828 research outputs found
Sustainability in pediatric hospitals: An exploration at the intersection of quality improvement and implementation science
BACKGROUND: Although new evidence-based practices are frequently implemented in clinical settings, many are not sustained, limiting the intended impact. Within implementation science, there is a gap in understanding sustainability. Pediatric healthcare settings have a robust history of quality improvement (QI), which includes a focus on continuation of change efforts. QI capability and sustainability capacity, therefore, serve as a useful concept for connecting the broader fields of QI and implementation science to provide insights on improving care. This study addresses these gaps in understanding of sustainability in pediatric settings and its relationship to QI.
METHODS: This is a cross-sectional observational study conducted within pediatric academic medical centers in the United States. Clinicians surveyed worked with one of three evidence-based clinical programs: perioperative antimicrobial stewardship prescribing, early mobility in the intensive care unit, and massive blood transfusion administration. Participants completed two assessments: (1) the Clinical Sustainability Assessment Tool (CSAT) and (2) a 19-question assessment that included demographics and validation questions, specifically a subset of questions from the
RESULTS: A total of 181 individuals from three different programs and 30 sites were included in the final analyses. QI capability scores were assessed as a single construct (5-point Likert scale), with an average response of 4.16 (higher scores indicate greater QI capability). The overall CSAT score (7-point Likert scale) was the highest for massive transfusion programs (5.51, SD = 0.91), followed by early mobility (5.25, SD = 0.92) and perioperative antibiotic prescribing (4.91, SD = 1.07). Mixed-effects modeling illustrated that after controlling for person and setting level variables, higher perceptions of QI capabilities were significantly related to overall clinical sustainability.
CONCLUSION: Organizations and programs with higher QI capabilities had a higher sustainability capacity, even when controlling for differences at the individual and intervention levels. Organizational factors that enable evidence-based interventions should be further studied, especially as they relate to sustainability. Issues to be considered by practitioners when planning for sustainability include bedside provider perceptions, intervention achievability, frequency of delivery, and organizational influences
Parity Violating Measurements of Neutron Densities
Parity violating electron nucleus scattering is a clean and powerful tool for
measuring the spatial distributions of neutrons in nuclei with unprecedented
accuracy. Parity violation arises from the interference of electromagnetic and
weak neutral amplitudes, and the of the Standard Model couples primarily
to neutrons at low . The data can be interpreted with as much confidence
as electromagnetic scattering. After briefly reviewing the present theoretical
and experimental knowledge of neutron densities, we discuss possible parity
violation measurements, their theoretical interpretation, and applications. The
experiments are feasible at existing facilities. We show that theoretical
corrections are either small or well understood, which makes the interpretation
clean. The quantitative relationship to atomic parity nonconservation
observables is examined, and we show that the electron scattering asymmetries
can be directly applied to atomic PNC because the observables have
approximately the same dependence on nuclear shape.Comment: 38 pages, 7 ps figures, very minor changes, submitted to Phys. Rev.
Direct measurement of the mass difference between top and antitop quarks
We present a direct measurement of the mass difference between top and
antitop quarks (dm) in lepton+jets top-antitop final states using the "matrix
element" method. The purity of the lepton+jets sample is enhanced for
top-antitop events by identifying at least one of the jet as originating from a
b quark. The analyzed data correspond to 3.6 fb-1 of proton-antiproton
collisions at 1.96 TeV acquired by D0 in Run II of the Fermilab Tevatron
Collider. The combination of the e+jets and mu+jets channels yields dm = 0.8
+/- 1.8 (stat) +/- 0.5 (syst) GeV, which is in agreement with the standard
model expectation of no mass difference.Comment: submitted to Phys. Rev.
Precise measurement of the top quark mass in the dilepton channel at D0
We measure the top quark mass (mt) in ppbar collisions at a center of mass
energy of 1.96 TeV using dilepton ttbar->W+bW-bbar->l+nubl-nubarbbar events,
where l denotes an electron, a muon, or a tau that decays leptonically. The
data correspond to an integrated luminosity of 5.4 fb-1 collected with the D0
detector at the Fermilab Tevatron Collider. We obtain mt = 174.0 +- 1.8(stat)
+- 2.4(syst) GeV, which is in agreement with the current world average mt =
173.3 +- 1.1 GeV. This is currently the most precise measurement of mt in the
dilepton channel.Comment: 7 pages, 4 figure
Search for the standard model and a fermiophobic Higgs boson in diphoton final states
We present a search for the standard model Higgs boson and a fermiophobic
Higgs boson in the diphoton final states based on 8.2 fb-1 of ppbar collisions
collected with the D0 detector at the Fermilab Tevatron Collider. No excess of
data above background predictions is observed and upper limits at the 95% C.L.
on the cross section multiplied by the branching fraction are set which are the
most restrictive to date. A fermiophobic Higgs boson with a mass below 112.9
GeV is excluded at the 95% C.L.Comment: 12 pages, 21 figures, submitted to PR
Measurement of the t-channel single top quark production cross section
The D0 collaboration reports direct evidence for electroweak production of
single top quarks through the t-channel exchange of a virtual W boson. This is
the first analysis to isolate an individual single top quark production
channel. We select events containing an isolated electron or muon, missing
transverse energy, and two, three or four jets from 2.3 fb^-1 of ppbar
collisions at the Fermilab Tevatron Collider. One or two of the jets are
identified as containing a b hadron. We combine three multivariate techniques
optimized for the t-channel process to measure the t- and s-channel cross
sections simultaneously. We measure cross sections of 3.14 +0.94 -0.80 pb for
the t-channel and 1.05 +-0.81 pb for the s-channel. The measured t-channel
result is found to have a significance of 4.8 standard deviations and is
consistent with the standard model prediction.Comment: 7 pages, 6 figure
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