591 research outputs found
Understanding urban water performance at the city-region scale using an urban water metabolism evaluation framework
Development of Flutter Constraints for High-fidelity Aerostructural Optimization
Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/143080/1/6.2017-4455.pd
Clinicians' perception of the preventability of inpatient mortality
PURPOSE:
The purpose of this paper is to assess whether clinicians have an accurate perception of the preventability of their patientsâ mortality. Case note review estimates that approximately 5 percent of inpatient deaths are preventable.
DESIGN/METHODOLOGY/APPROACH:
The design involved in the study is a prospective audit of inpatient mortality in a single NHS hospital trust. The case study includes 979 inpatient mortalities. A number of outcome measures were recorded, including a Likert scale of the preventability of death- and NCEPOD-based grading of care quality.
FINDINGS:
Clinicians assessed only 1.4 percent of deaths as likely to be preventable. This is significantly lower than previously published values (p<0.0001). Clinicians were also more likely to rate the quality of care as âgood,â and less likely to identify areas of substandard clinical or organizational management.
RESEARCH LIMITATIONS/IMPLICATIONS:
The implications of objective assessment of the preventability of mortality are essential to drive quality improvement in this area.
PRACTICAL IMPLICATIONS:
There is a wide disparity between independent case note review and clinicians assessing the care of their own patients. This may be due to a âknowledge gapâ between reviewers and treating clinicians, or an âobjectivity gapâ meaning clinicians may not recognize preventability of death of patients under their care.
SOCIAL IMPLICATIONS:
This study gives some insight into deficiencies in clinical governance processes.
ORIGINALITY/VALUE:
No similar study has been performed. This has significant implications for the idea of the preventability of mortality
A metabolism perspective on alternative urban water servicing options using water mass balance
Urban areas will need to pursue new water servicing options to ensure local supply security. Decisions about how best to employ them are not straightforward due to multiple considerations and the potential for problem shifting among them. We hypothesise that urban water metabolism evaluation based a water mass balance can help address this, and explore the utility of this perspective and the new insights it provides about water servicing options. Using a water mass balance evaluation framework, which considers direct urban water flows (both ânaturalâ hydrological and âanthropogenicâ flows), as well as water-related energy, we evaluated how the use of alternative water sources (stormwater/rainwater harvesting, wastewater/greywater recycling) at different scales influences the âlocal water metabolismâ of a case study urban development. New indicators were devised to represent the water-related âresource efficiencyâ and âhydrological performanceâ of the urban area. The new insights gained were the extent to which alternative water supplies influence the water efficiency and hydrological performance of the urban area, and the potential energy trade-offs. The novel contribution is the development of new indicators of urban water resource performance that bring together considerations of both the âanthropogenicâ and ânaturalâ water cycles, and the interactions between them. These are used for the first time to test alternative water servicing scenarios, and to provide a new perspective to complement broader sustainability assessments of urban water
Urban water security - what does it mean?
This research is focussed on understanding what urban water security meansâa surprisingly elusive concept given the global shift from rural to urban living. We first make the case for a distinct urban water security definition. We then identify 25 unique water security definitions, of which three relate to the urban context but all with scope for improvement. Applying novel indices, we assess the prevalence, complexity and evolution of themes and dimensions within all definitions and find a stable spectrum of themes; but note a shifting emphasis towards environmental and social dimensions, away from quality and quantity of supply. Overall the definitions are becoming more comprehensive by simply listing more outcomes to be achieved. Instead of this âshopping-listâ approach, we propose a simplified urban water security definition with a focus on agreement of needs with community stakeholders, while using the themes to guide what the objectives might be
'Special Sport' for misfits and losers: educational triage and the constitution of schooled subjectivities
Children, family and the state : revisiting public and private realms
The state is often viewed as part of the impersonal public sphere in opposition to the private family as a locus of warmth and intimacy. In recent years this modernist dichotomy has been challenged by theoretical and institutional trends which have altered the relationship between state and family. This paper explores changes to both elements of the dichotomy that challenge this relationship: a more fragmented family structure and more individualised and networked support for children. It will also examine two new elements that further disrupt any clear mapping between state/family and public/private dichotomies: the third party role of the child in family/state affairs and children's application of virtual technology that locates the private within new cultural and social spaces. The paper concludes by examining the rise of the 'individual child' hitherto hidden within the family/state dichotomy and the implications this has for intergenerational relations at personal and institutional levels
An inclusive city water account by integrating multiple data sources for South-East Queensland (SEQ), Australia
Cities are the hotspots of impacts on local and distant water resources through economic activity and consumption. More than half of the world's population lives in cities, which is expected to reach around two-thirds by 2050. Such a high level of increased urbanization calls for higher attention towards inclusive, safe, resilient, and sustainable cities (Sustainable Development Goals 11). To evaluate sustainability, inclusiveness, and resiliency pathways, a variety of sustainability indicators have been proposed, including the water footprint. The water footprint is defined as the total volume of freshwater used for the goods and services consumed. It covers both direct (e.g. drinking and cleaning) and virtual water flows (water used in the goods and services supply chain, hence also known as embedded water). Virtual water flows through products and services produced in other locations using their water resources influence the function, prosperity, and growth of the cities. Yet, this aspect is absent in the sustainability and strategic city water footprint reduction goals of Australian cities. To fully account for the water dependencies of Australian cities, direct and virtual water flows need to be known. To this purpose, we build inclusive city water of South-East Queensland (SEQ) by combining material flow analysis (MFA) and the multiregional input-output (MRIO) model. Water consumption in SEQ is used to quantify the water footprint on local water resources and net blue virtual water import. Together, this constitutes the water footprint on national water resources. Our results show that the water footprint of SEQ on local water resources is 620 GL with a net virtual water import of 1382 GL. Therefore, the water footprint of SEQ on national water resources is 2002 GL. The water footprint of SEQ on local water resources consists of direct water consumption by households (192 GL) and the industrial sector (428 GL). The consumed direct water of the SEQ industrial sector flows as virtual water to SEQ (149 GL), the rest of Australia (RoAUS) (all other regions except SEQ) (211 GL), and the rest of the world (68 GL). The virtual water inflows breakdown by source regions showed that 386 GL, 1019 GL, and 256 GL of virtual water imported from the major cities (Sydney, Melbourne, Adelaide, and Perth); regional areas of NSW, Victoria, and QLD; and RoAUS, respectively. Overall, the proposed inclusive city water account can enhance subnational estimates of city water footprint for benchmarking, as well as inclusive and resilient city water planning
Scalable Parallel Approach for High-Fidelity Steady-State Aeroelastic Analysis and Adjoint Derivative Computations
Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140671/1/1.j052255.pd
Lattice QCD with mixed actions
We discuss some of the implications of simulating QCD when the action used
for the sea quarks is different from that used for the valence quarks. We
present exploratory results for the hadron mass spectrum and pseudoscalar meson
decay constants using improved staggered sea quarks and HYP-smeared overlap
valence quarks. We propose a method for matching the valence quark mass to the
sea quark mass and demonstrate it on UKQCD clover data in the simpler case
where the sea and valence actions are the same.Comment: 15 pages, 10 figures some minor modification to text and figures.
Accepted for publicatio
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