A non-linear discrete stochastic optimization model for Advanced Access patient appointment scheduling

Access to healthcare is a major problem in which patients are deprived of receiving timely admission to healthcare. Poor access has resulted in significant but avoidable healthcare cost, poor quality of healthcare, and deterioration in the general public health. Advanced Access is a simple and direct approach to appointment scheduling in which the majority of a clinic's appointments slots are kept open in order to provide access for immediate or same day healthcare needs and therefore, alleviate the problem of poor access the healthcare. This research formulates a non-linear discrete stochastic mathematical model of the Advanced Access appointment scheduling policy. The model objective is to maximize the expected profit of the clinic subject to constraints on minimum access to healthcare provided. Patient behavior is characterized with probabilities for no-show, balking, and related patient choices. Structural properties of the model are analyzed to determine whether Advanced Access patient scheduling is feasible. To solve the complex combinatorial optimization problem, a heuristic that combines greedy construction algorithm and neighborhood improvement search was developed. The model and the heuristic were used to evaluate the Advanced Access patient appointment policy compared to existing policies. Trade-off between profit and access to healthcare are established, and parameter analysis of input parameters was performed. The trade-off curve is a characteristic curve and was observed to be concave. This implies that there exists an access level at which at which the clinic can be operated at optimal profit that can be realized. The results also show that, in many scenarios by switching from existing scheduling policy to Advanced Access policy clinics can improve access without any decrease in profit. Further, the success of Advanced Access policy in providing improved access and/or profit depends on the expected value of demand, variation in demand, and the ratio of demand for same day and advanced appointments. The contributions of the dissertation are a model of Advanced Access patient scheduling, a heuristic to solve the model, and the use of the model to understand the scheduling policy trade-offs which healthcare clinic managers must make. ^

Nonlinear dynamics and chaos simulation system analysis for improved design

Small errors proved catastrophic. Our purpose to remark that a very small cause which escapes our notice determined a considerable effect that we cannot fail to see, and then we say that the effect is due to chance. Small differences in the initial conditions produce very great ones in the final phenomena. A small error in the former will produce an enormous error in the latter. When dealing with any kind of electrical device specification, it is important to note that there exists a pair of test conditions that define a test: the forcing function and the limit. Forcing functions define the external operating constraints placed upon the device tested. The actual test defines how well the device responds to these constraints. Forcing inputs to threshold for example, represents the most difficult testing because this put those inputs as close as possible to the actual switching critical points and guarantees that the device will meet the Input-Output specifications. ^ Prediction becomes impossible by classical analytical analysis bounded by Newton and Euclides. We have found that non linear dynamics characteristics is the natural state of being in all circuits and devices. Opportunities exist for effective error detection in a nonlinear dynamics and chaos environment. ^ Nowadays there are a set of linear limits established around every aspect of a digital or analog circuits out of which devices are consider bad after failing the test. Deterministic chaos circuit is a fact not a possibility as it has been revived by our Ph.D. research. In practice for linear standard informational methodologies, this chaotic data product is usually undesirable and we are educated to be interested in obtaining a more regular stream of output data. ^ This Ph.D. research explored the possibilities of taking the foundation of a very well known simulation and modeling methodology, introducing nonlinear dynamics and chaos precepts, to produce a new error detector instrument able to put together streams of data scattered in space and time. Therefore, mastering deterministic chaos and changing the bad reputation of chaotic data as a potential risk for practical system status determination. ^

Diel Patterns of Patch Reef Community Dynamics in a Caribbean Back-Reef System

Back-reef seascapes represent critical habitat for juvenile and adult fishes. Patch reef, seagrass, and mangrove habitats form a heterogeneous mosaic, often linked by species that use reefs as structure during the day and make foraging migrations into soft-bottom habitat at night. Artificial reefs are used to model natural patch reefs, however may not function equivalently as fish habitat. To study the relative value of natural and artificial patch reefs as fish habitat, these communities in the Sea of Abaco, Bahamas were compared using roving diver surveys and time-lapse photography. Diel turnover in fish abundance, recorded with time-lapse photography and illuminated by infrared light, was quantified across midday, dusk, and night periods to explore possible effects of reef type (artificial vs. natural) on these patterns. Diurnal communities on natural reefs exhibited greater fish abundance, species richness, and functional diversity compared to artificial reefs. Furthermore, both types of reef communities exhibited a significant shift across the diel period, characterized by a decline in total fish density at night, especially for grunts (Haemulidae). Cross-habitat foraging migrations by diurnal or nocturnal species, such as haemulids, are likely central drivers of this twilight turnover and can represent important energy and nutrient subsidies. Time-lapse surveys provided more consistent measures of reef fish assemblages for the smaller artificial reef habitats, yet underestimated abundance of certain taxa and species richness on larger patch habitats when compared to the roving diver surveys. Time-lapse photography complemented with infrared light represent a valuable non-invasive approach to studying behavior of focal species and their fine-scale temporal dynamics in shallow-reef communities.

Functional near infrared spectroscopy study of language, joint attention and motor skills

Near infrared spectroscopy (NIRS) is an emerging non-invasive optical neuro imaging technique that monitors the hemodynamic response to brain activation with ms-scale temporal resolution and sub-cm spatial resolution. The overall goal of my dissertation was to develop and apply NIRS towards investigation of neurological response to language, joint attention and planning and execution of motor skills in healthy adults. Language studies were performed to investigate the hemodynamic response, synchrony and dominance feature of the frontal and fronto-temporal cortex of healthy adults in response to language reception and expression. The mathematical model developed based on granger causality explicated the directional flow of information during the processing of language stimuli by the fronto-temporal cortex. Joint attention and planning/ execution of motor skill studies were performed to investigate the hemodynamic response, synchrony and dominance feature of the frontal cortex of healthy adults and in children (5-8 years old) with autism (for joint attention studies) and individuals with cerebral palsy (for planning/execution of motor skills studies). The joint attention studies on healthy adults showed differences in activation as well as intensity and phase dependent connectivity in the frontal cortex during joint attention in comparison to rest. The joint attention studies on typically developing children showed differences in frontal cortical activation in comparison to that in children with autism. The planning and execution of motor skills studies on healthy adults and individuals with cerebral palsy (CP) showed difference in the frontal cortical dominance, that is, bilateral and ipsilateral dominance, respectively. The planning and execution of motor skills studies also demonstrated the plastic and learning behavior of brain wherein correlation was found between the relative change in total hemoglobin in the frontal cortex and the kinematics of the activity performed by the participants. Thus, during my dissertation the NIRS neuroimaging technique was successfully implemented to investigate the neurological response of language, joint attention and planning and execution of motor skills in healthy adults as well as preliminarily on children with autism and individuals with cerebral palsy. These NIRS studies have long-term potential for the design of early stage interventions in children with autism and customized rehabilitation in individuals with cerebral palsy.

Funtional Near Infrared Spectroscopy Study of Language, Joint Attention and Motor Skills

Near infrared spectroscopy (NIRS) is an emerging non-invasive optical neuro imaging technique that monitors the hemodynamic response to brain activation with ms-scale temporal resolution and sub-cm spatial resolution. The overall goal of my dissertation was to develop and apply NIRS towards investigation of neurological response to language, joint attention and planning and execution of motor skills in healthy adults. Language studies were performed to investigate the hemodynamic response, synchrony and dominance feature of the frontal and fronto-temporal cortex of healthy adults in response to language reception and expression. The mathematical model developed based on granger causality explicated the directional flow of information during the processing of language stimuli by the fronto-temporal cortex. Joint attention and planning/ execution of motor skill studies were performed to investigate the hemodynamic response, synchrony and dominance feature of the frontal cortex of healthy adults and in children (5-8 years old) with autism (for joint attention studies) and individuals with cerebral palsy (for planning/execution of motor skills studies). The joint attention studies on healthy adults showed differences in activation as well as intensity and phase dependent connectivity in the frontal cortex during joint attention in comparison to rest. The joint attention studies on typically developing children showed differences in frontal cortical activation in comparison to that in children with autism. The planning and execution of motor skills studies on healthy adults and individuals with cerebral palsy (CP) showed difference in the frontal cortical dominance, that is, bilateral and ipsilateral dominance, respectively. The planning and execution of motor skills studies also demonstrated the plastic and learning behavior of brain wherein correlation was found between the relative change in total hemoglobin in the frontal cortex and the kinematics of the activity performed by the participants. Thus, during my dissertation the NIRS neuroimaging technique was successfully implemented to investigate the neurological response of language, joint attention and planning and execution of motor skills in healthy adults as well as preliminarily on children with autism and individuals with cerebral palsy. These NIRS studies have long-term potential for the design of early stage interventions in children with autism and customized rehabilitation in individuals with cerebral palsy.

Engagement experiences of Hispanic Generation 1.5 English language learners at a Massachusetts community college

Hispanic Generation 1.5 students are foreign-born, U.S. high school graduates who are socialized in the English dominant K-12 school system while still maintaining the native language and culture at home (Allison, 2006; Blumenthal, 2002; Harklau, Siegal, & Losey, 1999; Rumbault & Ima, 1988). When transitioning from high school to college, these students sometimes assess into ESL courses based on their English language abilities, and because of this ESL placement, Hispanic Generation 1.5 students might have different engagement experiences than their mainstream peers. Engagement is a critical factor in student success and long-term retention because students’ positive and negative engagement experiences affect their membership and sense of belonging at the institution. The purpose of this study was to describe the engagement and membership experiences of Hispanic Generation 1.5 students’ at a Massachusetts community college. This study employed naturalistic inquiry within an embedded descriptive case study design that included three units of analysis: the students’ engagement experiences in (a) ESL courses, (b) developmental courses, and (c) mainstream courses. The main source of data was in-depth interviews with Hispanic Generation 1.5 students at Commonwealth of Massachusetts Community College. Criterion sampling was used to select the interview participants, ensuring that all participants were native Spanish speakers and were taking or had taken at least one ESL course at the institution. The study findings show that these Hispanic Generation 1.5 students at the college did not perceive peer engagement as critical to academic success. Most times the participants avoided peer engagement outside of the classroom, especially with fellow Hispanic students, who they felt would deter them from their English language development and general academic work. Engagement with ESL faculty and ESL academic support staff played the most critical role in the participants’ sense of belonging and success, and students who were required to engage with faculty and academic support staff outside of the classroom were the most satisfied with their educational experiences. While the participants were all disappointed with some aspect of their ESL placement, they valued the ESL engagement experiences more than the engagement experiences while completing developmental and credit coursework.

From Bilingualism to Interlinguistics: The Case Against the Deficit Model of Language Acquisition

The article argues against an ahistorical deficit model of Spanish/English bilingualism in educational practice based on interlinguistic research. The bidirectional facilitative effects of Hispanic bilingualism allow Spanish-speaking minorities to exploit their language background while learning academic English and integrating their language and culture into the American mainstream.

Perceptions of French and Creole Among First-Generation Adult Haitian English Language Learners

Context: Due to a unique combination of factors, outdoor athletes in the Southeastern United States are at high risk of lightning deaths and injuries. Lightning detection methods are available to minimize lightning strike victims. Objective: Becoming aware of the risk factors that predispose athletes to lightning strikes and determining the most reliable detection method against hazardous weather will enable Certified Athletic Trainers to develop protocols that protect athletes from injury. Data Sources: A comprehensive literature review of Medline and Pubmed using key words: lightning, lightning risk factors, lightning safety, lightning detection, and athletic trainers and lightning was completed. Data Synthesis: Factors predisposing athletes to lighting death or injury include: time of year, time of day, the athlete’s age, geographical location, physical location, sex, perspiration level, and lack of education and preparedness by athletes and staff. Although handheld lightning detectors have become widely accessible to detect lightning strikes, their performance has not been independently or objectively confirmed. There is evidence that these detectors inaccurately detect strike locations by recording false strikes and not recording actual strikes. Conclusions: Lightning education and preparation are two factors that can be controlled. Measures need to be taken by Certified Athletic Trainers to ensure the safety of athletes during outdoor athletics. It is critical for athletic trainers and supervising staff members to become fully aware of the risks of lightning strikes in order to most effectively protect everyone under their supervision. Even though lightning detectors have been manufactured in an attempt to minimize death and injuries due to lightning strikes, none of the detectors have been proven to be 100% effective. Educating coaches, athletes, and parents on the risks of lightning and the detection methods available, while implementing an emergency action plan for lightning safety, is crucial to ensure the well being of the student-athlete population.

Perceptions of French and Creole Among First-Generation Adult Haitian English Language Learners

This basic interpretive study investigated the literacy experiences of seven first-generation Haitian English language learners. During interviews and focus groups, participants expressed ambivalent feelings toward Creole and French and explained how their knowledge of these languages supported their English language learning.

A software tool that generates symbolic model verifier (SMV) input language from a predicate transition net

The purpose of this research was to apply model checking by using a symbolic model checker on Predicate Transition Nets (PrT Nets). A PrT Net is a formal model of information flow which allows system properties to be modeled and analyzed. The aim of this thesis was to use the modeling and analysis power of PrT nets to provide a mechanism for the system model to be verified. Symbolic Model Verifier (SMV) was the model checker chosen in this thesis, and in order to verify the PrT net model of a system, it was translated to SMV input language. A software tool was implemented which translates the PrT Net into SMV language, hence enabling the process of model checking. The system includes two parts: the PrT net editor where the representation of a system can be edited, and the translator which converts the PrT net into an SMV program.

The Effect of a Multi-Component Consultation Intervention on the Pragmatic Language Skills of Students with Symptoms of Attention Deficit Hyperactivity Disorder

The purpose of this research was to determine if a multi-component consultation intervention was effective in improving pragmatic performance in students with ADHD. Participants for this study consisted of 7 children for whom 3 data points were obtained by a parent or 2 data points by a teacher. Changes in pragmatic performance were measured by comparing reports provided by parents or teachers pre- and post- intervention. Descriptive analysis procedures were completed to summarize changes in pragmatic behavior. Results revealed the mean overall change in pragmatic behavior for children in the MCC condition (Χ=1.133) was greater than the change seen in the CAU condition (.334) after 2 months of intervention as per parent reported data. Data indicated improvement in each behavior but incongruence between teachers and parents was found. Results support the hypothesis that the multi-component consultation intervention is effective in improving the pragmatic language performance of children with ADHD.

An evaluation of English language instruction in universities/colleges in Taiwan

The purpose of this study is about to survey the effectiveness of English teaching in universities/colleges in Taiwan and provide suggestions to the educational authorities for upgrading or improving the English language teaching techniques or methods currently in use. On the one hand, the suggestions of English teachers in universities/colleges are the main concerns in this study. On the other hand, equal attention is given to the opinions and learning attitudes of the students, including the interaction between the teachers and the students.^ A social investigation methodology, consisting of questionnaire and data analysis, is devoted to this evaluation and analysis of teaching effectiveness. Among the significant findings reported in this study is the fact that both students and teachers consider evaluation of teaching effectiveness as a very important aspect of English Language programs at the university/college level. Another significant finding is that students are less concerned about the grades earned or awarded in English Language courses and more concerned about how much they learned in these classes.^ The analysis and suggestions based on the results for English teaching evaluation of universities/colleges in this dissertation can help teachers modify their teaching techniques and methods, the students to adjust their learning attitudes, and the authorities to schematize the English teaching plan that can facilitate the teaching goals to be realized. ^

An investigation of mathematics and science instruction in English and Spanish for English language learners

The contextual demands of language in content area are difficult for ELLS. Content in the native language furthers students' academic development and native language skills, while they are learning English. Content in English integrates pedagogical strategies for English acquisition with subject area instruction. The following models of curriculum content are provided in most Miami Dade County Public Schools: (a) mathematics instruction in the native language with science instruction in English or (b) science instruction in the native language with mathematics instruction in English. The purpose of this study was to investigate which model of instruction is more contextually supportive for mathematics and science achievement. ^ A pretest and posttest, nonequivalent group design was used with 94 fifth grade ELLs who received instruction in curriculum model (a) or (b). This allowed for statistical analysis that detected a difference in the means of .5 standard deviations with a power of .80 at the .05 level of significance. Pretreatment and post-treatment assessments of mathematics, reading, and science achievement were obtained through the administration of Aprenda-Segunda Edición and the Florida Comprehensive Achievement Test. ^ The results indicated that students receiving mathematics in English and Science in Spanish scored higher on achievement tests in both Mathematics and Science than the students who received Mathematics in Spanish and Science in English. In addition, the mean score of students on the FCAT mathematics examination was higher than their mean score on the FCAT science examination regardless of the language of instruction. ^

A framework for transforming, analyzing, and realizing software designs in unified modeling language

Unified Modeling Language (UML) is the most comprehensive and widely accepted object-oriented modeling language due to its multi-paradigm modeling capabilities and easy to use graphical notations, with strong international organizational support and industrial production quality tool support. However, there is a lack of precise definition of the semantics of individual UML notations as well as the relationships among multiple UML models, which often introduces incomplete and inconsistent problems for software designs in UML, especially for complex systems. Furthermore, there is a lack of methodologies to ensure a correct implementation from a given UML design. The purpose of this investigation is to verify and validate software designs in UML, and to provide dependability assurance for the realization of a UML design.^ In my research, an approach is proposed to transform UML diagrams into a semantic domain, which is a formal component-based framework. The framework I proposed consists of components and interactions through message passing, which are modeled by two-layer algebraic high-level nets and transformation rules respectively. In the transformation approach, class diagrams, state machine diagrams and activity diagrams are transformed into component models, and transformation rules are extracted from interaction diagrams. By applying transformation rules to component models, a (sub)system model of one or more scenarios can be constructed. Various techniques such as model checking, Petri net analysis techniques can be adopted to check if UML designs are complete or consistent. A new component called property parser was developed and merged into the tool SAM Parser, which realize (sub)system models automatically. The property parser generates and weaves runtime monitoring code into system implementations automatically for dependability assurance. The framework in the investigation is creative and flexible since it not only can be explored to verify and validate UML designs, but also provides an approach to build models for various scenarios. As a result of my research, several kinds of previous ignored behavioral inconsistencies can be detected.^