229 research outputs found
The effect of dynamical scattering on single-plane phase retrieval in electron ptychography
Segmented and pixelated detectors on scanning transmission electron microscopes enable the complex specimen transmission function to be reconstructed. Imaging the transmission function is key to interpreting the electric and magnetic properties of the specimen, and as such four-dimensional scanning transmission electron microscopy (4D-STEM) imaging techniques are crucial for our understanding of functional materials. Many of the algorithms used in the reconstruction of the transmission function rely on the multiplicative approximation and the (weak) phase object approximation, which are not valid for many materials, particularly at high resolution. Herein, we study the breakdown of simple phase imaging in thicker samples. We demonstrate the behavior of integrated center of mass imaging, single-side band ptychography, and Wigner distribution deconvolution over a thickness series of simulated GaN 4D-STEM datasets. We further give guidance as to the optimal focal conditions for obtaining a more interpretable dataset using these algorithms
Total hip arthroplasty: what information do we offer patients on websites of hospitals?
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97468.pdf (publisher's version ) (Open Access)BACKGROUND: Physicians face a new challenge; the self-educated patient. The internet is an important source that patients use to become self-educated. However, the individual choice for best treatment is difficult. The aim of this study was to investigate what kind of information is offered to total hip arthroplasty patients by internet and what information is appreciated by them. METHODS: Websites of orthopedic departments of all hospitals in the Netherlands were evaluated. In addition, a cohort of 102 patients, diagnosed with arthritic joint disorders, filled in an online survey and gave their opinion concerning the importance of this information. RESULTS: Eighty different orthopedic websites of hospitals were identified. Websites presented information regarding the orthopedic staff surgeon (76%) and the postoperative rehabilitation process (66%). They also offered referral to other orthopedic websites (61%), the opportunity to make an outpatient appointment (21%), and the opportunity to submit an online question (15%). Patients rated the presence of information regarding prosthesis survival as very important (>70%). However, the information on the type of prosthesis used by the hospital, and survival data of the prosthesis, were only present in ~9% and 5% respectively, of the websites. CONCLUSIONS: The content of health information on websites of hospitals is highly variable for total hip arthroplasty. Information regarding the hip implant and prosthesis survival is highly appreciated by patients, however, mostly absent on orthopedic websites in the Netherlands. The internet provides an enormous potential for orthopedic surgeons to inform the self-educated patient
The role of ICT in supporting disruptive innovation: a multi-site qualitative study of nurse practitioners in emergency departments
<p>Abstract</p> <p>Background</p> <p>The disruptive potential of the Nurse Practitioner (NP) is evident in their ability to offer services traditionally provided by primary care practitioners and their provision of a health promotion model of care in response to changing health trends. No study has qualitatively investigated the role of the Emergency NP in Australia, nor the impact of Information and Communication Technology (ICT) on this disruptive workforce innovation. This study aimed to investigate ways in which Nurse Practitioners (NP) have incorporated the use of ICT as a mechanism to support their new clinical role within Emergency Departments.</p> <p>Methods</p> <p>A cross-sectional qualitative study was undertaken in the Emergency Departments (EDs) of two large Australian metropolitan public teaching hospitals. Semi-structured, in-depth interviews were conducted with five nurse practitioners, four senior physicians and five senior nurses. Transcribed interviews were analysed using a grounded theory approach to develop themes in relation to the conceptualisation of the ED nurse practitioner role and the influences of ICT upon the role. Member checking of results was achieved by revisiting the sites to clarify findings with participants and further explore emergent themes.</p> <p>Results</p> <p>The role of the ENP was distinguished from those of Emergency nurses and physicians by two elements: advanced practice and holistic care, respectively. ICT supported the advanced practice dimension of the NP role in two ways: availability and completeness of electronic patient information enhanced timeliness and quality of diagnostic and therapeutic decision-making, expediting patient access to appropriate care. The ubiquity of patient data sourced from a central database supported and improved quality of communication between health professionals within and across sites, with wider diffusion of the Electronic Medical Record holding the potential to further facilitate team-based, holistic care.</p> <p>Conclusions</p> <p>ICT is a facilitator through which the disruptive impact of NPs can be extended. However, integration of ICT into work practices without detracting from provider-patient interaction is crucial to ensure utilisation of such interventions and realisation of potential benefits.</p
The atomic structure of polar and non-polar InGaN quantum wells and the green gap problem
We have used high resolution transmission electron microscopy (HRTEM), aberration-corrected quantitative scanning transmission electron microscopy (Q-STEM), atom probe tomography (APT) and X-ray diffraction (XRD) to study the atomic structure of (0001) polar and (11-20) non-polar InGaN quantum wells (QWs). This paper provides an overview of the results. Polar (0001) InGaN in QWs is a random alloy, with In replacing Ga randomly. The InGaN QWs have atomic height interface steps, resulting in QW width fluctuations. The electrons are localised at the top QW interface by the built-in electric field and the well-width fluctuations, with a localisation energy of typically 20 meV. The holes are localised near the bottom QW interface, by indium fluctuations in the random alloy, with a localisation energy of typically 60 meV. On the other hand, the non-polar (11-20) InGaN QWs contain nanometre-scale indium-rich clusters which we suggest localise the carriers and produce longer wavelength (lower energy) emission than from random alloy non-polar InGaN QWs of the same average composition. The reason for the indium-rich clusters in non-polar (11-20) InGaN QWs is not yet clear, but may be connected to the lower QW growth temperature for the (11-20) InGaN QWs compared to the (0001) polar InGaN QWs.We thank the UK Engineering and Physical Sciences Research Council for their support (grants EP/J001627/1, EP/I01259/1, and EP/J003603/1)
Implementation of multidimensional knowledge translation strategies to improve procedural pain in hospitalized children
The swimming kinematics of larval Atlantic cod, Gadus morhua L., are resilient to elevated seawater pCO2
Kinematics of swimming behavior of larval Atlantic cod, aged 12 and 27 days post-hatch (dph) and cultured under three pCO2 conditions (control-370, medium-1800, and high-4200 Îźatm) from March to May 2010, were extracted from swim path recordings obtained using silhouette video photography. The swim paths were analyzed for swim duration, distance and speed, stop duration, and horizontal and vertical turn angles to determine whether elevated seawater pCO2âat beyond near-future ocean acidification levelsâaffects the swimming kinematics of Atlantic cod larvae. There were no significant differences in most of the variables tested: the swimming kinematics of Atlantic cod larvae at 12 and 27 dph were highly resilient to extremely elevated pCO2 levels. Nonetheless, cod larvae cultured at the highest pCO2 concentration displayed vertical turn angles that were more restricted (median turn angle, 15°) than larvae in the control (19°) and medium (19°) treatments at 12 dph (but not at 27 dph). Significant reduction in the stop duration of cod larvae from the high treatment (median stop duration, 0.28 s) was also observed compared to the larvae from the control group (0.32 s) at 27 dph (but not at 12 dph). The functional and ecological significance of these subtle differences are unclear and, therefore, require further investigation in order to determine whether they are ecologically relevant or spurious
Composition Influences the Pathway but not the Outcome of the Metabolic Response of Bacterioplankton to Resource Shifts
Bacterioplankton community metabolism is central to the functioning of aquatic ecosystems, and strongly reactive to changes in the environment, yet the processes underlying this response remain unclear. Here we explore the role that community composition plays in shaping the bacterial metabolic response to resource gradients that occur along aquatic ecotones in a complex watershed in QuĂŠbec. Our results show that the response is mediated by complex shifts in community structure, and structural equation analysis confirmed two main pathways, one involving adjustments in the level of activity of existing phylotypes, and the other the replacement of the dominant phylotypes. These contrasting response pathways were not determined by the type or the intensity of the gradients involved, as we had hypothesized, but rather it would appear that some compositional configurations may be intrinsically more plastic than others. Our results suggest that community composition determines this overall level of community plasticity, but that composition itself may be driven by factors independent of the environmental gradients themselves, such that the response of bacterial communities to a given type of gradient may alternate between the adjustment and replacement pathways. We conclude that community composition influences the pathways of response in these bacterial communities, but not the metabolic outcome itself, which is driven by the environment, and which can be attained through multiple alternative configurations
Assessment of variation in the alberta context tool: the contribution of unit level contextual factors and specialty in Canadian pediatric acute care settings
Background: There are few validated measures of organizational context and none that we located are
parsimonious and address modifiable characteristics of context. The Alberta Context Tool (ACT) was developed to
meet this need. The instrument assesses 8 dimensions of context, which comprise 10 concepts. The purpose of
this paper is to report evidence to further the validity argument for ACT. The specific objectives of this paper are
to: (1) examine the extent to which the 10 ACT concepts discriminate between patient care units and (2) identify
variables that significantly contribute to between-unit variation for each of the 10 concepts.
Methods: 859 professional nurses (844 valid responses) working in medical, surgical and critical care units of 8
Canadian pediatric hospitals completed the ACT. A random intercept, fixed effects hierarchical linear modeling
(HLM) strategy was used to quantify and explain variance in the 10 ACT concepts to establish the ACTâs ability to
discriminate between units. We ran 40 models (a series of 4 models for each of the 10 concepts) in which we
systematically assessed the unique contribution (i.e., error variance reduction) of different variables to between-unit
variation. First, we constructed a null model in which we quantified the variance overall, in each of the concepts.
Then we controlled for the contribution of individual level variables (Model 1). In Model 2, we assessed the
contribution of practice specialty (medical, surgical, critical care) to variation since it was central to construction of
the sampling frame for the study. Finally, we assessed the contribution of additional unit level variables (Model 3).
Results: The null model (unadjusted baseline HLM model) established that there was significant variation between
units in each of the 10 ACT concepts (i.e., discrimination between units). When we controlled for individual
characteristics, significant variation in the 10 concepts remained. Assessment of the contribution of specialty to
between-unit variation enabled us to explain more variance (1.19% to 16.73%) in 6 of the 10 ACT concepts. Finally,
when we assessed the unique contribution of the unit level variables available to us, we were able to explain
additional variance (15.91% to 73.25%) in 7 of the 10 ACT concepts.
Conclusion: The findings reported here represent the third published argument for validity of the ACT and adds
to the evidence supporting its use to discriminate patient care units by all 10 contextual factors. We found
evidence of relationships between a variety of individual and unit-level variables that explained much of this
between-unit variation for each of the 10 ACT concepts. Future research will include examination of the
relationships between the ACTâs contextual factors and research utilization by nurses and ultimately the
relationships between context, research utilization, and outcomes for patients
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