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.     

Gas-phase thermal decomposition of peroxy-N-butyryl nitrate

The gas-phase thermal decomposition rate of peroxy-n-butyryl nitrate (n-C₃H₇C(O)OONO₂, PnBN) has been measured at ambient temperature (296 K) and 1 atm of air relative to that of peroxyacetyl nitrate (CH₃C(O)OONO₂, PAN) using mixtures of PAN (14–19 ppb), PnBN (22–46 ppb), and nitric oxide (1.35–1.90 ppm). The PnBN/PAN decomposition rate ratio was 0.773 ± 0.030. This ratio, together with a literature value of 3.0 × 10^?4 s^?1 for the thermal decomposition rate of PAN at 296 K, yields a PnBN thermal decomposition rate of (2.32 ± 0.09) × 10^?4 s^?1. The results are briefly discussed by comparison with data for other peroxyacyl nitrates and with respect to the atmospheric persistence of PnBN. © 1994 John Wiley & Sons, Inc.     

Ultrasonic wave propagation in cancellous and cortical bone: prediction of some experimental results by Biot's theory.

Pulse transmission ultrasound was used to determine the longitudinal wave speed along the direction of trabecular alignment in 32 water-saturated anisotropic tibial bovine cancellous bone samples and in one cortical bone sample also from the bovine tibia. These results are compared to published ultrasound wave-speed data obtained from bovine femoral specimens. Nonlinear regression was used to fit Biot's theory to the data. The correlation coefficient for regression analysis between the experimental ultrasound velocities and the velocities predicted by Biot's theory was r = 0.78.     

Ultraviolet photoemission spectroscopy of hydrogen complex deactivation on InP:Zn(1 0 0) surfaces

Ultraviolet photoemission spectroscopy is used to study the kinetics of the H-Zn complex deactivation in Zn doped InP(1 0 0). Hydrogen injected into the material electronically passivates the local carrier concentration. Reverse-biased anneals of the InP under ultra-high vacuum show a dramatic change in the work function of the material with increasing temperature. Spectral features are also shown to be sensitive to sample temperature. To our knowledge, we show the first view of hydrogen retrapping at the surface using photoemission spectroscopy. A simple photoelectron threshold energy analysis shows the state of charge compensation of the material.     

Evidence of shear-dependent boundary slip in newtonian liquids

The European Physical Journal E - The flow of Newtonian fluids was studied by directly measuring the hydrodynamic drainage force acting on a sphere approaching a flat surface. Our force...     

Optical properties of a high-efficiency glass ceramic X-ray storage phosphor

The turbidity, photoluminescence, and photo-stimulated luminescence (PSL) of fluorozirconate glass containing barium chloride nano- and micro-crystals have been measured for samples prepared by isochronal (70 min) annealing over a temperature range of 220–283°C, and correlated with the microstructure as determined by X-ray diffraction measurements. Crystallization of hexagonal phase barium chloride commences at around 220°C, but until 275°C the material retains excellent transparency although it displays negligible PSL. Between 275°C and 277°C, the hexagonal phase converts to the orthorhombic phase, the transparency abruptly decreases, and the PSL rises to a value of around 13% of that found for the commercial storage phosphor BaFBr:Eu. For a slightly higher temperature of 280°C, new phases appear which correspond to the onset of bulk crystallization, and at 283°C the relative PSL rises to 33%, while the transparency falls further. The trade-off between optical transparency and PSL over this narrow temperature window for X-ray imaging plate applications is briefly discussed.     

New developments in X-ray storage phosphors

We found a significant PSL effect in Eu²⁺-doped fluorozirconate glasses (ZBLAN) which were additionally doped with Br⁻ or Cl⁻ ions. The PSL is attributed to the characteristic emission of Eu²⁺ present in nano-crystallites of BaBr₂ or BaCl₂, which form in the glass upon annealing. The metastable hexagonal form of BaX₂ (X=Br,Cl) is always formed first before it is converted into the stable orthorhombic form. The particle size increases upon annealing and so does the PSL efficiency of the glass ceramic. However, there is a saturation of the PSL efficiency, which is for Br⁻ doping about 9% and for Cl⁻-doping about 80% of the Eu-doped BaFBr standard. The particle size was determined by transmission electron microscopy (TEM). The TEM results show a clear tendency for bigger particles for longer annealing at the expense of its number. The particle size for the most efficient phosphor is about 100 nm.