2,412 research outputs found
Algorithms for geodesics
Algorithms for the computation of geodesics on an ellipsoid of revolution are
given. These provide accurate, robust, and fast solutions to the direct and
inverse geodesic problems and they allow differential and integral properties
of geodesics to be computed.Comment: LaTex, 12 pages, 8 figures. Version 2 corrects some errors and adds
numerical examples. Supplementary material is available at
http://geographiclib.sourceforge.net/geod.htm
Perceptual Context in Cognitive Hierarchies
Cognition does not only depend on bottom-up sensor feature abstraction, but
also relies on contextual information being passed top-down. Context is higher
level information that helps to predict belief states at lower levels. The main
contribution of this paper is to provide a formalisation of perceptual context
and its integration into a new process model for cognitive hierarchies. Several
simple instantiations of a cognitive hierarchy are used to illustrate the role
of context. Notably, we demonstrate the use context in a novel approach to
visually track the pose of rigid objects with just a 2D camera
Investigation of Natural Effective Gamma Dose Rates case study: Ardabil Province in Iran
Gamma rays pose enough energy to form charged particles and adversely affect human health. Since, the external exposure of human beings to natural environmental gamma radiation normally exceeds that from all man-made sources combined, natural background gamma dose rates and corresponding annual effective doses were determined for selected cities of Ardabil province from 2009 to 2010. Outdoor gamma dose rates were measured using an Ion Chamber Survey Meter in 105 locations in selected districts. Average absorbed dose for Ardabil, Sar-Ein, Germy, Neer, Shourabil Recreational Lake, and Kosar were determined as 265, 219, 344, 233, 352, and 358 nSvh-1, respectively. Although dose rates recorded for Germi and Kosar are comparable with some areas with high natural radiation background, however, the dose rates in other districts are well below the levels reported for such locations. Average annual effective dose due to indoor and outdoor gamma radiation for Ardabil province was estimated to be 1.73 (1.35-2.39) mSv, which is on average 2 times higher than the world population weighted average
Top mass dependent alpha_s^3 corrections to B-meson mixing in the MSSM
We compute the top mass dependent NLO strong interaction matching conditions
to the Delta F=2 effective Hamiltonian in the general MSSM. We study the
relevance of such corrections, comparing its size with that of previously known
NLO corrections in the limit mt->0, in scenarios with degeneracy, alignment,
and hierarchical squarks. We find that, while these corrections are generally
small, there are regions in the parameter space where the contributions to the
Wilson coefficients C1 and C4 could partially overcome the expected suppression
m_t/M_SUSY.Comment: 15 pages, 6 figure
Process evaluation for complex interventions in primary care: understanding trials using the normalization process model
Background: the Normalization Process Model is a conceptual tool intended to assist in understanding the factors that affect implementation processes in clinical trials and other evaluations of complex interventions. It focuses on the ways that the implementation of complex interventions is shaped by problems of workability and integration.Method: in this paper the model is applied to two different complex trials: (i) the delivery of problem solving therapies for psychosocial distress, and (ii) the delivery of nurse-led clinics for heart failure treatment in primary care.Results: application of the model shows how process evaluations need to focus on more than the immediate contexts in which trial outcomes are generated. Problems relating to intervention workability and integration also need to be understood. The model may be used effectively to explain the implementation process in trials of complex interventions.Conclusion: the model invites evaluators to attend equally to considering how a complex intervention interacts with existing patterns of service organization, professional practice, and professional-patient interaction. The justification for this may be found in the abundance of reports of clinical effectiveness for interventions that have little hope of being implemented in real healthcare setting
Patients’ use of information about medicine side effects in relation to experiences of suspected adverse drug reactions
Background
Adverse drug reactions (ADRs) are common, and information about medicines is increasingly widely available to the public. However, relatively little work has explored how people use medicines information to help them assess symptoms that may be suspected ADRs.
Objective
Our objective was to determine how patients use patient information leaflets (PILs) or other medicines information sources and whether information use differs depending on experiences of suspected ADRs.
Method
This was a cross-sectional survey conducted in six National Health Service (NHS) hospitals in North West England involving medical in-patients taking at least two regular medicines prior to admission. The survey was administered via a questionnaire and covered use of the PIL and other medicines information sources, perceived knowledge about medicines risks/ADRs, experiences of suspected ADRs, plus demographic information.
Results
Of the 1,218 respondents to the survey, 18.8 % never read the PIL, whilst 6.5 % only do so if something unexpected happens. Educational level was related to perceived knowledge about medicines risks, but not to reading the PIL or seeking further information about medicines risks. Over half the respondents (56.0 %) never sought more information about possible side effects of medicines. A total of 57.2 % claimed they had experienced a suspected ADR. Of these 85.9 % were either very sure or fairly sure this was a reaction to a medicine. Over half of those experiencing a suspected ADR (53.8 %) had read the PIL, of whom 36.2 % did so before the suspected ADR occurred, the remainder afterwards. Reading the PIL helped 84.8 % of these respondents to decide they had experienced an ADR. Educational level, general knowledge of medicines risks and number of regular medicines used all increased the likelihood of experiencing an ADR.
Conclusion
More patients should be encouraged to read the PIL supplied with medicines. The results support the view that most patients feel knowledgeable about medicines risks and suspected ADRs and value information about side effects, but that reading about side effects in PILs or other medicines information sources does not lead to experiences of suspected ADRs
Arduous implementation: Does the Normalisation Process Model explain why it's so difficult to embed decision support technologies for patients in routine clinical practice
Background: decision support technologies (DSTs, also known as decision aids) help patients and professionals take part in collaborative decision-making processes. Trials have shown favorable impacts on patient knowledge, satisfaction, decisional conflict and confidence. However, they have not become routinely embedded in health care settings. Few studies have approached this issue using a theoretical framework. We explained problems of implementing DSTs using the Normalization Process Model, a conceptual model that focuses attention on how complex interventions become routinely embedded in practice.Methods: the Normalization Process Model was used as the basis of conceptual analysis of the outcomes of previous primary research and reviews. Using a virtual working environment we applied the model and its main concepts to examine: the 'workability' of DSTs in professional-patient interactions; how DSTs affect knowledge relations between their users; how DSTs impact on users' skills and performance; and the impact of DSTs on the allocation of organizational resources.Results: conceptual analysis using the Normalization Process Model provided insight on implementation problems for DSTs in routine settings. Current research focuses mainly on the interactional workability of these technologies, but factors related to divisions of labor and health care, and the organizational contexts in which DSTs are used, are poorly described and understood.Conclusion: the model successfully provided a framework for helping to identify factors that promote and inhibit the implementation of DSTs in healthcare and gave us insights into factors influencing the introduction of new technologies into contexts where negotiations are characterized by asymmetries of power and knowledge. Future research and development on the deployment of DSTs needs to take a more holistic approach and give emphasis to the structural conditions and social norms in which these technologies are enacte
A systematic review of strategies to recruit and retain primary care doctors
Background There is a workforce crisis in primary care. Previous research has looked at the reasons underlying recruitment and retention problems, but little research has looked at what works to improve recruitment and retention. The aim of this systematic review is to evaluate interventions and strategies used to recruit and retain primary care doctors internationally. Methods A systematic review was undertaken. MEDLINE, EMBASE, CENTRAL and grey literature were searched from inception to January 2015.Articles assessing interventions aimed at recruiting or retaining doctors in high income countries, applicable to primary care doctors were included. No restrictions on language or year of publication. The first author screened all titles and abstracts and a second author screened 20%. Data extraction was carried out by one author and checked by a second. Meta-analysis was not possible due to heterogeneity. Results 51 studies assessing 42 interventions were retrieved. Interventions were categorised into thirteen groups: financial incentives (n=11), recruiting rural students (n=6), international recruitment (n=4), rural or primary care focused undergraduate placements (n=3), rural or underserved postgraduate training (n=3), well-being or peer support initiatives (n=3), marketing (n=2), mixed interventions (n=5), support for professional development or research (n=5), retainer schemes (n=4), re-entry schemes (n=1), specialised recruiters or case managers (n=2) and delayed partnerships (n=2). Studies were of low methodological quality with no RCTs and only 15 studies with a comparison group. Weak evidence supported the use of postgraduate placements in underserved areas, undergraduate rural placements and recruiting students to medical school from rural areas. There was mixed evidence about financial incentives. A marketing campaign was associated with lower recruitment. Conclusions This is the first systematic review of interventions to improve recruitment and retention of primary care doctors. Although the evidence base for recruiting and care doctors is weak and more high quality research is needed, this review found evidence to support undergraduate and postgraduate placements in underserved areas, and selective recruitment of medical students. Other initiatives covered may have potential to improve recruitment and retention of primary care practitioners, but their effectiveness has not been established
Fractional quantum Hall effect in a quantum point contact at filling fraction 5/2
Recent theories suggest that the excitations of certain quantum Hall states
may have exotic braiding statistics which could be used to build topological
quantum gates. This has prompted an experimental push to study such states
using confined geometries where the statistics can be tested. We study the
transport properties of quantum point contacts (QPCs) fabricated on a
GaAs/AlGaAs two dimensional electron gas that exhibits well-developed
fractional quantum Hall effect, including at bulk filling fraction 5/2. We find
that a plateau at effective QPC filling factor 5/2 is identifiable in point
contacts with lithographic widths of 1.2 microns and 0.8 microns, but not 0.5
microns. We study the temperature and dc-current-bias dependence of the 5/2
plateau in the QPC, as well as neighboring fractional and integer plateaus in
the QPC while keeping the bulk at filling factor 3. Transport near QPC filling
factor 5/2 is consistent with a picture of chiral Luttinger liquid edge-states
with inter-edge tunneling, suggesting that an incompressible state at 5/2 forms
in this confined geometry
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