Overcoming Challenges to Teamwork in Patient-Centered Medical Homes: A Qualitative Study

There is emerging consensus that enhanced inter-professional teamwork is necessary for the effective and efficient delivery of primary care, but there is less practical information specific to primary care available to guide practices on how to better work as teams. The purpose of this study was to describe how primary care practices have overcome challenges to providing team-based primary care and the implications for care delivery and policy

Electronic Health Records and Support For Primary Care Teamwork

This study examined primary care practices' experiences using electronic health records (EHRs) as they strive to function as teams in patientcentered medical homes (PCMHs). We identify how EHRs facilitate and pose challenges to teamwork and how practices overcame such challenges. We describe solutions and identify opportunities to improve care processes as well as EHR functionalities and policies, to support teamwork

A Stellar Model-fitting Pipeline for Solar-like Oscillations

Over the past two decades, helioseismology has revolutionized our understanding of the interior structure and dynamics of the Sun. Asteroseismology will soon place this knowledge into a broader context by providing structural data for hundreds of Sun-like stars. Solar-like oscillations have already been detected from the ground in several stars, and NASA's Kepler mission is poised to unleash a flood of stellar pulsation data. Deriving reliable asteroseismic information from these observations demands a significant improvement in our analysis methods. We report the initial results of our efforts to develop an objective stellar model-fitting pipeline for asteroseismic data. The cornerstone of our automated approach is an optimization method using a parallel genetic algorithm. We describe the details of the pipeline and we present the initial application to Sun-as-a-star data, yielding an optimal model that accurately reproduces the known solar properties.Comment: 5 pages, 2 figs, Stellar Pulsation: Challenges for Theory and Observation (proceedings to be published by AIP

Eliminating Discrimination and Enhancing Equality: A Case for Inclusive Basic Education Rights of Children with Albinism in Africa

Background: Various international treaties have acknowledged the rights of children to education; however, for millions of children, this right is just a dream, especially with a vulnerable group of children with physical challenges and other disabilities. Reports by the UN gives an estimate of a significantly large number of children who are yet to take advantage of good quality education. This article examines the plight of children with albinism who suffer discrimination both at the special and regular schools largely because the nature of their disability is not physical. Children with albinism have their right to education and in education limited by the difficulty to understand their impairment both at school and at home leading to entrenched discrimination and inequality, which ultimately erodes their human dignity. Methodology: This article adopts the desk research argues that the proper application of the concept of inclusive basic education of children with albinism will help eliminate discrimination and enhance equality of education of children with albinism. Conclusion: The article concludes that the existing legal framework abound, but proper implementation of article 24 of the Convention on the Rights of Persons with Disabilities will enhance the desired equality. Keywords: Albinism, children, inclusive education, persons with disabilities, righ

Numerical Arc Segmentation Algorithm for a Radio Conference (NASARC), version 4.0: User's manual

The information in the NASARC (Version 4.0) Technical Manual (NASA-TM-101453) and NASARC (Version 4.0) User's Manual (NASA-TM-101454) relates to the state of Numerical Arc Segmentation Algorithm for a Radio Conference (NASARC) software development through November 1, 1988. The Technical Manual describes the NASARC concept and the algorithms used to implement the concept. The User's Manual provides information on computer system considerations, installation instructions, description of input files, and program operation instructions. Significant revisions were incorporated in the Version 4.0 software over prior versions. These revisions have further enhanced the modeling capabilities of the NASARC procedure and provide improved arrangements of predetermined arcs within the geostationary orbit. Array dimensions within the software were structured to fit within the currently available 12-megabyte memory capacity of the International Frequency Registration Board (IFRB) computer facility. A piecewise approach to predetermined arc generation in NASARC (Version 4.) allows worldwide planning problem scenarios to be accommodated within computer run time and memory constraints with enhanced likelihood and ease of solution

Numerical Arc Segmentation Algorithm for a Radio Conference-NASARC (version 4.0) technical manual

The information contained in the NASARC (Version 4.0) Technical Manual and NASARC (Version 4.0) User's Manual relates to the Numerical Arc Segmentation Algorithm for a Radio Conference (NASARC) software development through November 1, 1988. The Technical Manual describes the NASARC concept and the algorithms used to implement the concept. The User's Manual provides information on computer system considerations, installation instructions, description of input files, and program operation instructions. Significant revisions were incorporated in the Version 4.0 software over prior versions. These revisions have further enhanced the modeling capabilities of the NASARC procedure and provide improved arrangements of predetermined arcs within the geostationary orbits. Array dimensions within the software were structured to fit within the currently available 12 megabyte memory capacity of the International Frequency Registration Board (IFRB) computer facility. A piecewise approach to predetermined arc generation in NASARC (Version 4.0) allows worldwide planning problem scenarios to be accommodated within computer run time and memory constraints with enhanced likelihood and ease of solution

Numerical arc segmentation algorithm for a radio conference-NASARC (version 2.0) technical manual

The information contained in the NASARC (Version 2.0) Technical Manual (NASA TM-100160) and NASARC (Version 2.0) User's Manual (NASA TM-100161) relates to the state of NASARC software development through October 16, 1987. The Technical Manual describes the Numerical Arc Segmentation Algorithm for a Radio Conference (NASARC) concept and the algorithms used to implement the concept. The User's Manual provides information on computer system considerations, installation instructions, description of input files, and program operating instructions. Significant revisions have been incorporated in the Version 2.0 software. These revisions have enhanced the modeling capabilities of the NASARC procedure while greatly reducing the computer run time and memory requirements. Array dimensions within the software have been structured to fit within the currently available 6-megabyte memory capacity of the International Frequency Registration Board (IFRB) computer facility. A piecewise approach to predetermined arc generation in NASARC (Version 2.0) allows worldwide scenarios to be accommodated within these memory constraints while at the same time effecting an overall reduction in computer run time

Recent Dissertations on Service and Service-Learning Topics

Rumor has it that there is very little research on service and service-leaming. A brief literature review of dissertations from 1990 onward revealed that over 110 studies have been completed on service and related topics. So much for the rumor! Our intent in performing this literature review is to identify academic studies that have been completed in the past several years on issues related to service-learning. Covering a variety of interest areas and related topics, the National Service-Learning Clearinghouse is initially interested in identifying studies that add to the knowledge base on service-learning. The collection of titles, authors, and abstract summaries presented here is designed simply to inform the field of the number and diversity of studies available. We make no claims about the accuracy, integrity, value or strength of each work. That decision is left to the reader. We provide only information about the studies and where and how they can be obtained. We encourage you to seek out the researchers identified and to contact them for more information about the nature and content of the studies. We anticipate that this compilation will be the first of several volumes on current dissertation work in American universities. We expect in future publications to actually review the material and make critical comments about the value of the contributions to the field of service-learning. We hope that by publishing this work we will encourage others who have completed studies or are designing and implementing dissertation research to contact us and share their projects with the Clearinghouse. We will do our best to make sure this information is circulated among and between service-learning professionals. As you review this document, please feel free to send your comments to the Clearinghouse or discuss the work on our listserv. Access to our website, listserv and the 800 number to the Clearinghouse are listed on the cover of this document. Your feedback will help us determine what materials to include in future editions

The parkinsonian mimetic, MPP+, specifically impairs mitochondrial transport in dopamine axons

Impaired axonal transport may play a key role in Parkinson’s disease. To test this notion, a microchamber system was adapted to segregate axons from cell bodies using green fluorescent protein-labeled mouse dopamine (DA) neurons. Transport was examined in axons challenged with the DA neurotoxin MPP(+). MPP(+) rapidly reduced overall mitochondrial motility in DA axons; among motile mitochondria, anterograde transport was slower yet retrograde transport was increased. Transport effects were specific for DA mitochondria, which were smaller and transported more slowly than their non-DA counterparts. MPP(+) did not affect synaptophysin-tagged vesicles or any other measureable moving particle. Toxin effects on DA mitochondria were not dependent upon ATP, calcium, free radical species, JNK, or caspase3/PKC pathways but were completely blocked by the thiol-anti-oxidant N-acetyl-cysteine or membrane-permeable glutathione. Since these drugs also rescued processes from degeneration, these findings emphasize the need to develop therapeutics aimed at axons as well as cell bodies to preserve “normal” circuitry and function as long as possible

Development of an Objective Structured Clinical Examination as a Component of Assessment for Initial Board Certification in Anesthesiology.

With its first administration of an Objective Structured Clinical Examination (OSCE) in 2018, the American Board of Anesthesiology (ABA) became the first US medical specialty certifying board to incorporate this type of assessment into its high-stakes certification examination system. The fundamental rationale for the ABA's introduction of the OSCE is to include an assessment that allows candidates for board certification to demonstrate what they actually "do" in domains relevant to clinical practice. Inherent in this rationale is that the OSCE will capture competencies not well assessed in the current written and oral examinations-competencies that will allow the ABA to judge whether a candidate meets the standards expected for board certification more properly. This special article describes the ABA's journey from initial conceptualization through first administration of the OSCE, including the format of the OSCE, the process for scenario development, the standardized patient program that supports OSCE administration, examiner training, scoring, and future assessment of reliability, validity, and impact of the OSCE. This information will be beneficial to both those involved in the initial certification process, such as residency graduate candidates and program directors, and others contemplating the use of high-stakes summative OSCE assessments