Search

Objective: To assess perspectives and experiences of healthcare professionals and other relevant stakeholders regarding psychosocial support and palliative care in mesothelioma patients and their relatives, to identify gaps and to explore potential improvements in current healthcare. Methods: Individual, semi‐structured interviews were conducted with healthcare professionals and other relevant stakeholders. Interviews were transcribed verbatim and analysed thematically using ATLAS.ti. Results: In total, 16 respondents participated in an interview (69% women; mean age: 51.8 years (SD 12.41; range 28–75)). Four key themes were identified: (1) availability of tailored psychosocial and palliative care, (2) timely integration and organisation of psychosocial support and palliative care, (3) differences in provided support and care between healthcare professionals and hospitals and (4) training of healthcare professionals and stakeholders on psychosocial problems. Conclusion: Our study showed that psychosocial support and palliative care for patients with mesothelioma could be improved. A more fluent transition between primary and secondary cancer care and early integration of psychosocial support and palliative care is advised. Lastly, more attention is needed for psychosocial and palliative care in the basic medical training of healthcare professionals. [ABSTRACT FROM AUTHOR]

Rationale, aim, and objectives: More knowledge is needed regarding the complex factors and perceptions that enable the implementation of change in health care. The study aimed to examine the enabling factors and barriers encountered in the implementation of improvements in health care in order to achieve patient‐centred care (PCC) and to study if there was a correlation in the extent the improvements were perceived to be implemented and the preconditions that were considered to affect them. Methods: Using a mixed method design, data were gathered via a questionnaire and individual interviews with health care personnel, clinic managers, and first‐line managers. The data collection and analyses were based on the framework for Promoting Action on Research Implementation in Health Services (PARiHS). Correlations between PCC improvements and preconditions for improvements were performed. Results: A high level of involvement, knowledge, and adequate resources were considered important to achieve an implementation of PCC with joint responsibility. Leadership and management need to be explicit and promote continuous follow‐up and feedback. Preconditions for improvement had a linear correlation with the perceived level of implementation. Knowledge‐related preconditions had greatest impact on implementation. Conclusions: The PARiHS framework was appropriate to use since the three components of evidence, context, and facilitation present different important preconditions in the implementation process. Evidence was the highest rated contributor since evidence‐based practices in health care are necessary. It is vital that the important role of the context and facilitators is acknowledged in the implementation process to enable a successful implementation of change. There is a need to incorporate a clear strategy involving all levels in the organization. Furthermore, leaders play an important role in the implementation by facilitating communication and support and by having trust in facilitators and health care personnel. The results are applicable to other interventions implementing change in health care. [ABSTRACT FROM AUTHOR]

China is facing many challenges in the area of high‐precision exploration for deep mineral resources, and also in environmental and engineering fields. It has become an urgent task to realize geophysical explorations with high precision and high efficiency in complex environments. It has been found that the traditional transient electromagnetic method (TEM) had a series of problems related to theory, method, and instrument, as well as data interpretation. Based on the reviews of present TEM achievements, three new improved measurements are introduced. The central‐loop system was improved by a large fixed‐loop system; the long‐offset system was changed to the short‐offset one; the resistivity profile was transformed into a virtual wave‐field profile. Finally, this paper points out that the future research direction of the TEM method is in terms of equipment, data processing, and big data information. [ABSTRACT FROM AUTHOR]

Child welfare removals of children are among the most invasive decisions a state can make toward its citizens, and typically it is the courts that make these decisions. These interventions are regularly exposed to criticism. In this paper, we examine if and how care order proceedings could be improved in England, Finland, Norway, and California, USA. We have asked the judiciary decision‐makers about their view on what should be improved. Our findings show that the organization of the proceedings, including time and staff, are identified as issues in all four systems. Furthermore, the preparations by the child welfare agency are also mentioned as an issue, for English, Finnish, and Californian decision‐makers. Very few decision‐makers indicate features related to the individual, situational, and contextual dimensions, which is interesting since this would be expected from organization theory. The strong call for change in the way proceedings are organized indicates a need for modernization as well as better use of available competency from child development experts. The respondents focus on the elements that a decision‐maker has direct experience with and knowledge about, and this is indeed worth noting for policymakers in the four systems. [ABSTRACT FROM AUTHOR]

In this study, the authors introduce new solutions and improvements to the multi‐channel blind image deconvolution problem. More precisely, authors' contributions are threefold: (i) At first, a simplified version of the existing cross‐relation method for blind system identification is proposed; but most importantly, the authors incorporate into the channel estimation cost function a sparsity constraint to deal with the challenging issue of channel order overestimation errors; (ii) then, once the channel identification is achieved, a new image restoration method based on the stack decoding algorithm is introduced; and (iii) finally, a refining approach using an 'all‐at‐once' optimisation technique with an improved mixed norm regularisation is considered. The performance of the proposed approach was evaluated using several numerical simulations. Blind system identification and image restoration tasks were evaluated with respect to several criteria: numerical complexity, robustness to noise effects and channel order estimation. The results obtained are promising and highlight the effectiveness of the proposed approach. [ABSTRACT FROM AUTHOR]

The improvement of process representations in hydrological models is often only driven by the modelers' knowledge and data availability. We present a comprehensive comparison between two hydrological models of different complexity that is developed to support (1) the understanding of the differences between model structures and (2) the identification of the observations needed for model assessment and improvement. The comparison is conducted on both space and time and by aggregating the outputs at different spatiotemporal scales. In the present study, mHM, a process‐based hydrological model, and ParFlow‐CLM, an integrated subsurface‐surface hydrological model, are used. The models are applied in a mesoscale catchment in Germany. Both models agree in the simulated river discharge at the outlet and the surface soil moisture dynamics, lending their supports for some model applications (drought monitoring). Different model sensitivities are, however, found when comparing evapotranspiration and soil moisture at different soil depths. The analysis supports the need of observations within the catchment for model assessment, but it indicates that different strategies should be considered for the different variables. Evapotranspiration measurements are needed at daily resolution across several locations, while highly resolved spatially distributed observations with lower temporal frequency are required for soil moisture. Finally, the results show the impact of the shallow groundwater system simulated by ParFlow‐CLM and the need to account for the related soil moisture redistribution. Our comparison strategy can be applied to other models types and environmental conditions to strengthen the dialog between modelers and experimentalists for improving process representations in Earth system models. Key Points: A comprehensive approach is developed to compare states and fluxes simulated by different models at different spatial and temporal scalesDifferent strategies depending on the model output are identified to discriminate between model structures and for modeling improvementsThe approach strengthens the dialog between modelers and experimentalists for improving process representation in hydrological models [ABSTRACT FROM AUTHOR]

Objective: To (1) determine how intended users interact with and use the BD Odon Device in simulation, (2) use these findings to alter progressively the design of the BD Odon Device and (3) validate that these changes have improved the ability of practitioners to use the BD Odon Device.Design: Human factors evaluation study.Setting: Simulation suite designed to mimic delivery room.Population or Sample: Three hundred and ninety simulated operative births, performed by 100 practising clinicians.Methods: Simulated operative vaginal births performed using the BD Odon Device and the device Instructions for use were subjected to three formative human factors evaluations and one human factors validation test. Following each evaluation, findings were reviewed and the design of the BD Odon Device and Instructions for use were modified.Main Outcome Measures: Successful performance of an operative vaginal birth using the BD Odon Device in accordance with provided training and Instructions for use.Results: Using version two of the BD Odon Device, and following exposure to face-to-face training and written instructions, 25% of accouchers were able successfully to perform a simulated operative vaginal birth. In the final evaluation, following device design and training material alterations, all accouchers were able successfully to perform a simulated operative vaginal birth using version four of the BD Odon Device.Conclusions: Human factors evaluations have enabled a multi-professional device and training materials design team to alter the design of the BD Odon Device and the Instructions for use in an evidence-based fashion. This process has resulted in a device which has a predictable and likely safe pattern of use.Tweetable Abstract: Human Factors evaluations help make the BD Odon Device safe and usable for clinical practice. [ABSTRACT FROM AUTHOR]

SUMMARY In the past, two-way left-turn lane (TWLTL) median treatments have been frequently used in Florida to inexpensively improve traffic and safety performances. In order to identify factors that may have significant impacts on safety operations in TWLTL sections and to identify TWLTL locations that present existing and future safety concerns, a research project was carried out and results are summarized in the paper. In the research, a three-year crash history database with crashes and section characteristics from a total of 1688 TWLTL sections all over Florida was developed and used. A negative binomial regression model was developed to determine the statistical relationship between the number of crashes per mile per year and several variables such as traffic volume, access density, posted speed, and number of lanes. In regard to the methodology, in order to identify locations with safety concerns, several steps are needed: development of real crash data distribution, determination of statistical distribution models that better represent the actual crash data, determination of percentile values for the average number of crashes, estimation of crash rates for sections with the same characteristics, estimation of critical values for the variables corresponding to the percentile values for average number of crashes, calculation of tables of critical average annual daily traffic values, and generation of a list of TWLTL locations with critical safety concerns. Results presented in the paper have been used in real applications. Copyright © 2012 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Evidence-based medicine implies that randomised controlled trials, meta-analyses and systematic reviews will be used by clinicians to determine the most appropriate therapy for patients. Cochrane reviews are the prototype of systematic reviews, but they are not optimally utilised by physicians in the United States. This may be related to lack of access, unfamiliarity with the format, and the perception that they are impractical for actual patient care. An opportunity exists to criticize and improve systematic reviews, and changes are suggested to make them more user-friendly. [ABSTRACT FROM AUTHOR]

Objective: To (1) determine how intended users interact with and use the BD Odon Device in simulation, (2) use these findings to alter progressively the design of the BD Odon Device and (3) validate that these changes have improved the ability of practitioners to use the BD Odon Device., Design: Human factors evaluation study., Setting: Simulation suite designed to mimic delivery room., Population or Sample: Three hundred and ninety simulated operative births, performed by 100 practising clinicians., Methods: Simulated operative vaginal births performed using the BD Odon Device and the device Instructions for use were subjected to three formative human factors evaluations and one human factors validation test. Following each evaluation, findings were reviewed and the design of the BD Odon Device and Instructions for use were modified., Main Outcome Measures: Successful performance of an operative vaginal birth using the BD Odon Device in accordance with provided training and Instructions for use., Results: Using version two of the BD Odon Device, and following exposure to face-to-face training and written instructions, 25% of accouchers were able successfully to perform a simulated operative vaginal birth. In the final evaluation, following device design and training material alterations, all accouchers were able successfully to perform a simulated operative vaginal birth using version four of the BD Odon Device., Conclusions: Human factors evaluations have enabled a multi-professional device and training materials design team to alter the design of the BD Odon Device and the Instructions for use in an evidence-based fashion. This process has resulted in a device which has a predictable and likely safe pattern of use., Tweetable Abstract: Human Factors evaluations help make the BD Odon Device safe and usable for clinical practice., (© 2017 Royal College of Obstetricians and Gynaecologists.)