Inverse airfoil design procedure using a multigrid Navier-Stokes method

The Modified Garabedian McFadden (MGM) design procedure was incorporated into an existing 2-D multigrid Navier-Stokes airfoil analysis method. The resulting design method is an iterative procedure based on a residual correction algorithm and permits the automated design of airfoil sections with prescribed surface pressure distributions. The new design method, Multigrid Modified Garabedian McFadden (MG-MGM), is demonstrated for several different transonic pressure distributions obtained from both symmetric and cambered airfoil shapes. The airfoil profiles generated with the MG-MGM code are compared to the original configurations to assess the capabilities of the inverse design method

A realistic evaluation : the case of protocol-based care

Background 'Protocol based care' was envisioned by policy makers as a mechanism for delivering on the service improvement agenda in England. Realistic evaluation is an increasingly popular approach, but few published examples exist, particularly in implementation research. To fill this gap, within this paper we describe the application of a realistic evaluation approach to the study of protocol-based care, whilst sharing findings of relevance about standardising care through the use of protocols, guidelines, and pathways. Methods Situated between positivism and relativism, realistic evaluation is concerned with the identification of underlying causal mechanisms, how they work, and under what conditions. Fundamentally it focuses attention on finding out what works, for whom, how, and in what circumstances. Results In this research, we were interested in understanding the relationships between the type and nature of particular approaches to protocol-based care (mechanisms), within different clinical settings (context), and what impacts this resulted in (outcomes). An evidence review using the principles of realist synthesis resulted in a number of propositions, i.e., context, mechanism, and outcome threads (CMOs). These propositions were then 'tested' through multiple case studies, using multiple methods including non-participant observation, interviews, and document analysis through an iterative analysis process. The initial propositions (conjectured CMOs) only partially corresponded to the findings that emerged during analysis. From the iterative analysis process of scrutinising mechanisms, context, and outcomes we were able to draw out some theoretically generalisable features about what works, for whom, how, and what circumstances in relation to the use of standardised care approaches (refined CMOs). Conclusions As one of the first studies to apply realistic evaluation in implementation research, it was a good fit, particularly given the growing emphasis on understanding how context influences evidence-based practice. The strengths and limitations of the approach are considered, including how to operationalise it and some of the challenges. This approach provided a useful interpretive framework with which to make sense of the multiple factors that were simultaneously at play and being observed through various data sources, and for developing explanatory theory about using standardised care approaches in practice

A case study evaluation of implementation of a care pathway to support normal birth in one English birth centre: anticipated benefits and unintended consequences

Background: The policy drive for the UK National Health Service (NHS) has focused on the need for high quality services informed by evidence of best practice. The introduction of care pathways and protocols to standardise care and support implementation of evidence into practice has taken place across the NHS with limited evaluation of their impact. A multi-site case study evaluation was undertaken to assess the impact of use of care pathways and protocols on clinicians, service users and service delivery. One of the five sites was a midwifery-led Birth Centre, where an adapted version of the All Wales Clinical Pathway for Normal Birth had been implemented. Methods: The overarching framework was realistic evaluation. A case study design enabled the capture of data on use of the pathway in the clinical setting, use of multiple methods of data collection and opportunity to study and understand the experiences of clinicians and service users whose care was informed by the pathway. Women attending the Birth Centre were recruited at their 36 week antenatal visit. Episodes of care during labour were observed, following which the woman and the midwife who cared for her were interviewed about use of the pathway. Interviews were also held with other key stakeholders from the study site. Qualitative data were content analysed. Results: Observations were undertaken of four women during labour. Eighteen interviews were conducted with clinicians and women, including the women whose care was observed and the midwives who cared for them, senior midwifery managers and obstetricians. The implementation of the pathway resulted in a number of anticipated benefits, including increased midwifery confidence in skills to support normal birth and promotion of team working. There were also unintended consequences, including concerns about a lack of documentation of labour care and negative impact on working relationships with obstetric and other midwifery colleagues. Women were unaware their care was informed by a care pathway. Conclusion: Care pathways are complex interventions which generate a number of consequences for practice. Those considering introduction of pathways need to ensure all relevant stakeholders are engaged with this and develop robust evaluation strategies to accompany implementation

Making authentic: exploring boundary objects and bricolage in knowledge mobilisation through National Health Service-university partnerships

Background: In healthcare, bridging the research-to-practice gap is a top priority. Knowledge mobilisation scholars suggest that this gap can be closed through collaboration between knowledge users and producers. The concept of boundary objects – shared things and ideas that enable communication – has gained popularity across various collaborative work practices, but their potential within knowledge mobilisation in health care is understudied. An ongoing challenge for designers of boundary objects is how to create objects that are valued and shared both in principle and in practice. Aims and objectives: This paper reports on a study of boundary objects used during knowledge mobilisation through NHS-university partnerships called Collaborations for Leadership in Applied Health Research and Care (CLAHRCs). The distinction is investigated between boundary objects-in-theory and boundary objects-in-use, considering whether the latter possess specific characteristics which make them more effective during knowledge mobilisation. Methods: A qualitative case study of three CLAHRCs was conducted. Twenty-one people employed as ‘boundary spanners’ were interviewed to explore whether boundary objects played a role in knowledge mobilisation. Findings: The most effective boundary objects-in-use were co-produced through a process of bricolage. These possessed high levels of meaningfulness and resonance, and reconciled multiple user perspectives. Together these properties contributed to the overall authenticity of boundary objects-in-use. Discussion and conclusion: This paper helps to explain why designated boundary objects frequently fail in practice, and why there is a need to focus on understanding boundary objects based on symbolic, rather than structural, dimensions

Decentralised Learning MACs for Collision-free Access in WLANs

By combining the features of CSMA and TDMA, fully decentralised WLAN MAC schemes have recently been proposed that converge to collision-free schedules. In this paper we describe a MAC with optimal long-run throughput that is almost decentralised. We then design two \changed{schemes} that are practically realisable, decentralised approximations of this optimal scheme and operate with different amounts of sensing information. We achieve this by (1) introducing learning algorithms that can substantially speed up convergence to collision free operation; (2) developing a decentralised schedule length adaptation scheme that provides long-run fair (uniform) access to the medium while maintaining collision-free access for arbitrary numbers of stations

Dairy and hog farming in northeastern Iowa

On Northeastern Iowa dairy and hog farms, highest returns were obtained where the number of milk cows equaled litters of pigs. This meant about 6 pounds of hogs were produced to each pound of butterfat. Where hog production was less, returns were lower. The butterfat-hog price ratio, during the years of the study, favored hogs, with 1 pound butterfat worth only 3.5 pounds of hogs. Generally, the strictly dairy herds were more profitable than the dual-purpose herds, even though butterfat prices were unfavorable in comparison to beef, during the period studied. Income from beef in the dual-purpose herds was not enough to offset the lower sales of butterfat. The dairy herds, with 16.6 cows, averaged 229 pounds butterfat sold or used in the household, and 493 pounds beef per cow, while the dual-purpose herds, with 14.1 cows, averaged 162 pounds butterfat output and 711 pounds beef per cow

An economic study of the dairy enterprise in northeastern Iowa

In a study of 51 dairy and dual-purpose herds in 1935 and ] 936 it was found that the average value per head of the milk cows was $66 in the high producing dairy herds, compared to$49 in the low producing ones; while investment in buildings and fences was $120 per cow in the high as compared to$90 in the low producing herds. Investment per pound of butterfat produced, however , was lower with the higher producing and more valuable cows. The cows in the higher producing herds were fed more heavily and received better balanced rations; the total amount of concentrates amounting to approximately 2,300 pounds in the high and 1,200 in the low producing herds, while total value of all feeds plus pasture amounted to $72, compared to$50. When expressed per pound of butterfat, however, the values of feed and pasture were but little different between the high and low producing herds. In fact, the advantage was slightly with the high producing herds. There was a wide variation in amount of feed fed per cow, which was only partly related to the production per cow. The cows receiving the most feed generally produced more butterfat but not necessarily in proportion to the difference in amount of feed. Consequently, the cows receiving the most feed did not give the highest return per $100 of feed fed