Unity in diversity: electronic patient record use in multidisciplinary practice

In this paper we examine the use of electronic patient records (EPR) by clinical specialists in their development of multidisciplinary care for diagnosis and treatment of breast cancer. We develop a practice theory lens to investigate EPR use across multidisciplinary team practice. Our findings suggest that there are oppositional tendencies towards diversity in EPR use and unity which emerges across multidisciplinary work, and this influences the outcomes of EPR use. The value of this perspective is illustrated through the analysis of a year-long, longitudinal case study of a multidisciplinary team of surgeons, oncologists, pathologists, radiologists, and nurse specialists adopting a new EPR. Each group adapted their use of the EPR to their diverse specialist practices, but they nonetheless orientated their use of the EPR to each others' practices sufficiently to support unity in multidisciplinary teamwork. Multidisciplinary practice elements were also reconfigured in an episode of explicit negotiations, resulting in significant changes in EPR use within team meetings. Our study contributes to the growing literature that questions the feasibility and necessity of achieving high levels of standardized, uniform health information technology use in healthcare.

Influence of voltage and frequency dimming on power losses in HF electronic ballasts for compact fluorescent lamps

Compact Fluorescent Lamps (CFL) incorporating electronic ballasts are widely used in lighting. In many cases the ability to dim the lamp is a requirement Dimming can be achieved by varying the voltage supplied to the inverter or by changing the switching frequency of the inverter. The effect of dimming by both approaches on the power losses in the inverter is studied in this work. The lamp and associated inverter has been modeled in PSPICE, using a behavioral model for the CFL. Predicted losses are in good agreement with experimental data obtained from calorimetry. The model was then used to determine the distribution of losses within the inverter, enabling a comparison of the effects of the two dimming methods to be made. © 2006 IEEE.

Influence of ion energy and substrate temperature on the optical and electronic properties of tetrahedral amorphous carbon (ta-C) films

The properties of amorphous carbon (a-C) deposited using a filtered cathodic vacuum arc as a function of the ion energy and substrate temperature are reported. The sp3 fraction was found to strongly depend on the ion energy, giving a highly sp3 bonded a-C denoted as tetrahedral amorphous carbon (ta-C) at ion energies around 100 eV. The optical band gap was found to follow similar trends to other diamondlike carbon films, varying almost linearly with sp2 fraction. The dependence of the electronic properties are discussed in terms of models of the electronic structure of a-C. The structure of ta-C was also strongly dependent on the deposition temperature, changing sharply to sp2 above a transition temperature, T1, of ≈200°C. Furthermore, T1 was found to decrease with increasing ion energy. Most film properties, such as compressive stress and plasmon energy, were correlated to the sp3 fraction. However, the optical and electrical properties were found to undergo a more gradual transition with the deposition temperature which we attribute to the medium range order of sp2 sites. We attribute the variation in film properties with the deposition temperature to diffusion of interstitials to the surface above T1 due to thermal activation, leading to the relaxation of density in context of a growth model. © 1997 American Institute of Physics.

Electronic structure and surface properties of SrBi2Ta2O9 and related oxides

The electronic structure of SrBi2Ta2O9 and related oxides such as SrBi2Nb2O9, Bi2WO6 and Bi3Ti4O12 have been calculated by the tight-binding method. In each case, the band gap is about 4.1 eV and the band edge states occur on the Bi-O layers and consist of mixed O p/Bi s states at the top of the valence band and Bi p states at the bottom of the conduction band. The main difference between the compounds is that Nb 5d and Ti 4d states in the Nb and Ti compounds lie lower than the Ta 6d states in the conduction band. The surface pinning levels are found to pin Schottky barriers 0.8 eV below the conduction band edge.

Electronic structure of the layered ferroelectric perovskite SrBi2Ta2O9

The band structure of the Bi layered perovskite SrBi2Ta2O9 (SBT) has been calculated by the tight binding method. We find both the valence and conduction band edges to consist of states primarily derived from the Bi-O layer rather than the perovskite Sr-Ta-O block. The valence band maximum arises from O p and some Bi s states, while the conduction band minimum consists of Bi p states, with a band gap of 5.1 eV. It is argued that the Bi-O layers largely control the electronic response of SBT while the ferroelectric response originates from the perovskite Sr-Ta-O block. Bi and Ta centered traps are calculated to be shallow, which may account in part for the excellent fatigue properties of SBT.