Response to Miles and Mezzich:“Medicine in crisis and a crisis in semantics”

Miles and Mezzich offer a welcome and comprehensive account of historical recent developments in healthcare and the role of its practice models. They identify a ‘crisis’ in medicine, which seems to have occurred in part because the science of medicine has been over-emphasised and the importance of compassion and care de-emphasised.  As they point out, this crisis has been perceived to have evolved over the past one hundred years. Evidence Based Medicine (EBM) is suggested to be inadequate to solve the crisis and it may be the case that EBM, in fact, has precipitated it because it ignores patients qua persons. It is also suggested that Patient Centred Care (PCC) seeks to address the imbalance, but that this is inadequate, too. Between these existing views it is claimed that Person Centred Medicine (PCM) solves the crisis by giving persons and evidence their proper roles and relative importances</jats:p

Complex Adaptive Team Systems (CATS): Scaling of a Team Leadership Development Model

Complex adaptive systems (CAS) have been identified as being hard to comprehend, composed of multiple interacting components acting interdependently with overlapping functions aimed at adapting to external/environmental forces. The current theoretical model utilized the natural functions of teams, viewing teams as a complex adaptive system, to develop the structure of the theory of complex adaptive team systems (CATS). The CATS model was formulated around the components of complexity theory (interactions, nonlinearity, interdependency, heterogeneity, complex systems, emergence, self-organizing, and adaptability) to show its utility across multiple domains (the role of leadership, organizational learning, organizational change, collective cognitive structures, innovation, cross-business-unit collaborations). In theorizing the CATS model, a new level of analysis was implemented, the interactions between agents as a move toward emergence in complex systems. The CATS model ultimately provides a model for organizations/institutions to drive knowledge creation and innovation while operating in today’s complexity

Final design report of a personnel launch system and a family of heavy lift launch vehicles

The objective was to design both a Personnel Launch System (PLS) and a family of Heavy Lift Launch Vehicles (FHLLVs) that provide low cost and efficient operation in missions not suited for the Shuttle. The PLS vehicle is designed primarily for space station crew rotation and emergency crew return. The final design of the PLS vehicle and its interior is given. The mission of the FHLLVs is to place large, massive payloads into Earth orbit with payload flexibility being considered foremost in the design. The final design of three launch vehicles was found to yield a payload capacity range from 20 to 200 mt. These designs include the use of multistaged, high thrust liquid engines mounted on the core stages of the rocket

Monetary valuation of recreational fishing in a restored estuary and implications for future management measures

Recreational fishing is considered a cultural ecosystem service, important in terms of the socio-economic benefits that it provides. In the Nerbioi estuary (northern Spain), investments in water treatment and the closure of polluting industries have led to several benefits such as improvements in water quality, fish abundance and richness, and recreational fishing activity. Currently, this activity is performed along the whole estuary including areas that previously were severely polluted. Valuing the benefits of recreational fishing is crucial to support the management of the estuary. The economic valuation is performed using a multi-site travel cost analysis. In addition, the effect on welfare measures of future scenarios where environmental conditions and accessibility change is analysed. Results indicate that each recreational trip in Nerbioi has a use value of 14.98€, with an aggregate value of 1.12 M€year−1 for the whole recreational fishers’ community. The simulated scenarios suggest that further environmental improvements would have a positive effect in the activity, increasing the current welfare by 7.5–11.5%. In contrast, worsening of environmental conditions and accessibility could translate into a welfare reduction up to 71%. The monetary use value of recreational fishing partially covers (4.7%) the costs of maintaining the environmental quality of the estuary

Integrating Geographic Information into the Analysis of the Genetic Distribution of South African Vervet Monkeys

This project uses the program Geneland to reanalyze McAuliffe’s (2008) thesis data on genetic variability in three South African vervet monkey populations (Polokwane, Oribi and Blyde). Using information on the geographic location and genetic variability of these populations, the spatially explicit Geneland program shows that the three populations are weakly differentiated. These findings oppose the results of previous genetic studies of South African vervet monkeys as well as the results obtained by McAuliffe with the spatially implicit Structure program, which found that the 34 individuals all come from one population. Based on this historic data and the fact that other studies have found the same number of subpopulations with both Structure and Geneland, I conclude that Polokwane, Oribi and Blyde are slightly differentiated, though not distinct enough to be considered separate populations (Latch et al. 2008). These results need to be supported by an analysis of the entire sample of South African vervet monkey genetic data from up to 200 animals prior to suggesting policy changes regarding genetic structuring in South African vervet monkeys

A modular approach for automated sample preparation and chemical analysis

Changes in international relations, especially within the past several years, have dramatically affected the programmatic thrusts of the U.S. Department of Energy (DOE). The DOE now is addressing the environmental cleanup required as a result of 50 years of nuclear arms research and production. One major obstacle in the remediation of these areas is the chemical determination of potentially contaminated material using currently acceptable practices. Process bottlenecks and exposure to hazardous conditions pose problems for the DOE. One proposed solution is the application of modular automated chemistry using Standard Laboratory Modules (SLM) to perform Standard Analysis Methods (SAM). The Contaminant Analysis Automation (CAA) Program has developed standards and prototype equipment that will accelerate the development of modular chemistry technology and is transferring this technology to private industry

System and Process for Upgrading Hydrocarbons

In one embodiment, a system for upgrading a hydrocarbon material may include a black wax upgrade subsystem and a molten salt gasification (MSG) subsystem. The black wax upgrade subsystem and the MSG subsystem may be located within a common pressure boundary, such as within a pressure vessel. Gaseous materials produced by the MSG subsystem may be used in the process carried out within the black wax upgrade subsystem. For example, hydrogen may pass through a gaseous transfer interface to interact with black wax feed material to hydrogenate such material during a cracking process. In one embodiment, the gaseous transfer interface may include one or more openings in a tube or conduit which is carrying the black wax material. A pressure differential may control the flow of hydrogen within the tube or conduit. Related methods are also disclosed

System and Process for Upgrading Hydrocarbons

In one embodiment, a system for upgrading a hydrocarbon material may include a black wax upgrade subsystem and a molten salt gasification (MSG) subsystem. The black wax upgrade subsystem and the MSG subsystem may be located within a common pressure boundary, such as within a pressure vessel. Gaseous materials produced by the MSG subsystem may be used in the process carried out within the black wax upgrade subsystem. For example, hydrogen may pass through a gaseous transfer interface to interact with black wax feed material to hydrogenate such material during a cracking process. In one embodiment, the gaseous transfer interface may include one or more openings in a tube or conduit which is carrying the black wax material. A pressure differential may control the flow of hydrogen within the tube or conduit. Related methods are also disclosed

Assessing subjective preferences for river quality improvements: combining Q-methodology and choice experiment data

Choice decisions are inherently subjective but capturing and explaining nuanced variation in respondents’ attitudes is difficult and needs more than the simple socio-demographic variables traditionally used in economic research. In recent years, environmental economists have been shifting towards a more holistic approach to economic valuation, making an increased use of psychology within behavioural economics, to better understand subjective preferences on the environment. This research applies a novel mixed-methods approach to integrate the results from a Q-methodological analysis, which reveals respondents’ latent traits and perceptions about river management, into a choice experiment which estimates respondents’ preferences for potential future improvements to river water quality. The purpose is to improve the quantification of subjectivity within stated preference experiments. Q-methodology reveals five statistically distinct narratives (characterised as Ecological, Financial, Leadership, Collaboration, Legislation) which define the main perspectives respondents hold for river management strategies. Choice experiment results suggest subjectivity causes significant differences in respondents’ choice behaviour. Statistically verified Q-methodological narratives provide plausible explanations for differences in respondents’ choice preferences regarding river water quality improvements. By triangulating between quantitative and qualitative research methods, we demonstrate a research strategy that can contribute to a better understanding of the impact socially contested perspectives have on respondents’ choice behaviour

Integrated modelling for economic valuation of the role of forests and woodlands in drinking water provision to two African cities

Rapidly growing economies often have high population growth, resulting in agricultural expansion in rural areas and increased water demand in urban areas. Conversion of forests and woodlands to agriculture may threaten safe and reliable water supply in cities. This study assesses the regulating functions and economic values of forests and woodlands in meeting the water needs of two major cities in Tanzania and proposes an integrated modelling approach with a scenario-based analysis to estimate costs of water supply avoided by forest conservation. We use the process-based hydrological Soil and Water Assessment Tool (SWAT) to simulate the role of woody habitats in the regulation of hydrological flow and sediment control. We find that the forests and woodlands play a significant role in regulating sediment load in rivers and reducing peak flows, with implications for the water supply from the Ruvu River to Dar es Salaam and Morogoro. A cost-based value assessment under water treatment works conditions up to 2016 suggests that water supply failure due to deforestation would cost Dar es Salaam USD 4.6-17.6 million per year and Morogoro USD 308 thousand per year. Stronger enforcement of forest and woodland protection in Tanzania must balance water policy objectives and food security