Structuring communication relationships for interprofessional teamwork (SCRIPT): a cluster randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>Despite a burgeoning interest in using interprofessional approaches to promote effective collaboration in health care, systematic reviews find scant evidence of benefit. This protocol describes the first cluster randomized controlled trial (RCT) to design and evaluate an intervention intended to improve interprofessional collaborative communication and patient-centred care.</p> <p>Objectives</p> <p>The objective is to evaluate the effects of a four-component, hospital-based staff communication protocol designed to promote collaborative communication between healthcare professionals and enhance patient-centred care.</p> <p>Methods</p> <p>The study is a multi-centre mixed-methods cluster randomized controlled trial involving twenty clinical teaching teams (CTTs) in general internal medicine (GIM) divisions of five Toronto tertiary-care hospitals. CTTs will be randomly assigned either to receive an intervention designed to improve interprofessional collaborative communication, or to continue usual communication practices.</p> <p>Non-participant naturalistic observation, shadowing, and semi-structured, qualitative interviews were conducted to explore existing patterns of interprofessional collaboration in the CTTs, and to support intervention development. Interviews and shadowing will continue during intervention delivery in order to document interactions between the intervention settings and adopters, and changes in interprofessional communication.</p> <p>The primary outcome is the rate of unplanned hospital readmission. Secondary outcomes are length of stay (LOS); adherence to evidence-based prescription drug therapy; patients' satisfaction with care; self-report surveys of CTT staff perceptions of interprofessional collaboration; and frequency of calls to paging devices. Outcomes will be compared on an intention-to-treat basis using adjustment methods appropriate for data from a cluster randomized design.</p> <p>Discussion</p> <p>Pre-intervention qualitative analysis revealed that a substantial amount of interprofessional interaction lacks key core elements of collaborative communication such as self-introduction, description of professional role, and solicitation of other professional perspectives. Incorporating these findings, a four-component intervention was designed with a goal of creating a culture of communication in which the fundamentals of collaboration become a routine part of interprofessional interactions during unstructured work periods on GIM wards.</p> <p>Trial registration</p> <p>Registered with National Institutes of Health as NCT00466297.</p

School Web Sites within the Educational Marketplace: A Case Study Investigating the Parents as Engaged Consumer-Users

Schools -- like their corporate counterparts -- recognize the many advantages that the Internet affords. Today\u27s schools vie for students, and thus use the web to market their services and showcase their management team (administrators, teachers, staff) and academic accomplishments. In a sense, then, web sites are the public face of education; those that are well-designed and multi-featured can enhance a district\u27s public image and create the perception of excellence and competence. This case study explores how one suburban, K-8 school district approaches web site development, specifically, the process by which decisions about design, development, and maintenance are made (and by whom); the ways in which they engage those who explore them--with a particular focus on parents; and, how well the sites adhere to generally recognized design attributes. Data were gathered through interviews with school administrators, document review, web site analysis, parent surveys, and parent focus groups. Results offer information to policymakers, administrators, and site designers regarding principles of web design unique to parents as educational consumers. Principles emerging from the case study can lead to additional research not only in the field of education, but, also, in the fields of web design and marketing

RF Coverage Planning And Analysis With Adaptive Cell Sectorization In Millimeter Wave 5G Networks

The advancement of Fifth Generation Network (5G) technology is well underway, with Mobile Network Operators (MNOs) globally commencing the deployment of 5G networks within the mid-frequency spectrum range (3GHz–6GHz). Nevertheless, the escalating demands for data traffic are compelling MNOs to explore the high-frequency spectrum (24GHz–100GHz), which offers significantly larger bandwidth (400MHz-800 MHz) compared to the mid-frequency spectrum (3GHz–6GHz), which typically provides 50MHz-100MHz of bandwidth. However, it is crucial to note that the higher-frequency spectrum imposes substantial challenges due to exceptionally high free space propagation loss, resulting in 5G cell site coverage being limited to several hundred meters, in contrast to the several kilometers achievable with 4G. Consequently, MNOs are faced with the formidable task of accurately planning and deploying hundreds of new 5G cells to cover the same areas served by a single 4G cell.This dissertation embarks on a comprehensive exploration of Radio Frequency (RF) coverage planning for 5G networks, initially utilizing a conventional three-sector cell architecture. The coverage planning phase reveals potential challenges, including coverage gaps and poor Signal-to-Interference-plus-Noise Ratio (SINR). In response to these issues, the dissertation introduces an innovative cell site architecture that embraces both nine and twelve sector cells, enhancing RF coverage through the adoption of an advanced antenna system designed with subarrays, offering adaptive beamforming and beam steering capabilities. To further enhance energy efficiency, the dissertation introduces adaptive higher-order cell-sectorization (e.g., nine sector cells and twelve sector cells). In this proposed method, all sectors within a twelve-sector cell remain active during peak hours (e.g., daytime) and are reduced to fewer sectors (e.g., nine sectors or six sectors per cell) during off-peak hours (e.g., nighttime). This dynamic adjustment is facilitated by an advanced antenna system utilizing sub-array architecture, which employs adaptive beamforming and beam steering to tailor the beamwidth and radiation angle of each active sector. Simulation results unequivocally demonstrate significant enhancements in RF coverage and SINR with the implementation of higher-order cell-sectorization. Furthermore, the proposed adaptive cell-sectorization method significantly reduces energy consumption during off-peak hours. In addition to addressing RF coverage planning, this dissertation delves into the numerous challenges associated with deploying 5G networks in the higher frequency spectrum (30GHz-300GHz). It encompasses issues such as precise cell site planning, location acquisition, propagation modeling, energy efficiency, backhauling, and more. Furthermore, the dissertation offers valuable insights into future research directions aimed at effectively surmounting these challenges and optimizing the deployment of 5G networks in the high-frequency spectrum

Cooperative high-performance storage in the accelerated strategic computing initiative

The use and acceptance of new high-performance, parallel computing platforms will be impeded by the absence of an infrastructure capable of supporting orders-of-magnitude improvement in hierarchical storage and high-speed I/O (Input/Output). The distribution of these high-performance platforms and supporting infrastructures across a wide-area network further compounds this problem. We describe an architectural design and phased implementation plan for a distributed, Cooperative Storage Environment (CSE) to achieve the necessary performance, user transparency, site autonomy, communication, and security features needed to support the Accelerated Strategic Computing Initiative (ASCI). ASCI is a Department of Energy (DOE) program attempting to apply terascale platforms and Problem-Solving Environments (PSEs) toward real-world computational modeling and simulation problems. The ASCI mission must be carried out through a unified, multilaboratory effort, and will require highly secure, efficient access to vast amounts of data. The CSE provides a logically simple, geographically distributed, storage infrastructure of semi-autonomous cooperating sites to meet the strategic ASCI PSE goal of highperformance data storage and access at the user desktop

Information Outlook, September 2000

Volume 4, Issue 9https://scholarworks.sjsu.edu/sla_io_2000/1008/thumbnail.jp

A National Dialogue on Health Information Technology and Privacy

Increasingly, government leaders recognize that solving the complex problems facing America today will require more than simply keeping citizens informed. Meeting challenges like rising health care costs, climate change and energy independence requires increased level of collaboration. Traditionally, government agencies have operated in silos -- separated not only from citizens, but from each other, as well. Nevertheless, some have begun to reach across and outside of government to access the collective brainpower of organizations, stakeholders and individuals.The National Dialogue on Health Information Technology and Privacy was one such initiative. It was conceived by leaders in government who sought to demonstrate that it is not only possible, but beneficial and economical, to engage openly and broadly on an issue that is both national in scope and deeply relevant to the everyday lives of citizens. The results of this first-of-its-kind online event are captured in this report, together with important lessons learned along the way.This report served as a call to action. On his first full day in office, President Obama put government on notice that this new, more collaborative model can no longer be confined to the efforts of early adopters. He called upon every executive department and agency to "harness new technology" and make government "transparent, participatory, and collaborative." Government is quickly transitioning to a new generation of managers and leaders, for whom online collaboration is not a new frontier but a fact of everyday life. We owe it to them -- and the citizens we serve -- to recognize and embrace the myriad tools available to fulfill the promise of good government in the 21st Century.Key FindingsThe Panel recommended that the Administration give stakeholders the opportunity to further participate in the discussion of heath IT and privacy through broader outreach and by helping the public to understand the value of a person-centered view of healthcare information technology

Evaluation of a digital diabetes prevention program adapted for the Medicaid population: Study design and methods for a non-randomized, controlled trial.

Previous studies have shown that lifestyle modification can successfully prevent or delay development of type 2 diabetes. This trial aimed to test if an underserved, low-income population would engage in a digital diabetes prevention program and successfully achieve lifestyle changes to reduce their risk of type 2 diabetes. Participants were recruited from three health care facilities serving low-income populations. The inclusion criteria were: a recent blood test indicating prediabetes, body mass index (BMI) \u3e 24 kg/

Website Content Extraction Using Web Structure Analysis

The Web poses itself as the largest data repository ever available in the history of humankind. Major efforts have been made in order to provide efficient to relevant information within huge repository of data. Although several techniques have been developed to the problem of Web data extraction, their use is still not spread, mostly because of the need for high human intervention and the low quality of the extraction results. For this project a domain-oriented approach to Web data extraction and discuss it application to extracting news from Web Sites. It will use the abstraction method to identify important sections in a web document. The relevance information will be taken account and will be highlighted in order to develop a focused web content output. The fact-finding and data about the project are gathered from various sources such as internet, and books. The methodology used is a Waterfall Model that involves several phases which are Planning, Analysis, Design and Implementation. The result of this project is the display and review of web content extraction and how it being currently being developed which the goals is to give more usability and easiness toward web users

CPA\u27s guide to information security

https://egrove.olemiss.edu/aicpa_guides/1963/thumbnail.jp