Trial of the Primary Care Practice Improvement Tool: Building organisational performance in Australian general practice and primary health care

Objective: To nationally trial the Primary Care Practice Improvement Tool (PC-PIT), an organisational performance improvement tool previously co-created with Australian primary care practices to increase their focus on relevant quality improvement (QI) activities. Design: The study was conducted from March to December 2015 with volunteer general practices from a range of Australian primary care settings. We used a mixed-methods approach in two parts. Part 1 involved staff in Australian primary care practices assessing how they perceived their practice met (or did not meet) each of the 13 PC-PIT elements of high-performing practices, using a 1–5 Likert scale. In Part 2, two external raters conducted an independent practice visit to independently and objectively assess the subjective practice assessment from Part 1 against objective indicators for the 13 elements, using the same 1–5 Likert scale. Concordance between the raters was determined by comparing their ratings. In-depth interviews conducted during the independent practice visits explored practice managers’ experiences and perceived support and resource needs to undertake organisational improvement in practice. Results: Data were available for 34 general practices participating in Part 1. For Part 2, independent practice visits and the inter-rater comparison were conducted for a purposeful sample of 19 of the 34 practices. Overall concordance between the two raters for each of the assessed elements was excellent. Three practice types across a continuum of higher- to lower-scoring practices were identified, with each using the PC-PIT in a unique way. During the in-depth interviews, practice managers identified benefits of having additional QI tools that relate to the PC-PIT elements. Conclusions: The PC-PIT is an organisational performance tool that is acceptable, valid and relevant to our range of partners and the end users (general practices). Work is continuing with our partners and end users to embed the PC-PIT in existing organisational improvement programs.

HARMONY: a server for the assessment of protein structures

Protein structure validation is an important step in computational modeling and structure determination. Stereochemical assessment of protein structures examine internal parameters such as bond lengths and Ramachandran (phi, psi) angles. Gross structure prediction methods such as inverse folding procedure and structure determination especially at low resolution can sometimes give rise to models that are incorrect due to assignment of misfolds or mistracing of electron density maps. Such errors are not reflected as strain in internal parameters. HARMONY is a procedure that examines the compatibility between the sequence and the structure of a protein by assigning scores to individual residues and their amino acid exchange patterns after considering their local environments. Local environments are described by the backbone conformation, solvent accessibility and hydrogen bonding patterns. We are now providing HARMONY through a web server such that users can submit their protein structure files and, if required, the alignment of homologous sequences. Scores are mapped on the structure for subsequent examination that is useful to also recognize regions of possible local errors in protein structures. HARMONY server is located at http://caps.ncbs.res.in/harmony/

Local systems, global impacts : Using life cycle assessment to analyse the potential and constraints of industrial symbioses

Human activities extract and displace different substances and materials from the earth s crust, thus causing various environmental problems, such as climate change, acidification and eutrophication. As problems have become more complicated, more holistic measures that consider the origins and sources of pollutants have been called for. Industrial ecology is a field of science that forms a comprehensive framework for studying the interactions between the modern technological society and the environment. Industrial ecology considers humans and their technologies to be part of the natural environment, not separate from it. Industrial operations form natural systems that must also function as such within the constraints set by the biosphere. Industrial symbiosis (IS) is a central concept of industrial ecology. Industrial symbiosis studies look at the physical flows of materials and energy in local industrial systems. In an ideal IS, waste material and energy are exchanged by the actors of the system, thereby reducing the consumption of virgin material and energy inputs and the generation of waste and emissions. Companies are seen as part of the chains of suppliers and consumers that resemble those of natural ecosystems. The aim of this study was to analyse the environmental performance of an industrial symbiosis based on pulp and paper production, taking into account life cycle impacts as well. Life Cycle Assessment (LCA) is a tool for quantitatively and systematically evaluating the environmental aspects of a product, technology or service throughout its whole life cycle. Moreover, the Natural Step Sustainability Principles formed a conceptual framework for assessing the environmental performance of the case study symbiosis (Paper I). The environmental performance of the case study symbiosis was compared to four counterfactual reference scenarios in which the actors of the symbiosis operated on their own. The research methods used were process-based life cycle assessment (LCA) (Papers II and III) and hybrid LCA, which combines both process and input-output LCA (Paper IV). The results showed that the environmental impacts caused by the extraction and processing of the materials and the energy used by the symbiosis were considerable. If only the direct emissions and resource use of the symbiosis had been considered, less than half of the total environmental impacts of the system would have been taken into account. When the results were compared with the counterfactual reference scenarios, the net environmental impacts of the symbiosis were smaller than those of the reference scenarios. The reduction in environmental impacts was mainly due to changes in the way energy was produced. However, the results are sensitive to the way the reference scenarios are defined. LCA is a useful tool for assessing the overall environmental performance of industrial symbioses. It is recommended that in addition to the direct effects, the upstream impacts should be taken into account as well when assessing the environmental performance of industrial symbioses. Industrial symbiosis should be seen as part of the process of improving the environmental performance of a system. In some cases, it may be more efficient, from an environmental point of view, to focus on supply chain management instead.  

Experimental and Numerical Studies in a Compact Trapped Vortex Combustor: Stability Assessment and Augmentation

Fundamental studies on a compact trapped vortex combustor indicate that cavity injection strategies play a major role on flame stability. Detailed experiments indicate that blow-out occurs for a certain range of cavity air flow velocities. An unsteady RANS-based reacting flow simulation tool has been utilized to study the basic dynamics of cavity vortex for various flow conditions. The phenomenon of flame blow-out at certain intermediate cavity air velocities is explained on the basis of transition from a cavity-stabilized mode to an opposed flow stagnation mode. A novel strategy is proposed for achieving flame stability at all conditions. This involves using a flow guide vane in the path of the main flow to direct a portion of the main flow into the cavity. This seems to result in a desirable dual vortex structure, i.e., a small clockwise vortex behind the vane and large counterclockwise vortex in the cavity. Experimental results show stable flame at all flow conditions with the flow guide vane, and pressure drop is estimated to be within acceptable limits. Cold flow simulations show self-similar velocity profiles for a range of main inlet velocities, and high reverse velocity ratios (-0.3) are observed. Such a high-velocity ratio in the reverse flow shear layer profile leads to enhanced production of turbulence imperative to compact combustors. Reacting flow simulations show even higher reverse velocity ratios (above -0.7) due to flow acceleration. The flame is observed to be stable, even though minor shear layer oscillations are present in the form of vortex shedding. Self-similarity is also observed in reacting flow temperature profiles at combustor exit over the entire range of the mainstream velocity. This indicates that the present configuration holds a promise of delivering robust performance invariant of the flow operating conditions.

NMR studies of preimplantation embryo metabolism in human assisted reproductive techniques: a new biomarker for assessment of embryo implantation potential

There has been growing interest in understanding energy metabolism in human embryos generated using assisted reproductive techniques (ART) for improving the overall success rate of the method. Using NMR spectroscopy as a noninvasive tool, we studied human embryo metabolism to identify specific biomarkers to assess the quality of embryos for their implantation potential. The study was based on estimation of pyruvate, lactate and alanine levels in the growth medium, ISM1, used in the culture of embryos. An NMR study involving 127 embryos from 48 couples revealed that embryos transferred on Day 3 (after 72 h in vitro culture) with successful implantation (pregnancy) exhibited significantly (p < 10(-5)) lower pyruvate/alanine ratios compared to those that failed to implant. Lactate levels in media were similar for all embryos. This implies that in addition to lactate production, successfully implanted embryos use pyruvate to produce alanine and other cellular functions. While pyruvate and alanine individually have been used as biomarkers, the present study highlights the potential of combining them to provide a single parameter that correlates strongly with implantation potential. Copyright (C) 2012 John Wiley & Sons, Ltd.

Study on ride comfort assessment of multiple occupants using lumped parameter analysis

Growing consumer expectations continue to fuel further advancements in vehicle ride comfort analysis including development of a comprehensive tool capable of aiding the understanding of ride comfort. To date, most of the work on biodynamic responses of human body in the context of ride comfort mainly concentrates on driver or a designated occupant and therefore leaves the scope for further work on ride comfort analysis covering a larger number of occupants with detailed modeling of their body segments. In the present study, governing equations of a 13-DOF (degrees-of-freedom) lumped parameter model (LPM) of a full car with seats (7-DOF without seats) and a 7-DOF occupant model, a linear version of an earlier non-linear occupant model, are presented. One or more occupant models can be coupled with the vehicle model resulting into a maximum of 48-DOF LPM for a car with five occupants. These multi-occupant models can be formulated in a modular manner and solved efficiently using MATLAB/SIMULINK for a given transient road input. The vehicle model and the occupant model are independently verified by favorably comparing computed dynamic responses with published data. A number of cases with different dispositions of occupants in a small car are analyzed using the current modular approach thereby underscoring its potential for efficient ride quality assessment and design of suspension systems.

Luminescent Molecular Sensors for Assessment of Temperature Field in Machining

A new technique based on luminescent molecular sensors is utilized in these series of experiments for measurement of temperatures in material removal processes. 2-Dimensional machining of metals at low speeds and surface grinding configurations are used as the model experimental systems to understand the efficacy of this experimental technique. The experiments were conducted with a series of luminescent sensors and binder combinations for the temperature measurement. The luminescence of the sensor was measured through a charge-coupled device imaging camera, and intensive calibration exercises were performed on these sensors. Excellent agreement in the temperature fields measured through this new experimental approach and traditional infrared thermography is seen here. This technique offers the unique capability of allowing measurement of temperatures in the presence of a lubricant, akin to manufacturing conditions in situ. Extension of the technique to measure the temperature field at the tool-chip contact is described.

Evaluating FuncSION: A software for automated synthesis of design solutions for stimulating ideation during mechanical conceptual design

The goal of the work reported in this paper is to use automated, combinatorial synthesis to generate alternative solutions to be used as stimuli by designers for ideation. FuncSION, a computational synthesis tool that can automatically synthesize solution concepts for mechanical devices by combining building blocks from a library, is used for this purpose. The objectives of FuncSION are to help generate a variety of functional requirements for a given problem and a variety of concepts to fulfill these functions. A distinctive feature of FuncSION is its focus on automated generation of spatial configurations, an aspect rarely addressed by other computational synthesis programs. This paper provides an overview of FuncSION in terms of representation of design problems, representation of building blocks, and rules with which building blocks are combined to generate concepts at three levels of abstraction: topological, spatial, and physical. The paper then provides a detailed account of evaluating FuncSION for its effectiveness in providing stimuli for enhanced ideation.

Multi-scale vulnerability assessment for adaptation planning

Vulnerability of communities and natural ecosystems, to potential impacts of climate change in developing countries like India, and the need for adaptation are rapidly emerging as central issues in the debate around policy responses to climate change. The present study presents an approach to identify and prioritize the most vulnerable districts, villages and households in Karnataka State, through a multi-scale assessment of inherent vulnerability to current climate variability. It also identifies the drivers of inherent vulnerability, thereby providing a tool for developing and mainstreaming adaptation strategies, in ongoing developmental or dedicated adaptation programmes. The multi-scale assessment was made for all 30 districts at the state level in Karnataka, about 1220 villages in Chikballapur district, and at the household level for two villages - Gundlapalli and Saddapalli - in Bagepalli taluk of Chikballapur district. At the district, village and household levels, low levels of education and skills are the dominant factors contributing to vulnerability. At the village and household level, the lack of income diversification and livelihood support institutions are key drivers of vulnerability. The approach of multi-scale vulnerability assessment facilitates identification and prioritization of the drivers of vulnerability at different scales, to focus adaptation interventions to address these drivers.

KE Workshop report: Report Knowledge Exchange workshop Making data count - Research Data and Research Assessment

The possibilities of digital research have altered the production, publication and use of research results. Academic research practice and culture are changing or have already been transformed, but to a large degree the system of academic recognition has not yet adapted to the practices and possibilities of digital research. This applies especially to research data, which are increasingly produced, managed, published and archived, but play hardly a role yet in practices of research assessment. The aim of the workshop was to bring experts and stakeholders from research institutions, universities, scholarly societies and funding agencies together in order to review, discuss and build on possibilities to implement the culture of sharing and to integrate publication of data into research assessment procedures. The report 'The Value of Research Data - Metrics for datasets from a cultural and technical point of view' was presented and discussed. Some of the key finding were that data sharing should be considered normal research practice, in fact not sharing should be considered malpractice. Research funders and universities should support and encourage data sharing. There are a number of important aspects to consider when making data count in research and evaluation procedures. Metrics are a necessary tool in monitoring the sharing of data sets. However, data metrics are at present not very well developed and there is not yet enough experience in what these metrics actually mean. It is important to implement the culture of sharing through codes of conducts in the scientific communities. For further key findings please read the report.

Water quality assessment and characterisation of chlorophyll-a variability related to river discharges, within the southeastern Bay of Biscay : evaluation and development of chlorophyll-a algorithms for MODIS and MERIS imagery

222 p. : il.

Image-based delineation and classification of built heritage masonry

[EN]Fundación Zain is developing new built heritage assessment protocols. The goal is to objectivize and standardize the analysis and decision process that leads to determining the degree of protection of built heritage in the Basque Country. The ultimate step in this objectivization and standardization effort will be the development of an information and communication technology (ICT) tool for the assessment of built heritage. This paper presents the ground work carried out to make this tool possible: the automatic, image-based delineation of stone masonry. This is a necessary first step in the development of the tool, as the built heritage that will be assessed consists of stone masonry construction, and many of the features analyzed can be characterized according to the geometry and arrangement of the stones. Much of the assessment is carried out through visual inspection. Thus, this process will be automated by applying image processing on digital images of the elements under inspection. The principal contribution of this paper is the automatic delineation the framework proposed. The other contribution is the performance evaluation of this delineation as the input to a classifier for a geometrically characterized feature of a built heritage object. The element chosen to perform this evaluation is the stone arrangement of masonry walls. The validity of the proposed framework is assessed on real images of masonry walls.

Metallothionein as an indicator of water quality: assessment of the bioavailability of cadmium, copper, mercury and zinc in aquatic animals at the cellular level

The study of metallothioneins (MTs) has greatly improved our understanding of body burdens, metal storage and detoxification in aquatic organisms subjected to contamination by the toxic heavy metals, Cd, Cu, Hg and Zn. These studies have shown that in certain organisms MT status can be used to assess impact of these metals at the cellular level and, whilst validation is currently limited to a few examples, this stress response may be linked to higher levels of organisation, thus indicating its potential for environmental quality assessment. Molluscs, such as Mytilus spp., and several commonly occurring teleost species, are the most promising of the indicator species tested. Natural variability of MT levels caused by the organism's size, condition, age, position in the sexual cycle, temperature and various stressors, can lead to difficulties in interpretation of field data as a definitive response-indicator of metal contamination unless a critical appraisal of these variables is available. From laboratory and field studies these data are almost complete for teleost fish. Whilst for molluscs much of this information is lacking, when suitable controls are utilised and MT measurements are combined with observations of metal partitioning, current studies indicate that they are nevertheless a powerful tool in the interpretation of impact, and may prove useful in water quality assessment.

Image-Based Delineation and Classification of Built Heritage Masonry

Fundacion Zain is developing new built heritage assessment protocols. The goal is to objectivize and standardize the analysis and decision process that leads to determining the degree of protection of built heritage in the Basque Country. The ultimate step in this objectivization and standardization effort will be the development of an information and communication technology (ICT) tool for the assessment of built heritage. This paper presents the ground work carried out to make this tool possible: the automatic, image-based delineation of stone masonry. This is a necessary first step in the development of the tool, as the built heritage that will be assessed consists of stone masonry construction, and many of the features analyzed can be characterized according to the geometry and arrangement of the stones. Much of the assessment is carried out through visual inspection. Thus, this process will be automated by applying image processing on digital images of the elements under inspection. The principal contribution of this paper is the automatic delineation the framework proposed. The other contribution is the performance evaluation of this delineation as the input to a classifier for a geometrically characterized feature of a built heritage object. The element chosen to perform this evaluation is the stone arrangement of masonry walls. The validity of the proposed framework is assessed on real images of masonry walls.

Tracking Pacific bluefin tuna (Thunnus thynnus orientalis) in the northeastern Pacific with an automated algorithm that estimates latitude by matching sea-surface-temperature data from satellites with temperature data from tags on fish

Data recovered from 11 popup satellite archival tags and 3 surgically implanted archival tags were used to analyze the movement patterns of juvenile northern bluefin tuna (Thunnus thynnus orientalis) in the eastern Pacific. The light sensors on archival and pop-up satellite transmitting archival tags (PSATs) provide data on the time of sunrise and sunset, allowing the calculation of an approximate geographic position of the animal. Light-based estimates of longitude are relatively robust but latitude estimates are prone to large degrees of error, particularly near the times of the equinoxes and when the tag is at low latitudes. Estimating latitude remains a problem for researchers using light-based geolocation algorithms and it has been suggested that sea surface temperature data from satellites may be a useful tool for refining latitude estimates. Tag data from bluefin tuna were subjected to a newly developed algorithm, called “PSAT Tracker,” which automatically matches sea surface temperature data from the tags with sea surface temperatures recorded by satellites. The results of this algorithm compared favorably to the estimates of latitude calculated with the lightbased algorithms and allowed for estimation of fish positions during times of the year when the lightbased algorithms failed. Three near one-year tracks produced by PSAT tracker showed that the fish range from the California−Oregon border to southern Baja California, Mexico, and that the majority of time is spent off the coast of central Baja Mexico. A seasonal movement pattern was evident; the fish spend winter and spring off central Baja California, and summer through fall is spent moving northward to Oregon and returning to Baja California.