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Selected AbstractsChemical Injury to the Eye from Trichloroacetic AcidDERMATOLOGIC SURGERY, Issue 7 2002Jason F. Fung MD background. Trichloroacetic acid (TCA) is frequently utilized for chemical peeling by physicians practicing dermatologic surgery. Ocular complications from TCA have not been reported previously. objective. The purpose of this article is to underscore the irritating and corrosive effects of TCA on the eye. methods. A patient is described who experienced seepage of 35% TCA into the eye during a chemical peel. results. The patient developed marked conjunctivitis of the affected eye and abrasions involving 25% of the cornea. conclusion. TCA must be applied carefully around the eyes to avoid ocular complications, which albeit rare, can be quite grave if not addressed in a timely manner. [source] Cash-based interventions: lessons from southern SomaliaDISASTERS, Issue 3 2006Hanna Mattinen Abstract Commodity distributions, the predominant relief response, are subject to growing criticism, while donors and humanitarian actors are increasingly viewing cash-based interventions as a viable alternative. This paper aims to contribute to the current debate on cash-based interventions by drawing on the experience of Action Contre la Faim in southern Somalia, where it has implemented cash for work programmes since 2004. The authors conclude that cash-based interventions are a feasible option in complex emergencies as well as in highly insecure environments as long as appropriate modalities are employed and objectives are clearly set in accordance with the needs and the context. Cash as a relief response offers wide-reaching possibilities for the future from both the perspective of the donor/agency and the standpoint of the beneficiary. It enables the beneficiaries to take control of the relief themselves and to adapt it to their individual requirements in a timely manner. [source] Clinical research networks in diabetes: the evolving role of the research nurseEUROPEAN DIABETES NURSING, Issue 1 2007P Chester PhD Visiting Academic Abstract The importance of evidence-based care for patients with diabetes is well established, and the evidence required to make decisions about patient care is generated through research and audit. The rigours of the research process and the need to enrol large numbers of patient volunteers in a timely manner has meant that most studies are now conducted at multiple sites. Research infrastructure is costly to implement, but is important for successful clinical research projects. By establishing permanent networks this infrastructure can be maintained and built upon. Research nursing has evolved as a new but very important discipline within the nursing profession in recent years and it has been pivotal for the success of many studies. In this article we examine the potential for clinical research networks to facilitate high quality clinical research and in particular the development of the research nurse role. Copyright © 2007 FEND. [source] Waiting for Broadband: Local Competition and the Spatial Distribution of Advanced Telecommunication Services in the United StatesGROWTH AND CHANGE, Issue 2 2004TONY H. GRUBESIC ABSTRACT With the passage of the Telecommunications Act of 1996, Congress directed the Federal Communications Commission and all fifty U.S. states to encourage the deployment of advanced telecommunication capability in a reasonable and timely manner. Today, with the rollout of advanced data services such as digital subscriber lines (xDSL), cable modems, and fixed wireless technologies, broadband has become an important component of telecommunication service and competition. Unfortunately, the deployment of last-mile infrastructure enabling high-speed access has proceeded more slowly than anticipated and competition in many areas is relatively sparse. More importantly, there are significant differences in the availability of broadband services between urban and rural areas. This paper explores aspects of broadband access as a function of market demand and provider competition. Data collected from the Federal Communications Commission is analyzed using a geographic information system and spatial statistical techniques. Results suggest significant spatial variation in broadband Internet access as a function of provider competition in the United States. [source] Living donor liver transplantation for patients with fulminant hepatic failureHEPATOLOGY RESEARCH, Issue 2008Yasuhiko Hashikura The prognosis for patients with fulminant hepatic failure has improved since the introduction of liver transplantation. However, the death rate of patients awaiting liver transplantation is high, possibly because of the difficulty in obtaining grafts in a timely manner, given the relative shortage of cadaveric donors. Under these circumstances, living donor liver transplantation is an alternative therapeutic option for patients with fulminant hepatic failure. The present review provides recent updates on the clinical and therapeutic aspects of living donor liver transplantation for fulminant hepatic failure. [source] Transforming information systems development through computer-aided systems engineering (CASE): lessons from practiceINFORMATION SYSTEMS JOURNAL, Issue 3 2000Tom Butler Abstract. In dealing with the challenges posed by the ongoing problem of developing and integrating an evermore complex and diverse range of information systems in a timely manner, practitioners continue to grapple with important issues such as increasing developer productivity and bringing quality improvements to the process and product of systems development. Many organizations have adopted computer-aided systems engineering (CASE) tools with such outcomes in mind. With few exceptions, previous research into the phenomenon of CASE adoption and use has been survey based in the main, and has resulted in some confusion over the benefits to be derived from the use of CASE tools within the systems development process. This paper extends previous work as part of an interpretive, case-based research strategy to examine the adoption and use of integrated CASE (I-CASE) in a single organization. Such an approach facilitates a deeper understanding of the impact that CASE exerts on the process and product of systems development. Based on the experience of practitioners in the organization studied, a set of recommendations is presented. The findings of this study also lend support to the view that an I-CASE development platform does indeed have the potential to exert a positive impact on the development process and its product. [source] Systematic review of the effectiveness of integrated care pathways: what works, for whom, in which circumstances?INTERNATIONAL JOURNAL OF EVIDENCE BASED HEALTHCARE, Issue 2 2009Davina Allen RGN BA(Hons) PhD Abstract Aim, Integrated care pathways (ICP) are management technologies which formalise multidisciplinary team-working and enable professionals to examine their roles and responsibilities. ICPs are now being implemented across international healthcare arena, but evidence to support their use is equivocal. The aim of this study was to identify the circumstances in which ICPs are effective, for whom and in what contexts. Methods, A systematic review of high-quality randomised controlled trials published between 1980 and 2008 (March) evaluating ICP use in child and adult populations in the full range of healthcare settings. Results 1For relatively predictable trajectories of care ICPs can be effective in supporting proactive care management and ensuring that patients receive relevant clinical interventions and/or assessments in a timely manner. This can lead to improvements in service quality and service efficiency without adverse consequences for patients. 2ICPs are an effective mechanism for promoting adherence to guidelines or treatment protocols thereby reducing variation in practice. 3ICPs can be effective in improving documentation of treatment goals, documentation of communication with patients, carers and health professionals. 4ICPs can be effective in improving physician agreement about treatment options. 5ICPs can be effective in supporting decision-making when they incorporate a decision-aide. 6The evidence considered in this review indicates that ICPs may be particularly effective in changing professional behaviours in the desired direction, where there is scope for improvement or where roles are new. 7Even in contexts in which health professionals are already experienced with a particular pathway, ICP use brings additional beneficial effects in directing professional practice in the desired direction. 8ICPs may be less effective in bringing about service quality and efficiency gains in variable patient trajectories. 9ICPs may be less effective in bringing about quality improvements in circumstances in which services are already based on best evidence and multidisciplinary working is well established. 10Depending on their purpose, the benefits of ICPs may be greater for certain patient subgroups than others. 11We do not know whether the costs of ICP development and implementation are justified by any of their reported benefits. 12ICPs may need supporting mechanisms to underpin their implementation and ensure their adoption in practice, particularly in circumstances in which ICP use is a significant change in organisational culture. 13ICP documentation can introduce scope for new kinds of error. Conclusions, ICPs are most effective in contexts where patient care trajectories are predictable. Their value in settings in which recovery pathways are more variable is less clear. ICPs are most effective in bringing about behavioural changes where there are identified deficiencies in services; their value in contexts where inter-professional working is well established is less certain. None of the studies reviewed included an economic evaluation and thus it is not known whether their benefits justify the costs of their implementation. [source] Mobility prediction and routing in ad hoc wireless networksINTERNATIONAL JOURNAL OF NETWORK MANAGEMENT, Issue 1 2001William Su By exploiting non-random behaviors for the mobility patterns that mobile users exhibit, we can predict the future state of network topology and perform route reconstruction proactively in a timely manner. Moreover, by using the predicted information on the network topology, we can eliminate transmissions of control packets otherwise needed to reconstruct the route and thus reduce overhead. In this paper, we propose various schemes to improve routing protocol performances by using mobility prediction. We then evaluate the effectiveness of using mobility prediction via simulation. Copyright © 2001 John Wiley & Sons, Ltd. [source] Concurrent Detection of Heroin, Fentanyl, and Xylazine in Seven Drug-related Deaths Reported from the Philadelphia Medical Examiner's OfficeJOURNAL OF FORENSIC SCIENCES, Issue 2 2008Stella C. Wong D.O. Abstract:, Recreational drugs, such as cocaine and heroin, are often adulterated with other pharmacological agents to either enhance or diminish the drug effects. Between April 21, 2006 and August 8, 2006, the Philadelphia Medical Examiner's Office detected xylazine (a veterinary sedative) and fentanyl (a synthetic opioid) in specimens taken from seven cases. Initial immunoassay screening was performed on urine and blood for fentanyl, opiate, cocaine, phencyclidine (PCP), and benzodiazepines. All tests reported positive were confirmed by gas chromatography-mass spectrometry. All seven xylazine positive cases tested positive for fentanyl and six cases tested positive for 6-acetylmorphine (a metabolite and definitive marker for heroin). The seventh case was positive for morphine and had a history of heroin abuse. Xylazine was present in urine in all seven cases and blood levels were detected in three cases. The blood concentrations ranged from trace to 130 ng/mL. Fentanyl was present in the blood and urine in each case and blood concentrations ranged from 4.7 to 47 ng/mL. Adulteration of illicit drugs has become an epidemic health concern for drug users. Healthcare professionals need to be aware of this issue, so the patients can be treated in an effective, timely manner. [source] The Role of International Financial Reporting Standards in Accounting Quality: Evidence from the European UnionJOURNAL OF INTERNATIONAL FINANCIAL MANAGEMENT & ACCOUNTING, Issue 3 2010Huifa Chen Previous studies on the effect of International Financial Reporting Standards (IFRS) on accounting quality often have difficulties to control for confounding factors on accounting quality. As a result, the observed changes in accounting quality could not be attributed mainly to IFRS. We use a unique research setting to address this issue by comparing the accounting quality of publicly listed companies in 15 member states of the European Union (EU) before and after the full adoption of IFRS in 2005. We use five indicators as proxies for accounting quality. We find that the majority of accounting quality indicators improved after IFRS adoption in the EU. That is, there is less of managing earnings toward a target, a lower magnitude of absolute discretionary accruals, and higher accruals quality. But our results also show that firms engage in more earnings smoothing and recognize large losses in a less timely manner in post-IFRS periods. In addition, we examine the effects of institutional variables on financial reporting quality. Our contribution to the literature is that we show the improved accounting quality is attributable to IFRS, rather than changes in managerial incentives, institutional features of capital markets, and general business environment, etc. [source] Drug rash with eosinophilia and systemic symptoms secondary to sulfasalazineJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 4 2010Jeremy Rosenbaum Abstract A severe cutaneous eruption in an unwell patient can be a major cause of physician anxiety. With numerous differential diagnoses, an early accurate diagnosis can be challenging. infectious causes are the most important to exclude in a timely manner and drug rash and eosinophilia with systemic symptoms (DRESS) is another differential diagnosis that should be considered in children. This hypersensitivity reaction is associated with multisystem involvement. Children with underlying chronic diseases may have impairment of normal metabolic pathways and are also often on multiple medications. Therefore, drugs should always be considered in the aetiopathology of any new symptoms and signs. This case report informs readers of the association of sulfasalazine and DRESS in an 11-year-old with inflammatory bowel disease and discusses its pathogenesis and treatment. Increased awareness of this disorder will hopefully lead to increased reporting and consequently illuminate the syndrome more clearly and help guide its prevention and treatment. [source] Common complaints, difficult diagnosis: Multiple myelomaJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 5 2006Clinical Nurse), Colleen Dvorak RN, OCN (Graduate student, currently in the Acute Care Nurse Practitioner Program with a focus in oncology Abstract Purpose: To review the presenting signs and symptoms of multiple myeloma, its pathophysiology, diagnostic evaluation, and treatment options. Data sources: A literature review of research articles and publications by oncology experts who specialize in multiple myeloma, supplemented by a case study. Conclusions: Multiple myeloma is a cancer of the geriatric population, with the average age at diagnosis between 65 and 68 years. As the population of those over age 65 is predicted to double by the year 2050, the incidence of myeloma is expected to increase. Nurse practitioners (NPs) must become familiar with the signs, symptoms, and complications of myeloma for patients to be diagnosed and referred to specialists in a timely manner. Implications for practice: Patients with multiple myeloma often present with vague, common symptoms such as back pain, bony pain, fatigue, and anemia. These symptoms may be treated as separate medical conditions if NPs fail to include multiple myeloma in their differential diagnosis. If NPs are educated on this malignancy, they will have the expertise to look for other signs of the disease such as hypercalcemia, pathological fractures, osteopenia, or renal failure. Without early recognition of multiple myeloma and referrals to oncology specialists, patients are left with a delayed diagnosis and poor symptom control. [source] Disseminating early interventions following traumaJOURNAL OF TRAUMATIC STRESS, Issue 5 2006Jonathan I. Bisson Dissemination of effective early interventions following trauma is necessary to ensure the provision of the best possible care in a timely manner. To achieve this, agreement from all key stakeholders is required regarding the messages to be disseminated and the means of dissemination. This article is based on a National Institute of Mental Health sponsored symposium on the dissemination of early interventions at the 21st annual meeting of the International Society for Traumatic Stress Studies in Toronto in 2005. The current knowledge base regarding the effectiveness and dissemination of early interventions (defined here as those that are begun within the first 3 months after exposure) following trauma for children, adolescents, and adults is considered. [source] The management lessons learned from sediment remediation in the Detroit River , western Lake Erie watershedLAKES & RESERVOIRS: RESEARCH AND MANAGEMENT, Issue 3-4 2004John H. Hartig Abstract During the 1970s,1990s, considerable emphasis was placed on minimizing the inputs of polychlorinated biphenyls (PCBs) from active sources. In addition, between 1993 and 2001, , $US130 × 106 was spent for sediment remediation within the western Lake Erie , Detroit River basin. In general, although PCB contamination of the Detroit River and Lake Erie declined significantly between the 1970s and mid-1990s, it has remained fairly stable over the past 10 years. Control of PCBs and other contaminants at their source remains a primary imperative for action. Remediation of contaminated sediments is growing in importance, however, as greater levels of source control are achieved. From a sediment management perspective, it is estimated that between 1993 and 2001 a substantially higher mass of PCBs (over two orders of magnitude higher) was removed as a result of contaminated sediment remediation, as compared to navigational dredging of shipping channels. In addition, there is a strong and compelling rationale for moving expeditiously to remediate severely contaminated sediment while it is still relatively contained in a small geographical area. The cost of not acting in a timely manner might be to exacerbate environmental problems including increased deformities and reproductive problems in wildlife, delayed ecosystem recovery and increased costs, or even preclusion of future sediment remediation. Based on discussions at a United States of America,Canada workshop held in 2002, key management advice includes continued emphasis to be placed on remediating contaminated sediment hot spots (including evaluating the effectiveness of projects), integrated monitoring efforts to be focused on beneficial use restoration and a high priority to be placed on sustaining and building upon modelling efforts, in order to be able to accurately predict and evaluate ecosystem responses to remedial and preventive actions. [source] Collateral Capillary Arterialization following Arteriolar Ligation in Murine Skeletal MuscleMICROCIRCULATION, Issue 5 2010FEILIM MAC GABHANN Microcirculation (2010) 17, 333,347. doi: 10.1111/j.1549-8719.2010.00034.x Abstract Objective:, Chronic and acute ischemic diseases,peripheral artery disease, coronary artery disease, stroke,result in tissue damage unless blood flow is maintained or restored in a timely manner. Mice of different strains recover from arteriolar ligation (by increasing collateral blood flow) at different speeds. We quantify the spatio-temporal patterns of microvascular network remodeling following arteriolar ligation in different mouse strains to better understand inter-individual variability. Methods:, Whole-muscle spinotrapezius microvascular networks of mouse strains C57Bl/6, Balb/c and CD1 were imaged using confocal microscopy following ligation of feeding arterioles. Results:, Baseline arteriolar structures of C57Bl/6 and Balb/c mice feature heavily ramified arcades and unconnected dendritic trees, respectively. This network angioarchitecture identifies ischemia-protected and ischemia-vulnerable tissues; unlike C57Bl/6, downstream capillary perfusion in Balb/c spinotrapezius is lost following ligation. Perfusion recovery requires arterialization (expansion and investment of mural cells) of a subset of capillaries forming a new low-resistance collateral pathway between arteriolar trees. Outbred CD1 exhibit either Balb/c-like or C57Bl/6-like spinotrapezius angioarchitecture, predictive of response to arteriolar ligation. Conclusions:, This collateral capillary arterialization process may explain the reported longer time required for blood flow recovery in Balb/c hindlimb ischemia, as low-resistance blood flow pathways along capillary conduits must be formed ("arterialization") before reperfusion. [source] Understanding the Chain of Communication During a DisasterPERSPECTIVES IN PSYCHIATRIC CARE, Issue 1 2007Heather Shover MD TOPIC.,Every disaster begins on a local level and may, depending on size, evolve to a state of federal disaster response. Understanding California's State Disaster Plan and the importance of the chain of communication is a first step to understanding the Federal Disaster Response system. The chain of command is critical to making sure services and resources are utilized in a timely manner without duplication. PURPOSE.,This paper's intent is to define California's present emergency management system (EMS) infrastructure from local to state level and educate healthcare professionals for disaster activation. CONCLUSIONS.,It is imperative that all voluntary healthcare professionals learn the chain of command within the disaster response system. Each disaster response begins with the individual's preparedness at the local level and all disaster preparedness must incorporate training of health professionals, citizens, and families in local disaster drills. [source] Pulmonary complications following hematopoietic stem cell transplantation: Diagnostic approachesAMERICAN JOURNAL OF HEMATOLOGY, Issue 2 2005Kasem Sirithanakul Abstract Pulmonary complications are a significant cause of morbidity and mortality in hematopoietic stem cell transplant recipients. Pulmonary infiltrates in such patients pose a major challenge for clinicians because of the wide differential diagnosis of infectious and noninfectious conditions. It is rare for the diagnosis to be made by chest radiograph, and commonly these patients will need further invasive and noninvasive studies to confirm the etiology of the pulmonary infiltrates. This review describes the role of the different diagnostic tools available to reach a diagnosis in a timely manner in this patient population. Am. J. Hematol. 80:137,146, 2005. © 2005 Wiley-Liss, Inc. [source] Management of red cell alloimmunisation in pregnancy: the non-invasive monitoring of the diseasePRENATAL DIAGNOSIS, Issue 7 2010Sebastian Illanes Abstract Haemolytic disease of the fetus and newborn (HDFN) due to red cell alloimmunization was a significant cause of fetal and neonatal morbidity and mortality until the introduction of anti-D immunoglobulin, which has dramatically changed the incidence of the disease. However, it is still a major problem in affected pregnancies. The emphasis of current clinical management has shifted from an invasive approach to non-invasive monitoring of the disease. The key elements of the modern management are determining which fetuses are at risk of HDFN with the use of cell-free fetal DNA in maternal plasma (fetal RHD genotype) and the follow-up of antigen positive fetuses by Doppler ultrasonography to detect anaemia severe enough to need treatment. When anaemia is suspected, an invasive approach is still required in a timely manner for confirmation of the degree of anaemia and to administer blood transfusions. This non-invasive approach prevents unnecessary administration of human-derived blood products, with the consequent ethical and cost implications and most importantly avoids iatrogenic conversion of mild to severe disease by avoiding need for techniques such as amniocentesis. The potential problem of the non-invasive approach is the reduction in the total number of invasive procedures, with the subsequent difficulty of maintaining the skills required to perform them. Copyright © 2010 John Wiley & Sons, Ltd. [source] A Review of the Cluster Survey Sampling Method in Humanitarian EmergenciesPUBLIC HEALTH NURSING, Issue 4 2008Shaun K. Morris ABSTRACT Obtaining quality data in a timely manner from humanitarian emergencies is inherently difficult. Conditions of war, famine, population displacement, and other humanitarian disasters, cause limitations in the ability to widely survey. These limitations hold the potential to introduce fatal biases into study results. The cluster sample method is the most frequently used technique to draw a representative sample in these types of scenarios. A recent study utilizing the cluster sample method to estimate the number of excess deaths due to the invasion of Iraq has generated much controversy and confusion about this sampling technique. Although subject to certain intrinsic limitations, cluster sampling allows researchers to utilize statistical methods to draw inferences regarding entire populations when data gathering would otherwise be impossible. [source] Lead in soil by field-portable x-ray fluorescence spectrometry,an examination of paired In Situ and laboratory ICP-AES resultsREMEDIATION, Issue 3 2008David A. Binstock A major aspect of lead hazard control is the evaluation of soil lead hazards around housing coated with lead-based paint. The use of field-portable X-ray fluorescence (FPXRF) to do detailed surveying, with limited laboratory confirmation, can provide lead measurements in soil (especially for planning abatement activities) in a far more cost-efficient and timely manner than laboratory analysis. To date, one obstacle to the acceptance of FPXRF as an approved method of measuring lead in soil has been a lack of correspondence between field and laboratory results. In order to minimize the differences between field and laboratory results, RTI International (RTI) has developed a new protocol for field drying and sieving soil samples for field measurement by FPXRF. To evaluate this new protocol, composite samples were collected in the field following both U.S. Department of Housing and Urban Development (HUD) guidelines and ASTM International (ASTM) protocols, measured after drying by FPXRF, and returned to the laboratory for confirmatory inductively coupled plasma atomic emission spectroscopy (ICP-AES) analysis. Evaluation of study data from several diverse sites revealed no statistical difference between paired FPXRF and ICP-AES measurements using the new method. © 2008 Wiley Periodicals, Inc. [source] A data integration framework to support Triad projectsREMEDIATION, Issue 1 2004Jim Mack Cost-effective and efficient site remediation and scientifically defensible decisions require site characterizations that are representative of site conditions. The Triad conceptual site model (CSM) is at the center of a continually improving site characterization process that begins during systematic planning and ends after the last data are developed. To gain the full benefit and greatest cost-effectiveness, the process of CSM refinement should be performed in real time. Thus, the use of collaborative data is critical for evolving and maturing the CSM. In the field, through the use of all available data that are of known quality, a skilled and experienced field team can collect sufficient site information to mature the CSM in a timely manner. To facilitate the planning and execution of such a process, an easily understandable framework is needed to structure data quality that supports scientifically defensible decisions and efficient projects. This article explores such a framework. © 2004 Wiley Periodicals, Inc. [source] Elucidation of the gating of the GIRK channel using a spectroscopic approachTHE JOURNAL OF PHYSIOLOGY, Issue 22 2009Adi Raveh The traditional view of G protein-coupled receptor (GPCR)-mediated signalling puts the players in this signalling cascade, namely the GPCR, the G protein and its effector, as individual components in space, where the signalling specificity is obtained mainly by the interaction of the GPCR and the G, subunits of the G protein. A question is then raised as to how fidelity in receptor signalling is achieved, given that many systems use the same components of the G protein signalling machinery. One possible mechanism for obtaining the specific flow of the downstream signals, from the activated G protein to its specific effector target, in a timely manner, is compartmentalization, a spatial arrangement of the complex in a rather restricted space. Here we review our recent findings related to these issues, using the G protein-coupled potassium channel (GIRK) as a model effector and fluorescence-based approaches to reveal how the signalling complex is arranged and how the G protein exerts its action to activate the GIRK channel in intact cells. [source] Techniques of vision: photography, disco and renderings of present perceptions in highland PapuaTHE JOURNAL OF THE ROYAL ANTHROPOLOGICAL INSTITUTE, Issue 1 2004Eric Hirsch This article draws on ethnographic and historical materials to interpret several related photographs and ritual images created by Fuyuge-speakers of highland Papua. The images are analysed as techniques of vision. That is, the images are shown to bring forth present perceptions in a timely manner, as evaluated by Fuyuge men and women. It is shown how the representations are informed by distinctive Fuyuge retentions of the past in the present, and extensions of the present in the future. The article suggests that the tendency to ,read' photographic images for their semiotic connotations misses the local perceptions at work in their creation and use. Rather, photographic and ritual images are analogous to the relations of persons that produce them, with their mutually connected temporality. [source] An overview of the heterogeneous telescope network system: Concept, scalability and operationASTRONOMISCHE NACHRICHTEN, Issue 3 2008R.R. White Abstract In the coming decade there will be an avalanche of data streams devoted to astronomical exploration opening new windows of scientific discovery. The shear volume of data and the diversity of event types (Kantor 2006; Kaiser 2004; Vestrand & Theiler & Wozniak 2004) will necessitate; the move to a common language for the communication of event data, and enabling telescope systems with the ability to not just simply respond, but to act independently in order to take full advantage of available resources in a timely manner. Developed over the past three years, the Virtual Observatory Event (VOEvent) provides the best format for carrying these diverse event messages (White et al. 2006a; Seaman & Warner 2006). However, in order for the telescopes to be able to act independently, a system of interoperable network nodes must be in place, that will allow the astronomical assets to not only issue event notifications, but to coordinate and request specific observations. The Heterogeneous Telescope Network (HTN) is a network architecture that can achieve the goals set forth and provide a scalable design to match both fully autonomous and manual telescope system needs (Allan et al. 2006a;White et al. 2006b; Hessman 2006b). In this paper we will show the design concept of this meta-network and nodes, their scalable architecture and complexity, and how this concept can meet the needs of institutions in the near future. (© 2008 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [source] The acute,aged care interface: Exploring the dynamics of ,bed blocking'AUSTRALASIAN JOURNAL ON AGEING, Issue 3 2008Catherine M Travers Objective: To understand the dynamics underlying ,bed-blocking' in Australian public hospitals that is frequently blamed on older patients. Methods: Analysis of primary and secondary data of utilisation patterns of hospital and aged care services by older Australians. Results: A model of the dynamics at the acute,aged care interface was developed, in which the pathway into permanent high-care Residential Aged Care (RAC) is conceptualised as competing queues for available places by applicants from the hospital, the community and from within RAC facilities. The hospital effectively becomes a safety net to accommodate people with high-care needs who cannot be admitted into RAC in a timely manner. Conclusion: The model provides a useful tool to explore some of the issues that give rise to access-block within the public hospital system. Access-block cannot be understood by viewing the hospital system in isolation from other sectors that support the health and well-being of older Australians. [source] Dynamic Comparison of Kaplan,Meier Proportions: Monitoring a Randomized Clinical Trial with a Long-Term Binary EndpointBIOMETRICS, Issue 1 2008Erica Brittain Summary The approach to early termination for efficacy in a trial where events occur over time but the primary question of interest relates to a long-term binary endpoint is not straightforward. This article considers comparison of treatment groups with Kaplan,Meier (KM) proportions evaluated at increasing times from randomization, at increasing calendar testing times. This strategy is employed to improve the ability to detect important treatment effects and provide critical treatments to patients in a timely manner. This dynamic Kaplan,Meier (DKM) approach is shown to be robust; that is, it produces high power and early termination time across a wide range of circumstances. In contrast, a fixed time KM comparison and the log-rank test are both shown to be more variable in performance. Practical considerations of implementing the DKM method are discussed. [source] | |||||||||||||||||||||||||