Estimating Weighted Panel Sizes for Primary Care Providers: An assessment of clustering and novel methods of panel size estimation on electronic medical records

Primary Care is on the frontlines of healthcare, thus they see the most diverse set of patients. In order to achieve high functioning primary care, a practice must establish empanelment, the pairing of patients to providers. Enumeration of empanelment, or estimating panel sizes, helps ensure that the demands of the patients demand the supply of providers and optimize the balance of primary care resources to improve quality of care. Further we can adjust panel sizes by using patient-level data on healthcare utilization and complexity extracted from the electronic medial record to determine the amount of care or burden of work that a patient poses to a provider. With this adjustment we can have a more informed estimation of panel sizes that can differentiate the amount of care provided to individuals instead of assuming work for each patient is the same. This dissertation attempts to evaluate different methods of estimating adjusted panel sizes and understand the best practices for extracting data from the EMR to build decision making tools. In our analysis we compare the current best panel size estimation method introduced by Rajkomar et al 2016 with processes that change the clustering method (*k*-means vs gaussian mixture model), provide a direct estimation of a burden score, incorporate demographics and complexity data into the clustering (*KAMILA* and gaussian multinomial mixture model) and assess how to conduct panel size estimation with a larger set of features beyond utilization counts

Elbow Injury - Football

Please refer to the pdf version of the abstract located adjacent to the title

“Teamwork done to a tee”:a golf caddie’s perspective on their perceived role and associated skills

Objectives: This study explored what caddies perceive as their role and the associated skills required to support golfers. Method: Semi-structured interviews were completed with seven Professional male caddies from the United Kingdom (3 Caddies) and USA (4 Caddies). Interviews were audio recorded, transcribed and reflexive thematic analysis performed.Results: Thematic analysis generated twenty-one lower-order themes and six higher-order themes, which were organised into three dimensions; (i) the demands of being a caddie; (ii) caddie’s expertise to do the role; and (iii), importance of support.Conclusion: Caddies demonstrate expertise in a range of areas from perceptual to intrapersonal skills when developing and maintaining effective golfer-caddie partnerships. Our findings highlight the skills the caddies require are role dependent. The findings from this study have implications on understanding future training needs for caddies in relation to maintaining effective golfer-caddie relationships and best practices to support caddies

A psycho-educational curriculum for sport career transition practitioners: Development and evaluation

Research question: This paper is an integration of three studies. Study 1 investigates sport career transition organisational intervention programmes for high performance athletes and training and development programmes for sport career transition practitioners in order to find a research gap with regard to sport career transition supporting services. A psycho-educational curriculum was developed for sport career transition practitioner in Study 2 to fill the research gap. In Study 3, the curriculum was examined to see if the curriculum contributed to enhancing practitioners’ confidence in key competences.  Research methods: A range of methods were applied to the studies including One Group Pre- and Post-test design, Case Study, Focus Group, Semi-Structured Interview, two-round Delphi-Method and Questionnaires. The data for Study 1 collected from 19 countries worldwide and total 16 participants based in seven different countries were invited to development and evaluation of the curriculum.  Results and Findings: A novel psycho-educational curriculum for sport career transition practitioner was developed and evaluated concerning four competences as a form of curriculum package. The findings revealed that the curriculum package increased the participants’ confidence in key competences concerning sport career transition.  Implications: The findings deepen the knowledge of sport career transition in the areas of organisational intervention programmes focusing on high performance athletes and sport career transition practitioners. These findings contribute to modifying the Conceptual Model of Adaptation to Career Transition (Lavallee, Park, & Taylor, 2014) by strengthening the organisational intervention perspective and applied work in respect of sporting organisation management strategie

The permeability of fractured rocks in pressurised volcanic and geothermal systems

AbstractThe connectivity of rocks’ porous structure and the presence of fractures influence the transfer of fluids in the Earth’s crust. Here, we employed laboratory experiments to measure the influence of macro-fractures and effective pressure on the permeability of volcanic rocks with a wide range of initial porosities (1–41 vol. %) comprised of both vesicles and micro-cracks. We used a hand-held permeameter and hydrostatic cell to measure the permeability of intact rock cores at effective pressures up to 30 MPa; we then induced a macro-fracture to each sample using Brazilian tensile tests and measured the permeability of these macro-fractured rocks again. We show that intact rock permeability increases non-linearly with increasing porosity and decreases with increasing effective pressure due to compactional closure of micro-fractures. Imparting a macro-fracture both increases the permeability of rocks and their sensitivity to effective pressure. The magnitude of permeability increase induced by the macro-fracture is more significant for dense rocks. We finally provide a general equation to estimate the permeability of intact and fractured rocks, forming a basis to constrain fluid flow in volcanic and geothermal systems.</jats:p

DNA waves and water

Some bacterial and viral DNA sequences have been found to induce low frequency electromagnetic waves in high aqueous dilutions. This phenomenon appears to be triggered by the ambient electromagnetic background of very low frequency. We discuss this phenomenon in the framework of quantum field theory. A scheme able to account for the observations is proposed. The reported phenomenon could allow to develop highly sensitive detection systems for chronic bacterial and viral infections.Comment: Invited talk at the DICE2010 Conference, Castiglioncello, Italy September 201