Innovative approaches to generational instruction: Welcoming the NeXters via the Hybrid

Students currently entering highereducation were born between 1980-2000 and are often referred to asNeXters, Millennials, or Generation Y. An undergraduate nursing corecurriculum course was developed andimplemented using a constructivistpedagogy approach whichcharacterizes generationaldistinctiveness to optimize learningand student satisfaction

Thomas Jefferson Health System Medical Legal Partnership

Introduction: Medical-legal partnerships (MLPs) provide civil legal services in concert with healthcare services to mitigate complex social conditions with health-harming effects. Currently, there are 333 MLPs in 46 states. Thomas Jefferson Health System (TJHS) does not have a systemwide MLP. (Magee Rehabilitation Hospital does have an MLP used by qualifying Magee patients). This project sought to identify the core components of an MLP and to demonstrate the value an MLP would provide TJHS. Methods: Assessed existing literature. Interviewed an existing MLP director. Patients from the Jefferson Hospital Ambulatory Practice (JHAP) clinic completed a written survey regarding health-harming social-legal issues. Entered survey data into Excel and analyzed using descriptive statistics. Results: Six common core components of all MLPs were identified. Existing MLPs have demonstrated a reduction in readmission rates, decreased inpatient and emergency department visits, and recovery of payments for unreimbursed clinical services. Patients report improved health when unmet civil legal needs are addressed. Results of the JHAP clinic survey are pending, but preliminarily many patients appear to have social-legal issues. Conclusions: This project demonstrates that a TJHS MLP program could improve patient health and reduce overutilization of the health system. Over time the cost of the program would potentially be offset by the recovery of healthcare dollars. TJHS patients appear to have social-legal issues that negatively impact their health and could be addressed through legal remedies. Based on the analysis, an Opportunity Assessment was generated. Critical next steps are to draft a business plan and identify potential funding

On Inflation with Non-minimal Coupling

A simple realization of inflation consists of adding the following operators to the Einstein-Hilbert action: (partial phi)^2, lambda phi^4, and xi phi^2 R, with xi a large non-minimal coupling. Recently there has been much discussion as to whether such theories make sense quantum mechanically and if the inflaton phi can also be the Standard Model Higgs. In this note we answer these questions. Firstly, for a single scalar phi, we show that the quantum field theory is well behaved in the pure gravity and kinetic sectors, since the quantum generated corrections are small. However, the theory likely breaks down at ~ m_pl / xi due to scattering provided by the self-interacting potential lambda phi^4. Secondly, we show that the theory changes for multiple scalars phi with non-minimal coupling xi phi dot phi R, since this introduces qualitatively new interactions which manifestly generate large quantum corrections even in the gravity and kinetic sectors, spoiling the theory for energies > m_pl / xi. Since the Higgs doublet of the Standard Model includes the Higgs boson and 3 Goldstone bosons, it falls into the latter category and therefore its validity is manifestly spoiled. We show that these conclusions hold in both the Jordan and Einstein frames and describe an intuitive analogy in the form of the pion Lagrangian. We also examine the recent claim that curvature-squared inflation models fail quantum mechanically. Our work appears to go beyond the recent discussions.Comment: 14 pages, 2 figures. Version 2: Clarified findings and improved wording. Elaborated important sections and removed an unnecessary section. Added references. Version 3: Updated towards JHEP version. Version 4: Final JHEP versio

Inflation with Non-minimal Gravitational Couplings and Supergravity

We explore in the supergravity context the possibility that a Higgs scalar may drive inflation via a non-minimal coupling to gravity characterised by a large dimensionless coupling constant. We find that this scenario is not compatible with the MSSM, but that adding a singlet field (NMSSM, or a variant thereof) can very naturally give rise to slow-roll inflation. The inflaton is necessarily contained in the doublet Higgs sector and occurs in the D-flat direction of the two Higgs doublets.Comment: 13 pages, 1 figur

Vacuum stability, neutrinos, and dark matter

Motivated by the discovery hint of the Standard Model (SM) Higgs mass around 125 GeV at the LHC, we study the vacuum stability and perturbativity bounds on Higgs scalar of the SM extensions including neutrinos and dark matter (DM). Guided by the SM gauge symmetry and the minimal changes in the SM Higgs potential we consider two extensions of neutrino sector (Type-I and Type-III seesaw mechanisms) and DM sector (a real scalar singlet (darkon) and minimal dark matter (MDM)) respectively. The darkon contributes positively to the $\beta$ function of the Higgs quartic coupling $\lambda$ and can stabilize the SM vacuum up to high scale. Similar to the top quark in the SM we find the cause of instability is sensitive to the size of new Yukawa couplings between heavy neutrinos and Higgs boson, namely, the scale of seesaw mechanism. MDM and Type-III seesaw fermion triplet, two nontrivial representations of $SU(2)_{L}$ group, will bring the additional positive contributions to the gauge coupling $g_{2}$ renormalization group (RG) evolution and would also help to stabilize the electroweak vacuum up to high scale.Comment: 18 pages, 15 figures; published versio

Designing an automated clinical decision support system to match clinical practice guidelines for opioid therapy for chronic pain

Abstract Background Opioid prescribing for chronic pain is common and controversial, but recommended clinical practices are followed inconsistently in many clinical settings. Strategies for increasing adherence to clinical practice guideline recommendations are needed to increase effectiveness and reduce negative consequences of opioid prescribing in chronic pain patients. Methods Here we describe the process and outcomes of a project to operationalize the 2003 VA/DOD Clinical Practice Guideline for Opioid Therapy for Chronic Non-Cancer Pain into a computerized decision support system (DSS) to encourage good opioid prescribing practices during primary care visits. We based the DSS on the existing ATHENA-DSS. We used an iterative process of design, testing, and revision of the DSS by a diverse team including guideline authors, medical informatics experts, clinical content experts, and end-users to convert the written clinical practice guideline into a computable algorithm to generate patient-specific recommendations for care based upon existing information in the electronic medical record (EMR), and a set of clinical tools. Results The iterative revision process identified numerous and varied problems with the initially designed system despite diverse expert participation in the design process. The process of operationalizing the guideline identified areas in which the guideline was vague, left decisions to clinical judgment, or required clarification of detail to insure safe clinical implementation. The revisions led to workable solutions to problems, defined the limits of the DSS and its utility in clinical practice, improved integration into clinical workflow, and improved the clarity and accuracy of system recommendations and tools. Conclusions Use of this iterative process led to development of a multifunctional DSS that met the approval of the clinical practice guideline authors, content experts, and clinicians involved in testing. The process and experiences described provide a model for development of other DSSs that translate written guidelines into actionable, real-time clinical recommendations.http://deepblue.lib.umich.edu/bitstream/2027.42/78267/1/1748-5908-5-26.xmlhttp://deepblue.lib.umich.edu/bitstream/2027.42/78267/2/1748-5908-5-26.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/78267/3/1748-5908-5-26-S3.TIFFhttp://deepblue.lib.umich.edu/bitstream/2027.42/78267/4/1748-5908-5-26-S2.TIFFhttp://deepblue.lib.umich.edu/bitstream/2027.42/78267/5/1748-5908-5-26-S1.TIFFPeer Reviewe

Comprehensive Analysis of Market Conditions in the Foreign Exchange Market: Fluctuation Scaling and Variance-Covariance Matrix

We investigate quotation and transaction activities in the foreign exchange market for every week during the period of June 2007 to December 2010. A scaling relationship between the mean values of number of quotations (or number of transactions) for various currency pairs and the corresponding standard deviations holds for a majority of the weeks. However, the scaling breaks in some time intervals, which is related to the emergence of market shocks. There is a monotonous relationship between values of scaling indices and global averages of currency pair cross-correlations when both quantities are observed for various window lengths $\Delta t$.Comment: 13 pages, 10 figure

Vacuum Stability, Perturbativity, and Scalar Singlet Dark Matter

We analyze the one-loop vacuum stability and perturbativity bounds on a singlet extension of the Standard Model (SM) scalar sector containing a scalar dark matter candidate. We show that the presence of the singlet-doublet quartic interaction relaxes the vacuum stability lower bound on the SM Higgs mass as a function of the cutoff and lowers the corresponding upper bound based on perturbativity considerations. We also find that vacuum stability requirements may place a lower bound on the singlet dark matter mass for given singlet quartic self coupling, leading to restrictions on the parameter space consistent with the observed relic density. We argue that discovery of a light singlet scalar dark matter particle could provide indirect information on the singlet quartic self-coupling.Comment: 25 pages, 10 figures; v2 - fixed minor typos; v3 - added to text discussions of other references, changed coloring of figures for easier black and white viewin