Stability of an upwind Petrov Galerkin discretization of convection diffusion equations

We study a numerical method for convection diffusion equations, in the regime of small viscosity. It can be described as an exponentially fitted conforming Petrov-Galerkin method. We identify norms for which we have both continuity and an inf-sup condition, which are uniform in mesh-width and viscosity, up to a logarithm, as long as the viscosity is smaller than the mesh-width or the crosswind diffusion is smaller than the streamline diffusion. The analysis allows for the formation of a boundary layer.Comment: v1: 18 pages. 2 figures. v2: 22 pages. Numerous details added and completely rewritten final proof. 8 pages appendix with old proo

Complex Line Bundles over Simplicial Complexes and their Applications

Discrete vector bundles are important in Physics and recently found remarkable applications in Computer Graphics. This article approaches discrete bundles from the viewpoint of Discrete Differential Geometry, including a complete classification of discrete vector bundles over finite simplicial complexes. In particular, we obtain a discrete analogue of a theorem of Andr\'e Weil on the classification of hermitian line bundles. Moreover, we associate to each discrete hermitian line bundle with curvature a unique piecewise-smooth hermitian line bundle of piecewise constant curvature. This is then used to define a discrete Dirichlet energy which generalizes the well-known cotangent Laplace operator to discrete hermitian line bundles over Euclidean simplicial manifolds of arbitrary dimension

Simplicial gauge theory on spacetime

We define a discrete gauge-invariant Yang-Mills-Higgs action on spacetime simplicial meshes. The formulation is a generalization of classical lattice gauge theory, and we prove consistency of the action in the sense of approximation theory. In addition, we perform numerical tests of convergence towards exact continuum results for several choices of gauge fields in pure gauge theory.Comment: 18 pages, 2 figure

A Stepwise Pharmacist-Led Medication Review Service in Interdisciplinary Teams in Rural Nursing Homes

Source at https://doi.org/10.3390/pharmacy7040148.Background - The provision of responsible medication therapy to old nursing home residents with comorbidities is a difficult task and requires extensive knowledge about optimal pharmacotherapy for different conditions. We describe a stepwise pharmacist-led medication review service in combination with an interdisciplinary team collaboration in order to identify, resolve, and prevent medication related problems (MRPs). Methods - The service included residents from four rural Norwegian nursing homes during August 2016–January 2017. All residents were eligible if they (or next of kin) supplied oral consent. The interdisciplinary medication review service comprised four steps: (1) patient and medication history taking; (2) systematic medication review; (3) interdisciplinary case conference; and (4) follow-up of pharmaceutical care plan. The pharmacist collected information about previous and present medication use, and clinical and laboratory values necessary for the medication review. The nurses collected information about possible symptoms related to adverse drug reactions. The pharmacist conducted the medication reviews, identified medication-related problems (MRPs) which were discussed at case conferences with the responsible physician and the responsible nurses. The main outcome measures were number and types of MRPs, percentage agreement between pharmacists and physicians and factors associated with MRPs. Results - The service was delivered for 151 (94%) nursing home residents. The pharmacist identified 675 MRPs in 146 (97%) medication lists (mean 4.0, SD 2.6, range 0–13). The MRPs most frequently identified concerned ‘unnecessary drug’ (22%), ‘too high dosage’ (17%) and ‘drug interactions’ (16%). The physicians agreed upon 64% of the pharmacist recommendations, and action was taken immediately for 32% of these. We identified no association between the number of MRPs and sex (p = 0.485), but between the number of MRPs, and the number of medications and the individual nursing homes. Conclusion - The pharmacist-led medication review service in the nursing homes was highly successfully piloted with many solved and prevented MRPs in interdisciplinary collaboration between the pharmacist, physicians, and nurses. Implementation of this service as a standard in all four nursing homes seems necessary and feasible. If such a service is implemented, effects related to patient outcomes, interdisciplinary collaboration, and health economy should be studied

Three Types of Tightrope Dance in the Comeback Process: Preliminary Findings from a Longitudinal Study of Young People at the Margins of Upper Secondary School in Norway

Fewer than half of the young people attending vocational institutions in Norway complete their education within the allotted five years. Indeed, many of these students have non-linear paths to completion. However, it is not changes in the dropout rate that make this different from earlier generations but the expansion of formal education and the rise of the knowledge society and individualisation. The term “tightrope biographies” is used here to encapsulate why individualisation cannot be thought of in terms of choice, because today’s youth are often held accountable for their educational progression rather than this progression being viewed as dependent on institutional mechanisms. The present study characterises young people as “tightrope dancers” in their interactions with vocational schools. Selected data collected from ethnographic interviews during the ongoing longitudinal project Youth, Completion and Dropout in Telemark are used here to capture the voices of young people. These data focus on the non-linear educational careers of these youth when they re-enter schools and explore the stories they tell about dropping out and re-entering. These stories suggest that, to succeed, students need customised support throughout the process from school to the workplace and that many depend on this support. The study identifies three different ways of understanding these students as tightrope dancers trying to get back on track, characterising them as The Steady, The Shaky and The Shivering

‘Illuminating determinants of implementation of non-dispensing pharmacist services in home care: a qualitative interview study’

Objectives - Medication errors are leading causes of hospitalization and death in western countries and WHO encourages health care providers to implement non-dispensing pharmacist services in primary care to improve medication work. However, these services struggle to provide any impact on clinical outcomes. We wanted to explore health care professionals’ views on medication work to illuminate determinants of the implementation success. The research was designed to inform and adapt implementation strategies for non-dispensing pharmacist services. Design - Semi-structured interview study with nine healthcare professionals. Setting - Four Norwegian home care wards. Subjects - Nine healthcare professionals working at different wards within one home care unit. Main outcome measures - Determinants of implementation outcomes. Results - Contextual determinants of the implementation process were mainly related to characteristics of the setting such as poorly designed information systems, work overload, and chaotic work environments. The identified barriers question the innovation’s appropriateness related to the setting’s needs but also provide possibilities for tailoring pharmacist services to local medication work issues. The observable positive effects and the perceived advantage of the pharmacist services are likely to facilitate the implementation process. Conclusion - Our study provided information on contextual elements that influence the implementation process of non-dispensing pharmacist services. Awareness of these factors can help develop strategies to help the organization succeed in in achieving program outcomes

Using prospective methods to identify fieldwork locations favourable to understand divergences in health care accessibility

Central to this article is the issue of choosing sites for where a fieldwork could provide a better understanding of divergences in health care accessibility. Access to health care is critical to good health, but inhabitants may experience barriers to health care limiting their ability to obtain the care they need. Most inhabitants of low-income countries need to walk long distances along meandering paths to get to health care services. Individuals in Malawi responded to a survey with a battery of questions on perceived difficulties in accessing health care services. Using both vertical and horizontal impedance, we modelled walking time between household locations for the individuals in our sample and the health care centres they were using. The digital elevation model and Tobler’s hiking function were used to represent vertical impedance, while OpenStreetMap integrated with land cover map were used to represent horizontal impedance. Combining measures of walking time and perceived accessibility in Malawi, we used spatial statistics and found spatial clusters with substantial discrepancies in health care accessibility, which represented fieldwork locations favourable for providing a better understanding of barriers to health access.publishedVersio

Biometric Fish Classification of Temperate Species Using Convolutional Neural Network with Squeeze-and-Excitation

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Exploring stakeholders' perspectives on the quality of services provided through community pharmacies

Introduction - It is important to understand the factors impacting the quality of services provided through community pharmacies. Exploring how key stakeholders perceive good quality in these services is a logical first step. This could also inform the development of quality measures, such as quality indicators (QIs). Aim - To identify key stakeholders' perspectives on the quality of services provided through community pharmacies in Norway, specifically by exploring their experiences and perceptions about what constitutes good service quality. Methods - A convenient sampling approach was used to recruit participants for five semi-structured focus groups from Facebook, pharmacy chains, and patient organizations. The interviews with twenty-six participants were conducted via Microsoft Teams. Interviews were transcribed verbatim, and an inductive thematic analysis with a reflexive approach was used. Results - Four main themes emerged from the analysis; 1) sufficient and substantively suitable information to cover individual needs, 2) communication skills and relationships with the pharmacy professionals, 3) customer satisfaction with knowledgeable employees and conveniently located pharmacies, and 4) factors that affect the pharmacy working environment. Conclusion - This study has identified areas that pharmacy professionals and customers regard as essential to define good quality of community pharmacy services. Effective communication skills, appropriate provision of information, customer satisfaction, and working environment are all essential factors when developing quality metrics for community pharmacies

A simplicial gauge theory

We provide an action for gauge theories discretized on simplicial meshes, inspired by finite element methods. The action is discretely gauge invariant and we give a proof of consistency. A discrete Noether's theorem that can be applied to our setting, is also proved.Comment: 24 pages. v2: New version includes a longer introduction and a discrete Noether's theorem. v3: Section 4 on Noether's theorem has been expanded with Proposition 8, section 2 has been expanded with a paragraph on standard LGT. v4: Thorough revision with new introduction and more background materia