Geisinger Health System: Achieving the Potential of System Integration Through Innovation, Leadership, Measurement, and Incentives

Presents a case study of a physician-led nonprofit healthcare group exhibiting the attributes of an ideal healthcare delivery system as defined by the Fund. Describes how its ProvenCare model improved clinical outcomes with reduced resource utilization

Mayo Clinic: Multidisciplinary Teamwork, Physician-Led Governance, and Patient-Centered Culture Drive World-Class Health Care

Describes Fund-defined attributes of an ideal care delivery system, Mayo's model of multidisciplinary practice with salary-based compensation, and best practices, including a shared electronic health record and innovations to implement research quickly

Direct EIT Reconstructions of Complex Admittivities on a Chest-Shaped Domain in 2-D

Electrical impedance tomography (EIT) is a medical imaging technique in which current is applied on electrodes on the surface of the body, the resulting voltage is measured, and an inverse problem is solved to recover the conductivity and/or permittivity in the interior. Images are then formed from the reconstructed conductivity and permittivity distributions. In the 2-D geometry, EIT is clinically useful for chest imaging. In this work, an implementation of a D-bar method for complex admittivities on a general 2-D domain is presented. In particular, reconstructions are computed on a chest-shaped domain for several realistic phantoms including a simulated pneumothorax, hyperinflation, and pleural effusion. The method demonstrates robustness in the presence of noise. Reconstructions from trigonometric and pairwise current injection patterns are included

Incorporating a Spatial Prior into Nonlinear D-Bar EIT imaging for Complex Admittivities

Electrical Impedance Tomography (EIT) aims to recover the internal conductivity and permittivity distributions of a body from electrical measurements taken on electrodes on the surface of the body. The reconstruction task is a severely ill-posed nonlinear inverse problem that is highly sensitive to measurement noise and modeling errors. Regularized D-bar methods have shown great promise in producing noise-robust algorithms by employing a low-pass filtering of nonlinear (nonphysical) Fourier transform data specific to the EIT problem. Including prior data with the approximate locations of major organ boundaries in the scattering transform provides a means of extending the radius of the low-pass filter to include higher frequency components in the reconstruction, in particular, features that are known with high confidence. This information is additionally included in the system of D-bar equations with an independent regularization parameter from that of the extended scattering transform. In this paper, this approach is used in the 2-D D-bar method for admittivity (conductivity as well as permittivity) EIT imaging. Noise-robust reconstructions are presented for simulated EIT data on chest-shaped phantoms with a simulated pneumothorax and pleural effusion. No assumption of the pathology is used in the construction of the prior, yet the method still produces significant enhancements of the underlying pathology (pneumothorax or pleural effusion) even in the presence of strong noise.Comment: 18 pages, 10 figure

The Unwilling Donor

For nearly forty years, the Supreme Court has evaluated campaign finance restrictions by weighing the First Amendment burden they place on a donor eager to engage the political process against the government’s interest in avoiding corruption of that process. Most recently, in McCutcheon v. FEC, the Court struck down aggregate contribution limits, allowing donors to give—and candidates and parties to solicit—millions of dollars directly to candidates, parties, and political action committees. Yet what should have been a significant victory for big donors was greeted with dismay by many of the same. There is growing evidence that the story we have been telling ourselves about political money is, at best, incomplete, and that many donors give only reluctantly, out of fear of political repercussions. This Article examines the problem of the unwilling donor and argues for the first time that it has significant implications for campaign finance doctrine. Flipping the narrative allows a fresh view of key concepts, including the need for systemic campaign finance regulations, the Court’s current emphasis on quid pro quo corruption, and the First Amendment interests of campaign donors. Previous scholarship has overlooked the existence and constitutional import of this alternative, “extortionate,” framework. The Unwilling Donor steps into this critical gap. The Article first provides an overview of the Supreme Court’s past campaign finance jurisprudence, including McCutcheon, almost all of which is premised on the notion of a willing donor. It then surveys empirical studies and historical data to demonstrate that the unwilling donor, while perhaps not a sympathetic character, is a very real one. The final Part of the Article contemplates the legal significance of the unwilling donor problem, concluding that it is relevant to the continued vitality of campaign finance efforts, to the Court’s analysis of campaign finance reform restrictions, and to future litigation strategies in this area

The Influence of Menarche on Fathers\u27 Perceptions of Father-Daughter Relationships

Adolescence is a time of transformation for a young girl and her relationships with her parents. One way to conceptualize the evolving dynamics between father and adolescent daughter is to use the Circumplex Model of Marital and Family Systems. The purpose of this study is to examine the differences in relationships between fathers and their premenarchal daughters, girls who have not had their first menstrual period, compared to fathers and postmenarchal daughters, girls who have experienced their first menstrual period. The participants completed three questionnaires. The Demographic questionnaire included general demographic questions in order to learn more about the participants. The Family Adaptability and Cohesion Evaluation Scales II-Modified assessed family cohesion and family adaptability. The Parent-Adolescent Communication Scale-Modified assessed the degree of open family communication and extent of problems in father-daughter communication. The overall hypothesis was that there would be a fundamental difference in fathers’ relationships with their daughters as the girls experience menarche. Specifically, it was believed that fathers and premenarchal daughters would have more balanced relationships compared to fathers and postmenarchal daughters. In addition, the effect of amount of time that fathers spend with their daughters was examined. It is important to study this father-daughter relationship because this knowledge may help reduce the conflict that can occur during adolescence and may help a father feel more connected to and open with his daughter. Menarchal status only accounted for a significant difference on the Cohesion subscaie between fathers of premenarchal and postmenarcha) daughters. Monarchal status did not account for any significant differences in levels of communication between fathers of premenarchal or postmenarchal daughters. The results also showed the amount of time that fathers spend with their daughters significantly effects balanced relationships, levels of Cohesion and Adaptability, and Open Family Communication. The results suggest that the amount of time that father spend with their daughters may have a stronger effect on the father-daughter relationship than the daughters’ menarchal status. Continued research should focus on an intensive, longitudinal study that incorporates the daughter’s perspective and examines the influence of other biopsychosocial variables of pubertal development on the father- daughter relationship