Four Poems

Poetry by Roger Nas

Improved pH buffering agent for sodium hypochlorite

Sodium citrate/citric acid was found to be an effective buffer for pH control when used with sodium hypochlorite. The mixture does not corrode aluminum. The buffer appears to form a type of conversion coating that may provide corrosion-resistant properties to aluminum in other applications

Population Health Research: Early Description of the Organizational Shift Toward Population Health Management and Defining a Vision for Leadership.

As health care delivery systems adapt to the changing marketplace, many struggle to define a clear strategy that will prove successful in managing the health of entire populations. The federal government continues to put increasing pressure on organizations to shift away from the traditional way of delivering episodic care and move toward managing populations as a whole-before, during, and after a patient presents in a health care facility. Private payers have begun to follow suit as risk-based payer contracts and bundled payment models become increasingly popular. For organizations to adequately influence the health outcomes of a population, they must be responsible for more than just a patient\u27s medical care. They must partner with the community to create a strategy that encompasses the psychosocial and environmental factors that contribute to one\u27s health. Although health care leaders know this industry transformation is imminent, there is minimal research that shares best practices in regard to designing and implementing a successful population health management strategy. Interviews were conducted with leadership from 10 organizations in order to understand the strategic approach taken by delivery systems and health care institutions that view population health as a key aspect of their overall mission. Responses were recorded and outlined in a detailed response grid. The objective is to provide a qualitative overview of how industry leaders are currently responding to population health. Additionally, common themes and recommendations are presented to serve as guidance for other health care organizations that are at the start of their journey toward population health management

Bridging the Climate Information Gap: A Framework for Engaging Knowledge Brokers and Decision Makers in State Climate Assessments

Large-scale analyses like the National Climate Assessment (NCA) contain a wealth of information critical to national and regional responses to climate change but tend to be insufficiently detailed for action at state or local levels. Many states now engage in assessment processes to meet information needs for local authorities. The goals of state climate assessments (SCAs) should be to provide relevant, actionable information to state and local authorities, and to generate primary sources, build networks and inform stakeholders. To communicate local climate impacts to decision makers, SCAs should express credibility, salience and legitimacy. They can provide information (e.g., case studies, data sets) and connect stakeholders to the NCA and its process. Based on our experience in the Vermont Climate Assessment (VCA), we present a framework to engage decision makers in SCAs using a fluid network of scientific experts and knowledge brokers to conduct subject area prioritization, data analysis and writing. The VCA addressed economic, environmental and social impacts of climate change at local scales to increase resiliency and manage risk. Knowledge brokers communicated VCA findings through their own stakeholder networks. We include a qualitative impact evaluation, and believe our framework for interaction among scientists, knowledge brokers and stakeholders to be an effective structure for SCAs and a transformative experience for students

Preferences for Prenatal Tests for Cystic Fibrosis: A Discrete Choice Experiment to Compare the Views of Adult Patients, Carriers of Cystic Fibrosis and Health Professionals

As new technologies enable the development of non-invasive prenatal diagnosis (NIPD) for cystic fibrosis (CF), research examining stakeholder views is essential for the preparation of implementation strategies. Here, we compare the views of potential service users with those of health professionals who provide counselling for prenatal tests. A questionnaire incorporating a discrete choice experiment examined preferences for key attributes of NIPD and explored views on NIPD for CF. Adult patients (n = 92) and carriers of CF (n = 50) were recruited from one children’s and one adult NHS specialist CF centre. Health professionals (n = 70) were recruited via an e-mail invitation to relevant professional bodies. The key attribute affecting service user testing preferences was no miscarriage risk, while for health professionals, accuracy and early testing were important. The uptake of NIPD by service users was predicted to be high and includes couples that would currently decline invasive testing. Many service users (47%) and health professionals (55.2%) thought the availability of NIPD for CF would increase the pressure to undergo prenatal testing. Most service users (68.5%) thought NIPD for CF should be offered to all pregnant women, whereas more health professionals (68.2%) thought NIPD should be reserved for known carrier couples. The implications for clinical practice are discussed

Euler-Lagrange Optimal Control of Indirect Fire Symmetric Projectiles

An important aspect of controls engineering is the dynamic modeling and flight control of smart weapons. One division of this area involves the guidance, navigation, and control of smart projectiles. In recent decades, methods for controlling projectiles have become much more sophisticated. In this thesis, principles of optimal control are used to develop a controller for indirect fire symmetric projectiles, or high-launch projectiles. A plant model is created to simulate the flight of a 2.75-inch Hydra-70 rocket. Two pairs of forward-mounted controllable canards are used as actuators to modify the flight toward a downrange target. A linear optimal regulator is used to compute control inputs which minimize a cost function. Results are demonstrated through impact point dispersion plots which show both the effectiveness and robustness of the controller. Additionally, defining characteristics of the control method are explored and optimized

Maintaining Social Services After-Hours in a Hospital Emergency Department: Health Care Preferences with On-Call and In-House Programs

This research describes the satisfaction of emergency department staff in relation to the social service after-hours coverage at Fairview Southdale hospital. The participants of the study were physicians, nurses, health unit coordinators, and social workers of Fairview Southdale hospital working with the emergency department. The participants completed a 17-question mailed survey. The findings illustrated the desire of staff to expand the current after-hours coverage of the emergency department to more in-house availability. The information gathered and compiled for this study will be used to help support the increase of social work services role in the emergency department at Fairview Southdale Hospital. The information will also be used to provide increased literature on the subject of health care staff satisfaction with social work services

Study of natural and induced tissue response in Macrobrachium rosenbergii de Man

The tissue response of the giant freshwater prawn Macrobrachium rosenbergii de Man, was studied histologically by investigating clinical cases of natural infectious and non-infectious diseases which occurred in cultured prawns and by carrying out the following experimental intramuscular injection of alcian blue dye, intramuscular injection of BCG vaccine (also using TEM), intramuscular injection of complete Freund’s adjuvant, intramuscular and systemic injection of heat-killed Aeromonas hydrophila, intramuscular and systemic injection of heat-killed and live Vibrio parahaemolyticus and Vibrio anguillarum, grafting or insertion of pieces of cuticle into the muscle of the same or different prawns and by cuticular traumatization or wounding of slight, moderate and severe degrees (also using SEM). Results demonstrated histologically the presence of a unified system of haemocytic cells participating in a range of defensive activities in varying degrees of intensity; viz. infiltration, aggregation, coagulation, melanization, phagocytosis, encapsulation, nodule formation and fibroplasia. More pronounced haemocytic activity occurred in the gills, hepatopancreas, heart and antennal gland, in addition to locally at the site of injection, wounding or grafting. Electron microscopy revealed that the haemocytes which participate in the tissue inflammatory response consist of cell types belonging to all three main classes, namely agranular, semi-granular and granular haemocytes, although semi-granular and granular haemocytes appeared to predominate. Findings of the experimentally induced tissue response were comparable to observations in the natural infectious and non-infectious disease conditions in Macrobrachium and in general, similar to those reported in natural infections and experimental challenges of other important wild and cultured crustaceans including penaeid shrimps, crabs and crayfish. A routine study of the haemocytic tissue response in cultured prawns can be recommended as a useful means of monitoring their health status and identifying the early stages of a disease process. This can prove of assistance in developing disease control strategies