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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. 相似文献
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Theoretical and experimental investigations of metal-jets, produced by interaction of a plane shock wave with a conical cavity at free surface of metals like aluminium, copper and mild steel, have been carried out and an attempt has been made to correlate the jet velocity with shock parameters. The velocity of the jet, obtained from the cavity of different half angles have been mostly measured with oscillographic technique. The experimental results agree with theory within experimental variations. The velocity of the jet increases monotonically with the particle velocity but decreases with increase in the angle of the cavity. 相似文献
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Marilyn Daisy Milton Sarbjot Singh Sokhi Monika Maheshwari Minakshi Asnani 《Tetrahedron letters》2004,45(48):8941-8944
A novel class of multifunctional and multinucleate chalcogen (selenium and tellurium) containing derivatives (1-10) has been developed based on sequential chloride substitution of 2,4,6-trichloro-1,3,5-triazine with chalcogen-bearing amines. The structure of compound 1 has been determined in the solid state by X-ray crystallography. 相似文献
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Longitudinal vortices disrupt the growth of the thermal boundary layer, thereby the vortex generators producing the longitudinal vortices are well known for the enhancement of heat transfer in compact heat exchangers. The present investigation determines the heat transfer characteristics with secondary flow analysis in plate fin triangular ducts with delta wing vortex generators. This geometrical configuration is investigated for various angles of attack of the wing i.e. 15°, 20°, 26° and 37° and Reynolds numbers 100 and 200. The constant wall temperature boundary condition is used. The solution of the complete Navier Stokes equation and the energy equation is carried out using the staggered grid arrangement. The performance of the combination of triangular secondary fins and delta wing with stamping on slant surfaces has also been studied. Copyright © 2009 John Wiley & Sons, Ltd. 相似文献
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Thioketones react with molybdenum hexacarbonyl in tetrahydrofuran (60–65°C, 2–3 h) to give molybdenum pentacarbonyl complexes in 52–80% yield. Geometric isomers were isolated in the case of thiocamphor. 相似文献
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Thomas Bridge Saher A. Shaikh Paul Thomas Joaquin Botta Peter J. McCormick Amit Sachdeva 《Angewandte Chemie (Weinheim an der Bergstrasse, Germany)》2019,131(50):18154-18161
Antibodies have found applications in several fields, including, medicine, diagnostics, and nanotechnology, yet methods to modulate antibody–antigen binding using an external agent remain limited. Here, we have developed photoactive antibody fragments by genetic site‐specific replacement of single tyrosine residues with photocaged tyrosine, in an antibody fragment, 7D12. A simple and robust assay is adopted to evaluate the light‐mediated binding of 7D12 mutants to its target, epidermal growth factor receptor (EGFR), on the surface of cancer cells. Presence of photocaged tyrosine reduces 7D12‐EGFR binding affinity by over 20‐fold in two out of three 7D12 mutants studied, and binding is restored upon exposure to 365 nm light. Molecular dynamics simulations explain the difference in effect of photocaging on 7D12‐EGFR interaction among the mutants. Finally, we demonstrate the application of photoactive antibodies in delivering fluorophores to EGFR‐positive live cancer cells in a light‐dependent manner. 相似文献
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Sachdeva Jaspreet S. Nermoen Anders Korsnes Reidar I. Madland Merete V. 《Transport in Porous Media》2019,128(2):755-795
Transport in Porous Media - The injection of seawater-like brines alters stiffness, strength and time-dependent deformation rates for water-saturated chalks. This study deals with the mechanical... 相似文献