Operationalizing Lewin’s 3-Step Change Model in the Outpatient Setting: A COVID-19 Case Study

The COVID-19 pandemic has disrupted the healthcare industry and forced organizations to fundamentally change their operations to ensure the highest level of safety for both patients and staff alike. The purpose of this study is to analyze the rapid response change process to COVID-19 in an outpatient setting and provide current and future healthcare leaders and organizations elements for consideration in redesigning healthcare delivery during a pandemic. Through a series of semi-structured interviews with Independent American Health Clinic employees, coupled with a thematic analysis, three main themes emerged the organization’s response: environment of care, healthcare operations, and organizational infrastructure. These themes were placed into a framework consisting of Lewin’s 3-Step Change model (unfreezing, moving, and refreezing) to retrospectively analyze an organization’s change efforts in response to COVID-19. The analysis highlighted a nine month period that started just prior to the pandemic declaration and aligned with the early trend of increasing cases and transmission levels. The analysis also outlined distinct challenges presented to the change efforts set by the existing culture of the organization. Additional information provided by participants during the interview process offered supplementary areas for discussion to include pandemic planning and training, the importance of staff resiliency, and the need to continuously monitor and improve business operations. The results showed that while there are many similarities to the conditions for which healthcare organizations needed to respond, the change efforts are unique to each organization

Environmental Monitoring on Research Centres and Large Farms Using Spatial Data Management Tools.

End of Project ReportThe objective of project 4480 was to build an environmental management system by using a visual or map based approach to develop new ways to manage environmental data on a large farm or an estate of several farms. Geographic information system (GIS) techniques are extremely powerful, but they tend to be complex, and often require a high degree of skill and training in order to use them. Using systems analysis, the fundamental environmental management data were identified and a simplified spatial approach was developed to manage these environmental data. Johnstown Castle Research Centre consists of three farms, ornamental grounds, forests, lakes and streams. A set of database tables was generated to hold farm environmental data on these farms. These included: annual management summary data giving the average number of different types of animals, the amount of organic manure and N, P and K nutrients produced by them, fertiliser purchases, organic and chemical nutrient usage on the farm, achievement of nutrient management planning targets, etc. monthly livestock information recording the numbers of livestock of different types for the three farms, together with management comments on the changes and transfer that take place over the month, detailed land use and nutrient use information for each field or plot on the estate, recent soil analyses information for the experimental plots, analysis results of recent water samples which are taken regularly at sampling points throughout the estate. The topographical, soil and site features were digitised, in order to collect information on the overall and individual farm boundaries. This included roads, hedges and ditches, streams, rivers and lakes, the buildings and most particularly, the boundaries of all field and experimental plots. When the digitisation was complete, a set of bespoke programs was built, using the GIS system, ArcView. To make the system "user friendly", the menu system was customised by removing complex features; retaining only those buttons and menu options that served a purpose useful to the application. The programs were unified into a PC system called Johnstown Castle Environmental Monitoring System or JCEMS. For the future, it is envisaged that the maps and spatial techniques will be embodied into an Access database system and developed for use by other research stations and farms.European Union Structural Funding (EAGGF

Prostate cancer radiotherapy: potential applications of metal nanoparticles for imaging and therapy

Prostate cancer (CaP) is the most commonly diagnosed cancer in males. There have been dramatic technical advances in radiotherapy delivery, enabling higher doses of radiotherapy to primary cancer, involved lymph nodes and oligometastases with acceptable normal tissue toxicity. Despite this, many patients relapse following primary radical therapy, and novel treatment approaches are required. Metal nanoparticles are agents that promise to improve diagnostic imaging and image-guided radiotherapy and to selectively enhance radiotherapy effectiveness in CaP. We summarize current radiotherapy treatment approaches for CaP and consider pre-clinical and clinical evidence for metal nanoparticles in this condition

Defining a Mechanism of Educational Interface Between NASA Life Sciences the Nation's Students

Harnessing our greatest national resource, as represented by the nation's students, will require a thoughtful, well developed and administered program that includes precise, executable strategies and valid evaluation tools. Responding to a national education outreach priority, the National Aeronautics and Space Administration's Life and Biomedical Sciences and Applications Division has initiated a process or organizing and implementing various strategies through a steering committee that includes representatives from Headquarters and three field centers with major Life Sciences programs. The mandate of the Life Sciences Education Outreach Steering Committee is to develop ways of communicating space life science issues to America's students through the nation's teachers by curriculum enhancement and direct participation in the education process with an emphasis in the primary and secondary schools. Metrics are also developed for each individually defined process so that the mechanis can be continuously refined and improved

Principles of International Law for Multilateral Development Banks: The Obligation to Respect Human Rights

41 pages. January, 2009 www.indianlaw.or

Principles of International Law for Multilateral Development Banks: The Obligation to Respect Human Rights

41 pages. January, 2009 www.indianlaw.or

The influence of structural defects on intra-granular critical currents of bulk MgB2

Bulk MgB2 samples were prepared under different synthesis conditions and analyzed by scanning and transmission electron microscopy. The critical current densities were determined from the magnetization versus magnetic field curves of bulk and powder-dispersed-in-epoxy samples. Results show that through a slow cooling process, the oxygen dissolved in bulk MgB2 at high synthesis temperatures can segregate and form nanometer-sized coherent precipitates of Mg(B,O)2 in the MgB2 matrix. Magnetization measurements indicate that these precipitates act as effective flux pinning centers and therefore significantly improve the intra-grain critical current density and its field dependence.Comment: 4 pages, 4 figures, to be published in IEE Transactions in Applied Superconductivit