A Guided Study to the Gospel According to John

This project is intended to be used as an adult Bible study guide. It could be used in a Bible study, Sunday School class, or Sunday evening service. The purpose of this research project is compound. First, it is to make the Scriptures vividly understandable to the student. Hopefully it will be so real that the student can almost reach out his hand and feel the splinters on the cross. It is the hope of the author that each student will see each Biblical person as someone the student can identify with and that he can put himself in the historical person\u27s place. This will move the Scriptures from abstract facts to vivid encounters with the person of Jesus Christ

A Determination of the Neutron Spin Structure Function gⁿ₁ with the 1995 HERMES Data

The internal spin structure of the neutron was studied in deep inelastic scattering of longitudinally polarized positrons from a polarized 3He target in the HERMES spectrometer at the DESY storage ring. The spin asymmetry was measured at an energy of 27.52 GeV in the range 0.023 ˂ x ˂ 0.8 at an average Q2 of 2.5 (GeV/c)2. The results are evolved to a constant Q2 of 2.5 (GeV /c)2 and arc in agreement with the world data for the spin dependent structure function gn 1. The integral of gn1 (ʃ10(x, Q2 = 2.5(Gev/c)2)dx) is found to he -0.036 ± 0.012(stat) ± 0.005(syst) ± 0.003(extrapolation) which is 2 standard deviations from the Ellis-Jaffe Sum Rule and, combined with the world data for the proton, is in good agreement with the Bjorken Sum Rule. Combining this result with the weak coupling constants F and D implies the quarks carry (38 ± 11)% of the nucleon spin and the polarization of the strange sea represents (-7 ± 4)% of the nucleon spin.</p

Crater population and resurfacing of the Martian north polar layered deposits

Present-day accumulation in the north polar layered deposits (NPLD) is thought to occur via deposition on the north polar residual cap. Understanding current mass balance in relation to current climate would provide insight into the climatic record of the NPLD. To constrain processes and rates of NPLD resurfacing, a search for craters was conducted using images from the Mars Reconnaissance Orbiter Context Camera. One hundred thirty craters have been identified on the NPLD, 95 of which are located within a region defined to represent recent accumulation. High Resolution Imaging Science Experiment images of craters in this region reveal a morphological sequence of crater degradation that provides a qualitative understanding of processes involved in crater removal. A classification system for these craters was developed based on the amount of apparent degradation and infilling and where possible depth/diameter ratios were determined. The temporal and spatial distribution of crater degradation is interpreted to be close to uniform. Through comparison of the size-frequency distribution of these craters with the expected production function, the craters are interpreted to be an equilibrium population with a crater of diameter D meters having a lifetime of ~30.75D^(1.14) years. Accumulation rates within these craters are estimated at 7.2D^(−0.14) mm/yr, which corresponds to values of ~3–4 mm/yr and are much higher than rates thought to apply to the surrounding flat terrain. The current crater population is estimated to have accumulated in the last ~20 kyr or less

Pretransitional phenomena in dilute crystals with first-order phase transition

Pretransitional phenomena at first-order phase transition in crystals diluted by 'neutral' impurities (analogue of nonmagnetic atoms in dilute magnets) are considered. It is shown that field dependence of order parameter becomes nonanalytical in the stability region of the ordered phase, while smeared jumps of thermodynamic parameters and anomalous (non-exponential) relaxation appear near transition temperature of pure crystal.Comment: 4 page

Enabling Hospital Staff to Care for People with Dementia

This is the fourth and final article in a short series that presents case study examples of the positive work achieved by trusts who participated in the Royal College of Nursing’s development programme to improve dementia care in acute hospitals. Dementia training in hospitals is often inadequate and staff do not always have sufficient knowledge of dementia to provide appropriate care. It can also be difficult for them to identify when patients with dementia are in pain, especially when their communication skills deteriorate. The case studies presented illustrate how two NHS trusts have worked to ensure that their staff are fully equipped to care for people with dementia in hospital. Basildon and Thurrock University hospitals NHS Foundation Trust in Essex made dementia training a priority by including dementia awareness in staff induction across a range of roles and providing additional training activities tailored to meet staff needs. Nottingham University Hospitals NHS Trust focused on pain assessment, aiming to standardise its approach for patients with dementia. The pain assessment in advanced dementia tool was chosen and piloted, and is being implemented across the trust after a positive response

Improving Activity and Engagement for Patients with Dementia

This is the second in a short series that presents case study examples of the positive work achieved by trusts that participated in the Royal College of Nursing’s development programme to improve dementia care in acute hospitals. Staff often think that there is insufficient time to get to know patients and carers, especially with large and challenging workloads. Combined with a lack of activities and stimulation for patients with dementia in hospital, this can result in poor engagement and a disconnect between staff and patients. To improve these relationships and give staff more time with patients, Cambridge University Hospitals NHS Foundation Trust has introduced bay nursing for patients with dementia, where one nurse is responsible for monitoring a bay alongside a healthcare assistant for an entire shift. Part of Betsi Cadwaladr University Health Board, Glan Clwyd Hospital in North Wales has focused on improving stimulation by creating an activity room with a specially trained activity worker, providing a relaxed and friendly setting where patients with dementia can take part in a range of activities and have lunch together

The effect of simulated narratives that leverage EMR data on shared decision-making: a pilot study

BACKGROUND: Shared decision-making can improve patient satisfaction and outcomes. To participate in shared decision-making, patients need information about the potential risks and benefits of treatment options. Our team has developed a novel prototype tool for shared decision-making called hearts like mine (HLM) that leverages EHR data to provide personalized information to patients regarding potential outcomes of different treatments. These potential outcomes are presented through an Icon array and/or simulated narratives for each “person” in the display. In this pilot project we sought to determine whether the inclusion of simulated narratives in the display affects individuals’ decision-making. Thirty subjects participated in this block-randomized study in which they used a version of HLM with simulated narratives and a version without (or in the opposite order) to make a hypothetical therapeutic decision. After each decision, participants completed a questionnaire that measured decisional confidence. We used Chi square tests to compare decisions across conditions and Mann–Whitney U tests to examine the effects of narratives on decisional confidence. Finally, we calculated the mean of subjects’ post-experiment rating of whether narratives were helpful in their decision-making. RESULTS: In this study, there was no effect of simulated narratives on treatment decisions (decision 1: Chi squared = 0, p = 1.0; decision 2: Chi squared = 0.574, p = 0.44) or Decisional confidence (decision 1, w = 105.5, p = 0.78; decision 2, w = 86.5, p = 0.28). Post-experiment, participants reported that narratives helped them to make decisions (mean = 3.3/4). CONCLUSIONS: We found that simulated narratives had no measurable effect on decisional confidence or decisions and most participants felt that the narratives were helpful to them in making therapeutic decisions. The use of simulated stories holds promise for promoting shared decision-making while minimizing their potential biasing effect

Doodle Health: A Crowdsourcing Game for the Co-design and Testing of Pictographs to Reduce Disparities in Healthcare Communication

Supplementing patient education content with pictographs can improve the comprehension and recall of information, especially patients with low health literacy. Pictograph design and testing, however, are costly and time consuming. We created a Web-based game, Doodle Health, for crowdsourcing the drawing and validation of pictographs. The objective of this pilot study was to test the usability of the game and its appeal to healthcare consumers. The chief purpose of the game is to involve a diverse population in the co-design and evaluation of pictographs. We conducted a community-based focus group to inform the game design. Game designers, health sciences librarians, informatics researchers, clinicians, and community members participated in two Design Box meetings. The results of the meetings were used to create the Doodle Health crowdsourcing game. The game was presented and tested at two public fairs. Initial testing indicates crowdsourcing is a promising approach to pictograph development and testing for relevancy and comprehension. Over 596 drawings were collected and 1,758 guesses were performed to date with 70-90% accuracies, which are satisfactorily high

Identification and Use of Frailty Indicators from Text to Examine Associations with Clinical Outcomes Among Patients with Heart Failure.

Frailty is an important health outcomes indicator and valuable for guiding healthcare decisions in older adults, but is rarely collected in a quantitative, systematic fashion in routine healthcare. Using a cohort of 12,000 Veterans with heart failure, we investigated the feasibility of topic modeling to identify frailty topics in clinical notes. Topics were generated through unsupervised learning and then manually reviewed by an expert. A total of 53 frailty topics were identified from 100,000 notes. We further examined associations of frailty with age-, sex-, and Charlson Comorbidity Index-adjusted 1-year hospitalizations and mortality (composite outcome) using logistic regression. Frailty (≤ 4 topics versu