The ConStratO model of handover: a tool to support technology design and evaluation

Handovers are a specific kind of multidisciplinary team meeting. Shift handovers and transfers are both regular features of hospital work but there is currently great variation in how such handovers are conducted, presenting a challenging for those seeking to develop technology to support handover. This paper presents the ConStratO model of handover, which captures aspects of the context that influence how the handover is conducted, a range of different handover strategies relating to different aspects of the handover, and possible outcomes of handover. The model is based on detailed data collection in a range of clinical settings. We present the model as a tool for developing and evaluating technology support for handover

OH rotational lines as a diagnostic of the warm neutral gas in galaxies

We present Infrared Space Observatory (ISO) observations of several OH, CH and H2O rotational lines toward the bright infrared galaxies NGC253 and NGC1068. As found in the Galactic clouds in SgrB2 and Orion, the extragalactic far-IR OH lines change from absorption to emission depending on the physical conditions and distribution of gas and dust along the line of sight. As a result, most of the OH rotational lines that appear in absorption toward NGC253 are observed in emission toward NGC1068. We show that the far-IR spectrum of OH can be used as a powerful diagnostic to derive the physical conditions of extragalactic neutral gas. In particular, we find that a warm (Tk~150 K, n(H2)< 5 10^4 cm^-3) component of molecular gas with an OH abundance of 10^{-7} from the inner <15'' can qualitatively reproduce the OH lines toward NGC253. Similar temperatures but higher densities (5 10^5 cm^-3) are required to explain the OH emission in NGC1068.Comment: 5 pages, 4 figures, accepted in ApJ Part I (2004, October 6

Shared visiting in Equator city

In this paper we describe an infrastructure and prototype system for sharing of visiting experiences across multiple media. The prototype supports synchronous co-visiting by physical and digital visitors, with digital access via either the World Wide Web or 3-dimensional graphics

Chamber basis of the Orlik-Solomon algebra and Aomoto complex

We introduce a basis of the Orlik-Solomon algebra labeled by chambers, so called chamber basis. We consider structure constants of the Orlik-Solomon algebra with respect to the chamber basis and prove that these structure constants recover D. Cohen's minimal complex from the Aomoto complex.Comment: 16 page

Temporal differences in gamma-hydroxybutyrate overdoses involving injecting drug users versus recreational drug users in Helsinki : a retrospective study

Peer reviewe

Phenotypic marker expression during fetal and neonatal differentiation of rat tracheal epithelial cells.

The expression of phenotypic markers was examined during fetal and neonatal differentiation of rat tracheal epithelial (RTE) cells. The rat counterpart of human keratin 18 was predominantly found in columnar cells in the adult trachea. It was detected in the primordial tracheal epithelium first seen on gestational day (GD) 12 (term = 21.5 days). Staining intensity gradually increased, and by GD 17 it was principally localized to the apical portion of the epithelium. The rat counterpart of human keratin 19 was barely detectable in the trachea on GD 13 but became abundant in almost all RTE cells on and after GD 19. Morphologically and immunocytochemically identifiable secretory and ciliated cells appeared on GD 18. Ciliated cell number slowly rose while secretory cells increased dramatically on GD 19 through postnatal day 1. The secretory granule antigens detected by monoclonal antibodies RTE 9 and 11 were rare in the adult trachea but were highly expressed in virtually all of the perinatal secretory cells. In contrast, the epitope detected by monoclonal antibody RTE 12, which was present in all adult tracheal surface secretory cells, did not appear until postnatal day 1 and slowly increased. These results demonstrate marked shifts in the biochemical composition of secretory cells during development and postnatal maturation. For the above-mentioned molecules, a similar expression pattern was observed during epithelial regeneration in tracheal grafts (Am. J. Respir. Cell Mol. Biol. 1992; 7:30-41). Pseudo-stratification of the epithelium and basal cells was first observed on GD 20. Keratin 14, which is confined to basal cells in the normal adult trachea, was not present in the nascent basal cells but appeared after postnatal day 1. In contrast to the present results, during epithelial regeneration in tracheal grafts keratin 14 appeared before markers of highly differentiated secretory or ciliated cells. Thus, the biochemical sequence of cellular differentiation during regeneration did not precisely recapitulate development

Effect of display resolution on time to diagnosis with virtual pathology slides in a systematic search task

Performing diagnoses using virtual slides can take pathologists significantly longer than with glass slides, presenting a significant barrier to the use of virtual slides in routine practice. Given the benefits in pathology workflow efficiency and safety that virtual slides promise, it is important to understand reasons for this difference and identify opportunities for improvement. The effect of display resolution on time to diagnosis with virtual slides has not previously been explored. The aim of this study was to assess the effect of display resolution on time to diagnosis with virtual slides. Nine pathologists participated in a counterbalanced crossover study, viewing axillary lymph node slides on a microscope, a 23-in 2.3-megapixel single-screen display and a three-screen 11-megapixel display consisting of three 27-in displays. Time to diagnosis and time to first target were faster on the microscope than on the single and three-screen displays. There was no significant difference between the microscope and the three-screen display in time to first target, while the time taken on the single-screen display was significantly higher than that on the microscope. The results suggest that a digital pathology workstation with an increased number of pixels may make it easier to identify where cancer is located in the initial slide overview, enabling quick location of diagnostically relevant regions of interest. However, when a comprehensive, detailed search of a slide has to be made, increased resolution may not offer any additional benefit

Vp/Vs ratios in the Parnaíba Basin from joint active-passive seismic analysis – Implications for continental amalgamation and basin formation

Acknowledgements The authors thank Jordi Julià and two anonymous reviewers for valuable comments on an earlier version of the manuscript. Thanks to the PBAP program for the availability of WARR, DSR and teleseismic three-component data (Project 5547: BP ENERGY/FUB/FINATEC— PARNAÍBA BASIN REFRACTION EXPERIMENT). RAF thanks CNPq and INCT Estudos Tectônicos (CNPq, CAPES, FAP-DF) for research fellowship and funds. *The data that support the findings of this study may be available from the authors upon reasonable request.Peer reviewedPublisher PD

The Effect of 53 micron IR Radiation on 18 cm OH Megamaser Emission

OH megamasers (OHMs) emit primarily in the main lines at 1667 and 1665 MHz, and differ from their Galactic counterparts due to their immense luminosities, large linewidths and 1667/1665 MHz flux ratios, which are always greater than one. We find that these maser properties result from strong 53 micron radiative pumping combined with line overlap effects caused by turbulent linewidths of about 20 km/s; pumping calculations that do not include line overlap are unreliable. A minimum dust temperature of about 45 K is needed for inversion, and maximum maser efficiency occurs for dust temperatures in the range 80 - 140 K. We find that warmer dust can support inversion at lower IR luminosities, in agreement with observations. Our results are in good agreement with a clumpy model of OHMs, with clouds sizes about 1 pc and OH column densities about 5e16 cm^2, that is able to explain both the diffuse and compact emission observed for OHMs. We suggest that all OH main line masers may be pumped by far-IR radiation, with the major differences between OHMs and Galactic OH masers caused by differences in linewidth produced by line overlap. Small Galactic maser linewidths tend to produce stronger 1665 MHz emission. The large OHM linewidths lead to inverted ground state transitions having approximately the same excitation temperature, producing 1667/1665 MHz flux ratios greater than one and weak satellite line emission. Finally, the small observed ratio of pumping radiation to dense molecular gas, as traced by HCN and HCO$^+$, is a possible reason for the lack of OH megamaser emission in NGC 6240.Comment: Accepted to ApJ, 26 pages including 1 table and 7 figure

Evaluation of provider documentation of medication management in a Patient-Centered Medical Home (PCMH)

Purpose: The National Committee for Quality Assurance (NCQA) has standards for recognizing Patient-Centered Medical Homes (PCMH) including one for medication management. Study objectives were to identify if and how providers within a PCMH recognized under the 2008 guidelines were documenting components of medication management to meet NCQA’s 2011 requirements including: 1) providing information about new prescriptions to >80% of patients; 2) assessing understanding of medications for >50% of patients; and 3) assessing response and barriers to medication adherence for >50% of patients. Methods: Physician and pharmacist-led patient visits from a family medicine office, from February 1 to August 1, 2012 were assessed. Patients over 18 years old taking at least one medication were included. A retrospective chart review was performed to assess documented components of medication management. Descriptive statistics were used to analyze data. Results: A systematic sampling of 450 physician-led and 195 pharmacist-led patient visits, demonstrated providers did not meet documentation goals for providing patients information on new prescriptions (65% pharmacist, 24% physician, 36% of total provider notes) or for assessment of patients’ understanding of medications (9% pharmacist 12% physician, 11% of total provider notes). Individually each type of provider did not meet the goal of assessing patient response and barriers to adherence to medication, but with combined intervention by the pharmacists and the physicians, the site was able to surpass NCQA’s percentage goal (57% and 58%). Conclusions: No components of medication management are well documented. Using the electronic medical record, pharmacists may be able to develop documentation tools and assist sites to meet NCQA’s goals for medication management