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There is an urgent need to develop sustainable and impactful interventions to mitigate the high risk of diet-related non-communicable diseases (diet-NCDs) in South Asians living in high-income countries. The current study using a co-design methodology aimed to identify community-led intervention components (solutions) to address barriers and enablers of disease-promoting dietary and physical activity behaviours in New Zealand South Asians. Data were collected from South Asian immigrants aged 25–59 years via three focus group discussions (n = 21) and 10 telephone or face-to-face interviews between 2018 and 2019. The thematic analysis resulted in identifying 22 barrier and enabler codes and 12 solution codes which were summarised under five themes. The key solutions (intervention components) to mitigate the identified target behaviours were providing recipes for using local vegetables in South Asian cuisine, information on the nutritional quality of frozen vegetables and canned lentils, simple home gardening techniques, the saturated fat content of dairy foods, interpreting nutrition labels, optimal portion sizes of foods, and framing low-fat messages positively. Similarly, group-based activities with peer support such as walking, cultural dancing and community sports like cricket, football, and tennis were the identified solutions to increase physical activity levels. The identified solutions for health promoting dietary habits and physical activity levels could be part of any targeted multicomponent health promoting programme to reduce the risk of diet-NCDs in South Asian immigrants.
Do you want to help save human civilisation? If so, this book is for you. How to Fix a Broken Planet describes the ten catastrophic risks that menace human civilisation and our planet, and what we can all do to overcome or mitigate them. It explains what must be done globally to avert each megathreat, and what each of us can do in our own lives to help preserve a habitable world. It offers the first truly integrated world plan-of-action for a more sustainable human society - and fresh hope. A must-read for anyone seeking sound practical advice on what citizens, governments, companies, and community groups can do to safeguard our future.
This chapter examines the ten mega-threats, how they link and why they must be solved together; why the solutions must occur at both global and personal levels; and the importance of the individual in saving humankind.
This chapter reviews the history of the IPCC’s efforts to achieve and maintain policy relevance while remaining policy-neutral and staying far away from ‘policy prescriptiveness’. The chapter argues that the boundaries between policy relevance, neutrality and prescriptiveness are a practical achievement – they must be constantly negotiated as the science and politics of climate change evolve. The chapter uses historical case studies to illustrate this point, such as the controversy over the so-called ‘burning embers’ diagram. It ends by discussing recent debates about the IPCC’s new role in the post-Paris Agreement policy landscape. While IPCC actors call for greater policy relevance, observers and critics contend that the IPCC will always and inevitably be policy-prescriptive, even if on a tacit and unintentional level. Achieving even greater policy relevance may therefore mean jettisoning or modifying the aspiration to be policy-neutral.
Proper documentation and relevant updating of patients’ health status has become a cumbersome task with the inception of electronic medical records.Inpatient, ED, and ambulatory patient evaluation generate billions of records each year.It brings about a burden on the workload of the providers regarding registering and completing patients’ records.Incomplete medical records set up complications in patient management and subsequent administrative operations.Specifically, denials for reimbursement because of incomplete medical records emerge as a critical concern.Effective measures, consisting of both technical and administrative enforcements are required to reduce number of open charts.
Objectives
To understand the reasons,consequences and solutions for Incomplete/Delinquent medical records.
Methods
We searched Google scholar and Pubmed database using keywords “Incomplete medical records”, “Imapacts” and “Solutions”.Articles popped up.We selected 4 based on internal and external validity.
Results
Incomplete/Delinquent medical records are nowadays imposing a critical challenge upon financial, administrative and legal affairs in practicing Medicine.Our review shows that CMS recovery audit with hospital denials went high from 7-10% in recent years because of open/incomplete medical records.Provider’s documentation time increases as well with implementation of EHR.Appropriate measures could be taken to resolve this issue, broadly we can try two ways- training and administrative courses.
Conclusions
Physicians,residents and all respective providers should get training on a regular basis regarding EMR/EHR to complete medical records duly and effectively.The other way is administrative surveillance.If providers fail repeatedly to comply with HIM standard and complete delinquent medical records, warnings, suspensions or other regulatory actions can be executed strictly to keep them on track.
Emergencies and disasters occur in any society, and it is the hospitals and their emergency department staff who must be prepared in such cases. Therefore, 1 of the effective methods of training medical care staff is the use of simulators. However, when introducing new simulation approaches, we face many challenges. The aim of this study was to identify challenges of the simulation of the hospital emergency department during disasters and provide effective solutions.
Methods:
This conventional content, thematic, analysis study was conducted in 2021. Participants were selected from Iranian experts using purposeful and snowball sampling methods. Data were collected using semi-structured interviews and were analyzed by the content analysis.
Results:
After analyzing the data, the challenges of simulating the hospital emergency department during disasters were identified in 2 main components and 6 perspectives, which included organizational components (inappropriate and aimless training methods, lack of interaction and cooperation, lack of funding, and inadequate physical space) and technological components (weak information management and lack of interdisciplinary cooperation). Solutions included management (resource support) and data sharing and exchange (infrastructures, cooperation and coordination).
Conclusion:
The simulation technology can be used as a method for training and improving the quality of health care services in emergencies. Considering that most of these challenges can be solved and need the full support of managers and policy makers, by examining these issues, supporting staff of health care centers are advised to make a significant contribution to the advancement of education and problem reduction in the event of disasters.
Chapter 3 contains the complete and elaborated solutions to all 300 problems stated and described in Chapters 1 and 2, respectively. The idea to present the solutions in a separate chapter is to help the reader to avoid the temptation of peeking at the solutions too soon.
Einstein's theories of special relativity and general relativity form a core part of today's undergraduate (or Masters-level) physics curriculum. This is a supplementary problem book or student's manual, consisting of 150 problems in each of special and general relativity. The problems, which have been developed, tested and refined by the authors over the past two decades, are a mixture of short-form and multi-part extended problems, with hints provided where appropriate. Complete solutions are elaborated for every problem, in a different section of the book; some solutions include brief discussions on their physical or historical significance. Designed as a companion text to complement a main relativity textbook, it does not assume access to any specific textbook. This is a helpful resource for advanced students, for self-study, a source of problems for university teaching assistants, or as inspiration for instructors and examiners constructing problems for their lectures, homework or exams.
Romantic nature writing emerges at roughly the same time as the industrial innovations that will eventually lead to global carbon capitalism and therefore is for some scholars coeval with the birth of the Anthropocene. This chapter takes a genealogical approach to the Anthropocene by suggesting that there are significant continuities between Romantic literature and contemporary discourses on environmental catastrophe. Focusing on two case studies – William Cowper’s The Task and Mary Shelley’s Frankenstein, both of which responded to climate change caused by volcanic eruptions – this chapter shows how Romantic writers address what it means to be alive at a catastrophic turning point in planetary history. They are concerned with the power of the human imagination to shape its environments, yet also with our vulnerability to elemental forces that we may affect but that we cannot control.
We have presented many facts, exhortations, editorials, and regulatory efforts about medication safety. We begin this conclusion and call to arms by recalling all of the very real patients who have died or suffered from medicaiton harm, and whose families grieve their loss everyday. At times the enormity of the data, theories and regulations obscure that patients every day suffer and die due to medication failures. As we move forward with efforts to change the face of medication safety, we must remember always why these efforts are important. It should be very clear to any reader that we (neither “we” the authors or “we” in the more general sense), do not know all the answers to the challenge of improving medication safety in anesthesia and perioperative medicine. However, it should also be clear now to do nothing is unacceptable. Furthermore, it should also be clear that the situation is far from hopeless – there is a great deal that can be done. Thus, the imperative is to act, not just as individual practitioners but collectively, within and beyond institutional boundary's, in a coordinated, committed and sustained manner.
The Innovation Pyramid is an inverted triangular pyramid. The methodology for creating impactful solutions to real problems separates the innovation's design from its execution. It further bifurcates design into identifying the real problem before crafting a solution to it. Execution is similarly bifurcated into execution planning and implementation. The four stacked levels of The Innovation Pyramid, from top to bottom, represent Problem Identification, Solution Formulation, Planning and Implementation; two design stages followed by two execution stages. The Pyramid has three faces. These three pyramid sections address three different aspects of designing and executing impactful solutions:
What: What is the desired outcome at that level?
How: How will this be accomplished or enabled?
Who: Who will lead the activities and/or is impacted by the outcome of this level?
This structure streamlines innovation creation as well as providing a structural means for diagnosing the cause of the variance between the actual and forecasted impact of the innovation. This diagnostic aspect is especially important when we may be traversing The Innovation Pyramid structure multiple times, once for say, prototype development, and a second time for the final product launch.
Chapter 2 explains T–cphase diagrams, which are maps of equilibrium alloy phases in a space spanned by temperature T and chemical composition c. The emphasis is on deriving T–c phase diagrams by minimizing the total free energy of an alloy with two or three phases. The lever rule and common tangent constructions are developed. Some basic ideas about chemical interactions and entropy are used to justify of the free energies of alloy phases at different temperatures. For binary alloys, the shapes of free energy versus composition curves and their dependence on temperature are used to deduce eutectic, peritectic, and continuous solid solubility phase diagrams. Some features of ternary alloy phase diagrams are discussed. If atoms are confined to sites on an Ising lattice, free energy functions can be calculated with a minimum set of assumptions about the energies of different atomic configurations. These generalizations of chemical interactions are useful for identifying phenomena common to unmixing and ordering transitions, but warnings about their limitations are presented.
Most writers on negotiation (e.g. Cohen 2003; Fisher & Ertel 1995; Lax & Sebenius 2006; Thompson 2005) and most practitioners will acknowledge that good preparation leads to improved negotiation. However, there is little research specifically into how negotiators actually prepare. In one major commercial negotiation (the Tanker Refit case, examined more closely in Chapter 4), one of the parties invested a lot of time in collecting information to try to fully understand the situation they were negotiating about. In another major negotiation (the Telco JV case – see Chapter 12) the negotiators found themselves spending about two hours in preparation for each hour of meeting with the other party. On the other hand a team negotiating a major infrastructure contract spent very little preparation time together prior to their meeting with the potential customer (Lindholst 2015). What the negotiation literature does offer are preparation checklists that give some structure to a negotiator’s preparation (for examples, see Fisher & Ertel 1995; Fleming & Hawes 2017; Lewicki, Barry & Saunders 2015; Thompson 2005). These checklists vary in their advice, but they commonly include the need to set goals for the negotiation, as goals are believed to be an inherent aspect of planning (Futrell 2011; Wilson & Putnam 1990) and central to negotiation success.
In this chapter Maxwell’s equations are described and common ways to solve them analytically are discussed. The equations imply certain properties of matter with which it interacts and full solutions that describes this behavior analytically are provided from first principles. The chapter shows specifically that one can derive very fundamental properties with simple calculations. Furthermore, the concept of inductance and capacitance are highlighted by reference to their duality. Various high-speed phenomena are studied in some detail with particular attention to the current distributions induced by the magnetic field.
Although the numerical properties of a step-by-step integration method can be evaluated based on the currently available techniques, there is still lack of a technique for evaluating its capability to capture dynamic loading. In this work, the amplitude error caused by the step discretization error is identified and the correlation between the relative amplitude error and relative step discretization error is analytically established. As a result, it is thoroughly confirmed that the asymptotic constant of the discretization error amplification factor for the displacement response to a cosine loading can be considered as an indicator of the capability to capture dynamic loading for a general step-by-step integration method.
The soluble fibre (1 → 3)(1 → 4)-β-d-glucan attenuates postprandial glycaemic responses when administered in solution. This attenuating effect is strengthened when solution viscosity is increased by increasing the β-glucan dose or molecular weight (MW). The effect of varying solution viscosity by changing solution volume, without changing the β-glucan dose or MW, on glycaemic responses was determined. A total of fifteen healthy subjects received six 50 g oral glucose beverages prepared with or without 4 g of high-MW (HMW, 580 000 g/mol) or low-MW (LMW, 145 000 g/mol) β-glucan, with a beverage volume of 250 or 600 ml. Postprandial plasma glucose concentration was measured over 2 h, and the peak blood glucose rise (PBGR) and the incremental area under the glycaemic response curve (AUC) were calculated. Subjects served as their own controls. The physico-chemical properties of the beverages were measured to examine their relationship with glycaemic response results. The HMW β-glucan beverage was more viscous and achieved greater reductions in PBGR than the glucose beverage with LMW β-glucan (P< 0·05). At the same MW, the 250 and 600 ml β-glucan beverages differed in viscosity (>9-fold difference) but not in PBGR (P>0·05). No differences in AUC were detected among the beverages (P= 0·147). The effects of β-glucan on glycaemic response were altered by changes in beverage viscosity achieved through changes in MW but not in volume. Therefore, β-glucan dose and MW are the most vital characteristics for optimising the bioactivity of β-glucan solutions with respect to glycaemic response.
Maintaining the principles of asepsis when performing wound care and other invasive procedures is one of the fundamental approaches of preventing healthcare-acquired infection. Such an approach has been advocated for community practitioners.
Literature
The performance of an aseptic technique is an under-researched area. The few studies that have been conducted have identified how strict adherence to the technique is difficult and contamination of hands/gloves is common and that community nurses often have a fatalistic view about whether asepsis is possible in a community setting.
Aim
The overall aim of this research project was to examine how experienced practitioners have adapted the aseptic technique within a community setting and to what extent the changed procedure still adhered to the principles of asepsis.
Methods
This study used a mixture of non-participant observation and individual semi-structured interviews to examine adherence to the principles of the aseptic technique among the district nurses. Data were collected from one Trust in England with a total of 10 district nurses taking part and 30 aseptic procedures been observed.
Results
The results show that almost all of the staff understood the principles of asepsis and had adapted the standard procedure for use in a patient’s home. Common challenges included wound cleaning using a single nurse procedure, the contents of the pack and the home environment. The research also identified misconceptions about clean versus aseptic procedures and a lack of training for staff.
Conclusions
This study highlights the challenges of maintaining the principles of asepsis in a home environment and the fact that district nurses are often relied upon to find creative solutions to such challenges. The study also highlights issues around the implementation of evidence-based practice and the need for clearer guidance about how evidence should be used alongside existing procedures.
In Canada, the care provided by families occurs in an increasingly multiethnic context. Against this backdrop, the present qualitative study aims to explore the needs/expectations and solutions not only of (female) natural caregivers of an elderly relative hailing from Haiti (presented in terms of tracking cases) but also of remunerated home care providers - all with a view to developing a culturally sensitive service offering. As such, this study works from a conceptual framework centring on the negotiation of a common area of agreement between the stakeholders involved (i.e., natural caregivers and home care providers). To this end, focus groups and individual interviews were conducted among 15 caregivers and 37 home care providers. The three recurrent themes emerging from the data analysis concern, in context, the needs/expectations and solutions surrounding the experience of service use, barriers to use, and the relationships between natural caregivers and home care providers. The statements of both groups evidenced a consistency of views and have thus provided a basis for developing some recommendations acceptable to all stakeholders from the perspective of making culturally-based adjustments to the service offering.
The production and import of fertilizer have previously been identified as the major source of three separate European environmental problems related to nitrogen compounds. In order to obtain a picture of the changes in the anthropogenic nitrogen flows needed for a solution, the effectiveness of several more radical interventions is estimated using Substance Flow Analysis (SFA). A selection of rigorous technical measures is expected to reduce the atmospheric deposition of N compounds to a level that seems acceptable for the EU as a whole, and will reduce the anthropogenic input of N compounds into the North Sea well below the agreed level of 50% of the present load. The third problem, the pollution of groundwater with nitrates, would remain unsolved. Resolution of this last problem requires radical changes in the agricultural sector, reducing agricultural output substantially. Two directions are explored by assessing the impacts of the extremes: termination of industrial fertilizer use to combat the problems at the source, and abolition of the entire stock-breeding sector to increase agricultural efficiency radically. These changes do contribute to a solution of the groundwater problem, but imply either greater dependence on imported food, or a major change in food consumption patterns, from animal towards vegetable products. The current EU population and diet are incompatible with the absence of environmental problems. The question then arises, how does acceptance of the draconian measures required to solve such an environmental problem weigh up against acceptance of the fact of having to cope with contaminated groundwater?
The dynamics of “simple, redundant robots” are developed. A “redundant” robot is a robot whose degrees of freedom are greater than those needed to perform a given kinetmatic task. A “simple” robot is a robot with all joints being revolute joints with axes perpendicular or parallel to the arm segments. A general formulation, and a solution algorithm, for the “inverse kinematics problem” for such systems, is presented. The solution is obtained using orthogonal complement arrays which in turn are obtained from a “zero-eigenvalues” algorithm. The paper concludes with an assertion that this solution, called the “natural dynamics solution,” is optimal in that it requires the least energy to drive the robot.