Surfing through a Sea Change: The Coming Transformation of Chaplaincy Training

This essay introduces a mini-symposium that asks whether the preparation of future chaplains today anticipates sufficiently the emerging patterns of healthcare and the challenges of religious diversity

Response to Respondents

Kevin Massey responds to commentary by others

The anxious wait: assessing the impact of patient accessible EHRs for breast cancer patients

<p>Abstract</p> <p>Background</p> <p>Personal health records (PHRs) provide patients with access to personal health information (PHI) and targeted education. The use of PHRs has the potential to improve a wide range of outcomes, including empowering patients to be more active participants in their care. There are a number of widespread barriers to adoption, including privacy and security considerations. In addition, there are clinical concerns that patients could become anxious or distressed when accessing complex medical information. This study assesses the implementation of a PHR, and its impact on anxiety levels and perceptions of self-efficacy in a sample of breast cancer patients.</p> <p>Methods</p> <p>A quasi-experimental pre-test/post-test design was used to collect data from participants to evaluate the use of the PHR. Study participants completed background and pre-assessment questionnaires and were then registered into the portal. By entering an activation key, participants were then able to review their lab results and diagnostic imaging reports. After six weeks, participants completed post-assessment questionnaires and usability heuristics. All data were collected using an online survey tool. Data were cleaned and analyzed using SAS v9.1.</p> <p>Results</p> <p>A total of 311 breast cancer patients completed demographic and pre-assessment questionnaires, 250 registered to use the online intervention, and 125 participants completed all required study elements. Matching the pre- and post-anxiety scores demonstrated a decrease in mean anxiety scores (-2.2, p = 0.03); the chemotherapy sub-group had a statistically insignificant mean increase (1.8, p = .14). There was no mean change in self-efficacy scores.</p> <p>Conclusions</p> <p>Participants generally found the portal easy to use; however, the perceived value of improved participation was not detected in the self-efficacy scores. Having access to personal health information did not increase anxiety levels. While these results suggest that the use of this PHR may be of benefit for informing patients, further research is required to investigate the impact on the patients experiences, their participation in their care, their relationships with the health care team, and their health outcomes.</p

Understanding valuing devices in tourism through ‘place-making’

The paper explores how valuing devices and verification mechanisms such as user-generated content (UGC) websites partake in performing placeness. The findings are based upon a corpus of data including a case study at the offices of the largest user-generated travel website, TripAdvisor, a longitudinal netnographic approach and a conceptual review. Originally inspired by theorists of space we treat places as sites of becoming that are performed through everyday practices. In claiming that places become meaningful only in and through practices we stress the importance of treating rating and ranking mechanisms as generative, rather than merely reductive algorithmically produced representations. By juxtaposing traditional enactments of traveling, we are discussing how placeness has been transformed and how this has fueled a series of further revisions to valuing tourism. We conclude the paper by appreciating the multiplicity of performativity as being implicated in the algorithmic configurations on contemporary valuing devices and enacted as we read, interpret, write, imagine. It is suggested that although earlier valuing devices have evoked place-making in various ways, the rise of UGC websites has converted the travel experience into a constant negotiation process whereby both the value of places and the value of valuing devices are contested

Sensitivity Analysis for Multidisciplinary Systems (SAMS)

This report describes the research conducted under an interagency collaboration agreement between the Aerospace Systems Directorate of the Air Force Research Laboratory (AFRL/RQ) and the Computational AeroSciences Branch of NASA Langley (NASA LaRC). Both organizations have a long-term goal of developing a modular computational system for coupling fluids and structures to enable both analysis and optimization of aerospace vehicles. Ultimately, the system should support multiple solvers within the fluid and structure domains to allow the best combination for the task at hand, as well as to allow for institutional preferences of specific software components. Towards this goal, the current research was focused on enhancing the existing modal aeroelastic analysis in the NASA FUN3D (Fully-UNstructured three-dimensional CFD (Computational Fluid Dynamics) code) software (Biedron et al. 2018), as well as developing new aeroelastic analysis and optimization capabilities based on a non-linear finite-element method. The methods and enhancements described in this document pertain to FUN3D Version 13.4

The Dark Matter Halos of Moderate Luminosity X-ray AGN as Determined fromWeak Gravitational Lensing and Host Stellar Masses

Understanding the relationship between galaxies hosting active galactic nuclei (AGN) and the dark matter haloes in which they reside is key to constraining how black hole fuelling is triggered and regulated. Previous efforts have relied on simple halo mass estimates inferred from clustering, weak gravitational lensing, or halo occupation distribution modelling. In practice, these approaches remain uncertain because AGN, no matter how they are identified, potentially live a wide range of halo masses with an occupation function whose general shape and normalization are poorly known. In this work, we show that better constraints can be achieved through a rigorous comparison of the clustering, lensing, and cross-correlation signals of AGN hosts to the fiducial stellar-to-halo mass relation (SHMR) derived for all galaxies, irrespective of nuclear activity. Our technique exploits the fact that the global SHMR can be measured with much higher accuracy than any statistic derived from AGN samples alone. Using 382 moderate luminosity X-ray AGN at z < 1 from the COSMOS field, we report the first measurements of weak gravitational lensing from an X-ray-selected sample. Comparing this signal to predictions from the global SHMR, we find that, contrary to previous results, most X-ray AGN do not live in medium size groups – nearly half reside in relatively low mass haloes with M_(200b) ∼ 10^(12.5) M_⊙. The AGN occupation function is well described by the same form derived for all galaxies but with a lower normalization – the fraction of haloes with AGN in our sample is a few per cent. The number of AGN satellite galaxies scales as a power law with host halo mass with a power-law index α = 1. By highlighting the relatively ‘normal’ way in which moderate luminosity X-ray AGN hosts occupy haloes, our results suggest that the environmental signature of distinct fuelling modes for luminous quasars compared to moderate luminosity X-ray AGN is less obvious than previously claimed

Discordance to ASHP Therapeutic Guidelines Increases the Risk of Surgical Site Infection

Clean surgery without contamination does not require prophylactic antibiotics, but there are high-risk surgical procedures that may cause infection and/or involve vital organs such as the heart, brain, and lungs, and these indeed require the use of antibiotics. This study aimed to deter- mine the quantity of antibiotic use based on the defined daily dose (DDD) per 100 bed days and the quality of antibiotic use based on the percentage of concordance with The American Society of Health-System Pharmacists (ASHP) therapeutic guidelines (i.e., route of administration, time of ad- ministration, selection, dose, and duration). This includes the profiles of surgical site infection (SSI) in surgical patients from January through June 2019. The study subjects were 487 surgical patients from two hospitals who met the inclusion criteria. There were 322 patients out of 487 patients who had a clean surgical procedure. Ceftriaxone (J01DD04) was the most used antibiotic, with a total DDD/100 bed days value in hospitals A and B, respectively: pre-surgery: 14.71, 77.65, during sur- gery: 22.57, 87.31, and postsurgery: 38.34, 93.65. In addition, 35% of antibiotics were given more than 120 min before incision. The lowest concordance to ASHP therapeutic guideline in hospital A (17.6%) and B (1.9%) was antibiotic selection. Two patients experienced SSI with bacterial growths of Proteus spp., Staphylococcus aureus, Staphylococcus epidermidis, and Escherichia coli. The usage of prophylactic antibiotics for surgical procedures was high and varied between hospitals. Hospital B had significantly lower concordance to antibiotic therapeutic guidelines, resulting to a higher infec- tion rate, compared with hospital A. ASHP adherence components were then further investigated, after which antibiotic dosing interval and injection time was found to be a significant predictor for positive bacterial growth based on logit–logistic regression. Further interventions and strategies to implement antibiotic stewardship is needed to improve antibiotic prescriptions and their use

The WiggleZ Dark Energy Survey: Direct constraints on blue galaxy intrinsic alignments at intermediate redshifts

Correlations between the intrinsic shapes of galaxy pairs, and between the intrinsic shapes of galaxies and the large-scale density field, may be induced by tidal fields. These correlations, which have been detected at low redshifts (z<0.35) for bright red galaxies in the Sloan Digital Sky Survey (SDSS), and for which upper limits exist for blue galaxies at z~0.1, provide a window into galaxy formation and evolution, and are also an important contaminant for current and future weak lensing surveys. Measurements of these alignments at intermediate redshifts (z~0.6) that are more relevant for cosmic shear observations are very important for understanding the origin and redshift evolution of these alignments, and for minimising their impact on weak lensing measurements. We present the first such intermediate-redshift measurement for blue galaxies, using galaxy shape measurements from SDSS and spectroscopic redshifts from the WiggleZ Dark Energy Survey. Our null detection allows us to place upper limits on the contamination of weak lensing measurements by blue galaxy intrinsic alignments that, for the first time, do not require significant model-dependent extrapolation from the z~0.1 SDSS observations. Also, combining the SDSS and WiggleZ constraints gives us a long redshift baseline with which to constrain intrinsic alignment models and contamination of the cosmic shear power spectrum. Assuming that the alignments can be explained by linear alignment with the smoothed local density field, we find that a measurement of \sigma_8 in a blue-galaxy dominated, CFHTLS-like survey would be contaminated by at most +/-0.02 (95% confidence level, SDSS and WiggleZ) or +/-0.03 (WiggleZ alone) due to intrinsic alignments. [Abridged]Comment: 18 pages, 12 figures, accepted to MNRAS; v2 has correction to one author's name, NO other changes; v3 has minor changes in explanation and calculations, no significant difference in results or conclusions; v4 has an additional footnote about model interpretation, no changes to data/calculations/result

On-Orbit Data and Validation of Astra\u27s ACE Electric Propulsion System

The first ACE propulsion system reached orbit on July 1st 2021 as part of Spaceflight’s demonstration of the Sherpa-LTE all-electric Orbital Transfer Vehicle (OTV). We are now able to share on-orbit data and have successfully verified the on-orbit performance of the ACE propulsion system, using xenon propellent. The mission objective was to lower altitude and use on-orbit data to derive performance, correlating the propulsion system’s performance to ground test data. The demonstration consisted of activating the propulsion system for 5- minute durations at a total input power of 340 W into the Power Processing Unit (PPU). Altitude change and propellant usage were used to derive thrust and total specific impulse. On-orbit performance is compared to ground test data in Table 1. Averaged performance is within one standard deviation of ground test data. Astra considers this a validation of system performance, as well as the ground test facilities used to test propulsion systems. On-orbit thrust has a large standard deviation as a result of the limited data sampling rate and measurement errors, rather than variability in thruster performance. Figure 1 shows the thruster operating on-orbit. The Astra team gratefully acknowledges the support of Spaceflight, Inc., the U.S. Air Force, and Defense Innovation Unit (DIU) without which this mission would not have been possible

Oxford SWIFT IFS and multi-wavelength observations of the Eagle galaxy at z=0.77

The `Eagle' galaxy at a redshift of 0.77 is studied with the Oxford Short Wavelength Integral Field Spectrograph (SWIFT) and multi-wavelength data from the All-wavelength Extended Groth strip International Survey (AEGIS). It was chosen from AEGIS because of the bright and extended emission in its slit spectrum. Three dimensional kinematic maps of the Eagle reveal a gradient in velocity dispersion which spans 35-75 +/- 10 km/s and a rotation velocity of 25 +/- 5 km/s uncorrected for inclination. Hubble Space Telescope images suggest it is close to face-on. In comparison with galaxies from AEGIS at similar redshifts, the Eagle is extremely bright and blue in the rest-frame optical, highly star-forming, dominated by unobscured star-formation, and has a low metallicity for its size. This is consistent with its selection. The Eagle is likely undergoing a major merger and is caught in the early stage of a star-burst when it has not yet experienced metal enrichment or formed the mass of dust typically found in star-forming galaxies.Comment: accepted for publication in MNRA