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.     

Acute Triangulations of Flat Mobius Strips

In this paper we investigate the acute triangulations of flat Mobius strips. We find out that we can always triangulate a flat Mobius strip with at most nine acute triangles, and sometimes (but not always) that many triangles are really needed.     

Stagnation flow on a cylinder with partial slip--an exact solution of the Navier-Stokes equations

The stagnation slip flow on an axially moving cylinder is studied.The Navier–Stokes and energy equations reduce to nonlinearordinary differential equations under a similarity transform.For large slip, the flow field decays exponentially into potentialflow. The heat transfer can be expressed as an incomplete gammafunction. In general, the heat transfer increases with slip,Prandtl number and Reynolds number.     

Expedient synthesis of villosin and its isomer (E)-labda-8(17),12,14-trien-15(16)-olide

The synthesis of the title compounds has been achieved in concise, highly regiocontrolled fashion from commercially available (+)-sclareolide. In addition, we offer evidence that the structure of a newly reported natural product from Zingiber ottensii is incorrect.     

Studies on the method of total synthesis of koumine: I. 4-Substituted 1,2-dihydropyridine derivatives and their function as a conjugated diene in Diels-Alder reaction

A route to the total synthesis of koumine has been suggested. Five 4-substituted 1, 2-d hydropyridine derivatives, which are supposed to be a conjugated diene of Diels-Alder reaction to produce the isoquinuclidine ring of koumine, have been synthesized. Only two of them were found to be able to undergo the Diels-Alder reaction. The stereochemistry of the reaction product has also been examined.     

Coupled Thermo-Hydro-Mechanical and Chemical Analysis of Expansive Clay Subjected to Heating and Hydration

A fully coupled formulation combining reactive transport and an existing thermo-hydro-mechanical (THM) code is presented. Special attention has been given to phenomena likely to be encountered in clay barriers used as part of containment systems of nuclear waste. The types of processes considered include hydrolysis, complex formation, oxidation/reduction reactions, acid/base reactions, precipitation/dissolution of minerals and cation exchange. Both kinetically-controlled and equilibrium-controlled reactions have been incorporated. The total analytical concentrations (including precipitated minerals) are adopted as basic transport variables and chemical equilibrium is achieved by minimizing Gibbs Free Energy. The formulation has been incorporated in a general purpose computer code capable of performing numerical analysis of engineering problems. A validation exercise concerning a laboratory experiment involving the heating and hydration of an expansive compacted clay is described.     

Second order evolution equations with time-dependent subdifferentials

We study an abstract second order nonlinear evolution equation in a real Hilbert space. We consider time-dependent convex functions and their subdifferentials operating on the first derivative of the unknown function. Introducing appropriate assumptions on the convex functions and other data, we prove the existence and uniqueness of a strong solution, and give some applications of the abstract theorem to hyperbolic variational inequalities with time-dependent constraints.      

Cathodoluminescence study of extended defects in hydrothermal ZnO crystals

Understanding the luminescence of ZnO is very important for some applications. In spite of the many studies carried out, there are still some points concerning the origin of some of the luminescence emissions in ZnO crystals that require additional study; in particular, the role of extended defects remains to be a matter of controversy. We present here a cathodoluminescence analysis of the defects generated by Vickers indentation in hydrothermal HTT crystals. Special emphasis was paid to the luminescence band peaking around 3.3 eV. The origin of this band is a matter of controversy, since it has been related to different causes, extended defects being one of the candidates for this emission. The CL images were acquired around crystal defects. It is observed that the 3.3 eV emission is enhanced around the crystal defects; though it is also observed, but weaker, out of the defect regions, which suggests that there exist two luminescence emissions peaking very close to 3.3 eV. The two emissions, one related to structural defects and the other to the LO phonon replica of the free excitonic band, appear very close each other and their relative intensity should determine the shape of the spectrum.