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.     

The essential Lagrangian-Grassmannian and the homotopy type of the Fredholm Lagrangian-Grassmannian

Let H be a separable infinite dimensional Hilbert space endowed with a symplectic structure and let L₀⊂H be a Lagrangian subspace. Using the results of [A. Abbondandolo, P. Majer, Infinite dimensional Grassmannians, math.AT/0307192], we show that the Fredholm Lagrangian-Grassmannian FL₀(Λ) has the homotopy type of Gc(L₀), the Grassmannian of all Lagrangian subspaces of H that are compact perturbations of L₀. It is well known that the latter has the homotopy type of the quotient U(∞)/O(∞). As a corollary, we recover a result by B. Booss-Bavnbek and K. Furutani (see [B. Booss-Bavnbek, K. Furutani, Symplectic functional analysis and spectral invariants, Contemp. Math. 242 (1999) 53-83; K. Furutani, Fredholm-Lagrangian-Grassmannian and the Maslov index, J. Geom. Phys. 51 (2004) 269-331]) that the L₀-Maslov index is an isomorphism between the fundamental group of FL₀(Λ) and the integers.     

A real time method for surface cleanliness measurement

The measurement of surface cleanliness is a significant problem in many industrial and technological processes. Existing methods are based on laboratory procedures, that are not performed in real time, can not be automated, and usually are restricted to a small portion of the sample. In this study we describe a new method for real time measurement of the amount of surface dirt or contamination deposited on a surface. It relies on the ablation of the surface dirt film by means of a short laser pulse, and the subsequent measurement of the emitted sound. The intensity of the sound is proportional to the amount of surface dirt and provides a direct measurement of the cleanliness of the surface. We also developed a reference sample for calibration, based on a uniform distribution of dots printed on white paper. The density and the dot size can be easily modified providing a homogeneous, uniform and reproducible standard for the measurement. Based on this method, we designed, developed and patented the first industrial instrument for on-line determination of the degree of cleanliness of manufactured cold rolled steel plate bobbins. PACS 79.20.D; 81.70.C; 42.62.     

Critical dynamics of the Potts model in several dimensionalities

We study critical dynamics of general q-state Potts models on d-dimensional hypercubic lattices. The master equation is formulated according to a theory recently presented by the author. A simple bond moving technique, followed by decimation, is used to obtain the dynamical exponents. Although this approximation yields poor results for the static exponents, the dynamic behaviour is closer to Monte Carlo simulations. We compare our results with those obtained with a different formulation of dynamics. A final discussion is included.     

Epimerization, diastereoselectivity and hemilability in dicationic chiral ruthenium complexes with bidentate (PS) bisphosphine monosulfide ligands

The binding of heterobidentate P^∧S ligands introduces metal-centered chirality to the planar chiral parent complex Ru(η⁶:η¹-NMe₂C₆H₄C₆H₄PCy₂)Cl₂. Observed diastereomeric ratios for the kinetic product vary dramatically depending upon ring size of the chelate formed with the P^∧S ligand. The complexes epimerize very slowly to thermodynamic product ratios that are substantially different from the kinetic product ratios.     

Effect of crack tip sharpness on the strength of vulcanized rubbers

The effect of crack tip sharpness on crack propagation in vulcanized rubbers has been studied. For very sharp cracks, tearing is found to occur on a small scale at very low energies not far above the threshold required for the onset of mechanical crack growth. The “small-scale” tearing energies show relatively little variation for rubbers that differ widely in tear strength as normally measured. Thus the latter property appears to be strongly influenced by variations in the ability of rubbers to promote tip blunting. The small-scale tear behavior is of relevance to other fracture phenomena, including cutting by sharp objects and tensile failure. Natural variations in tip sharpness occur during cyclic or time-dependent mechanical crack growth and influence the form of the crack growth characteristics.     

Determination of cyanuric acid in swimming pool water by differential pulse polarography

A reliable differential pulse polarographic method is described for the determination of cyanuric acid (1,3,5-triazine-2,4,6-triol) in pool water. Cyanuric acid in the range 10^?5–10^?3 M is determined by means of the peak at ca. –60 mV (vs. Ag/AgCl/3 M NAcl). The high sensitivity of the polarographic technique allows ten-fold dilution of samples, thus avoiding matrix effects. It it shown that the peak can be attributed to formation of insoluble mercury(I) cyanurate, Hg₂(HC₃N₃O₃), at the mercury electrode.