1,392 research outputs found

    An International Catholic Health Institute and Medical Service: A Proposal

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    The Health of the Family, The Future of the Church

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    A New Health Care Initiative Within the Church

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    A new method for learning imprecise hidden Markov models

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    We present a method for learning imprecise local uncertainty models in stationary hidden Markov models. If there is enough data to justify precise local uncertainty models, then existing learning algorithms, such as the Baum–Welch algorithm, can be used. When there is not enough evidence to justify precise models, the method we suggest here has a number of interesting features

    Clinicopathological determinants of an elevated systemic inflammatory response following elective potentially curative resection for colorectal cancer

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    Introduction: The postoperative systemic inflammatory response (SIR) is related to both long- and short-term outcomes following surgery for colorectal cancer. However, it is not clear which clinicopathological factors are associated with the magnitude of the postoperative SIR. The present study was designed to determine the clinicopathological determinants of the postoperative systemic inflammatory response following colorectal cancer resection. Methods: Patients with a histologically proven diagnosis of colorectal cancer who underwent elective, potentially curative resection during a period from 1999 to 2013 were included in the study (n = 752). Clinicopathological data and the postoperative SIR, as evidenced by postoperative Glasgow Prognostic Score (poGPS), were recorded in a prospectively maintained database. Results: The majority of patients were aged 65 years or older, male, were overweight or obese, and had an open resection. After adjustment for year of operation, a high day 3 poGPS was independently associated with American Society of Anesthesiologists (ASA) grade (hazard ratio [HR] 1.96; confidence interval [CI] 1.25–3.09; p = 0.003), body mass index (BMI) (HR 1.60; CI 1.07–2.38; p = 0.001), mGPS (HR 2.03; CI 1.35–3.03; p = 0.001), and tumour site (HR 2.99; CI 1.56–5.71; p < 0.001). After adjustment for year of operation, a high day 4 poGPS was independently associated with ASA grade (HR 1.65; CI 1.06–2.57; p = 0.028), mGPS (HR 1.81; CI 1.22–2.68; p = 0.003), NLR (HR 0.50; CI 0.26–0.95; p = 0.034), and tumour site (HR 2.90; CI 1.49–5.65; p = 0.002). Conclusions: ASA grade, BMI, mGPS, and tumour site were consistently associated with the magnitude of the postoperative systemic inflammatory response, evidenced by a high poGPS on days 3 and 4, in patients undergoing elective potentially curative resection for colorectal cancer

    IT Project Success w\7120 and 7123 NPRs to Achieve Project Success

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    This slide presentation reviews management techniques to assure information technology development project success. Details include the work products, the work breakdown structure (WBS), system integration, verification and validation (IV&V), and deployment and operations. An example, the NASA Consolidated Active Directory (NCAD), is reviewed

    Study of Radiographic Linear Indications and Subsequent Microstructural Features in Gas Tungsten Arc Welds of Inconel 718

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    This study presents examples and considerations for differentiating linear radiographic indications produced by gas tungsten arc welds in a 0.05-in-thick sheet of Inconel 718. A series of welds with different structural features, including the enigma indications and other defect indications such as lack of fusion and penetration, were produced, radiographed, and examined metallographically. The enigma indications were produced by a large columnar grain running along the center of the weld nugget occurring when the weld speed was reduced sufficiently below nominal. Examples of respective indications, including the effect of changing the x-ray source location, are presented as an aid to differentiation. Enigma, nominal, and hot-weld specimens were tensile tested to demonstrate the harmlessness of the enigma indication. Statistical analysis showed that there is no difference between the strengths of these three weld conditions

    Co-Produced Care in Veterinary Services: A Qualitative Study of UK Stakeholders' Perspectives

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    Changes in client behaviour and expectations, and a dynamic business landscape, amplify the already complex nature of veterinary and animal health service provision. Drawing on prior experiences, veterinary clients increasingly pursue enhanced involvement in services and have expectations of relationship-centred care. Co-production as a conceptualisation of reciprocity in service provision is a fundamental offering in the services sector, including human medicine, yet the role of co-production in veterinary services has been minimally explored. Utilising a service satisfaction framework, semi-structured interviews (n = 13) were completed with three veterinary stakeholder groups, veterinarians, allied animal health practitioners, and veterinary clients. Interview transcript data were subject to the qualitative data analysis techniques, thematic analysis and grounded theory, to explore relationship-centred care and subsequently conceptualise co-production service for the sector. Six latent dimensions of service were emergent, defined as: empathy, bespoke care, professional integrity, value for money, confident relationships, and accessibility. The dimensions strongly advocate wider sector adoption of a co-produced service, and a contextualised co-production framework is presented. Pragmatic challenges associated with integration of active veterinary clients in a practitioner–client partnership are evident. However, adopting a people-centric approach to veterinary services and partnerships with clients can confer the advantages of improved client satisfaction, enhanced treatment adherence and outcomes, and business sustainability
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