A flexible,object-centric approach for business process modelling

Mainstream business process modelling techniques often promote a design paradigm wherein the activities that may be performed within a case, together with their usual execution order, form the backbone on top of which other aspects are anchored. This Fordist paradigm, while effective in standardised and production-oriented domains, breaks when confronted with processes in which case-by-case variations and exceptions are the norm. We contend that the effective design of flexible processes calls for a substantially different modelling paradigm. Motivated by requirements from the human services domain, we explore the hypothesis that a framework consisting of a small set of coordination concepts, combined with established object-oriented modelling principles, provides a suitable foundation for designing highly flexible processes. Several human service delivery processes have been designed using this framework, and the resulting models have been used to realise a system to support these processes in a pilot environment.     

The use of performance profiles in the design of a systematic medical suturing training programme

Systematic training methods are generated by contrasting task knowledge and skill performance profiles of highly experienced workers against those of inexperienced, through task and skills analysis. Training methods are then developed based on performance profile differences rather than similarities. The studies reported in this paper are concerned with the methodology and findings of task and skills analysis used in the development of a systematic training programme for medical suturing. The general conclusions suggest the following: (1) the experienced and inexperienced groups differ in task knowledge on the task components - (a) proper instrument handling, (b) hierarchy of elements that must be followed in attaining symmetric and atraumatic would closures and (c) proper suture tension during instrument knot-tying; (2) inexperienced workers exhibited significantly higher number of anatomical position changes during task performance than the experienced surgeons; (3) due to task knowledge profiles and unique usage of hand, finger and thumb of the favoured and non-favoured hand, the surgeons were approximately three times faster than the students on critical task elements; and (4) the contrasting of performance profiles developed through task and skills analysis is a valuable tool in the development of an analytical training strategies for technical psychomotor surgical skills.     

The role of veterinarians and feed-store vendors in the prescription and use of antibiotics on small dairy farms in rural Peru

This study aimed to describe and compare the role of veterinarians and feed-store vendors in the use of antibiotics on small dairy farms in Cajamarca, Peru, a major dairy-producing center characterized by small, rural farms with poor, mostly uneducated farmers. We used a purposive sampling strategy to recruit 12 veterinarians into 2 focus group discussions and supplemented these data with 8 semi-structured interviews with feed-store vendors. Participants reported that inappropriate antibiotic usage was widespread among their clients, which may prevent the efficient use of drugs on farms where animal disease can be devastating to the livelihood of the farmer. Participants also identified many barriers to appropriate prescribing and use, including availability of drugs, competition from other prescribers, economic constraints and habits of farmers, and limited farmer knowledge of drugs and disease. Veterinarians expressed mistrust toward nonprofessional prescribers, whereas feed-store vendors felt that veterinarians were important partners in promoting the health of their clients’ animals.     

Determination of thorium in plutonium by X-ray spectrometry

An X-ray fluorescence method for the determination of thorium (0.1 to 1.2 %) in plutonium-238 was developed. The PuO₂ is mounted in a dimpled slide, and the slide is packaged so that the plutonium and thorium L-alpha lines can be counted in a nonradioactive laboratory. A standard deviation of 0.02 % is estimated. The method is applicable to both solid and solution samples.     

Popular self-help books for anxiety, depression, and trauma: How scientifically grounded and useful are they?

Self-help books for psychological disorders have become increasingly popular, yet there is surprisingly little research on their scientific status or overall utility. The authors identified 50 top-selling self-help books for anxiety, depressive, and trauma-related disorders. Using a scale derived from the literature on bibliotherapy, expert psychologists rated each book on overall usefulness, grounding in psychological science, the extent to which it offers reasonable expectations, the extent to which it offers specific guidance for implementing the self-help techniques and for monitoring treatment progress, and whether it offers potentially harmful advice. The results revealed strong intercorrelations among the scales, such that books scoring high along one dimension tended to score high along others. There was wide variability in the overall quality of the books, but several factors emerged as predictors of book quality. The most highly rated books tended to be those having a cognitive behavioral perspective, those written by mental health professionals, those written by authors holding a doctoral degree, and those focusing on specific problems. Implications of the findings, including specific recommendations for authors and consumers of self-help books, are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The impact of asthma and asthma-like illness in Seattle school children

The impact of asthma and asthma-like illness was measured in a population of 5-9-year-old Seattle public school children. Child health information was obtained from a survey of 1665 parents of first and second grade students to assess medical services use and impaired physical functioning among diagnosed asthmatics and those with current wheezing, defined as wheezing in the past 12 months without a diagnosis of asthma, relative to an asymptomatic population with neither condition. Relative to the asymptomatic population, the prevalence of respiratory-related activity limitation, and perception of poorer child health was larger among diagnosed asthmatics than children with current wheezing. However, the prevalence of sleep disturbances, school absences, medical services use, and parental concern over their child's health was similar for both the asthmatic and wheezing groups relative to the asymptomatic group. Also, in both symptomatic groups, a history of moderate or severe wheezing was associated with an increased prevalence of respiratory-related sleep disturbances and activity limitation. The similarity between the impact of diagnosed asthma and undiagnosed asthma-like illness suggests that the overall social and economic burden of asthma may be higher than previously estimated.     

Quantification of antibiotic use on dairy farms in Pennsylvania

Antibiotic use data are critical for drawing conclusions about the epidemiological connections between antibiotic use in farms animals, antibiotic resistance, animal health, and human health. The goal of this study was to quantitatively and qualitatively characterize antibiotic use on dairy farms in Pennsylvania, the state with second largest number of dairy farms nationally. A survey was sent to 10% of the 6,580 dairy farms registered in Pennsylvania and completed by 235 producers (response rate of 36%). Data on antibiotic use in the previous month and in the previous 6 mo were collected based on farmer self-report, using either recall or treatment records. Two metrics were used to quantify antibiotic consumption: animal-defined daily doses (ADD) and days of therapy (DOT), a metric used in human medicine for purposes of antimicrobial stewardship. Across all farms, 24,444 ADD and 19,029 DOT were reported, representing treatment incidences of 4.2 ADD/1,000 animal-days and 3.3 DOT/1,000 animal-days. These rates were generally lower than those found in other states and countries. The main indication for antibiotic use was mastitis, and first-generation cephalosporins were the most commonly used class of antibiotic for all indications, followed by penicillins and third-generation cephalosporins. Trends in use were similar for ADD and DOT, but the numbers of recorded DOT and associated treatment incidences were generally lower than the number of ADD and associated treatment incidences. Rates of treatment were significantly associated with herd size. This study is the first to quantify antibiotic use on dairy farms in Pennsylvania and the first to use the DOT metric in a dairy setting.     

Occurrence of infected amoebae in cooling towers compared with natural aquatic environments: implications for emerging pathogens

Many species of bacteria pathogenic to humans, such as Legionella, are thought to have evolved in association with amoebal hosts. Several novel unculturable bacteria related to Legionella have also been found in amoebae, a few of which have been thought to be causes of nosocomial infections in humans. Because amoebae can be found in cooling towers, we wanted to know whether cooling tower environments might enhance the association between amoebae and bacterial pathogens of amoebae in order to identify potential "hot spots" for emerging human pathogens. To compare occurrence of infected amoebae in natural environments with those in cooling towers, 40 natural aquatic environments and 40 cooling tower samples were examined. Logistic regression analysis determined variables that were significant predictors of the occurrence of infected amoebae, which were found in 22 of 40 cooling tower samples but in only 3 of the 40 natural samples. An odds ratio showed that it is over 16 times more likely to encounter infected amoebae in cooling towers than in natural environments. Environmental data from cooling towers and natural habitats combined revealed dissolved organic carbon (DOC) and pH were predictors of the occurrence of the pathogens, however, when cooling tower data alone were analyzed, no variables accounted for the occurrence. Several bacteria have novel rRNA sequences, and most strains were not culturable outside of amoebae. Such pathogens of amoebae may spread to the environment via aerosols from cooling towers. Studies of emerging infectious diseases should strongly consider cooling towers as a source of amoeba-associated pathogens.     

Effects of curved mirrors in waveguide resonators

Waveguide gas lasers (CO(2) ones especially) continue to be widely used. We have previously studied simple resonator designs with plane mirrors close to each end of the waveguide. Here we examine theoretical predictions concerning hybrid waveguide/free-space resonators with square-bore guides and curved mirrors. We show how resonator mode losses vary as functions of guide length and width, guide-to-mirror distance, mirror radius of curvature, and mirror tilt. We have tested a 7-W cw rf-excited CO(2) laser with unusually good near-TEM(00) transverse-mode quality; it is one of many promising resonator geometries not covered by earlier published research. The common case 3 reflector, sometimes viewed as guaranteeing near-TEM(00) mode performance, is shown to be alarmingly sensitive to small misalignments for certain guide geometries.