The influence of adaptive challenge on engagement of multidisciplinary staff in standardising aseptic technique in an emergency department: A qualitative study

Aims and objectives: To explore the challenge of engaging multidisciplinary staff in standardising aseptic technique (AT) in an emergency department (ED) in an Australian tertiary hospital, and to better understand the enablers and barriers to implementing practice change within this setting. Background: Healthcare‐associated infections are the most common complication for patients in acute care. A clinical practice framework developed in the United Kingdom (UK) standardised AT practice to reduce potential infection risk. One Australian tertiary hospital drew upon this framework to similarly improve clinical practice. It was understood that standardising practice would require some practitioners only to revisit and demonstrate AT principles already embedded in their practice, while others would be challenged to adopt a new approach. Design: Qualitative, descriptive research design. Methods: Data were collected through focus groups held before and after implementation of the AT programme. Data were analysed using the framework method. The (COREQ) checklist was followed. Results: Four emergent themes described the influence of motivation on individuals\u27 beliefs and attitudes towards practice change, relationships within the ED context, delivery of education and management directives. Conclusion: Implementing practice change is more than just providing technical knowledge and includes changing individuals\u27 beliefs and attitudes. An understanding of adaptive challenge can assist in implementing practice change that involves the multidisciplinary team. Relevance to clinical practice: Results provide evidence as to how the adaptive challenge framework could be a suitable approach to manage potential enablers and barriers to implementing change within a multidisciplinary team in an acute hospital

Millimeter Wave Scattering from Neutral and Charged Water Droplets

We investigated 94GHz millimeter wave (MMW) scattering from neutral and charged water mist produced in the laboratory with an ultrasonic atomizer. Diffusion charging of the mist was accomplished with a negative ion generator (NIG). We observed increased forward and backscattering of MMW from charged mist, as compared to MMW scattering from an uncharged mist. In order to interpret the experimental results, we developed a model based on classical electrodynamics theory of scattering from a dielectric sphere with diffusion-deposited mobile surface charge. In this approach, scattering and extinction cross-sections are calculated for a charged Rayleigh particle with effective dielectric constant consisting of the volume dielectric function of the neutral sphere and surface dielectric function due to the oscillation of the surface charge in the presence of applied electric field. For small droplets with (radius smaller than 100nm), this model predicts increased MMW scattering from charged mist, which is qualitatively consistent with the experimental observations. The objective of this work is to develop indirect remote sensing of radioactive gases via their charging action on atmospheric humid air.Comment: 18 pages, 8 figure

Awareness Logic: A Kripke-based Rendition of the Heifetz-Meier-Schipper Model

Heifetz, Meier and Schipper (HMS) present a lattice model of awareness. The HMS model is syntax-free, which precludes the simple option to rely on formal language to induce lattices, and represents uncertainty and unawareness with one entangled construct, making it difficult to assess the properties of either. Here, we present a model based on a lattice of Kripke models, induced by atom subset inclusion, in which uncertainty and unawareness are separate. We show the models to be equivalent by defining transformations between them which preserve formula satisfaction, and obtain completeness through our and HMS' results.Comment: 18 pages, 2 figures, proceedings of DaLi conference 202

Hit-to-lead and lead optimization binding free energy calculations for G protein-coupled receptors

We apply the hit-to-lead ESMACS (enhanced sampling of molecular dynamics with approximation of continuum solvent) and lead-optimization TIES (thermodynamic integration with enhanced sampling) methods to compute the binding free energies of a series of ligands at the A1 and A2A adenosine receptors, members of a subclass of the GPCR (G protein-coupled receptor) superfamily. Our predicted binding free energies, calculated using ESMACS, show a good correlation with previously reported experimental values of the ligands studied. Relative binding free energies, calculated using TIES, accurately predict experimentally determined values within a mean absolute error of approximately 1 kcal mol−1. Our methodology may be applied widely within the GPCR superfamily and to other small molecule–receptor protein systems

Computational Methods Used in Hit-to-Lead and Lead Optimization Stages of Structure-Based Drug Discovery

GPCR modeling approaches are widely used in the hit-to-lead (H2L) and lead optimization (LO) stages of drug discovery. The aims of these modeling approaches are to predict the 3D structures of the receptor-ligand complexes, to explore the key interactions between the receptor and the ligand and to utilize these insights in the design of new molecules with improved binding, selectivity or other pharmacological properties. In this book chapter, we present a brief survey of key computational approaches integrated with hierarchical GPCR modeling protocol (HGMP) used in hit-to-lead (H2L) and in lead optimization (LO) stages of structure-based drug discovery (SBDD). We outline the differences in modeling strategies used in H2L and LO of SBDD and illustrate how these tools have been applied in three drug discovery projects

Reasoning with global assumptions in arithmetic modal logics

We establish a generic upper bound ExpTime for reasoning with global assumptions in coalgebraic modal logics. Unlike earlier results of this kind, we do not require a tractable set of tableau rules for the in- stance logics, so that the result applies to wider classes of logics. Examples are Presburger modal logic, which extends graded modal logic with linear inequalities over numbers of successors, and probabilistic modal logic with polynomial inequalities over probabilities. We establish the theoretical upper bound using a type elimination algorithm. We also provide a global caching algorithm that offers potential for practical reasoning