improved limits of detection by approximately 22× for 20 μL and 4 x for 2 μL over the other two substrates. While they operate by fundamentally different processes, this choice of substrate is not restricted to the LS-APGD, but may also be applicable to other AD methods such as DESI, DART, or LIBS. Further developments will be directed towards a field-deployable ambient desorption OES source for quantitative analysis of microvolume solution residues of nuclear forensics importance.

Endodontic 'solutions' part 1: a literature review on the use of endodontic lubricants, irrigants and medicaments.

PubMed

Good, Melissa; El, Karim Ikhlas A; Hussey, David L

2012-05-01

Endodontic lubricants, irrigants and medicaments help prepare and disinfect root canal systems (RCS) but primary and secondary cases involve different microbes and therefore it is unlikely that one protocol will be effective for both case types. Each individual 'solution' or sequence of'solutions' could play a significant role in each case type, but there are no detailed published guidelines in existence. To help inform clinical practice it was decided to undertake a literature review followed by a UK and Republic of Ireland wide audit on current endodontic'solution' usage within dental schools. The literature review was undertaken under the following headings: pre-op oral rinse; file lubricants; root canal irrigants and intracanal medicaments and provides an evidence base for protocol development for both primary and retreatment cases.The audit project and the protocols developed from the findings of both the literature review and audit will be presented in Part 2.

Some aspects of strategies and solutions in accident prevention.

PubMed

Häkkinen, K

1983-04-01

Accident prevention measures are traditionally classified into technical, organizational and behavioral solutions. A review of some commonly used strategies for accident prevention illustrates some discrepancies between different approaches and the need to develop more comprehensive strategies. Several factors, including protective efficiency and disadvantages at work, must be taken into account when the solutions are evaluated. Some solutions to prevent load disengagement from cranes were evaluated. Measurements of the pressing force showed that the efficiency of the safety latch of a clamp for plate lifting is inadequate to provide protection under all exceptional lifting conditions and in all situations for which the safety latch is intended. The delay caused by the attachment of a lifting hook equipped with a safety latch was measured. The handling of some of the most reliable and technically safe latches requires additional operations and thereby limits their practical application.

The solar textile challenge: how it will not work and where it might.

PubMed

Krebs, Frederik C; Hösel, Markus

2015-03-01

Solar textiles are highlighted as a future technology with transformative power within the fields of both textiles and solar cells provided that developments are made in critical areas. Specifically, these are fundamental solutions to materials and material combinations with mechanical stability and flexibility imposed by textile architectures, scientific solutions to achieve high carrier transport efficiency and optical transmission in a textile topology, technical solutions to controlling the physical disposition of the anode and cathode along with their specific and error-free contacting and, finally, practical solutions to fast and efficient manufacture and integration. The areas of application and the penetration of solar textiles into our everyday life are expected to be explosive pending efficient developments within these four key areas. A shortcoming in one or more of these will, however, lead to the solar textiles being banned to academic existence. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Clinical data interoperability based on archetype transformation.

PubMed

Costa, Catalina Martínez; Menárguez-Tortosa, Marcos; Fernández-Breis, Jesualdo Tomás

2011-10-01

The semantic interoperability between health information systems is a major challenge to improve the quality of clinical practice and patient safety. In recent years many projects have faced this problem and provided solutions based on specific standards and technologies in order to satisfy the needs of a particular scenario. Most of such solutions cannot be easily adapted to new scenarios, thus more global solutions are needed. In this work, we have focused on the semantic interoperability of electronic healthcare records standards based on the dual model architecture and we have developed a solution that has been applied to ISO 13606 and openEHR. The technological infrastructure combines reference models, archetypes and ontologies, with the support of Model-driven Engineering techniques. For this purpose, the interoperability infrastructure developed in previous work by our group has been reused and extended to cover the requirements of data transformation. Copyright © 2011 Elsevier Inc. All rights reserved.

Patterning technology for solution-processed organic crystal field-effect transistors

PubMed Central

Li, Yun; Sun, Huabin; Shi, Yi; Tsukagoshi, Kazuhito

2014-01-01

Organic field-effect transistors (OFETs) are fundamental building blocks for various state-of-the-art electronic devices. Solution-processed organic crystals are appreciable materials for these applications because they facilitate large-scale, low-cost fabrication of devices with high performance. Patterning organic crystal transistors into well-defined geometric features is necessary to develop these crystals into practical semiconductors. This review provides an update on recentdevelopment in patterning technology for solution-processed organic crystals and their applications in field-effect transistors. Typical demonstrations are discussed and examined. In particular, our latest research progress on the spin-coating technique from mixture solutions is presented as a promising method to efficiently produce large organic semiconducting crystals on various substrates for high-performance OFETs. This solution-based process also has other excellent advantages, such as phase separation for self-assembled interfaces via one-step spin-coating, self-flattening of rough interfaces, and in situ purification that eliminates the impurity influences. Furthermore, recommendations for future perspectives are presented, and key issues for further development are discussed. PMID:27877656

SPIRIT: Systematic Planning of Intelligent Reuse of Integrated Clinical Routine Data. A Conceptual Best-practice Framework and Procedure Model.

PubMed

Hackl, W O; Ammenwerth, E

2016-01-01

Secondary use of clinical routine data is receiving an increasing amount of attention in biomedicine and healthcare. However, building and analysing integrated clinical routine data repositories are nontrivial, challenging tasks. As in most evolving fields, recognized standards, well-proven methodological frameworks, or accurately described best-practice approaches for the systematic planning of solutions for secondary use of routine medical record data are missing. We propose a conceptual best-practice framework and procedure model for the systematic planning of intelligent reuse of integrated clinical routine data (SPIRIT). SPIRIT was developed based on a broad literature overview and further refined in two case studies with different kinds of clinical routine data, including process-oriented nursing data from a large hospital group and high-volume multimodal clinical data from a neurologic intensive care unit. SPIRIT aims at tailoring secondary use solutions to specific needs of single departments without losing sight of the institution as a whole. It provides a general conceptual best-practice framework consisting of three parts: First, a secondary use strategy for the whole organization is determined. Second, comprehensive analyses are conducted from two different viewpoints to define the requirements regarding a clinical routine data reuse solution at the system level from the data perspective (BOTTOM UP) and at the strategic level from the future users perspective (TOP DOWN). An obligatory clinical context analysis (IN BETWEEN) facilitates refinement, combination, and integration of the different requirements. The third part of SPIRIT is dedicated to implementation, which comprises design and realization of clinical data integration and management as well as data analysis solutions. The SPIRIT framework is intended to be used to systematically plan the intelligent reuse of clinical routine data for multiple purposes, which often was not intended when the primary clinical documentation systems were implemented. SPIRIT helps to overcome this gap. It can be applied in healthcare institutions of any size or specialization and allows a stepwise setup and evolution of holistic clinical routine data reuse solutions.

A new and inexpensive non-bit-for-bit solution reproducibility test based on time step convergence (TSC1.0)

DOE PAGES

Wan, Hui; Zhang, Kai; Rasch, Philip J.; ...

2017-02-03

A test procedure is proposed for identifying numerically significant solution changes in evolution equations used in atmospheric models. The test issues a fail signal when any code modifications or computing environment changes lead to solution differences that exceed the known time step sensitivity of the reference model. Initial evidence is provided using the Community Atmosphere Model (CAM) version 5.3 that the proposed procedure can be used to distinguish rounding-level solution changes from impacts of compiler optimization or parameter perturbation, which are known to cause substantial differences in the simulated climate. The test is not exhaustive since it does not detect issues associatedmore » with diagnostic calculations that do not feedback to the model state variables. Nevertheless, it provides a practical and objective way to assess the significance of solution changes. The short simulation length implies low computational cost. The independence between ensemble members allows for parallel execution of all simulations, thus facilitating fast turnaround. The new method is simple to implement since it does not require any code modifications. We expect that the same methodology can be used for any geophysical model to which the concept of time step  convergence is applicable.« less

A tool to measure whether business management capacity in general practice impacts on the quality of chronic illness care.

PubMed

Holton, Christine H; Proudfoot, Judith G; Jayasinghe, Upali W; Grimm, Jane; Bubner, Tanya K; Winstanley, Julie; Harris, Mark F; Beilby, Justin J

2010-11-01

Our aim was to develop a tool to identify specific features of the business and financial management of practices that facilitate better quality care for chronic illness in primary care. Domains of management were identified, resulting in the development of a structured interview tool that was administered in 97 primary care practices in Australia. Interview items were screened and subjected to factor analysis, subscales identified and the overall model fit determined. The instrument's validity was assessed against another measure of quality of care. Analysis provided a four-factor solution containing 21 items, which explained 42.5% of the variance in the total scores. The factors related to administrative processes, human resources, marketing analysis and business development. All scores increased significantly with practice size. The business development subscale and total score were higher for rural practices. There was a significant correlation between the business development subscale and quality of care. The indicators of business and financial management in the final tool appear to be useful predictors of the quality of care. The instrument may help inform policy regarding the structure of general practice and implementation of a systems approach to chronic illness care. It can provide information to practices about areas for further development.

Optimal placement of multiple types of communicating sensors with availability and coverage redundancy constraints

NASA Astrophysics Data System (ADS)

Vecherin, Sergey N.; Wilson, D. Keith; Pettit, Chris L.

2010-04-01

Determination of an optimal configuration (numbers, types, and locations) of a sensor network is an important practical problem. In most applications, complex signal propagation effects and inhomogeneous coverage preferences lead to an optimal solution that is highly irregular and nonintuitive. The general optimization problem can be strictly formulated as a binary linear programming problem. Due to the combinatorial nature of this problem, however, its strict solution requires significant computational resources (NP-complete class of complexity) and is unobtainable for large spatial grids of candidate sensor locations. For this reason, a greedy algorithm for approximate solution was recently introduced [S. N. Vecherin, D. K. Wilson, and C. L. Pettit, "Optimal sensor placement with terrain-based constraints and signal propagation effects," Unattended Ground, Sea, and Air Sensor Technologies and Applications XI, SPIE Proc. Vol. 7333, paper 73330S (2009)]. Here further extensions to the developed algorithm are presented to include such practical needs and constraints as sensor availability, coverage by multiple sensors, and wireless communication of the sensor information. Both communication and detection are considered in a probabilistic framework. Communication signal and signature propagation effects are taken into account when calculating probabilities of communication and detection. Comparison of approximate and strict solutions on reduced-size problems suggests that the approximate algorithm yields quick and good solutions, which thus justifies using that algorithm for full-size problems. Examples of three-dimensional outdoor sensor placement are provided using a terrain-based software analysis tool.

From 'solution shop' model to 'focused factory' in hospital surgery: increasing care value and predictability.

PubMed

Cook, David; Thompson, Jeffrey E; Habermann, Elizabeth B; Visscher, Sue L; Dearani, Joseph A; Roger, Veronique L; Borah, Bijan J

2014-05-01

The full-service US hospital has been described organizationally as a "solution shop," in which medical problems are assumed to be unstructured and to require expert physicians to determine each course of care. If universally applied, this model contributes to unwarranted variation in care, which leads to lower quality and higher costs. We purposely disrupted the adult cardiac surgical practice that we led at Mayo Clinic, in Rochester, Minnesota, by creating a "focused factory" model (characterized by a uniform approach to delivering a limited set of high-quality products) within the practice's solution shop. Key elements of implementing the new model were mapping the care process, segmenting the patient population, using information technology to communicate clearly defined expectations, and empowering nonphysician providers at the bedside. Using a set of criteria, we determined that the focused-factory model was appropriate for 67 percent of cardiac surgical patients. We found that implementation of the model reduced resource use, length-of-stay, and cost. Variation was markedly reduced, and outcomes were improved. Assigning patients to different care models increases care value and the predictability of care process, outcomes, and costs while preserving (in a lesser clinical footprint) the strengths of the solution shop. We conclude that creating a focused-factory model within a solution shop, by applying industrial engineering principles and health information technology tools and changing the model of work, is very effective in both improving quality and reducing costs.

Retrofit implementation of Zernike phase plate imaging for cryo-TEM

PubMed Central

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

2011-01-01

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

Managerial and professional collaboration in the provision of home care rehabilitation.

PubMed

Hollis, Vivien; May, Laura

2005-01-01

Demand for home care rehabilitation continues to grow in response to faster hospital discharges. One solution is to expand rehabilitation services using therapist assistants. Professionals voice concerns regarding many instances of assistants providing interventions outside their expertise and practicing without therapist supervision. This paper provides principles elicited from practitioners' experiences of an effective management culture and collaboration in one home care organization that effectively assimilated assistants, with reports of consequent improvements to rehabilitation service and client outcomes.

Strategies for Providing Low-Cost Water Immersion Therapy With Limited Resources.

PubMed

Brickhouse, Brenda; Isaacs, Christine; Batten, Meghann; Price, Amber

At our university-affiliated medical center, a major renovation of the women's health and birthing unit resulted in the temporary loss of the permanent tub used for water immersion therapy during labor. Because 40 percent of the women in the nurse-midwifery practice utilize hydrotherapy, we undertook a rigorous search for an interim solution. We developed a safe and cost-effective strategy that can be easily replicated and utilized by others to provide hydrotherapy for laboring women. © 2015 AWHONN.

Application of Multi-Hypothesis Sequential Monte Carlo for Breakup Analysis

NASA Astrophysics Data System (ADS)

Faber, W. R.; Zaidi, W.; Hussein, I. I.; Roscoe, C. W. T.; Wilkins, M. P.; Schumacher, P. W., Jr.

As more objects are launched into space, the potential for breakup events and space object collisions is ever increasing. These events create large clouds of debris that are extremely hazardous to space operations. Providing timely, accurate, and statistically meaningful Space Situational Awareness (SSA) data is crucial in order to protect assets and operations in space. The space object tracking problem, in general, is nonlinear in both state dynamics and observations, making it ill-suited to linear filtering techniques such as the Kalman filter. Additionally, given the multi-object, multi-scenario nature of the problem, space situational awareness requires multi-hypothesis tracking and management that is combinatorially challenging in nature. In practice, it is often seen that assumptions of underlying linearity and/or Gaussianity are used to provide tractable solutions to the multiple space object tracking problem. However, these assumptions are, at times, detrimental to tracking data and provide statistically inconsistent solutions. This paper details a tractable solution to the multiple space object tracking problem applicable to space object breakup events. Within this solution, simplifying assumptions of the underlying probability density function are relaxed and heuristic methods for hypothesis management are avoided. This is done by implementing Sequential Monte Carlo (SMC) methods for both nonlinear filtering as well as hypothesis management. This goal of this paper is to detail the solution and use it as a platform to discuss computational limitations that hinder proper analysis of large breakup events.

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

ERIC Educational Resources Information Center

Tracey, Monica W.; Unger, Kelly L.

2012-01-01

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

Continuum of eLearning: 2012 Project Summary Report

DTIC Science & Technology

2012-10-01

Taylor, Emilie Reitz, Kathleen Bartlett, and John Killilea DSCI MESH Solutions General Dynamics Information Technology 12601...goes on to write , “Joint Knowledge Online ( JKO) provides a Joint Indi- vidual Training Toolkit of web enabled individual and small group training...the interviews, we compiled relevant best practices from the academic literature. We call these “practical” limitations be- cause the technology and

Enhancing Learning Management Systems Utility for Blind Students: A Task-Oriented, User-Centered, Multi-Method Evaluation Technique

ERIC Educational Resources Information Center

Babu, Rakesh; Singh, Rahul

2013-01-01

This paper presents a novel task-oriented, user-centered, multi-method evaluation (TUME) technique and shows how it is useful in providing a more complete, practical and solution-oriented assessment of the accessibility and usability of Learning Management Systems (LMS) for blind and visually impaired (BVI) students. Novel components of TUME…

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

ERIC Educational Resources Information Center

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

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

Robust authentication through stochastic femtosecond laser filament induced scattering surfaces

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

Zhang, Haisu; Tzortzakis, Stelios, E-mail: stzortz@iesl.forth.gr; Materials Science and Technology Department, University of Crete, 71003 Heraklion

2016-05-23

We demonstrate a reliable authentication method by femtosecond laser filament induced scattering surfaces. The stochastic nonlinear laser fabrication nature results in unique authentication robust properties. This work provides a simple and viable solution for practical applications in product authentication, while also opens the way for incorporating such elements in transparent media and coupling those in integrated optical circuits.

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

ERIC Educational Resources Information Center

O'Reilly, Naziya

2017-01-01

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

An Analysis of Governance Policies and Practices in One School District Regarding English Learners

ERIC Educational Resources Information Center

Lysko, V. Lynn

2012-01-01

In a large, urban, high school district, secondary English-learning students are not achieving at the same rates as other identified subgroups on state and local standardized tests. This gap compounds economic and social inequities in the region. A solution to the problem is important to educators and policy makers in providing an equitable…

Work, Productivity, and Human Performance: Practical Case Studies in Ergonomics, Human Factors and Human Engineering.

ERIC Educational Resources Information Center

Fraser, T. M.; Pityn, P. J.

This book contains 12 case histories, each based on a real-life problem, that show how a manager can use common sense, knowledge, and interpersonal skills to solve problems in human performance at work. Each case study describes a worker's problem and provides background information and an assignment; solutions are suggested. The following cases…

Systems solutions by lactic acid bacteria: from paradigms to practice

PubMed Central

2011-01-01

Lactic acid bacteria are among the powerhouses of the food industry, colonize the surfaces of plants and animals, and contribute to our health and well-being. The genomic characterization of LAB has rocketed and presently over 100 complete or nearly complete genomes are available, many of which serve as scientific paradigms. Moreover, functional and comparative metagenomic studies are taking off and provide a wealth of insight in the activity of lactic acid bacteria used in a variety of applications, ranging from starters in complex fermentations to their marketing as probiotics. In this new era of high throughput analysis, biology has become big science. Hence, there is a need to systematically store the generated information, apply this in an intelligent way, and provide modalities for constructing self-learning systems that can be used for future improvements. This review addresses these systems solutions with a state of the art overview of the present paradigms that relate to the use of lactic acid bacteria in industrial applications. Moreover, an outlook is presented of the future developments that include the transition into practice as well as the use of lactic acid bacteria in synthetic biology and other next generation applications. PMID:21995776

From Nonclinical Research to Clinical Trials and Patient-registries: Challenges and Opportunities in Biomedical Research

PubMed Central

de la Torre Hernández, José M.; Edelman, Elazer R.

2018-01-01

The most important challenge faced by human beings is health. The only way to provide better solutions for health care is innovation, true innovation. The only source of true innovation is research, good research indeed. The pathway from a basic science study to a randomized clinical trial is long and not free of bumps and even landmines. These are all the obstacles and barriers that limit the availability of resources, entangle administrative-regulatory processes, and restrain investigators’ initiatives. There is increasing demand for evidence to guide clinical practice but, paradoxically, biomedical research has become increasingly complex, expensive, and difficult to integrate into clinical care with increased barriers to performing the practical aspects of investigation. We face the challenge of increasing the volume of biomedical research and simultaneously improving the efficiency and output of this research. In this article, we review the main stages and methods of biomedical research, from nonclinical studies with animal and computational models to randomized trials and clinical registries, focusing on their limitations and challenges, but also providing alternative solutions to overcome them. Fortunately, challenges are always opportunities in disguise. PMID:28838647

Non-linear eigensolver-based alternative to traditional SCF methods

NASA Astrophysics Data System (ADS)

Gavin, Brendan; Polizzi, Eric

2013-03-01

The self-consistent iterative procedure in Density Functional Theory calculations is revisited using a new, highly efficient and robust algorithm for solving the non-linear eigenvector problem (i.e. H(X)X = EX;) of the Kohn-Sham equations. This new scheme is derived from a generalization of the FEAST eigenvalue algorithm, and provides a fundamental and practical numerical solution for addressing the non-linearity of the Hamiltonian with the occupied eigenvectors. In contrast to SCF techniques, the traditional outer iterations are replaced by subspace iterations that are intrinsic to the FEAST algorithm, while the non-linearity is handled at the level of a projected reduced system which is orders of magnitude smaller than the original one. Using a series of numerical examples, it will be shown that our approach can outperform the traditional SCF mixing techniques such as Pulay-DIIS by providing a high converge rate and by converging to the correct solution regardless of the choice of the initial guess. We also discuss a practical implementation of the technique that can be achieved effectively using the FEAST solver package. This research is supported by NSF under Grant #ECCS-0846457 and Intel Corporation.

Who to Blame: Irrational Decision-Makers or Stupid Modelers? (Arne Richter Award for Outstanding Young Scientists Lecture)

NASA Astrophysics Data System (ADS)

Madani, Kaveh

2016-04-01

Water management benefits from a suite of modelling tools and techniques that help simplifying and understanding the complexities involved in managing water resource systems. Early water management models were mainly concerned with optimizing a single objective, related to the design, operations or management of water resource systems (e.g. economic cost, hydroelectricity production, reliability of water deliveries). Significant improvements in methodologies, computational capacity, and data availability over the last decades have resulted in developing more complex water management models that can now incorporate multiple objectives, various uncertainties, and big data. These models provide an improved understanding of complex water resource systems and provide opportunities for making positive impacts. Nevertheless, there remains an alarming mismatch between the optimal solutions developed by these models and the decisions made by managers and stakeholders of water resource systems. Modelers continue to consider decision makers as irrational agents who fail to implement the optimal solutions developed by sophisticated and mathematically rigours water management models. On the other hand, decision makers and stakeholders accuse modelers of being idealist, lacking a perfect understanding of reality, and developing 'smart' solutions that are not practical (stable). In this talk I will have a closer look at the mismatch between the optimality and stability of solutions and argue that conventional water resources management models suffer inherently from a full-cooperation assumption. According to this assumption, water resources management decisions are based on group rationality where in practice decisions are often based on individual rationality, making the group's optimal solution unstable for individually rational decision makers. I discuss how game theory can be used as an appropriate framework for addressing the irrational "rationality assumption" of water resources management models and for better capturing the social aspects of decision making in water management systems with multiple stakeholders.

Reprocessing anesthesia instruments and devices.

PubMed

Ball, K

2000-02-01

Reprocessing anesthesia instruments and devices can often present a challenge for anesthesia providers because anesthesia devices have become more complex, cross-contamination with disease-forming pathogens can occur, and the importance of appropriate reprocessing may not be fully understood. Based on accepted practice recommendations, regulations, and research, reprocessing must be performed by skilled individuals who understand asepsis, cleaning, disinfection, and sterilization principles. This article describes the art of reprocessing and includes highlighted information on recommended practices, Spaulding's classifications, personal protective attire, precleaning, leak testing of flexible endoscopes, device disassembly, cleaning supplies and solutions, cleaning methods, rinsing, reassembly of the device, inspection, disinfection, and sterilization.

Field modeling and ray-tracing of a miniature scanning electron microscope beam column.

PubMed

Loyd, Jody S; Gregory, Don A; Gaskin, Jessica A

2017-08-01

A miniature scanning electron microscope (SEM) focusing column design is introduced and its potential performance assessed through an estimation of parameters that affect the probe radius, to include source size, spherical and chromatic aberration, diffraction and space charge broadening. The focusing column, a critical component of any SEM capable of operating on the lunar surface, was developed by the NASA Marshall Space Flight Center and Advanced Research Systems. The ray-trace analysis presented uses a model of the electrostatic field (within the focusing column) that is first calculated using the boundary element method (BEM). This method provides flexibility in modeling the complex electrode shapes of practical electron lens systems. A Fourier series solution of the lens field is then derived within a cylindrical domain whose boundary potential is provided by the BEM. Used in this way, the Fourier series solution is an accuracy enhancement to the BEM solution, allowing sufficient precision to assess geometric aberrations through direct ray-tracing. Two modes of operation with distinct lens field solutions are described. © The Author 2017. Published by Oxford University Press on behalf of The Japanese Society of Microscopy. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

A zonal method for modeling powered-lift aircraft flow fields

NASA Technical Reports Server (NTRS)

Roberts, D. W.

1989-01-01

A zonal method for modeling powered-lift aircraft flow fields is based on the coupling of a three-dimensional Navier-Stokes code to a potential flow code. By minimizing the extent of the viscous Navier-Stokes zones the zonal method can be a cost effective flow analysis tool. The successful coupling of the zonal solutions provides the viscous/inviscid interations that are necessary to achieve convergent and unique overall solutions. The feasibility of coupling the two vastly different codes is demonstrated. The interzone boundaries were overlapped to facilitate the passing of boundary condition information between the codes. Routines were developed to extract the normal velocity boundary conditions for the potential flow zone from the viscous zone solution. Similarly, the velocity vector direction along with the total conditions were obtained from the potential flow solution to provide boundary conditions for the Navier-Stokes solution. Studies were conducted to determine the influence of the overlap of the interzone boundaries and the convergence of the zonal solutions on the convergence of the overall solution. The zonal method was applied to a jet impingement problem to model the suckdown effect that results from the entrainment of the inviscid zone flow by the viscous zone jet. The resultant potential flow solution created a lower pressure on the base of the vehicle which produces the suckdown load. The feasibility of the zonal method was demonstrated. By enhancing the Navier-Stokes code for powered-lift flow fields and optimizing the convergence of the coupled analysis a practical flow analysis tool will result.

Practical solution concepts for planning and designing roadways in Kentucky.

DOT National Transportation Integrated Search

2008-10-01

Kentucky's highway agency has embarked upon an initiative tagged "Practical Solutions" which sets its goal toward reducing costs throughout the project development process extended into operations and maintenance of all highway facilities. This study...

From Guide to Practice: Improving Your After School Science Program to Increase Student Academic Achievement

NASA Astrophysics Data System (ADS)

Taylor, J.

2013-12-01

Numerous science organizations, such as NASA, offer educational outreach activities geared towards after school. For some programs, the primary goal is to grow students' love of science. For others, the programs are also intended to increase academic achievement. For those programs looking to support student learning in out-of-school time environments, aligning the program with learning during the classroom day can be a challenge. The Institute for Education Sciences, What Works Clearinghouse, put together a 'Practice Guide' for maximizing learning time beyond the regular school day. These practice guides provide concrete recommendations for educators supported by research. While this guide is not specific to any content or subject-area, the recommendations provided align very well with science education. After school science is often viewed as a fun, dynamic environment for students. Indeed, one of the recommendations to ensure time is structured according to students' needs is to provide relevant and interesting experiences. Given that our after school programs provide such creative environments for students, what other components are needed to promote increased academic achievement? The recommendations provided to academic achievement, include: 1. Align Instruction, 2. Maximize Attendance and Participation, 3. Adapt Instruction, 4. Provide Engaging Experiences, and 5. Evaluate Program. In this session we will examine these five recommendations presented in the Practice Guide, discuss how these strategies align with science programs, and examine what questions each program should address in order to provide experiences that lend themselves to maximizing instruction. Roadblocks and solutions for overcoming challenges in each of the five areas will be presented. Jessica Taylor will present this research based on her role as an author on the Practice Guide, 'Improving Academic Achievement in Out-of-School Time' and her experience working in various informal science programs for NASA.

Consumer-driven and commercialised practice in dentistry: an ethical and professional problem?

PubMed

Holden, A C L

2018-03-20

The rise and persistence of a commercial model of healthcare and the potential shift towards the commodification of dental services, provided to consumers, should provoke thought about the nature and purpose of dentistry and whether this paradigm is cause for concern. Within this article, whether dentistry is a commodity and the legitimacy of dentistry as a business is explored and assessed. Dentistry is perceived to be a commodity, dependent upon the context of how services are to be provided and the interpretation of the patient-professional relationship. Commercially-focused practices threaten the fiduciary nature of the interaction between consumer and provider. The solution to managing commercial elements within dentistry is not through rejection of the new paradigm of the consumer of dental services, but in the rejection of competitive practices, coercive advertising and the erosion of professional values and duty. Consumerism may bring empowerment to those accessing dental services. However, if the patient-practitioner relationship is reduced to a mere transaction in the name of enhanced consumer participation, this empowerment is but a myth.

Foundational ethics of the health care system: the moral and practical superiority of free market reforms.

PubMed

Sade, Robert M

2008-10-01

Proposed solutions to the problems of this country's health care system range along a spectrum from central planning to free market. Central planners and free market advocates provide various ethical justifications for the policies they propose. The crucial flaw in the philosophical rationale of central planning is failure to distinguish between normative and metanormative principles, which leads to mistaken understanding of the nature of rights. Natural rights, based on the principle of noninterference, provide the link between individual morality and social order. Free markets, the practical expression of natural rights, are uniquely capable of achieving the goals that central planners seek but find beyond their grasp. The history of this country's health care system and the experiences of other nations provide evidence of the superiority of free markets in reaching for the goals of universal access, control of costs, and sustaining the quality of health care.

Modeling individual effects in the Cormack-Jolly-Seber Model: A state-space formulation

USGS Publications Warehouse

Royle, J. Andrew

2008-01-01

In population and evolutionary biology, there exists considerable interest in individual heterogeneity in parameters of demographic models for open populations. However, flexible and practical solutions to the development of such models have proven to be elusive. In this article, I provide a state-space formulation of open population capture-recapture models with individual effects. The state-space formulation provides a generic and flexible framework for modeling and inference in models with individual effects, and it yields a practical means of estimation in these complex problems via contemporary methods of Markov chain Monte Carlo. A straightforward implementation can be achieved in the software package WinBUGS. I provide an analysis of a simple model with constant parameter detection and survival probability parameters. A second example is based on data from a 7-year study of European dippers, in which a model with year and individual effects is fitted.

Critical Race Theory and the Limits of Relational Theory in Social Work with Women.

PubMed

Quinn, Camille R; Grumbach, Giesela

2015-01-01

The authors present a conceptual framework for expanding the use of relational theory with African-American women. Relational theory (RT) informs practice with women but is inadequate in addressing all aspects of culture and identity. RT presumes that all women desire or are able to make therapeutic connections, yet race, gender, and cultural experiences influence their ability to do so. Successful practice with minority women must address racism and its impact. Critical race theory (CRT) that incorporates a solution-focused (SF) approach is well-suited to address the limits of RT. This overview of a CRT/SF approach describes treatment for diverse women that extends RT and enhances effective social work practice to provide culturally sensitive treatment to women.

Artificial intelligence in medicine: the challenges ahead.

PubMed Central

Coiera, E W

1996-01-01

The modern study of artificial intelligence in medicine (AIM) is 25 years old. Throughout this period, the field has attracted many of the best computer scientists, and their work represents a remarkable achievement. However, AIM has not been successful-if success is judged as making an impact on the practice of medicine. Much recent work in AIM has been focused inward, addressing problems that are at the crossroads of the parent disciplines of medicine and artificial intelligence. Now, AIM must move forward with the insights that it has gained and focus on finding solutions for problems at the heart of medical practice. The growing emphasis within medicine on evidence-based practice should provide the right environment for that change. PMID:8930853

Advanced marketing: how to protect and advance your practice.

PubMed

Lexa, Frank James

2007-02-01

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

The ambiguity of patient-centred practices: the case of a Dutch fertility clinic.

PubMed

Gerrits, Trudie

2014-01-01

When in-vitro fertilization (IVF) was introduced in the 1970s, doctors were criticized for not properly informing prospective users about its possible risks and limited success rates as well as for medicalizing fertility problems. Nowadays, many fertility clinics are seeking to improve their accountability to stakeholders through patient-centred practices. Based on an ethnographic study of a Dutch fertility clinic, outspoken in its aims to provide patient-centred medicine and to empower clients, this paper addresses how patient-centred medicine affects couples' decision-making to use IVF and related reproductive technologies. The author contends that while patient-centred practices facilitate informed decision-making and support couples emotionally, they may also have unintended disciplining and normalizing effects. The information and support provided, the trust couples have in clinic staff, the ongoing visualization of conception mediated by medical technology--all can be seen as practices that strengthen lay people's 'medical gaze' in how they come to view their bodies, fertility problems and possible solutions. These unintended effects are labelled 'the ambiguity of patient-centeredness' as they (may) interfere with processes of autonomous decision-making.

Data based abnormality detection

NASA Astrophysics Data System (ADS)

Purwar, Yashasvi

Data based abnormality detection is a growing research field focussed on extracting information from feature rich data. They are considered to be non-intrusive and non-destructive in nature which gives them a clear advantage over conventional methods. In this study, we explore different streams of data based anomalies detection. We propose extension and revisions to existing valve stiction detection algorithm supported with industrial case study. We also explored the area of image analysis and proposed a complete solution for Malaria diagnosis. The proposed method is tested over images provided by pathology laboratory at Alberta Health Service. We also address the robustness and practicality of the solution proposed.

A wavelet approach to binary blackholes with asynchronous multitasking

NASA Astrophysics Data System (ADS)

Lim, Hyun; Hirschmann, Eric; Neilsen, David; Anderson, Matthew; Debuhr, Jackson; Zhang, Bo

2016-03-01

Highly accurate simulations of binary black holes and neutron stars are needed to address a variety of interesting problems in relativistic astrophysics. We present a new method for the solving the Einstein equations (BSSN formulation) using iterated interpolating wavelets. Wavelet coefficients provide a direct measure of the local approximation error for the solution and place collocation points that naturally adapt to features of the solution. Further, they exhibit exponential convergence on unevenly spaced collection points. The parallel implementation of the wavelet simulation framework presented here deviates from conventional practice in combining multi-threading with a form of message-driven computation sometimes referred to as asynchronous multitasking.

Analytic solution for quasi-Lambertian radiation transfer.

PubMed

Braun, Avi; Gordon, Jeffrey M

2010-02-10

An analytic solution is derived for radiation transfer between flat quasi-Lambertian surfaces of arbitrary orientation, i.e., surfaces that radiate in a Lambertian fashion but within a numerical aperture smaller than unity. These formulas obviate the need for ray trace simulations and provide exact, physically transparent results. Illustrative examples that capture the salient features of the flux maps and the efficiency of flux transfer are presented for a few configurations of practical interest. There is also a fundamental reciprocity relation for quasi-Lambertian exchange, akin to the reciprocity theorem for fully Lambertian surfaces. Applications include optical fiber coupling, fiber-optic biomedical procedures, and solar concentrators.

What Is Evidence-Based Behavior Analysis?

PubMed Central

Smith, Tristram

2013-01-01

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

The Peckham Health Centre, “PEP”, and the concept of general practice during the 1930s and 1940s

PubMed Central

Lewis, Jane; Brookes, Barbara

1983-01-01

This paper documents the proposals put forward by George Scott Williamson and Innes Pearse, founders of the Peckham Health Centre and members of the Political and Economic Planning (PEP) Health Group, to enhance the role and status of the general practitioner (GP). Their ideas are significant in terms of their understanding of the threat that specialism posed to general practice and of the problems of control and finance raised by reform. Their solution - the establishment of GP therapeutic centres or cells - is located in terms of their own ideas regarding health and medical practice and is compared with the other major proposal for group practice in health centres, which emanated from the Dawson Committee in 1920. Finally, the paper provides some suggestions as to the reason for their failure. PMID:6345961

Simple method to make a supersaturated oxygen fluid.

PubMed

Tange, Yoshihiro; Yoshitake, Shigenori; Takesawa, Shingo

2018-01-22

Intravenous oxygenation has demonstrated significant increase in partial pressure of oxygen (PO 2 ) in animal models. A highly dissolved oxygen solution might be able to provide a sufficient level of oxygen delivery to the tissues and organs in patients with hypoxia. However, conventional fluid oxygenation methods have required the use of original devices. If simpler oxygenation of a solution is possible, it will be a useful strategy for application in clinical practice. We simply developed its administration by injection of either air or oxygen gas into conventional saline. We determined the PO 2 values in the solutions in comparison with conventional saline in vitro. To examine the effects of the administration of the new solutions on the blood gas profile, we diluted bovine blood with either conventional or the new solutions and analyzed PO 2 , oxygen saturation (SO 2 ) and total oxygen content. PO 2 levels in the blood and new solution mixture significantly increased with each additional injected gas volume. Significant increases in the PO 2 and SO 2 of the bovine blood were found in those blood samples with the new solution, as compared with those with the control solution. These results suggest that this solution promotes oxygen delivery to the hypoxic tissue and recovery from hypoxia. This method is simpler and easier than previous methods.

Does social marketing provide a framework for changing healthcare practice?

PubMed

Morris, Zoë Slote; Clarkson, Peter John

2009-07-01

We argue that social marketing can be used as a generic framework for analysing barriers to the take-up of clinical guidelines, and planning interventions which seek to enable this change. We reviewed the literature on take-up of clinical guidelines, in particular barriers and enablers to change; social marketing principles and social marketing applied to healthcare. We then applied the social marketing framework to analyse the literature and to consider implications for future guideline policy to assess its feasibility and accessibility. There is sizeable extant literature on healthcare practitioners' non-compliance with clinical guidelines. This is an international problem common to a number of settings. The reasons for poor levels of take up appear to be well understood, but not addressed adequately in practice. Applying a social marketing framework brings new insights to the problem." We show that a social marketing framework provides a useful solution-focused framework for systematically understanding barriers to individual behaviour change and designing interventions accordingly. Whether the social marketing framework provides an effective means of bringing about behaviour change remains an empirical question which has still to be tested in practice. The analysis presented here provides strong motivation to begin such testing.

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

PubMed

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

2003-01-01

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

Can Economic Model Transparency Improve Provider Interpretation of Cost-effectiveness Analysis? Evaluating Tradeoffs Presented by the Second Panel on Cost-effectiveness in Health and Medicine.

PubMed

Padula, William V; McQueen, Robert Brett; Pronovost, Peter J

2017-11-01

The Second Panel on Cost-Effectiveness in Health and Medicine convened on December 7, 2016 at the National Academy of Medicine to disseminate their recommendations for conduct, methodological practices, and reporting of cost-effectiveness analyses (CEAs). Following its summary, panel proceedings included lengthy discussions including the field's struggle to disseminate findings efficiently through peer-reviewed literature to target audiences. With editors of several medical and outcomes research journals in attendance, there was consensus that findings of cost-effectiveness analyses do not effectively reach other researchers or health care providers. The audience members suggested several solutions including providing additional training to clinicians in cost-effectiveness research and requiring that cost-effectiveness models are made publicly available. However, there remains the questions of whether making economic modelers' work open-access through journals is fair under the defense that these models remain one's own intellectual property, or whether journals can properly manage the peer-review process specifically for cost-effectiveness analyses. In this article, we elaborate on these issues and provide some suggested solutions that may increase the dissemination and application of cost-effectiveness literature to reach its intended audiences and ultimately benefit the patient. Ultimately, it is our combined view as economic modelers and clinicians that cost-effectiveness results need to reach the clinician to improve the efficiency of medical practice, but that open-access models do not improve clinician access or interpretation of the economics of medicine.

Not at All Effective: Differences in Views on the Causes of Prescription Non-adherence Between North Korean Defectors and Medical Providers in South Korea.

PubMed

Hong, Soo Jung

2015-06-01

By focusing on North Korean defectors' medical experiences in South Korea and their medical providers' experiences treating the defectors, this article considers the differences between the views of these two groups in regard to the causes of prescription non-adherence. The results suggest that (a) whereas the defectors tended to see their symptoms as being physical in nature, the medical providers often ascribed symptoms to psychological/socio-cultural influence; (b) whereas the defectors tended to trust in their ability to self-diagnose and in their belief systems established in North Korea, the medical providers tended not to place trust in these aspects; (c) whereas the defectors tended to view the available medical treatment as inappropriate for them, the medical providers often noted the presence of tolerant bacterial strains as causes of treatment failure; and (d) whereas the defectors felt that the treatment they received was slow and ineffective and attributed this to capitalism, the medical providers felt that the defectors failed to understand the concept of staged treatments. Based on the findings, some solutions are suggested to address the complex issue of North Korean defectors' prescription non-adherence in terms of subjective/objective health assessments and patient-centered care. North Korean defectors' established health beliefs/lack of medical knowledge based on their previous medical and cultural experiences gave rise to beliefs and practices associated with medicine that differ significantly from those of the health providers and that have the potential to severely compromise the defectors' health. Therefore, therapy negotiation and appropriate education are suggested as possible solutions, and as an agenda, the notion of civic friendship is addressed. Implications for medical practice, prevention, and intervention are also discussed.

Electrochemistry at a Metal Nanoparticle on a Tunneling Film: A Steady-State Model of Current Densities at a Tunneling Ultramicroelectrode.

PubMed

Hill, Caleb M; Kim, Jiyeon; Bard, Allen J

2015-09-09

Here, a new methodology is proposed for treating electrochemical current densities in metal-insulator-metal nanoparticle (M-I-MNP) systems. The described model provides broad, practical insights about MNP-mediated electron transfer to redox species in solution, where electron transfer from the underlying electrode to a MNP via tunneling and heterogeneous electron transfer from the MNP to redox species in solution are treated as sequential steps. Tunneling is treated through an adaptation of the Simmons model of tunneling in metal-insulator-metal structures, and explicit equations are provided for tunneling currents, which demonstrate the effect of various experimental parameters, such as insulator thickness and MNP size. Overall, a general approach is demonstrated for determining experimental conditions where tunneling will have a measurable impact on the electrochemistry of M-I-MNP systems.

A general heuristic for genome rearrangement problems.

PubMed

Dias, Ulisses; Galvão, Gustavo Rodrigues; Lintzmayer, Carla Négri; Dias, Zanoni

2014-06-01

In this paper, we present a general heuristic for several problems in the genome rearrangement field. Our heuristic does not solve any problem directly, it is rather used to improve the solutions provided by any non-optimal algorithm that solve them. Therefore, we have implemented several algorithms described in the literature and several algorithms developed by ourselves. As a whole, we implemented 23 algorithms for 9 well known problems in the genome rearrangement field. A total of 13 algorithms were implemented for problems that use the notions of prefix and suffix operations. In addition, we worked on 5 algorithms for the classic problem of sorting by transposition and we conclude the experiments by presenting results for 3 approximation algorithms for the sorting by reversals and transpositions problem and 2 approximation algorithms for the sorting by reversals problem. Another algorithm with better approximation ratio can be found for the last genome rearrangement problem, but it is purely theoretical with no practical implementation. The algorithms we implemented in addition to our heuristic lead to the best practical results in each case. In particular, we were able to improve results on the sorting by transpositions problem, which is a very special case because many efforts have been made to generate algorithms with good results in practice and some of these algorithms provide results that equal the optimum solutions in many cases. Our source codes and benchmarks are freely available upon request from the authors so that it will be easier to compare new approaches against our results.

A Framework for Understanding Physics Students' Computational Modeling Practices

NASA Astrophysics Data System (ADS)

Lunk, Brandon Robert

With the growing push to include computational modeling in the physics classroom, we are faced with the need to better understand students' computational modeling practices. While existing research on programming comprehension explores how novices and experts generate programming algorithms, little of this discusses how domain content knowledge, and physics knowledge in particular, can influence students' programming practices. In an effort to better understand this issue, I have developed a framework for modeling these practices based on a resource stance towards student knowledge. A resource framework models knowledge as the activation of vast networks of elements called "resources." Much like neurons in the brain, resources that become active can trigger cascading events of activation throughout the broader network. This model emphasizes the connectivity between knowledge elements and provides a description of students' knowledge base. Together with resources resources, the concepts of "epistemic games" and "frames" provide a means for addressing the interaction between content knowledge and practices. Although this framework has generally been limited to describing conceptual and mathematical understanding, it also provides a means for addressing students' programming practices. In this dissertation, I will demonstrate this facet of a resource framework as well as fill in an important missing piece: a set of epistemic games that can describe students' computational modeling strategies. The development of this theoretical framework emerged from the analysis of video data of students generating computational models during the laboratory component of a Matter & Interactions: Modern Mechanics course. Student participants across two semesters were recorded as they worked in groups to fix pre-written computational models that were initially missing key lines of code. Analysis of this video data showed that the students' programming practices were highly influenced by their existing physics content knowledge, particularly their knowledge of analytic procedures. While this existing knowledge was often applied in inappropriate circumstances, the students were still able to display a considerable amount of understanding of the physics content and of analytic solution procedures. These observations could not be adequately accommodated by the existing literature of programming comprehension. In extending the resource framework to the task of computational modeling, I model students' practices in terms of three important elements. First, a knowledge base includes re- sources for understanding physics, math, and programming structures. Second, a mechanism for monitoring and control describes students' expectations as being directed towards numerical, analytic, qualitative or rote solution approaches and which can be influenced by the problem representation. Third, a set of solution approaches---many of which were identified in this study---describe what aspects of the knowledge base students use and how they use that knowledge to enact their expectations. This framework allows us as researchers to track student discussions and pinpoint the source of difficulties. This work opens up many avenues of potential research. First, this framework gives researchers a vocabulary for extending Resource Theory to other domains of instruction, such as modeling how physics students use graphs. Second, this framework can be used as the basis for modeling expert physicists' programming practices. Important instructional implications also follow from this research. Namely, as we broaden the use of computational modeling in the physics classroom, our instructional practices should focus on helping students understand the step-by-step nature of programming in contrast to the already salient analytic procedures.

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

PubMed

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

2018-05-04

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

The Third National Telemedicine & Telehealth Service Provider Showcase Conference: Advancing Telehealth Partnerships.

PubMed

Alverson, Dale C; Krupinski, Elizabeth A; Erps, Kristine A; Rowe, Nancy S; Weinstein, Ronald S

2018-05-31

As telemedicine and telehealth services are experiencing increasing rates of adoption, industry leaders and healthcare service providers are becoming increasingly focused on human resource issues encountered in the delivery of a broad range of telehealth services. To create a forum for the discussion of many interrelated elements of telehealth service industry, a national conference entitled "Telemedicine & Telehealth Service Provider Showcase" (SPS) Conference was established in 2014, and repeated in 2016 and 2017, in Arizona. These SPS Conferences include thought leaders, telehealth service providers, government administrators, and academicians from leading programs addressing service provider workforce issues. This report summarizes the content of SPS 2017 conference, held in Phoenix, AZ, October 2-3, 2017. The topics covered at SPS 2017 include using telehealth services as a strategic asset; development of appropriate effective partnerships; direct-to-consumer initiatives; important reimbursement, legislative, and regulatory issues (i.e., Centers for Medicare & Medicaid Services [CMS] approaches, financial models, and return on investment [ROI]); marketing; evaluation and applied metrics; remote monitoring and sensors; integration with electronic health records; and overall lessons learned. The content of SPS 2017 is summarized in the body of this report. The SPS 2017 program evaluators included attendees, speakers, and exhibitors. The knowledge attendees gained at SPS 2017 was characterized, by all three groups, as forward-looking and practical. SPS 2017 succeeded in identifying, and focusing on, solutions for issues, challenges, and barriers impacting the rapidly expanding telehealth service segment of the healthcare industry. The growing interest in this annual SPS Conference series apparently reflects, in part, the program committee's successes in identifying practical issues and their potential solutions.

Architecture of high-rise buildings as a brand of the modern Kazakhstan

NASA Astrophysics Data System (ADS)

Abdrassilova, Gulnara; Kozbagarova, Nina; Tuyakayeva, Ainagul

2018-03-01

Using practical examples article reviews urban-planning and space-planning features of design and construction of high-rise buildings in Kazakhstan conditions; methods are identified that provide for structural stability against wind and seismic loads based on innovative technical and technological solutions. Article authors stress out the fashion function of high-rise buildings in the new capital of Kazakhstan, the Astana city.

Making Waves: Career Development and Public Policy. International Symposium 1999 Papers, Proceedings, and Strategies (Ottawa, Ontario, Canada, May 2-4, 1999).

ERIC Educational Resources Information Center

Hiebert, Bryan, Ed.; Bezanson, Lynne, Ed.

People in many countries are experimenting with solutions to changes in the structure and delivery of career development services. As a result, there is vast opportunity to learn from, and be guided by, exemplary practices from other countries. The International Symposium is designed to provide such opportunities, and to give policymakers and…

The Toll of Too Much Technology on Teens' Mental Health.

PubMed

Solecki, Susan; Fay-Hillier, Theresa

2015-01-01

Technology is here to stay, and forbidding adolescents to access electronic media may not be a sustainable solution. Pediatric health care providers should include technology use and the parents' knowledge of the child's technology use, in their screening practices with patients. With the guidance of pediatric nurses, parents and children together can collaborate on ways to maximize the benefits of technology and decrease its risks.

Priorities in health care: reply to Lewis and Charny.

PubMed Central

Lamb, David

1989-01-01

This paper is a reply to proposals to base priority health-care decisions on public opinion surveys. Whilst it is recognised that current practice is less than satisfactory, it is argued here that basing health-care priorities on societal attitudes in this way is not a solution and does not provide a satisfactory basis for bringing democracy to the health service. PMID:11644371

A Social Science Guide for Communication on Climate Change

NASA Astrophysics Data System (ADS)

St John, C.; Marx, S.; Markowitz, E.

2014-12-01

Researchers from the Center for Research on Environmental Decisions (CRED) published "The Psychology of Climate Change Communication: A Guide for Scientists, Journalists, Educators, Political Aides, and the Interested Public" in 2009. This landmark guide provided climate change communicators a synthesis of the social science research that was pertinent to understanding how people think about climate change and how the practice could be improved. In the fall of 2014 this guide will be rereleased, with a new title, and in a partnership between CRED and ecoAmerica. The updated guide addresses how and why Americans respond in certain ways to climate change and explains how communicators can apply best practices to their own work. The guide, which includes research from a range of social science fields including psychology, anthropology, communications, and behavioral economics, is designed to be useful for experienced and novice communicators alike. Included in the guide are strategies to boost engagement, common mistakes to avoid, and best practices that organizations around the world have used to meaningfully engage individuals and groups on climate change. The proposed presentation will provide an overview of the main findings and tips from the 2014 climate change communication guide. It will provide a deeper look at a few of the key points that are crucial for increasing audience engagement with climate change including understanding how identity shapes climate change, how to lead with solutions, and how to bring the impacts of climate change close to home. It will highlight tips for motivating positive behavior change that will lead people down the path toward solutions. Finally, it will address the benefits and challenges associated with producing a communication guide and insight into synthesizing social science research findings into a usable format for a variety of audiences.

Introducing the Postsecondary Instructional Practices Survey (PIPS): A Concise, Interdisciplinary, and Easy-to-Score Survey

PubMed Central

Walter, Emily M.; Henderson, Charles R.; Beach, Andrea L.; Williams, Cody T.

2016-01-01

Researchers, administrators, and policy makers need valid and reliable information about teaching practices. The Postsecondary Instructional Practices Survey (PIPS) is designed to measure the instructional practices of postsecondary instructors from any discipline. The PIPS has 24 instructional practice statements and nine demographic questions. Users calculate PIPS scores by an intuitive proportion-based scoring convention. Factor analyses from 72 departments at four institutions (N = 891) support a 2- or 5-factor solution for the PIPS; both models include all 24 instructional practice items and have good model fit statistics. Factors in the 2-factor model include (a) instructor-centered practices, nine items; and (b) student-centered practices, 13 items. Factors in the 5-factor model include (a) student–student interactions, six items; (b) content delivery, four items; (c) formative assessment, five items; (d) student-content engagement, five items; and (e) summative assessment, four items. In this article, we describe our development and validation processes, provide scoring conventions and outputs for results, and describe wider applications of the instrument. PMID:27810868

Using Registered Dental Hygienists to Promote a School-Based Approach to Dental Public Health

PubMed Central

Wellever, Anthony; Kelly, Patricia

2017-01-01

We examine a strategy for improving oral health in the United States by focusing on low-income children in school-based settings. Vulnerable children often experience cultural, social, economic, structural, and geographic barriers when trying to access dental services in traditional dental office settings. These disparities have been discussed for more than a decade in multiple US Department of Health and Human Services publications. One solution is to revise dental practice acts to allow registered dental hygienists increased scope of services, expanded public health delivery opportunities, and decreased dentist supervision. We provide examples of how federally qualified health centers have implemented successful school-based dental models within the parameters of two state policies that allow registered dental hygienists varying levels of dentist supervision. Changes to dental practice acts at the state level allowing registered dental hygienists to practice with limited supervision in community settings, such as schools, may provide vulnerable populations greater access to screening and preventive services. We derive our recommendations from expert opinion. PMID:28661808

Trench Safety–Using a Qualitative Approach to Understand Barriers and Develop Strategies to Improve Trenching Practices

PubMed Central

FLYNN, MICHAEL A.; SAMPSON, JULIE M.

2015-01-01

Despite efforts to ensure workplace safety and health, injuries and fatalities related to trenching and excavation remain alarmingly high in the construction industry. Because properly installed trenching protective systems can potentially reduce the significant number of trenching fatalities, there is clearly a need to identify the barriers to the use of these systems and to develop strategies to ensure these systems are utilized consistently. The current study reports on the results of focus groups with construction workers and safety management personnel to better understand these barriers and to identify solutions. The results suggest several factors, from poor planning to pressures from experienced workers and supervisors, which present barriers to safe trenching practices. Based on the results, it is recommended that safety trainings incorporate unique messages for new workers, experienced workers and management in an effort to motivate each group to work safely as well as provide them with solutions to overcome the identified barriers. PMID:26550006

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

NASA Astrophysics Data System (ADS)

Oladoja, Nurudeen Abiola

2017-11-01

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

Developing Analytical Inspection Criteria for Health IT Personnel with Minimum Training in Cognitive Ergonomics: A Practical Solution to EHR Improving EHR Usability

PubMed Central

Zhang, Zhen; Franklin, Amy; Walji, Muhammad; Zhang, Jiajie; Gong, Yang

2014-01-01

EHR usability has been identified as a major barrier to care quality optimization. One major challenge of improving EHR usability is the lack of systematic training in usability or cognitive ergonomics for EHR designers/developers in the vendor community and EHR analysts making significant configurations in healthcare organizations. A practical solution is to provide usability inspection tools that can be easily operationalized by EHR analysts. This project is aimed at developing a set of usability tools with demonstrated validity and reliability. We present a preliminary study of a metric for cognitive transparency and an exploratory experiment testing its validity in predicting the effectiveness of action-effect mapping. Despite the pilot nature of both, we found high sensitivity and specificity of the metric and higher response accuracy within a shorter time for users to determine action-effect mappings in transparent user interface controls. We plan to expand the sample size in our empirical study. PMID:25954439

Implications of utility and deontology for the clinical nurse specialist.

PubMed

Ayres, L

1989-01-01

Faced with prospective payment plans and personnel shortages nurses in advanced clinical practice are under pressure to find practical solutions. These solutions may reflect the institutional philosophy of utility rather than the traditional nursing ethic of deontology, illustrating the need to examine the differences between utilitarian and deontological principles as they affect nursing practice. This paper discusses deontology and utility as they apply to nursing practice, considers how these different philosophical positions may affect advanced practitioners, and describes the current status of ethics in nursing.

Touchscreen questionnaire patient data collection in rheumatology practice: development of a highly successful system using process redesign.

PubMed

Newman, Eric D; Lerch, Virginia; Jones, J B; Stewart, Walter

2012-04-01

While questionnaires have been developed to capture patient-reported outcomes (PROs) in rheumatology practice, these instruments are not widely used. We developed a touchscreen interface designed to provide reliable and efficient data collection. Using the touchscreen to obtain PROs, we compared 2 different workflow models implemented separately in 2 rheumatology clinics. The Plan-Do-Study-Act methodology was used in 2 cycles of workflow redesign. Cycle 1 relied on off-the-shelf questionnaire builder software, and cycle 2 relied on a custom programmed software solution. During cycle 1, clinic 1 (private practice model, resource replete, simple flow) demonstrated a high completion rate at the start, averaging between 74% and 92% for the first 12 weeks. Clinic 2 (academic model, resource deficient, complex flow) did not achieve a consistent completion rate above 60%. The revised cycle 2 implementation protocol incorporated a 15-minute "nurse visit," an instant messaging system, and a streamlined authentication process, all of which contributed to substantial improvement in touchscreen questionnaire completion rates of ∼80% that were sustained without the need for any additional clinic staff support. Process redesign techniques and touchscreen technology were used to develop a highly successful, efficient, and effective process for the routine collection of PROs in a busy, complex, and resource-depleted academic practice and in typical private practice. The successful implementation required both a touchscreen questionnaire, human behavioral redesign, and other technical solutions. Copyright © 2012 by the American College of Rheumatology.

Tonometer disinfection practice in the United Kingdom: a national survey.

PubMed

Hillier, R J; Kumar, N

2008-08-01

To assess current tonometer disinfection practice in the UK, and compare with published recommendations. Every ophthalmology unit with training recognition in the UK was contacted (n=155). A senior nurse at each institution completed a telephone questionnaire regarding local tonometer disinfection practice. The response rate was 100%. Thirty-five units (23%) reported exclusive use of disposable tonometer heads and were excluded from further analysis. One hundred and twenty units (77%) used either reusable or a combination of reusable and disposable tonometer heads. Where reusable heads were used, 80 units (67%) immersed them in a chlorine-based solution such as sodium hypochlorite or sodium dichloroisocyanurate. Others used isopropyl alcohol (18 units), hydrogen peroxide (12 units), chloramine (5 units), chlorhexidine (4 units) and peracetic acid (1 unit). Where a chlorine-based agent was used, the concentration of available chlorine ranged from 125 to 30 000 p.p.m., with 50 units (63%) using a concentration of less than 5 000 p.p.m. (i.e., inadequate based on published recommendations). Where the tonometer head was immersed in disinfectant between patients (n=101), 29 units (29%) provided just one tonometer head per practitioner, making adequate soak time between patients unlikely. Every unit replenished the disinfectant at least daily, deemed sufficient for most agents. However, hydrogen peroxide solutions should be replenished twice daily, which did not take place in nine units. This survey reveals disparity between current tonometer disinfection practice and published international recommendations, with some institutions using practices that may render patients susceptible to transmissible infection.

Building managed primary care practice networks to deliver better clinical care: a qualitative semi-structured interview study.

PubMed

Pawa, Jasmine; Robson, John; Hull, Sally

2017-11-01

Primary care practices are increasingly working in larger groups. In 2009, all 36 primary care practices in the London borough of Tower Hamlets were grouped geographically into eight managed practice networks to improve the quality of care they delivered. Quantitative evaluation has shown improved clinical outcomes. To provide insight into the process of network implementation, including the aims, facilitating factors, and barriers, from both the clinical and managerial perspectives. A qualitative study of network implementation in the London borough of Tower Hamlets, which serves a socially disadvantaged and ethnically diverse population. Nineteen semi-structured interviews were carried out with doctors, nurses, and managers, and were informed by existing literature on integrated care and GP networks. Interviews were recorded and transcribed, and thematic analysis used to analyse emerging themes. Interviewees agreed that networks improved clinical care and reduced variation in practice performance. Network implementation was facilitated by the balance struck between 'a given structure' and network autonomy to adopt local solutions. Improved use of data, including patient recall and peer performance indicators, were viewed as critical key factors. Targeted investment provided the necessary resources to achieve this. Barriers to implementing networks included differences in practice culture, a reluctance to share data, and increased workload. Commissioners and providers were positive about the implementation of GP networks as a way to improve the quality of clinical care in Tower Hamlets. The issues that arose may be of relevance to other areas implementing similar quality improvement programmes at scale. © British Journal of General Practice 2017.

Assessment of the accuracy of pharmacy students' compounded solutions using vapor pressure osmometry.

PubMed

Kolling, William M; McPherson, Timothy B

2013-04-12

OBJECTIVE. To assess the effectiveness of using a vapor pressure osmometer to measure the accuracy of pharmacy students' compounding skills. DESIGN. Students calculated the theoretical osmotic pressure (mmol/kg) of a solution as a pre-laboratory exercise, compared their calculations with actual values, and then attempted to determine the cause of any errors found. ASSESSMENT. After the introduction of the vapor pressure osmometer, the first-time pass rate for solution compounding has varied from 85% to 100%. Approximately 85% of students surveyed reported that the instrument was valuable as a teaching tool because it objectively assessed their work and provided immediate formative assessment. CONCLUSIONS. This simple technique of measuring compounding accuracy using a vapor pressure osmometer allowed students to see the importance of quality control and assessment in practice for both pharmacists and technicians.

Assessment of the Accuracy of Pharmacy Students’ Compounded Solutions Using Vapor Pressure Osmometry

PubMed Central

McPherson, Timothy B.

2013-01-01

Objective. To assess the effectiveness of using a vapor pressure osmometer to measure the accuracy of pharmacy students’ compounding skills. Design. Students calculated the theoretical osmotic pressure (mmol/kg) of a solution as a pre-laboratory exercise, compared their calculations with actual values, and then attempted to determine the cause of any errors found. Assessment. After the introduction of the vapor pressure osmometer, the first-time pass rate for solution compounding has varied from 85% to 100%. Approximately 85% of students surveyed reported that the instrument was valuable as a teaching tool because it objectively assessed their work and provided immediate formative assessment. Conclusions. This simple technique of measuring compounding accuracy using a vapor pressure osmometer allowed students to see the importance of quality control and assessment in practice for both pharmacists and technicians. PMID:23610476

Boosting standard order sets utilization through clinical decision support.

PubMed

Li, Haomin; Zhang, Yinsheng; Cheng, Haixia; Lu, Xudong; Duan, Huilong

2013-01-01

Well-designed standard order sets have the potential to integrate and coordinate care by communicating best practices through multiple disciplines, levels of care, and services. However, there are several challenges which certainly affected the benefits expected from standard order sets. To boost standard order sets utilization, a problem-oriented knowledge delivery solution was proposed in this study to facilitate access of standard order sets and evaluation of its treatment effect. In this solution, standard order sets were created along with diagnostic rule sets which can trigger a CDS-based reminder to help clinician quickly discovery hidden clinical problems and corresponding standard order sets during ordering. Those rule set also provide indicators for targeted evaluation of standard order sets during treatment. A prototype system was developed based on this solution and will be presented at Medinfo 2013.

Command and Control Concepts and Solutions for Major Events Safety and Security: Lessons Learned from the Canadian Experience with Vancouver 2010 and G8/G20 Events

DTIC Science & Technology

2011-06-01

discuss best practices and the prerogatives of major events C2 solutions. In section 6, we present the conclusion. 2 Complexity of the Command and Control...best practices for sharing information, standard operating procedure (SOPs) and response plans have been investigated through formal studies and an...and contributed to the deployment of an information sharing solution on Command Network. This solution was based on Microsoft SharePoint. The team

Scotland's Knowledge Network: translating knowledge into action to improve quality of care.

PubMed

Wales, A; Graham, S; Rooney, K; Crawford, A

2012-11-01

The Knowledge Network (www.knowledge.scot.nhs.uk) is Scotland's online knowledge service for health and social care. It is designed to support practitioners to apply knowledge in frontline delivery of care, helping to translate knowledge into better health-care outcomes through safe, effective, person-centred care. The Knowledge Network helps to combine the worlds of evidence-based practice and quality improvement by providing access to knowledge about the effectiveness of clinical interventions ('know-what') and knowledge about how to implement this knowledge to support individual patients in working health-care environments ('know-how'). An 'evidence and guidance' search enables clinicians to quickly access quality-assured evidence and best practice, while point of care and mobile solutions provide knowledge in actionable formats to embed in clinical workflow. This research-based knowledge is complemented by social networking services and improvement tools which support the capture and exchange of knowledge from experience, facilitating practice change and systems improvement. In these cases, the Knowledge Network supports key components of the knowledge-to-action cycle--acquiring, creating, sharing and disseminating knowledge to improve performance and innovate. It provides a vehicle for implementing the recommendations of the national Knowledge into Action review, which outlines a new national approach to embedding knowledge in frontline practice and systems improvement.

Singular perturbation solutions of steady-state Poisson-Nernst-Planck systems.

PubMed

Wang, Xiang-Sheng; He, Dongdong; Wylie, Jonathan J; Huang, Huaxiong

2014-02-01

We study the Poisson-Nernst-Planck (PNP) system with an arbitrary number of ion species with arbitrary valences in the absence of fixed charges. Assuming point charges and that the Debye length is small relative to the domain size, we derive an asymptotic formula for the steady-state solution by matching outer and boundary layer solutions. The case of two ionic species has been extensively studied, the uniqueness of the solution has been proved, and an explicit expression for the solution has been obtained. However, the case of three or more ions has received significantly less attention. Previous work has indicated that the solution may be nonunique and that even obtaining numerical solutions is a difficult task since one must solve complicated systems of nonlinear equations. By adopting a methodology that preserves the symmetries of the PNP system, we show that determining the outer solution effectively reduces to solving a single scalar transcendental equation. Due to the simple form of the transcendental equation, it can be solved numerically in a straightforward manner. Our methodology thus provides a standard procedure for solving the PNP system and we illustrate this by solving some practical examples. Despite the fact that for three ions, previous studies have indicated that multiple solutions may exist, we show that all except for one of these solutions are unphysical and thereby prove the existence and uniqueness for the three-ion case.

A new sensitive method of dissociation constants determination based on the isohydric solutions principle.

PubMed

Michałowski, Tadeusz; Pilarski, Bogusław; Asuero, Agustin G; Dobkowska, Agnieszka

2010-10-15

The paper provides a new formulation and analytical proposals based on the isohydric solutions concept. It is particularly stated that a mixture formed, according to titrimetric mode, from a weak acid (HX, C(0)mol/L) and a strong acid (HB, Cmol/L) solutions, assumes constant pH, independently on the volumes of the solutions mixed, provided that the relation C(0)=C+C(2)·10(pK(1)) is valid, where pK(1)=-log K(1), K(1) the dissociation constant for HX. The generalized formulation, referred to the isohydric solutions thus obtained, was extended also to more complex acid-base systems. Particularly in the (HX, HB) system, the titration occurs at constant ionic strength (I) value, not resulting from presence of a basal electrolyte. This very advantageous conjunction of the properties provides, among others, a new, very sensitive method for verification of pK(1) value. The new method is particularly useful for weak acids HX characterized by low pK(1) values. The method was tested experimentally on four acid-base systems (HX, HB), in aqueous and mixed-solvent media and compared with the literature data. Some useful (linear and hyperbolic) correlations were stated and applied for validation of pK(1) values. Finally, some practical applications of analytical interest of the isohydricity (pH constancy) principle as one formulated in this paper were enumerated, proving the usefulness of such a property which has its remote roots in the Arrhenius concept. Copyright © 2010 Elsevier B.V. All rights reserved.

[Increasing cost of insulin therapy in Belgium. From a critical analysis of the situation to a search for practical solutions].

PubMed

Scheen, A J

2006-09-01

Cost related to insulin therapy is markedly increasing in Belgium, as in other Eucopean countries. In the present paper, we will briefly analyze the main reasons for such aa increase, integrate such observation withIn the global context of diabetes management and suggest some solutions to provide best care to insulin-treated diabetic patients at a reasonable cost. The rise of the cost of insulin therapy has a multifactorial origin. It mainly results from an increase in the number of diabetic patients, a more intensive management, In both type 1 and type 2 diabetes, and a greater use of more expansive insulin analogues. It is important to analyze the increase of the cost of insulin therapy within the global burden of diabetes melitus. Only a better responsibility of all health care partners, patients, physicians, pharmaceutical companies, public health authorities, could provide solutions allowing diabetic people to profit from best treatments they should receive in order to prevent diabetic complications, by far the main cause of expenses.

New Technical Solution for Vertical Shaft Equipping Using Steel Headframe of Multifunction Purpose

NASA Astrophysics Data System (ADS)

Kassikhina, Elena; Pershin, Vladimir; Glazkov, Yurij

2017-11-01

The article reviews a novel approach to the design of steel angle headframe for vertical shafts of coal and ore mines on the basis of rational design solutions. Practice of construction of coal and ore mines provides application of various designs for steel angle headframes which are divided into separate large assembly blocks and constructive elements during assembling operations. Design of these blocks and elements, their weight and dimensions effect the chose of the method of assembling on which economic and technological indicators, as well as duration of down-time, depend on during performance of construction operations in shaft. The technical solution on equipment provision for mine vertical shaft using headframe of multifunctional purpose will allow changing the management construction of vertical shaft. The constructive design of the headgear allows application of the effective method of assembly and thus to provide improvement of the technical and economic indexes, and high calendar time rate of the shaft construction due to reduction of duration of works on equipment provision for the shaft and to refurbishment of the shaft in order to carry out horizontal mining.

Safety of parenteral nutrition in newborns: Results from a nationwide prospective cohort study.

PubMed

Lapillonne, Alexandre; Berleur, Marie-Pierre; Brasseur, Yvette; Calvez, Sophie

2018-04-01

Limited or delayed availability of parenteral nutrition (PN) solutions, as well as difficulties in ordering are often identified as reasons for non-compliance with international guidelines in newborns. This study aims at assessing the modality of use and safety of premixed standardized PN solutions in a nationwide prospective cohort of newborns treated in clinical practice. Two premixed fixed formulations with respective osmolarity of 715 and 790 mOsm/L specifically designed for neonates were made available throughout the country for clinical use from birth onwards. Descriptive data and modality of use were prospectively collected in a case report form, whereas all related and unrelated adverse events were recorded on a separate adverse event form. A total of 14,167 infants were prospectively included and 16,640 parenteral nutrition periods were analyzed. Mean age was 33 weeks of gestation, and mean weight was 2086 g. The majority of infants (81%) started the parenteral nutrition the first day of life or the day after. The route of parenteral nutrition delivery was peripheral in 47% of the parenteral nutrition periods. During the whole study, a total of 72 adverse events occurring in 68 infants were reported. Of these adverse events, 59 (0.37% of the nutrition periods), among which 19 serious adverse events, were reported as related to the parenteral nutrition solutions. The events related to parenteral nutrition solutions were general disorders and administration site conditions (n = 42 including 9 cases of cutaneous necrosis), and nutrition and metabolism disorders (n = 17). There was no case of thrombophlebitis. Six of the 19 serious events related to the parenteral nutrition solutions (32%) were due to the misuse of the infusion bag. These data support the concept that ready-to-use parenteral nutrition formulations can safely provide parenteral nutrition from birth onwards. They further support that parenteral solutions with an osmolarity up to 800 mOsm/L are well-tolerated when infused on a peripheral vein. Considering the potential risk of errors and misuses, this study also highlights the need for nutrition practice care guidelines for neonates and for regular campaigns providing information and strategies for a safe use of parenteral nutrition solutions. Copyright © 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

A centralized platform for geo-distributed PACS management.

PubMed

Silva, Luís A Bastião; Pinho, Renato; Ribeiro, Luís S; Costa, Carlos; Oliveira, José Luís

2014-04-01

Picture Archive and Communication System (PACS) is a globally adopted concept and plays a fundamental role in patient care flow within healthcare institutions. However, the deployment of medical imaging repositories over multiple sites still brings several practical challenges namely related to operation and management (O&M). This paper describes a Web-based centralized console that provides remote monitoring, testing, and management over multiple geo-distributed PACS. The system allows the PACS administrator to define any kind of service or operation, reducing the need for local technicians and providing a 24/7 monitoring solution.

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

PubMed

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

2011-05-01

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

Multiple Choice Knapsack Problem: example of planning choice in transportation.

PubMed

Zhong, Tao; Young, Rhonda

2010-05-01

Transportation programming, a process of selecting projects for funding given budget and other constraints, is becoming more complex as a result of new federal laws, local planning regulations, and increased public involvement. This article describes the use of an integer programming tool, Multiple Choice Knapsack Problem (MCKP), to provide optimal solutions to transportation programming problems in cases where alternative versions of projects are under consideration. In this paper, optimization methods for use in the transportation programming process are compared and then the process of building and solving the optimization problems is discussed. The concepts about the use of MCKP are presented and a real-world transportation programming example at various budget levels is provided. This article illustrates how the use of MCKP addresses the modern complexities and provides timely solutions in transportation programming practice. While the article uses transportation programming as a case study, MCKP can be useful in other fields where a similar decision among a subset of the alternatives is required. Copyright 2009 Elsevier Ltd. All rights reserved.

Using MD simulations to calculate how solvents modulate solubility

PubMed Central

Liu, Shuai; Cao, Shannon; Hoang, Kevin; Young, Kayla L.; Paluch, Andrew S.; Mobley, David L.

2016-01-01

Here, our interest is in predicting solubility in general, and we focus particularly on predicting how the solubility of particular solutes is modulated by the solvent environment. Solubility in general is extremely important, both for theoretical reasons – it provides an important probe of the balance between solute-solute and solute-solvent interactions – and for more practical reasons, such as how to control the solubility of a given solute via modulation of its environment, as in process chemistry and separations. Here, we study how the change of solvent affects the solubility of a given compound. That is, we calculate relative solubilities. We use MD simulations to calculate relative solubility and compare our calculated values with experiment as well as with results from several other methods, SMD and UNIFAC, the latter of which is commonly used in chemical engineering design. We find that straightforward solubility calculations based on molecular simulations using a general small-molecule force field outperform SMD and UNIFAC both in terms of accuracy and coverage of the relevant chemical space. PMID:26878198

Online Solution of Two-Player Zero-Sum Games for Continuous-Time Nonlinear Systems With Completely Unknown Dynamics.

PubMed

Fu, Yue; Chai, Tianyou

2016-12-01

Regarding two-player zero-sum games of continuous-time nonlinear systems with completely unknown dynamics, this paper presents an online adaptive algorithm for learning the Nash equilibrium solution, i.e., the optimal policy pair. First, for known systems, the simultaneous policy updating algorithm (SPUA) is reviewed. A new analytical method to prove the convergence is presented. Then, based on the SPUA, without using a priori knowledge of any system dynamics, an online algorithm is proposed to simultaneously learn in real time either the minimal nonnegative solution of the Hamilton-Jacobi-Isaacs (HJI) equation or the generalized algebraic Riccati equation for linear systems as a special case, along with the optimal policy pair. The approximate solution to the HJI equation and the admissible policy pair is reexpressed by the approximation theorem. The unknown constants or weights of each are identified simultaneously by resorting to the recursive least square method. The convergence of the online algorithm to the optimal solutions is provided. A practical online algorithm is also developed. Simulation results illustrate the effectiveness of the proposed method.

Using Written Narratives in Public Health Practice: A Creative Writing Perspective

PubMed Central

Kreuter, Matthew W.

2014-01-01

Narratives have become an increasingly common health communication tool in recent years. Vivid, engaging writing can help audiences identify with storytellers and understand health messages, but few public health practitioners are trained to create such stories. A transdisciplinary perspective, informed by both creative writing advice and evidence-based public health practices, can help public health professionals use stories more effectively in their work. This article provides techniques for creating written narratives that communicate health information for chronic disease prevention. We guide public health professionals through the process of soliciting, writing, and revising such stories, and we discuss challenges and potential solutions. PMID:24901794

A multiple indicator solution approach to endogeneity in discrete-choice models for environmental valuation.

PubMed

Mariel, Petr; Hoyos, David; Artabe, Alaitz; Guevara, C Angelo

2018-08-15

Endogeneity is an often neglected issue in empirical applications of discrete choice modelling despite its severe consequences in terms of inconsistent parameter estimation and biased welfare measures. This article analyses the performance of the multiple indicator solution method to deal with endogeneity arising from omitted explanatory variables in discrete choice models for environmental valuation. We also propose and illustrate a factor analysis procedure for the selection of the indicators in practice. Additionally, the performance of this method is compared with the recently proposed hybrid choice modelling framework. In an empirical application we find that the multiple indicator solution method and the hybrid model approach provide similar results in terms of welfare estimates, although the multiple indicator solution method is more parsimonious and notably easier to implement. The empirical results open a path to explore the performance of this method when endogeneity is thought to have a different cause or under a different set of indicators. Copyright © 2018 Elsevier B.V. All rights reserved.

Conducting international nursing research: challenges and opportunities.

PubMed

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

2014-11-01

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

Digital technologies and chronic disease management.

PubMed

Georgeff, Michael

2014-12-01

Digital technologies will become a major part of our healthcare system, with particular impact in primary care. However, many healthcare professionals are not sufficiently informed of the digital technologies available today and how they and their patients can gain substantial benefit from adoption of these technologies. To raise awareness of the potential benefits of using digital technologies for improving practice efficiencies and patient health outcomes. Implementing best practice care for patients with chronic and complex conditions is one of the greatest challenges facing general practice and other primary care providers. It has been suggested that digital technologies could assist by decreasing the administrative burden of care delivery, improving quality of care, increasing practice efficiencies and better supporting patient self-management. In this paper, we consider some areas in the management of chronic and long-term conditions where digital and mobile health solutions can make a difference today.

Economic Incentives for Cybersecurity: Using Economics to Design Technologies Ready for Deployment

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

Vishik, Claire; Sheldon, Frederick T; Ott, David

Cybersecurity practice lags behind cyber technology achievements. Solutions designed to address many problems may and do exist but frequently cannot be broadly deployed due to economic constraints. Whereas security economics focuses on the cost/benefit analysis and supply/demand, we believe that more sophisticated theoretical approaches, such as economic modeling, rarely utilized, would derive greater societal benefits. Unfortunately, today technologists pursuing interesting and elegant solutions have little knowledge of the feasibility for broad deployment of their results and cannot anticipate the influences of other technologies, existing infrastructure, and technology evolution, nor bring the solutions lifecycle into the equation. Additionally, potentially viable solutionsmore » are not adopted because the risk perceptions by potential providers and users far outweighs the economic incentives to support introduction/adoption of new best practices and technologies that are not well enough defined. In some cases, there is no alignment with redominant and future business models as well as regulatory and policy requirements. This paper provides an overview of the economics of security, reviewing work that helped to define economic models for the Internet economy from the 1990s. We bring forward examples of potential use of theoretical economics in defining metrics for emerging technology areas, positioning infrastructure investment, and building real-time response capability as part of software development. These diverse examples help us understand the gaps in current research. Filling these gaps will be instrumental for defining viable economic incentives, economic policies, regulations as well as early-stage technology development approaches, that can speed up commercialization and deployment of new technologies in cybersecurity.« less

A/R systems reduce delayed and denied reimbursements.

PubMed

Escobar, Carlos

2007-01-01

The day-to-day benefits of a comprehensive billing and collections system are pro-active and preventive--administrators are increasingly learning that accelerating billings hastens collections and, ultimately, facility profitability. Effective billing and collections management services work closely with the facility, matching nightly "dumps" of patient files with transcripts. This marriage of otherwise disparate data creates a billing unit that reduces errors and ensures no billable procedures are lost. Ultimately, the goal of any medical practice that engages an ASP application or outsource solution is not to sit idly by while allowing a billing company to take control of a practice's revenue stream. The ability to track the billing process from transcript submission to payment provides a facility with all information necessary to manage cash flow, revenues, and even personal and practice financial planning.

Documenting Sociolinguistic Variation in Lesser-Studied Indigenous Communities: Challenges and Practical Solutions

ERIC Educational Resources Information Center

Mansfield, John; Stanford, James

2017-01-01

Documenting sociolinguistic variation in lesser-studied languages presents methodological challenges, but also offers important research opportunities. In this paper we examine three key methodological challenges commonly faced by researchers who are outsiders to the community. We then present practical solutions for successful variationist…

School Administration: Persistent Dilemmas in Preparation and Practice.

ERIC Educational Resources Information Center

Jacobson Stephen L., Ed.; Hickcox, Edward S., Ed.; Stevenson, Robert B., Ed.

Much of administrative preparation and practice centers on problem solving, developing alternative solutions, and selecting among competing alternatives for the most feasible solutions. Some of the persistent dilemmas resident in the training and the functioning of administrators are examined here by scholars and practitioners of educational…

Food for thought: obstacles to menu labelling in restaurants and cafeterias.

PubMed

Thomas, Erica

2016-08-01

Menu labelling is recommended as a policy intervention to reduce obesity and diet-related disease. The present commentary considers the many challenges the restaurant industry faces in providing nutrition information on its menus. Barriers include lack of nutrition expertise, time, cost, availability of nutrition information for exotic ingredients, ability to provide accurate nutrition information, libel risk, customer dissatisfaction, limited space on the menu, menu variations, loss of flexibility in changing the menu, staff training and resistance of employees to change current practice. Health promotion specialists and academics involved in fieldwork must help restaurateurs find solutions to these barriers for menu labelling interventions to be widely implemented and successful. Practical support for small independent restaurants such as free or subsidised nutrition analysis, nutrition training for staff and menu design may also be necessary to encourage voluntary participation.

Using relationship marketing to develop and sustain nurse loyalty: a case of a rural health care institution.

PubMed

Peltier, J W; Boyt, T; Westfall, J

1999-01-01

The prosperity of a health care organization is contingent on its ability to compete for and retain a high quality staff of "loyal" nurses. Although the benefits of maintaining a loyal nursing staff are obvious, turnover in the health care industry is dangerously high. One solution for reducing turnover is to develop and sustain a loyal nursing staff. The purpose of this article is to apply customer-oriented marketing theories and practices to better understand how strong nurse-provider relationships can be developed and maintained over time. The authors first examine relationship marketing literature as it applies to nurse relationship and management issues. Second, a framework for conceptualizing internal marketing efforts devoted to enhancing nursing staff satisfaction and retention in tested. Finally, strategies for practicing relationship marketing will be provided.

The Genesis of Cyberscience and its Mathematical Models (CYBERSCIENCE)

DTIC Science & Technology

2005-02-01

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

Planar-Processed Polymer Transistors.

PubMed

Xu, Yong; Sun, Huabin; Shin, Eul-Yong; Lin, Yen-Fu; Li, Wenwu; Noh, Yong-Young

2016-10-01

Planar-processed polymer transistors are proposed where the effective charge injection and the split unipolar charge transport are all on the top surface of the polymer film, showing ideal device characteristics with unparalleled performance. This technique provides a great solution to the problem of fabrication limitations, the ambiguous operating principle, and the performance improvements in practical applications of conjugated-polymer transistors. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Air Force Geophysics Laboratory Management Information System Study.

DTIC Science & Technology

1985-11-01

management information system (MIS) at AFGL. The study summarizes current management and administrative practices at AFGL. Requirements have been identified for automating several currently manual functions to compile accurate and timely information to better manage and plan AFGL programs. This document describes the functions and relative priorities of five MIS subsystems and provides suggestions for implementation solutions. Creation of a detailed Development Plan is recommended as the follow-on task.

Hypervalent surface interactions for colloidal stability and doping of silicon nanocrystals

PubMed Central

Wheeler, Lance M.; Neale, Nathan R.; Chen, Ting; Kortshagen, Uwe R.

2013-01-01

Colloidal semiconductor nanocrystals have attracted attention for cost-effective, solution-based deposition of quantum-confined thin films for optoelectronics. However, two significant challenges must be addressed before practical nanocrystal-based devices can be realized. The first is coping with the ligands that terminate the nanocrystal surfaces. Though ligands provide the colloidal stability needed to cast thin films from solution, these ligands dramatically hinder charge carrier transport in the resulting film. Second, after a conductive film is achieved, doping has proven difficult for further control of the optoelectronic properties of the film. Here we report the ability to confront both of these challenges by exploiting the ability of silicon to engage in hypervalent interactions with hard donor molecules. For the first time, we demonstrate the significant potential of applying the interaction to the nanocrystal surface. In this study, hypervalent interactions are shown to provide colloidal stability as well as doping of silicon nanocrystals. PMID:23893292

Telematic integration of health data: a practicable contribution.

PubMed

Guerriero, Lorenzo; Ferdeghini, Ezio M; Viola, Silvia R; Porro, Ivan; Testi, Angela; Bedini, Remo

2011-09-01

The patients' clinical and healthcare data should virtually be available everywhere, both to provide a more efficient and effective medical approach to their pathologies, as well as to make public healthcare decision makers able to verify the efficacy and efficiency of the adopted healthcare processes. Unfortunately, customised solutions adopted by many local Health Information Systems in Italy make it difficult to share the stored data outside their own environment. In the last years, worldwide initiatives have aimed to overcome such sharing limitation. An important issue during the passage towards standardised, integrated information systems is the possible loss of previously collected data. The herein presented project realises a suitable architecture able to guarantee reliable, automatic, user-transparent storing and retrieval of information from both modern and legacy systems. The technical and management solutions provided by the project avoid data loss and overlapping, and allow data integration and organisation suitable for data-mining and data-warehousing analysis.

Extended Analytic Device Optimization Employing Asymptotic Expansion

NASA Technical Reports Server (NTRS)

Mackey, Jonathan; Sehirlioglu, Alp; Dynsys, Fred

2013-01-01

Analytic optimization of a thermoelectric junction often introduces several simplifying assumptionsincluding constant material properties, fixed known hot and cold shoe temperatures, and thermallyinsulated leg sides. In fact all of these simplifications will have an effect on device performance,ranging from negligible to significant depending on conditions. Numerical methods, such as FiniteElement Analysis or iterative techniques, are often used to perform more detailed analysis andaccount for these simplifications. While numerical methods may stand as a suitable solution scheme,they are weak in gaining physical understanding and only serve to optimize through iterativesearching techniques. Analytic and asymptotic expansion techniques can be used to solve thegoverning system of thermoelectric differential equations with fewer or less severe assumptionsthan the classic case. Analytic methods can provide meaningful closed form solutions and generatebetter physical understanding of the conditions for when simplifying assumptions may be valid.In obtaining the analytic solutions a set of dimensionless parameters, which characterize allthermoelectric couples, is formulated and provide the limiting cases for validating assumptions.Presentation includes optimization of both classic rectangular couples as well as practically andtheoretically interesting cylindrical couples using optimization parameters physically meaningful toa cylindrical couple. Solutions incorporate the physical behavior for i) thermal resistance of hot andcold shoes, ii) variable material properties with temperature, and iii) lateral heat transfer through legsides.

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

PubMed

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

1999-01-01

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

Childhood diarrhoea management practices in Bangladesh: private sector dominance and continued inequities in care.

PubMed

Larson, Charles P; Saha, Unnati Rani; Islam, Rafiqul; Roy, Nikhil

2006-12-01

Monitoring for disparities in health and services received based upon gender, income, and geography should continue as renewed efforts to reduce under-five mortality are made in response to millennium development goal #4. The purpose of this survey was to provide a nationally representative description of current childhood diarrhoea management practices and disparities in Bangladesh. A nationally representative, cross-sectional, cluster-sample survey was carried out in randomly selected rural and urban populations across Bangladesh. The survey was completed over an 8 month period between November 2003 and June 2004. A total of 7308 children with a prevalent diarrhoeal illness episode within 560 clusters were identified and enrolled in the survey. In 61% of the cases help was sought from a health care provider, with over 90% practicing in the private sector. Caretaker practice disparities favouring males and higher income households were identified. Significant trends (P < 0.001) favouring higher income households were found for having sought help from any provider or a licensed doctor and for treating their child with oral rehydration solution or an antibiotic. Female children in urban households were less likely to be seen by a licensed allopath, adj OR 0.73 (95% CI 0.57, 0.94). Among rural households gender disparities were limited to females being less likely to receive an antibiotic, adj OR 0.74 (95% CI 0.65, 0.86). Households seeking help from a health provider overwhelmingly utilize the private sector in Bangladesh. Gender inequities in the utilization of licensed providers and purchase of antibiotics, favouring males were identified. Findings suggest that higher income, urban households tend to practice greater gender discrimination. In order to better understand health dynamics in urban populations, in particular slum-dwellers, there is a need to disaggregate survey data by household location.

An Investigation of the Effects of Self-Assembled Monolayers on Protein Crystallisation

PubMed Central

Zhang, Chen-Yan; Shen, He-Fang; Wang, Qian-Jin; Guo, Yun-Zhu; He, Jin; Cao, Hui-Ling; Liu, Yong-Ming; Shang, Peng; Yin, Da-Chuan

2013-01-01

Most protein crystallisation begins from heterogeneous nucleation; in practice, crystallisation typically occurs in the presence of a solid surface in the solution. The solid surface provides a nucleation site such that the energy barrier for nucleation is lower on the surface than in the bulk solution. Different types of solid surfaces exhibit different surface energies, and the nucleation barriers depend on the characteristics of the solid surfaces. Therefore, treatment of the solid surface may alter the surface properties to increase the chance to obtain protein crystals. In this paper, we propose a method to modify the glass cover slip using a self-assembled monolayer (SAM) of functional groups (methyl, sulfydryl and amino), and we investigated the effect of each SAM on protein crystallisation. The results indicated that both crystallisation success rate in a reproducibility study, and crystallisation hits in a crystallisation screening study, were increased using the SAMs, among which, the methyl-modified SAM demonstrated the most significant improvement. These results illustrated that directly modifying the crystallisation plates or glass cover slips to create surfaces that favour heterogeneous nucleation can be potentially useful in practical protein crystallisation, and the utilisation of a SAM containing a functional group can be considered a promising technique for the treatment of the surfaces that will directly contact the crystallisation solution. PMID:23749116

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

PubMed Central

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

2014-01-01

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

Cosmet'eau-Changes in the personal care product consumption practices: from whistle-blowers to impacts on aquatic environments.

PubMed

Bressy, Adèle; Carré, Catherine; Caupos, Émilie; de Gouvello, Bernard; Deroubaix, José-Frédéric; Deutsch, Jean-Claude; Mailler, Romain; Marconi, Anthony; Neveu, Pascale; Paulic, Laurent; Pichon, Sébastien; Rocher, Vincent; Severin, Irina; Soyer, Mathilde; Moilleron, Régis

2016-07-01

The Cosmet'eau project (2015-2018) investigates the "changes in the personal care product (PCP) consumption practices: from whistle-blowers to impacts on aquatic environments." In this project, the example of PCPs will be used to understand how public health concerns related to micropollutants can be addressed by public authorities-including local authorities, industries, and consumers. The project aims to characterize the possible changes in PCP consumption practices and to evaluate the impact of their implementation on aquatic contamination. Our goals are to study the whistle-blowers, the risk perception of consumers linked with their practices, and the contamination in parabens and their substitutes, triclosan, and triclocarban from wastewater to surface water. The project investigates the following potential solutions: modifications of industrial formulation or changes in consumption practices. The final purpose is to provide policy instruments for local authorities aiming at building effective strategies to fight against micropollutants in receiving waters.

Developing Best Practices: System-wide Actions for Coastal Resilience

DTIC Science & Technology

2015-10-09

solutions for a safer, better world flooding and major storms in low-lying areas 6 10/9/2015 3 Bayville and Breezy Point, NY - Protocol to move emergency...vehicles and debris removal equipment to high ground before flooding . Best Practices: Examples BUILDING STRONG® Innovative solutions for a safer

Common quandaries and their practical solutions in Bayesian network modeling

Treesearch

Bruce G. Marcot

2017-01-01

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

Multiple Solutions Approach (MSA): Conceptions and Practices of Primary School Teachers in Ghana

ERIC Educational Resources Information Center

Nabie, Michael Johnson; Raheem, Kolawole; Agbemaka, John Bijou; Sabtiwu, Rufai

2016-01-01

The study explored the curriculum guidelines and primary school teachers' conceptions and practices of the Multiple Solutions Approach (MSA) in teaching mathematics using basic qualitative research design. Informal conversation interviews (ICIs), observations, video and document analyses were used to collect data. Participants included a purposive…

Longitudinal Adult Practical Problem-Solving: 1983, 1993, 2003

ERIC Educational Resources Information Center

Haught, Patricia A.; Walls, Richard T.

2007-01-01

A 20-year longitudinal study was conducted to examine adult performance on practical problems. Effects of independent variables of age, education, and administration time were assessed on solutions generated and quality points earned. Younger adults generated more solutions than other adults in 1983, 1993, and 2003. Both younger and middle adults…

Transient Seepage Analyses in Levee Engineering Practice

DTIC Science & Technology

2016-07-01

and contractors in conventional engineering practice has outpaced the development of guidance documents and design recommendations. The major...ERDC TR-16-8 99 B.5 Final solution The final solution is obtained by first solving for ht from Equation B.5 as follows: t t tssˆh h h  (B

Nursing home provider perceptions of telemedicine for reducing potentially avoidable hospitalizations

PubMed Central

Driessen, Julia; Bonhomme, Andro; Chang, Woody; Nace, David A.; Kavalieratos, Dio; Perera, Subashan; Handler, Steven M.

2016-01-01

Objective Potentially avoidable hospitalizations (PAHs) of nursing home (NH) residents are common, costly, and can have significant economic consequences. Telemedicine has been shown to reduce emergency department and hospitalization of NH residents, yet adoption has been limited and little is known about provider's perceptions and desired functionality for a telemedicine program. The goal of this study was to survey a nationally representative sample of NH physicians and advanced practice providers to quantify provider perceptions and desired functionality of telemedicine in NHs to reduce PAHs. Design/Setting/Participants/Measurement We surveyed physician and advanced practice providers who attended the 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine Annual Conference about their perceptions of telemedicine and desired attributes of a telemedicine program for managing acute changes of condition associated with PAHs. Results We received surveys from 435 of the 947 conference attendees for a 45.6% response rate. Providers indicated strong agreement with the potential for telemedicine to improve timeliness of care and fill existing service gaps, while disagreeing most with the ideas that telemedicine would reduce care effectiveness and jeopardize resident privacy. Responses indicated clear preferences for the technical requirements of such a program, such as high-quality audio and video and inclusion of an electronic stethoscope, but without strong opinions about who should be performing the consults. Conclusion Among NH providers, there is a high degree of confidence in the potential for a telemedicine solution to PAHs in NHs, as well as concrete views about features of such a solution. Such consensus could be used to drive an approach to telemedicine for PAHs in NHs that retains the theoretical strengths of telemedicine and reflects the needs of facilities, providers, and patients. Further research is needed to objectively study the impact of successful telemedicine implementations on patient, provider, and economic outcomes. PMID:26969534

Nursing Home Provider Perceptions of Telemedicine for Reducing Potentially Avoidable Hospitalizations.

PubMed

Driessen, Julia; Bonhomme, Andro; Chang, Woody; Nace, David A; Kavalieratos, Dio; Perera, Subashan; Handler, Steven M

2016-06-01

Potentially avoidable hospitalizations (PAHs) of nursing home (NH) residents are common, costly, and can have significant economic consequences. Telemedicine has been shown to reduce emergency department and hospitalization of NH residents, yet adoption has been limited and little is known about provider's perceptions and desired functionality for a telemedicine program. The goal of this study was to survey a nationally representative sample of NH physicians and advanced practice providers to quantify provider perceptions and desired functionality of telemedicine in NHs to reduce PAHs. We surveyed physicians and advanced practice providers who attended the 2015 AMDA-The Society for Post-Acute and Long-Term Care Medicine Annual Conference about their perceptions of telemedicine and desired attributes of a telemedicine program for managing acute changes of condition associated with PAHs. We received surveys from 435 of the 947 conference attendees for a 45.9% response rate. Providers indicated strong agreement with the potential for telemedicine to improve timeliness of care and fill existing service gaps, while disagreeing most with the ideas that telemedicine would reduce care effectiveness and jeopardize resident privacy. Responses indicated clear preferences for the technical requirements of such a program, such as high-quality audio and video and inclusion of an electronic stethoscope, but with varying opinions about who should be performing the consults. Among NH providers, there is a high degree of confidence in the potential for a telemedicine solution to PAHs in NHs, as well as concrete views about features of such a solution. Such consensus could be used to drive an approach to telemedicine for PAHs in NHs that retains the theoretical strengths of telemedicine and reflects the needs of facilities, providers, and patients. Further research is needed to objectively study the impact of successful telemedicine implementations on patient, provider, and economic outcomes. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

The Biopsychosocial-Digital Approach to Health and Disease: Call for a Paradigm Expansion.

PubMed

Ahmadvand, Alireza; Gatchel, Robert; Brownstein, John; Nissen, Lisa

2018-05-18

Digital health is an advancing phenomenon in modern health care systems. Currently, numerous stakeholders in various countries are evaluating the potential benefits of digital health solutions at the individual, population, and/or organizational levels. Additionally, driving factors are being created from the customer-side of the health care systems to push health care providers, policymakers, or researchers to embrace digital health solutions. However, health care providers may differ in their approach to adopt these solutions. Health care providers are not assumed to be appropriately trained to address the requirements of integrating digital health solutions into daily everyday practices and procedures. To adapt to the changing demands of health care systems, it is necessary to expand relevant paradigms and to train human resources as required. In this article, a more comprehensive paradigm will be proposed, based on the 'biopsychosocial model' of assessing health and disease, originally introduced by George L Engel. The "biopsychosocial model" must be leveraged to include a "digital" component, thus suggesting a 'biopsychosocial-digital' approach to health and disease. Modifications to the "biopsychosocial" model and transition to the "biopsychosocial-digital" model are explained. Furthermore, the emerging implications of understanding health and disease are clarified pertaining to their relevance in training human resources for health care provision and research. ©Alireza Ahmadvand, Robert Gatchel, John Brownstein, Lisa Nissen. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 18.05.2018.

The human resource crisis in neuro-ophthalmology.

PubMed

Frohman, Larry P

2008-09-01

Neuro-ophthalmology is facing a serious human resource issue. Few are entering the subspecialty, which is perceived as being poorly compensated compared with other subspecialties of ophthalmology. The low compensation comes from the fact that 1) non-procedural encounters remain undervalued, 2) efforts that benefit other medical specialists are not counted, and 3) the relatively low expenses of neuro-ophthalmologists are not factored into compensation formulas. Mission-based budgeting, which forces academic departments to be financially accountable without the expectation of fiscal relief from medical schools or practice plans, has exacerbated the compensation issue. Solutions must come from within neuro-ophthalmology, academic departments, medical schools, and medical practice plans. They include 1) providing educational resources so that neuro-ophthalmologists need not spend so much time teaching the basics, 2) factoring into compensation the impact of neuro-ophthalmologists in teaching and on revenue generation by procedure-based specialists, 3) improving the efficiency of neuro-ophthalmologists in their consultative practices by providing ample clerical support and other measures, 4) providing contractual salary compensation by departments such as neurosurgery to recognize the contributions made by neuro-ophthalmologists, and 5) reorganizing the academic clinical effort as multidisciplinary rather than departmental.

Assessing Medicare's Approach To Covering New Drugs In Bundled Payments For Oncology.

PubMed

Muldoon, L Daniel; Pelizzari, Pamela M; Lang, Kelsey A; Vandigo, Joe; Pyenson, Bruce S

2018-05-01

New oncology therapies can contribute to survival or quality of life, but payers and policy makers have raised concerns about the cost of these therapies. Similar concerns extend beyond cancer. In seeking a solution, payers are increasingly turning toward value-based payment models in which providers take financial risk for costs and outcomes. These models, including episode payment and bundled payment, create financial gains for providers who reduce cost, but they also create concerns about potential stinting on necessary treatments. One approach, which the Centers for Medicare and Medicaid Services adopted in the Oncology Care Model (OCM), is to partially adjust medical practices' budgets for their use of novel therapies, defined in this case as new oncology drugs or new indications for existing drugs approved after December 31, 2014. In an analysis of the OCM novel therapies adjustment using historical Medicare claims data, we found that the adjustment may provide important financial protection for practices. In a simulation we performed, the adjustment reduced the average loss per treatment episode by $758 (from $807 to $49) for large practices that use novel therapies often. Lessons from the OCM can have implications for other alternative payment models.

Anaphylaxis challenges on the front line: perspectives from community medicine.

PubMed

Bennett, John R; Fromer, Leonard; Hayden, Mary Lou

2014-01-01

This report reflects a discussion from the multidisciplinary Partnership for Anaphylaxis Round Table meeting, held in November 2012, in Dallas, Texas. Community medicine participants included John R. Bennett, MD, an internist who practiced in Cumming, Georgia, and whose patients were adults; Leonard Fromer, MD, a family practitioner in Los Angeles, California, who was the medical director of a network of 600 medical groups, including pediatricians, internists, and family physicians, and who in his previous practice treated children and adults, many of them with severe allergies; and Mary Lou Hayden, MS, RN, FNP-BC, AE-C, a nurse practitioner who treated adults in a university employee health clinic and in an allergy clinic in Charlottesville, Virginia, and whose prior practice focused on allergy and immunology in children and adults. This discussion was moderated by Dr Bennett. Participants provided their perspectives as primary care providers (PCPs) concerning anaphylaxis, which has become a major public health concern. The rising prevalence of severe allergies and incidence of anaphylaxis and other severe allergic reactions among children and adults is shifting more care to PCPs. This discussion provides insights into challenges faced by PCPs in treating patients at risk for anaphylaxis in the community setting and provides potential solutions to those challenges. Copyright © 2014 Elsevier Inc. All rights reserved.

The Advantages and Challenges of Unannounced Standardized Patients Methodology to Assess Healthcare Communication

PubMed Central

Siminoff, Laura A.; Rogers, Heather L.; Waller, Allison C.; Harris-Haywood, Sonja; Esptein, Ronald M.; Borrell Carrio, Francesc; Gliva-McConvey, Gayle; Longo, Daniel R.

2011-01-01

Objective This paper provides an overview of the implementation of using Unannounced Standardized Patients (USPs) to conduct health communication research in clinical settings. Methods Certain types of health communication situations are difficult to capture because of their rarity or unpredictable nature. In primary care the real reasons for a visit are frequently unknown until the consultation is well under way. Therefore, it is logistically difficult for communication studies to capture many real-time communications between patients and their physicians. Although the USP methodology is ideal for capturing these communication behaviors, challenges to using this method include developing collaborative relationships with clinical practices, logistical issues such as safeguarding the identity of the USP, training USPs and creating their identities, maintaining fidelity to the role, and analyzing the resultant data. Results This paper discusses the challenges and solutions to USP implementation. We provide an example of how to implement a USP study using an on-going study being conducted in primary care practices. Conclusion This paper explores the advantages and challenges as well as strategies to overcome obstacles to implementing a USP study. Practice Implications Despite the challenges, USP methodology can contribute much to our understanding of health communication and practice. PMID:21316182

The ambiguity of patient-centred practices: the case of a Dutch fertility clinic

PubMed Central

Gerrits, Trudie

2014-01-01

When in-vitro fertilization (IVF) was introduced in the 1970s, doctors were criticized for not properly informing prospective users about its possible risks and limited success rates as well as for medicalizing fertility problems. Nowadays, many fertility clinics are seeking to improve their accountability to stakeholders through patient-centred practices. Based on an ethnographic study of a Dutch fertility clinic, outspoken in its aims to provide patient-centred medicine and to empower clients, this paper addresses how patient-centred medicine affects couples’ decision-making to use IVF and related reproductive technologies. The author contends that while patient-centred practices facilitate informed decision-making and support couples emotionally, they may also have unintended disciplining and normalizing effects. The information and support provided, the trust couples have in clinic staff, the ongoing visualization of conception mediated by medical technology – all can be seen as practices that strengthen lay people's ‘medical gaze’ in how they come to view their bodies, fertility problems and possible solutions. These unintended effects are labelled ‘the ambiguity of patient-centeredness’ as they (may) interfere with processes of autonomous decision-making. PMID:24827743

Clinical and Pharmaceutical Solutions through Analysis (CPSA BRASIL 2015): on the way to innovation - pharmaceutical/analytical technology, regulation and knowledge management.

PubMed

Needham, Shane; Yates, Nathan; Barrientos, Rafael; Steel, Martin; Lee, Mike

2015-12-01

Clinical and Pharmaceutical Solutions through Analysis, São Paulo, Brazil, 3-5 August 2015 The 2nd Annual Symposium on Clinical and Pharmaceutical Solutions through Analysis was held on 3-5 August 2015 at Club Transatlântico, São Paulo, Brazil. This annual meeting began in 2014 and was the first industry-led event in Brazil to focus on the specific needs of industry researchers while bringing together technology and regulators. The goal of CPSA is to provide an in-depth review of innovative technology and industry practices through open discussion of industry-related issues and needs. Education and specialized training are the foundation of all CPSA events. As the industry has evolved so has CPSA. The CPSA annual meeting thrived with high quality scientific content, open interaction from industry opinion leaders and a collegial environment.

Passive RFID Localisation Framework in Smart Homes Healthcare Settings.

PubMed

Alsinglawi, Belal; Liu, Tony; Nguyen, Quang Vinh; Gunawardana, Upul; Maeder, Anthony; Simoff, Simeon

2016-01-01

In recent years, Smart Homes have become a solution to benefit impaired individuals and elderly in their daily life settings. In healthcare applications, pervasive technologies have enabled the practicality of personal monitoring using Indoor positioning technologies. Radio-Frequency Identification (RFID) is a promising technology, which is useful for non-invasive tracking of activities of daily living. Many implementations have focused on using battery-enabled tags like in RFID active tags, which require frequent maintenance and they are costly. Other systems can use wearable sensors requiring individuals to wear tags which may be inappropriate for elders. Successful implementations of a tracking system are dependent on multiple considerations beyond the physical performance of the solution, such as affordability and human acceptance. This paper presents a localisation framework using passive RFID sensors. It aims to provide a low cost solution for subject location in Smart Homes healthcare.

Cell separation: Terminology and practical considerations

PubMed Central

Tomlinson, Sophie; Yang, Xuebin B; Kirkham, Jennifer

2013-01-01

Cell separation is a powerful tool in biological research. Increasing usage, particularly within the tissue engineering and regenerative medicine communities, means that researchers from a diverse range of backgrounds are utilising cell separation technologies. This review aims to offer potential solutions to cell sorting problems and to clarify common ambiguities in terminology and experimental design. The frequently used cell separation terms of ‘purity’, ‘recovery’ and ‘viability’ are discussed, and attempts are made to reach a consensus view of their sometimes ambiguous meanings. The importance of appropriate experimental design is considered, with aspects such as marker expression, tissue isolation and original cell population analysis discussed. Finally, specific technical issues such as cell clustering, dead cell removal and non-specific antibody binding are considered and potential solutions offered. The solutions offered may provide a starting point to improve the quality of cell separations achieved by both the novice and experienced researcher alike. PMID:23440031

MT3DMS: Model use, calibration, and validation

USGS Publications Warehouse

Zheng, C.; Hill, Mary C.; Cao, G.; Ma, R.

2012-01-01

MT3DMS is a three-dimensional multi-species solute transport model for solving advection, dispersion, and chemical reactions of contaminants in saturated groundwater flow systems. MT3DMS interfaces directly with the U.S. Geological Survey finite-difference groundwater flow model MODFLOW for the flow solution and supports the hydrologic and discretization features of MODFLOW. MT3DMS contains multiple transport solution techniques in one code, which can often be important, including in model calibration. Since its first release in 1990 as MT3D for single-species mass transport modeling, MT3DMS has been widely used in research projects and practical field applications. This article provides a brief introduction to MT3DMS and presents recommendations about calibration and validation procedures for field applications of MT3DMS. The examples presented suggest the need to consider alternative processes as models are calibrated and suggest opportunities and difficulties associated with using groundwater age in transport model calibration.

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

PubMed

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

2018-01-01

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

Parenting practices are associated with fruit and vegetable consumption in pre-school children

PubMed Central

O’Connor, Teresia M; Hughes, Sheryl O; Watson, Kathy B; Baranowski, Tom; Nicklas, Theresa A; Fisher, Jennie O; Beltran, Alicia; Baranowski, Janice C; Qu, Haiyan; Shewchuk, Richard M

2009-01-01

Objective Parents may influence children’s fruit and vegetable (F&V) consumption in many ways, but research has focused primarily on counterproductive parenting practices, such as restriction and pressure to eat. The present study aimed to assess the association of diverse parenting practices to promote F&V and its consumption among pre-school children. Design An exploratory analysis was performed on cross-sectional data from 755 Head Start pre-school children and their parents collected in 2004–5. Data included parent practices to facilitate child F&V consumption (grouped into five categories); parent-reported dietary intake of their child over 3 d; and a number of potential correlates. K-means cluster analysis assigned parents to groups with similar use of the food parenting practice categories. Stepwise linear regression analyses investigated the association of parent clusters with children’s consumption of F&V, after controlling for potential confounding factors. Results A three-cluster solution provided the best fit (R2 = 0 62), with substantial differences in the use of parenting practices. The clusters were labelled Indiscriminate Food Parenting, Non-directive Food Parenting and Low-involved Food Parenting. Non-directive parents extensively used enhanced availability and teachable moments’ practices, but less firm discipline practices than the other clusters, and were significantly associated with child F&V intake (standardized β = 0·09, P < 0·1; final model R2 = 0·17) after controlling for confounders, including parental feeding styles. Conclusions Parents use a variety of parenting practices, beyond pressuring to eat and restrictive practices, to promote F&V intake in their young child. Evaluating the use of combinations of practices may provide a better understanding of parental influences on children’s F&V intake. PMID:19490734

The Community Preceptor Crisis: Recruiting and Retaining Community-Based Faculty to Teach Medical Students-A Shared Perspective From the Alliance for Clinical Education.

PubMed

Christner, Jennifer G; Dallaghan, Gary Beck; Briscoe, Gregory; Casey, Petra; Fincher, Ruth Marie E; Manfred, Lynn M; Margo, Katherine I; Muscarella, Peter; Richardson, Joshua E; Safdieh, Joseph; Steiner, Beat D

2016-01-01

Community-based instruction is invaluable to medical students, as it provides "real-world" opportunities for observing and following patients over time while refining history taking, physical examination, differential diagnosis, and patient management skills. Community-based ambulatory settings can be more conducive to practicing these skills than highly specialized, academically based practice sites. The Association of American Medical Colleges and other national medical education organizations have expressed concern about recruitment and retention of preceptors to provide high-quality educational experiences in community-based practice sites. These concerns stem from constraints imposed by documentation in electronic health records; perceptions that student mentoring is burdensome resulting in decreased clinical productivity; and competition between allopathic, osteopathic, and international medical schools for finite resources for medical student experiences. In this Alliance for Clinical Education position statement, we provide a consensus summary of representatives from national medical education organizations in 8 specialties that offer clinical clerkships. We describe the current challenges in providing medical students with adequate community-based instruction and propose potential solutions. Our recommendations are designed to assist clerkship directors and medical school leaders overcome current challenges and ensure high-quality, community-based clinical learning opportunities for all students. They include suggesting ways to orient community clinic sites for students, explaining how students can add value to the preceptor's practice, focusing on educator skills development, recognizing preceptors who excel in their role as educators, and suggesting forms of compensation.

Multisite Investigation of Strategies for the Implementation of CYP2C19 Genotype-Guided Antiplatelet Therapy.

PubMed

Empey, Philip E; Stevenson, James M; Tuteja, Sony; Weitzel, Kristin W; Angiolillo, Dominick J; Beitelshees, Amber L; Coons, James C; Duarte, Julio D; Franchi, Francesco; Jeng, Linda J B; Johnson, Julie A; Kreutz, Rolf P; Limdi, Nita A; Maloney, Kristin A; Owusu Obeng, Aniwaa; Peterson, Josh F; Petry, Natasha; Pratt, Victoria M; Rollini, Fabiana; Scott, Stuart A; Skaar, Todd C; Vesely, Mark R; Stouffer, George A; Wilke, Russell A; Cavallari, Larisa H; Lee, Craig R

2017-12-26

CYP2C19 genotype-guided antiplatelet therapy following percutaneous coronary intervention is increasingly implemented in clinical practice. However, challenges such as selecting a testing platform, communicating test results, building clinical decision support processes, providing patient and provider education, and integrating methods to support the translation of emerging evidence to clinical practice are barriers to broad adoption. In this report, we compare and contrast implementation strategies of 12 early adopters, describing solutions to common problems and initial performance metrics for each program. Key differences between programs included the test result turnaround time and timing of therapy changes, which are both related to the CYP2C19 testing model and platform used. Sites reported the need for new informatics infrastructure, expert clinicians such as pharmacists to interpret results, physician champions, and ongoing education. Consensus lessons learned are presented to provide a path forward for those seeking to implement similar clinical pharmacogenomics programs within their institutions. © 2018, The American Society for Clinical Pharmacology and Therapeutics.

Crowdfunding: an innovative way to fund your project.

PubMed

Walker, Dawn-Marie

2017-06-22

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

Development and validation of a low-cost mobile robotics testbed

NASA Astrophysics Data System (ADS)

Johnson, Michael; Hayes, Martin J.

2012-03-01

This paper considers the design, construction and validation of a low-cost experimental robotic testbed, which allows for the localisation and tracking of multiple robotic agents in real time. The testbed system is suitable for research and education in a range of different mobile robotic applications, for validating theoretical as well as practical research work in the field of digital control, mobile robotics, graphical programming and video tracking systems. It provides a reconfigurable floor space for mobile robotic agents to operate within, while tracking the position of multiple agents in real-time using the overhead vision system. The overall system provides a highly cost-effective solution to the topical problem of providing students with practical robotics experience within severe budget constraints. Several problems encountered in the design and development of the mobile robotic testbed and associated tracking system, such as radial lens distortion and the selection of robot identifier templates are clearly addressed. The testbed performance is quantified and several experiments involving LEGO Mindstorm NXT and Merlin System MiaBot robots are discussed.

Adapting heart failure guidelines for nursing care in home health settings: challenges and solutions.

PubMed

Radhakrishnan, Kavita; Topaz, Maxim; Masterson Creber, Ruth

2014-07-01

Nurses provide most of home health services for patients with heart failure, and yet there are no evidence-based practice guidelines developed for home health nurses. The purpose of this article was to review the challenges and solutions for adapting generally available HF clinical practice guidelines to home health nursing. Appropriate HF guidelines were identified and home health nursing-relevant guidelines were extracted by the research team. In addition, a team of nursing academic and practice experts evaluated the extracted guidelines and reached consensus through Delphi rounds. We identified 172 recommendations relevant to home health nursing from the American Heart Association and Heart Failure Society of America guidelines. The recommendations were divided into 5 groups (generic, minority populations, normal ejection fraction, reduced ejection fraction, and comorbidities) and further subgroups. Experts agreed that 87% of the recommendations selected by the research team were relevant to home health nursing and rejected 6% of the selected recommendations. Experts' opinions were split on 7% of guideline recommendations. Experts mostly disagreed on recommendations related to HF medication and laboratory prescription as well as HF patient assessment. These disagreements were due to lack of patient information available to home health nurses as well as unclear understanding of scope of practice regulations for home health nursing. After 2 Delphi rounds over 8 months, we achieved 100% agreement on the recommendations. The finalized guideline included 153 recommendations. Guideline adaptation projects should include a broad scope of nursing practice recommendations from which home health agencies can customize relevant recommendations in accordance with available information and state and agency regulations.

Family Practice: A Proposed Solution to the Problem of Meeting the Medical Needs of the Community

PubMed Central

McAuley, R. G.

1967-01-01

Difficulties in meeting today's community medical needs are outlined, followed by a proposed solution in which the first-contact physician is the trained family physician. The McMaster Family Practice Course is described. The potential research contribution of a Department of Family Medicine is stressed. PMID:6020551

Evaluating Remote Reference Service: A Practical Guide to Problems and Solutions

ERIC Educational Resources Information Center

Pomerantz, Jeffrey; Mon, Lorri; McClure, Charles R.

2008-01-01

This paper identifies key methodological issues affecting quality of data in the evaluation of remote reference services. Despite a growing number of studies in this area, no comprehensive effort has been made to identify potential problems and suggest solutions. The strategies proposed in this paper offer practical ways in which libraries can…

Research-Practice Interactions as Reported in Recent Design Studies: Still Promising, Still Hazy

ERIC Educational Resources Information Center

Ormel, Bart J. B.; Pareja Roblin, Natalie N.; McKenney, Susan E.; Voogt, Joke M.; Pieters, Jules M.

2012-01-01

This study portrays recent research-practice connections found in 18 design research reports focusing on the creation of instructional solutions. Solutions in different stages of development varied greatly in duration, ranging from one lesson to a whole year curriculum, spanned all levels of education, many subjects (science, math, language,…

The Buddhist Approach to Education: An Alternative Approach for Sustainable Education

ERIC Educational Resources Information Center

Chansomsak, Sant; Vale, Brenda

2008-01-01

This article is based on research undertaken as part of a study of sustainable school design in Thailand. Since school design solutions are inevitably affected by educational theory and practice, in the search for appropriate building solutions, it has been necessary to review Thai educational theories and practices that relate to the…

Ergonomic best practices in masonry: regional differences, benefits, barriers, and recommendations for dissemination.

PubMed

Hess, Jennifer; Weinstein, Marc; Welch, Laura

2010-08-01

Within construction the masonry trade has particularly high rates of musculoskeletal disorders (MSDs). A NIOSH-sponsored meeting of masonry stakeholders explored current and potential "Best Practices" for reducing MSDs in masonry and identified potential regional differences in use of practices. To verify and better understand the regional effects and other factors associated with differences in practice use, a national telephone survey of masonry contractors was conducted. The United States was divided into four regions for evaluation: Northeast, Southeast, Midwest, and West Coast. Nine practices with the potential to reduce MSDs in masonry workers were evaluated. Masonry contractors, owners, and foremen completed 183 surveys. The results verify regional differences in use of best practices in masonry. Half-weight cement bags and autoclave aerated concrete were rarely used anywhere, while lightweight block and mortar silos appear to be diffusing across the country. The Northeast uses significantly fewer best practices than other regions. This article examines reasons for regional differences in masonry best practice, and findings provide insight into use and barriers to adoption that can be used by safety managers, researchers, and other safety advocates to more effectively disseminate ergonomic solutions across the masonry industry.

Evaluation of Bacterial Contamination of Clipper Blades in Small Animal Private Practice.

PubMed

Mount, Rebecca; Schick, Anthea E; Lewis, Thomas P; Newton, Heide M

2016-01-01

Nosocomial infections are a growing concern in veterinary hospitals, and identifying fomites is imperative to reducing the risk of pathogen transmission. In veterinary medicine, shaving of hair is necessary prior to many procedures. Contaminated clipper blades have been cited as potential fomites involved in the transmission of pathogens in veterinary and human medicine. The primary goal of this study was to evaluate bacterial contamination of clipper blades in veterinary practices. A secondary goal was to assess whether there was an association between bacterial contamination of clipper blades and clipper blade cleaning solutions, clipper blade cleaning protocols, clipper blade storage, and type of practice. Sixty clipper blades from 60 different practices were cultured. Information regarding blade cleaning solutions, protocols, and storage was collected from each practice. Fifty-one percent (31/60) of clipper blades sampled were contaminated with bacteria. Category of cleaning solutions had a significant association with bacterial contamination (P < 0.02). Cleaning frequency (P = 0.55), storage location (P = 0.26), and practice type (P = 0.06) had no significant association with bacterial contamination. This study documented bacterial contamination of clipper blades in veterinary practices, and clipper blades should be considered potential fomites.

Recent Advances in the Edge-Function Method 1979-1980

DTIC Science & Technology

1980-07-30

the residuals are within the limits within which an engineer can specify the boundary conditions of the problem, then the corresponding Mathematical ...truncation lvel . The consistent preference shown by the solver routine for verteA functions as opposed to polar functions reinforces the expectations of...Accordingly,each solution zr_.-4_des a Mathematical Model for the given physical problem- R.M.S. values provide a practical criterion for the enai--er to

Acute Blood Loss During Burn and Soft Tissue Excisions: An Observational Study of Blood Product Resuscitation Practices and Focused Review

DTIC Science & Technology

2015-06-24

centers have shifted to a damage-control resuscitation approach, focused on providing oxygen - carrying capacity while simultaneously mitigating...develop treatments for this widely recognized problem have yet to yield effective solutions. In both the ci- vilian and military settings, most deaths...characterizing the effects of significant intraoperative bleeding on coagulation may be an alternative source of data to guide ORIGINAL ARTICLE J

FPGA Based "Intelligent Tap" Device for Real-Time Ethernet Network Monitoring

NASA Astrophysics Data System (ADS)

Cupek, Rafał; Piękoś, Piotr; Poczobutt, Marcin; Ziębiński, Adam

This paper describes an "Intelligent Tap" - hardware device dedicated to support real-time Ethernet networks monitoring. Presented solution was created as a student project realized in Institute of Informatics, Silesian University of Technology with support from Softing A.G company. Authors provide description of realized FPGA based "Intelligent Tap" architecture dedicated for Real-Time Ethernet network monitoring systems. The practical device realization and feasibility study conclusions are presented also.

Direction to practical production of hydrogen by formic acid dehydrogenation with Cp*Ir complexes bearing imidazoline ligands

DOE PAGES

Onishi, Naoya; Ertem, Mehmed Z.; Xu, Shaoan; ...

2016-11-10

In a Cp*Ir complex with a bidentate pyridyl-imidazoline ligand achieved the evolution of 1.02 m 3 of H 2/CO 2 gases by formic acid dehydrogenation without any additives or adjustments in the solution system. Furthermore, the pyridyl-imidazoline moieties provided the optimum pH to be 1.7, resulting in high activity and stability even at very acidic conditions.

Direction to practical production of hydrogen by formic acid dehydrogenation with Cp*Ir complexes bearing imidazoline ligands

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

Onishi, Naoya; Ertem, Mehmed Z.; Xu, Shaoan

In a Cp*Ir complex with a bidentate pyridyl-imidazoline ligand achieved the evolution of 1.02 m 3 of H 2/CO 2 gases by formic acid dehydrogenation without any additives or adjustments in the solution system. Furthermore, the pyridyl-imidazoline moieties provided the optimum pH to be 1.7, resulting in high activity and stability even at very acidic conditions.

ESR teleradiology survey: results.

PubMed

2016-08-01

With recent developments of teleradiology technology and services, it has become necessary to better evaluate its extent and use among different countries in Europe. With this goal in mind, the ESR launched two specific surveys intended to gather the current state of adoption and implementation of teleradiology in clinical practice. A special focus on differentiating between insourcing teleradiology services among partners of the same organisation and outsourcing to external services was an essential part of the design of these surveys. The first survey was addressed to 44 national societies of different countries in Europe, while the second survey was intended for all practicing radiologist ESR members. While the results of these surveys reported here may provide a wealth of information to better understand the trends in adoption of teleradiology in Europe, they only represent a snapshot at a certain point in time. The rapid development of telecommunication tools as well as a fundamental change in practice and healthcare economics will certainly influence these observations in the upcoming years. These data, however, will provide objective and relevant parameters for supporting the efforts of experts and policy makers in promoting appropriate criteria and guidelines for adequate use of teleradiology in clinical practice. Main Messages • Understand concepts and challenges of teleradiology • Provide insight into current trends and solutions for teleradiology • Compare differences in teleradiolgy strategies between countries in Europe • Establish a reference on statistical data of usage of teleradiology in Europe.

Overcoming Practical Challenges to Conducting Clinical Research in the Inpatient Stroke Rehabilitation Setting

PubMed Central

Campbell, Grace B.; Skidmore, Elizabeth R.; Whyte, Ellen M.; Matthews, Judith T.

2015-01-01

There is a shortage of published empirical studies conducted in acute inpatient stroke rehabilitation, though such studies are greatly needed in order to shed light on the most efficacious inpatient stroke rehabilitation interventions. The inherent challenges of inpatient research may dissuade researchers from undertaking this important work. This paper describes our institution’s experience devising practical solutions to research barriers in this setting. Our efforts facilitated five simultaneous inpatient stroke rehabilitation studies, and led to several benefits, including increased effectiveness of research participant identification and enrollment, novel collaborative projects, innovative clinical care initiatives, and enhanced emotional and practical support for patients and their families. We provide recommendations based on lessons learned during our experience, and discuss benefits of this collaboration for our research participants, clinical staff, and the research team. PMID:25775955

Sun-Earth L1 Region Halo-To-Halo Orbit and Halo-To-LisaJous Orbit Transfers

NASA Technical Reports Server (NTRS)

Roberts, Craig E.; DeFazio, Robert

2004-01-01

Practical techniques for designing transfer trajectories between Libration Point Orbits (LPOs) are presented. Motivation for development of these techniques was provided by a hardware contingency experienced by the Solar Heliospheric Observatory (SOHO), a joint mission of the European Space Agency (ESA) and the National Aeronautics and Space Administration (NASA) orbiting the L1 point of the Sun-Earth system. A potential solution to the problem involved a transfer from SOHO s periodic halo orbit to a new LPO of substantially different dimensions. Assuming the SOHO halo orbit as the departure orbit, several practical LPO transfer techniques were developed to obtain new Lissajous or periodic halo orbits that satisfy mission requirements and constraints. While not implemented for the SOHO mission, practical LPO transfer techniques were devised that are generally applicable to current and future LPO missions.

Diagnosing and dealing with multicollinearity.

PubMed

Schroeder, M A

1990-04-01

The purpose of this article was to increase nurse researchers' awareness of the effects of collinear data in developing theoretical models for nursing practice. Collinear data distort the true value of the estimates generated from ordinary least-squares analysis. Theoretical models developed to provide the underpinnings of nursing practice need not be abandoned, however, because they fail to produce consistent estimates over repeated applications. It is also important to realize that multicollinearity is a data problem, not a problem associated with misspecification of a theorectical model. An investigator must first be aware of the problem, and then it is possible to develop an educated solution based on the degree of multicollinearity, theoretical considerations, and sources of error associated with alternative, biased, least-square regression techniques. Decisions based on theoretical and statistical considerations will further the development of theory-based nursing practice.

[Application of password manager software in health care].

PubMed

Ködmön, József

2016-12-01

When using multiple IT systems, handling of passwords in a secure manner means a potential source of problem. The most frequent issues are choosing the appropriate length and complexity, and then remembering the strong passwords. Password manager software provides a good solution for this problem, while greatly increasing the security of sensitive medical data. This article introduces a password manager software and provides basic information of the application. It also discusses how to select a really secure password manager software and suggests a practical application to efficient, safe and comfortable use for health care. Orv. Hetil., 2016, 157(52), 2066-2073.

Metal band drives in spacecraft mechanisms

NASA Technical Reports Server (NTRS)

Maus, Daryl

1993-01-01

Transmitting and changing the characteristics of force and stroke is a requirement in nearly all mechanisms. Examples include changing linear to rotary motion, providing a 90 deg change in direction, and amplifying stroke or force. Requirements for size, weight, efficiency and reliability create unique problems in spacecraft mechanisms. Flexible metal band and cam drive systems provide powerful solutions to these problems. Band drives, rack and pinion gears, and bell cranks are compared for effectiveness. Band drive issues are discussed including materials, bend radius, fabrication, attachment and reliability. Numerous mechanisms are shown which illustrate practical applications of band drives.

An assessment of maintainability of elevator system to improve facilities management knowledge-base

NASA Astrophysics Data System (ADS)

Siti, N. A.; Asmone, A. S.; Chew, M. Y. L.

2018-02-01

Elevator system is a highly specialized machinery that requires technicians that have a wider array of knowledge in maintaining the system to be safe and reliable. While attaining reliable data of elevator malfunction become challenges, this study has filled the gap by gathering the management-maintenance issues and operational defects of elevator system. Forty-three types of operation defects were found and the consequence defects and their possible causes of occurrences were discussed. To respond to the prime challenges of maintaining elevator system provided by the industry players’ perspective, a theoretical framework is established as a recommendation to improve knowledge base of defects in elevator system which comprises good practices, and solutions to rectify each defects found. Hence, this research paper has theoretically improved the knowledge base of maintainability of elevator system and provide meaningful guidelines in practical senses to the industry professionals.

Education Scholarship and its Impact on Emergency Medicine Education.

PubMed

Sherbino, Jonathan

2015-11-01

Emergency medicine (EM) education is becoming increasingly challenging as a result of changes to North American medical education and the growing complexity of EM practice. Education scholarship (ES) provides a process to develop solutions to these challenges. ES includes both research and innovation. ES is informed by theory, principles and best practices, is peer reviewed, and is disseminated and archived for others to use. Digital technologies have improved the discovery of work that informs ES, broadened the scope and timing of peer review, and provided new platforms for the dissemination and archiving of innovations. This editorial reviews key steps in raising an education innovation to the level of scholarship. It also discusses important areas for EM education scholars to address, which include the following: the delivery of competency-based medical education programs, the impact of social media on learning, and the redesign of continuing professional development.

Making Patient Engagement a Reality.

PubMed

Pushparajah, Daphnee S

2018-02-01

Patients are increasingly recognised as the true customers of healthcare. By providing insights and perspectives, patients can help the wider healthcare community better understand their needs and ultimately enhance the value of healthcare solutions being developed. In the development of new medicines, for example, meaningful patient engagement can enable the pharmaceutical industry, healthcare providers and other stakeholders to achieve more meaningful health outcomes. While both the pharmaceutical industry and regulators have achieved some progress in incorporating patient perspectives into their activities, the lack of standardised best practices and metrics has made it challenging to achieve consistency and measure success in patient engagement. Practical guidance for patient engagement can facilitate better interactions between patients or patient groups and other collaborators, e.g. industry, regulators and other healthcare stakeholders. Accordingly, UCB has developed an internal model for Patient Group Engagement incorporating four key principles, based on shared ambition, transparency, accountability and respect, essential for effective collaborations.

Clerkship maturity: does the idea of training clinical skills work?

PubMed

Stosch, Christoph; Joachim, Alexander; Ascher, Johannes

2011-01-01

With the reformed curriculum "4C", the Medical Faculty of the University of Cologne has started to systematically plan practical skills training, for which Clerkship Maturity is the first step. The key guidelines along which the curriculum was development were developed by experts. This approach has now been validated. Both students and teachers were asked to fill in a questionnaire regarding preclinical practical skills training to confirm the concept of Clerkship Maturity. The Cologne training program Clerkship Maturity can be validated empirically overall through the activities of the students awaiting the clerkship framework and through the evaluation by the medical staff providing the training. The subjective ratings of the advantages of the training by the students leave room for improvement. Apart from minor improvements to the program, the most likely solution providing sustainable results will involve an over-regional strategy for establishing skills training planned as part of the curriculum.

Education Scholarship and its Impact on Emergency Medicine Education

PubMed Central

Sherbino, Jonathan

2015-01-01

Emergency medicine (EM) education is becoming increasingly challenging as a result of changes to North American medical education and the growing complexity of EM practice. Education scholarship (ES) provides a process to develop solutions to these challenges. ES includes both research and innovation. ES is informed by theory, principles and best practices, is peer reviewed, and is disseminated and archived for others to use. Digital technologies have improved the discovery of work that informs ES, broadened the scope and timing of peer review, and provided new platforms for the dissemination and archiving of innovations. This editorial reviews key steps in raising an education innovation to the level of scholarship. It also discusses important areas for EM education scholars to address, which include the following: the delivery of competency-based medical education programs, the impact of social media on learning, and the redesign of continuing professional development. PMID:26594270

Review of Options for Ammonia/Ammonium Management

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

Nash, C. A.

This report is a review of literature supporting practical ammonia/ammonium destruction processes. Melter research supporting Hanford Low Activity Waste (LAW) glass production has shown that significant amounts of ammonia will be in the melter offgas condensate. Further work with secondary waste forms indicates the potential need to remove the ammonia, perhaps by an oxidative process. This review finds likely practical chemical methods to oxidize ammonia in aqueous solution at moderate temperatures and atmospheric pressure, using easily obtained reagents. Leading candidates include nitrite oxidation to produce nitrogen gas, various peroxide oxidative processes, and air stripping. This work reviews many other processesmore » and provides reasoning to not consider those processes further for this application.« less

Building a COTS archive for satellite data

NASA Technical Reports Server (NTRS)

Singer, Ken; Terril, Dave; Kelly, Jack; Nichols, Cathy

1994-01-01

The goal of the NOAA/NESDIS Active Archive was to provide a method of access to an online archive of satellite data. The archive had to manage and store the data, let users interrogate the archive, and allow users to retrieve data from the archive. Practical issues of the system design such as implementation time, cost and operational support were examined in addition to the technical issues. There was a fixed window of opportunity to create an operational system, along with budget and staffing constraints. Therefore, the technical solution had to be designed and implemented subject to constraint imposed by the practical issues. The NOAA/NESDIS Active Archive came online in July of 1994, meeting all of its original objectives.

Practical gigahertz quantum key distribution robust against channel disturbance.

PubMed

Wang, Shuang; Chen, Wei; Yin, Zhen-Qiang; He, De-Yong; Hui, Cong; Hao, Peng-Lei; Fan-Yuan, Guan-Jie; Wang, Chao; Zhang, Li-Jun; Kuang, Jie; Liu, Shu-Feng; Zhou, Zheng; Wang, Yong-Gang; Guo, Guang-Can; Han, Zheng-Fu

2018-05-01

Quantum key distribution (QKD) provides an attractive solution for secure communication. However, channel disturbance severely limits its application when a QKD system is transferred from the laboratory to the field. Here a high-speed Faraday-Sagnac-Michelson QKD system is proposed that can automatically compensate for the channel polarization disturbance, which largely avoids the intermittency limitations of environment mutation. Over a 50 km fiber channel with 30 Hz polarization scrambling, the practicality of this phase-coding QKD system was characterized with an interference fringe visibility of 99.35% over 24 h and a stable secure key rate of 306 k bits/s over seven days without active polarization alignment.

Full-arch implant-retained prosthetics in general dental practice.

PubMed

Rosenbaum, Nigel

2012-03-01

The loss of all teeth from one or both dental arches is a significant disability affecting self-confidence, communication, masticatory function and aesthetics. Whilst missing teeth cannot be restored to the natural state, the development of a prosthetic dentition has been a goal of dental science throughout the centuries. Contemporary techniques allow for the replacement of missing dentition with fixed or removable solutions, solving many of the problems. Implant dentistry has transformed this area of medicine. This article provides dental practitioners with an overview of this important area of patient care. Dental practitioners in clinical practice will frequently see edentulism; a good understanding of the available options for rehabilitation is essential.

Choosing a New Telephone System for Your Medical Practice.

PubMed

Metherell, Brian

2016-01-01

E-mail may rule the world in other types of businesses, but for medical practices, the telephone remains the primary mode of communication with patients, specialists, and pharmacies. From making appointments to calling in prescriptions, telephones are essential to patient care. With technology changing very quickly and new capabilities coming into the medical practice, such as telemedicine and Skype, you need to know your options when choosing a new telephone system. The possibilities include on-site, cloud, and hybrid networked solutions. A wide variety of features and capabilities are available, from dozens of vendors. Of course, no matter what telephone solution you choose, you must meet regulatory compliance, particularly HIPAA, and Payment Card Industry Data Security Standard if you take credit cards. And it has to be affordable, reliable, and long lasting. This article explores what medical practices need to know when choosing a new business telephone system in order to find the right solutions for their businesses.

Local anesthetic use in tumescent liposuction: an American Society of Plastic Surgeons survey.

PubMed

Paik, Angie M; Daniali, Lily N; Lee, Edward S; Hsia, Henry C

2015-02-01

Current guidelines favor the use of lidocaine in liposuction wetting solutions. The use of bupivacaine as an alternative remains controversial despite reports of its use with safe and favorable outcomes suggesting faster postoperative recovery time secondary to improved pain control. The goals of this study were to determine the prevalence of bupivacaine use, examine liposuction practices of bupivacaine users, and elucidate opinions regarding bupivacaine use. An online survey was distributed to 2500 randomly selected members of the American Society of Plastic Surgeons. Data were collected and analyzed with special attention toward the practice and opinions of bupivacaine use. The response rate of the survey met the average American Society of Plastic Surgeons online survey response rate at 12.8% (n=320). Respondents (7.2%; n=22) reported using bupivacaine in their wetting solutions (bupivacaine group) and provided a dosage range of 62.5 to 150 mg. Respondents (83.5%; n=254) reported using either lidocaine or prilocaine (no-bupivacaine group). There were no reports of bupivacaine toxicity in 2011. The demographic profile and liposuction practices of both groups were comparable. Although 36% of the no-bupivacaine group did not know or had no opinion on when it is appropriate to use bupivacaine in liposuction wetting solutions, 85% of this group has used bupivacaine for other clinical purposes. A review of 320 plastic surgeons' experiences revealed that 7% of respondents are using bupivacaine in their tumescent solutions with no reported cases of toxicity. Bupivacaine users differed dramatically only in their opinion regarding the safety of bupivacaine in tumescent liposuction. The recent studies suggesting better postoperative pain control with bupivacaine along with the proportion of respondents reporting bupivacaine use call for distinct guidelines on bupivacaine use in liposuction. Further studies, including a rigorous clinical trial documenting the safety and efficacy of bupivacaine when compared with lidocaine, would be warranted.

Short-term effects of using verbal instructions and demonstration at the beginning of learning a complex skill in figure skating.

PubMed

Haguenauer, Marianne; Fargier, Patrick; Legreneur, Pierre; Dufour, Anne-Béatrice; Cogerino, Geneviève; Begon, Mickaël; Monteil, Karine M

2005-02-01

This study examined whether providing verbal instructions plus demonstration and task repetition facilitates the early acquisition of a sport skill for which learners had a prior knowledge of the individual motor components. After one demonstration of the task by an expert, 18 novice skaters practiced a figure skating jump during a 15-min. period. Subjects were randomly assigned to one of 3 groups: a group provided with a verbal instruction that specified the subgoals of the task (Subgoals group), a group provided with a verbal instruction that used a metaphor (Metaphoric group), and a group not receiving any specific instruction during training (Control group). Subjects were filmed prior to and immediately following the practice session. Analysis indicated that the modifications of performance were related to the demonstration and the subsequent task repetitions only. Providing additional verbal instructions generated no effect. Therefore, guiding the learner toward a solution to the task problem by means of verbal instruction seems to be ineffective if done too early in the course of learning.

Computerisation of general practice in the Republic of Croatia: experience gained in general practice use.

PubMed

Bergman-Marković, Biserka; Katić, Milica; Kern, Josipa

2007-01-01

Well-organised medical records are the prerequisite for achieving a high level of performance in primary healthcare settings. Recording balanced structured and coded data as well as free text can improve both quality and organisation of work in the office. It provides a more substantiated support of financial transactions and accountancy, allows better communication with other facilities and institutions, and is a source of valuable scientific research material. This article is the result of an individual experience gained in general practice use of various programs/systems employed within the family medicine frame, and the frame of evaluation of available and commonly-exploited program solutions. The use of various programs allows for systematic adjustments as to the increasingly complex requirements imposed on electronic medical records (EMRs). The experience of a general practitioner, presented in this paper, confirms the assumption that an adequate program to be employed with EMRs should be developed, provided that family medicine practitioners, that is, the final users, have been involved in each and every stage of its development, adjustment, implementation and evaluation.

Soil engineering in vivo: harnessing natural biogeochemical systems for sustainable, multi-functional engineering solutions

PubMed Central

DeJong, Jason T.; Soga, Kenichi; Banwart, Steven A.; Whalley, W. Richard; Ginn, Timothy R.; Nelson, Douglas C.; Mortensen, Brina M.; Martinez, Brian C.; Barkouki, Tammer

2011-01-01

Carbon sequestration, infrastructure rehabilitation, brownfields clean-up, hazardous waste disposal, water resources protection and global warming—these twenty-first century challenges can neither be solved by the high-energy consumptive practices that hallmark industry today, nor by minor tweaking or optimization of these processes. A more radical, holistic approach is required to develop the sustainable solutions society needs. Most of the above challenges occur within, are supported on, are enabled by or grown from soil. Soil, contrary to conventional civil engineering thought, is a living system host to multiple simultaneous processes. It is proposed herein that ‘soil engineering in vivo’, wherein the natural capacity of soil as a living ecosystem is used to provide multiple solutions simultaneously, may provide new, innovative, sustainable solutions to some of these great challenges of the twenty-first century. This requires a multi-disciplinary perspective that embraces the science of biology, chemistry and physics and applies this knowledge to provide multi-functional civil and environmental engineering designs for the soil environment. For example, can native soil bacterial species moderate the carbonate cycle in soils to simultaneously solidify liquefiable soil, immobilize reactive heavy metals and sequester carbon—effectively providing civil engineering functionality while clarifying the ground water and removing carbon from the atmosphere? Exploration of these ideas has begun in earnest in recent years. This paper explores the potential, challenges and opportunities of this new field, and highlights one biogeochemical function of soil that has shown promise and is developing rapidly as a new technology. The example is used to propose a generalized approach in which the potential of this new field can be fully realized. PMID:20829246

Soil engineering in vivo: harnessing natural biogeochemical systems for sustainable, multi-functional engineering solutions.

PubMed

DeJong, Jason T; Soga, Kenichi; Banwart, Steven A; Whalley, W Richard; Ginn, Timothy R; Nelson, Douglas C; Mortensen, Brina M; Martinez, Brian C; Barkouki, Tammer

2011-01-06

Carbon sequestration, infrastructure rehabilitation, brownfields clean-up, hazardous waste disposal, water resources protection and global warming-these twenty-first century challenges can neither be solved by the high-energy consumptive practices that hallmark industry today, nor by minor tweaking or optimization of these processes. A more radical, holistic approach is required to develop the sustainable solutions society needs. Most of the above challenges occur within, are supported on, are enabled by or grown from soil. Soil, contrary to conventional civil engineering thought, is a living system host to multiple simultaneous processes. It is proposed herein that 'soil engineering in vivo', wherein the natural capacity of soil as a living ecosystem is used to provide multiple solutions simultaneously, may provide new, innovative, sustainable solutions to some of these great challenges of the twenty-first century. This requires a multi-disciplinary perspective that embraces the science of biology, chemistry and physics and applies this knowledge to provide multi-functional civil and environmental engineering designs for the soil environment. For example, can native soil bacterial species moderate the carbonate cycle in soils to simultaneously solidify liquefiable soil, immobilize reactive heavy metals and sequester carbon-effectively providing civil engineering functionality while clarifying the ground water and removing carbon from the atmosphere? Exploration of these ideas has begun in earnest in recent years. This paper explores the potential, challenges and opportunities of this new field, and highlights one biogeochemical function of soil that has shown promise and is developing rapidly as a new technology. The example is used to propose a generalized approach in which the potential of this new field can be fully realized.

Problem Definition and Solution Strategies in Dental Practice. Executive Summary, September 19, 1979-October 31, 1980.

ERIC Educational Resources Information Center

Dane, J. K.; And Others

An executive summary of a study designed to investigate the identification and solution of clinical and nonclinical problems in dental practice is presented. The study used a combination of structured group meetings of individuals involved in dentistry and related areas and written workbooks completed by participants. A steering committee advised…

International Graduate Students' Academic Writing Practices in Malaysia: Challenges and Solutions

ERIC Educational Resources Information Center

Singh, Manjet Kaur Mehar

2015-01-01

This article focuses on the challenges faced by non-native English speaking international graduate students in their academic writing practices while they studied at a university in Malaysia as well as the solutions they employed when faced with the challenges. Academic Literacies Questionnaire was used to collect data. Based on 131 participants,…

Investigation of Service Quality of Measurement Reference Points for the Internet Services on Mobile Networks

NASA Astrophysics Data System (ADS)

Lipenbergs, E.; Bobrovs, Vj.; Ivanovs, G.

2016-10-01

To ensure that end-users and consumers have access to comprehensive, comparable and user-friendly information regarding the Internet access service quality, it is necessary to implement and regularly renew a set of legislative regulatory acts and to provide monitoring of the quality of Internet access services regarding the current European Regulatory Framework. The actual situation regarding the quality of service monitoring solutions in different European countries depends on national regulatory initiatives and public awareness. The service monitoring solutions are implemented using different measurement methodologies and tools. The paper investigates the practical implementations for developing a harmonising approach to quality monitoring in order to obtain objective information on the quality of Internet access services on mobile networks.

Gap analysis: synergies and opportunities for effective nursing leadership.

PubMed

Davis-Ajami, Mary Lynn; Costa, Linda; Kulik, Susan

2014-01-01

Gap analysis encompasses a comprehensive process to identify, understand, address, and bridge gaps in service delivery and nursing practice. onducting gap analysis provides structure to information gathering and the process of finding sustainable solutions to important deficiencies. Nursing leaders need to recognize, measure, monitor, and execute on feasible actionable solutions to help organizations make adjustments to address gaps between what is desired and the actual real-world conditions contributing to the quality chasm in health care. Gap analysis represents a functional and comprehensive tool to address organizational deficiencies. Using gap analysis proactively helps organizations map out and sustain corrective efforts to close the quality chasm. Gaining facility in gap analysis should help the nursing profession's contribution to narrowing the quality chasm.

Fixing responsibility for risk management.

PubMed

Maniccia, M D

2000-01-01

The responsibility for carrying financial risk for medical coverage has migrated from individuals to insurers to employers to providers, without finding a satisfactory home. Each shift further complicates the health care infrastructure, as other responsibilities in the management of benefits and provision of care gravitate to the stakeholder who accepts risk. The social imperative to broaden coverage is forcing a change in the mechanisms of risk management--from avoiding high-risk patients, to managing those patients to better outcomes. In this paper we seek to identify objectively the most appropriate party to carry the financial risk of medical coverage, consider what characteristics are necessary to make that a practical and enduring solution, and examine the secondary effects of the structure required to support that solution.

High-resolution inkjet printing of all-polymer transistor circuits.

PubMed

Sirringhaus, H; Kawase, T; Friend, R H; Shimoda, T; Inbasekaran, M; Wu, W; Woo, E P

2000-12-15

Direct printing of functional electronic materials may provide a new route to low-cost fabrication of integrated circuits. However, to be useful it must allow continuous manufacturing of all circuit components by successive solution deposition and printing steps in the same environment. We demonstrate direct inkjet printing of complete transistor circuits, including via-hole interconnections based on solution-processed polymer conductors, insulators, and self-organizing semiconductors. We show that the use of substrate surface energy patterning to direct the flow of water-based conducting polymer inkjet droplets enables high-resolution definition of practical channel lengths of 5 micrometers. High mobilities of 0.02 square centimeters per volt second and on-off current switching ratios of 10(5) were achieved.

Dynamic Online Bandwidth Adjustment Scheme Based on Kalai-Smorodinsky Bargaining Solution

NASA Astrophysics Data System (ADS)

Kim, Sungwook

Virtual Private Network (VPN) is a cost effective method to provide integrated multimedia services. Usually heterogeneous multimedia data can be categorized into different types according to the required Quality of Service (QoS). Therefore, VPN should support the prioritization among different services. In order to support multiple types of services with different QoS requirements, efficient bandwidth management algorithms are important issues. In this paper, I employ the Kalai-Smorodinsky Bargaining Solution (KSBS) for the development of an adaptive bandwidth adjustment algorithm. In addition, to effectively manage the bandwidth in VPNs, the proposed control paradigm is realized in a dynamic online approach, which is practical for real network operations. The simulations show that the proposed scheme can significantly improve the system performances.

Leading clinical handover improvement: a change strategy to implement best practices in the acute care setting.

PubMed

Clarke, Christina M; Persaud, Drepaul David

2011-03-01

Many contemporary acute care facilities lack safe and effective clinical handover practices resulting in patient transitions that are vulnerable to discontinuities in care, medical errors, and adverse patient safety events. This article is intended to supplement existing handover improvement literature by providing practical guidance for leaders and managers who are seeking to improve the safety and the effectiveness of clinical handovers in the acute care setting. A 4-stage change model has been applied to guide the application of strategies for handover improvement. Change management and quality improvement principles, as well as concepts drawn from safety science and high-reliability organizations, were applied to inform strategies. A model for handover improvement respecting handover complexity is presented. Strategies targeted to stages of change include the following: 1. Enhancing awareness of handover problems and opportunities with the support of strategic directions, accountability, end user involvement, and problem complexity recognition. 2. Identifying solutions by applying and adapting best practices in local contexts. 3. Implementing locally adapted best practices supported by communication, documentation, and training. 4. Institutionalizing practice changes through integration, monitoring, and active dissemination. Finally, continued evaluation at every stage is essential. Although gaps in handover process and function knowledge remain, efforts to improve handover safety and effectiveness are still possible. Continued evaluation is critical in building this understanding and to ensure that practice changes lead to improvements in patient safety, organizational effectiveness, and patient and provider satisfaction. Through handover knowledge building, fundamental changes in handover policies and practices may be possible.

Societal views and animal welfare science: understanding why the modified cage may fail and other stories.

PubMed

Weary, D M; Ventura, B A; von Keyserlingk, M A G

2016-02-01

The innovations developed by scientists working on animal welfare are often not adopted in practice. In this paper, we argue that one important reason for this failure is that the solutions proposed do not adequately address the societal concerns that motivated the original research. Some solutions also fail because they do not adequately address perceived constraints within the industry. Using examples from our own recent work, we show how research methods from the social sciences can address both of these limitations. For example, those who persist in tail-docking cattle (despite an abundance of evidence showing that the practice has no benefits) often justify their position by citing concern for cow cleanliness. This result informs the nature of new extension efforts directed at farmers that continue to tail dock, suggesting that these efforts will be more effective if they focus on providing producers with methods (of proven efficacy) for keeping cows clean. Work on pain mitigation for dehorning shows that some participants reluctant to provide pain relief believe that the pain from this procedure is short lasting and has little impact on the calf. This result informs the direction of new biological research efforts to understand both the magnitude and duration of any suffering that result from this type of procedure. These, and other examples, illustrate how social science methodologies can document the shared and divergent values of different stakeholders (to ensure that proposed solutions align with mainstream values), beliefs regarding the available evidence (to help target new scientific research that meets the perceived gaps), and barriers in implementing changes (to ease adoption of ideas by addressing these barriers).

Fast and Adaptive Lossless Onboard Hyperspectral Data Compression System

NASA Technical Reports Server (NTRS)

Aranki, Nazeeh I.; Keymeulen, Didier; Kimesh, Matthew A.

2012-01-01

Modern hyperspectral imaging systems are able to acquire far more data than can be downlinked from a spacecraft. Onboard data compression helps to alleviate this problem, but requires a system capable of power efficiency and high throughput. Software solutions have limited throughput performance and are power-hungry. Dedicated hardware solutions can provide both high throughput and power efficiency, while taking the load off of the main processor. Thus a hardware compression system was developed. The implementation uses a field-programmable gate array (FPGA). The implementation is based on the fast lossless (FL) compression algorithm reported in Fast Lossless Compression of Multispectral-Image Data (NPO-42517), NASA Tech Briefs, Vol. 30, No. 8 (August 2006), page 26, which achieves excellent compression performance and has low complexity. This algorithm performs predictive compression using an adaptive filtering method, and uses adaptive Golomb coding. The implementation also packetizes the coded data. The FL algorithm is well suited for implementation in hardware. In the FPGA implementation, one sample is compressed every clock cycle, which makes for a fast and practical realtime solution for space applications. Benefits of this implementation are: 1) The underlying algorithm achieves a combination of low complexity and compression effectiveness that exceeds that of techniques currently in use. 2) The algorithm requires no training data or other specific information about the nature of the spectral bands for a fixed instrument dynamic range. 3) Hardware acceleration provides a throughput improvement of 10 to 100 times vs. the software implementation. A prototype of the compressor is available in software, but it runs at a speed that does not meet spacecraft requirements. The hardware implementation targets the Xilinx Virtex IV FPGAs, and makes the use of this compressor practical for Earth satellites as well as beyond-Earth missions with hyperspectral instruments.

Optimal design of a main driving mechanism for servo punch press based on performance atlases

NASA Astrophysics Data System (ADS)

Zhou, Yanhua; Xie, Fugui; Liu, Xinjun

2013-09-01

The servomotor drive turret punch press is attracting more attentions and being developed more intensively due to the advantages of high speed, high accuracy, high flexibility, high productivity, low noise, cleaning and energy saving. To effectively improve the performance and lower the cost, it is necessary to develop new mechanisms and establish corresponding optimal design method with uniform performance indices. A new patented main driving mechanism and a new optimal design method are proposed. In the optimal design, the performance indices, i.e., the local motion/force transmission indices ITI, OTI, good transmission workspace good transmission workspace(GTW) and the global transmission indices GTIs are defined. The non-dimensional normalization method is used to get all feasible solutions in dimensional synthesis. Thereafter, the performance atlases, which can present all possible design solutions, are depicted. As a result, the feasible solution of the mechanism with good motion/force transmission performance is obtained. And the solution can be flexibly adjusted by designer according to the practical design requirements. The proposed mechanism is original, and the presented design method provides a feasible solution to the optimal design of the main driving mechanism for servo punch press.

Source sparsity control of sound field reproduction using the elastic-net and the lasso minimizers.

PubMed

Gauthier, P-A; Lecomte, P; Berry, A

2017-04-01

Sound field reproduction is aimed at the reconstruction of a sound pressure field in an extended area using dense loudspeaker arrays. In some circumstances, sound field reproduction is targeted at the reproduction of a sound field captured using microphone arrays. Although methods and algorithms already exist to convert microphone array recordings to loudspeaker array signals, one remaining research question is how to control the spatial sparsity in the resulting loudspeaker array signals and what would be the resulting practical advantages. Sparsity is an interesting feature for spatial audio since it can drastically reduce the number of concurrently active reproduction sources and, therefore, increase the spatial contrast of the solution at the expense of a difference between the target and reproduced sound fields. In this paper, the application of the elastic-net cost function to sound field reproduction is compared to the lasso cost function. It is shown that the elastic-net can induce solution sparsity and overcomes limitations of the lasso: The elastic-net solves the non-uniqueness of the lasso solution, induces source clustering in the sparse solution, and provides a smoother solution within the activated source clusters.

Research-Practice Integration in Real Practice Settings: Issues and Suggestions

ERIC Educational Resources Information Center

Cheung, Monit; Ma, Anny K.; Thyer, Bruce A.; Webb, Ann E.

2015-01-01

At the National Bridging the Research and Practice Gap Symposium to discuss evidence-based practice (EBP) in social work, 150 participants attended five breakout groups to address real practice setting applications. These participants from social work academia and practice communities addressed issues and looked for solutions to promote…

Well-Child Care Practice Redesign for Low-Income Children: The Perspectives of Health Plans, Medical Groups, and State Agencies

PubMed Central

Coker, Tumaini R.; DuPlessis, Helen M.; Davoudpour, Ramona; Moreno, Candice; Rodriguez, Michael A.; Chung, Paul J.

2015-01-01

Objective The aim of this study was to examine the views of key stakeholders in health care payer organizations on the use of practice redesign strategies to improve the delivery of well-child care (WCC) to low-income children aged 0 to 3 years. Methods We conducted semistructured interviews with 18 key stakeholders (eg, chief medical officers, medical directors) in 11 California health plans and 2 medical group organizations serving low-income children, as well as the 2 state agencies that administer the 2 largest low-income insurance programs for California children. Discussions were recorded, transcribed, and analyzed using the constant comparative method of qualitative analysis. Results Participants reported that nonphysicians were underutilized as WCC providers, and group visits and Internet services were likely a more effective way to provide anticipatory guidance and behavioral/developmental services. Participants described barriers to redesign, including the start-up costs required to implement redesign as well as a lack of financial incentives to support innovation in WCC delivery. Participants suggested solutions to these barriers, including using pay-for-performance programs to reward practices that expanded WCC services, and providing practices with start-up grants to implement pilot redesign projects that would eventually become self-sustaining. State-level barriers included poor Medicaid reimbursement rates and disincentives to innovation created by current Healthcare Effectiveness Data and Information Set measures. Conclusions All stakeholders will ultimately be needed to support WCC redesign; however, California payers may need to provide logistic, design, and financial support to practices, whereas state agencies may need to reshape the incentives to reward innovation around child preventive health and developmental services. PMID:22075467

Secure smart grid communications and information integration based on digital watermarking in wireless sensor networks

NASA Astrophysics Data System (ADS)

Yan, Xin; Zhang, Ling; Wu, Yang; Luo, Youlong; Zhang, Xiaoxing

2017-02-01

As more and more wireless sensor nodes and networks are employed to acquire and transmit the state information of power equipment in smart grid, we are in urgent need of some viable security solutions to ensure secure smart grid communications. Conventional information security solutions, such as encryption/decryption, digital signature and so forth, are not applicable to wireless sensor networks in smart grid any longer, where bulk messages need to be exchanged continuously. The reason is that these cryptographic solutions will account for a large portion of the extremely limited resources on sensor nodes. In this article, a security solution based on digital watermarking is adopted to achieve the secure communications for wireless sensor networks in smart grid by data and entity authentications at a low cost of operation. Our solution consists of a secure framework of digital watermarking, and two digital watermarking algorithms based on alternating electric current and time window, respectively. Both watermarking algorithms are composed of watermark generation, embedding and detection. The simulation experiments are provided to verify the correctness and practicability of our watermarking algorithms. Additionally, a new cloud-based architecture for the information integration of smart grid is proposed on the basis of our security solutions.

Improving occupational physicians' adherence to a practice guideline: feasibility and impact of a tailored implementation strategy.

PubMed

Joosen, Margot C W; van Beurden, Karlijn M; Terluin, Berend; van Weeghel, Jaap; Brouwers, Evelien P M; van der Klink, Jac J L

2015-04-24

Although practice guidelines are important tools to improve quality of care, implementation remains challenging. To improve adherence to an evidence-based guideline for the management of mental health problems, we developed a tailored implementation strategy targeting barriers perceived by occupational physicians (OPs). Feasibility and impact on OPs' barriers were evaluated. OPs received 8 training-sessions in small peer-learning groups, aimed at discussing the content of the guideline and their perceived barriers to adhere to guideline recommendations; finding solutions to overcome these barriers; and implementing solutions in practice. The training had a plan-do-check-act (PDCA) structure and was guided by a trainer. Protocol compliance and OPs' experiences were qualitatively and quantitatively assessed. Using a questionnaire, impact on knowledge, attitude, and external barriers to guideline adherence was investigated before and after the training. The training protocol was successfully conducted; guideline recommendations and related barriers were discussed with peers, (innovative) solutions were found and implemented in practice. The participating 32 OPs were divided into 6 groups and all OPs attended 8 sessions. Of the OPs, 90% agreed that the peer-learning groups and the meetings spread over one year were highly effective training components. Significant improvements (p < .05) were found in knowledge, self-efficacy, motivation to use the guideline and its applicability to individual patients. After the training, OPs did not perceive any barriers related to knowledge and self-efficacy. Perceived adherence increased from 48.8% to 96.8% (p < .01). The results imply that an implementation strategy focusing on perceived barriers and tailor-made implementation interventions is a feasible method to enhance guideline adherence. Moreover, the strategy contributed to OPs' knowledge, attitudes, and skills in using the guideline. As a generic approach to overcome barriers perceived in specific situations, this strategy provides a useful method to guideline implementation for other health care professionals too.

Replacing revolving door: a collaborative approach to treating individuals in crisis.

PubMed

Lauer, Michelle; Brownstein, Rose

2008-06-01

The Crisis Assessment and Psychiatric Emergency Services (CAPES) unit was designed to improve the quality of psychiatric treatment, contain costs, and provide relief to overburdened psychiatric inpatient and emergency services in Delaware. This innovative program is the result of collaboration between public and private agencies to treat individuals in crisis. The myriad factors that contributed to a broken system and instigated Delaware's search for a solution are discussed in this article. The CAPES unit has resulted in improved communication among providers, decreased committal rates, better linkage to appropriate levels of care, increased safety, and improved coordination of services. Clinical implications for nursing practice include providing more holistic care in a safer environment.

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

PubMed

Yalch, Matthew M

2016-03-01

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

A review of recent advances in the spherical harmonics expansion method for semiconductor device simulation.

PubMed

Rupp, K; Jungemann, C; Hong, S-M; Bina, M; Grasser, T; Jüngel, A

The Boltzmann transport equation is commonly considered to be the best semi-classical description of carrier transport in semiconductors, providing precise information about the distribution of carriers with respect to time (one dimension), location (three dimensions), and momentum (three dimensions). However, numerical solutions for the seven-dimensional carrier distribution functions are very demanding. The most common solution approach is the stochastic Monte Carlo method, because the gigabytes of memory requirements of deterministic direct solution approaches has not been available until recently. As a remedy, the higher accuracy provided by solutions of the Boltzmann transport equation is often exchanged for lower computational expense by using simpler models based on macroscopic quantities such as carrier density and mean carrier velocity. Recent developments for the deterministic spherical harmonics expansion method have reduced the computational cost for solving the Boltzmann transport equation, enabling the computation of carrier distribution functions even for spatially three-dimensional device simulations within minutes to hours. We summarize recent progress for the spherical harmonics expansion method and show that small currents, reasonable execution times, and rare events such as low-frequency noise, which are all hard or even impossible to simulate with the established Monte Carlo method, can be handled in a straight-forward manner. The applicability of the method for important practical applications is demonstrated for noise simulation, small-signal analysis, hot-carrier degradation, and avalanche breakdown.

Assessment of a Hybrid Continuous/Discontinuous Galerkin Finite Element Code for Geothermal Reservoir Simulations

DOE PAGES

Xia, Yidong; Podgorney, Robert; Huang, Hai

2016-03-17

FALCON (“Fracturing And Liquid CONvection”) is a hybrid continuous / discontinuous Galerkin finite element geothermal reservoir simulation code based on the MOOSE (“Multiphysics Object-Oriented Simulation Environment”) framework being developed and used for multiphysics applications. In the present work, a suite of verification and validation (“V&V”) test problems for FALCON was defined to meet the design requirements, and solved to the interests of enhanced geothermal system (“EGS”) design. Furthermore, the intent for this test problem suite is to provide baseline comparison data that demonstrates the performance of the FALCON solution methods. The simulation problems vary in complexity from singly mechanical ormore » thermo process, to coupled thermo-hydro-mechanical processes in geological porous media. Numerical results obtained by FALCON agreed well with either the available analytical solution or experimental data, indicating the verified and validated implementation of these capabilities in FALCON. Some form of solution verification has been attempted to identify sensitivities in the solution methods, where possible, and suggest best practices when using the FALCON code.« less

Assessment of a hybrid finite element and finite volume code for turbulent incompressible flows

DOE PAGES

Xia, Yidong; Wang, Chuanjin; Luo, Hong; ...

2015-12-15

Hydra-TH is a hybrid finite-element/finite-volume incompressible/low-Mach flow simulation code based on the Hydra multiphysics toolkit being developed and used for thermal-hydraulics applications. In the present work, a suite of verification and validation (V&V) test problems for Hydra-TH was defined to meet the design requirements of the Consortium for Advanced Simulation of Light Water Reactors (CASL). The intent for this test problem suite is to provide baseline comparison data that demonstrates the performance of the Hydra-TH solution methods. The simulation problems vary in complexity from laminar to turbulent flows. A set of RANS and LES turbulence models were used in themore » simulation of four classical test problems. Numerical results obtained by Hydra-TH agreed well with either the available analytical solution or experimental data, indicating the verified and validated implementation of these turbulence models in Hydra-TH. Where possible, we have attempted some form of solution verification to identify sensitivities in the solution methods, and to suggest best practices when using the Hydra-TH code.« less

Assessment of a hybrid finite element and finite volume code for turbulent incompressible flows

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

Xia, Yidong; Wang, Chuanjin; Luo, Hong

Hydra-TH is a hybrid finite-element/finite-volume incompressible/low-Mach flow simulation code based on the Hydra multiphysics toolkit being developed and used for thermal-hydraulics applications. In the present work, a suite of verification and validation (V&V) test problems for Hydra-TH was defined to meet the design requirements of the Consortium for Advanced Simulation of Light Water Reactors (CASL). The intent for this test problem suite is to provide baseline comparison data that demonstrates the performance of the Hydra-TH solution methods. The simulation problems vary in complexity from laminar to turbulent flows. A set of RANS and LES turbulence models were used in themore » simulation of four classical test problems. Numerical results obtained by Hydra-TH agreed well with either the available analytical solution or experimental data, indicating the verified and validated implementation of these turbulence models in Hydra-TH. Where possible, we have attempted some form of solution verification to identify sensitivities in the solution methods, and to suggest best practices when using the Hydra-TH code.« less

I need to know! Timely accessing of perioperative user manuals.

PubMed

Landreneau, Raphael

2010-12-01

Ready access to equipment or product information is essential for the safe operation of the many items that a perioperative nurse is asked to use, troubleshoot, or maintain. One institution's solution for making manufacturer information available in the practice setting was to create a facility intranet site dedicated to OR equipment manuals. This site provides information access to perioperative nurses and support staff members and, ultimately, helps improve patient care. Published by Elsevier Inc. All rights reserved.

Intelligence and Technology. Joint Force Quarterly, Issue 46, 3rd Quarter 2007

DTIC Science & Technology

2007-01-01

pioneering work of B.F. Skinner overcame this obstacle by embracing the notion of the “black box.” At the practical level, one does not need to see...possibilities here is the pioneering adaptation of the discipline of movement analysis described by Brenda Connors.19 In contrast to traditional profil- ing...unfamiliarity with the local geography and demography by arming them with informa- tion technology solutions, providing each Applying Law Enforcement

Healthcare Hackathons Provide Educational and Innovation Opportunities: A Case Study and Best Practice Recommendations.

PubMed

Silver, Julie K; Binder, David S; Zubcevik, Nevena; Zafonte, Ross D

2016-07-01

Physicians and other healthcare professionals are often the end users of medical innovation; however, they are rarely involved in the beginning design stages. This often results in ineffective healthcare solutions with poor adoption rates. At the early design stage, innovation would benefit from input from healthcare professionals. This report describes the first-ever rehabilitation hackathon-an interdisciplinary and competitive team event aimed at accelerating and improving healthcare solutions and providing an educational experience for participants. Hackathons are gaining traction as a way to accelerate innovation by bringing together a diverse group of interdisciplinary professionals from different industries who work collaboratively in teams and learn from each other, focus on a specific problem ("pain point"), develop a solution using design thinking techniques, pitch the solution to participants, gather fast feedback and quickly alter the prototype design ("pivoting"). 102 hackers including 19 (18.6 %) physicians and other professionals participated, and over the course of 2 days worked in teams, pitched ideas and developed design prototypes. Three awards were given for prototypes that may improve function in persons with disabilities. 43 hackers were women (42.2 %) and 59 men (57.8 %); they ranged in age from 16 to 79 years old; and, of the 75 hackers who reported their age, 63 (84 %) were less than 40 years old and 12 (16 %) were 40 years or older. This report contributes to the emerging literature on healthcare hackathons as a means of providing interdisciplinary education and training and supporting innovation.

Solving Hard Computational Problems Efficiently: Asymptotic Parametric Complexity 3-Coloring Algorithm

PubMed Central

Martín H., José Antonio

2013-01-01

Many practical problems in almost all scientific and technological disciplines have been classified as computationally hard (NP-hard or even NP-complete). In life sciences, combinatorial optimization problems frequently arise in molecular biology, e.g., genome sequencing; global alignment of multiple genomes; identifying siblings or discovery of dysregulated pathways. In almost all of these problems, there is the need for proving a hypothesis about certain property of an object that can be present if and only if it adopts some particular admissible structure (an NP-certificate) or be absent (no admissible structure), however, none of the standard approaches can discard the hypothesis when no solution can be found, since none can provide a proof that there is no admissible structure. This article presents an algorithm that introduces a novel type of solution method to “efficiently” solve the graph 3-coloring problem; an NP-complete problem. The proposed method provides certificates (proofs) in both cases: present or absent, so it is possible to accept or reject the hypothesis on the basis of a rigorous proof. It provides exact solutions and is polynomial-time (i.e., efficient) however parametric. The only requirement is sufficient computational power, which is controlled by the parameter . Nevertheless, here it is proved that the probability of requiring a value of to obtain a solution for a random graph decreases exponentially: , making tractable almost all problem instances. Thorough experimental analyses were performed. The algorithm was tested on random graphs, planar graphs and 4-regular planar graphs. The obtained experimental results are in accordance with the theoretical expected results. PMID:23349711

Dental hygiene intervention to prevent nosocomial pneumonias.

PubMed

Barnes, Caren M

2014-06-01

Nosocomial and ventilator associated pneumonias that plague critically ill, elderly and long-term care residents could be reduced with effective oral hygiene practices facilitated collaboratively between nurses and dental hygienists. Nosocomial pneumonias, specifically aspiration pneumonias and ventilator-associated pneumonias in the elderly and infirm have become a major health care issue, The provision of oral care in hospital and hospital-like facilities presents challenges that can prevent patients from receiving optimal oral care One sequela can be aspiration pneumonia which ranks first in mortality and second in morbidity among all nosocomial infections. Since aspiration pneumonia is linked to the colonization of oral bacteria in dental plaque and biofilm, it is time to look for creative solutions to integrating the expertise of dental hygienists into health care teams in these institutional settings. A comprehensive review of the literature was conducted regarding the etiology and prevalence of health care related pneumonias. Evidence describing the challenges and barriers that the nurses, nursing staff, and dental hygienists face in the provision of oral care in hospitals and long-term care facilities is provided. Intercollaborative solutions to providing optimal oral care in hospitals and long-term care facilities are suggested. Dental hygienists have the expertise and practice experience to provide oral care in hospitals, long-term care and residential facilities. They can contribute to solving oral care challenges through intercollaboration with other health care team members. Yet, there are long-standing systemic barriers that must be addressed in order to provide this optimal care. Dental hygienists becoming better assimilated within the total health care team in hospital and residential facilities can positively impact the suffering, morbidity and mortality associated with aspiration pneumonias. Copyright © 2014 Elsevier Inc. All rights reserved.

Structured inspection of medications carried and stored by emergency medical services agencies identifies practices that may lead to medication errors.

PubMed

Kupas, Douglas F; Shayhorn, Meghan A; Green, Paul; Payton, Thomas F

2012-01-01

Medications are essential to emergency medical services (EMS) agencies when providing lifesaving care, but the EMS environment has challenges related to safe medication storage when compared with a hospital setting. We developed a structured process, based on common pharmacy practices, to review medications carried by EMS agencies to identify situations that may lead to medication error and to determine some best practices that may reduce potential errors and the risk of patient harm. To provide a descriptive account of EMS practices related to carrying and storing medications that have the potential for causing a medication administration error or patient harm. Using a structured process for inspection, an emergency medicine pharmacist and emergency physician(s) reviewed the medication carrying and storage practices of all nine advanced life support ambulance agencies within a five-county EMS region. Each medication carried and stored by the EMS agency was inspected for predetermined and spontaneously observed issues that could lead to medication error. These issues were documented and photographed. Two EMS medical directors reviewed each potential error for the risk of producing patient harm and assigned each to a category of high, moderate, or low risk. Because issues of temperature on EMS medications have been addressed elsewhere, this study concentrated on potential for EMS medication administration errors exclusive of storage temperatures. When reviewing medications carried by the nine EMS agencies, 38 medication safety issues were identified (range 1 to 8 per EMS agency). Of these, 16 were considered to be high risk, 14 moderate risk, and eight low risk for patient harm. Examples of potential issues included carrying expired medications, container-labeling issues, different medications stored in look-alike vials or prefilled syringes in the same compartment, and carrying crystalloid solutions next to solutions premixed with a medication. When reviewing medications stored at the EMS agency stations, eight safety issues were identified (range from 0 to 4 per station), including five moderate-risk and three low-risk issues. No agency had any high-risk medication issues related to storage of medication stock in the station. We observed potential medication safety issues related to how medications are carried and stored at all nine EMS agencies in a five-county region. Understanding these issues may assist EMS agencies in reducing the potential for a medication error and risk of patient harm. More research is needed to determine whether following these suggested best practices for carrying medications on EMS vehicles actually reduces errors in medication administration by EMS providers or decreases patient harm.

The role of culture in breast health practices among Chinese-Australian women.

PubMed

Kwok, Cannas; Sullivan, Gerard; Cant, Rosemary

2006-12-01

Exploring how cultural meanings of the breast impact on perceived images of breast cancer and breast health practices. In-depth interviews were conducted with 20 Chinese-Australian women in their native language (Cantonese). The findings revealed that the meanings of the breast are constructed within the women's social and cultural context where breasts are associated with sex; and talking about, being concerned with or expressing curiosity about breasts is considered inappropriate. These views have a significant impact on (1) the way the informants viewed breast cancer; (2) perceptions of breast health practices; and (3) the explanations of breast cancer and associated risk perception. Understanding the nature of culturally-based barriers to utilization of breast cancer screening is the first step to discovering solutions for making screening tests more acceptable to women from other cultures. This study provides insight about obstacles for breast health promotion practices and for developing culturally appropriate health education programs and counselling strategies.

Nursing practice and work environment issues in the 21st century: a leadership challenge.

PubMed

Manojlovich, Milisa; Barnsteiner, Jane; Bolton, Linda Burnes; Disch, Joanne; Saint, Sanjay

2008-01-01

A leadership conference titled "Have Patient Safety and the Workforce Shortage Created the Perfect Storm?" was held in honor of Dr. Ada Sue Hinshaw, who was ending her tenure as dean of the University of Michigan School of Nursing. A morning panel on the preferred future for practice featured plenary speaker Dr. Linda Burnes Bolton and participating panelists Dr. Sanjay Saint, Dr. Jane Barnsteiner, and Dr. Joanne Disch. Each speaker presented a unique yet complementary perspective, with several common themes permeating the morning's presentations. For example, all of the speakers mentioned how important interprofessional collaboration is to promoting patient safety. The themes can be categorized broadly as nursing practice and work environment issues, with subthemes of interprofessional communication and collaboration, systems solutions to patient safety problems, and future directions in nursing education. A synopsis of comments made during the morning practice panel and empirical support for the themes and subthemes identified by panelists are provided in this article.

Ability of Social Work Students to Determine the Appropriateness of Solutions to Problems Encountered in Social Work Practice.

ERIC Educational Resources Information Center

Sturges, Jack; Yarbrough, Roy D.

The purpose of this study was to determine whether there was an association between the amount of formal social work education completed and ability of students to judge the degree of appropriateness of proposed solutions to problems frequently encountered in social work practice, and secondarily to determine whether students' judgments of problem…

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

PubMed

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

2017-10-01

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

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

PubMed Central

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

2018-01-01

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

Modelling the dispersion of treated wastewater in a shallow coastal wind-driven environment, Geographe Bay, Western Australia: implications for environmental management.

PubMed

Dunn, Ryan J K; Zigic, Sasha; Shiell, Glenn R

2014-10-01

Numerical models are useful for predicting the transport and fate of contaminants in dynamic marine environments, and are increasingly a practical solution to environmental impact assessments. In this study, a three-dimensional hydrodynamic model and field data were used to validate a far-field dispersion model that, in turn, was used to determine the fate of treated wastewater (TWW) discharged to the ocean via a submarine ocean outfall under hypothetical TWW flows. The models were validated with respect to bottom and surface water current speed and direction, and in situ measurements of total nitrogen and faecal coliforms. Variations in surface and bottom currents were accurately predicted by the model as were nutrient and coliform concentrations. Results indicated that the ocean circulation was predominately wind driven, evidenced by relatively small oscillations in the current speeds along the time-scale of the tide, and that dilution mixing zones were orientated in a predominantly north-eastern direction from the outfall and parallel to the coastline. Outputs of the model were used to determine the 'footprint' of the TWW plume under a differing discharge scenario and, particularly, whether the resultant changes in TWW contaminants, total nitrogen and faecal coliforms would meet local environmental quality objectives (EQO) for ecosystem integrity, shellfish harvesting and primary recreation. Modelling provided a practical solution for predicting the dilution of contaminants under a hypothetical discharge scenario and a means for determining the aerial extent of exclusion zones, where the EQOs for shellfish harvesting and primary recreation may not always be met. Results of this study add to the understanding of regional discharge conditions and provide a practical case study for managing impacts to marine environments under a differing TWW discharge scenario, in comparison to an existing scenario.

Improving small-angle X-ray scattering data for structural analyses of the RNA world

PubMed Central

Rambo, Robert P.; Tainer, John A.

2010-01-01

Defining the shape, conformation, or assembly state of an RNA in solution often requires multiple investigative tools ranging from nucleotide analog interference mapping to X-ray crystallography. A key addition to this toolbox is small-angle X-ray scattering (SAXS). SAXS provides direct structural information regarding the size, shape, and flexibility of the particle in solution and has proven powerful for analyses of RNA structures with minimal requirements for sample concentration and volumes. In principle, SAXS can provide reliable data on small and large RNA molecules. In practice, SAXS investigations of RNA samples can show inconsistencies that suggest limitations in the SAXS experimental analyses or problems with the samples. Here, we show through investigations on the SAM-I riboswitch, the Group I intron P4-P6 domain, 30S ribosomal subunit from Sulfolobus solfataricus (30S), brome mosaic virus tRNA-like structure (BMV TLS), Thermotoga maritima asd lysine riboswitch, the recombinant tRNAval, and yeast tRNAphe that many problems with SAXS experiments on RNA samples derive from heterogeneity of the folded RNA. Furthermore, we propose and test a general approach to reducing these sample limitations for accurate SAXS analyses of RNA. Together our method and results show that SAXS with synchrotron radiation has great potential to provide accurate RNA shapes, conformations, and assembly states in solution that inform RNA biological functions in fundamental ways. PMID:20106957

EPA Technical Support Centers (TSC): FY14 Lessons ...

EPA Pesticide Factsheets

EPA’s Technical Support Centers (TSC) included in ORD’s Safe and Healthy Communities (SHC) Research Action Plan fill the need for supplying subject-matter experts to continually assess state-of-the-art research and practices and channel this information to users in both direct applications (i.e., site-specific technical support) and general applications (i.e., technical transfer activities such as technical guidance documents, conferences, or workshops) . The TSCs are charged with providing solutions by: 1) linking EPA research to Agency decision-makers; 2) applying best practices to real world field applications; and 3) channeling feedback from field application to research communities. The TSP goal is to provide Regional Remedial Project Managers (RPMs), Corrective Action Staff, and On-Scene Coordinators (OSCs) with a diverse set of readily-accessible resources for technical assistance. This research summary provides six case studies – two from each of the three TSCs (Ground Water Technical Support Center, Engineering Technical Support Center, and Site Characterization Technical Support Center) – to exemplify and summarize the variety of TSC approaches that contribute to fulfilling the TSP mission. EPA’s Technical Support Centers (TSC) included in ORD’s Safe and Healthy Communities (SHC) Research Action Plan fill the need for supplying subject-matter experts to continually assess state-of-the-art research and practices and channel this informati

A roadmap and best practices for organizations to reduce racial and ethnic disparities in health care.

PubMed

Chin, Marshall H; Clarke, Amanda R; Nocon, Robert S; Casey, Alicia A; Goddu, Anna P; Keesecker, Nicole M; Cook, Scott C

2012-08-01

Over the past decade, researchers have shifted their focus from documenting health care disparities to identifying solutions to close the gap in care. Finding Answers: Disparities Research for Change, a national program of the Robert Wood Johnson Foundation, is charged with identifying promising interventions to reduce disparities. Based on our work conducting systematic reviews of the literature, evaluating promising practices, and providing technical assistance to health care organizations, we present a roadmap for reducing racial and ethnic disparities in care. The roadmap outlines a dynamic process in which individual interventions are just one part. It highlights that organizations and providers need to take responsibility for reducing disparities, establish a general infrastructure and culture to improve quality, and integrate targeted disparities interventions into quality improvement efforts. Additionally, we summarize the major lessons learned through the Finding Answers program. We share best practices for implementing disparities interventions and synthesize cross-cutting themes from 12 systematic reviews of the literature. Our research shows that promising interventions frequently are culturally tailored to meet patients' needs, employ multidisciplinary teams of care providers, and target multiple leverage points along a patient's pathway of care. Health education that uses interactive techniques to deliver skills training appears to be more effective than traditional didactic approaches. Furthermore, patient navigation and engaging family and community members in the health care process may improve outcomes for minority patients. We anticipate that the roadmap and best practices will be useful for organizations, policymakers, and researchers striving to provide high-quality equitable care.

Hierarchy curriculum for practical skills training in optics and photonics

NASA Astrophysics Data System (ADS)

Zheng, XiaoDong; Wang, XiaoPing; Liu, Xu; Liu, XiangDong; Lin, YuanFang

2017-08-01

The employers in optical engineering fields hope to recruit students who are capable of applying optical principles to solve engineering problems and have strong laboratory skills. In Zhejiang University, a hierarchy curriculum for practical skill training has been constructed to satisfy this demand. This curriculum includes "Introductive practicum" for freshmen, "Opto-mechanical systems design", "Engineering training", "Electronic system design", "Student research training program (SRTP)", "National University Students' Optical-Science-Technology Competition game", and "Offcampus externship". Without cutting optical theory credit hours, this hierarchy curriculum provides a step-by-step solution to enhance students' practical skills. By following such a hierarchy curriculum, students can smoothly advance from a novice to a qualified professional expert in optics. They will be able to utilize optical engineering tools to design, build, analyze, improve, and test systems, and will be able to work effectively in teams to solve problems in engineering and design.

Wisdom in clinical reasoning and medical practice.

PubMed

Edmondson, Ricca; Pearce, Jane; Woerner, Markus H

2009-01-01

Exploring informal components of clinical reasoning, we argue that they need to be understood via the analysis of professional wisdom. Wise decisions are needed where action or insight is vital, but neither everyday nor expert knowledge provides solutions. Wisdom combines experiential, intellectual, ethical, emotional and practical capacities; we contend that it is also more strongly social than is usually appreciated. But many accounts of reasoning specifically rule out such features as irrational. Seeking to illuminate how wisdom operates, we therefore build on Aristotle's work on informal reasoning. His account of rhetorical communication shows how non-formal components can play active parts in reasoning, retaining, or even enhancing its reasonableness. We extend this account, applying it to forms of healthcare-related reasoning which are characterised by the need for wise decision-making. We then go on to explore some of what clinical wise reasoning may mean, concluding with a case taken from psychotherapeutic practice.

Debates—Stochastic subsurface hydrology from theory to practice: The relevance of stochastic subsurface hydrology to practical problems of contaminant transport and remediation. What is characterization and stochastic theory good for?

NASA Astrophysics Data System (ADS)

Fiori, A.; Cvetkovic, V.; Dagan, G.; Attinger, S.; Bellin, A.; Dietrich, P.; Zech, A.; Teutsch, G.

2016-12-01

The emergence of stochastic subsurface hydrology stemmed from the realization that the random spatial variability of aquifer properties has a profound impact on solute transport. The last four decades witnessed a tremendous expansion of the discipline, many fundamental processes and principal mechanisms being identified. However, the research findings have not impacted significantly the application in practice, for several reasons which are discussed. The paper discusses the current status of stochastic subsurface hydrology, the relevance of the scientific results for applications and it also provides a perspective to a few possible future directions. In particular, we discuss how the transfer of knowledge can be facilitated by identifying clear goals for characterization and modeling application, relying on recent recent advances in research in these areas.

Helping secondary school students develop a conceptual understanding of refraction

NASA Astrophysics Data System (ADS)

Ashmann, Scott; Anderson, Charles W.; Boeckman, Heather

2016-07-01

Using real-world examples, ray diagrams, and a cognitive apprenticeship cycle, this paper focuses on developing students’ conceptual (not mathematical) understanding of refraction. Refraction can be a difficult concept for students to comprehend if they do not have well-designed opportunities to practice explaining situations where reflection and refraction occur. The use of ray diagrams can be useful in (a) the teacher modelling a correct explanation to a situation where refraction occurs and (b) for students to create as they practice other examples. This paper includes eight examples of increasing complexity that use a cognitive apprenticeship cycle approach to scaffold student learning. The first examples (rock fish, floating penny) are shown and a solution is modeled using a ray diagram. Three more examples (bent pencil, dropping an item in water, sunrise/sunset) are presented for students to practice, with each becoming more sophisticated. Three assessment exercises are then provided (two dots, three coins, broken tube).

Overcoming practical challenges to conducting clinical research in the inpatient stroke rehabilitation setting.

PubMed

Campbell, Grace B; Skidmore, Elizabeth R; Whyte, Ellen M; Matthews, Judith T

2015-10-01

There is a shortage of published empirical studies conducted in acute inpatient stroke rehabilitation, though such studies are greatly needed in order to shed light on the most efficacious inpatient stroke rehabilitation interventions. The inherent challenges of inpatient research may dissuade researchers from undertaking this important work. This paper describes our institution's experience devising practical solutions to research barriers in this setting. Through concentrated efforts to overcome research barriers, such as by cultivating collaborative relationships and capitalizing on unanticipated benefits, we successfully facilitated conduct of five simultaneous inpatient stroke studies. Tangible benefits realized include increased effectiveness of research participant identification and enrollment, novel collaborative projects, innovative clinical care initiatives, and enhanced emotional and practical support for patients and their families. We provide recommendations based on lessons learned during our experience, and discuss benefits of this collaboration for our research participants, clinical staff, and the research team.

Diffusion of pain management research into nursing practice.

PubMed

Dooks, P

2001-04-01

The promotion of evidence based practice is a challenge within nursing. Pain management is a prime example of this practice research gap. There is solid evidence for 20 years to promote positive change in our methods of pain management, yet outdated approaches are still amazingly evident. Even among oncology nurses, who place a high value on promoting patient comfort, there is a lack of evidence-based pain management. Rogers' Diffusion of Innovation Theory provides an interesting framework for examining the issues and possible solutions to this complex problem. Rogers' theory examines how changes diffuse through a social system over time and also exposes some of the barriers and facilitators to this process. The theory looks at adopters, the nature of the innovation, the social system, and communication patterns. Identifying the barriers of the past will help nursing to overcome these same barriers and increase the adoption of evidence-based pain management approaches in the future.

Implementation of a novel occupational and environmental medicine specialty teleconsultation service: the VHA experience.

PubMed

Eaton, Jennifer L; Mohr, David C; Mohammad, Amir; Kirkhorn, Steven; Gerstel-Santucci, Christina; McPhaul, Kathleen; Hodgson, Michael J

2015-02-01

Occupational and environmental medicine (OEM) physician specialty practices continue to grow in scope and intensity across the Veterans Health Administration. This study characterizes the implementation of a novel, nationwide telemedicine program that provides OEM specialty consultation to providers across the Veterans Health Administration. We examined provider requests and specialist responses for a 6-month pilot from May to October 2013. Characteristics of consult users, determinants of case complexity, and specific applications of OEM specialty expertise were identified. Over a 6-month period, employee occupational health providers consulted the OEM telemedicine pilot a total of 65 times. Employee occupational health providers without formal training repeatedly identified complex cases related to work and disability. The program has created a new system management solution to deliver expert, in-depth consultation and real-time provider education in OEM.

Subharmonic Solutions of Order One-Third

ERIC Educational Resources Information Center

Fay, Temple H.

2005-01-01

Finding a periodic solution to a nonlinear ordinary differential equation is in general a difficult task. Only in a very few cases can direct methods be applied to an equation to find initial values leading to a solution of the corresponding initial value problem that is periodic. Oscillatory periodic solutions have such practical importance that…

A practical guide for nurses in diluent selection for subcutaneous infusion using a syringe driver.

PubMed

McLeod, Fiona; Flowers, Charne

2006-12-01

Appropriate diluent selection in continuous subcutaneous infusion optimises symptom management and client well-being. The responsibility of diluent selection is commonly one of the attending nurse. This paper was developed with the intention of providing nurses with practical instruction for diluent selection when preparing medications for administration subcutaneously using a syringe driver. A literature review was undertaken of published journal databases and published guidelines sites. Recommendations regarding diluent choice were reviewed in two iterations by an expert panel of palliative care nurse clinicians. The principles for diluent selection are presented. They are based primarily on expert opinion level of evidence given a lack of primary research evidence in the area of diluent selection. There is a pressing need for manufacturers' guidance on diluent selection and independent research to establish the impact of diluents on drug and drug combinations when using syringe drivers. Until such time that this evidence is available to guide practice, clinicians need to be trained to inspect solutions and assess the effectiveness of the medication in controlling symptoms. The capacity of this paper to provide practical instruction has been limited by the lack of rigorous evidence available, and indeed, the process of developing this guide identified perhaps more questions than answers available at the present time.

Generalized Buneman Pruning for Inferring the Most Parsimonious Multi-state Phylogeny

NASA Astrophysics Data System (ADS)

Misra, Navodit; Blelloch, Guy; Ravi, R.; Schwartz, Russell

Accurate reconstruction of phylogenies remains a key challenge in evolutionary biology. Most biologically plausible formulations of the problem are formally NP-hard, with no known efficient solution. The standard in practice are fast heuristic methods that are empirically known to work very well in general, but can yield results arbitrarily far from optimal. Practical exact methods, which yield exponential worst-case running times but generally much better times in practice, provide an important alternative. We report progress in this direction by introducing a provably optimal method for the weighted multi-state maximum parsimony phylogeny problem. The method is based on generalizing the notion of the Buneman graph, a construction key to efficient exact methods for binary sequences, so as to apply to sequences with arbitrary finite numbers of states with arbitrary state transition weights. We implement an integer linear programming (ILP) method for the multi-state problem using this generalized Buneman graph and demonstrate that the resulting method is able to solve data sets that are intractable by prior exact methods in run times comparable with popular heuristics. Our work provides the first method for provably optimal maximum parsimony phylogeny inference that is practical for multi-state data sets of more than a few characters.

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

PubMed

Neville, Lillian; Swift, Juliette

2012-04-01

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

An Innovative Solution to NASA's NEO Impact Threat Mitigation Grand Challenge and Flight Validation Mission Architecture Development

NASA Technical Reports Server (NTRS)

Wie, Bong; Barbee, Brent W.

2015-01-01

This paper presents the results of a NASA Innovative Advanced Concept (NIAC) Phase 2 study entitled "An Innovative Solution to NASA's Near-Earth Object (NEO) Impact Threat Mitigation Grand Challenge and Flight Validation Mission Architecture Development." This NIAC Phase 2 study was conducted at the Asteroid Deflection Research Center (ADRC) of Iowa State University in 2012-2014. The study objective was to develop an innovative yet practically implementable mitigation strategy for the most probable impact threat of an asteroid or comet with short warning time (< 5 years). The mitigation strategy described in this paper is intended to optimally reduce the severity and catastrophic damage of the NEO impact event, especially when we don't have sufficient warning times for non-disruptive deflection of a hazardous NEO. This paper provides an executive summary of the NIAC Phase 2 study results. Detailed technical descriptions of the study results are provided in a separate final technical report, which can be downloaded from the ADRC website (www.adrc.iastate.edu).

Fast food in the diet: Implications and solutions for families.

PubMed

Fulkerson, Jayne A

2018-04-06

Fast food is omnipresent in the United States (U.S.) and contributes to poor dietary quality and poor health among youth and adults alike. Children need adults to teach them good eating habits to attain and maintain good health by introducing them to healthful foods and being good role models. The fast food industry, through vast funds and advertising, contribute to challenges parents face to provide healthful foods for their families and thwart our best efforts to meet health goals. Research shows fast food consumption is influenced by lack of cooking confidence, time pressures, and perceptions of ease and convenience. We need practical strategies to help parents and children make healthier food choices. As a product of conference proceedings, this paper provides a non-exhaustive narrative summary of the fast food marketplace and marketing, the contributions of fast food to diet and health, struggles with healthful eating among families, and possible solutions of how we can help children and parents empower themselves to have healthier lives. Copyright © 2018. Published by Elsevier Inc.

The design and implementation of a parallel unstructured Euler solver using software primitives

NASA Technical Reports Server (NTRS)

Das, R.; Mavriplis, D. J.; Saltz, J.; Gupta, S.; Ponnusamy, R.

1992-01-01

This paper is concerned with the implementation of a three-dimensional unstructured grid Euler-solver on massively parallel distributed-memory computer architectures. The goal is to minimize solution time by achieving high computational rates with a numerically efficient algorithm. An unstructured multigrid algorithm with an edge-based data structure has been adopted, and a number of optimizations have been devised and implemented in order to accelerate the parallel communication rates. The implementation is carried out by creating a set of software tools, which provide an interface between the parallelization issues and the sequential code, while providing a basis for future automatic run-time compilation support. Large practical unstructured grid problems are solved on the Intel iPSC/860 hypercube and Intel Touchstone Delta machine. The quantitative effect of the various optimizations are demonstrated, and we show that the combined effect of these optimizations leads to roughly a factor of three performance improvement. The overall solution efficiency is compared with that obtained on the CRAY-YMP vector supercomputer.

A novel microfluidic mixer-based approach for determining inactivation kinetics of Escherichia coli O157:H7 in chlorine solutions.

PubMed

Zhang, Boce; Luo, Yaguang; Zhou, Bin; Wang, Qin; Millner, Patricia D

2015-08-01

Determination of the minimum free chlorine concentration needed to prevent pathogen survival/cross-contamination during produce washing is essential for the development of science-based food safety regulations and practices. Although the trend of chlorine concentration-contact time on pathogen inactivation is generally understood, specific information on chlorine and the kinetics of pathogen inactivation at less than 1.00 s is urgently needed by the produce processing industry. However, conventional approaches to obtain this critical data have been unable to adequately measure very rapid responses. This paper reports our development, fabrication, and test of a novel microfluidic device, and its application to obtain the necessary data on pathogen inactivation by free chlorine in produce wash solution in times as short as 0.10 s. A novel microfluidic mixer with the capability to accurately determine the reaction time and control the chlorine concentration was designed with three inlets for bacterial, chlorine and dechlorinating solutions, and one outlet for effluent collection. The master mold was fabricated on a silicon wafer with microchannels via photopolymerization. Polydimethylsiloxane replicas with patterned microchannels were prototyped via soft lithography. The replicas were further assembled into the micromixer on glass via O2 plasma treatment, and the inlets were connected to a syringe pump for solution delivery. To determine the kinetics of free chlorine on pathogen inactivation, chlorine solutions of varying concentrations were first pumped into the micromixer, together with the addition of bacterial suspension of Escherichia coli O157:H7 through a separate inlet. This was followed by injection of dechlorinating solution to stop the chlorine-pathogen reaction. The effluent was collected and the surviving bacteria cells were enumerated using a modified 'Most Probable Number' method. Free chlorine concentration was determined using a standard colorimetric method. The contact time was experimentally set by adjusting the solution flow rate, and was estimated by computational fluid dynamics modeling. Results showed that 1) pathogen inactivation was significantly affected by free chlorine concentration (P < 0.0001) and subsecond reaction time (P < 0.0001) and their interactions (P < 0.0001); and 2) the current industry practice of using 1.0 mg/L free chlorine will require more than 1.00 s total contact to achieve a 5-log10 reduction in an E. coli O157:H7 population, whereas a 10.0 mg/L free chlorine solution will achieve 5-log10 reduction in as little as 0.25 s. Information obtained from this study will provide critical insight on kinetics of bacterial inactivation for a broad range of sanitizers and produce wash operational conditions, thus facilitating the development and implementation of science-based food safety regulations and practices for improving food safety. Published by Elsevier Ltd.

Working with culture: culturally appropriate mental health care for Asian Americans.

PubMed

Park, Mijung; Chesla, Catherine A; Rehm, Roberta S; Chun, Kevin M

2011-11-01

The aim of this study is to describe how mental healthcare providers adapted their practice to meet the unique needs of Asian Americans. As the number of ethnic minorities and multicultural patients and families rapidly increases, cultural competency becomes an essential skill for all healthcare providers. The lack of knowledge about how healthcare providers grapple with diverse cultures and cultural competency limits the ability of others to deliver patient-centred care across cultural lines. Interpretive phenomenology guided the design and conduct of this study. Twenty mental healthcare providers who treated Asian Americans were recruited. Narrative data were collected through face-to-face, in-depth interviews between 2006 and 2007. Three characteristics of culturally appropriate care for Asian Americans were identified. Cultural brokering: providers addressed issues stemming from cultural differences via bicultural skills education. Asian American patients generally received broader education than current literature recommended. Supporting families in transition: providers assisted Asian American families during transition from and to professional care. Using cultural knowledge to enhance competent care: providers' knowledge of Asian culture and flexible attitudes affected the care that they provided. Culturally competent providers were able to identify cultural issues that were relevant to the specific situation, and incorporated cultural solutions into the care provided. Culturally appropriate care is nuanced and context specific. Thus, more sophisticated and broader conceptualizations are necessary to prepare nurses for such complex practice. © 2011 Blackwell Publishing Ltd.

Development of a Practical Methodology for Elastic-Plastic and Fully Plastic Fatigue Crack Growth

NASA Technical Reports Server (NTRS)

McClung, R. C.; Chell, G. G.; Lee, Y. -D.; Russell, D. A.; Orient, G. E.

1999-01-01

A practical engineering methodology has been developed to analyze and predict fatigue crack growth rates under elastic-plastic and fully plastic conditions. The methodology employs the closure-corrected effective range of the J-integral, delta J(sub eff) as the governing parameter. The methodology contains original and literature J and delta J solutions for specific geometries, along with general methods for estimating J for other geometries and other loading conditions, including combined mechanical loading and combined primary and secondary loading. The methodology also contains specific practical algorithms that translate a J solution into a prediction of fatigue crack growth rate or life, including methods for determining crack opening levels, crack instability conditions, and material properties. A critical core subset of the J solutions and the practical algorithms has been implemented into independent elastic-plastic NASGRO modules. All components of the entire methodology, including the NASGRO modules, have been verified through analysis and experiment, and limits of applicability have been identified.

Development of a Practical Methodology for Elastic-Plastic and Fully Plastic Fatigue Crack Growth

NASA Technical Reports Server (NTRS)

McClung, R. C.; Chell, G. G.; Lee, Y.-D.; Russell, D. A.; Orient, G. E.

1999-01-01

A practical engineering methodology has been developed to analyze and predict fatigue crack growth rates under elastic-plastic and fully plastic conditions. The methodology employs the closure-corrected effective range of the J-integral, (Delta)J(sub eff), as the governing parameter. The methodology contains original and literature J and (Delta)J solutions for specific geometries, along with general methods for estimating J for other geometries and other loading conditions, including combined mechanical loading and combined primary and secondary loading. The methodology also contains specific practical algorithms that translate a J solution into a prediction of fatigue crack growth rate or life, including methods for determining crack opening levels, crack instability conditions, and material properties. A critical core subset of the J solutions and the practical algorithms has been implemented into independent elastic-plastic NASGRO modules. All components of the entire methodology, including the NASGRO modules, have been verified through analysis and experiment, and limits of applicability have been identified.

Applying Best Business Practices from Corporate Performance Management to DoD

DTIC Science & Technology

2013-01-01

leading or governing large, complex corporations and are experienced in creating reliable solutions to complex management issues guided by best business ...recommendations and effective solutions aimed at improving DoD. Defense Business Board Corporate Performance Management REPORT FY13-03 Task...Group 1 Applying Best Business Practices from Corporate Performance Management to DoD TASK The Deputy Secretary of Defense (DEPSECDEF

Linear elastic fracture mechanics primer

NASA Technical Reports Server (NTRS)

Wilson, Christopher D.

1992-01-01

This primer is intended to remove the blackbox perception of fracture mechanics computer software by structural engineers. The fundamental concepts of linear elastic fracture mechanics are presented with emphasis on the practical application of fracture mechanics to real problems. Numerous rules of thumb are provided. Recommended texts for additional reading, and a discussion of the significance of fracture mechanics in structural design are given. Griffith's criterion for crack extension, Irwin's elastic stress field near the crack tip, and the influence of small-scale plasticity are discussed. Common stress intensities factor solutions and methods for determining them are included. Fracture toughness and subcritical crack growth are discussed. The application of fracture mechanics to damage tolerance and fracture control is discussed. Several example problems and a practice set of problems are given.

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

Makarov, Yuri V.; Du, Pengwei; Etingov, Pavel V.

This planning reference book is a document reflecting a Western Electricity Coordination Council (WECC) effort to put together multiple sources of information and provide a clear, systemic, comprehensive outline of the problems, both existing and anticipated; their impacts on the system; currently used and proposed solutions by the industry and research community; planning practices; new technologies, equipment, and standards; and expected future trends. This living (periodically updated) document could help WECC and other practicing engineers, especially the younger generation of engineers joining the workforce, to get familiar with a large variety of information related to the integration of variable resourcesmore » into the WECC system, bypassing in part the need for time-consuming information gathering and learning processes from more experienced engineers or from the literature.« less

Omics approaches in food safety: fulfilling the promise?

PubMed Central

Bergholz, Teresa M.; Moreno Switt, Andrea I.; Wiedmann, Martin

2014-01-01

Genomics, transcriptomics, and proteomics are rapidly transforming our approaches to detection, prevention and treatment of foodborne pathogens. Microbial genome sequencing in particular has evolved from a research tool into an approach that can be used to characterize foodborne pathogen isolates as part of routine surveillance systems. Genome sequencing efforts will not only improve outbreak detection and source tracking, but will also create large amounts of foodborne pathogen genome sequence data, which will be available for data mining efforts that could facilitate better source attribution and provide new insights into foodborne pathogen biology and transmission. While practical uses and application of metagenomics, transcriptomics, and proteomics data and associated tools are less prominent, these tools are also starting to yield practical food safety solutions. PMID:24572764

Resilient Control Systems Practical Metrics Basis for Defining Mission Impact

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

Craig G. Rieger

"Resilience” describes how systems operate at an acceptable level of normalcy despite disturbances or threats. In this paper we first consider the cognitive, cyber-physical interdependencies inherent in critical infrastructure systems and how resilience differs from reliability to mitigate these risks. Terminology and metrics basis are provided to integrate the cognitive, cyber-physical aspects that should be considered when defining solutions for resilience. A practical approach is taken to roll this metrics basis up to system integrity and business case metrics that establish “proper operation” and “impact.” A notional chemical processing plant is the use case for demonstrating how the system integritymore » metrics can be applied to establish performance, and« less

Strategies for integrating personalized medicine into healthcare practice.

PubMed

Pritchard, Daryl E; Moeckel, Franziska; Villa, Mary Susan; Housman, Laura T; McCarty, Catherine A; McLeod, Howard L

2017-03-01

Research and innovation in personalized medicine are surging, however, its adoption into clinical practice is comparatively slow. We identify common challenges to the clinical adoption of personalized medicine and provide strategies for addressing these challenges. Our team developed a list of common challenges through a series of group discussions, surveys and interviews, and convened a national summit to discuss solutions for overcoming these challenges. We used a framework approach for thematic analysis. We categorized challenges into five areas of need: education and awareness; patient empowerment; value recognition; infrastructure and information management; and ensuring access to care. We then developed strategies to address these challenges. In order for healthcare to transition into personalized medicine, it is necessary for stakeholders to build momentum by implementing a progression of strategies.

Impact of simple conventional and Telehealth solutions on improving mental health in Afghanistan.

PubMed

Khoja, Shariq; Scott, Richard; Husyin, Nida; Durrani, Hammad; Arif, Maria; Faqiri, Faqir; Hedayat, Ebadullah; Yousufzai, Wahab

2016-12-01

For more than a century Afghanistan has been unstable, facing decades of war, social problems, and intense poverty. As a result, many of the population suffer from a variety of mental health problems. The Government recognises the situation and has prioritised mental health, but progress is slow and services outside of Kabul remain poor. An international collaborative implemented a project in Badakshan province of Afghanistan using conventional and simple low-cost e-Health solutions to address the four most common issues: depression, psychosis, post-traumatic stress disorder, and substance abuse. Conventional town hall meetings informed community members to raise awareness and knowledge. In addition, an android-based mobile application used the World Health Organization's Mental Health Gap Action Programme guidelines and protocols to: collect information from community healthcare workers; provide referral services to patients; provide blended learning to improve providers' mental health knowledge, skills, and practice; and to provide store-and-forward and live consultations. Preliminary evaluation of the intervention shows enhanced access to care for remote communities, decreased stigma, and improved quality of health services. Primary care workers are also able to bridge the gap in consultations for rural and remote communities, connecting them with specialists and providing better access to care. © The Author(s) 2016.

Game-Based Practice versus Traditional Practice in Computer-Based Writing Strategy Training: Effects on Motivation and Achievement

ERIC Educational Resources Information Center

Proske, Antje; Roscoe, Rod D.; McNamara, Danielle S.

2014-01-01

Achieving sustained student engagement with practice in computer-based writing strategy training can be a challenge. One potential solution is to foster engagement by embedding practice in educational games; yet there is currently little research comparing the effectiveness of game-based practice versus more traditional forms of practice. In this…

Crowd-sourcing delivery system innovation: A public-private solution.

PubMed

Agrawal, Shantanu; Chen, Christopher; Tanio, Craig P

2015-03-01

We propose the establishment of a public-private approach which creates and maintains a "delivery systems innovations knowledge management system" to define, describe, and assess novel delivery approaches. The public sector could provide the foundational technology, resources and convening power for this innovations database. The private sector would contribute practical innovations that could guide annual strategic planning and implementation. A crowd-sourced effort would jump start delivery system reform. We believe that providing a comprehensive knowledge resource will not stifle competition or private sector opportunities but rather augment and speed the application of effective innovation. Copyright © 2014 Elsevier Inc. All rights reserved.

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

NASA Astrophysics Data System (ADS)

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

2017-08-01

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

The stakeholder approach: a new perspective on developing and marketing clinical trials.

PubMed

Droms, Courtney M; Ferguson, Michael; Giuliano, Karen

2014-01-01

The use of evidence-based medical practice has become the standard for health care decision-making. Thus, it has become increasingly important for medical device manufactures to provide evidence for the efficacy of their products. As new products, services, and solutions are developed, it is important to perform a stakeholder analysis to assess clinical evidence needs. As evidenced by the variety of stakeholders in clinical trials, we expect that each has different interests in how clinical trials are developed, conducted, and promoted to the general public. This analysis of the stakeholders' concerns provides recommendations for marketing professionals on meeting the needs of these stakeholders.

Saving mothers and newborns in communities: strengthening community midwives to provide high quality essential newborn and maternal care in Baluchistan, Pakistan in a financially sustainable manner.

PubMed

Mumtaz, Zubia; Cutherell, Andrea; Bhatti, Afshan

2014-04-06

To address it's persistently high maternal mortality rate of 276/100,000 live births, the government of Pakistan created a new cadre of community based midwives (CMW). One expectation is that CMWs will improve access to maternal health services for underserved women. Recent research shows the CMWs have largely failed to establish midwifery practices, because CMW's lack of skills, both clinical and entrepreneurial and funds necessary to develop their practice infrastructure and logistics. Communities also lack trust in their competence to conduct safe births. To address these issues, the Saving Mothers and Newborn (SMNC) intervention will implement three key elements to support the CMWs to establish their private practices: (1) upgrade CMW clinical skills (2) provide business-skills training and small loans (3) generate demand for CMW services using cellular phone SMS technology and existing women's support groups. This 3-year project aims to investigate whether CMWs enrolled in this initiative are providing the essential maternal and newborn health care to women and children living in districts of Quetta, and Gwadar in a financially self-sustaining manner. Specifically the research will use quasi-experimental impact assessment to document whether the SMNC initiative is having an impact on CMW services uptake, financial analysis to assess if the initiative enabled CMWs to develop financially self-sustainable practices and observation methods to assess the quality of care the CMWs are providing. A key element of the SMNC initiative - the provision of business skills training and loans to establish private practices - is an innovative initiative in Pakistan and little is known about its effectiveness. This research will provide emperic evidence of the effectiveness of the intervention as well as contribute to the body of evidence around potential solutions to improve sustainable coverage of high impact Maternal, Neonatal and Child Health interventions in vulnerable populations living in remote rural areas.

21 CFR 58.83 - Reagents and solutions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Testing Facilities Operation § 58.83 Reagents and solutions. All reagents and solutions in the laboratory areas shall be labeled to indicate identity, titer...

SFTYCHEF: A Consultative, Diagnostic Expert System for Trench Excavation Safety Analysis on Light Commercial Construction Projects.

DTIC Science & Technology

1987-03-30

Safe Trench Excavation ...... 2 Applicability to Solution via Expert System. 3 Background: Expert Systems ..................... 4 Definition of an...trench, drownings in the trench, and other mishaps which are the result of a lack of S C- proper consideration for safe construction practices. Although...the problem is not a new one, there is as yet no *" obvious method that will guarantee a safe trench. In addition, the expertise needed to provide case

Economic importance of bats in agriculture

USGS Publications Warehouse

Boyles, Justin G.; Cryan, Paul M.; McCracken, Gary F.; Kunz, Thomas H.

2011-01-01

White-nose syndrome (WNS) and the increased development of wind-power facilities are threatening populations of insectivorous bats in North America. Bats are voracious predators of nocturnal insects, including many crop and forest pests. We present here analyses suggesting that loss of bats in North America could lead to agricultural losses estimated at more than $3.7 billion/year. Urgent efforts are needed to educate the public and policy-makers about the ecological and economic importance of insectivorous bats and to provide practical conservation solutions.

The development of low temperature curing adhesives

NASA Technical Reports Server (NTRS)

Green, H. E.; Sutherland, J. D.; Hom, J. M.; Sheppard, C. H.

1975-01-01

An approach for the development of a practical low temperature (293 K-311 K/68 F-100 F) curing adhesive system based on a family of amide/ester resins was studied and demonstrated. The work was conducted on resin optimization and adhesive compounding studies. An improved preparative method was demonstrated which involved the reaction of an amine-alcohol precursor, in a DMF solution with acid chloride. Experimental studies indicated that an adhesive formulation containing aluminum powder provided the best performance when used in conjunction with a commercial primer.

FLOWER IPv4/IPv6 Network Flow Summarization software

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

Nickless, Bill; Curtis, Darren; Christy, Jason

FLOWER was written as a refactoring/reimplementation of the existing Flo software used by the Cooperative Protection Program (CPP) to provide network flow summaries for analysis by the Operational Analysis Center (OAC) and other US Department of Energy cyber security elements. FLOWER is designed and tested to operate at 10 gigabits/second, nearly 10 times faster than competing solutions. FLOWER output is optimized for importation into SQL databases for categorization and analysis. FLOWER is written in C++ using current best software engineering practices.

File Management In Space

NASA Technical Reports Server (NTRS)

Critchfield, Anna R.; Zepp, Robert H.

2000-01-01

We propose that the user interact with the spacecraft as if the spacecraft were a file server, so that the user can select and receive data as files in standard formats (e.g., tables or images, such as jpeg) via the Internet. Internet technology will be used end-to-end from the spacecraft to authorized users, such as the flight operation team, and project scientists. The proposed solution includes a ground system and spacecraft architecture, mission operations scenarios, and an implementation roadmap showing migration from current practice to the future, where distributed users request and receive files of spacecraft data from archives or spacecraft with equal ease. This solution will provide ground support personnel and scientists easy, direct, secure access to their authorized data without cumbersome processing, and can be extended to support autonomous communications with the spacecraft.

Extraction of gravitational waves in numerical relativity.

PubMed

Bishop, Nigel T; Rezzolla, Luciano

2016-01-01

A numerical-relativity calculation yields in general a solution of the Einstein equations including also a radiative part, which is in practice computed in a region of finite extent. Since gravitational radiation is properly defined only at null infinity and in an appropriate coordinate system, the accurate estimation of the emitted gravitational waves represents an old and non-trivial problem in numerical relativity. A number of methods have been developed over the years to "extract" the radiative part of the solution from a numerical simulation and these include: quadrupole formulas, gauge-invariant metric perturbations, Weyl scalars, and characteristic extraction. We review and discuss each method, in terms of both its theoretical background as well as its implementation. Finally, we provide a brief comparison of the various methods in terms of their inherent advantages and disadvantages.

Interactions between grape skin cell wall material and commercial enological tannins. Practical implications.

PubMed

Bautista-Ortín, Ana Belén; Cano-Lechuga, Mario; Ruiz-García, Yolanda; Gómez-Plaza, Encarna

2014-01-01

Commercial enological tannins were used to investigate the role that cell wall material plays in proanthocyanidin adsorption. Insoluble cell wall material, prepared from the skin of Vitis vinifera L. cv. Monastrell berries, was combined with solutions containing six different commercial enological tannins (proanthocyanidin-type tannins). Analysis of the proanthocyanidins in the solution, after fining with cell wall material, using phloroglucinolysis and size exclusion chromatography, provided quantitative and qualitative information on the non-adsorbed compounds. Cell wall material showed strong affinity for the proanthocyanidins, one of the commercial tannins being bound up to 61% in the experiment. Comparison of the molecular mass distribution of the commercial enological tannins in solution, before and after fining, suggested that cell walls affinity for proanthocyanidins was more related with the proanthocyanidin molecular mass than with their percentage of galloylation. These interactions may have some enological implications, especially as regards the time of commercial tannins addition to the must/wine. Copyright © 2013 Elsevier Ltd. All rights reserved.

Constraint-based integration of planning and scheduling for space-based observatory management

NASA Technical Reports Server (NTRS)

Muscettola, Nicola; Smith, Steven F.

1994-01-01

Progress toward the development of effective, practical solutions to space-based observatory scheduling problems within the HSTS scheduling framework is reported. HSTS was developed and originally applied in the context of the Hubble Space Telescope (HST) short-term observation scheduling problem. The work was motivated by the limitations of the current solution and, more generally, by the insufficiency of classical planning and scheduling approaches in this problem context. HSTS has subsequently been used to develop improved heuristic solution techniques in related scheduling domains and is currently being applied to develop a scheduling tool for the upcoming Submillimeter Wave Astronomy Satellite (SWAS) mission. The salient architectural characteristics of HSTS and their relationship to previous scheduling and AI planning research are summarized. Then, some key problem decomposition techniques underlying the integrated planning and scheduling approach to the HST problem are described; research results indicate that these techniques provide leverage in solving space-based observatory scheduling problems. Finally, more recently developed constraint-posting scheduling procedures and the current SWAS application focus are summarized.

Sixth Goddard Conference on Mass Storage Systems and Technologies Held in Cooperation with the Fifteenth IEEE Symposium on Mass Storage Systems

NASA Technical Reports Server (NTRS)

Kobler, Benjamin (Editor); Hariharan, P. C. (Editor)

1998-01-01

This document contains copies of those technical papers received in time for publication prior to the Sixth Goddard Conference on Mass Storage Systems and Technologies which is being held in cooperation with the Fifteenth IEEE Symposium on Mass Storage Systems at the University of Maryland-University College Inn and Conference Center March 23-26, 1998. As one of an ongoing series, this Conference continues to provide a forum for discussion of issues relevant to the management of large volumes of data. The Conference encourages all interested organizations to discuss long term mass storage requirements and experiences in fielding solutions. Emphasis is on current and future practical solutions addressing issues in data management, storage systems and media, data acquisition, long term retention of data, and data distribution. This year's discussion topics include architecture, tape optimization, new technology, performance, standards, site reports, vendor solutions. Tutorials will be available on shared file systems, file system backups, data mining, and the dynamics of obsolescence.

Design applications for supercomputers

NASA Technical Reports Server (NTRS)

Studerus, C. J.

1987-01-01

The complexity of codes for solutions of real aerodynamic problems has progressed from simple two-dimensional models to three-dimensional inviscid and viscous models. As the algorithms used in the codes increased in accuracy, speed and robustness, the codes were steadily incorporated into standard design processes. The highly sophisticated codes, which provide solutions to the truly complex flows, require computers with large memory and high computational speed. The advent of high-speed supercomputers, such that the solutions of these complex flows become more practical, permits the introduction of the codes into the design system at an earlier stage. The results of several codes which either were already introduced into the design process or are rapidly in the process of becoming so, are presented. The codes fall into the area of turbomachinery aerodynamics and hypersonic propulsion. In the former category, results are presented for three-dimensional inviscid and viscous flows through nozzle and unducted fan bladerows. In the latter category, results are presented for two-dimensional inviscid and viscous flows for hypersonic vehicle forebodies and engine inlets.

Generalized bipartite quantum state discrimination problems with sequential measurements

NASA Astrophysics Data System (ADS)

Nakahira, Kenji; Kato, Kentaro; Usuda, Tsuyoshi Sasaki

2018-02-01

We investigate an optimization problem of finding quantum sequential measurements, which forms a wide class of state discrimination problems with the restriction that only local operations and one-way classical communication are allowed. Sequential measurements from Alice to Bob on a bipartite system are considered. Using the fact that the optimization problem can be formulated as a problem with only Alice's measurement and is convex programming, we derive its dual problem and necessary and sufficient conditions for an optimal solution. Our results are applicable to various practical optimization criteria, including the Bayes criterion, the Neyman-Pearson criterion, and the minimax criterion. In the setting of the problem of finding an optimal global measurement, its dual problem and necessary and sufficient conditions for an optimal solution have been widely used to obtain analytical and numerical expressions for optimal solutions. Similarly, our results are useful to obtain analytical and numerical expressions for optimal sequential measurements. Examples in which our results can be used to obtain an analytical expression for an optimal sequential measurement are provided.

A transient laboratory method for determining the hydraulic properties of 'tight' rocks-II. Application

USGS Publications Warehouse

Neuzil, C.E.; Cooley, C.; Silliman, Stephen E.; Bredehoeft, J.D.; Hsieh, P.A.

1981-01-01

In Part I a general analytical solution for the transient pulse test was presented. Part II presents a graphical method for analyzing data from a test to obtain the hydraulic properties of the sample. The general solution depends on both hydraulic conductivity and specific storage and, in theory, analysis of the data can provide values for both of these hydraulic properties. However, in practice, one of two limiting cases may apply in which case it is possible to calculate only hydraulic conductivity or the product of hydraulic conductivity times specific storage. In this paper we examine the conditions when both hydraulic parameters can be calculated. The analyses of data from two tests are presented. In Appendix I the general solution presented in Part I is compared with an earlier analysis, in which compressive storage in the sample is assumed negligible, and the error in calculated hydraulic conductivity due to this simplifying assumption is examined. ?? 1981.

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

PubMed Central

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

2012-01-01

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

Healthcare e-commerce: connecting with patients.

PubMed

Joslyn, J S

2001-01-01

Electronically connecting with patients is a challenging frontier at which technical hurdles are probably exceeded by political, legal, and other barriers. The rise of consumerism, however, compels a response focused more on revenue and strategic advantage than on pure cost savings. Among the difficulties faced by providers is choosing among various models of connectivity and component function. Emerging models include "free-floating" personal medical records largely independent of the office-based physician, systems with compatible and intertwined physician and consumer relationships using an application services provider office practice system, and systems that connect patients and providers through e-mail, office triage, prescription refills, scheduling, and so on. This article discusses these and other combinations of technology that significantly overcome the barriers involved and that may be woven together to provide solutions uniquely suited to various competitive situations.

A flexible architecture for advanced process control solutions

NASA Astrophysics Data System (ADS)

Faron, Kamyar; Iourovitski, Ilia

2005-05-01

Advanced Process Control (APC) is now mainstream practice in the semiconductor manufacturing industry. Over the past decade and a half APC has evolved from a "good idea", and "wouldn"t it be great" concept to mandatory manufacturing practice. APC developments have primarily dealt with two major thrusts, algorithms and infrastructure, and often the line between them has been blurred. The algorithms have evolved from very simple single variable solutions to sophisticated and cutting edge adaptive multivariable (input and output) solutions. Spending patterns in recent times have demanded that the economics of a comprehensive APC infrastructure be completely justified for any and all cost conscious manufacturers. There are studies suggesting integration costs as high as 60% of the total APC solution costs. Such cost prohibitive figures clearly diminish the return on APC investments. This has limited the acceptance and development of pure APC infrastructure solutions for many fabs. Modern APC solution architectures must satisfy the wide array of requirements from very manual R&D environments to very advanced and automated "lights out" manufacturing facilities. A majority of commercially available control solutions and most in house developed solutions lack important attributes of scalability, flexibility, and adaptability and hence require significant resources for integration, deployment, and maintenance. Many APC improvement efforts have been abandoned and delayed due to legacy systems and inadequate architectural design. Recent advancements (Service Oriented Architectures) in the software industry have delivered ideal technologies for delivering scalable, flexible, and reliable solutions that can seamlessly integrate into any fabs" existing system and business practices. In this publication we shall evaluate the various attributes of the architectures required by fabs and illustrate the benefits of a Service Oriented Architecture to satisfy these requirements. Blue Control Technologies has developed an advance service oriented architecture Run to Run Control System which addresses these requirements.

Using Cogenerative Dialogs to Improve Science Teaching and Learning: Challenges and Solutions in High School Students' Internships

NASA Astrophysics Data System (ADS)

Hsu, Pei-Ling

2018-05-01

Internships in science research settings have received increasing attention as a means of helping students construct appropriate understandings, practices, tools, and language in scientific activities. To advance student-scientist partnerships beyond the status quo, the study aimed to investigate how cogenerative dialogs (cogens) may help high school students and scientists identify and address challenges collectively. The analysis identified nine major challenges discussed during cogens: (1) the quality and progress of scientific practice in laboratories, (2) the quality of scientists'/assistants' instructions in classrooms, (3) the quality of student participation in classrooms and homework, (4) students' absences, including arriving late or leaving early, (5) the quality of administrative support, (6) preparation for scientific presentations, (7) the process of deciding project topics, (8) students' peer interactions and communication, and (9) students' physiological needs. The three most salient challenges were "the quality and progress of scientific practice in laboratories" (39%), "the quality of scientists'/assistants' instructions in classrooms" (20%), and "the quality of student participation in classrooms and homework" (17%). The study shows that cogens allowed students and scientists to agree on teaching modifications that positively influenced teaching and learning processes during the internship, such that issues were reduced from the beginning to the closing stages. Importantly, the challenges and solutions identified by students and scientists in this study provide accounts of first-hand experience as well as insights to aid program directors or coordinators in designing a learning environment that can foster effective practice for internships by avoiding the issues identified in the study.

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

PubMed

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

2015-08-01

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

Genomic cloud computing: legal and ethical points to consider

PubMed Central

Dove, Edward S; Joly, Yann; Tassé, Anne-Marie; Burton, Paul; Chisholm, Rex; Fortier, Isabel; Goodwin, Pat; Harris, Jennifer; Hveem, Kristian; Kaye, Jane; Kent, Alistair; Knoppers, Bartha Maria; Lindpaintner, Klaus; Little, Julian; Riegman, Peter; Ripatti, Samuli; Stolk, Ronald; Bobrow, Martin; Cambon-Thomsen, Anne; Dressler, Lynn; Joly, Yann; Kato, Kazuto; Knoppers, Bartha Maria; Rodriguez, Laura Lyman; McPherson, Treasa; Nicolás, Pilar; Ouellette, Francis; Romeo-Casabona, Carlos; Sarin, Rajiv; Wallace, Susan; Wiesner, Georgia; Wilson, Julia; Zeps, Nikolajs; Simkevitz, Howard; De Rienzo, Assunta; Knoppers, Bartha M

2015-01-01

The biggest challenge in twenty-first century data-intensive genomic science, is developing vast computer infrastructure and advanced software tools to perform comprehensive analyses of genomic data sets for biomedical research and clinical practice. Researchers are increasingly turning to cloud computing both as a solution to integrate data from genomics, systems biology and biomedical data mining and as an approach to analyze data to solve biomedical problems. Although cloud computing provides several benefits such as lower costs and greater efficiency, it also raises legal and ethical issues. In this article, we discuss three key ‘points to consider' (data control; data security, confidentiality and transfer; and accountability) based on a preliminary review of several publicly available cloud service providers' Terms of Service. These ‘points to consider' should be borne in mind by genomic research organizations when negotiating legal arrangements to store genomic data on a large commercial cloud service provider's servers. Diligent genomic cloud computing means leveraging security standards and evaluation processes as a means to protect data and entails many of the same good practices that researchers should always consider in securing their local infrastructure. PMID:25248396

Genomic cloud computing: legal and ethical points to consider.

PubMed

Dove, Edward S; Joly, Yann; Tassé, Anne-Marie; Knoppers, Bartha M

2015-10-01

The biggest challenge in twenty-first century data-intensive genomic science, is developing vast computer infrastructure and advanced software tools to perform comprehensive analyses of genomic data sets for biomedical research and clinical practice. Researchers are increasingly turning to cloud computing both as a solution to integrate data from genomics, systems biology and biomedical data mining and as an approach to analyze data to solve biomedical problems. Although cloud computing provides several benefits such as lower costs and greater efficiency, it also raises legal and ethical issues. In this article, we discuss three key 'points to consider' (data control; data security, confidentiality and transfer; and accountability) based on a preliminary review of several publicly available cloud service providers' Terms of Service. These 'points to consider' should be borne in mind by genomic research organizations when negotiating legal arrangements to store genomic data on a large commercial cloud service provider's servers. Diligent genomic cloud computing means leveraging security standards and evaluation processes as a means to protect data and entails many of the same good practices that researchers should always consider in securing their local infrastructure.

An innovative and shared methodology for event reconstruction using images in forensic science.

PubMed

Milliet, Quentin; Jendly, Manon; Delémont, Olivier

2015-09-01

This study presents an innovative methodology for forensic science image analysis for event reconstruction. The methodology is based on experiences from real cases. It provides real added value to technical guidelines such as standard operating procedures (SOPs) and enriches the community of practices at stake in this field. This bottom-up solution outlines the many facets of analysis and the complexity of the decision-making process. Additionally, the methodology provides a backbone for articulating more detailed and technical procedures and SOPs. It emerged from a grounded theory approach; data from individual and collective interviews with eight Swiss and nine European forensic image analysis experts were collected and interpreted in a continuous, circular and reflexive manner. Throughout the process of conducting interviews and panel discussions, similarities and discrepancies were discussed in detail to provide a comprehensive picture of practices and points of view and to ultimately formalise shared know-how. Our contribution sheds light on the complexity of the choices, actions and interactions along the path of data collection and analysis, enhancing both the researchers' and participants' reflexivity. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Development of practical decontamination process for the removal of uranium from gravel.

PubMed

Kim, Ilgook; Kim, Gye-Nam; Kim, Seung-Soo; Choi, Jong-Won

2018-01-01

In this study, a practical decontamination process was developed to remove uranium from gravel using a soil washing method. The effects of critical parameters including particle size, H 2 SO 4 concentration, temperature, and reaction time on uranium removal were evaluated. The optimal condition for two-stage washing of gravel was found to be particle size of 1-2 mm, 1.0 M H 2 SO 4 , temperature of 60°C, and reaction time of 3 h, which satisfied the required uranium concentration for self-disposal. Furthermore, most of the extracted uranium was removed from the waste solution by precipitation, implying that the treated solution can be reused as washing solution. These results clearly demonstrated that our proposed process can be indeed a practical technique to decontaminate uranium-polluted gravel.

The "ins" and "outs" of provider-parent communication: perspectives from adolescent primary care providers on challenges to forging alliances to reduce adolescent risk.

PubMed

Helitzer, Deborah L; Sussman, Andrew L; de Hernandez, Brisa Urquieta; Kong, Alberta S

2011-04-01

For several decades, the goal to protect adolescents' confidentiality in addition to state and professional mandates to provide confidential health services have sometimes outweighed the interest of involving parents in risk reduction efforts. More recently, experts acknowledge that a balance must be found between maintaining adolescent confidentiality and involving parents in preventing poor adolescent outcomes resulting from risky behaviors. The purpose of this research was to elucidate the challenges in and identify solutions to realizing this newer vision in the primary care setting. We conducted a qualitative study featuring in-depth interviews with 37 primary care providers among whom a significant component of their practice involved adolescent patients. Purposeful sampling was aimed at a diversity of gender, practice specialty, practice venues, and geographic areas. We identified individual and structural barriers and facilitators to involving parents in their adolescents' primary care. Barriers included parents' lack of knowledge and awareness of their children's risk behaviors; providers time constraints and competing clinical demands, concerns for confidentiality and developing a trusting relationship with the child; and legal and system requirements that limit engagement with parents. Facilitators included interest and for some, planned approaches by the provider to engage the parent; encouragement by the provider to the adolescent to communicate with a trusted adult about their risky behavior; and opportunities to educate the parent about risk reduction in general. Opportunities for further research on strategies to improve communication and develop a partnership between providers and parents are described. Copyright © 2011 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

40 CFR 160.83 - Reagents and solutions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Reagents and solutions. 160.83 Section 160.83 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS GOOD LABORATORY PRACTICE STANDARDS Testing Facilities Operation § 160.83 Reagents and solutions. All reagents and...

Protecting the health of the @hlete: how online technology may aid our common goal to prevent injury and illness in sport.

PubMed

Verhagen, Evert; Bolling, Caroline

2015-09-01

Online technology dominates our era and eHealth has become a reality for sports clinicians and researchers. Contemporary online platforms enable self-monitoring and provide tailored feedback to the different stakeholders who play a role in the health and care of athletes. Innovations such as digital monitoring, mobile applications and connected hardware provide the critical tools to solve current enigmas in sports medicine research, and to streamline and facilitate injury prevention, management and rehabilitation. eHealth is not an emerging future of sports medicine-the technology to move our field forward in terms of research and practice is already available. This Analysis is based on Evert Verhagen's keynote presentation at the IOC World Conference on Injury and Illness Prevention in Sport (Monaco, 12 April 2014). It outlines the use of eHealth in research, implementation and practice, and provides an overview of possibilities and opportunities that existing and emerging eHealth solutions provide for sports and exercise medicine and physiotherapy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

"Working towards being ready": A grounded theory study of how practising midwives maintain their ongoing competence to practise their profession.

PubMed

Calvert, Susan; Smythe, Elizabeth; McKenzie-Green, Barbara

2017-07-01

to present a grounded theory research study explaining how New Zealand midwives maintain their ongoing competence to practise their profession. grounded theory, an interpretive emergent research methodology was used to examine the process of maintaining competence in midwifery practice. New Zealand urban and rural practice settings. twenty-six midwives from across New Zealand were interviewed and asked about maintaining their competence to practise. Five midwives were interviewed twice, to explore the emerging findings and as one method of member checking. the grounded theory of 'working towards being ready' describes a continuous process in which midwives engage as they work to maintain practice competence. The component parts comprise professional positioning, identifying needs, strategizing solutions and reflecting on practice. The process is contextual, diverse and is influenced by the practice setting where the salient conditions of resourcing, availability and opportunity for engagement in activities are significant. across the midwifery profession, midwives in New Zealand are currently working under the generic umbrella of midwifery practice. Midwives work across a range of practice arenas in diverse ways focussed on providing safe care and require a range of professional development activities germane to their area of practice. When the midwife has access to professional development pertinent to their practice, women and the profession benefit. As there is diversity of practice, then mandated processes for ongoing competence need to have flexibility to reflect that diversity. midwives engage in development that allows them to remain current in practice and that enables them to provide appropriate care to women and their babies. As a consequence they can develop expertise in certain aspects of midwifery. Mandated processes that require engagement in activities aimed at demonstration of competence should be evaluated and tailored to ensure they meet the needs of the developing profession. Copyright © 2017 Elsevier Ltd. All rights reserved.

Management of agricultural soils for greenhouse gas mitigation: Learning from a case study in NE Spain.

PubMed

Sánchez, B; Iglesias, A; McVittie, A; Álvaro-Fuentes, J; Ingram, J; Mills, J; Lesschen, J P; Kuikman, P J

2016-04-01

A portfolio of agricultural practices is now available that can contribute to reaching European mitigation targets. Among them, the management of agricultural soils has a large potential for reducing GHG emissions or sequestering carbon. Many of the practices are based on well tested agronomic and technical know-how, with proven benefits for farmers and the environment. A suite of practices has to be used since none of the practices can provide a unique solution. However, there are limitations in the process of policy development: (a) agricultural activities are based on biological processes and thus, these practices are location specific and climate, soils and crops determine their agronomic potential; (b) since agriculture sustains rural communities, the costs and potential for implementation have also to be regionally evaluated and (c) the aggregated regional potential of the combination of practices has to be defined in order to inform abatement targets. We believe that, when implementing mitigation practices, three questions are important: Are they cost-effective for farmers? Do they reduce GHG emissions? What policies favour their implementation? This study addressed these questions in three sequential steps. First, mapping the use of representative soil management practices in the European regions to provide a spatial context to upscale the local results. Second, using a Marginal Abatement Cost Curve (MACC) in a Mediterranean case study (NE Spain) for ranking soil management practices in terms of their cost-effectiveness. Finally, using a wedge approach of the practices as a complementary tool to link science to mitigation policy. A set of soil management practices was found to be financially attractive for Mediterranean farmers, which in turn could achieve significant abatements (e.g., 1.34 MtCO2e in the case study region). The quantitative analysis was completed by a discussion of potential farming and policy choices to shape realistic mitigation policy at European regional level. Copyright © 2016 Elsevier Ltd. All rights reserved.

Private sector approaches to workforce enhancement.

PubMed

Wendling, Wayne R

2010-06-01

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

An approximate stationary solution for multi-allele neutral diffusion with low mutation rates.

PubMed

Burden, Conrad J; Tang, Yurong

2016-12-01

We address the problem of determining the stationary distribution of the multi-allelic, neutral-evolution Wright-Fisher model in the diffusion limit. A full solution to this problem for an arbitrary K×K mutation rate matrix involves solving for the stationary solution of a forward Kolmogorov equation over a (K-1)-dimensional simplex, and remains intractable. In most practical situations mutations rates are slow on the scale of the diffusion limit and the solution is heavily concentrated on the corners and edges of the simplex. In this paper we present a practical approximate solution for slow mutation rates in the form of a set of line densities along the edges of the simplex. The method of solution relies on parameterising the general non-reversible rate matrix as the sum of a reversible part and a set of (K-1)(K-2)/2 independent terms corresponding to fluxes of probability along closed paths around faces of the simplex. The solution is potentially a first step in estimating non-reversible evolutionary rate matrices from observed allele frequency spectra. Copyright © 2016 Elsevier Inc. All rights reserved.

Three-dimensional flow of a nanofluid over a permeable stretching/shrinking surface with velocity slip: A revised model

NASA Astrophysics Data System (ADS)

Jusoh, R.; Nazar, R.; Pop, I.

2018-03-01

A reformulation of the three-dimensional flow of a nanofluid by employing Buongiorno's model is presented. A new boundary condition is implemented in this study with the assumption of nanoparticle mass flux at the surface is zero. This condition is practically more realistic since the nanoparticle fraction at the boundary is latently controlled. This study is devoted to investigate the impact of the velocity slip and suction to the flow and heat transfer characteristics of nanofluid. The governing partial differential equations corresponding to the momentum, energy, and concentration are reduced to the ordinary differential equations by utilizing the appropriate transformation. Numerical solutions of the ordinary differential equations are obtained by using the built-in bvp4c function in Matlab. Graphical illustrations displaying the physical influence of the several nanofluid parameters on the flow velocity, temperature, and nanoparticle volume fraction profiles, as well as the skin friction coefficient and the local Nusselt number are provided. The present study discovers the existence of dual solutions at a certain range of parameters. Surprisingly, both of the solutions merge at the stretching sheet indicating that the presence of the velocity slip affects the skin friction coefficients. Stability analysis is carried out to determine the stability and reliability of the solutions. It is found that the first solution is stable while the second solution is not stable.

Methodological approach for evaluating the response of soil hydrological behavior to irrigation with treated municipal wastewater

NASA Astrophysics Data System (ADS)

Coppola, A.; Santini, A.; Botti, P.; Vacca, S.; Comegna, V.; Severino, G.

2004-06-01

This paper aims mainly to provide experimental evidence of the consequences of urban wastewater reuse in irrigation practices on the hydrological behavior of soils. The effects on both the hydraulic and dispersive properties of representative soils in southern Sardinia are illustrated. Ten undisturbed soil monoliths, 120 cm in height and 40 cm in diameter, were collected from plots previously selected through a soil survey. Soil hydraulic and solute transport properties were determined before and after application of wastewater using transient water infiltration and steady state-solute transport column experiments. Detailed spatial-temporal information on the propagation of water and solute through the soil profiles were obtained by monitoring soil water contents, θ, pressure heads, h, and solute concentrations, C, measured by a network of time domain reflectometry probes, tensiometers and solution samplers horizontally inserted in each column at different depths. A disturbed layer at the soil surface, which expands in depth with time, was observed, characterized by reduced soil porosity, translation of pore size distribution towards narrower pores and consequent decrease in water retention, hydraulic conductivity and hydrodynamic dispersion. It is shown that these changes occurring in the disturbed soil layer, although local by nature, affect the hydrological behavior of the whole soil profile. Due to the disturbed layer formation, the soil beneath never saturates. Such behavior has important consequences on the solute transport in soils, as unsaturated conditions mean higher residence times of solutes, even of those normally characterized by considerable mobility (e.g. boron), which may accumulate along the profile. The results mainly provide experimental evidence that knowledge of the chemical and microbiological composition of the water is not sufficient to evaluate its suitability for irrigation. Other factors, mainly soil physical and hydrological characteristics, should be considered in order to define appropriate guidelines for wastewater management.

University of Saskatchewan Radiology Courseware (USRC): an assessment of its utility for teaching diagnostic imaging in the medical school curriculum.

PubMed

Burbridge, Brent; Kalra, Neil; Malin, Greg; Trinder, Krista; Pinelle, David

2015-01-01

We have found it very challenging to integrate images from our radiology digital imaging repository into the curriculum of our local medical school. Thus, it has been difficult to convey important knowledge related to viewing and interpreting diagnostic radiology images. We sought to determine if we could create a solution for this problem and evaluate whether students exposed to this solution were able to learn imaging concepts pertinent to medical practice. We developed University of Saskatchewan Radiology Courseware (USRC), a novel interactive web application that enables preclinical medical students to acquire image interpretation skills fundamental to clinical practice. This web application reformats content stored in Medical Imaging Resource Center teaching cases for BlackBoard Learn™, a popular learning management system. We have deployed this solution for 2 successive years in a 1st-year basic sciences medical school course at the College of Medicine, University of Saskatchewan. The "courseware" content covers both normal anatomy and common clinical pathologies in five distinct modules. We created two cohorts of learners consisting of an intervention cohort of students who had used USRC for their 1st academic year, whereas the nonintervention cohort was students who had not been exposed to this learning opportunity. To assess the learning experience of the users we designed an online questionnaire and image review quiz delivered to both of the student groups. Comparisons between the groups revealed statistically significant differences in both confidence with image interpretation and the ability to answer knowledge-based questions. Students were satisfied with the overall usability, functions, and capabilities of USRC. USRC is an innovative technology that provides integration between Medical Imaging Resource Center, a teaching solution used in radiology, and a Learning Management System.

Polynomial-time solution of prime factorization and NP-complete problems with digital memcomputing machines

NASA Astrophysics Data System (ADS)

Traversa, Fabio L.; Di Ventra, Massimiliano

2017-02-01

We introduce a class of digital machines, we name Digital Memcomputing Machines, (DMMs) able to solve a wide range of problems including Non-deterministic Polynomial (NP) ones with polynomial resources (in time, space, and energy). An abstract DMM with this power must satisfy a set of compatible mathematical constraints underlying its practical realization. We prove this by making a connection with the dynamical systems theory. This leads us to a set of physical constraints for poly-resource resolvability. Once the mathematical requirements have been assessed, we propose a practical scheme to solve the above class of problems based on the novel concept of self-organizing logic gates and circuits (SOLCs). These are logic gates and circuits able to accept input signals from any terminal, without distinction between conventional input and output terminals. They can solve boolean problems by self-organizing into their solution. They can be fabricated either with circuit elements with memory (such as memristors) and/or standard MOS technology. Using tools of functional analysis, we prove mathematically the following constraints for the poly-resource resolvability: (i) SOLCs possess a global attractor; (ii) their only equilibrium points are the solutions of the problems to solve; (iii) the system converges exponentially fast to the solutions; (iv) the equilibrium convergence rate scales at most polynomially with input size. We finally provide arguments that periodic orbits and strange attractors cannot coexist with equilibria. As examples, we show how to solve the prime factorization and the search version of the NP-complete subset-sum problem. Since DMMs map integers into integers, they are robust against noise and hence scalable. We finally discuss the implications of the DMM realization through SOLCs to the NP = P question related to constraints of poly-resources resolvability.

Waste management outlook for mountain regions: Sources and solutions.

PubMed

Semernya, Larisa; Ramola, Aditi; Alfthan, Björn; Giacovelli, Claudia

2017-09-01

Following the release of the global waste management outlook in 2015, the United Nations Environment Programme (UN Environment), through its International Environmental Technology Centre, is elaborating a series of region-specific and thematic waste management outlooks that provide policy recommendations and solutions based on current practices in developing and developed countries. The Waste Management Outlook for Mountain Regions is the first report in this series. Mountain regions present unique challenges to waste management; while remoteness is often associated with costly and difficult transport of waste, the potential impact of waste pollutants is higher owing to the steep terrain and rivers transporting waste downstream. The Outlook shows that waste management in mountain regions is a cross-sectoral issue of global concern that deserves immediate attention. Noting that there is no 'one solution fits all', there is a need for a more landscape-type specific and regional research on waste management, the enhancement of policy and regulatory frameworks, and increased stakeholder engagement and awareness to achieve sustainable waste management in mountain areas. This short communication provides an overview of the key findings of the Outlook and highlights aspects that need further research. These are grouped per source of waste: Mountain communities, tourism, and mining. Issues such as waste crime, plastic pollution, and the linkages between exposure to natural disasters and waste are also presented.

Satellite attitude motion models for capture and retrieval investigations

NASA Technical Reports Server (NTRS)

Cochran, John E., Jr.; Lahr, Brian S.

1986-01-01

The primary purpose of this research is to provide mathematical models which may be used in the investigation of various aspects of the remote capture and retrieval of uncontrolled satellites. Emphasis has been placed on analytical models; however, to verify analytical solutions, numerical integration must be used. Also, for satellites of certain types, numerical integration may be the only practical or perhaps the only possible method of solution. First, to provide a basis for analytical and numerical work, uncontrolled satellites were categorized using criteria based on: (1) orbital motions, (2) external angular momenta, (3) internal angular momenta, (4) physical characteristics, and (5) the stability of their equilibrium states. Several analytical solutions for the attitude motions of satellite models were compiled, checked, corrected in some minor respects and their short-term prediction capabilities were investigated. Single-rigid-body, dual-spin and multi-rotor configurations are treated. To verify the analytical models and to see how the true motion of a satellite which is acted upon by environmental torques differs from its corresponding torque-free motion, a numerical simulation code was developed. This code contains a relatively general satellite model and models for gravity-gradient and aerodynamic torques. The spacecraft physical model for the code and the equations of motion are given. The two environmental torque models are described.

An experimental clinical evaluation of EIT imaging with ℓ1 data and image norms.

PubMed

Mamatjan, Yasin; Borsic, Andrea; Gürsoy, Doga; Adler, Andy

2013-09-01

Electrical impedance tomography (EIT) produces an image of internal conductivity distributions in a body from current injection and electrical measurements at surface electrodes. Typically, image reconstruction is formulated using regularized schemes in which ℓ2-norms are used for both data misfit and image prior terms. Such a formulation is computationally convenient, but favours smooth conductivity solutions and is sensitive to outliers. Recent studies highlighted the potential of ℓ1-norm and provided the mathematical basis to improve image quality and robustness of the images to data outliers. In this paper, we (i) extended a primal-dual interior point method (PDIPM) algorithm to 2.5D EIT image reconstruction to solve ℓ1 and mixed ℓ1/ℓ2 formulations efficiently, (ii) evaluated the formulation on clinical and experimental data, and (iii) developed a practical strategy to select hyperparameters using the L-curve which requires minimum user-dependence. The PDIPM algorithm was evaluated using clinical and experimental scenarios on human lung and dog breathing with known electrode errors, which requires a rigorous regularization and causes the failure of reconstruction with an ℓ2-norm solution. The results showed that an ℓ1 solution is not only more robust to unavoidable measurement errors in a clinical setting, but it also provides high contrast resolution on organ boundaries.