Service Line Development Serves to Support the Entire System

2021 ◽  
Vol 37 (3) ◽  
pp. 29-34
Author(s):  
Sarah Roberts
Keyword(s):  
2008 ◽  
Vol 1 (2) ◽  
pp. 109-134 ◽  
Author(s):  
Stephen R. Anderson

Alternations between allomorphs that are not directly related by phonological rule, but whose selection is governed by phonological properties of the environment, have attracted the sporadic attention of phonologists and morphologists. Such phenomena are commonly limited to rather small corners of a language's structure, however, and as a result have not been a major theoretical focus. This paper examines a set of alternations in Surmiran, a Swiss Rumantsch language, that have this character and that pervade the entire system of the language. It is shown that the alternations in question, best attested in the verbal system, are not conditioned by any coherent set of morphological properties (either straightforwardly or in the extended sense of ‘morphomes’ explored in other Romance languages by Maiden). These alternations are, however, straightforwardly aligned with the location of stress in words, and an analysis is proposed within the general framework of Optimality Theory to express this. The resulting system of phonologically conditioned allomorphy turns out to include the great majority of patterning which one might be tempted to treat as productive phonology, but which has been rendered opaque (and subsequently morphologized) as a result of the working of historical change.


Author(s):  
Jennifer J. Smith

Coherence of place often exists alongside irregularities in time in cycles, and chapter three turns to cycles linked by temporal markers. Ray Bradbury’s The Martian Chronicles (1950) follows a linear chronology and describes the exploration, conquest, and repopulation of Mars by humans. Conversely, Louise Erdrich’s Love Medicine (1984) jumps back and forth across time to narrate the lives of interconnected families in the western United States. Bradbury’s cycle invokes a confluence of historical forces—time as value-laden, work as a calling, and travel as necessitating standardized time—and contextualizes them in relation to anxieties about the space race. Erdrich’s cycle invokes broader, oppositional conceptions of time—as recursive and arbitrary and as causal and meaningful—to depict time as implicated in an entire system of measurement that made possible the destruction and exploitation of the Chippewa people. Both volumes understand the United States to be preoccupied with imperialist impulses. Even as they critique such projects, they also point to the tenacity with which individuals encounter these systems, and they do so by creating “interstitial temporalities,” which allow them to navigate time at the crossroads of language and culture.


2010 ◽  
Vol 1 (1) ◽  
pp. 65-103
Author(s):  
Vered Noam

This paper examines the rabbinic concept of impurity in terms of the essence of the reality that this term implies. Did the Rabbis consider impurity to be a force of nature, or rather an abstract formalistic structure devoid of any actual existence? A review of rabbinic sources regarding corpse impurity reveals that the essential structures of tannaitic halakhah are grounded in a natural, immanent perception of impurity, which gave rise to an entire system, intricate and coherent, of “natural laws of impurity.” Layered onto this system, as a secondary stratum of sorts comprising exceptions and “addenda,” is a more subtle halakhic tapestry woven from a diametrically opposed perception. This view subjects the concept of impurity to human awareness and intention, severing it from reality and, in so doing, also stripping it of its “natural” substance.


2020 ◽  
pp. 54-73
Author(s):  
V.N. Bobkov ◽  
A.A. Gulyugina ◽  
Ye.V. Odintsova

The article argues for a proposal for such a step in the direction of strengthening social support for the least protected groups of the Russian population and the development of the entire system of social state guarantees as a whole, as the introduction of a socially acceptable consumer basket instead of a consumer basket of the subsistence minimum. The advantages of the normative method of forming consumer baskets over the normative-statistical method are revealed. Based on the analysis of actual consumption of both food and non-food products and services, the qualitative and quantitative structure of the socially acceptable consumer basket is determined (using natural and value indicators).


Neurosurgery ◽  
2019 ◽  
Vol 86 (1) ◽  
pp. 132-138
Author(s):  
Christopher D Shank ◽  
Nicholas J Erickson ◽  
David W Miller ◽  
Brittany F Lindsey ◽  
Beverly C Walters

Abstract BACKGROUND Neurosciences intensive care units (NICUs) provide institutional centers for specialized care. Despite a demonstrable reduction in morbidity and mortality, NICUs may experience significant capacity strain with resulting supraoptimal utilization and diseconomies of scale. We present an implementation study in the recognition and management of capacity strain within a large NICU in the United States. Excessive resource demand in an NICU creates significant operational issues. OBJECTIVE To evaluate the efficacy of a Reserved Bed Pilot Program (RBPP), implemented to maximize economies of scale, to reduce transfer declines due to lack of capacity, and to increase transfer volume for the neurosciences service-line. METHODS Key performance indicators (KPIs) were created to evaluate RBPP efficacy with respect to primary (strategic) objectives. Operational KPIs were established to evaluate changes in operational throughput for the neurosciences and other service-lines. For each KPI, pilot-period data were compared to the previous fiscal year. RESULTS RBPP implementation resulted in a significant increase in accepted transfer volume to the neurosciences service-line (P = .02). Transfer declines due to capacity decreased significantly (P = .01). Unit utilization significantly improved across service-line units relative to theoretical optima (P < .03). Care regionalization was achieved through a significant reduction in “off-service” patient placement (P = .01). Negative externalities were minimized, with no significant negative impact in the operational KPIs of other evaluated service-lines (P = .11). CONCLUSION Capacity strain is a significant issue for hospital units. Reducing capacity strain can increase unit efficiency, improve resource utilization, and augment service-line throughput. RBPP implementation resulted in a significant improvement in service-line operations, regional access to care, and resource efficiency, with minimal externalities at the institutional level.


2021 ◽  
Vol 113 (3) ◽  
pp. 6-13
Author(s):  
Daniel T. Duffy ◽  
William J. Pickering
Keyword(s):  

Sensors ◽  
2020 ◽  
Vol 20 (24) ◽  
pp. 7084
Author(s):  
Song Kang ◽  
Yongfeng Rong ◽  
Wusheng Chou

In this paper, an output-feedback fuzzy adaptive dynamic surface controller (FADSC) based on fuzzy adaptive extended state observer (FAESO) is proposed for autonomous underwater vehicle (AUV) systems in the presence of external disturbances, parameter uncertainties, measurement noises and actuator faults. The fuzzy logic system is incorporated into both the observers and controllers to improve the adaptability of the entire system. The dynamics of the AUV system is established first, considering the external disturbances and parameter uncertainties. Based on the dynamic models, the ESO, combined with a fuzzy logic system tuning the observer bandwidth, is developed to not only adaptively estimate both system states and the lumped disturbances for the controller, but also reduce the impact of measurement noises. Then, the DSC, together with fuzzy logic system tuning the time constant of the low-pass filter, is designed using estimations from the FAESO for the AUV system. The asymptotic stability of the entire system is analyzed through Lyapunov’s direct method in the time domain. Comparative simulations are implemented to verify the effectiveness and advantages of the proposed method compared with other observers and controllers considering external disturbances, parameter uncertainties and measurement noises and even the actuator faults that are not considered in the design process. The results show that the proposed method outperforms others in terms of tracking accuracy, robustness and energy consumption.


Neurosurgery ◽  
1988 ◽  
Vol 22 (3) ◽  
pp. 454-464 ◽  
Author(s):  
Ken R. Winston ◽  
Wendell Lutz

Abstract A new system has been developed for stereotactically delivering prescribed high doses of radiation to precisely located volumes of approximately 0.6 to 10.0 ml within the brain. A Brown-Roberts-Wells stereotactic apparatus and a 6-MeV linear accelerator equipped with a special collimator (12.5 to 30 mm in diameter) have been adapted. The 20-mm collimator allows treatment of a nearly spherical volume of 2.1 ml. Outside the treatment field, the dosage declines to 80% of the dose prescribed for the periphery of the lesion over a distance of 1.8 mm and to 50% over the next 3.4 mm. Localization can be accomplished via computed tomography or cerebral angiography. Treatment is accomplished with an arcing beam of photon radiation with the turntable (couch) in each of four positions. The entire system has been extensively tested for accuracy in alignment and distribution of radiation. Errors have been measured for the alignment of the apparatus and for the process of localization. Safety of operation was emphasized throughout the design and testing phase. (Neurosurgery 22:454-464, 1988)


1975 ◽  
Vol 48 (1) ◽  
pp. 1-13 ◽  
Author(s):  
F. S. Conant

Abstract SI surpasses previous metric systems in coherence, simplicity, distinction between force and mass, choice of units, and uniformity of usage. Coherence eliminates conversion factors, other than powers of ten, within the system. Through simplification, only seven base units, two supplementary units, fifteen named derived units, and fourteen prefixes are needed to describe the entire system. Introduction of the newton as a unit of force and retention of the kilogram for mass clarifies the difference between the two quantities. Other new units are: pascal for pressure, Siemens for electric conductance and mole for amount of a substance. International agreement minimizes proliferation of specialized units or usage. Adopted conventions include spelling, abbreviations, style, and usage, as well as definitions for the units. Tolerances, rounding of numbers, and elimination of the comma in multidigit numbers assume new significance. Conversion to SI offers a unique opportunity to reduce the number of sizes of many products. Several schemes for metric modularism have been developed for this purpose. In changing from conventional to SI units the key idea is “think metric” rather than use dual dimensioning.


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