Mixing methodologies to enhance the implementation of healthcare operational research

Healthcare Operational Research (OR) has had limited success in achieving a sufficient level of stakeholder acceptance to lead to implementation of results. This research study is aimed at combining OR methodologies to achieve greater acceptance of results for organizational change. Patient flow delays in the Paediatric intensive care unit (PICU) at Children's Hospital of Wisconsin were identified using case studies. Patient flow was modelled using hard OR (simulation) using case study findings, with active stakeholder participation, and enhanced with outcomes research. Outcomes research allowed achieving greater clinical relevance of OR findings. Results from hard OR, particularly for politically sensitive issues, were persuasive but inadequate to result in change. Soft OR (cognitive mapping) was used to identify new issues and enhance results. Consequently, the planned PICU expansion was deferred, and resources focused on improving staffing strategies identified independently from both hard and soft OR. These findings suggest that: (1) Outcomes research can play a unique role to enhance results in healthcare OR. (2) After obtaining a holistic understanding of the system using hard and soft OR, stakeholders are willing to implement results from each independently, supporting the development of a common form of knowledge, which is consistent with Mixed-Mode Modelling. (3) Hard OR, enhanced with outcomes research, with active stakeholder participation, and combined with soft OR, results in greater acceptance and sustained organizational change.     

Differential algebraic equations with after-effect

In this paper, we are concerned with the solution of delay differential algebraic equations. These are differential algebraic equations with after-effect, or constrained delay differential equations. The general semi-explicit form of the problem consists of a set of delay differential equations combined with a set of constraints that may involve retarded arguments. Even simply stated problems of this type can give rise to difficult analytical and numerical problems. The more tractable examples can be shown to be equivalent to systems of delay or neutral delay differential equations. Our purpose is to highlight some of the complexities and obstacles that can arise when solving these problems, and to indicate problems that require further research.     

Epitaxy: the motion picture

The engineering of many modern electronic devices demands control over a crystal down to the thickness of a single layer of atoms—and future demands will be even more challenging. Such control is achieved by the method of crystal growth known as epitaxy, and that makes this method the subject of intense study. More than that, recent advances are revolutionizing our knowledge of how surfaces grow. In fact, growing surfaces show a beautifully rich variety of phenomena, many of which are only now beginning to be uncovered. In the past few years many surface imaging techniques have been used to give us a close look at how crystals grow—while they are growing. The purpose of this article will be to illustrate some of the ways real surfaces grow and change as revealed by some of the latest in situ microscopic imaging technologies.

It is often said that crystal growth is more of an art than a science. Here we will show that it is emphatically both.     

The two-dimensional quantum Euclidean algebra

The algebra dual to Woronowicz's deformation of the two-dimensional Euclidean group is constructed. The same algebra is obtained from SU _q (2) via contraction on both the group and algebra levels.     

A self-organizing network in the weak-coupling limit

We prove the existence of spatially localized ground states of the diffusive Haken model. This model describes a self-organizing network whose elements are arranged on a d-dimensional lattice with short-range diffusive coupling. The network evolves according to a competitive gradient dynamics in which the effects of diffusion are counteracted by a localizing potential that incorporates an additional global coupling term. In the absence of diffusive coupling, the ground states of the system are strictly localized, i.e. only one lattice site is excited. For sufficiently small non-zero diffusive coupling , it is shown analytically that localized ground states persist in the network with the excitations exponentially decaying in space. Numerical results establish that localization occurs for arbitrary values of in one dimension but vanishes beyond a critical coupling _c(d), when d> 1. The one-dimensional localized states are interpreted in terms of instanton solutions of a continuum version of the model.     

Steady state analysis of an M/G/1 queue with two phase service and Bernoulli vacation schedule under multiple vacation policy

This paper examines the steady state behaviour of a batch arrival queue with two phases of heterogeneous service along and Bernoulli schedule vacation under multiple vacation policy, where after two successive phases service or first vacation the server may go for further vacations until it finds a new batch of customer in the system. We carry out an extensive stationary analysis of the system, including existence of stationary regime, queue size distribution of idle period process, embedded Markov chain steady state distribution of stationary queue size, busy period distribution along with some system characteristics.