2,930 research outputs found

    Comparison between transfer function and modal minimization methods for system identification

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    The reliability of two methods of structural identification is assessed employing noise-contaminated data. The statistical properties of the results of the transfer function approach and those of the modal minimization technique are compared, at different levels of noise, with the exact values of the modal parameters being estimated. Comparison indicates that the modal minimization is a far superior technique for structural parameter estimation using linear models

    Development and Delivery of a Quality Improvement Program to Reduce Antipsychotic Polytherapy

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    BACKGROUND: Although antipsychotic polytherapy is considered appropriate in limited circumstances (e.g., during a brief “cross-titration” period when switching medications), its increasing prevalence indicates use beyond this limited scope. Despite absence of support in the medical literature and higher costs, antipsychotic polytherapy is common in the treatment of schizophrenia and related disorders. The highest utilization of antipsychotic polytherapy occurs on psychiatric inpatient units, and in 2008, the Joint Commission released the first set of 7 hospital-based inpatient psychiatric services (HBIPS) core measures, 2 of which assess antipsychotic polytherapy at time of discharge. OBJECTIVE: To describe the effect on antipsychotic polytherapy at time of discharge of a 2-part quality improvement program composed of educational seminars and prescriber-specific feedback provided to 11 psychiatrists in 4 acute inpatient psychiatric units in 2 hospitals. METHODS: In a regional academic health care system, we determined the prevalence of antipsychotic monotherapy and polytherapy at time of discharge for all patients discharged on standing antipsychotic medications during 3 periods: (a) a 3-month baseline period (August 2006 through October 2006); (b) in July 2007, after delivery of 4 educational luncheon seminars to 11 psychiatrists from November 2006 through June 2007; and (c) in June 2008, following the provision of monthly prescriber-specific audit feedback from August 2007 through June 2008. To prepare nurses for the change and address possible safety concerns, an educational module was delivered to the psychiatric nursing staff at “best practice” day lectures held in the first quarter of 2007. General themes in the educational presentations included literature-based reviews of (a) safety and efficacy of antipsychotic polytherapy, (b) medical risks of antipsychotic medications, (c) specific versus nonspecific effects of these medications, and (d) effectiveness of first- versus second-generation antipsychotic medications. The prescriber-specific audit feedback was provided in paper form and masked the identity of the other prescribers. The chief of service reviewed audit feedback individually with each psychiatrist on a quarterly basis. The primary outcome measure was the percentage of patients prescribed 2 or more antipsychotics at discharge. A secondary outcome measure was the percentage of patients prescribed 3 or more antipsychotics at discharge. Differences in the primary outcome measure, comparing (a) July 2007 with the baseline period and (b) June 2008 with July 2007, were analyzed using Fisher’s Exact tests. The Cochran-Armitage test for trend was used to assess the relationship between the primary outcome measure and the extent of the intervention, measured as the 3 time periods. For the secondary outcome measure, the Goodman-Kruskal gamma test for ordered categorical data was calculated to examine the association between the proportion of patients receiving 1, 2, or 3 or more antipsychotics at discharge and the 3 time periods. RESULTS: The percentage of patients prescribed 2 or more antipsychotics at discharge declined from 33.9% at baseline (132 of 389 patients), to 21.8% after delivery of the educational modules (44 of 202 patients, P = 0.002), and to 12.2% after audit feedback (18 of 147 patients, P = 0.023; Cochran-Armitage test for trend P \u3c 0.001). When antipsychotic use was classified as 1, 2, or 3 or more antipsychotic medications, more extensive intervention was associated with decreased combination use (Goodman-Kruskal gamma = 0.39, P \u3c 0.001). In the baseline period, 5.9% of patients were prescribed 3 or more antipsychotics at discharge. Following completion of the educational and audit components, respectively, the proportion of patients prescribed 3 or more antipsychotics declined to 2.5% and then to 0.0%. CONCLUSION: Educational modules presented to psychiatrists and nurses in group settings were associated with a decrease in the rate of prescribing 2 or more antipsychotics at discharge from acute psychiatric inpatient units. Addition of monthly audit feedback provided to psychiatrists was associated with further decreases

    A Successful Portable Computer Lab Training Program

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    Penn State Cooperative Extension and the Pennsylvania Farm Credit System joined forces to fund a portable computer laboratory. A simplified lab management procedure allowed Extension agents to offer 33 computer operation workshops for 300 participants at minimal participant cost. Participants indicated their future use of computers would focus on farm financial, crop, and livestock management. Although considerable competence was gained, more than 50% viewed themselves with poor to moderate computer skills at the end of the workshops. The lab has enabled agents to contact a preciously under-served population as 54% of the participants had not attended any Extension workshops in the previous year

    Course-based Science Research Promotes Learning in Diverse Students at Diverse Institutions

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    Course-based research experiences (CREs) are powerful strategies for spreading learning and improving persistence for all students, both science majors and nonscience majors. Here we address the crucial components of CREs (context, discovery, ownership, iteration, communication, presentation) found across a broad range of such courses at a variety of academic institutions. We also address how the design of a CRE should vary according to the background of student participants; no single CRE format is perfect. We provide a framework for implementing CREs across multiple institutional types and several disciplines throughout the typical four years of undergraduate work, designed to a variety of student backgrounds. Our experiences implementing CREs also provide guidance on overcoming barriers to their implementation

    Strategic Planning for Environmental Stewardship at Eastern Kentucky University

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    The 2006-2010 Strategic Plan for Eastern Kentucky University, under Strategic Direction 5.4, mandates the formulation of a plan to guide the University toward greater environmental stewardship. The creation and implementation of that plan is the charge of the Eastern Committee on Responsible Environmental Stewardship (ECRES), which was formed in September of 2005. On October 27th, 2006, ECRES hosted a Strategic Planning Workshop. This workshop brought together a wide range of paticipants, including elected officials, college and university representatives, and interested citizens. The result was a broad consensus in the identification of environmental goals and objectives toward which EKU should strive

    Surface-Controlled Dissolution Rates: A Case Study of Nanoceria in Carboxylic Acid Solutions

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    Nanoparticle dissolution in local milieu can affect their ecotoxicity and therapeutic applications. For example, carboxylic acid release from plant roots can solubilize nanoceria in the rhizosphere, affecting cerium uptake in plants. Nanoparticle dispersions were dialyzed against ten carboxylic acid solutions for up to 30 weeks; the membrane passed cerium-ligand complexes but not nanoceria. Dispersion and solution samples were analyzed for cerium by inductively coupled plasma mass spectrometry (ICP-MS). Particle size and shape distributions were measured by transmission electron microscopy (TEM). Nanoceria dissolved in all carboxylic acid solutions, leading to cascades of progressively smaller nanoparticles and producing soluble products. The dissolution rate was proportional to nanoparticle surface area. Values of the apparent dissolution rate coefficients varied with the ligand. Both nanoceria size and shape distributions were altered by the dissolution process. Density functional theory (DFT) estimates for some possible Ce(IV) products showed that their dissolution was thermodynamically favored. However, dissolution rate coefficients did not generally correlate with energy of formation values. The surface-controlled dissolution model provides a quantitative measure for nanoparticle dissolution rates: further studies of dissolution cascades should lead to improved understanding of mechanisms and processes at nanoparticle surfaces
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