A case study of asthma care in school age children using nurse-coordinated multidisciplinary collaborative practices

Aim: To describe the role of school nursing in leading and coordinating a multidisciplinary networked system of support for children with asthma, and to analyze the strengths and challenges of undertaking and supporting multiagency interprofessional practice. Background: The growth of networked and interprofessional collaborations arises from the recognition that a number of the most pressing public health problems cannot be addressed by single-discipline or -agency interventions. This paper identifies the potential of school nursing to provide the vision and multiagency leadership required to coordinate multidisciplinary collaboration. Method: A mixed-method single-case study design using Yin’s approach, including focus groups, interviews, and analysis of policy documents and public health reports. Results: A model that explains the integrated population approach to managing school-age asthma is described; the role of the lead school nurse coordinator was seen as critical to the development and sustainability of the model. Conclusion: School nurses can provide strategic multidisciplinary leadership to address pressing public health issues. Health service managers and commissioners need to understand how to support clinicians working across multiagency boundaries and to identify how to develop leadership skills for collaborative interprofessional practice so that the capacity for nursing and other health care professionals to address public health issues does not rely on individual motivation. In England, this will be of particular importance to the commissioning of public health services by local authorities from 2015

On Minimum Violations Ranking in Paired Comparisons

Ranking a set of objects from the most dominant one to the least, based on the results of paired comparisons, proves to be useful in many contexts. Using the rankings of teams or individuals players in sports to seed tournaments is an example. The quality of a ranking is often evaluated by the number of violations, cases in which an object is ranked lower than another that it has dominated in a comparison, that it contains. A minimum violations ranking (MVR) method, as its name suggests, searches specifically for rankings that have the minimum possible number of violations which may or may not be zero. In this paper, we present a method based on statistical physics that overcomes conceptual and practical difficulties faced by earlier studies of the problem.Comment: 10 pages, 10 figures; typos corrected (v2

On the Reliability of Cross Correlation Function Lag Determinations in Active Galactic Nuclei

Many AGN exhibit a highly variable luminosity. Some AGN also show a pronounced time delay between variations seen in their optical continuum and in their emission lines. In effect, the emission lines are light echoes of the continuum. This light travel-time delay provides a characteristic radius of the region producing the emission lines. The cross correlation function (CCF) is the standard tool used to measure the time lag between the continuum and line variations. For the few well-sampled AGN, the lag ranges from 1-100 days, depending upon which line is used and the luminosity of the AGN. In the best sampled AGN, NGC 5548, the H_beta lag shows year-to-year changes, ranging from about 8.7 days to about 22.9 days over a span of 8 years. In this paper it is demonstrated that, in the context of AGN variability studies, the lag estimate using the CCF is biased too low and subject to a large variance. Thus the year-to-year changes of the measured lag in NGC 5548 do not necessarily imply changes in the AGN structure. The bias and large variance are consequences of finite duration sampling and the dominance of long timescale trends in the light curves, not due to noise or irregular sampling. Lag estimates can be substantially improved by removing low frequency power from the light curves prior to computing the CCF.Comment: To appear in the PASP, vol 111, 1999 Nov; 37 pages; 10 figure

1865-09-22 P.F. Kendall inquires about state bounty due the widow of William Cockburn, alias Graham

https://digitalmaine.com/cw_me_4th_regiment_corr/1551/thumbnail.jp

Indication of Anisotropy in Electromagnetic Propagation over Cosmological Distances

We report a systematic rotation of the plane of polarization of electromagnetic radiation propagating over cosmological distances. The effect is extracted independently from Faraday rotation, and found to be correlated with the angular positions and distances to the sources. Monte Carlo analysis yields probabilistic P-values of order 10^(-3) for this to occur as a fluctuation. A fit yields a birefringence scale of order 10^(25) meters. Dependence on redshift z rules out a local effect. Barring hidden systematic bias in the data, the correlation indicates a new cosmological effect.Comment: 5 pages, 1 figure, ReVTeX. For more information, see http://www.cc.rochester.edu/college/rtc/Borge/aniso.htm

Real time imaging, forecasting and management of human-induced seismicity at Preston New Road, Lancashire, England

Earthquakes induced by subsurface fluid injection pose a significant issue across a range of industries. Debate continues as to the most effective methods to mitigate the resulting seismic hazard. Observations of induced seismicity indicate that the rate of seismicity scales with the injection volume and that events follow the Gutenberg-Richter distribution. These two inferences permit us to populate statistical models of the seismicity and extrapolate them to make forecasts of the expected event magnitudes as injection continues. Here, we describe a shale gas site where this approach was used in real time to make operational decisions during hydraulic fracturing operations. Microseismic observations revealed the intersection between hydraulic fracturing and a pre-existing fault or fracture network that became seismically active. Although "red light" events, requiring a pause to the injection program, occurred on several occasions, the observed event magnitudes fell within expected levels based on the extrapolated statistical models, and the levels of seismicity remained within acceptable limits as defined by the regulator. To date, induced seismicity has typically been regulated using retroactive traffic light schemes. This study shows that the use of high-quality microseismic observations to populate statistical models that forecast expected event magnitudes can provide a more effective approach

Measuring degree-degree association in networks

The Pearson correlation coefficient is commonly used for quantifying the global level of degree-degree association in complex networks. Here, we use a probabilistic representation of the underlying network structure for assessing the applicability of different association measures to heavy-tailed degree distributions. Theoretical arguments together with our numerical study indicate that Pearson's coefficient often depends on the size of networks with equal association structure, impeding a systematic comparison of real-world networks. In contrast, Kendall-Gibbons' $\tau_{b}$ is a considerably more robust measure of the degree-degree association

Non-linear relationship between maternal work hours and child body weight: Evidence from the Western Australian Pregnancy Cohort (Raine) Study

Using longitudinal data from the Western Australia Pregnancy Cohort (Raine) Study and both random-effects and fixed-effects models, this study examined the connection between maternal work hours and child overweight or obesity. Following children in two-parent families from early childhood to early adolescence, multivariate analyses revealed a non-linear and developmentally dynamic relationship. Among preschool children (ages 2 to 5), we found lower likelihood of child overweight and obesity when mothers worked 24 h or less per week, compared to when mothers worked 35 or more hours. This effect was stronger in low-to-medium income families. For older children (ages 8 to 14), compared to working 35–40 h a week, working shorter hours (1–24, 25–34) or longer hours (41 or more) was both associated with increases in child overweight and obesity. These non-linear effects were more pronounced in low-to-medium income families, particularly when fathers also worked long hours