Operations Management in Ambulatory Care in Switzerland

Practice efficiency is influenced by its operations management. We aim at studying implementation of operations management in Swiss medical practices and we develop a dashboard that allows controlling and managing resources. To study operations management and relevant indicators in ambulant care, we distributed questionnaires by e-mail and conducted 6 interviews. In collaboration with a group practice, we collected requirements regarding a dashboard for operations management, developed a mockup and finally a prototype. This prototype was deployed and implemented in daily routine. From the assessments we learned that practice information systems (PIS) are not sufficiently supporting production planning and control. Relevant indicators include processing time per patient or waiting time for quantifying efficiency and identify potential improvements in production. Within 5 weeks of implementation of our dashboard in a group practice, we learned that calculating indicators and support of operations management by means of a dashboard is well appreciated by practice employees. Indicators are considered extremely useful for operations management

5d-5f Electric-multipole Transitions in Uranium Dioxide Probed by Non-resonant Inelastic X-ray Scattering

Non-resonant inelastic x ray scattering (NIXS) experiments have been performed to probe the 5d-5f electronic transitions at the uranium O(4,5) absorption edges in uranium dioxide. For small values of the scattering vector q, the spectra are dominated by dipole-allowed transitions encapsulated within the giant resonance, whereas for higher values of q the multipolar transitions of rank 3 and 5 give rise to strong and well-defined multiplet structure in the pre-edge region. The origin of the observed non-dipole multiplet structures is explained on the basis of many-electron atomic spectral calculations. The results obtained demonstrate the high potential of NIXS as a bulk-sensitive technique for the characterization of the electronic properties of actinide materials.Comment: Submitted to Physical Review Letters on 31 December 200

Konzeption und prototypische Realisierung eines Informationssystems für das Prozeßmonitoring und -controlling

Durch die Überwachung der aktuellen Prozeßstatus (Prozeßmonitoring) sowie die Verdichtung und Gegenüberstellung dieser Istdaten mit Solldaten (Prozeßcontrolling) wird die Bewertung der Prozeßqualität möglich. Zur informationstechnischen Unterstützung dieser Aufgaben dienen Prozeßinformationssysteme. In diesem Arbeitsbericht werden nach einer Einordnung dieser Aufgaben in einem Vorgehensmodell des Prozeßmanagements Intention und Aufbau von Prozeßinformationssystemen beschrieben. Konkretisiert werden die Ausführungen durch die Vorstellung des Prototypen PISA, dessen Architektur und Funktionalität erläutert werden.<br/

Synthesis and characterization of thorium, uranium and cerium oxide nanoparticles

We describe the synthesis of cerium, thorium and uranium oxide nanoparticles embedded in a mesoporous matrix as template in a kind of nanocasting technique. The solid matrix is used as a template to obtain and stabilize the actinide oxide nanoparticles. We apply high resolution transmission electron microscopy (HR-TEM) to show evidence of metal oxide incorporation into the matrix pores and analyze their structure. Measured interplanar distances and calculated lattice parameters for synthesized nanosized CeO2−x and ThO2 samples differ from their bulk crystalline counterparts. We obtain with our synthesis CeO2−x particles containing both Ce4+ and larger sized Ce3+. The lattice parameter for these ceria nanoparticles is found to be larger than the bulk value due to the presence of Ce3+ with its larger ionic radius. The presence of Ce3+ was established by means of high resolution X-ray emission spectroscopy (HRXES), applied to the investigation of nanoparticles for the first time. The ThO2 nanoparticles exhibit a decrease in interplanar distances, as one might generally expected for these nanoclusters. However, the lattice distance decrease for our particles is remarkable, up to 5%, indicating that contact with the surrounding silica matrix may exert a bond distance shortening effect such as through significant external pressure on the particle surface

Polarised epithelial monolayers of the gastric mucosa reveal insights into mucosal homeostasis and defence against infection

Objective Helicobacter pylori causes life-long colonisation of the gastric mucosa, leading to chronic inflammation with increased risk of gastric cancer. Research on the pathogenesis of this infection would strongly benefit from an authentic human in vitro model. Design Antrum-derived gastric glands from surgery specimens served to establish polarised epithelial monolayers via a transient air–liquid interface culture stage to study cross-talk with H. pylori and the adjacent stroma. Results The resulting ‘mucosoid cultures’, so named because they recapitulate key characteristics of the gastric mucosa, represent normal stem cell-driven cultures that can be passaged for months. These highly polarised columnar epithelial layers encompass the various gastric antral cell types and secrete mucus at the apical surface. By default, they differentiate towards a foveolar, MUC5AC-producing phenotype, whereas Wnt signalling stimulates proliferation of MUC6-producing cells and preserves stemness—reminiscent of the gland base. Stromal cells from the lamina propria secrete Wnt inhibitors, antagonising stem-cell niche signalling and inducing differentiation. On infection with H. pylori, a strong inflammatory response is induced preferentially in the undifferentiated basal cell phenotype. Infection of cultures for several weeks produces foci of viable bacteria and a persistent inflammatory condition, while the secreted mucus establishes a barrier that only few bacteria manage to overcome. Conclusion Gastric mucosoid cultures faithfully reproduce the features of normal human gastric epithelium, enabling new approaches for investigating the interaction of H. pylori with the epithelial surface and the cross-talk with the basolateral stromal compartment. Our observations provide striking insights in the regulatory circuits of inflammation and defence.</p

Electronic structure and chemical bonding in Ti2AlC investigated by soft x-ray emission spectroscopy

The electronic structure of the nanolaminated transition metal carbide Ti2AlC has been investigated by bulk-sensitive soft x-ray emission spectroscopy. The measured Ti L, C K and Al L emission spectra are compared with calculated spectra using ab initio density-functional theory including dipole matrix elements. The detailed investigation of the electronic structure and chemical bonding provides increased understanding of the physical properties of this type of nanolaminates. Three different types of bond regions are identified; the relatively weak Ti 3d - Al 3p hybridization 1 eV below the Fermi level, and the Ti 3d - C 2p and Ti 3d - C 2s hybridizations which are stronger and deeper in energy are observed around 2.5 eV and 10 eV below the Fermi level, respectively. A strongly modified spectral shape of the 3s final states in comparison to pure Al is detected for the buried Al monolayers indirectly reflecting the Ti 3d - Al 3p hybridization. The differences between the electronic and crystal structures of Ti2AlC, Ti3AlC2 and TiC are discussed in relation to the number of Al layers per Ti layer in the two former systems and the corresponding change of the unusual materials properties.Comment: 14 pages, 7 figures; PACS:78.70.En, 71.15.Mb, 71.20.-