Using Technology-Driven Patient Communication Appointment Reminders to Improve Uniform Data System Measures in a Federally Qualified Health Center

Background: Process of meeting Uniform Data System (UDS) measures in a west Michigan Federally Qualified Health Center (FQHC) has several components with different team members sharing responsibility in the process and workflow to document preventative screenings. An evidence-based technology-enhanced patient communication intervention was developed to meet benchmarks for the FQHCs UDS reporting metrics. The purpose of this quality improvement project was to answer the clinical question: Will technology-enhanced communication appointment reminders using automated telephone communication increase rates of screening follow-up visits to improve data reported to UDS at a west Michigan FQHC organization? Objectives: Increase percentage of screening visits after the implementation of technologydriven patient communication appointment reminders to meet UDS metrics for the FQHC organization. Methods: The design for this evidenced-based quality improvement initiative was translation of evidence into practice. Use of quality and process improvement tools facilitated discussion and workflow redesign. Setting: The setting for this project was a FQHC clinic in west Michigan. The outcomes were measured using manual data collection. Results: Twenty-seven (n=27) automated phone call reminders were successfully arranged and delivered. Through the generation of automated phone call reminders 44% of patients scheduled appointments (n=12) and 56% of patients did not (n=15). Of the twelve who have scheduled, 8 (66.7%) have completed the appointment, 4 (33.3%) have not. Conclusions: Technology-enhanced patient communication workflow process workflow and activation of existing in the EMR functionality to increase rates of screening follow up visits in efforts to improve data reported to UDS were effective in setting an appointment 44% of the time and execution of the visit occurred in one third (33%) of those patients. Clinical Implications: While appointment setting and return visits occurred in less than half of the patients, the technology-driven automated phone calls did demonstrate an improvement in appointments set and completed. Therefore, technology-enhanced patient communication workflow process should be expanded to remaining clinical teams

Characteristic Dependence of Umbral Dots on their Magnetic Structure

Umbral dots (UDs) were observed in a stable sunspot in NOAA 10944 by the Hinode Solar Optical Telescope on 2007 March 1. The observation program consisted of blue continuum images and spectropolarimetric profiles of Fe I 630 nm line. An automatic detection algorithm for UDs was applied to the 2-hour continuous blue continuum images, and using the obtained data, the lifetime, size, and proper motion of UDs were calculated. The magnetic structure of the sunspot was derived through the inversion of the spectropolarimetric profiles. We calculated the correlations between UD's parameters (size, lifetime, occurrence rate, proper motion) and magnetic fields (field strength, inclination, azimuth), and obtained the following results: (1) Both the lifetime and size of UDs are almost constant regardless of the magnetic field strength at their emergence site. (2) The speed of UDs increases as the field inclination angle at their emergence site gets larger. (3) The direction of movement of UDs is nearly parallel to the direction of the horizontal component of magnetic field in the region with strongly inclined field, while UDs in the region with weakly inclined field show virtually no proper motion. Our results describe the basic properties of magnetoconvection in sunspots. We will discuss our results in comparison to recent MHD simulations by Schussler & Vogler (2006) and Rempel et al. (2009).Comment: 22 pages, 10 figures, accepted for publication in Ap

Modelling the Risks Remotely Piloted Aircraft Pose to People on the Ground

Worldwide there is much e ort being directed towards the development of a framework of air- worthiness regulations for remotely piloted aircraft systems (RPAS). It is now broadly accepted that regulations should have a strong foundation in, and traceability to, the management of the safety risks. Existing risk models for RPAS operations do not provide a simple means for incorporating the wide range of technical and operational controls into the risk analysis and evaluation processes. This paper describes a new approach for modelling and evaluating the risks associated with RPAS operations near populous areas based on the barrier bow tie (BBT) model. A BBT model is used to structure the underlying risk management problem. The model focuses risk analysis, evaluation, and decision making activities on the devices, people, and processes that can be employed to reduce risk. The BBT model and a comprehensive set of example risk controls are presented. The general model can be applied to any RPAS operation. The foundations for quantitative and qualitative assessments using a BBT model are also presented. The modelling and evaluation framework is illustrated through its application to a case-study rotary wing RPAS for two operational scenarios. The model can be used as a basis for determining airworthiness certification requirements for RPAS

Tracking down hyper-boosted top quarks

The identification of hadronically decaying heavy states, such as vector bosons, the Higgs, or the top quark, produced with large transverse boosts has been and will continue to be a central focus of the jet physics program at the Large Hadron Collider (LHC). At a future hadron collider working at an order-of-magnitude larger energy than the LHC, these heavy states would be easily produced with transverse boosts of several TeV. At these energies, their decay products will be separated by angular scales comparable to individual calorimeter cells, making the current jet substructure identification techniques for hadronic decay modes not directly employable. In addition, at the high energy and luminosity projected at a future hadron collider, there will be numerous sources for contamination including initial- and final-state radiation, underlying event, or pile-up which must be mitigated. We propose a simple strategy to tag such "hyper-boosted" objects that defines jets with radii that scale inversely proportional to their transverse boost and combines the standard calorimetric information with charged track-based observables. By means of a fast detector simulation, we apply it to top quark identification and demonstrate that our method efficiently discriminates hadronically decaying top quarks from light QCD jets up to transverse boosts of 20 TeV. Our results open the way to tagging heavy objects with energies in the multi-TeV range at present and future hadron colliders.Comment: 19 pages + appendices, 17 figures; v2: added references, updated cross section tabl

Comparing the effectiveness of equivalence partitioning, branch testing and code reading by stepwise abstraction applied by subjects

Some verification and validation techniques have been evaluated both theoretically and empirically. Most empirical studies have been conducted without subjects, passing over any effect testers have when they apply the techniques. We have run an experiment with students to evaluate the effectiveness of three verification and validation techniques (equivalence partitioning, branch testing and code reading by stepwise abstraction). We have studied how well able the techniques are to reveal defects in three programs. We have replicated the experiment eight times at different sites. Our results show that equivalence partitioning and branch testing are equally effective and better than code reading by stepwise abstraction. The effectiveness of code reading by stepwise abstraction varies significantly from program to program. Finally, we have identified project contextual variables that should be considered when applying any verification and validation technique or to choose one particular technique

Electron Beam Induced Damage on Passivated Metal Oxide Semiconductor Devices

Electron beam testing of integrated circuits (IC) is currently based on the electron beam induced conductivity in insulators to short the passivation layer and to enable a voltage measurement at covered conductor tracks. However, applying this technique to passivated MOS devices causes severe radiation damage, which was at first explained by primary electrons penetrating into the deep-lying gate oxide. Nondestructive electron beam testing was expected by using low electron energies that do not allow the primary electrons to reach into the gate oxide. Therefore here the influence of nonpenetrating electron irradiation on the characteristics of passivated NMOS transistors has been studied. The experiments demonstrate that significant damage is caused even when primary electrons do not reach into the gate oxide. This can be explained by secondary X-rays, generated by the primary electrons in the upper layers, that then penetrate into the gate oxide. Radiation damage increases with irradiation dose, primary energy and with decreasing gate size. Though using the lowest primary electron energy possible to build up the necessary conductive channel, even low irradiation doses alter the devices drastically. Only by blanking off the high energy electron beam at gate oxide areas during the scan, i.e. by application of the window scan mode, is a nearly nondestructive testing of passivated MOS devices via the electron beam induced conductivity made possible. Another possibility to decrease radiation damage is the reduction of primary electron energy to about 1 keV. Then electron beam testing is no longer based on the physics of electron beam induced conductivity, but on the capacitive coupling voltage contrast