Executive Nursing Leadership: Change and Conflict related to the Triple Aim

Executive nurses work at the top of organizations and face unique challenges in today’s healthcare system. This qualitative study investigated the lived experiences of executive nurses to better understand their leadership journey. This study explored the professional development of executive nurses navigating change and conflict. The study used phenomenological inquiry and gathered data through individual semi-structured interviews, workplace observations, and document reviews. Based on the collected data experiential themes were identified. The study focused on executive nursing and the Institute for Healthcare Improvement’s (IHI) “Triple Aim” of creating better patient experiences, reducing system cost, and improving population health. The study interpreted critical turning points in executive nurses’ careers and triangulated data to identify, then, analyze central themes. Through the analysis of themes, new insights were created which connected current executive nurse functioning and future healthcare design. As a result, this study informed future thinking. The semi-structured interviews uncovered points of major change and conflict; particularly, related to fundamental organizational transformation, strategic goals, and the “Triple Aim”. Six key themes affecting executive nurse leadership emerged. The six key themes included: Focusing on population health, relationships, knowledge of the healthcare environment, technical leadership and change management skills, defined professional competencies, and central business skills. To provoke innovation and thought leadership, the six themes were interpreted using Zweig’s (2012) Class Theory, Shiva’s (2005) Perceptions of Corporate Power, and Plato’s Allegory of the Cave (Duarte, 2012)

"A Little is Enough": Few-Shot Quality Estimation based Corpus Filtering improves Machine Translation

Quality Estimation (QE) is the task of evaluating the quality of a translation when reference translation is not available. The goal of QE aligns with the task of corpus filtering, where we assign the quality score to the sentence pairs present in the pseudo-parallel corpus. We propose a Quality Estimation based Filtering approach to extract high-quality parallel data from the pseudo-parallel corpus. To the best of our knowledge, this is a novel adaptation of the QE framework to extract quality parallel corpus from the pseudo-parallel corpus. By training with this filtered corpus, we observe an improvement in the Machine Translation (MT) system's performance by up to 1.8 BLEU points, for English-Marathi, Chinese-English, and Hindi-Bengali language pairs, over the baseline model. The baseline model is the one that is trained on the whole pseudo-parallel corpus. Our Few-shot QE model transfer learned from the English-Marathi QE model and fine-tuned on only 500 Hindi-Bengali training instances, shows an improvement of up to 0.6 BLEU points for Hindi-Bengali language pair, compared to the baseline model. This demonstrates the promise of transfer learning in the setting under discussion. QE systems typically require in the order of (7K-25K) of training data. Our Hindi-Bengali QE is trained on only 500 instances of training that is 1/40th of the normal requirement and achieves comparable performance. All the scripts and datasets utilized in this study will be publicly available

A Tagging Protocol for Asynchronous Testing

International audienceConformance testing has a rich underlying theory popularly called IOCO-test theory. In the realm of IOCO-test theory, this paper addresses the issue of testing a component of an asynchronously communicating distributed system. Testing a system which communicates asynchronously (i.e., through some medium) with its environment is more difficult than testing a system which communicates synchronously (i.e., directly without any medium). What impedes asynchronous testing is that the actual behavior of the implementation under test (IUT) appears distorted and infinite to the tester. This impediment consequently renders the problem of generating a complete test suite, from the given specification of the IUT, infeasible. To this end, this paper contributes by proposing a tagging protocol which when implemented by the asynchronously communicating distributed system will make the problem of generating a complete test suite, from the specification of any of its component, feasible. Further, this paper describes how to generate the test suite from the given specification of the component

Test Case Generation Using PDA

International audienceIOLTS (input output labeled transition system) is a versatile model and is frequently used in model based testing to model the functional behavior of an IUT (implementation under test). However when a system is tested remotely, its observed behavior can be different from its actual functional behavior. In [2], we defined a notion of remotely observed behavior of an IOLTS in terms of its actual behavior. This paper contributes by proposing a methodology to simulate a PDA (push down automaton) from the given IOLTS such that the simulated PDA precisely expresses the remotely observed behavior of the IOLTS. The simulated PDA can be thought of as an automatic test generator for remote testing

Obstetric outcome in elderly gravida

Background: Maternal age is an important determinant of the outcome of pregnancy. Advanced maternal age generally signify age after 35 years at the time of delivery. It is associated with decreased fertility and increased risk. Elderly gravida is associated with many complications during pregnancy, labour and also for the baby. In recent times women has changed their lifestyles such as pursuit of higher education and entry into work forces and career advancement outside the home.Methods: This was a retrospective study done in 57 elderly pregnant women more than 33 years age, over a period of 18 months, conducted in a multi-specialty hospital.Results: 57 elderly pregnant women were selected for the study. 47% were in age group of 33-35 years and 42% were in age group of 36-40 years. 61.40% patients were housewives and 38.59% were employed. 50.8% of patients had history of previous abortions and 35% were conceived after treatment for sterility. 64.9% of patients conceived spontaneously and 35% by assisted reproductive technology. Majority of patients (33.3%) required Invitro-fertilization. Multiple pregnancy was high- 21.05%. Hypertension was observed in 26.3% of patients, Antepartum haemorrhage in 4.34%,  Preterm delivery  49.1%, Induction of labour in 10.52%, Normal vaginal delivery only in14%. Majority of patients (80.7%) were delivered by caesarean section.Conclusions: Elderly pregnant patients have higher risks of specific pregnancy complications which contribute to a higher frequency of maternal morbidity and greater health care costs. The risks are due to Hypertension, diabetes, multiple pregnancy, preterm labour, antepartum haemorrhage, PROM, malpresentation, prolonged labour, increased caesarean section rate and postpartum haemorrhage

RAPID, METHOD FOR DETERMINATION OF METFORMIN AND CANAGLIFLOZIN IN PLASMA BY LIQUID CHROMATOGRAPHY-TANDEM MASS SPECTROMETER, APPLICATION TO BIOEQUIVALENCE STUDY

Objective: The objective of the study was to develop and validate a rapid selective bioanalytical method for the simultaneous determination of metformin and canagliflozin in plasma by liquid chromatography-tandem mass spectrometer (LC-MS/MS) to facilitate bioequivalence study sample analysis. Stock solutions and spiking solutions were prepared accurately in methanol and 80% methanol in water, respectively. Methods: Chromatography monitored using Analyst 1.6.2 software. Method was found selective, no matrix effect, reproducible and consistent recovery, accuracy, precision, and stable in aqueous as well as extracted/matrix samples. Method found linear over the range 10–2000 ng/ml for metformin and 30–6000 ng/ml for canagliflozin. The method is successfully applied to analyze samples collected in a bioequivalence study after administration of metformin/canagliflozin 1000/150 mg to 24 healthy male volunteers. Results: Extraction was carried out using a simple solid phase extraction using mobile phase elution. 5 μl sample delivered as injection volume in 1.000 ml/min isocratic mobile phase flow on turbo ion electron spray technique for positive mode on API 4000 MS. Discussion: Chromatography achieved within 3 min using a mobile phase containing acetonitrile and 10 mM ammonium formate buffer in a ratio of 70:30 on chromolith C18 analytical column. Q1/Q3 are 130.1/70.1, 136.3/77.1, 462.2/267.2 (with ammonium adduct), and 466.4/267.1 for metformin, metformin D6, canagliflozin, and canagliflozin D4, respectively. Conclusion: Rapid, sensitive method for the simultaneous estimation of metformin and canagliflozin in plasma by LC-MS/MS is successfully developed, validated and applied to analyze 960 unknown samples of a bioequivalence study. Incurred sample reanalysis was revealed great reproducibility

The Face of Tropical Sprue in 2010

Tropical sprue (TS), although endemic in certain tropical regions of the world, is rarely seen in North America and Europe. However, in this era of globalization and worldwide travel, it is important for all clinicians to be aware of the possibility of TS in patients presenting with nonspecific, persistent gastrointestinal complaints like diarrhea and weight loss. The symptoms and histologic findings of TS can resemble and be confused with those of diseases seen more commonly in nontropical climates like celiac disease and small intestine bacterial overgrowth. Therefore, if the usual causes of persistent diarrhea are ruled out, keeping a high index of suspicion for TS in patients who have a travel history to one of the endemic regions is important

Predictors of Lung Cancer Screening Recommendation in Virginia Using the Community Health Assessment Survey

Purpose: The purpose of this analysis was to determine the factors that may influence the probability of being recommended a lung cancer screening by a health professional in Virginia. Methods: Data were obtained from the Community Health Assessment Survey conducted by the University of Virginia (UVA) Health System and Cancer System in collaboration with Virginia Commonwealth University (VCU) Cancer Center. SAS software was used to conduct a logistic regression with the following variables: age, sex, race, current smoking status, cancer history, education level, income level, insurance, and rurality. Results: Statistically significant positive predictors included being a current smoker (OR: 3.504, CI: 1.576 - 7.794), having previous cancer history (OR: 2.159, CI: 1.090 - 4.278), and living in an urban environment (OR: 1.939, CI: 1.009 - 3.724). Conclusion: Smoking, cancer history, and rurality were considered significant predictors of lung cancer screening recommendations by a health professional in Virginia while age, sex, race, education level, income level, and insurance were not considered significant predictors in this model. This study suggests that key mechanisms underlying lung cancer outcome disparities among racial minorities and socioeconomically disadvantaged groups may lie beyond the level of screening recommendations. Further research investigating when along the disease progression these disparities tend to arise could help in creating more targeted public health interventions and improving health equity

Survey on Alumni Portal

Alumni portal is for the family of the same college student. The students study in college, get the degree, leave it and get the job. After that even they wish to contact their ex-friends, college or teacher, they can’t do. So this Alumni portal is for that, so that students, teachers and college can attach with each other and can share the updates by advance communication way

Research on Alumni Portal

Alumni portal is the advanced communication way. It is for the same institute students family because of this alumni portal the present students, Ex-students can easily keep themselves in contact with each other. Not only students but the teachers, management members & everyone who is attached with the same institute are the part of this alumni portal