J/Psi Decay Lepton Distribution in Hadronic Collisions

We propose the measurement of the decay angular distribution of leptons from J/Psi's produced at high transverse momentum balanced by a photon [or gluon] in hadronic collisions. The polar and azimuthal angular distribution are calculated in the color singlet model (CSM). It is shown that the general structure of the decay lepton distribution is controlled by four invariant structure functions, which are functions of the transverse momentum and the rapidity of the J/Psi. We found that two of these structure functions [the longitudinal and transverse interference structure functions] are identical in the CSM. We present analytical and numerical results in the Collins-Soper and in the Gottfried-Jackson frame.Comment: 8 pages, RevTex, 2 figures

Improving health outcomes by preventing intensive care related infection in Malaysia Intensive Care Unit (INVEST study)

Ventilator-associated pneumonia (VAP), catheter-related blood stream infection (CRBSI) and pressure ulcers (PU) are well recognized complications in intensive care units (ICUs). Many of these are preventable but can also complicate patient recovery, prolong length of stay, increase costs, morbidity and mortality. In Malaysia, the majority of studies investigating VAP and CRBSI in Malaysia have focussed on identifying risk factors, diagnostic criteria and treatment of ICU-related complications. Further, in spite of the burden of PU there are limited studies undertaken in Malaysia and few of these have been nurse-led. Importantly, to date there has been limited investigation of the efficacy and effectiveness of quality improvement initiatives and the contextual issues impacting on clinical practice improvement in Malaysia.In spite of the increasing emphasis on quality assurance in Malaysian ICUs there has been a limited focus on nurse-specific interventions and the majority of projects have been initiated by physicians. This study has evaluated the utility of a nurse-led action research project to drive clinical practice improvement in the ICU and is significant in demonstrating the capacity of nurses to critique and control their practice. The project conducted for this thesis was called the Improving health outcomes by preveNting intensiVe care related infEction in Malaysia intenSive care uniT - INVEST study. The INVEST Study as reported in this thesis has been undertaken using an action research approach to improve the uptake of evidence-based strategies to prevent infection in the ICU in the Malaysian cultural context.The aims of this thesis were to identify best practices, evaluate the current nursing practice in prevention of VAP, CRBSI and PU in ICU patients in a single Malaysian ICU, and evaluate the impact of the evidence-based interventions to improve patient outcomes. The specific and research objectives of this study were to:1. Identify best practice interventions for preventing VAP, CRBSI and PU in the ICU. 2. Document the current rates of VAP, CRBSI and PU in an ICU in Malaysia. 3. Implement an action research intervention to collaboratively develop and implement strategies for improvement 4. Assess the impact of the intervention on clinical outcomes, staff dynamics, work place culture and sustainability of practice change An action research approach was used in this study to involve and empower nurses and drive practice change. A literature review identified that many action research studies conducted in the ICU were mainly most focused on process measures and not outcomes. In this study the data were collected in three phases following the action research cycles which comprised of a period of planning, acting, observation, reflecting and re-planningIn Phase I of the thesis current best practice interventions for the prevention of VAP, CRBSI and PU in ICU are described. A literature search was conducted to identify evidence-based practices (EBP) that were recommended by bodies to improve the prevention of VAP, CRBSI and PU. A core set of nursing activities was identified in preventing the complications of VAP, CRBSI and PU. These were hand washing, hygiene care, positioning of patient, elevation of the head of bed and providing adequate nutrition.Pre- intervention data collection consisted of an environmental scan, including interview with the key stakeholders, patient profiling and a nurse survey. Twenty-one cases of ICU complications were identified in 18 of the 91 patients (19.8%) admitted in December 2009. Of the patients, three developed two complications - PU and VAP (two patients) or CRBSI (one patient). The findings indicated that this ICU had a high case load due to the high ICU bed demand. Patients needing ICU care were being nursed in general wards due to the unavailability of ICU beds.Nurses reported a good knowledge of prevention strategies with a mean score of 124.84 ±SD14.66 and reported a high level of positive regard for their professional practice environment based on the results of Revised Professional Practice Environment (RPPE). Three components had mean scores of ≥3 and five 55%. The nurses reported a positive regard for their practice environment in the pre- and post-intervention groups. The mean scores for each component were comparable for both the pre- and post-intervention groups except for Internal Work Motivation, Control Over Practice and Staff Relationship With Physician. The highest mean scores within the eight components for the post-intervention group were for Internal Work Motivation (M 3.13; SD 0.27), Relationship With Physician (M 3.04; SD 0.33) and Cultural Sensitivity (M 3.01; SD 0.23). The three lowest were for Handling Disagreement and Conflict (2.80; SD 0.20), Control Over Practice (2.71; SD 0.34) and Teamwork (2.48; SD 0.31).There was a reduction in overall complications from 19.8% to 8.7%. Few nurses in the focus group were optimistic that at least some changes had taken place, and positively improving their knowledge on assessment of patients and some of their common practices in the ICU. The challenge, which they were presently facing was the implementation of hospital information system because most of them were not knowledgeable in information technology.The main outcome of this study was that there was a reduction in number of patients with PU from 16 to 6 in pre and post intervention groups. This reduction of PU was statistically significant (χ[superscript]2=8.14, df=1, p=0.04).In conclusion whether there was a real improvement in patient care provided due to the interventions given was not able to be determined due to methodological considerations and inability to control for confounders. These data underscore the importance of considering cultural factors, both organisational and societal in quality improvement initiatives and empowering nurses for practice change. A risk management system which acknowledges competing demands in dynamic, real world environments is important to consider in future quality improvement studies. The series of studies presented in this thesis have contributed to understanding of factors influencing implementation and sustainability of quality improvement initiatives in a Malaysia ICU. Information acquired from the thesis will be useful information for further improvement targeting education, services, research, policy and future quality improvement project plans in Malaysia

Fast algorithms for large scale generalized distance weighted discrimination

High dimension low sample size statistical analysis is important in a wide range of applications. In such situations, the highly appealing discrimination method, support vector machine, can be improved to alleviate data piling at the margin. This leads naturally to the development of distance weighted discrimination (DWD), which can be modeled as a second-order cone programming problem and solved by interior-point methods when the scale (in sample size and feature dimension) of the data is moderate. Here, we design a scalable and robust algorithm for solving large scale generalized DWD problems. Numerical experiments on real data sets from the UCI repository demonstrate that our algorithm is highly efficient in solving large scale problems, and sometimes even more efficient than the highly optimized LIBLINEAR and LIBSVM for solving the corresponding SVM problems

The role of culture in quality improvement in the intensive care unit: A literature review

Improving the quality of patient care and patient outcomes is a major concern internationally. In a developing health care system, implementing quality improvement is challenging due not only to resource and workforce issues but also cultural factors. Using the method of a focused literature review, this paper discusses the importance of assessing a societal view of culture, social mores and customs, and power relationships in quality improvement activities using the intensive care unit as an exemplar. We conclude that implementing quality improvement strategies in a developing health care system needs to address the broader perspectives of social and cultural systems particularly hierarchical relationships and issues of non-disclosure

The impact of an eight-week aerobic and strength-training programme on agility and leg power of Malaysian netball players

The purposes of the study were: (1) to determine the agility and leg power among Malaysian national junior netball players and (2) to determine the impact of eight-week aerobic and strength-training programme on these two variables. A total of 21 netball players from Bukit Jalil Sport School were selected as the subjects in this study. The SEMO Agility Run test was used to determine the agility level while leg power was measured using the Vertical Jump test. Pre-test and post-test results showed no significant differences in the agility and leg power level among the netball players. The mean values for the agility and leg power post-test were 12.59 (SD = 0.56) seconds and 50.24 (SD = 4.90) cm respectively. The pre-test and post-test results for different playing positions recorded the highest improvement in agility and leg power among attacker, followed by centre, and defender. Thus, the training conducted in this study was found to have improved agility and leg power marginally, especially among attacker and centre netball players