2,293 research outputs found
Coexisting Values in Healthcare and the Leadership Practices That Were Found to Inspire Followership Among Healthcare Practitioners
Healthcare delivery in the United States has a storied history that has led the American public to expect that their Health Care Practitioners (HCPs) will personally and professionally enact values such as altruism, benevolence, equality, and capability. A progressive set of events that involves the implementation of the market-based solution in the Patient Protection and Affordable Care Act has led healthcare organizations to become increasingly concerned with a conceptually different set of values. It has become more necessary for healthcare organizations to dedicate attention to market values (e.g., competition; productivity) as they operate in an environment that is commonly described as a $3.3T industry. There is significant concern that important care values are being sacrificed as the U.S. health system becomes increasingly commercialized. It is also believed that HCPs are experiencing increasing levels of demoralization and burnout as a result of their inability to realize their personal and professional care value preferences. A qualitative investigation into the experiences of a selection of HCPs served to reveal how the administration in a large health system fosters compatibility among personal, professional, and market value priorities via an application of the tenets of values-based leadership. Study outcomes also feature implications for both the servant leadership and transformational leadership constructs
Analytic Calculation of 1-Jettiness in DIS at
We present an analytic calculation of cross sections
in deep inelastic scattering (DIS) dependent on an event shape, 1-jettiness,
that probes final states with one jet plus initial state radiation. This is the
first entirely analytic calculation for a DIS event shape cross section at this
order. We present results for the differential and cumulative 1-jettiness cross
sections, and express both in terms of structure functions dependent not only
on the usual DIS variables , but also on the 1-jettiness .
Combined with previous results for log resummation, predictions are obtained
over the entire range of the 1-jettiness distribution.Comment: 40 pages, 8 figure
Coexisting Values in Healthcare and the Leadership Practices That Were Found to Inspire Followership Among Healthcare Practitioners
Healthcare delivery in the United States has a storied history that has led the American public to expect that their Health Care Practitioners (HCPs) will personally and professionally enact values such as altruism, benevolence, equality, and capability. A progressive set of events that involves the implementation of the market-based solution in the Patient Protection and Affordable Care Act has led healthcare organizations to become increasingly concerned with a conceptually different set of values. It has become more necessary for healthcare organizations to dedicate attention to market values (e.g., competition; productivity) as they operate in an environment that is commonly described as a $3.3T industry. There is significant concern that important care values are being sacrificed as the U.S. health system becomes increasingly commercialized. It is also believed that HCPs are experiencing increasing levels of demoralization and burnout as a result of their inability to realize their personal and professional care value preferences. A qualitative investigation into the experiences of a selection of HCPs served to reveal how the administration in a large health system fosters compatibility among personal, professional, and market value priorities via an application of the tenets of values-based leadership. Study outcomes also feature implications for both the servant leadership and transformational leadership constructs
Adaptive grid methods for Q-tensor theory of liquid crystals : a one-dimensional feasibility study
This paper illustrates the use of moving mesh methods for solving partial differential equation (PDE) problems in Q-tensor theory of liquid crystals. We present the results of an initial study using a simple one-dimensional test problem which illustrates the feasibility of applying adaptive grid techniques in such situations. We describe how the grids are computed using an equidistribution principle, and investigate the comparative accuracy of adaptive and uniform grid strategies, both theoretically and via numerical examples
Hypertension in mice lacking 11beta-hydroxysteroid dehydrogenase type 2
Deficiency of 11β-hydroxysteroid dehydrogenase type 2 (11β-HSD2) in humans leads to the syndrome of apparent mineralocorticoid excess (SAME), in which cortisol illicitly occupies mineralocorticoid receptors, causing sodium retention, hypokalemia, and hypertension. However, the disorder is usually incompletely corrected by suppression of cortisol, suggesting additional and irreversible changes, perhaps in the kidney. To examine this further, we produced mice with targeted disruption of the 11β-HSD2 gene. Homozygous mutant mice (11β-HSD2(–/–)) appear normal at birth, but ∼50% show motor weakness and die within 48 hours. Both male and female survivors are fertile but exhibit hypokalemia, hypotonic polyuria, and apparent mineralocorticoid activity of corticosterone. Young adult 11β-HSD2(–/–) mice are markedly hypertensive, with a mean arterial blood pressure of 146 ± 2 mmHg, compared with 121 ± 2 mmHg in wild-type controls and 114 ± 4 mmHg in heterozygotes. The epithelium of the distal tubule of the nephron shows striking hypertrophy and hyperplasia. These histological changes do not readily reverse with mineralocorticoid receptor antagonism in adulthood. Thus, 11β-HSD2(–/–) mice demonstrate the major features of SAME, providing a unique rodent model to study the molecular mechanisms of kidney resetting leading to hypertension. J. Clin. Invest. 103:683–689 (1999
The MSR Mass and the Renormalon Sum Rule
We provide a detailed description and analysis of a low-scale short-distance
mass scheme, called the MSR mass, that is useful for high-precision top quark
mass determinations, but can be applied for any heavy quark . In contrast to
earlier low-scale short-distance mass schemes, the MSR scheme has a direct
connection to the well known mass commonly used for
high-energy applications, and is determined by heavy quark on-shell self-energy
Feynman diagrams. Indeed, the MSR mass scheme can be viewed as the simplest
extension of the mass concept to renormalization scales
. The MSR mass depends on a scale that can be chosen freely, and
its renormalization group evolution has a linear dependence on , which is
known as R-evolution. Using R-evolution for the MSR mass we provide details of
the derivation of an analytic expression for the normalization of the renormalon asymptotic behavior of the pole mass in
perturbation theory. This is referred to as the
renormalon sum rule, and can be applied to any perturbative series. The
relations of the MSR mass scheme to other low-scale short-distance masses are
analyzed as well.Comment: 42 pages + appendices, 6 figures, v2: Refs and Appendix B added,
Fig.3 changed from nl=4 to nl=5, v3: journal versio
Depression and Anxiety Screens as Predictors of 8-Year Incidence of Myocardial Infarction and Stroke in Primary Care Patients
Because depression and anxiety are typically studied in isolation, our purpose was to examine the relative importance of these overlapping emotional factors in predicting incident cardiovascular disease (CVD).
Methods
We examined depression and anxiety screens, and their individual items, as predictors of incident hard CVD events, myocardial infarction, and stroke over eight years in a diverse sample of 2,041 older primary care patients initially free of CVD. At baseline, participants completed self-report depression and anxiety screens. Data regarding CVD events were obtained from an electronic medical record system and the Centers for Medicare and Medicaid Services analytic files.
Results
During follow-up, 683 (33%) experienced a CVD event. Cox proportional hazards models – adjusted for demographic and CVD risk factors – revealed that a positive anxiety screen, but not a positive depression screen, was associated with an increased risk of a hard CVD event in separate models (Years 0–3: Anxiety HR=1.54, p<.001; Years 3+: Anxiety HR=0.99, p=.93; Depression HR=1.10, p=.41), as well as when entered into the same model (Years 0–3: Anxiety HR=1.53, p<.001; Years 3+: Anxiety HR=0.99, p=.99; Depression HR=1.03, p=.82). Analyses examining individual items and secondary outcomes showed that the anxiety-CVD association was largely driven by the feeling anxious item and the myocardial infarction outcome.
Conclusions
Anxiety, especially feeling anxious, is a unique risk factor for CVD events in older adults, independent of conventional risk factors and depression. Anxiety deserves increased attention as a potential factor relevant to CVD risk stratification and a potential target of CVD primary prevention efforts
Reply to : Accurate population proxies do not exist between 11.7 and 15 ka in North America
In a recent study we used a novel statistical approach to investigate whether Late Quaternary changes in North American megafauna populations correlated with changes in human population densities (as is predicted by most “overkill” hypotheses), climate change, or both. Following the design of a recent study by Broughton and Weitzel and using their datasets, we found no relationship between human and megafauna population levels. We did, however, find a significant positive relationship between megafauna population levels and climate change, suggesting that climate change played a key role in the demise of North America’s megafauna. Pelton et al. claim that the datasets and analyses used in our study are not “robust enough to support [our] conclusions.” We agree that the North American archaeological and palaeontological records are far from perfect—a point we emphasize in our article—and we welcome the opportunity here to clarify some of the points presented by Pelton and colleagues as well as provide additional analyses that support our original findings.peer-reviewe
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