Parameter dependence of acoustic mode quantities in an idealized model for shallow-water nonlinear internal wave ducts

Author Posting. © Acoustical Society of America, 2019. This article is posted here by permission of Acoustical Society of America for personal use, not for redistribution. The definitive version was published in Journal of the Acoustical Society of America 146(3), (2019): 1934-1945, doi:10.1121/1.5125261.Nonlinear internal waves in shallow water have significant acoustic impacts and cause three-dimensional ducting effects, for example, energy trapping in a duct between curved wavefronts that propagates over long distances. A normal mode approach applied to a three-dimensional idealized parametric model [Lin, McMahon, Lynch, and Siegmann, J. Acoust. Soc. Am. 133(1), 37–49 (2013)] determines the dependence of such effects on parameters of the features. Specifically, an extension of mode number conservation leads to convenient analytical formulas for along-duct (angular) acoustic wavenumbers. The radial modes are classified into five types depending on geometric characteristics, resulting in five distinct formulas to obtain wavenumber approximations. Examples of their dependence on wavefront curvature and duct width, along with benchmark comparisons, demonstrate approximation accuracy over a broad range of physical values, even including situations where transitions in mode types occur with parameter changes. Horizontal-mode transmission loss contours found from approximate and numerically exact wavenumbers agree well in structure and location of intensity features. Cross-sectional plots show only small differences between pattern phases and amplitudes of the two calculations. The efficiency and accuracy of acoustic wavenumber and field approximations, in combination with the mode-type classifications, suggest their application to determining parameter sensitivity and also to other feature models.This work was supported by the Office of Naval Research under grants to Rensselaer Polytechnic Institute (Grant Nos. N00014-14-1-0372 and N00014-17-1-2370) and to Woods Hole Oceanographic Institution (Grant Nos. N00014-11-1-0701 and N00014-17-1-2692). Additional funding was provided by Naval Undersea Warfare Center Division Newport through the SMART Scholarship for the first author's doctoral degree program. The authors also thank Dr. Timothy F. Duda of WHOI and Dr. David Wells of University of North Carolina at Chapel Hill for their assistance with this paper.2020-03-3

Instruments to measure patient experience of healthcare quality in hospitals: a systematic review

Improving and sustaining the quality of hospital care is an international challenge. Patient experience data can be used to target improvement and research. However, the use of patient experience data has been hindered by confusion over multiple instruments (questionnaires) with unknown psychometric testing and utility.MethodsWe conducted a systematic review and utility critique of questionnaires to measure patient experience of healthcare quality in hospitals. Databases (Medical Literature Analysis and Retrieval System (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Psychological Information (PsychINFO) and Web of Knowledge until end of November 2013) and grey literature were scrutinised. Inclusion criteria were applied to all records with a 10 % sample independently checked. Critique included (1) application of COSMIN checklists to assess the quality of each psychometric study, (2) critique of psychometric results of each study using Terwee et al. criteria and (3) development and critique of additional aspects of utility for each instrument. Two independent reviewers completed each critique. Synthesis included combining findings in a utility matrix.We obtained 1157 records. Of these, 26 papers measuring patient experience of hospital quality of care were identified examining 11 international instruments. We found evidence of extensive theoretical/development work. The quality of methods and results was variable but mostly of a high standard. Additional aspects of utility found that (1) cost efficiency was mostly poor, due to the resource necessary to obtain reliable samples; (2) acceptability of most instruments was good and (3) educational impact was variable, with evidence on the ease of use, for approximately half of the questionnaires.ConclusionsSelecting the right patient experience instrument depends on a balanced consideration of aspects of utility, aided by the matrix. Data required for high stakes purposes requires a high degree of reliability and validity, while those used for quality improvement may tolerate lower levels of reliability in favour of other aspects of utility (educational impact, cost and acceptability)

The National Adult Inpatient Survey conducted in the English National Health Service from 2002 to 2009: how have the data been used and what do we know as a result?

<p>Abstract</p> <p>Background</p> <p>When it was initiated in 2001, England's national patient survey programme was one of the first in the world and has now been widely emulated in other healthcare systems. The aim of the survey programme was to make the National Health Service (NHS) more "patient centred" and more responsive to patient feedback. The national inpatient survey has now been running in England annually since 2002 gathering data from over 600,000 patients. The aim of this study is to investigate how the data have been used and to summarise what has been learned about patients' evaluation of care as a result.</p> <p>Methods</p> <p>Two independent researchers systematically gathered all research that included analyses of the English national adult inpatient survey data. Journals, databases and relevant websites were searched. Publications prior to 2002 were excluded. Articles were also identified following consultation with experts. All documents were then critically appraised by two co-authors both of whom have a background in statistical analysis.</p> <p>Results</p> <p>We found that the majority of the studies identified were reports produced by organisations contracted to gather the data or co-ordinate the data collection and used mainly descriptive statistics. A few articles used the survey data for evidence based reporting or linked the survey to other healthcare data. The patient's socio-demographic characteristics appeared to influence their evaluation of their care but characteristics of the workforce and the. At a national level, the results of the survey have been remarkably stable over time. Only in those areas where there have been co-ordinated government-led campaigns, targets and incentives, have improvements been shown. The main findings of the review are that while the survey data have been used for different purposes they seem to have incited little academic interest.</p> <p>Conclusions</p> <p>The national inpatient survey has been a useful resource for many authors and organisations but the full potential inherent in this large, longitudinal publicly available dataset about patients' experiences has not as yet been fully exploited.</p> <p>This review suggests that the presence of survey results alone is not enough to improve patients' experiences and further research is required to understand whether and how the survey can be best used to improve standards of care in the NHS.</p

Assessing Patients\u27 Risk for Diabetes and Its Relationship to Gingival Disease

The prevalence of diabetes is increasing rapidly, and current research states periodontal disease may be a risk factor for diabetes. The purposes of this study were to determine: 1) the risk for diabetes among patients at a Midwest state university dental clinic, and 2) the relationship between risk level for diabetes and presence of gingival disease. Surveys were distributed to patients seen by senior students at Minnesota State University (MSU), Mankato dental hygiene clinic (N=70). The typical participant was male, 33 years old, exercised 1-2 times per week, and had a BMI of 27.3. Thirty percent of participants were obese, and an additional 34.3% were overweight. Using the American Diabetes Association Diabetes Risk Test, 21.4% of participants scored at high risk for diabetes. Independent t tests revealed no significant differences between patients at high and low risk for diabetes in number of periodontal pockets (p=.05) or in gingival inflammation (p=.79). This study suggests that the number of periodontal pockets and gingival inflammation are not correlated to the diabetes risk test score. Further research is needed to investigate if the presence of gingival pockets or gingival inflammation is a significant risk factor for diabetes. Dental hygienists would be excellent candidates to screen the public for the risk of diabetes

A scale of verbal accessibility in marriage

The purpose of this project was to develop a tool to clarify one concept of verbal interaction in marriage. This concept, Verbal Accessibility, was developed by Norman Polansky and defined as the degree of readiness of the individual to communicate verbally and to participate in communication about his determinant attitudes. Verbal Accessibility is dependent on two variables: l) the enduring characteristics of the individual, and 2) the release of inhibiting factors in a given situation. In order to facilitate the use of this concept in treatment, a scale was needed to measure Verbal Accessibility of both the person and of the attitudes in and about marriage. The present study began the development of such a scale. Results supported previous findings concerning the various aspects of marital interaction. The scale consisted of twenty questions intended to measure the Verbal Accessibility of certain determinant attitudes relevant for marital interaction. Four response categories were provided. The scale was administered to forty couples who were involved in marriage counseling: twenty at Family Counseling Service and twenty at the Court of Domestic Relations. Respondents were asked to indicate to what extent they would talk about feelings and concerns important in marriage with each of four target persons--Spouse, Relative, Confidant and Counselor. Following this self rating, each respondent rated his spouse\u27s accessibility with himself as target person. The counselors were asked to rate the respondents using the same scale. These ratings were intended to serve as validity checks, but chi-square comparisons with self ratings proved inconclusive. The scale was constructed to measure the variable Verbal Accessibility in such a way that persons as well as items could be ranked along a continuum from least accessible to most accessible. As constructed, the twenty item scale tapped an unknown number of attitudes. Guttman Scalogram Analysis was used to determine whether we had succeeded in measuring single attitudes with at least some of the items. This procedure had the additional advantage of permitting examination of the conceptual meaning of the attitudes measured. Scalogram analysis was attempted with the responses to the four target persons for the men and women separately at both agencies. With the Spouse and Counselor as target persons, no scalable areas were found in the responses of all of the four groups because of the high percentage of positive ( accessible ) responses which made scalogram analysis impossible. Scalar patterns were found in the responses with the Relative and Confidant as target persons for all four groups. Interpretations of the item content of the eight scalar patterns revealed what appeared to be a single underlying theme which is best expressed by Erving Goffman\u27s concept of impression management. This related to factors compelling and inhibiting communication in a given situation. This concept seemed prominent in the self avowed willingness to communicate all studied attitudes to the spouse as respondents attempted to conform to the ideal of a companionship marriage. The compelling force to be a “good client and discuss all concerns with the Counselor seemed to be operating. Toward the Relative and Confidant, impression management reflected more discrimination inaccessibility. This suggested that the respondents would communicate selectively to these target persons in order to convey a given impression. Thus, data tended to conform to existing theories concerning marital patterns of communication. This led to the conclusion that with further refinements, an instrument useful to clinical practice could be produced. No measure of reliability was possible within the limits of the study. Methodological refinements are needed in the areas of item selection, separation of research from service and the control of response bias. Investigation of the effect of the personality variable could be pursued

Alcohol Dependence, Co-occurring Conditions and Attributable Burden

AIMS: Alcohol dependence is associated with high rates of co-occurring disorders which impact health-related quality of life (HRQoL) and add to the cost-of-illness. This study investigated the burden of alcohol dependence and associated co-occurring conditions on health and productivity. METHODS: A cross-sectional survey was conducted in eight European countries. Physicians (Psychiatrists and General Practitioners) completed patient record forms, which included assessment of co-occurring conditions, and patients completed matching self-completion forms. Drinking risk level (DRL) was calculated and the relationship between DRL, co-occurring conditions, work productivity, hospitalisations and rehabilitation stays was explored. RESULTS: Data were collected for 2979 alcohol-dependent patients (mean age 48.8 ± 13.6 years; 70% male). In total, 77% of patients suffered from moderate-to-severe co-occurring psychiatric and/or somatic conditions. High DRL was significantly associated with depression, greater work productivity losses, increased hospitalisations and rehabilitation stays. Co-occurring conditions were significantly associated with poorer HRQoL and decreased work productivity, with a statistical trend towards an increased frequency of rehabilitation stays. CONCLUSIONS: Alcohol-dependent patients manifest high rates of co-occurring psychiatric and somatic conditions, which are associated with impaired work productivity and HRQoL. The continued burden of illness observed in these already-diagnosed patients suggests an unmet need in both primary and secondary care