Small high-temperature nuclear reactors for space power

Criticality calculations for small, cylindrical, lithium cooled reactors for space power system

Adapting Boot Camp Translation Methods to Engage Clinician/Patient Research Teams Within Practice-Based Research Networks

Purpose: Boot camp translation is a proven process to engage community members and health professionals in translating and disseminating evidence-based “best practices” models for health prevention and chronic illness care. Primary care practice improvement studies, particularly involving patient-driven change, as seen with self-management support (SMS), require engaged practice teams that include patients. Models of engagement such as boot camp translation may be effective. Methods: Four geographically dispersed practice-based research networks (PBRNs) from the Meta-LARC consortium engaged 16 practices to form SMS implementation teams involving a clinician, care manager, and 2 patients in each team. Our study adapted the boot camp translation model to engage the implementation teams in describing patient SMS, studying the Agency for Healthcare Research and Quality’s SMS Resource Library, and adapting and implementing self-management tools at each practice site. Testimonials and quotes were collected across the 4 PBRNs through a facilitated brainstorming discussion and consensus model at each PBRN kickoff meeting to address the focused question, “What do patients want and need in order to self-manage their chronic illnesses?” Results: Testimonials collected across the 4 PBRNs and participation levels indicated there was a high degree of engagement in the boot camp translation process across the PBRNs and the practices. Each PBRN developed themes expressed by patients and the practices regarding what patients want and need to self-manage their illnesses. Each practice selected, adapted, and implemented an SMS tool. Conclusions: Results suggest that adapted boot camp translation was effective in guiding multiple practices to implement self-management support tools for the INSTTEPP trial. Additional study of the adapted boot camp translation process in practice quality improvement and practice redesign studies is needed

How to Translate Self-Management Support Tools Into Clinical Practice

Purpose: Patient self-management is an inevitable part of the work of being a patient, and self-management support (SMS) has become increasingly important in chronic disease management. However, the majority of SMS resources available in the Agency for Healthcare Research and Quality SMS Resource Library were developed without explicit collaboration between clinicians and patients. Methods: Translation of SMS tools derived from the library into primary care practices occurred utilizing boot camp translation in four different practice-based research networks (PBRNs). The typical model of boot camp translation was adapted for the purpose of the Implementing Networks’ Self-management Tools Through Engaging Patients and Practices (INSTTEPP) study to develop SMS tools for implementation in the participating practices. Clinicians, clinic staff members, and patients were involved throughout the translation process. Existing resources from the SMS library were reviewed and adapted by each boot camp translation group to create tools unique to the patients in each network. Results: There was no preexisting resource within the library that was deemed suitable for implementation without modification. Each network adapted tools from the SMS library to create different products. Common themes emerged from each network’s translation process that highlighted the importance of patient engagement in the translation process. Boot camp translation, in conjunction with PBRNs, can be implemented to adapt SMS tools for implementation in member practices. Conclusions: Boot camp translation with a combination of practices and patients can be implemented to facilitate a process of local adaptation that improves the local applicability of SMS tools in primary care clinics

Collaborative research between clinicians and researchers: a multiple case study of implementation

<p>Abstract</p> <p>Background</p> <p>Bottom-up, clinician-conceived and directed clinical intervention research, coupled with collaboration from researcher experts, is conceptually endorsed by the participatory research movement. This report presents the findings of an evaluation of a program in the Veterans Health Administration meant to encourage clinician-driven research by providing resources believed to be critical. The evaluation focused on the extent to which funded projects: maintained integrity to their original proposals; were methodologically rigorous; were characterized by collaboration between partners; and resulted in sustained clinical impact.</p> <p>Methods</p> <p>Researchers used quantitative (survey and archival) and qualitative (focus group) data to evaluate the implementation, evaluation, and sustainability of four clinical demonstration projects at four sites. Fourteen research center mentors and seventeen clinician researchers evaluated the level of collaboration using a six-dimensional model of participatory research.</p> <p>Results</p> <p>Results yielded mixed findings. Qualitative and quantitative data suggested that although the process was collaborative, clinicians' prior research experience was critical to the quality of the projects. Several challenges were common across sites, including subject recruitment, administrative support and logistics, and subsequent dissemination. Only one intervention achieved lasting clinical effect beyond the active project period. Qualitative analyses identified barriers and facilitators and suggested areas to improve sustainability.</p> <p>Conclusions</p> <p>Evaluation results suggest that this participatory research venture was successful in achieving clinician-directed collaboration, but did not produce sustainable interventions due to such implementation problems as lack of resources and administrative support.</p

Measurements of ϕ\phi meson production in relativistic heavy-ion collisions at RHIC

We present results for the measurement of $\phi$ meson production via its charged kaon decay channel $\phi \to K^+K^-$ in Au+Au collisions at $\sqrt{s_{_{NN}}}=62.4$, 130, and 200 GeV, and in $p+p$ and $d$+Au collisions at $\sqrt{s_{_{NN}}}=200$ GeV from the STAR experiment at the BNL Relativistic Heavy Ion Collider (RHIC). The midrapidity ($|y|<0.5$) $\phi$ meson transverse momentum ($p_{T}$) spectra in central Au+Au collisions are found to be well described by a single exponential distribution. On the other hand, the $p_{T}$ spectra from $p+p$, $d$+Au and peripheral Au+Au collisions show power-law tails at intermediate and high $p_{T}$ and are described better by Levy distributions. The constant $\phi/K^-$ yield ratio vs beam species, collision centrality and colliding energy is in contradiction with expectations from models having kaon coalescence as the dominant mechanism for $\phi$ production at RHIC. The $\Omega/\phi$ yield ratio as a function of $p_{T}$ is consistent with a model based on the recombination of thermal $s$ quarks up to $p_{T}\sim 4$ GeV/$c$, but disagrees at higher transverse momenta. The measured nuclear modification factor, $R_{dAu}$, for the $\phi$ meson increases above unity at intermediate $p_{T}$, similar to that for pions and protons, while $R_{AA}$ is suppressed due to the energy loss effect in central Au+Au collisions. Number of constituent quark scaling of both $R_{cp}$ and $v_{2}$ for the $\phi$ meson with respect to other hadrons in Au+Au collisions at $\sqrt{s_{_{NN}}}$=200 GeV at intermediate $p_{T}$ is observed. These observations support quark coalescence as being the dominant mechanism of hadronization in the intermediate $p_{T}$ region at RHIC.Comment: 22 pages, 21 figures, 4 table

Impact of a Boot Camp Translation Intervention on Self-Management Support in Primary Care

Purpose: Self-management support (SMS) is a pillar of the well-established chronic care model and a key component of improving outcomes for patients with chronic illnesses. The Implementing Networks’ Self-management Tools Through Engaging Patients and Practices (INSTTEPP) trial sought to determine whether a boot camp translation process could assist small to medium-sized primary care practices with care managers implement SMS tools. Methods: INSTTEPP used a stepped-wedge design across 16 practices from 4 practice-based research networks over 12 months. Each network completed a 2-month boot camp translation for creating SMS tools with 16 participants (2 patients, a clinician, and a care manager from each of 4 practices) and subsequent implementation. Outcome measures for patients were the Patient Activation Measure (PAM), self-rated health, and Patient Assessment of Chronic Illness Care (PACIC) process-of-care items at baseline, 1 and 2 months. Clinician Support for Patient Activation Measure (CS-PAM) and theory of planned behavior outcomes were assessed at 5 points over 10 months for clinicians and staff. Results: A total of 297 patients and 89 practice staff and clinicians completed surveys during the study. Over successive 2-month sampling periods, intervention patients experienced greater improvement in PACIC process of care and self-rated health compared to control patients (P 0.10 for all) were not significantly different. Conclusions: Significant effects on process of care and self-rated health are evidence that the boot camp translation intervention impacted SMS. A larger trial with a typical 6-month boot camp intervention may show significant effects on other outcomes

Growth of Long Range Forward-Backward Multiplicity Correlations with Centrality in Au+Au Collisions at sNN\sqrt{s_{NN}} = 200 GeV

Forward-backward multiplicity correlation strengths have been measured with the STAR detector for Au+Au and $\textit{p+p}$ collisions at $\sqrt{s_{NN}}$ = 200 GeV. Strong short and long range correlations (LRC) are seen in central Au+Au collisions. The magnitude of these correlations decrease with decreasing centrality until only short range correlations are observed in peripheral Au+Au collisions. Both the Dual Parton Model (DPM) and the Color Glass Condensate (CGC) predict the existence of the long range correlations. In the DPM the fluctuation in the number of elementary (parton) inelastic collisions produces the LRC. In the CGC longitudinal color flux tubes generate the LRC. The data is in qualitative agreement with the predictions from the DPM and indicates the presence of multiple parton interactions.Comment: 6 pages, 3 figures The abstract has been slightly modifie

Hadronic resonance production in dd+Au collisions at sNN\sqrt{s_{_{NN}}} = 200 GeV at RHIC

We present the first measurements of the $\rho(770)^0$, $K^*$(892), $\Delta$(1232)$^{++}$, $\Sigma$(1385), and $\Lambda$(1520) resonances in $d$+Au collisions at $\sqrt{s_{_{NN}}}$ = 200 GeV, reconstructed via their hadronic decay channels using the STAR detector at RHIC. The masses and widths of these resonances are studied as a function of transverse momentum ($p_T$). We observe that the resonance spectra follow a generalized scaling law with the transverse mass ($m_T$). The $$of resonances in minimum bias collisions is compared to the$$ of $\pi$, $K$, and $\bar{p}$. The $\rho^0/\pi^-$, $K^*/K^-$, $\Delta^{++}/p$, $\Sigma(1385)/\Lambda$, and $\Lambda(1520)/\Lambda$ ratios in $d$+Au collisions are compared to the measurements in minimum bias $p+p$ interactions, where we observe that both measurements are comparable. The nuclear modification factors ($R_{dAu}$) of the $\rho^0$, $K^*$, and $\Sigma^*$ scale with the number of binary collisions ($N_{bin}$) for $p_T >$ 1.2 GeV/$c$.Comment: STAR Collaboration. Submitted to PR

Measurements of D0D^{0} and D∗D^{*} Production in pp + pp Collisions at s\sqrt{s} = 200 GeV

We report measurements of charmed-hadron ($D^{0}$, $D^{*}$) production cross sections at mid-rapidity in $p$ + $p$ collisions at a center-of-mass energy of 200 GeV by the STAR experiment. Charmed hadrons were reconstructed via the hadronic decays $D^{0}\rightarrow K^{-}\pi^{+}$, $D^{*+}\rightarrow D^{0}\pi^{+}\rightarrow K^{-}\pi^{+}\pi^{+}$ and their charge conjugates, covering the $p_T$ range of 0.6$-$2.0 GeV/$c$ and 2.0$-$6.0 GeV/$c$ for $D^{0}$ and $D^{*+}$, respectively. From this analysis, the charm-pair production cross section at mid-rapidity is $d\sigma/dy|_{y=0}^{c\bar{c}}$ = 170 $\pm$ 45 (stat.) $^{+38}_{-59}$ (sys.) $\mu$b. The extracted charm-pair cross section is compared to perturbative QCD calculations. The transverse momentum differential cross section is found to be consistent with the upper bound of a Fixed-Order Next-to-Leading Logarithm calculation.Comment: 15 pages, 16 figures. Revised version submitted to Phys. Rev.