943 research outputs found
Using Computer Simulation for Reducing the Appointment Lead-Time in a Public Pediatric Outpatient Department
Pediatric outpatient departments aim to provide a pleasant, effective and continuing care to children. However, a problem in these units is the long waiting time for children to receive an appointment. Prolonged appointment lead-time remains a global challenge since it results in delayed diagnosis and treatment causing increased morbidity and dissatisfaction. Additionally, it leads to an increased number of hospitalization and emergency department visits which augments the financial burden faced by healthcare systems. Despite these considerations, the studies directly concentrating on the reduction of appointment lead-time in these departments are largely limited. Therefore, this paper proposes the application of Discrete-event Simulation (DES) approach to evaluate potential improvement strategies aiming at reducing average appointment lead-time. Initially, the outpatient department is characterized to effectively identify the main activities, process variables, interactions, and system constraints. After data collection, input analysis is conducted through intra-variable independence, homogeneity and goodness-of-fit tests followed by the creation of a simulation model representing the real pediatric outpatient department. Then, Mann-Whitney tests are used to prove whether the model was statistically comparable with the real-world system. After this, the outpatient department performance is assessed in terms of average appointment lead-time and resource utilization. Finally, three improvement scenarios are assessed technically and financially, to determine if they are viable for implementation. A case study of a mixed-patient type environment in a public pediatric outpatient department has been explored to validate the proposed methodology. Statistical tests demonstrate that appointment lead-time in pediatric outpatient departments may be meaningfully minimized using this approach. © 2019, Springer Nature Switzerland AG
Astronomical Spectroscopy
Spectroscopy is one of the most important tools that an astronomer has for
studying the universe. This chapter begins by discussing the basics, including
the different types of optical spectrographs, with extension to the ultraviolet
and the near-infrared. Emphasis is given to the fundamentals of how
spectrographs are used, and the trade-offs involved in designing an
observational experiment. It then covers observing and reduction techniques,
noting that some of the standard practices of flat-fielding often actually
degrade the quality of the data rather than improve it. Although the focus is
on point sources, spatially resolved spectroscopy of extended sources is also
briefly discussed. Discussion of differential extinction, the impact of
crowding, multi-object techniques, optimal extractions, flat-fielding
considerations, and determining radial velocities and velocity dispersions
provide the spectroscopist with the fundamentals needed to obtain the best
data. Finally the chapter combines the previous material by providing some
examples of real-life observing experiences with several typical instruments.Comment: An abridged version of a chapter to appear in Planets, Stars and
Stellar Systems, to be published in 2011 by Springer. Slightly revise
Immigrant community integration in world cities
As a consequence of the accelerated globalization process, today major cities
all over the world are characterized by an increasing multiculturalism. The
integration of immigrant communities may be affected by social polarization and
spatial segregation. How are these dynamics evolving over time? To what extent
the different policies launched to tackle these problems are working? These are
critical questions traditionally addressed by studies based on surveys and
census data. Such sources are safe to avoid spurious biases, but the data
collection becomes an intensive and rather expensive work. Here, we conduct a
comprehensive study on immigrant integration in 53 world cities by introducing
an innovative approach: an analysis of the spatio-temporal communication
patterns of immigrant and local communities based on language detection in
Twitter and on novel metrics of spatial integration. We quantify the "Power of
Integration" of cities --their capacity to spatially integrate diverse
cultures-- and characterize the relations between different cultures when
acting as hosts or immigrants.Comment: 13 pages, 5 figures + Appendi
Ageing, Muscle Power and Physical Function: A Systematic Review and Implications for Pragmatic Training Interventions.
BACKGROUND: The physiological impairments most strongly associated with functional performance in older people are logically the most efficient therapeutic targets for exercise training interventions aimed at improving function and maintaining independence in later life. OBJECTIVES: The objectives of this review were to (1) systematically review the relationship between muscle power and functional performance in older people; (2) systematically review the effect of power training (PT) interventions on functional performance in older people; and (3) identify components of successful PT interventions relevant to pragmatic trials by scoping the literature. METHODS: Our approach involved three stages. First, we systematically reviewed evidence on the relationship between muscle power, muscle strength and functional performance and, second, we systematically reviewed PT intervention studies that included both muscle power and at least one index of functional performance as outcome measures. Finally, taking a strong pragmatic perspective, we conducted a scoping review of the PT evidence to identify the successful components of training interventions needed to provide a minimally effective training dose to improve physical function. RESULTS: Evidence from 44 studies revealed a positive association between muscle power and indices of physical function, and that muscle power is a marginally superior predictor of functional performance than muscle strength. Nine studies revealed maximal angular velocity of movement, an important component of muscle power, to be positively associated with functional performance and a better predictor of functional performance than muscle strength. We identified 31 PT studies, characterised by small sample sizes and incomplete reporting of interventions, resulting in less than one-in-five studies judged as having a low risk of bias. Thirteen studies compared traditional resistance training with PT, with ten studies reporting the superiority of PT for either muscle power or functional performance. Further studies demonstrated the efficacy of various methods of resistance and functional task PT on muscle power and functional performance, including low-load PT and low-volume interventions. CONCLUSIONS: Maximal intended movement velocity, low training load, simple training methods, low-volume training and low-frequency training were revealed as components offering potential for the development of a pragmatic intervention. Additionally, the research area is dominated by short-term interventions producing short-term gains with little consideration of the long-term maintenance of functional performance. We believe the area would benefit from larger and higher-quality studies and consideration of optimal long-term strategies to develop and maintain muscle power and physical function over years rather than weeks
Evidence for the Decay
We present a search for the ``wrong-sign'' decay D0 -> K+ pi- pi+ pi- using 9
fb-1 of e+e- collisions on and just below the Upsilon(4S) resonance. This decay
can occur either through a doubly Cabibbo-suppressed process or through mixing
to a D0bar followed by a Cabibbo-favored process. Our result for the
time-integrated wrong-sign rate relative to the decay D0 -> K- pi+ pi- pi+ is
(0.0041 +0.0012-0.0011(stat.) +-0.0004(syst.))x(1.07 +-0.10)(phase space),
which has a statistical significance of 3.9 standard deviations.Comment: 9 pages postscript, also available through
http://w4.lns.cornell.edu/public/CLNS, submitted to PR
Hadronic Mass Moments in Inclusive Semileptonic B Meson Decays
We have measured the first and second moments of the hadronic mass-squared
distribution in B -> X_c l nu, for P(lepton) > 1.5 GeV/c. We find <M_X^2 -
M_D[Bar]^2> = 0.251 +- 0.066 GeV^2, )^2 > = 0.576 +- 0.170
GeV^4, where M_D[Bar] is the spin-averaged D meson mass.
From that first moment and the first moment of the photon energy spectrum in
b -> s gamma, we find the HQET parameter lambda_1 (MS[Bar], to order 1/M^3 and
beta_0 alpha_s^2) to be -0.24 +- 0.11 GeV^2. Using these first moments and the
B semileptonic width, and assuming parton-hadron duality, we obtain |V_cb| =
0.0404 +- 0.0013.Comment: 11 pages postscript, also available through
http://w4.lns.cornell.edu/public/CLNS, submitted to PR
Evidence of New States Decaying into
Using 13.7 of data recorded by the CLEO detector at CESR, we report
evidence for two new charmed baryons: one decaying into
with the subsequent decay , and its
isospin partner decaying into followed by
. We measure the following mass differences
for the two states: =318.2+-1.3+-2.9 MeV,
and =324.0+-1.3+-3.0 MeV. We interpret
these new states as the particles, the charmed-strange
analogs of the .Comment: 10 pages postscript, also available through
http://w4.lns.cornell.edu/public/CLN
First Observation of B -> D(*) rho', rho' -> omega pi-
We report on the observation of B-> D(*) pi+ pi- pi- pi^o decays. The
branching ratios for D*+ and D*o are (1.72+/-0.14+/-0.24)% and
(1.80+/-0.24+/-0.27)%, respectively. Each final state has a D* omega pi-
component, with branching ratios (0.29+/-0.03+/-0.04)% and
(0.45+/-0.10+/-0.07)% for the D*+ and D*o modes, respectively. We also observe
B -> D omega pi- decays. The branching ratios for D+ and Do are
(0.28+/-0.05+/-0.04)% and (0.41+/-0.07+/-0.06)%, respectively. A spin parity
analysis of the D omega pi- final state prefers a wide 1^- resonance. A fit to
the omega pi- mass spectrum finds a central mass of (1349+/-25^{+10}_{-5}) MeV
and width of (547+/-86^{+46}_{-45}) MeV. We identify this object as the
rho(1450) or the \rho'.Comment: 42 pages postscript, also available through
http://w4.lns.cornell.edu/public/CLNS, To Appear in PR
Search for the Decay
We report on a search for the radiative decay U(1S) -> gamma + eta' in 61.3
pb^-1 of data taken with the CLEO II detector at the Cornell Electron Storage
Ring. Three decay chains were investigated, all involving eta' -> pi+ pi- +
eta, followed by eta -> gamma + gamma, eta -> pi0 + pi0 + pi0, or eta -> pi+ +
pi- + pi0. We find no candidate events in any of the three cases and set a
combined upper limit of 1.6 x 10^-5 at 90% C.L., significantly smaller than the
previous limit. We compare our result to other radiative U(1S) decays, to
radiative J/psi decays, and to theoretical predictions.Comment: 9 pages postscript, also available through
http://w4.lns.cornell.edu/public/CLNS, submitted to PR
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