349 research outputs found
Time, fear and transformation: Student nurses' experiences of doing a practicum (quality improvement project) in practice
Background Improving and sustaining quality in healthcare continues to be a global challenge, resulting in the necessity of developing quality improvement (QI) skills and knowledge to use in practice. This paper reports student nurses' experiences of conducting a quality improvement project (Practicum) as a compulsory assessment whilst on clinical placement areas across Scotland. Methods Telephone and face-to-face interviews (n=18) were conducted using a semi-structured interview schedule. Discussions were transcribed verbatim and data were analysed thematically. Data were extracted from Practicum assignments (n=50). Results Three key themes emerged from the analysis: 1) Time; students highlighted the necessity of time in practice areas to acclimatise, socialise and conduct the Practicum. Timing of the Practicum within the curriculum was also important. 2) Fear; was experienced by many students at the perceived enormity of the assignment, the bravery needed to attempt to change practice and the adjustment to a unique type of assignment. 3) Transformation; students shared their shifted perceptions on completing a Practicum, including a sense of achievement and acknowledgement of key improvement skills for the future. Conclusions Student nurses need to be stretched beyond their comfort zones to rise to the challenge of the Practicum, whilst ensuring adequate support mechanisms are in place from a range of sources
Interferometric Studies of the extreme binary, Aurigae: Pre-eclipse Observations
We report new and archival K-band interferometric uniform disk diameters
obtained with the Palomar Testbed Interferometer for the eclipsing binary star
Aurigae, in advance of the start of its eclipse in 2009. The
observations were inteded to test whether low amplitude variations in the
system are connected with the F supergiant star (primary), or with the
intersystem material connecting the star with the enormous dark disk
(secondary) inferred to cause the eclipses. Cepheid-like radial pulsations of
the F star are not detected, nor do we find evidence for proposed 6% per decade
shrinkage of the F star. The measured 2.27 +/- 0.11 milli-arcsecond K band
diameter is consistent with a 300 times solar radius F supergiant star at the
Hipparcos distance of 625 pc. These results provide an improved context for
observations during the 2009-2011 eclipse.Comment: Accepted for Ap.J. Letters, Oct. 200
Data Management Plan for Graduate Identity Formation Through Teaching
Data management plan for NSF Education and Human Resources (EHR) Innovations in Graduate Education (IGE) Program Proposa
A multidimensional view of racial differences in access to prostate cancer care
Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/139082/1/cncr30894.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/139082/2/cncr30894_am.pd
Use of the Behavior Assessment Tool in 18 Pilot Residency Programs
Background: The purpose of this study was to determine the feasibility and evaluate the effectiveness of the American Board of Orthopaedic Surgery Behavior Tool (ABOSBT) for measuring professionalism.
Methods: Through collaboration between the American Board of Orthopaedic Surgery and American Orthopaedic Association\u27s Council of Residency Directors, 18 residency programs piloted the use of the ABOSBT. Residents requested assessments from faculty at the end of their clinical rotations, and a 360° request was performed near the end of the academic year. Program Directors (PDs) rated individual resident professionalism (based on historical observation) at the outset of the study, for comparison to the ABOSBT results.
Results: Nine thousand eight hundred ninety-two evaluations were completed using the ABOSBT for 449 different residents by 1,012 evaluators. 97.6% of all evaluations were scored level 4 or 5 (high levels of professional behavior) across all of the 5 domains. In total, 2.4% of all evaluations scored level 3 or below reflecting poorer performance. Of 431 residents, the ABOSBT identified 26 of 32 residents who were low performers (2 or more \u3c level 3 scores in a domain) and who also scored below expectations by the PD at the start of the pilot project (81% sensitivity and 57% specificity), including 13 of these residents scoring poorly in all 5 domains. Evaluators found the ABOSBT was easy to use (96%) and that it was an effective tool to assess resident professional behavior (81%).
Conclusions: The ABOSBT was able to identify 2.4% low score evaluations (
Level of Evidence: Level II
The Dark Energy Survey Data Processing and Calibration System
The Dark Energy Survey (DES) is a 5000 deg2 grizY survey reaching
characteristic photometric depths of 24th magnitude (10 sigma) and enabling
accurate photometry and morphology of objects ten times fainter than in SDSS.
Preparations for DES have included building a dedicated 3 deg2 CCD camera
(DECam), upgrading the existing CTIO Blanco 4m telescope and developing a new
high performance computing (HPC) enabled data management system (DESDM).
The DESDM system will be used for processing, calibrating and serving the DES
data. The total data volumes are high (~2PB), and so considerable effort has
gone into designing an automated processing and quality control system. Special
purpose image detrending and photometric calibration codes have been developed
to meet the data quality requirements, while survey astrometric calibration,
coaddition and cataloging rely on new extensions of the AstrOmatic codes which
now include tools for PSF modeling, PSF homogenization, PSF corrected model
fitting cataloging and joint model fitting across multiple input images.
The DESDM system has been deployed on dedicated development clusters and HPC
systems in the US and Germany. An extensive program of testing with small rapid
turn-around and larger campaign simulated datasets has been carried out. The
system has also been tested on large real datasets, including Blanco Cosmology
Survey data from the Mosaic2 camera. In Fall 2012 the DESDM system will be used
for DECam commissioning, and, thereafter, the system will go into full science
operations.Comment: 12 pages, submitted for publication in SPIE Proceeding 8451-1
Toll-like Receptor 3 L412F Polymorphism Promotes a Persistent Clinical Phenotype in Pulmonary Sarcoidosis
Background: Sarcoidosis is a multisystemic disorder of unknown etiology, characterised by the
presence of non-caseating granulomas in target organs. In ninety percent of cases, there is
thoracic involvement. Fifty to seventy percent of pulmonary sarcoidosis patients will experience
acute, self-limiting disease. For the subgroup of patients who develop persistent disease, no
targeted therapy is currently available.
Aim: To investigate the potential of the single nucleotide polymorphism (SNP), Toll-like
receptor 3 Leu412Phe (TLR3 L412F; rs3775291), as a causative factor in the development of,
and in disease persistence in pulmonary sarcoidosis. To investigate the functionality of TLR3
L412F in vitro in primary human lung fibroblasts from pulmonary sarcoidosis patients.
Methods: Cohorts of Irish sarcoidosis patients (n=228), healthy Irish controls (n = 263) and a
secondary cohort of American sarcoidosis patients (n=123) were genotyped for TLR3 L412F.
Additionally, the effect of TLR3 L412F in primary lung fibroblasts from pulmonary sarcoidosis patients was quantitated following TLR3 activation in the context of cytokine and type I interferon production, TLR3 expression, and apoptotic- and fibroproliferative-responses.
Results: We report a significant association between TLR3 L412F and persistent clinical disease in two cohorts of Irish and American Caucasians with pulmonary sarcoidosis. Furthermore, activation of TLR3 in primary lung fibroblasts from 412F-homozygous pulmonary sarcoidosis patients resulted in reduced IFN-Ăą and TLR3 expression, reduced apoptosis- and dysregulated fibroproliferative-responses compared with TLR3 wild-type patients.
Conclusions: This study identifies defective TLR3 function as a previously unidentified factor in persistent clinical disease in pulmonary sarcoidosis and reveals TLR3 L412F as a candidate biomarker
iSAW: Integrating Structure, Actors, and Water to Study Socio-Hydro-Ecological Systems
Urbanization, climate, and ecosystem change represent major challenges for managing water resources. Although water systems are complex, a need exists for a generalized representation of these systems to identify important components and linkages to guide scientific inquiry and aid water management. We developed an integrated Structure-Actor-Water framework (iSAW) to facilitate the understanding of and transitions to sustainable water systems. Our goal was to produce an interdisciplinary framework for water resources research that could address management challenges across scales (e.g., plot to region) and domains (e.g., water supply and quality, transitioning, and urban landscapes). The framework was designed to be generalizable across all humanâenvironment systems, yet with sufficient detail and flexibility to be customized to specific cases. iSAW includes three major components: structure (natural, built, and social), actors (individual and organizational), and water (quality and quantity). Key linkages among these components include: (1) ecological/hydrologic processes, (2) ecosystem/geomorphic feedbacks, (3) planning, design, and policy, (4) perceptions, information, and experience, (5) resource access and risk, and (6) operational water use and management. We illustrate the flexibility and utility of the iSAW framework by applying it to two research and management problems: understanding urban water supply and demand in a changing climate and expanding use of green storm water infrastructure in a semi-arid environment. The applications demonstrate that a generalized conceptual model can identify important components and linkages in complex and diverse water systems and facilitate communication about those systems among researchers from diverse disciplines
LSST: from Science Drivers to Reference Design and Anticipated Data Products
(Abridged) We describe here the most ambitious survey currently planned in
the optical, the Large Synoptic Survey Telescope (LSST). A vast array of
science will be enabled by a single wide-deep-fast sky survey, and LSST will
have unique survey capability in the faint time domain. The LSST design is
driven by four main science themes: probing dark energy and dark matter, taking
an inventory of the Solar System, exploring the transient optical sky, and
mapping the Milky Way. LSST will be a wide-field ground-based system sited at
Cerro Pach\'{o}n in northern Chile. The telescope will have an 8.4 m (6.5 m
effective) primary mirror, a 9.6 deg field of view, and a 3.2 Gigapixel
camera. The standard observing sequence will consist of pairs of 15-second
exposures in a given field, with two such visits in each pointing in a given
night. With these repeats, the LSST system is capable of imaging about 10,000
square degrees of sky in a single filter in three nights. The typical 5
point-source depth in a single visit in will be (AB). The
project is in the construction phase and will begin regular survey operations
by 2022. The survey area will be contained within 30,000 deg with
, and will be imaged multiple times in six bands, ,
covering the wavelength range 320--1050 nm. About 90\% of the observing time
will be devoted to a deep-wide-fast survey mode which will uniformly observe a
18,000 deg region about 800 times (summed over all six bands) during the
anticipated 10 years of operations, and yield a coadded map to . The
remaining 10\% of the observing time will be allocated to projects such as a
Very Deep and Fast time domain survey. The goal is to make LSST data products,
including a relational database of about 32 trillion observations of 40 billion
objects, available to the public and scientists around the world.Comment: 57 pages, 32 color figures, version with high-resolution figures
available from https://www.lsst.org/overvie
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