Soft systems methodology: a context within a 50-year retrospective of OR/MS

Soft systems methodology (SSM) has been used in the practice of operations research and management science OR/MS) since the early 1970s. In the 1990s, it emerged as a viable academic discipline. Unfortunately, its proponents consider SSM and traditional systems thinking to be mutually exclusive. Despite the differences claimed by SSM proponents between the two, they have been complementary. An extensive sampling of the OR/MS literature over its entire lifetime demonstrates the richness with which the non-SSM literature has been addressing the very same issues as does SSM

The Relationship Between Ambient Atmospheric Fine Particulate Matter (PM₂.₅) and Glaucoma in a Large Community Cohort

PURPOSE: Glaucoma is more common in urban populations than in others. Ninety percent of the world's population are exposed to air pollution above World Health Organization (WHO) recommended limits. Few studies have examined the association between air pollution and glaucoma. Questionnaire data, ophthalmic measures, and ambient residential area air quality data for 111,370 UK Biobank participants were analyzed. Particulate matter with an aerodynamic diameter < 2.5 μm (PM₂.₅) was selected as the air quality exposure of interest. Eye measures included self-reported glaucoma, intraocular pressure (IOP), and average thickness of macular ganglion cell–inner plexiform layer (GCIPL) across nine Early Treatment Diabetic Retinopathy Study (ETDRS) retinal subfields as obtained from spectral-domain optical coherence tomography. We examined the associations of PM₂.₅ concentration with self-reported glaucoma, IOP, and GCIPL. RESULTS: Participants resident in areas with higher PM₂.₅ concentration were more likely to report a diagnosis of glaucoma (odds ratio = 1.06, 95% confidence interval [CI] = 1.01–1.12, per interquartile range [IQR] increase P = 0.02). Higher PM₂.₅ concentration was also associated with thinner GCIPL (β = −0.56 μm, 95% CI = −0.63 to −0.49, per IQR increase, P = 1.2 × 10^{-53}). A dose–response relationship was observed between higher levels of PM₂.₅ and thinner GCIPL (P < 0.001). There was no clinically relevant relationship between PM₂.₅ concentration and IOP. CONCLUSIONS: Greater exposure to PM₂.₅ is associated with both self-reported glaucoma and adverse structural characteristics of the disease. The absence of an association between PM₂.₅ and IOP suggests the relationship may occur through a non–pressure-dependent mechanism, possibly neurotoxic and/or vascular effects

Health effects of omega-3,6,9 fatty acids: Perilla frutescens is a good example of plant oils

Perilla frutescens seeds are a good source of polyunsaturated fatty acids (PUFAs). The seeds of perilla are small end globular weight about 4 g/1000, contained approximately 35–45% oil. However the leaves are a very poor source of oil, since they contain only 0.2%. In addition, only the seed oil contains the omega 3 fatty acid alpha-linolenic acid (ALA). In comparing to other plant oils, perilla seed oil consistently contains the one of the highest proportion of omega-3 (ALA) fatty acids, at 54–64%. The omega-6 (linoleic acid) component is usually around 14% and omega-9 (Oleic acid) is also present in perilla oil. These polyunsaturated fatty acids are most beneficial to human health and in prevention of different diseases like cardiovascular disorders, cancer, inflammatory, rheumatoid arthritis etc

Synthesis, Characterization and Magnetic Susceptibility of the Heavy Fermion Transition Metal Oxide LiV_{2}O_{4}

The preparative method, characterization and magnetic susceptibility \chi measurements versus temperature T of the heavy fermion transition metal oxide LiV_{2}O_{4} are reported in detail. The intrinsic \chi(T) shows a nearly T-independent behavior below ~ 30 K with a shallow broad maximum at about 16 K, whereas Curie-Weiss-like behavior is observed above 50-100 K. Field-cooled and zero-field-cooled magnetization M measurements in applied magnetic fields H = 10 to 100 G from 1.8 to 50 K showed no evidence for spin-glass ordering. Crystalline electric field theory for an assumed cubic V point group symmetry is found insufficient to describe the observed temperature variation of the effective magnetic moment. The Kondo and Coqblin-Schrieffer models do not describe the magnitude and T dependence of \chi with realistic parameters. In the high T range, fits of \chi(T) by the predictions of high temperature series expansion calculations provide estimates of the V-V antiferromagnetic exchange coupling constant J/k_{B} ~ 20 K, g-factor g ~ 2 and the T-independent susceptibility. Other possible models to describe the \chi(T) are discussed. The paramagnetic impurities in the samples were characterized using isothermal M(H) measurements with 0 < H <= 5.5 Tesla at 2 to 6 K. These impurities are inferred to have spin S_{imp} ~ 3/2 to 4, g_{imp} ~ 2 and molar concentrations of 0.01 to 0.8 %, depending on the sample.Comment: 19 typeset RevTeX pages, 16 eps figures included, uses epsf; to be published in Phys. Rev.

The power of practice: simulation training improving the quality of neonatal resuscitation skills in Bihar, India.

BACKGROUND: Globally, neonatal mortality accounts for nearly half of under-five mortality, and intrapartum related events are a leading cause. Despite the rise in neonatal resuscitation (NR) training programs in low- and middle-income countries, their impact on the quality of NR skills amongst providers with limited formal medical education, particularly those working in rural primary health centers (PHCs), remains incompletely understood. METHODS: This study evaluates the impact of PRONTO International simulation training on the quality of NR skills in simulated resuscitations and live deliveries in rural PHCs throughout Bihar, India. Further, it explores barriers to performance of key NR skills. PRONTO training was conducted within CARE India's AMANAT intervention, a maternal and child health quality improvement project. Performance in simulations was evaluated using video-recorded assessment simulations at weeks 4 and 8 of training. Performance in live deliveries was evaluated in real time using a mobile-phone application. Barriers were explored through semi-structured interviews with simulation facilitators. RESULTS: In total, 1342 nurses participated in PRONTO training and 226 NR assessment simulations were matched by PHC and evaluated. From week 4 to 8 of training, proper neck extension, positive pressure ventilation (PPV) with chest rise, and assessment of heart rate increased by 14%, 19%, and 12% respectively (all p ≤ 0.01). No difference was noted in stimulation, suction, proper PPV rate, or time to completion of key steps. In 252 live deliveries, identification of non-vigorous neonates, use of suction, and use of PPV increased by 21%, 25%, and 23% respectively (all p < 0.01) between weeks 1-3 and 4-8. Eighteen interviews revealed individual, logistical, and cultural barriers to key NR skills. CONCLUSION: PRONTO simulation training had a positive impact on the quality of key skills in simulated and live resuscitations throughout Bihar. Nevertheless, there is need for ongoing improvement that will likely require both further clinical training and addressing barriers that go beyond the scope of such training. In settings where clinical outcome data is unreliable, data triangulation, the process of synthesizing multiple data sources to generate a better-informed evaluation, offers a powerful tool for guiding this process

Effectiveness of Air Filters and Air Cleaners in Allergic Respiratory Diseases: A Review of the Recent Literature

Air filtration is frequently recommended as a component of environmental control measures for patients with allergic respiratory disease. Residential air filtration can be provided by whole house filtration via the home’s heating, ventilation, or air conditioning system, by portable room air cleaners, or a combination of the two. Appliances to filter the sleep breathing zone also have been developed. High-efficiency whole house filtration, high-efficiency particulate air sleep zone air filtration, and high-efficiency particulate air room air cleaners all appear to provide various degrees of benefit. Recent studies of various types of filtration, used alone or as part of more comprehensive environmental control measures, are reviewed