4,150 research outputs found
The effects of isometric work on heart rate, blood pressure, and net oxygen cost
Isometric exercise effects on heart rate, blood pressure, and net oxygen cos
Alignment of patient and primary care practice member perspectives of chronic illness care: a cross-sectional analysis
Polly H. Noel and Luci K. Leykum are with the South Texas Veterans Health Care System, 7400 Merton Minter Blvd, San Antonio, TX 78229, USA -- Polly H. Noel, Ray F. Palmer, Raquel L. Romero, Luci K. Leykum, Holly J. Lanham, and Krista W. Bowers are with the Department of Medicine, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, San Antonio, TX 78229, USA -- Michael L. Parchman is with the MacColl Center for Healthcare Innovation, Group Health Research Institute, Group Health Cooperative, 1730 Minor Ave 1600, Seattle, WA 98101, USA -- Holly J. Leykum is with the The McCombs School of Business, The University of Texas at Austin, 2110 Speedway, Stop B6000, Austin, TX 78712, USA -- John E. Zeber is with the Central Texas Veterans Health Care System, 1901 S. 1st St, Temple, TX 76504, USA and Scott and White Healthcare Center for Applied Health Research, 2401 S. 31st St, Temple, TX 76508, USABackground: Little is known as to whether primary care teamsâ perceptions of how well they have implemented the Chronic Care Model (CCM) corresponds with their patientsâ own experience of chronic illness care. We examined the extent to which practice membersâ perceptions of how well they organized to deliver care consistent with the CCM were associated with their patientsâ perceptions of the chronic illness care they have received. Methods: Analysis of baseline measures from a cluster randomized controlled trial testing a practice facilitation intervention to implement the CCM in small, community-based primary care practices. All practice âmembersâ (i.e., physician providers, non-physician providers, and staff) completed the Assessment of Chronic Illness Care (ACIC) survey and adult patients with 1 or more chronic illnesses completed the Patient Assessment of Chronic Illness Care (PACIC) questionnaire. Results: Two sets of hierarchical linear regression models accounting for nesting of practice members (Nâ=â283) and patients (Nâ=â1,769) within 39 practices assessed the association between practice member perspectives of CCM implementation (ACIC scores) and patientsâ perspectives of CCM (PACIC). ACIC summary score was not significantly associated with PACIC summary score or most of PACIC subscale scores, but four of the ACIC subscales were consistently associated with PACIC summary score and the majority of PACIC subscale scores after controlling for patient characteristics. The magnitude of the coefficients, however, indicates that the level of association is weak. Conclusions: The ACIC and PACIC scales appear to provide complementary and relatively unique assessments of how well clinical services are aligned with the CCM. Our findings underscore the importance of assessing both patient and practice member perspectives when evaluating quality of chronic illness care.Information, Risk, and Operations Management (IROM)[email protected]
The Lemaitre-Schwarzschild Problem Revisited
The Lemaitre and Schwarzschild analytical solutions for a relativistic
spherical body of constant density are linked together through the use of the
Weyl quadratic invariant. The critical radius for gravitational collapse of an
incompressible fluid is shown to vary continuously from 9/8 of the
Schwarzschild radius to the Schwarzschild radius itself while the internal
pressures become locally anisotropic.Comment: Final version as accepted by GR&G (to appear in vol. 34, september
2002
Reducing the burden of obesity-associated cancers with anti-inflammatory long-chain omega-3 polyunsaturated fatty acids
Todayâs world population has an unprecedented risk of dying from the consequences of being overweight and obese. Chronic diseases such as cardiovascular disease, type 2 diabetes, and cancer are often accelerated because of excessive adiposity. Various biological mechanisms are implicated in the obesity-cancer link, particularly local and systemic inflammation as well as altered growth factor signaling pathways. In order to combat obesity-induced inflammation and the resulting increases in cancer risk and progression, the identification of safe and effective mechanism-based interventions is imperative. Notably, long chain omega-3 polyunsaturated fatty acids (PUFAs) modulate the secretion of pro-inflammatory cytokines, prostaglandins and other inflammatory mediators, restore insulin sensitivity, and can prevent or delay tumorigenesis. Delineating the precise mechanisms by which omega-3 PUFAs suppress obesity-induced inflammation will help identify promising key mechanistic targets and intervention strategies to break the obesity-cancer link
Anisotropic static solutions in modelling highly compact bodies
Einstein field equations for anisotropic spheres are solved and exact
interior solutions obtained. This paper extends earlier treatments to include
anisotropic models which accommodate a wider variety of physically viable
energy densities. Two classes of solutions are possible. The first class
contains the limiting case for the energy density which
arises in many astrophysical applications. In the second class the singularity
at the center of the star is not present in the energy density. The models
presented in this paper allow for increasing and decreasing profiles in the
behavior of the energy density.Comment: 9 pages, to appear in Pramana - J. Phy
Discovery of Enhanced Germanium Abundances in Planetary Nebulae with FUSE
We report the discovery of Ge III 1088.46 in the planetary nebulae
(PNe) SwSt 1, BD+303639, NGC 3132, and IC 4593, observed with the Far
Ultraviolet Spectroscopic Explorer. This is the first astronomical detection of
this line and the first measurement of Ge (Z = 32) in PNe. We estimate Ge
abundances using S and Fe as reference elements, for a range of assumptions
about gas-phase depletions. The results indicate that Ge, which is synthesized
in the initial steps of the s-process and therefore can be self-enriched in
PNe, is enhanced by factors of > 3-10. The strongest evidence for enrichment is
seen for PNe with Wolf-Rayet central stars, which are likely to contain heavily
processed material.Comment: 11 pages, 1 figure, accepted for publication in ApJ Letter
Tackling Exascale Software Challenges in Molecular Dynamics Simulations with GROMACS
GROMACS is a widely used package for biomolecular simulation, and over the
last two decades it has evolved from small-scale efficiency to advanced
heterogeneous acceleration and multi-level parallelism targeting some of the
largest supercomputers in the world. Here, we describe some of the ways we have
been able to realize this through the use of parallelization on all levels,
combined with a constant focus on absolute performance. Release 4.6 of GROMACS
uses SIMD acceleration on a wide range of architectures, GPU offloading
acceleration, and both OpenMP and MPI parallelism within and between nodes,
respectively. The recent work on acceleration made it necessary to revisit the
fundamental algorithms of molecular simulation, including the concept of
neighborsearching, and we discuss the present and future challenges we see for
exascale simulation - in particular a very fine-grained task parallelism. We
also discuss the software management, code peer review and continuous
integration testing required for a project of this complexity.Comment: EASC 2014 conference proceedin
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