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Storylines of family medicine Ⅲ:core principles—primary care,systems and family

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Family Medicine and Community Health 2024年第S3期12卷 23-32页

作者： William B Ventres Leslie A Stone Timothy A Joslin john W Saultz Sommer Aldulaimi paul R Gordon john C Lane Eric R Lee Jacob Prunuske Limor Gildenblatt Michael H Friedman Colleen T Fogarty Susan H McDaniel Tessa Rohrberg Amy Odom Family and Preventive Medicine University of Arkansas for Medical Sciences College of MedicineLittle RockArkansasUSA Family Medicine Oregon Health&Science UniversityPortlandOregonUSA Family and Community Medicine University of Arizona Medical Center–South CampusTucsonArizonaUSA Family and Community Medicine University of Arizona Medical Center–University CampusTucsonArizonaUSA UAMS West Regional Campus Family Medicine Residency Program Fort SmithArkansasUSA Medical College of Wisconsin–Central Wisconsin Campus WausauWisconsinUSA Family and Community Medicine Medical College of Wisconsin–Central Wisconsin CampusWausauWisconsinUSA Family Medicine Advocate Illinois Masonic Medical CenterChicagoIllinoisUSA Family Medicine Presence Saints Mary and Elizabeth Medical CenterChicagoIllinoisUSA Family Medicine University of Rochester Medical CenterRochesterNew YorkUSA Psychiatry and Family Medicine University of Rochester Medical CenterRochesterNew YorkUSA Family and Community Medicine University of Kansas School of Medicine-WichitaWichitaKansasUSA Sparrow/Michigan State University Family Medicine Residency Program LansingMichiganUSA

Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine,as interpreted by individual family physicians and medical educators in the USA and elsewhere around the ***‘Ⅲ:core principles—primary care,systems,and family’,authors address the following themes:‘Continuity of care—building therapeutic relationships over time’,‘Comprehensiveness—combining breadth and depth of scope’,‘Coordination of care—managing multiple realities’,‘Access to care—intersectional,systemic,and personal’,‘Systems theory—a core value in patient-centered care’,‘Family-oriented practice—supporting patients’health and well-being’,‘Family physician as family member’and‘Family in the exam room’.May readers develop new understandings from these essays.

关键词： individual Storyline principles

Patients’experiences with‘sludge’(administrative burden)in the cancer screening process and its relationship with screening completion,experience and health system distrust

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Family Medicine and Community Health 2024年第S2期12卷 8-17页

作者： Michelle S Rockwell Brianna Chang Vivian Zagarese Jamie K Turner Ally Southworth YingXing Wu paul Yeaton Li Li Jeffrey S Stein Sarah H Parker john W Epling Department of Family and Community Medicine Virginia Tech Carilion School of MedicineRoanokeVirginiaUSA Department of Family and Community Medicine Carilion ClinicRoanokeVirginiaUSA Virginia Tech Carilion School of Medicine RoanokeVirginiaUSA Department of Health Systems and Implementation Science Virginia Tech Carilion School of MedicineRoanokeVirginiaUSA Graduate Program in Translational Biology Medicineand HealthVirginia TechRoanokeVirginiaUSA Health Analytics Research Team Carilion ClinicRoanokeVirginiaUSA Division of Gastroenterology Department of Internal MedicineCarilion ClinicRoanokeVirginiaUSA Department of Family Medicine University of Virginia School of MedicineCharlottesvilleVirginiaUSA Center for Health Behaviors Research Fralin Biomedical Research Institute at VTCRoanokeVirginiaUSA

Objective‘Sludge’refers to administrative burdens or frictions that preclude people from getting what they want or need(eg,duplicative forms,complicated instructions,long waiting times).This mixed methods study evaluated patients’perceptions of sludge in the colorectal cancer(CRC)screening process and some impacts of this *** We employed an exploratory sequential mixed methods study design that comprised patient interviews and a patient *** interviews informed final survey revisions and captured contextual data about patients’experiences with *** transcripts were inductively and deductively analysed to identify overarching *** survey quantified sludge,delayed or forgone screenings,screening experience(Net Promoter Score)and health system distrust(Health System Distrust Scale).We usedχ2 or t-tests for univariable comparisons and logistic or linear regressions to evaluate the association between cumulative sludge score and delayed or forgone screenings,screening experience and health system *** were integrated for *** Southeastern United *** Patients who were 45–75 years of age,at average risk for CRC and had either completed or been referred for CRC screening(colonoscopy or stool-based test)within the previous 12 *** 22 interview participants and 255 survey participants completed the study.38(15%)survey participants rated their screening experience as poor(Net Promoter Score=0–7 out of 10).The mean(SD)Health System Distrust Scale score was 22.4(6.3)out of 45 possible points(higher score=greater distrust).Perceptions of sludge in the CRC screening process varied,with long waiting times and burdensome communication being the most common sources(58%and 35%of participants,respectively).Sludge was positively associated with delayed or forgone screenings(OR=1.42,95%CI 1.28,1.57,p<0.001),poor screening experience(OR=1.15,95%CI 1.04,1.28,p=0.009)and health system distrust(β=0.47,p

关键词： sludge screening burden

Storylines of family medicine Ⅻ:family medicine and the healthcare system

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Family Medicine and Community Health 2024年第S3期12卷 109-118页

作者： William B Ventres Leslie A Stone Jeannette E South-paul Kendall M Campbell Aerial R Petty Hima Ekanadham Kurt C Stange Rebecca S Etz William L Miller Robert L Ferrer Marianna Kong Thomas Bodenheimer Roger Strasser Sharon C M Reece Joshua Freeman john M Westfall Family and Preventive Medicine University of Arkansas for Medical Sciences College of MedicineLittle RockArkansasUSA Meharry Medical College NashvilleTennesseeUSA Family Medicine University of Texas Medical Branch at Galveston School of MedicineGalvestonTexasUSA Family Medicine Residency Program New York-Presbyterian Columbia University Medical CenterNew YorkNew YorkUSA Center for Family and Community Medicine Columbia University Vagelos College of Physicians and SurgeonsNew YorkNew YorkUSA Center for Community Health Integration Case Western Reserve University School of MedicineClevelandOhioUSA Family Medicine and Population Health Virginia Commonwealth University School of MedicineRichmondVirginiaUSA Family Medicine Lehigh Valley Health NetworkAllentownPennsylvaniaUSA University of South Florida Morsani College of Medicine TampaFloridaUSA Family and Community Medicine UT Health San Antonio Long School of MedicineSan AntonioTexasUSA Family and Community Medicine University of California San Francisco School of MedicineSan FranciscoCaliforniaUSA Northern Ontario School of Medicine University SudburyOntarioCanada Family Medicine Baylor Scott and White HealthTempleTexasUSA Family Medicine University of Kansas School of MedicineKansas CityKansasUSA DARTNet Insitute AuroraColoradoUSA

Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine,as interpreted by individual family physicians and medical educators in the USA and elsewhere around the ***‘Ⅻ:Family medicine and the future of the healthcare system’,authors address the following themes:‘Leadership in family medicine’,‘Becoming an academic family physician’,‘Advocare—our call to act’,‘The paradox of primary care and three simple rules’,‘The quadruple aim—melding the patient and the health system’,‘Fit-for-purpose medical workforce’,‘Universal healthcare—coverage for all’,‘The futures of family medicine’and‘The 100th essay.’May readers of these essays feel empowered to be part of family medicine’s exciting future.

关键词： system illustration family

Quantitative Applications of Weather Satellite Data for Nowcasting:Progress and Challenges

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Journal of Meteorological Research 2024年第3期38卷 399-413页

作者： Jun LI Jing ZHENG Bo LI Min MIN Yanan LIU Chian-Yi LIU Zhenglong LI Wpaul MENZEL Timothy J.SCHMIT john L.CINTINEO Scott LINDSTROM Scott BACHMEIER Yunheng XUE Yayu MA Di DI Han LIN Innovation Centre for Fengyun Meteorological Satellite(FYSIC) National Satellite Meteorological CentreChina Meteorological AdministrationBeijing100081China School of Atmospheric Sciences and Guangdong Province Key Laboratory for Climate Change and Natural Disaster Studies Sun Yat-sen University and Southern Laboratory of Ocean Science and EngineeringZhuhai519082China Key Laboratory of Geographic Information Science(Ministry of Education) East China Normal UniversityShanghai200241China Research Center for Environmental Changes Academia SinicaTaipei11529China Cooperative Institute for Meteorological Satellite Studies University of Wisconsin-MadisonMadisonWI53706USA Sensors and Calibration Branch STAR/NESDISMadisonWI53706USA Wuxi University Wuxi214105China School of Computer Science Chengdu University of Information TechnologyChengdu610225China Collaborative Innovation Center on Forecast and Evaluation of Meteorological Disasters Nanjing University of Information Science&TechnologyNanjing210044China Key Laboratory of Spatial Data Mining and Information Sharing of Ministry of Education National and Local Joint Engineering Research Center of Satellite Geospatial Information TechnologyFuzhou UniversityFuzhou350108China

Monitoring and predicting highly localized weather events over a very short-term period,typically ranging from minutes to a few hours,are very important for decision makers and public *** these events usually relies on radar observations through monitoring and *** advanced high-resolution imaging and sounding observations from weather satellites,nowcasting can be enhanced by combining radar,satellite,and other data,while quantitative applications of those data for nowcasting are advanced through using machine learning *** applications include monitoring the location,impact area,intensity,water vapor,atmospheric instability,precipitation,physical properties,and optical properties of the severe storm at different stages(pre-convection,initiation,development,and decaying),identification of storm types(wind,snow,hail,etc.),and predicting the occurrence and evolution of the *** observations can provide information on the environmental characteristics in the preconvection stage and are very useful for situational awareness and storm *** paper provides an overview of recent progress on quantitative applications of satellite data in nowcasting and its challenges,and future perspectives are also addressed and discussed.

关键词： weather satellite quantitative applications nowcasting pre-convection

The Decarbonization of Construction—How Can Alkali-Activated Materials Contribute?

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Engineering 2024年第6期37卷 18-21页

作者： john L.Provis Susan A.Bernal Zuhua Zhang Department of Materials Science and Engineering University of SheffieldSheffield S13JDUK paul Scherrer Institut Villigen PSI 5232Switzerland School of Civil Engineering University of LeedsLeeds LS29JTUK School of Materials Sciences and Engineering Tongji UniversityShanghai 201804China

*** and context Enormous emphasis is currently being paid to the decarbonization of the global built environment as a leading priority for the engineering community and related industrial sectors[1].One of the main contributors to the overall emissions footprint of the built environment-and thus a cornerstone of efforts to achieve decarbonization-is the emissions profile of construction materials during their production and *** cement and concrete sector is the largest-volume contributor to the emissions incurred in meeting the world’s construction material needs and is therefore targeted in the discussion of the deep,rapid decarbonization that must be achieved in order to minimize irreversible damage to the Earth and its ecosystems.

关键词： Alkali corners irreversible

Influence of inter-grain cementation stiffness on the effective elastic properties of porous Bentheim sandstone

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Journal of Rock Mechanics and Geotechnical Engineering 2023年第3期15卷 573-583页

作者： Bin Chen Jiansheng Xiang john-paul Latham Department of Earth Science and Engineering Faculty of EngineeringImperial College LondonLondonSW72BXUK

Effective elastic properties of porous media are known to be significantly influenced by *** this paper,we investigated the influence of another critical factor,the inter-grain cementation stiffness,on the effective elastic properties of a granular porous rock(Bentheim sandstone)using an advanced numerical workflow with realistic rock microstructure and a theoretical ***,the disparity between the experimentally tested elastic properties of Bentheim sandstone and the effective elastic properties predicted by empirical equations was ***,a micro-computed tomography(CT)-scan based approach was implemented with digital imaging software AVIZO to construct the 3D(three-dimensional)realistic microstructure of Bentheim *** microstructural model was imported to a mechanics solver based on the 3D finite element model with inter-grain boundaries modelled by cohesive *** simulations were run to test the effective elastic properties for different shear and normal intergrain cementation ***,a relation between the macroscale Young’s modulus and inter-grain cementation stiffness was derived with a theoretical model which can also account for porosity *** the numerical and theoretical results indicate the influence of the inter-grain cementation stiffness,on the effective elastic properties is significant for porous *** calibrated normal and shear stiffnesses at the inter-grain boundaries are 1.2×10^(5) and 4×10^(4) GPa/m,respectively.

关键词： Porous sandstone Cohesive finite element model Grain-based model Rock microstructure Micro-computed tomography(CT)

A Survey of Language-Based Approaches to Cyber-Physical and Embedded System Development

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Tsinghua Science and Technology 2015年第2期20卷 130-141页

作者： paul Soulier Depeng Li john R. Williams University of Hawaii Massachusetts Institute of Technology(MIT)

As computers continue to advance, they are becoming more capable of sensing, interacting, and communicating with the physical and cyber world. Medical devices, electronic braking systems in automotive applications, and industrial control systems are examples of the many Cyber-Physical Systems （CPS） that utilize these computing capabilities. Given the potential consequences of software related failures in such systems, a high degree of safety, security, and reliability is often required. Programming languages are important tools used by programmers to develop CPS. They provide a programmer with the ability to transform designs into machine code. Of equal importance is their ability to detect and avoid programming mistakes. The development of CPS has predominantly been accomplished using the C programming language. Although C is a powerful language, it lacks features present in other languages that facilitate the development of reliable systems. This has prompted research into language-based alternatives for improving program quality through the use of programming languages. This paper presents an overview of the characteristics of embedded and cyber-physical systems and the associated requirements imposed on programming languages. This is followed by a survey of relevant research into language- based methods for creating safe, reliable, and robust software for CPS.

关键词： cyber-physical systems embedded systems programming languages type systems

A randomized controlled trial of Promoting Physical Activity in Regional and Remote Cancer Survivors(PPARCS)

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Journal of Sport and Health Science 2024年第1期13卷 81-89页

作者： Sarah J.Hardcastle Chloe Maxwell-Smith Vinicius Cavalheri Terry Boyle Marta Leyton Román Cameron Platell Michael Levitt Christobel Saunders Frank Sardelic Sophie Nightingale Jacob McCormick Craig Lynch paul A.Cohen Max Bulsara Dana Hince Sport and Physical Activity Research Centre Sheffield Hallam UniversitySheffieldS102BPUK Institute for Health Research The University of Notre DameFremantleWA 6959Australia Curtin School of Population Health Curtin UniversityPerthWA 6845Australia Curtin School of Allied Health Curtin UniversityPerthWA 6845Australia Allied Health South Metropolitan Health ServiceMurdochWA 6150Australia Australian Centre for Precision Health University of South AustraliaAdelaideSA 5001Australia Department of Didactics of Musical Plastic and Body ExpressionUniversity of ExtremaduraCaceres 10071Spain St.john of God Subiaco Hospital PerthWA 6008Australia Department of Surgery University of MelbourneMelbourneVIC 3010Australia Tamara Private Hospital TamworthNSW 2340Australia Peter MacCallum Cancer Centre MelbourneVIC 3000Australia College of Health and Medicine Australian National UniversityCanberraACT 2600Australia Division of Obstetrics and Gynaecology Medical SchoolUniversity of Western AustraliaPerthWA 6009Australia

Background:Physical activity(PA)is important for cancer *** of remotely delivered interventions are needed to assist in reaching under-served non-metropolitan cancer *** objective of this study was to ascertain whether wearable technology,coupled with health coaching was effective in increasing PA in breast and colorectal cancer survivors living in regional and remote areas in ***:Cancer survivors from 5 states were randomized to intervention and control *** participants were given a Fitbit Charge 2TMand received up to 6 telephone health coaching *** participants received PA print *** assessments at baseline and 12 weeks measured moderate-to-vigorous PA(MVPA),light PA,and sedentary ***:Eighty-seven participants were recruited(age=63±11 years;74(85%)female).There was a significant net improvement in MVPA of 49.8 min/week,favoring the intervention group(95%confidence interval(95%CI):13.6-86.1,p=0.007).There was also a net increase in MVPA bouts of 39.5 min/week(95%CI:11.9-67.1,p=0.005),favoring the intervention *** groups improved light PA and sedentary behavior,but there were no between-group ***:This’s the first study to demonstrate that,when compared to standard practice(i.e.,PA education),a wearable technology intervention coupled with distance-based health coaching,improves MVPA in non-metropolitan cancer *** results display promise for the use of scalable interventions using smart wearable technology in conjunction with phone-based health coaching to foster increased PA in geographically disadvantaged cancer survivors.

关键词： Behavior change Exercise Health disparities Oncology Wearable technology

Analysis on variety and characteristics of maghemite

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Science China Earth Sciences 2010年第8期53卷 1153-1162页

作者： SHAW john BLOEMENDAL Jan HESSE paul ROLPH Tim Department of Earth Sciences University of Liverpool Department of Geography University of Liverpool Department of Environment and Geography Macquarie University Department of Geology University of Newcastle

Maghemite (γ-Fe2O3) is a very common mineral at the earth’s surface and also an important material for making music and video tapes. Maghemite is usually synthesized from magnetite under oxidizing conditions after a few hours or a few days below a temperature of 300°C. The magnetic property of thermal instability and the chemical action after heating is an important character for maghemite. That is, it will become hematite in certain proportion after being heated above 250°C. Maghemite is therefore actually unable to have its Curie temperature measured. But late using synthetic sample, maghemite was further found partially thermal stable with a measurable Curie temperature ~645°C. During our thermally magnetic experiments for a set of synthetic magnetite, we found that extra fined grain size (pseudo single domain (PSD) and small multi-domain (MD), mainly 1-10 μm) magnetite was formed to a completely thermally stable maghemite. This maghemite can also be produced by heating the same powder up to 700°C in an oven and keeping this temperature for 10 min, then cooling it down. When the generated maghemite by these two ways is heated from room temperature to 700°C, it shows almost fully reversible, or thermally stable. We used X-ray powder diffraction and Mssbauer spectroscopy to confirm the identity of this maghemite and compared its magnetic hysteresis, high temperature magnetization, low temperature thermal demagnetization, and low temperature susceptibility with those of the original preheated magnetite. Such quickly oxidized maghemite by heating to high temperature implies some types of maghemite formed in certain natural condition can carry a thermal remnant magnetization (TRM). Four types of maghemite were characterized and discussed according to their thermal stability. Among them, partially stable and fully thermally stable maghemite after heating should possess capability of carrying TRM. There is possibly a compensation of synthetizing maghemite between heatin

关键词： maghemite paleomagnetism environmental magnetism magnetic mineral thermal stability TRM