131 research outputs found

    Bounded state space

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    This investigation is divided functionally into three different areas: (1) study of bounded state space, (2) nonlinear smoothing theory, and (3) system identification. (1) Study of bounded state space: necessary and sufficient conditions for an optimal control are obtained for a bounded state space optimal control problem. The difficulty of determining the so-called jump conditions is eliminated; however, the problem of determining the points where the response either enters or leaves the boundary still remains unsolved. (2) Nonlinear smoothing theory: nonlinear fixed-interval, fixed-point and fixed-lag smoothing of a random signal generated by a stochastic differential equation are investigated. Results on the asymptotic stability of a linear constant-parameter fixed-interval smoothing filter are obtained. (3) System identification: a particular stochastic modelling problem is solved. An Ito stochastic integral equation is used to mathematically model a black box having multiple inputs and multiple outputs. A new method for identifying system parameters is presented

    Assessing what matters: A milestone focused on justice, equity, diversity, & inclusion (JEDI)

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    Objective or purpose of innovation: To develop an ACGME-like milestone that concurrently serves as a curriculum blueprint across the continuum of medical education. Background and/or theoretical framework and importance to the field: In 2019, Milwaukee County became one of the first municipalities to declare racism a public health crisis.(1) Motivated by racial injustice and COVID-19 disparities medical education (2-4) are accelerating efforts to address racism and eliminate health disparities (AAMC’s DEI Cross-Continuum Competencies). Yet, the 2019 ACGME Common Program Requirements six core competencies fails to include the key terms (disparities, inequities, justice, community, underserved) and requires a new structural competency domain with assessments.(5) Design: To match our existing assessment framework, an ACGME like milestone, applicable across the continuum of medical education was developed by an interprofessional team (eg, MedEd, Ethics, DE&I). A literature review was completed to identify key milestone elements. Milestone was framed by ACGME core competencies (eg, MK, PC, SBP) and progression delineated across five levels. The 8-page milestone was iteratively revised by multiple stakeholders to 1-page suitable for inclusion as the end of each GME program’s required milestone assessment form. Outcomes: Enthusiastic and pervasive support for the structural fluency milestone was achieved across the continuum. It was approved by GME Council for inclusion as a required formative milestone in every program. GME milestone data informs curriculum/instruction across the continuum (UME, GME, CME) using an expanded 2-page milestone for use as a blueprint at it retained each of the competency domains and references. Innovation\u27s strengths and limitations: Our milestone innovation recognizes need for data: to monitor our ability to learn/teach and ultimately eliminate racism (and other isms) and health disparities. Its strength is its limitation as we recognize it’s a journey and it will evolve as we do. Feasibility and transferability for adoption: Formatted like existing ACGME milestones implementation within the assessment system was seamless enhancing its feasibility and transferability

    Health profile for Danish adults with activity limitation: a cross-sectional study

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    Abstract Background Studies have indicated that people with disabilities die earlier and may experience a poorer health than the general population. This study investigated 31 factors related to health and well-being, health behaviour and social relations among Danish adults with activity limitation (AL). Methods This study was based on data from the Danish Health and Morbidity Survey (DHMS) 2013 where 25,000 men and women aged 16 years or older were selected randomly from the adult Danish population. A total of 14,265 individuals answered the self-administered questionnaire including 100 questions on health-related quality of life, health behaviour, morbidity, consequences of illness and social relations. Based on an international standard question on AL, 888 individuals (6%) were defined as having profound AL and 4180 (29%) as having some AL. Multiple logistic regression analyses were used to analyse the associations between activity limitation and 31 indicators of health. The results were presented as relative risks 95% confidence intervals. Results Twenty-eight of 31 indicators showed consistently poorer health and well-being, health behaviour and social relations among individuals with AL as compared to individuals without AL. The increased relative risks were in a range of 7-661% the risk among individuals without AL. An example is obesity where RR (95% CI) was 2.07 (1.82–2.37). Only contact with internet friends was significantly higher among individuals with AL as compared to individuals with no AL. There was no association between alcohol and AL and no association between fast food and some AL. Conclusion Danish adults with AL experience a poorer health and well-being, and have an unhealthier lifestyle and poorer social relations than adults without AL. People with activity limitation should be prioritized in public health and efforts done to secure availability and flexibility of health care services and primary prevention programs. Policies should address accessibility, availability and affordability of health care and health behaviour among people with activity limitation

    Criminal Responsibility and Dissociation: Clarity by Continuum?

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