120 research outputs found
Efficient operator-coarsening multigrid schemes for local discontinuous Galerkin methods
An efficient -multigrid scheme is presented for local discontinuous
Galerkin (LDG) discretizations of elliptic problems, formulated around the idea
of separately coarsening the underlying discrete gradient and divergence
operators. We show that traditional multigrid coarsening of the primal
formulation leads to poor and suboptimal multigrid performance, whereas
coarsening of the flux formulation leads to optimal convergence and is
equivalent to a purely geometric multigrid method. The resulting
operator-coarsening schemes do not require the entire mesh hierarchy to be
explicitly built, thereby obviating the need to compute quadrature rules,
lifting operators, and other mesh-related quantities on coarse meshes. We show
that good multigrid convergence rates are achieved in a variety of numerical
tests on 2D and 3D uniform and adaptive Cartesian grids, as well as for curved
domains using implicitly defined meshes and for multi-phase elliptic interface
problems with complex geometry. Extension to non-LDG discretizations is briefly
discussed
Looking Beyond the Present:The Historical Dynamics of Adivasi (Indigenous and Tribal) Assertions in India
This essay is organized into two parts that describe some of the important conceptual, historical and representational issues that relate to Adivasi assertion. The first part, 'Adivasis' as 'Indigenous and Tribal Peoples', summarizes the key conceptual and semantic debates that have enabled Adivasis to assert themselves as Indigenous peoples internationally and nationally. This paves the way for a fuller engagement with the topic of Reinterpreting Adivasi History. Here I reflect upon a statement made about 'looking beyond the present' by Shibu Soren, a leading Santal politician, to question how and why movements led by Adivasi freedom-fighters sustain discourses of indigeneity in postcolonial India. The second part, on the ICITP (Indian Confederation of Indigenous and Tribal Peoples), links up the previous strands, to assess how this indigenist organization has developed a reading of Indigenous rights as relating to history, in a range of representational contexts
Looking Beyond the Present:The Historical Dynamics of Adivasi (Indigenous and Tribal) Assertions in India, Part 2
This essay is organized into two parts that describe some of the important conceptual, historical and representational issues that relate to Adivasi assertion. The first part, 'Adivasis' as 'Indigenous and Tribal Peoples', summarizes the key conceptual and semantic debates that have enabled Adivasis to assert themselves as Indigenous peoples internationally and nationally. This paves the way for a fuller engagement with the topic of Reinterpreting Adivasi History. Here I reflect upon a statement made about 'looking beyond the present' by Shibu Soren, a leading Santal politician, to question how and why movements led by Adivasi freedom-fighters sustain discourses of indigeneity in postcolonial India. The second part, on the ICITP (Indian Confederation of Indigenous and Tribal Peoples), links up the previous strands, to assess how this indigenist organization has developed a reading of Indigenous rights as relating to history, in a range of representational contexts
Multicellular Architecture of Malignant Breast Epithelia Influences Mechanics
Cellāmatrix and cellācell mechanosensing are important in many cellular processes, particularly for epithelial cells. A crucial question, which remains unexplored, is how the mechanical microenvironment is altered as a result of changes to multicellular tissue structure during cancer progression. In this study, we investigated the influence of the multicellular tissue architecture on mechanical properties of the epithelial component of the mammary acinus. Using creep compression tests on multicellular breast epithelial structures, we found that pre-malignant acini with no lumen (MCF10AT) were significantly stiffer than normal hollow acini (MCF10A) by 60%. This difference depended on structural changes in the pre-malignant acini, as neither single cells nor normal multicellular acini tested before lumen formation exhibited these differences. To understand these differences, we simulated the deformation of the acini with different multicellular architectures and calculated their mechanical properties; our results suggest that lumen filling alone can explain the experimentally observed stiffness increase. We also simulated a single contracting cell in different multicellular architectures and found that lumen filling led to a 20% increase in the āperceived stiffnessā of a single contracting cell independent of any changes to matrix mechanics. Our results suggest that lumen filling in carcinogenesis alters the mechanical microenvironment in multicellular epithelial structures, a phenotype that may cause downstream disruptions to mechanosensing
Using creative co-design to develop a decision support tool for people with malignant pleural effusion
Abstract: Background: Malignant pleural effusion (MPE) is a common, serious problem predominantly seen in metastatic lung and breast cancer and malignant pleural mesothelioma. Recurrence of malignant pleural effusion is common, and symptoms significantly impair peopleās daily lives. Numerous treatment options exist, yet choosing the most suitable depends on many factors and making decisions can be challenging in pressured, time-sensitive clinical environments. Clinicians identified a need to develop a decision support tool. This paper reports the process of co-producing an initial prototype tool. Methods: Creative co-design methods were used. Three pleural teams from three disparate clinical sites in the UK were involved. To overcome the geographical distance between sites and the ill-health of service users, novel distributed methods of creative co-design were used. Local workshops were designed and structured, including video clips of activities. These were run on each site with clinicians, patients and carers. A joint national workshop was then conducted with representatives from all stakeholder groups to consider the findings and outputs from local meetings. The design team worked with participants to develop outputs, including patient timelines and personas. These were used as the basis to develop and test prototype ideas. Results: Key messages from the workshops informed prototype development. These messages were as follows. Understanding and managing the pleural effusion was the priority for patients, not their overall cancer journey. Preferred methods for receiving information were varied but visual and graphic approaches were favoured. The main influences on peopleās decisions about their MPE treatment were personal aspects of their lives, for example, how active they are, what support they have at home. The findings informed the development of a first prototype/service visualisation (a video representing a web-based support tool) to help people identify personal priorities and to guide shared treatment decisions. Conclusion: The creative design methods and distributed model used in this project overcame many of the barriers to traditional co-production methods such as power, language and time. They allowed specialist pleural teams and service users to work together to create a patient-facing decision support tool owned by those who will use it and ready for implementation and evaluation
Pharmacokinetic Characteristics, Pharmacodynamic Effect and In Vivo Antiviral Efficacy of Liver-Targeted Interferon Alpha
Work carried out by JM was funded by the
National Institutes of Health (NIH). NIH contract
number is HHSN272201000039I/HHSN27200001/
A19
Qualitative study on the implementation of professional pharmacy services in Australian community pharmacies using framework analysis
Abbreviations: BCT, Behavioural change techniques taxonomy; BCW, Behavioural change wheel; CFIR, Consolidated
framework for implementation research; EPOC, Cochrane effective practice and organisation of care; FISpH, Framework
for the implementation of services in pharmacy; GIF, Generic implementation framework; KPI, Key performance
indicator; TDF, Theoretical domains frameworkBackground: Multiple studies have explored the implementation process and influences, however it appears there
is no study investigating these influences across the stages of implementation. Community pharmacy is attempting
to implement professional services (pharmaceutical care and other health services). The use of implementation
theory may assist the achievement of widespread provision, support and integration. The objective was to investigate
professional service implementation in community pharmacy to contextualise and advance the concepts of a generic
implementation framework previously published.
Methods: Purposeful sampling was used to investigate implementation across a range of levels of implementation in
community pharmacies in Australia. Twenty-five semi-structured interviews were conducted and analysed using a
framework methodology. Data was charted using implementation stages as overarching themes and each stage
was thematically analysed, to investigate the implementation process, the influences and their relationships. Secondary
analyses were performed of the factors (barriers and facilitators) using an adapted version of the Consolidated
Framework for Implementation Research (CFIR), and implementation strategies and interventions, using the
Expert Recommendations for Implementing Change (ERIC) discrete implementation strategy compilation.
Results: Six stages emerged, labelled as development or discovery, exploration, preparation, testing, operation
and sustainability. Within the stages, a range of implementation activities/steps and five overarching influences
(pharmacys' direction and impetus, internal communication, staffing, community fit and support) were identified.
The stages and activities were not applied strictly in a linear fashion. There was a trend towards the greater the
number of activities considered, the greater the apparent integration into the pharmacy organization. Implementation
factors varied over the implementation stages, and additional factors were added to the CFIR list and definitions
modified/contextualised for pharmacy. Implementation strategies employed by pharmacies varied widely.
Evaluations were lacking. Conclusions: The process of implementation and five overarching influences of professional services implementation
in community pharmacy have been outlined. Framework analysis revealed, outside of the five overarching influences,
factors influencing implementation varied across the implementation stages. It is proposed at each stage, for
each domain, the factors, strategies and evaluations should be considered. The Framework for the Implementation of
Services in Pharmacy incorporates the contextualisation of implementation science for pharmacy.The study was funded as part of a University of Technology Sydney (UTS)
Research Excellence Scholarship (RES), comprising of an Australian Postgraduate
Award (APA) Scholarship funded by the Australian Government, plus a Top-up
funded by the University of Technology Sydney, received from the primary
author (JCM)
'Collective Making' as knowledge mobilisation: the contribution of participatory design in the co-creation of knowledge in healthcare
The discourse in healthcare Knowledge Mobilisation (KMb) literature has shifted from simple, linear
models of research knowledge production and action to more iterative and complex models. These
aim to blend multiple stakeholdersā knowledge with research knowledge to address the researchpractice
gap. It has been suggested there is no 'magic bullet', but that a promising approach to take is
knowledge co-creation in healthcare, particularly if a number of principles are applied. These include
systems thinking, positioning research as a creative enterprise with human experience at its core, and
paying attention to process within the partnership. This discussion paper builds on this proposition
and extends it beyond knowledge co-creation to co-designing evidenced based interventions and
implementing them. Within a co-design model, we offer a specific approach to share, mobilise and
activate knowledge, that we have termed 'collective making'. We draw on KMb, design, wider
literature, and our experiences to describe how this framework supports and extends the principles of
co-creation offered by Geenhalgh et al[1] in the context of the state of the art of knowledge
mobilisation. We describe how collective making creates the right āconditionsā for knowledge to be
mobilised particularly addressing issues relating to stakeholder relationships, helps to discover, share
and blend different forms of knowledge from different stakeholders, and puts this blended
knowledge to practical use allowing stakeholders to learn about the practical implications of
knowledge use and to collectively create actionable products. We suggest this collective making has
three domains of influence: on the participants; on the knowledge discovered and shared; and on the
mobilisation or activation of this knowledge
- ā¦