A generalized expression for accelerating beamlet decomposition simulations.

Paraxial diffraction modeling based on the Fourier transform has seen widespread implementation for simulating the response of a diffraction-limited optical system. For systems where the paraxial assumption is not sufficient, a class of algorithms has been developed that employs hybrid propagation physics to compute the propagation of an elementary beamlet along geometric ray paths. These "beamlet decomposition" algorithms include the well-known Gaussian beamlet decomposition (GBD) algorithm, of which several variants have been created.

BONE Break: A Hot Debrief Tool to Reduce Second Victim Syndrome for Nurses.

The pandemic has intensified clinicians' workloads, leading to an increased incidence of adverse events and subsequent second victim syndrome, with almost half of health care clinicians experiencing its symptoms. However, following a literature review, no tools were found that addressed second victim syndrome in nurses. To address these issues and the gap in the literature, the authors developed the BONE Break hot debriefing tool.

Modeling and characterization of OASIS inflatable primary antenna by dual modality metrology.

OASIS (Orbiting Astronomical Satellite for Investigating Stellar Systems) is a space-based observatory with a 14 m diameter inflatable primary antenna that will perform high spectral resolution observations at terahertz frequencies. The large inflatable aperture, non-traditional surface configuration, and the double layered membrane structure afford unique challenges to the modeling and testing of the primary antenna. A 1-meter prototype of the primary antenna (A1) was built to validate our technical approach.

Medical Home-Head Start Partnership to Promote Early Learning for Low-Income Children.

Objective: To improve Early Head Start/Head Start (EHS/HS) screening, referral, and enrollment for children from diverse, low-income communities.

Method: Using existing resources, we built a pediatric clinic-Head Start partnership. Key steps included (1) screening protocol and tracking system, (2) a community partner as a single point of referral contact, (3) provider education, and (4) monthly outcome reporting.

Clinical Nurse Specialist-Driven Practice Change: Standardizing Vital Sign Monitoring.

Purpose: The purpose of this project was to standardize vital sign (VS) monitoring throughout a patient's stay in the hospital, including at admission, following transitions to different levels of care, reassessment of abnormal VS results, daily monitoring, and before dismissal. The population of focus was adult general and progressive care patients.

Description Of The Project: Standards for VS monitoring, documentation, and provider notification were established.

Hospitalizations and deaths caused by diarrhea in children five years old and younger at four hospitals in Haiti, 2010-2012.

Worldwide, diarrhea is a major contributor to morbidity and mortality in children; however, there are few data on the burden of diarrheal disease in Haiti. We conducted a retrospective review of hospital discharge registries from 2010 to 2012 in the pediatric wards of four Haitian hospitals and recorded the number of all-cause hospitalizations and deaths as well as diarrheal hospitalizations and deaths by age (≤ 2 and 3-5 years) and epidemiological week. Diarrhea was associated with 3,582 (33.

Using enriched observational data to develop and validate age-specific mortality risk adjustment models for hospitalized pediatric patients.

Background: Growth and development in early childhood are associated with rapid physiological changes. We sought to develop and validate age-specific mortality risk adjustment models for hospitalized pediatric patients using objective physiological variables on admission in addition to administrative variables.

Methods: Age-specific laboratory and vital sign variables were crafted for neonates (up to 30 d old), infants/toddlers (1-23 mo), and children (2-17 y).

Bedside nurse-to-nurse handoff promotes patient safety.

Unlabelled: Nurse-to-nurse beside handoff allows the oncoming nurse to visualize the patient and ask questions of the previous nurse. It encourages pateints to be involved actively in their care and allows standardized communication between nursing shifts.

Background: Patient handoff between nurses at shift change has been an important process in clinical nursing practice, allowing nurses to exchange necessary patient information to ensure continuity of care and patient safety.

Predicting the need for mechanical ventilation in acute exacerbations of chronic obstructive pulmonary disease: comparing the CURB-65 and BAP-65 scores.

Purpose: Clinicians lack a validated tool for risk stratification for need for mechanical ventilation (MV) in acute exacerbations of chronic obstructive pulmonary disease (AECOPD). We sought to compare 2 risk scores, BAP-65 and CURB-65, at predicting a need for MV in AECOPDs.

Materials And Methods: We analyzed 34,478 AECOPD admissions to 195 US hospitals (2007).

A proposed model curriculum in global child health for pediatric residents.

Objective: In response to the increasing engagement in global health (GH) among pediatric residents and faculty, academic GH training opportunities are growing rapidly in scale and number. However, consensus to guide residency programs regarding best practice guidelines or model curricula has not been established. We aimed to highlight critical components of well-established GH tracks and develop a model curriculum in GH for pediatric residency programs.

Correlating novice nurses' perceptions of nursing orientation and first-year support with direct preceptor interventions.

Can preceptors correlate novices' experiences of the transition into nursing with interventions for support? A medical specialty preceptor committee representing more than 300 nurses at a large academic medical center conducted educational sessions for 46 inpatient nurses who had successfully completed orientation, but were still in the first year of practice. The novice forum used literature themes to guide exploration of the novices' perceptions. In the two novice forum sessions, the new nurses were invited to reflect on their experiences using a Turning Point Query(©).

Developing and validating a risk score for lower-extremity amputation in patients hospitalized for a diabetic foot infection.

Objective: Diabetic foot infection is the predominant predisposing factor to nontraumatic lower-extremity amputation (LEA), but few studies have investigated which specific risk factors are most associated with LEA. We sought to develop and validate a risk score to aid in the early identification of patients hospitalized for diabetic foot infection who are at highest risk of LEA.

Research Design And Methods: Using a large, clinical research database (CareFusion), we identified patients hospitalized at 97 hospitals in the U.

Using electronic health information to risk-stratify rates of Clostridium difficile infection in US hospitals.

Background: Expanding hospitalized patients' risk stratification for Clostridium difficile infection (CDI) is important for improving patient safety. We applied definitions for hospital-onset (HO) and community-onset (CO) CDI to electronic data from 85 hospitals between January 2007 and June 2008 to identify factors associated with higher HO CDI rates.

Methods: Nonrecurrent CDI cases were identified among adult (≥ 18-year-old) inpatients by a positive C.

Two cases of restavek-related illness: clinical implications of foster neglect in Haiti.

Restaveks, or indentured foster children, are a poorly understood, vulnerable subclass of Haitian society. From 2001 to the present, a partnership between multiple US academic medical centers and Project Medishare for Haiti has held an ongoing series of mobile clinics in rural Haiti. Multiple cases of restavek-related illness were identified.

Development and validation of a disease-specific risk adjustment system using automated clinical data.

Objective: To develop and validate a disease-specific automated inpatient mortality risk adjustment system primarily using computerized numerical laboratory data and supplementing them with administrative data. To assess the values of additional manually abstracted data.

Methods: Using 1,271,663 discharges in 2000-2001, we derived 39 disease-specific automated clinical models with demographics, laboratory findings on admission, ICD-9 principal diagnosis subgroups, and secondary diagnosis-based chronic conditions.

Surgical site infections: Causative pathogens and associated outcomes.

Background: Surgical site infections (SSIs) are associated with substantial morbidity, mortality, and cost. Few studies have examined the causative pathogens, mortality, and economic burden among patients rehospitalized for SSIs.

Methods: From 2003 to 2007, 8302 patients were readmitted to 97 US hospitals with a culture-confirmed SSI.

Exposure to the carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) in smokers from 3 populations with different risks of lung cancer.

Native Hawaiian smokers are at higher risk and Japanese-American smokers at lower risk of lung cancer (LC), compared with white smokers, even after accounting for smoking history. Because variation in carcinogen exposure/metabolism may occur separately of smoking amount, we compared urinary biomarkers of uptake and detoxification of 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK)-a potent lung carcinogen-among 578 smokers in these ethnic/racial groups in Hawaii. We measured the NNK metabolite 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) and its glucuronide (NNAL-Gluc) and examined total NNAL (NNAL + NNAL-Gluc) and the NNAL detoxification ratio (NNAL-Gluc:NNAL).

Nicotine metabolism in three ethnic/racial groups with different risks of lung cancer.

Previously, we documented that smoking-associated lung cancer risk is greater in Hawaiians and lower in Japanese compared with Whites. Nicotine metabolism by cytochrome P450 2A6 (CYP2A6) varies across ethnicity/race and is hypothesized to affect smoking behavior. We investigated whether higher CYP2A6 activity results in the smoker extracting more nicotine (adjusting for cigarettes per day) and being exposed to higher levels of tobacco-specific nitrosamine [4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK)] and pyrene, a representative polycyclic aromatic hydrocarbon.

Smokers with the CHRNA lung cancer-associated variants are exposed to higher levels of nicotine equivalents and a carcinogenic tobacco-specific nitrosamine.

A locus at 15q24/15q25.1, which includes the nicotinic acetylcholine receptor A subunits 3 and 5 (CHRNA3 and CHRNA5) genes, has recently been associated with lung cancer risk, self-reported number of cigarettes smoked per day, and a nicotine dependence scale. It is not clear whether the association with lung cancer is direct or mediated through differences in smoking behavior.

A descriptive evaluation of long-term treatment integrity.

The validity of selecting treatment contingencies on the basis of the results obtained through functional analysis is well documented. However, a number of second-generation questions have emerged: For example, what are the parameters required to achieve desired treatment outcomes? More specifically, what is the degree of treatment integrity needed for the successful reduction of problem behavior? This study had two purposes: to describe the relationship between treatment integrity levels and treatment effectiveness and to highlight the importance of reporting the treatment integrity in outcome-based research. The results indicate that a high level of treatment integrity is required for treatment success.

Effects of increased response effort and reinforcer delay on choice and aberrant behavior.

A four-phase investigation was completed to analyze the utility of forced-choice preference assessments when response effort and reinforcer delays are altered within a subsequent reinforcer assessment. The results indicated that access to highly preferred stimuli continued to serve as a reinforcer when increased response effort was required. When reinforcer delay was increased, the utility of preferred stimuli to serve as a reinforcer was variable.

An analysis of initial acquisition and maintenance of sight words following picture matching and copy cover, and compare teaching methods.

This study compared the copy, cover, and compare method to a picture-word matching method for teaching sight word recognition. Participants were 5 kindergarten students with less than preprimer sight word vocabularies who were enrolled in a public school in the Pacific Northwest. A multielement design was used to evaluate the effects of the two interventions.

Effects of escape to alone versus escape to enriched environments on adaptive and aberrant behavior.

Escape-maintained aberrant behavior may be influenced by two outcomes: (a) a break from the activity and (b) subsequent access to preferred activities. To assess this hypothesis, a treatment was developed that analyzed response allocation across two break options: break alone and break with access to preferred social activities. The break with preferred activities decreased aberrant behavior and increased appropriate behavior.

Functional analysis of aberrant behavior through measurement of separate response topographies.

Functional analysis results for multiple topographies of aberrant behavior were graphed in an aggregate fashion and then separately for 48 clients. The results indicated that multiple topographies of behavior may be maintained by different contingencies. These results indicate that graphing functional analysis data in an aggregate fashion and then separately may improve the accuracy of their interpretation.