A conceptual analytics model for an outcome-driven quality management framework as part of professional healthcare education

BACKGROUND: Preparing the future health care professional workforce in a changing world is a significant undertaking. Educators and other decision makers look to evidence-based knowledge to improve quality of education. Analytics, the use of data to generate insights and support decisions, have been applied successfully across numerous application domains. Health care professional education is one area where great potential is yet to be realized. Previous research of Academic and Learning analytics has mainly focused on technical issues. The focus of this study relates to its practical implementation in the setting of health care education. OBJECTIVE: The aim of this study is to create a conceptual model for a deeper understanding of the synthesizing process, and transforming data into information to support educators’ decision making. METHODS: A deductive case study approach was applied to develop the conceptual model. RESULTS: The analytics loop works both in theory and in practice. The conceptual model encompasses the underlying data, the quality indicators, and decision support for educators. CONCLUSIONS: The model illustrates how a theory can be applied to a traditional data-driven analytics approach, and alongside the context- or need-driven analytics approach

The polar ring galaxy AM1934-563 revisited

We report long-slit spectroscopic observations of the dust-lane polar-ring galaxy AM1934-563 obtained with the Southern African Large Telescope (SALT) during its performance-verification phase. The observations target the spectral region of the Ha, [NII] and [SII] emission-lines, but show also deep NaI stellar absorption lines that we interpret as produced by stars in the galaxy. We derive rotation curves along the major axis of the galaxy that extend out to about 8 kpc from the center for both the gaseous and the stellar components, using the emission and absorption lines. We derive similar rotation curves along the major axis of the polar ring and point out differences between these and the ones of the main galaxy. We identify a small diffuse object visible only in Ha emission and with a low velocity dispersion as a dwarf HII galaxy and argue that it is probably metal-poor. Its velocity indicates that it is a fourth member of the galaxy group in which AM1934-563 belongs. We discuss the observations in the context of the proposal that the object is the result of a major merger and point out some observational discrepancies from this explanation. We argue that an alternative scenario that could better fit the observations may be the slow accretion of cold intergalactic gas, focused by a dense filament of galaxies in which this object is embedded (abridged).Comment: 19 pages, 13 figures, submitted to MNRAS. Some figures were bitmapped to reduce the size. Full resolution version is available from http://www.saao.ac.za/~akniazev/pub/AM1934_563.pd

The quest for H3+_3^+ at Neptune: deep burn observations with NASA IRTF iSHELL

Emission from the molecular ion H$_3^+$ is a powerful diagnostic of the upper atmosphere of Jupiter, Saturn, and Uranus, but it remains undetected at Neptune. In search of this emission, we present near-infrared spectral observations of Neptune between 3.93 and 4.00 $\mu$m taken with the newly commissioned iSHELL instrument on the NASA Infrared Telescope Facility in Hawaii, obtained 17-20 August 2017. We spent 15.4 h integrating across the disk of the planet, yet were unable to unambiguously identify any H$_3^+$ line emissions. Assuming a temperature of 550 K, we derive an upper limit on the column integrated density of $1.0^{+1.2}_{-0.8}\times10^{13}$ m$^{-2}$, which is an improvement of 30\% on the best previous observational constraint. This result means that models are over-estimating the density by at least a factor of 5, highlighting the need for renewed modelling efforts. A potential solution is strong vertical mixing of polyatomic neutral species from Neptune's upper stratosphere to the thermosphere, reacting with H$_3^+$, thus greatly reducing the column integrated H$_3^+$ densities. This upper limit also provide constraints on future attempts at detecting H$_3^+$ using the James Webb Space Telescope.Comment: 8 pages, 6 figures, published in Monthly Notices of the Royal Astronomical Societ

Latent tuberculosis infection screening of adult close contacts in London: a cost-utility analysis

Background: The National Institute for Health and Care Excellence (NICE) guidelines in 2016 recommend tuberculin skin test (TST) at a 5 mm induration size cut-off for latent tuberculosis infection (LTBI) screening of adult close contacts of active tuberculosis (TB) cases. An alternative would be to use an interferon-gamma release assay (IGRA) which has a higher specificity, such as the QuantiFERON-TB Gold in Tube (QFT-GIT) or T-SPOT.TB (T-SPOT). We aimed to evaluate the cost-effectiveness of the screening and treatment of LTBI in adult close contacts with various combinations of these tests in a representative London cohort. Methods: Clinical data of adult close contacts of pulmonary TB cases who were recommended to receive TST and IGRA in a TB clinic in London between 2008 and 2010 were retrospectively reviewed. A Markov decision analytic model, using an NHS perspective and lifetime horizon, was used to compare costs and quality-adjusted life-years (QALYs) associated with 7 screening strategies followed by chemoprophylaxis: TST alone, IGRA (QFT-GIT or T-SPOT) alone, TST positive followed by IGRA, and TST negative followed by IGRA. Future costs and QALYs were discounted at 3.5% per year. Results: 381 asymptomatic close contacts aged 18 to 65 years were included in this study. The mean age was 35.2 years and the majority (75.3%) were BCG vaccinated. In the base-case analysis, QFT-GIT was the most cost-effective strategy with £6876 per QALY gained, compared to TST positive followed by QFT-GIT strategy. QFT-GIT alone averted 1.6 TB cases per 1000 contacts compared to TST positive followed by QFT-GIT. Conclusion: Of the considered testing strategies, the QFT-GIT alone is preferable for LTBI screening in adult close contacts of pulmonary TB cases in London

P109 The impact of tb nice guidance on resource capacity and contact screening outcomes: a retrospective, observational study within a central london tb centre

Introduction and objectives: Recently published NICE guidance has significantly expanded the approach to adult tuberculosis (TB) contact screening by recommending tuberculin skin testing (TST) for pulmonary and laryngeal contacts only, increasing the age threshold for screening and treatment to 65 years and defining a positive TST as induration ≥5 mm, regardless of BCG vaccination status. Interferon Gamma Release Assay (IGRA) is recommended only in situations where more evidence of infection is needed. Our institution has previously adopted an approach comprising a chest radiograph, TST and IGRA. The aim of our study was to evaluate the impact of NICE guidance on screening outcomes and resource capacity by applying the criteria to a well-defined historic cohort of TB contacts. Methods: This was a retrospective, observational study carried out at a central London teaching hospital. The study population comprised 593 consecutive, adult TB contacts screened between 1/1/2008 and 31/12/2010. Data was collected through a retrospective review of TST and IGRA tests. Results: Of the 593 contacts screened, 358 pulmonary contacts had TST and IGRA results. 56% had a TST ≥5 mm, regardless of BCG status, qualifying them for treatment as per the new NICE guidance. Of these, 61% were IGRA negative (discordant) and may therefore include false positive diagnoses, resulting in the potential for over treatment. In those with TST 5–14 mm, discordance rises to 84%. Conversely, 6% of those with TST < 5 mm are IGRA positive representing potentially missed cases. 16% of screened individuals were contacts of extra pulmonary TB. Not screening this group would reduce the demand for outpatient appointments by 151* in our cohort. In contrast, testing contacts > 35 years would require capacity for an additional 165* appointments. Furthermore, there were 162 additional LTBI cases in comparison to previous guidance requiring an additional 648* appointments. 72% of this group were IGRA negative. (*Approximate) Conclusions: Our results show the revised guidance will require increased resource capacity largely due to more patients being classified as having latent TB. In addition to workforce planning to meet these demands, further debate is needed to decide if this new approach truly reduces the incidence of active TB or results in unnecessary treatment

Persistence in systems with conserved order parameter

We consider the low-temperature coarsening dynamics of a one-dimensional Ising ferromagnet with conserved Kawasaki-like dynamics in the domain representation. Domains diffuse with size-dependent diffusion constant, $D(l) \propto l^\gamma$ with $\gamma = -1$. We generalize this model to arbitrary $\gamma$, and derive an expression for the domain density, $N(t) \sim t^{-\phi}$ with $\phi=1/(2-\gamma)$, using a scaling argument. We also investigate numerically the persistence exponent $\theta$ characterizing the power-law decay of the number, $N_p(t)$, of persistent (unflipped) spins at time $t$, and find $N_{p}(t)\sim t^{-\theta}$ where $\theta$ depends on $\gamma$. We show how the results for $\phi$ and $\theta$ are related to similar calculations in diffusion-limited cluster-cluster aggregation (DLCA) where clusters with size-dependent diffusion constant diffuse through an immobile `empty' phase and aggregate irreversibly on impact. Simulations show that, while $\phi$ is the same in both models, $\theta$ is different except for $\gamma=0$. We also investigate models that interpolate between symmetric domain diffusion and DLCA.Comment: 9 pages, minor revision

The ``Outside-In'' Outburst of HT Cassiopeiae

We present results from photometric observations of the dwarf nova system HT Cas during the eruption of November 1995. The data include the first two--colour observations of an eclipse on the rise to outburst. They show that during the rise to outburst the disc deviates significantly from steady state models, but the inclusion of an inner-disc truncation radius of about 4 $R_{wd}$ and a ``flared'' disc of semi-opening angle of $10^{\circ}$ produces acceptable fits. The disc is found to have expanded at the start of the outburst to about $0.41R_{L1}$, as compared to quiescent measurements. The accretion disc then gradually decreases in radius reaching $<0.32R_{L1}$ during the last stages of the eruption. Quiescent eclipses were also observed prior to and after the eruption and a revised ephemeris is calculated.Comment: 9 pages, 11 figures, to appear in MNRA

Whole Earth Telescope observations of the hot helium atmosphere pulsating white dwarf EC 20058-5234

We present the analysis of a total of 177h of high-quality optical time-series photometry of the helium atmosphere pulsating white dwarf (DBV) EC 20058-5234. The bulk of the observations (135h) were obtained during a WET campaign (XCOV15) in July 1997 that featured coordinated observing from 4 southern observatory sites over an 8-day period. The remaining data (42h) were obtained in June 2004 at Mt John Observatory in NZ over a one-week observing period. This work significantly extends the discovery observations of this low-amplitude (few percent) pulsator by increasing the number of detected frequencies from 8 to 18, and employs a simulation procedure to confirm the reality of these frequencies to a high level of significance (1 in 1000). The nature of the observed pulsation spectrum precludes identification of unique pulsation mode properties using any clearly discernable trends. However, we have used a global modelling procedure employing genetic algorithm techniques to identify the n, l values of 8 pulsation modes, and thereby obtain asteroseismic measurements of several model parameters, including the stellar mass (0.55 M_sun) and T_eff (~28200 K). These values are consistent with those derived from published spectral fitting: T_eff ~ 28400 K and log g ~ 7.86. We also present persuasive evidence from apparent rotational mode splitting for two of the modes that indicates this compact object is a relatively rapid rotator with a period of 2h. In direct analogy with the corresponding properties of the hydrogen (DAV) atmosphere pulsators, the stable low-amplitude pulsation behaviour of EC 20058 is entirely consistent with its inferred effective temperature, which indicates it is close to the blue edge of the DBV instability strip. (abridged)Comment: 19 pages, 8 figures, 5 tables, MNRAS accepte

10 simple rules to create a serious game, illustrated with examples from structural biology

Serious scientific games are games whose purpose is not only fun. In the field of science, the serious goals include crucial activities for scientists: outreach, teaching and research. The number of serious games is increasing rapidly, in particular citizen science games, games that allow people to produce and/or analyze scientific data. Interestingly, it is possible to build a set of rules providing a guideline to create or improve serious games. We present arguments gathered from our own experience ( Phylo , DocMolecules , HiRE-RNA contest and Pangu) as well as examples from the growing literature on scientific serious games