bluuebunny/crossref_metadata_2025 huggingface dataset:
A note on the properties of the primitive hydrostatic equations of motion
Authors: Norbury J. , Cullen M. J. P.
Published: July 2010

Discussion of the proper boundary conditions to use in limited area forecasting models requires knowledge of the properties of the governing equations. the theory of Oliger and Sundstrom states that the primitive hydrostatic equations commonly used are not hyperbolic and no local boundary conditions can be chosen. This paper shows their result to be incorrect, the equations are hyperbolic but not all the characteristics involve the time variable. Implications for the boundary conditions are discussed.
Aircraft and dual polarization radar observations of hydrometeors in light stratiform precipitation
Authors: Bader M. J. , Clough S. A. , Cox G. P.
Published: July 2010

A case study investigating the relationship of ice phase microphysical structure to differential reflectivity is presented. the distribution of ice crystal types in light precipitation is discussed and shown to agree with a theoretical model of an individual precipitation fallstreak. the particle characteristics were found to reflect sorting by size and type associated with fall through weak wind shear as well as growth in regimes of varying temperature and humidity within the fallstreak.

The observed differential reflectivities were compared with the in situ particle measurements and the association of high values with planar crystal structures demonstrated. the particle size distribution was found to have a marked influence on radar returns, particularly through the obscuring effects of large particles of indefinite shape. This effect gave rise to relative variations of differential reflectivity which were found to differ from the predictions of monodisperse models. In particular large dendritic crystals of low density were found in this case to be associated with stronger signatures than denser plate‐like crystals which from theoretical studies might be expected to produce the greatest differential reflectivity. Because of these complicating factors under stratiform conditions it was concluded that differential reflectivity data must be interpreted with considerable caution in the absence of in situ measurements or other supporting data.
The Influence of Diffusional Growth Rates On the Charge Transfer Accompanying Rebounding Collisions Between Ice Crystals and Soft Hailstones
Authors: Baker B. , Baker M. B. , Jayaratne E. R. , Latham J. , Saunders C. P. R.
Published: July 2010

Laboratory experiments designed to investigate the charge transfer accompanying rebounding collisions between ice crystals and soft hailstones were performed inside a cold room. They constitute an extension of those conducted with the same apparatus, reported in 1983 by Jayaratne et al. In particular, the range of temperature was extended (to cover −1.5°C to −35°C) and specific tests were performed in an effort to establish relationships between the sign and magnitude of the charging and the growth characteristics of both types of hydrometeor.

Significant charging was obtained only when the interacting surfaces were growing by vapour diffusion. the sign of the current, I, flowing to the simulated soft hailstone target in these circumstances was a sensitive function of time, liquid water content, and temperature. the complete set of results is qualitatively consistent with the hypothesis that I is positive if the target surface is growing more rapidly from the vapour than the ice crystals and is negative for the opposite case. In formulating a qualitative model of this hypothesis, account is taken of the contribution made to the diffusional growth of the target by the flux of vapour from droplets freezing onto its surface.

Crude calculations designed to assess the implications of these studies with respect to thunderstorm electrification, yield the conclusion that negative soft hailstone charging is likely to predominate over positive in most circumstances.
Estimating the subgrid variance of saturation, and its parametrization for use in a gcm cloud scheme
Authors: Cusack S. , Edwards J. M. , Kershaw R.
Published: July 2010

The prediction of cloud fraction and condensate in the unified weather forecasting/climate prediction model of the UK Meteorological Office, and many other general‐circulation models, depends upon a probability distribution of a saturation variable in a grid box. A method of estimating the width of the probability distribution of the saturation variable on the scales of one grid box of the climate configuration (2.5° latitude × 3.75° longitude) has been created, using analyses from the global weather forecasting configuration (0.55° latitude × 0.833° longitude). This width was found to be potentially very variable in time at many locations, therefore the use of climatological values was inappropriate. A parametrization was created to predict the width of the probability distribution of the saturation variable for use in the climate model. the concept of this empirical parametrization was based upon a scaling relationship often observed, and which is present in the global analyses. This new statistically based parametrization replaced the standard approximation used in the Hadley Centre climate model, and significantly reduced the model's biases concerning water vapour, temperature and cloud amount in the upper troposphere.
Thermodynamic control of tropical rainfall
Authors: Raymond D. J.
Published: July 2010

In 1987, Neelin and Held showed how, in the tropics, surface heat fluxes and infrared radiation control atmospheric convergence, and hence rainfall, by means of their joint effect on the supply of moist static energy to the troposphere. They also showed that for a given rate of supply of moist static energy, the strength of convergence is inversely proportional to a ‘gross moist stability’, which is related to the humidity of the troposphere and to the difference between the height of the environmental minimum in moist static energy and the elevation of maximum vertical mass‐flux. The present paper extends Neelin and Held's analysis to the non‐equilibrium case by invoking the somewhat speculative hypothesis that rainfall is primarily controlled by the mean saturation‐deficit of the troposphere. The relaxation time of the atmosphere to the Neelin‐Held equilibrium is found to be a strong function of the existing saturation‐deficit under this hypothesis.
On the mapping of multivariate geophysical fields: Error and variability subspace estimates
Authors: Lermusiaux P. F. J. , Anderson D. G. M. , Lozano C. J.
Published: July 2010

A basis is outlined for the first‐guess spatial mapping of three‐dimensional multivariate and multiscale geophysical fields and their dominant errors. The a priori error statistics are characterized by covariance matrices and the mapping obtained by solving a minimum‐error‐variance estimation problem. The size of the problem is reduced efficiently by focusing on the error subspace, here the dominant eigendecomposition of the a priori error covariance. The first estimate of this a priori error subspace is constructed in two parts. For the ‘observed’ portions of the subspace, the covariance of the a priori missing variability is directly specified and eigendecomposed. For the ‘non‐observed’ portions, an ensemble of adjustment dynamical integrations is utilized, building the non‐observed covariances in statistical accord with the observed ones. This error subspace construction is exemplified and studied in a Middle Atlantic Bight simulation and in the eastern Mediterranean. Its use allows an accurate, global, multiscale and multivariate, three‐dimensional analysis of primitive‐equation fields and their errors, in real time. The a posteriori error covariance is computed and indicates complex data‐variability influences. The error and variability subspaces obtained can also confirm or reveal the features of dominant variability, such as the Ierapetra Eddy in the Levantine basin.
Three‐dimensional chemical model simulations of the ozone layer: 1979–2015
Authors: Austin John , Knight Jeffrey , Butchart Neal
Published: July 2010

One‐year simulations of stratospheric chemistry are performed in a general‐circulation model (GCM). A fairly comprehensive description of stratospheric chemistry is included in a state‐of‐the‐art GCM which has been extended to the middle mesosphere. The predicted ozone concentration is used in the model radiation scheme, thereby coupling the dynamical and chemical processes. Simulations commence on 1 March in each of the years 1979, 1994, 1999, 2004, 2009 and 2014, and consist of a 4 month spin‐up period, followed by a 1‐year integration. Past and projected values of halogen amounts and greenhouse gases (GHGs) are imposed on the model. The results for 1979–80 and 1994–95 are generally in good agreement with observations, indicating in the latter case a deep Antarctic ozone hole and some Arctic ozone loss. For the 1979 simulation only a very shallow ozone hole was simulated, in agreement with observations. In about the year 2005, the Antarctic ozone hole reaches its maximum size and globally averaged ozone reaches its minimum, depending on the month. Tropical ozone continues to decrease until about 2010. Results in the Arctic are dominated by interannual variability, but minimum ozone may not be attained until the year 2010. The results suggest that the increase in GHGs is delaying the onset of ozone recovery. Relative to 1980 conditions, the model changes in ozone result in small predicted increases in surface ultraviolet radiation in the Arctic and mid‐latitude summer but large increases in the tropics and in the Antarctic summer.
Report on the phenological observations in the British Isles from December, 1933, to November, 1934. No. 44
Authors: Clark J. Edmund , Margary Ivan D. , Cave C. J. P.
Published: July 2010

The weather conditions of 1334 were almost as favourable as those of the preceding exceptional year. This is less obvious in the yearly totals, but the better distribution of rainfall reacted well in mitigating the serious droughts.

The conditions in the northern British districts Were again specially advantageous. Table V, p. 261, shows that the normal flowering divergence between England SW. and Scotland N., reduced to 9 days from the normal 20, was a day less than in 1933. In fact all parts south of the Humber averaged 3 days late.

For the first time in our 44 years the isakairs, Fig. 4, p. 239, show all Scotland and adjacent sections of England and Ireland as early; in parts up to 10 days. The great bulk of the remainder was as much or more late. As the 8 Districts in Table VI fall chiefly in the latter, their average divergence for the 13 plants is nil against 1 1/2 + days early in Table V.

As recorded on the opening page, we are deeply indebted to many helpers, apart from the year‐long alertness of our more than 500 recorders of over 16,000 observations embodied in this Report.
Configuration, air mass and rainfall
Authors: Poulter R. M.
Published: July 2010

After a survey of existing literature on this subject, the following theory is developed.

If a warm front, sloping at about I in 100, arrives and passes over land sloping upwards at I in 100, the rainfall will be approximately doubled; if a cold front sloping at about I in 50 arrives and passes over this land the rainfall will increase nearly 50 per cent. If, in the British Isles, France and similarly situated countries, the proportion of the annual rainfall which is associated with warm fronts is W and the proportion associated with cold fronts is C, then the ratio of annual rainfall on a slope of I in 100 facing the prevailing wind to the annual amount at the same height on level ground may be taken as I + W + 1/2C, which includes an allowance for rain in the warm sector. For a slope of n/100 where n is small, this ratio become I + n (W + 1/C). If the normal increase of rainfall with height above M.S.L. in the locality is P, the increase of rainfall with height on a slope facing the prevailing wind is P(I + n (W+1/2C)). Therefore Rh = Rc + hP (I + N (W + 1/C)). Values of P, W and C for the British Isles are given, and then leeward slopes are considered. The rate of increase per 100 feet of altitude varies from 0.4 ins. on leeward slopes to 4 or 4 1/2 inches on a windward slope of 4/100. The higher figure of 4 1/2 inches applies to the western coasts where warm front rain forms a greater proportion of the year's rain than in the south and east.
A Stakeholder's Communication Approach for Balancing Hospital Information Systems Investment Priorities
Authors: Lay Colin M. , Ferrand Dominique J.
Published: July 2010

The Stakeholders Communication Approach is aimed at supporting the decision process in the choice of information systems (IS) applications at the start of a hospital IS planning cycle. It promotes discussion among senior management, key stakeholders, IS Department management, end users and the Accounting Department using specific tools and a negotiation process. The IS applications portfolio profile allows visualizing the hospital's strategic position and directions for development of IS. End users' responses to a questionnaire give a measure of “user functional value added” (UFVA) to inform management about the effectiveness and usefulness of the systems implemented. Stakeholders' evaluation of recently completed IS applications uses UFVA and cost, both separately and combined, along with assessment of strategic changes; to edify the priority-balancing process for deciding on investments in further IS applications.
Une approche visant la communication entre intervenants pour attribuer les priorités d'investissement en systèmes d'information dans les hôpitaux
Authors: Lay Colin M. , Ferrand Dominique J.
Published: July 2010

L'approche de communication entre intervenants (ACI) est une méthode visant à épauler le processus décisionnel concernant le choix des applications de systèmes d'information (SI) au début d'un cycle de planification SI dans un milieu hospitalier. Cette méthode encourage la discussion entre la haute direction, les principaux intervenants, la gestion du département de SI, les utilisateurs finals et le département de la comptabilité, au moyen d'outils précis et d'un processus de négociation. Le profil du portefeuille des applications de SI permet de visualiser la stratégie et les orientations d'un hôpital concernant le développement des SI. Les réponses des utilisateurs à un questionnaire donnent une évaluation de la valeur ajoutée fonctionnelle par l'utilisateur (VAFU) afin d'informer la direction sur l'efficacité et l'utilité des systèmes mis en place. L'évaluation par les intervenants des applications de SI récemment implantées s'effectue à partir de la VAFU et des coûts, pris séparément ou de façon combinée, en tenant compte des orientations stratégiques, afin d'amorcer un processus visant à fixer des priorités d'investissement pour choisir les futures applications.
Development, Testing and Implementation of an Emergency Services Methodology in Alberta
Authors: Eliasoph Hy , Ashdown Chris
Published: July 2010

Alberta was the first province in Canada to mandate reporting of hospital-based emergency services. This reporting is based on a workload measurement system that groups emergency visits into five discreet workload levels/classes driven by ICD-9-CM diagnoses. Other related workload measurement variables are incorporated, including admissions, transfers, maintenance monitoring, nursing and non-nursing patient support activities, trips, staff replacement, and personal fatigue and delay. The methodology used to design the reporting system has been subjected to extensive testing, auditing and refinement.

The results of one year of province-wide data collection yielded approximately 1.5 million emergency visits. These data reveal consistent patterns/trends of workload that vary by hospital size and type. Although this information can assist in utilization management efforts to predict and compare workload and staffing levels, the impetus for establishing this system derived from its potential for funding hospital-based emergency services. This would be the first time that such services would be funded on a systemic, system-wide basis whereby hospitals would be reimbursed in relation to workload. This proposed funding system would distribute available funding in a consistent, fair and equitable manner across all hospitals providing a similar set of services, thus achieving one of the key goals of the Alberta Acute Care Funding Plan. Ultimately, this proposed funding methodology would be integrated into a broader Ambulatory Care Funding system currently being developed in Alberta.
Evaluation of a Hospital-Based Utilization Management Program
Authors: Cardiff Karen , Anderson Geoffrey , Sheps Samuel
Published: July 2010

The objective of this study was to evaluate the impact of a utilization management (UM) program designed to decrease inappropriate use of acute care hospital beds while maintaining quality of care. The measure used to define appropriateness was the ISD-A, a diagnosis-independent measurement tool which relies on severity of illness and intensity of service criteria. The outcome measures for the study included appropriate admission to hospital and continued days of stay in hospital, 30-day readmission rates and physician perceptions of the impact of the intervention on quality of care, access to services and patient discharge patterns. The sample frame for the study included two control and two intervention community hospitals, involving 1,800 patient charts. Readmission rates were determined by analyzing all separations from medical services (N=42,014) in the two experimental and two control hospitals. All physicians with admitting privileges (N=312) at the intervention hospitals were surveyed; obstetricians, pediatricians, and psychiatrists were excluded from the survey.

The results of the study demonstrated that the proportion of inappropriate admissions did not decrease significantly in any of the hospitals, but there were significant decreases in inappropriate continued stay in the intervention hospitals (p < 0.05). Both intervention and one of the control hospitals had lower 30-day readmission rates in the “after” period than in the “before” period (p < 0.05). Eighty-six percent believed that there had been no adverse impact on access to care and, although 25% thought the program may have led to premature discharge, this was not supported by the readmission data.
Locating Community Health Care Centres in Rural Saskatchewan: The Case of the Living Sky Health District
Authors: Backman Allen M. , Rigby John M. , Rice Murray D. , Rivers L. Mark
Published: July 2010

Using the Living Sky Health District in rural Saskatchewan as a sample case, this paper illustrates and discusses the use of location theory modelling tools as an aid to achieving high levels of efficiency coupled with administrator-determined levels of access. The paper begins by examining access issues as they affect location decisions. One of the empirical pillars of the paper is the well-documented idea that people will travel great distances in situations of acute circumstances, but are unwilling to travel far for important preventive care and monitoring of some chronic conditions. The study continues by presenting a non-technical overview of location theory which demonstrates the applicability of location modelling to the present problem; several possible location scenarios for Living Sky Health District are calculated, the most appropriate of which will depend on the goals and priorities of the district board. Finally, the study's results and more general conclusions are presented and discussed.
Hemodialysis Unit at Renfrew Victoria Hospital
Authors: Penney Randy
Published: July 2010

In June 1994, the Renfrew Victoria Hospital was selected as the first-ever recipient of the Health Care Quality Team Award in the “Small and Rural Provider” category. This award, offered by the Canadian College of Health Service Executives and 3M Health Care, was established to recognize health care organizations that have sustained measurable improvements in their network of services, and have done so through the use of a team. Renfrew Victoria Hospital's entry focused on the establishment of a hemodialysis unit for the residents of Renfrew County. This article summarizes the parameters of this award, as presented in our submission.
Le Renfrew Victoria Hospital remporte le prix de la qualité décerné à des équipes de soins de santé
Authors: Penney Randy
Published: July 2010

En juin 1994, le Renfrew Victoria Hospital a été le tout premier récipiendaire du prix de la qualité décerné à des équipes de soins de santé dans la catégorie «établissement rural». On a créé ce prix, présenté par le Collège canadien des directeurs de services de santé et 3M Soins de santé, aux établissements de soins de santé en reconnaissance des améliorations notables dans leur réseau de services réalisées en équipe.

Les établissements de santé de tout le Canada furent invités à soumettre leur candidature. Cependant, seuls ont été retenus les projets ayant créé un changement important au sein d'un établissement. La demande d'admission consistait à soumettre un rapport écrit respectant plusieurs critères précis. Le projet du Renfrew Victoria Hospital concernait la création d'une unité d'hémodialyse pour les résidents du comté de Renfrew. Cet article résume les paramètres de ce prix, tels que présentés dans notre candidature.
Alberta's Acute Care Funding Plan: Update to December 1994
Authors: Jacobs Philip , Hall Edward M. , Plain Richard H.M.
Published: July 2010

From 1990 until 1994 Alberta Health adjusted the acute care portion of hospital budgets based on a case mix index, initially called the Hospital Performance Index (HPI). The HPI formula method was a temporary measure; in November 1993, Alberta Health announced that, commencing in 1994, hospitals would be funded on a prospective basis, although they would still use the core of the HPI in the setting of funding rates. The creation of 17 health regions in June 1994 created the need for a new system of funding which would supplant the modified prospective system. In this paper we review the evolution of the HPI plan and its individual components — patient data, patient classification, funding weights, inpatient costs and adjustment factors.
Technology Acquisition in Canadian Hospitals: How are We Doing?
Authors: Deber Raisa , Wiktorowicz Mary , Leatt Peggy , Champagne François
Published: July 2010

We surveyed attitudes of decision makers involved in making decisions about technology acquisition in hospitals, receiving replies from 989 (72%) anglophone respondents and 201 (68%) from francophone respondents. Respondents split on whether to try unverified procedures, strongly agreed that medical technology should be evaluated, and expressed a desire for technology assessment data. The quality of health care, need, and compatibility with the institution's role and mission were seen as the most important factors affecting acquisitions.

Our study suggests that half the battle has been won; decision makers appear convinced that technologies must be evaluated. Organizational mechanisms, however, may still be required to ensure implementation.
New Management Structures at Sunnybrook Health Science Centre: Identifying Patient Groupings
Authors: MacTavish Marilyn , Norton Peter , Glouberman Sholom
Published: July 2010

An important step in re-engineering to achieve patient focused care is to define operational units of patients with like needs. This paper describes one process-oriented approach for this task. The approach allowed early and significant involvement of the staff in the re-engineering project.
Manitoba's Population-Based Databases and Long-Term Planning: Beyond the Hospital Databases
Authors: Cohen Marsha M. , Roos Noralou P. , DeCoster Carolyn , Black Charlyn , Decker Kathleen M.
Published: July 2010

The Manitoba Centre for Health Policy and Evaluation (MCHPE) conducts health services research focusing on Manitoba's administrative databases. Administrative databases contain information which is routinely and systematically collected for administrative purposes such as hospital and physician claims and funding requirements. This article describes the MCHPE's five major databases, their strengths and limitations, and the development of the Population Health Information System (PHIS). Four modules from PHIS illustrate how the data are used to provide useful information for health care planners, administrators and policy analysts. Finally, future projects and directions for using administrative databases are explored.
Bases de données du Manitoba basées sur la population et planification à long terme: Au-Delà des bases de données d'hôpitaux
Authors: Cohen Marsha M. , Roos Noralou P. , DeCoster Carolyn , Black Charlyn , Decker Kathleen M.
Published: July 2010

Le Manitoba Centre for Health Policy and Evaluation (MCHPE) fait une recherche sur les services de santé concentrée sur les bases de données administratives du Manitoba. Les bases de données administratives contiennent de l'information qui est recueillie de façon constante et systématique pour les besoins de l'administration, comme les demandes de remboursement des hôpitaux et des médecins, et les exigences de financement. On décrit dans cet article les cinq principales bases de données du MCHPE, leurs points forts et leurs points faibles, ainsi que le fonctionnement du Population Health Information System (PHIS). Quatre modules du PHIS illustrent comment les données sont utilisées pour fournir de l'information utile aux planificateurs de soins de santé, aux administrateurs et aux analystes de politiques. Enfin, on explore les projets et les orientations futurs pour l'utilisation de bases de données administratives.
Review of the Multi-Hospital Arrangements Literature: Benefits, Disadvantages and Lessons for Implementation
Authors: Markham Barbara , Lomas Jonathan
Published: July 2010

The multi-hospital arrangements literature is reviewed for Canada and the United States. There is a notable lack of evaluations on the outcomes of these arrangements, especially in the Canadian context. For evaluations that do make it to the literature, generalizability of conclusions is difficult because most is based on case studies and relates to “for-profit” U.S. hospitals. We are forced to conclude, however, that there is little definitive evidence that quality of care is improved by multi-hospital arrangements or to support or refute the claims of better human resources deployment. The most striking organizational benefit appears to be that institutions considering merger or other arrangements are forced into explicit considerations of their mission and goals. Many of the potential disadvantages of multi-hospital arrangements may be ameliorated with appropriate strategic planning and attention to detail during negotiation of the arrangement. As new multi-institutional arrangements may cause harm as well as reap benefits, careful evaluation is needed.
Comparative Costs for Substitutable Services: Inpatient and Day Surgery Episodes of Care
Authors: Jacobs Philip , Nichols Debra , Dubitz Tracy
Published: July 2010

The authors analyze the differences in costs between inpatient and outpatient elective surgery, by case mix group*, using the University of Alberta Hospitals Patient Resource Consumption Profile database (PRCP), supplemented with additional data from other agencies. PRCP measures costs for both inpatient and outpatient cases and is linked to the hospital's medical records, so that individual case-costing and detailed cost comparisons can be made. The focus of the comparison is on cost per case, measured in terms of the entire episode of outpatient surgery.
Governance for Quality: Getting to the Heart of it
Authors: MacDonald Melanie , Boulianne Ruth
Published: July 2010

This article discusses the information a board needs to ensure that a systematic and strategic approach is taken to the management of quality throughout the organization; the outcomes of care/service meet professional standards, external requirements and key expectations of clients; and care/service is continually being improved. A practical framework for the reporting of quality management issues and their implications is provided, within the context of a chronic care/long-term care setting with multiple levels of care. The constraints presented by issue-based reporting are also addressed briefly.
Patient Satisfaction: A Customer Service Approach
Authors: Man Jo-Anne , Greengarten Moshe
Published: July 2010

In health care, as in any service business, monitoring quality is an important component. Patient satisfaction, despite its measurement difficulties, is an excellent gauge of the institution's ability to delivery quality service. As part of quality improvement activities, the Division of Neurosciences at the Toronto Hospital measured patient satisfaction on various validated dimensions, then attempted to identify which components of service provision were key in determining patients' overall levels of perceived satisfaction with care. Results indicated that much of perceived quality and satisfaction was explained by the dimension of care which included prompt response to needs, organization, efficiency of care and communication. The authors recommend focusing improvement efforts on activities with the greatest potential to influence patient satisfaction.
The Medical Information Highway: Where is the Access Ramp?
Authors: Knock Marion , Newsome David , Poole Barbara
Published: July 2010

In this article, an analogy is drawn between a health care information system and a freeway transportation system. Unfinished access ramps and disconnected road sections are likened to unlinked computer information systems. It is not until there is “connectivity” between roadways that vehicles can take advantage of the efficiencies of a freeway system or until there are comrehensive, integrated information systems that quality health care can be provided.

The Greater Victoria Hospital Society used quality improvement techniques to improve the medical information highway, and theories of change management to encourage physician leaders to “buy into” the information system to produce needed change in the organization and in patient care.
A Balanced Scorecard for Canadian Hospitals
Authors: Baker G. Ross , Pink George H.
Published: July 2010

Managing a health care organization on the basis of one set of information alone (e.g., financial information) does not give a full view of the impact of changes on the organization. A balanced scorecard approach can provide management with a comprehensive framework that turns an organization's strategic objectives into a coherent set of performance measures. This approach has been used extensively in industry, but seldom in health care organizations. By developing a scorecard approach, these organizations could obtain feedback providing a balanced view of organizational performance, letting them see if improvements in one area may have been achieved at the expense of another. It also demands that managers translate their general mission statement on customer service into specific measures that reflect the factors that really matter to customers.
Une fiche de pointage équilibrée pour les hôpitaux canadiens
Authors: Baker G. Ross , Pink George H.
Published: July 2010

La gestion d'un organisme de soins de santé basée sur un seul type de donnée (comme les données financières) n'offre pas une image complète de l'impact des changements sur cet organisme. Une approche utilisant une fiche de pointage équilibrée peut offrir à la direction un cadre de travail global dans lequel les objectifs stratégiques d'un organisme deviennent un ensemble cohérent pour mesurer la performance. Cette approche a été très utilisée dans l'industrie, mais elle l'est rarement au sein d'organismes de soins de santé. En élaborant l'approche de la fiche de pointage équilibrée, ces organismes pourraient obtenir des commentaires offrant une vue d'ensemble équilibrée de la performance de l'organisme; ils pourraient ainsi voir si les améliorations dans un secteur particulier n'ont pas été réalisées au détriment d'un autre secteur. Cette approche demande aussi que les directeurs traduisent leur énoncé général de mission concernant le service aux clients en critères précis qui reflètent les facteurs qui importent vraiment aux yeux du client.
Comprehensive Approach to Utilization Review Based on Patient-Specific Costing Data
Authors: Potvin Kenneth A. , Leclair Marcel C.
Published: July 2010

The Ottawa General Hospital (OGH) is one of a growing number of institutions that has implemented a cost accounting system. The ability to track costs on a patient-specific basis provides an exciting avenue for reviewing the use of resources. With the accumulation of a complete fiscal year of data, the hospital recently embarked on a review process to identify opportunities for more detailed review with practitioners. This will support the OGH's surgical approach of targeting cuts, rather than making across-the-board reductions. The objective is to allow the hospital to maintain the highest levels of quality and service as the eroding funding situation allows. This paper describes the comprehensive approach taken by the review team to identify populations of patients that were relatively homogeneous and yet showed the greatest practice pattern variances between physicians. The method described provides a template for others to summarize large amounts of data and stratify patient groups for more detailed analysis of the patient care delivery process.
Estimating the Cost of Outpatient Hospital Care
Authors: Jacobs P. , Hall E.M.
Published: July 2010

Hospital services can be divided into inpatient, outpatient and non-patient areas; outpatient care can be further subdivided into emergency room care, general and special clinic care, day procedures and non-admitted day/night care. Using 1992–93 Statistics Canada data on expenditures and outpatient activity from the Part One form for 29 Alberta hospitals, we estimated the average cost of each of the four outpatient areas. The estimated cost per visit was $183 for clinic visits, $166 for day/night care, $69 per emergency visit and $627 per day procedure. These estimates can be used in cost-effectiveness studies and, if supplemented with outpatient case weights and volumes, in provincial funding systems.
Quality and Governance in Hospitals
Authors: Graham D.E. , Cawsey T.F.
Published: July 2010

What is the role of the board in quality initiatives in an organization? How can the board improve its own processes through quality initiatives? What are the quality attributes that a board should monitor? The board at St. Mary's Hospital in Kitchener addressed these questions, resulting in a rethinking of the board's role and its relationship to the operation of the hospital. This article discusses how the board has been restructured, and how it has shifted over the past few years to a CQI focus.
Redesign of a Health Science Centre: Reflections on Co-Leadership
Authors: MacTavish Marilyn , Norton Peter
Published: July 2010

Since 1988, the Sunnybrook Health Science Centre has been proactive in re-designing its system toward decentralized management, the purpose being to further enhance patient care. This process has involved numerous changes, among which were the establishment of three large clinical units. These clinical units are not defined following the historic medical model, but group patients with similar service and care needs. Subsequently, each of the clinical units defined Patient Service Units (PSUs). The hospital has chosen a co-leadership model for the lead management at each of the unit levels. This paper describes the model for clinical units.
Preimplantation Genetic Screening: An Effective Testing for Infertile and Repeated Miscarriage Patients?
Authors: Wang Ning , Zheng Ying-Ming , Li Lei , Jin Fan
Published: July 2010

Aneuploidy in pregnancy is known to increase with advanced maternal age (AMA) and associate with repeated implantation failure (RIF), and repeated miscarriage (RM). Preimplantation genetic screening (PGS) has been introduced into clinical practice, screening, and eliminating aneuploidy embryos, which can improve the chance of conceptions for infertility cases with poor prognosis. These patients are a good target group to assess the possible benefit of aneuploidy screening. Although practiced widely throughout the world, there still exist some doubts about the efficacy of this technique. Recent randomized trials were not as desirable as we expected, suggesting that PGS needs to be reconsidered. The aim of this review is to discuss the efficacy of PGS.
Organic Solar Cells: Problems and Perspectives
Authors: Chidichimo G. , Filippelli L.
Published: July 2010

For photovoltaic cells to convert solar into electric energy is probably the most interesting research challenge nowadays. A good efficiency of these devices has been obtained by using inorganic semiconductor materials. On the other hand, manufacture processes are very expensive in terms of both materials and techniques. For this reason organic-based photovoltaic (OPV) cells are attracting the general attention because of the possible realization of more economical devices. Organic materials are abundant and easily handling. Unfortunately OPV cells efficiency is significantly lower than that of inorganic-based devices, representing a big point of weakness at the present. This is mainly due to the fact that organic semiconductors have a much higher band gap with respect to inorganic semiconductors. In addition, OPV cells are very susceptible to oxygen and water. In this paper we will describe some of the different approaches to the understanding and improving of organic photovoltaic devices.
Antineoplastic Activity of New Transition Metal Complexes of 6‐Methylpyridine‐2‐carbaldehyde‐N(4)‐ethylthiosemicarbazone: X‐Ray Crystal Structures of [VO2(mpETSC)] and [Pt(mpETSC)Cl]
Authors: Elsayed Shadia A. , El-Hendawy Ahmed M. , Mostafa Sahar I. , Jean-Claude Bertrand J. , Todorova Margarita , Butler Ian S.
Published: July 2010

New complexes of dioxovanadium(V), zinc(II), ruthenium(II), palladium(II), and platinum(II) with 6‐methylpyridine‐2‐carbaldehyde‐N(4)‐ethylthiosemicarbazone (HmpETSC) have been synthesized. The composition of these complexes is discussed on the basis of elemental analyses, IR, Raman, NMR ( 1H,  13C, and  31P), and electronic spectral data. The X‐ray crystal structures of [VO2(mpETSC)] and [Pt(mpETSC)Cl] are also reported. The HmpETSC and its [Zn(HmpETSC)Cl2] and [Pd(mpETSC)Cl] complexes exhibit antineoplastic activity against colon cancer human cell lines (HCT 116).
The Effect of Stereochemistry on Sodium Ion Complexation in Nucleoside‐Metallacarborane Conjugates
Authors: Olejniczak Agnieszka B. , Milecki Jan , Schroeder Grzegorz
Published: July 2010

Conjugates of purine and pyrimidine nucleosides: thymidine and 2′‐deoxyguanosine with cobalt‐metallacarborane were studied for their sodium ion complexing properties. Formation of stable complexes of 1 : 1 stoichiometry was proved by ESI MS spectroscopy and  23Na NMR. Equilibrium constants and energies of complex formation were calculated. Complexation of alkali‐metals by nucleoside‐metallacarborane conjugates may affect the physicochemical and biological properties of the conjugates and should be taken into consideration during biological evaluation of these types of modifications.
Effect of the Material Parameters on Layered Viscoelastic Frictional Contact Systems
Authors: Mahmoud Fatin F. , El-Shafei Ahmed G. , Al-Shorbagy Amal E. , Abdel Rahman Alaa A.
Published: July 2010

In the design process, one of the main targets is to reduce the peak values of the contact stresses. This can be attained by layering the contacting bodies by layers of different material characteristics. Viscoelastic materials are characterized by either a stress relaxation or a creep deformation; therefore, the contacting bodies can be layered with such materials to attain this target. This paper discusses effects of the material characteristics of viscoelastic layers upon the unbounded contact configuration. Three material parameters are considered: the layer/contact solids stiffness ratio, the delayed/instantaneous elasticity ratio, and the material relaxation time. The results are obtained by using a two-dimensional time-dependent nonlinear computational model, developed by the authors, capable of analyzing quasistatic viscoelastic frictional contact problems.
On a New Integral Transform and Differential Equations
Authors: Kiliçman A. , Eltayeb H.
Published: July 2010

Integral transform method is widely used to solve the several differential equations with the initial values or boundary conditions which are represented by integral equations. With this purpose, the Sumudu transform was introduced as a new integral transform by Watugala to solve some ordinary differential equations in control engineering. Later, it was
proved that Sumudu transform has very special and useful properties. In this paper we study this interesting integral transform and its efficiency in solving the linear ordinary differential equations with constant and nonconstant coefficients as well as system of differential equations.
Advancing Large Interactive Surfaces for Use in the Real World
Authors: Teichert Jens , Herrlich Marc , Walther-Franks Benjamin , Schwarten Lasse , Feige Sebastian , Krause Markus , Malaka Rainer
Published: July 2010

Interactive surfaces are only just beginning to break into the market, and they still do not offer the advanced functionality demonstrated with many lab prototypes. The path from a prototype system to a finished product for use in real-world scenarios is a long one, and many obstacles must be overcome. The design of an interactive multitouch table had to address issues like optical recognition, hardware design, and ergonomics. This paper describes in detail the construction of a large, robust multi-touch table called mrT. It will show how to solve major problems of the diffuse illumination technique and other challenges of constructing a large-screen, high-resolution, self-contained interactive multitouch surface that not only serves as a development system but can be deployed in the real-world. Additionally, to further motivate some of the design decisions, especially why the diffuse illumination technology was chosen, this paper will discuss related on-going research projects on the application side.
On Maslanka′s Representation for the Riemann Zeta Function
Authors: Báez-Duarte Luis
Published: July 2010

A rigorous proof is given of the hypergeometric‐like representation of the Riemann zeta function ζ(s) discovered by Maslanka as a series of Pochhamer polynomials with coefficients depending on the values of ζ at the positive even integers.
Treatment of Mesh Skin Grafted Scars Using a Plasma Skin Regeneration System
Authors: Higashimori Takamitsu , Kono Taro , Sakurai Hiroyuki , Nakazawa Hiroaki , Groff William Frederick
Published: July 2010

Objectives. Several modalities have been advocated to treat traumatic scars, including surgical techniques and laser resurfacing. Recently, a plasma skin regeneration (PSR) system has been investigated. There are no reports on plasma treatment of mesh skin grafted scars. The objective of our study is to evaluate the effectiveness and complications of plasma treatment of mesh skin grafted scars in Asian patients. Materials and Methods. Four Asian patients with mesh skin grafted scars were enrolled in the study. The plasma treatments were performed at monthly intervals with PSR, using energy settings of 3 to 4 J. Improvement was determined by patient questionnaires and physician evaluation of digital photographs taken prior to treatment and at 3 months post treatment. The patients were also evaluated for any side effects from the treatment. Results. All patients showed more than 50% improvement. The average pain score on a 10-point scale was 6.9 +/− 1.2 SD and all patients tolerated the treatments. Temporary, localized hypopigmentation was observed in two patients. Hyperpigmentation and worsening of scarring were not observed. Conclusions. Plasma treatment is clinically effective and is associated with minimal complications when used to treat mesh skin grafted scars in Asian patients.
Preparation of a Counter Electrode withP-Type NiO and Its Applications in Dye-Sensitized Solar Cell
Authors: Chou Chuen-Shii , Hsiung Chin-Min , Wang Chun-Po , Yang Ru-Yuan , Guo Ming-Geng
Published: July 2010

This study investigates the applicability of a counter electrode with aP-type semiconductor oxide (such as NiO) on a dye-sensitized solar cell (DSSC). The counter electrode is fabricated by depositing an NiO film on top of a Pt film, which has been deposited on a Fluorine-doped tin oxide (FTO) glass using an ion-sputtering coater (or E-beam evaporator), using a simple spin coating method. This study also examines the effect of the average thickness ofTiO2film deposited on a working electrode upon the power conversion efficiency of a DSSC. This study shows that the power conversion efficiency of a DSSC with a Pt(E)/NiO counter electrode (4.28%) substantially exceeds that of a conventional DSSC with a Pt(E) counter electrode (3.16%) on which a Pt film was deposited using an E-beam evaporator. This result is attributed to the fact that the NiO film coated on the Pt(E) counter electrode improves the electrocatalytic activity of the counter electrode.
Electron-Phonon Interaction in Strongly Correlated Systems
Authors: Capone M. , Castellani C. , Grilli M.
Published: July 2010

The Hubbard-Holstein model is a simple model including both electron-phonon interaction and electron-electron correlations. We review a body of theoretical work investigating, the effects of strong correlations on the electron-phonon interaction. We focus on the regime, relevant to high-Tcsuperconductors, in which the electron correlations are dominant. We find that electron-phonon interaction can still have important signatures, even if many anomalies appear, and the overall effect is far from conventional. In particular in the paramagnetic phase the effects of phonons are much reduced in the low-energy properties, while the high-energy physics can still be affected by phonons. Moreover, the electron-phonon interaction can give rise to important effects, like phase separation and charge-ordering, and it assumes a predominance of forward scattering even if the bare interaction is assumed to be local (momentum independent). Antiferromagnetic correlations reduce the screening effects due to electron-electron interactions and revive the electron-phonon effects.
Lucian, Fronto, and the Absence of Contemporary Historiography under the Antonines
Authors: Kemezis Adam M.
Published: July 2010

Starting with the question of why critical contemporary history is almost entirely absent in the century between Tacitus and Cassius Dio, this article examines Lucian's and Fronto's writings on the historiography of the Parthian war of the mid-160s. I argue that these authors demonstrate a particularly Antonine form of historical consciousness, in which the present is detached from any grand narrative, and the historian is seen as a narrator of events alien to his own life-experience. Elements of this view are also traced in the writings of Appian, Florus, and other contemporary authors.
Chariton and Tragedy: Reconsiderations and New Evidence
Authors: Trzaskoma Stephen M.
Published: July 2010

I argue that the tragic allusions in Chariton, Callirhoe 2.9.3 (to Euripides, Medea ) and 3.8.8 (to Sophocles, Ajax 550-51), are to be read in combination with a hitherto unnoticed verbatim citation of a portion of Euripides, Heracles 1307-8 at Chariton 3.10.6. These three allusions occur in speeches by the novel's heroine and have a more or less obvious connection to the surrounding context and thereby lend a clearly tragic tone to Callirhoe's situation. Both individually and taken together, however, they have deeper resonances and introduce complex thematic interplay among child-murder, suicide, heroism, and redemption.