Wrong Path Research Articles

Causes and Occurrences of Interruptions During ED Triage

Interruptions have been shown to cause errors and delays in the treatment of emergency patients and pose a real threat during the triage process. Missteps during the triage assessment can send a patient down the wrong treatment path and lead to delays. The purpose of this project was to identify the types and frequency of interruptions during the ED triage interview process. A focus group of emergency nurses was organized to identify the types of interruptions that commonly occur during the triage interview. These interruptions would be validated through observations in triage. A tally sheet was developed and implemented to determine how often each interruption occurred during an 8-hour shift. Triage nurses completed the tally sheets while working the first shift (7 am to 3 pm). This shift was selected because patient intake in the US Department of Veterans Affairs Emergency Department is highest during this time. The categories of interruptions identified included provision of conveniences to visitors, coworker-related interruptions, patient care-related interruptions, locating of family members in the emergency department, and other miscellaneous interruptions. Tally sheets were completed by the triage nurses during 10 shifts. On average, triage nurses were interrupted 48.2 times during an 8-hour shift (7 interruptions per hour). After reviewing the data, we found that only 22% of interruptions were related to patient care. More frequently, the causes of interruptions were not related to patient care: opening the door (33%), providing conveniences to visitors (21%), waiting patients or family members asking "How much longer?" (14%), and other causes (10%). Frequent interruptions can interfere with concentration and may affect patient care. Non-patient care-related interruptions not only can be frustrating to the triage nurse but also can be offensive to triage patients; they ultimately delay care and may even affect the quality of care. However, because scarce research is available regarding interruptions during ED triage, the effects on patient outcomes are unclear. Additional research needs to be conducted to explore the causes and effects of interruptions to the triage process.

ICTs in Universities: Stakes and Reality

Abstract Pedagogical innovations, including Information and Communication Technologies (ICTs), are at the center of many changes in the universities currently part of the Bologna Process. When European universities invested massively in deploying technologies, their effectiveness was not really questioned, at least at a pedagogical level. After experimenting for several years, the time has come to consider the real place of ICTs in universities. Does technologizing in higher education represent a beneficial questioning of pedagogical methods or can it be considered as a certain admission of weakness? It seems hard to deny what ICTs can bring to a classroom: a driver for changes, a redistribution of the roles and maybe a solution to the actual challenges. However, on the other side, with the sociology of uses, we can notice a dangerous gap in the practices that we find in and out of university. We feel therefore justified in asking whether universities are on the wrong path, considering (outdated?) ICTs. Between the hopes, challenges and reality of practices, it seems now essential to question the place of ICTs in higher education.

Are Current Approaches to Improving LTC Quality Hits or Errors?

Are Current Approaches to Improving LTC Quality Hits or Errors?

Weighty talks about wise choices

Weighty talks about wise choices

Hits, Misses and Close Calls: An Image Essay on Pattern Formation in On Growth and Form

The second edition of D’Arcy Thompson’s On Growth and Form was written only shortly before the advent of computers made it possible to develop more sophisticated mathematical models of processes of growth, morphogenesis and pattern formation in nature. It also predates the blossoming of several branches of science with the conceptual tools to investigate complex phenomena such as self-organization, nonlinear dynamics and chaos, fractal geometry and self-organization. As a result, Thompson’s aspirations sometimes fall short of his means — and occasionally he sets out on the wrong path. This image essay explores some of the instances in which Thompson surpassed his limitations or, alternatively, was constrained by them. In either circumstance, it illustrates how his themes remain areas of significant scientific activity today.

Gastrointestinal stromal tumor mesenchymal neoplasms: the offspring that choose the wrong path

Gastrointestinal stromal tumors (GISTs) are relatively rare neoplasms of the gastrointestinal tract originating from the pluripotential mesenchymal stem cells, which differentiate into interstitial Cajal cells. They are usually located in the upper gastrointestinal track. These tumors are typically defined by the expression of c-KIT (CD117) and CD34 proteins in the tumor cells. A small percentage of these tumors is negative for c-KIT. The neoplasms are positive for platelet-derived growth factor α (PDGFα) mutations. In addition to PDGFRα mutations, wild-type c-KIT mutations can also be present. The therapeutic approach to locally developed gastrointestinal stromal tumors is surgical resection, either with open or laparoscopic surgery. In case of systemic disease, molecular pharmacologic agents such as imatinib and sunitinib are used for treatment. These agents block the signaling pathways of neoplastic-cell tyrosine kinases, interfering in their proliferation and causing apoptosis.

Project governance and path creation in the early stages of Finnish nuclear power projects

In this paper we focus on the early stages of projects and their governance implications by investigating the introduction of nuclear power in Finland. We look at the early stages through the lens of path dependence and illustrate how early decisions may lead the project down the wrong path. However, we also develop a path creation perspective in order to develop an understanding of how the project actors in our case deliberately navigated in the cold war atmosphere to avoid a budding lock-in. This historical study highlights the importance of building relationships between key actors and securing their commitment during the early stages of a project. We argue that strong relationships and commitment open up opportunities for creating alternative paths during project appraisal, increase the array of available governance mechanisms, and hence lay the foundations for the final governance structure of the project execution phase.

Exploring the Side Effects of Assessment in Secondary Schools and Its Impact on Students: Perspective from Bangladesh

The main objective of the study was to explore the side effects of assessment in secondary schools and its impact on students. The study was descriptive in nature and the researcher used a qualitative approach to collect and analyze data. The researcher selected three schools, as a sample of the study, by Stratified Sampling method based on their last two years board result. She also selected fifteen students of secondary schools conveniently from the sample schools. For collecting relevant evidence and data from respondents, the researcher used tools like classroom observation, in-depth interview and focus group discussion. From the study it was found that, some noticeable side effects of assessment are suffering from Self-inferiority complex, losing self- confidence, disregard for school and teachers, attempt of hurting them, selecting wrong path, increase of competitive behavior etc. Based on the findings of the study the researcher recommended allowing students’ participation while developing assessment tool for them.

The butterfly rash of lupus: An example of aposematism?

The butterfly rash of lupus: An example of aposematism?

Nauczanie św. Augustyna o Żydach w świetle "Enarrationes in psalmos"

Christian reflection of God’s Revelation, given especially in Jesus Christ, from the very beginning has developed with a personal tension between the continuing message of the Old Testament and the newness brought on by the New Covenant. The Christian attitude towards the traditions of Judaism have held a special place in this field. Many of the early Christian writers engaged in this attitude, proclaim­ing the superiority of the Gospel to the Law of Moses, meanwhile also underlining the idea of continuity, which occurred between the Church and Israel. These same views found their way into the teachings of St. Augustine, among others, in his Enarrationes in Psalmos. The main perspective from which he looks at this prob­lem always remains the mystery of Christ and the Church. That is why his views are theological in nature, and not socio-political. The Synagogue, which symbolizes the Jewish people, is described by St. Augustine as a mother figure. Christ leaving her behind was due to the rejection by the Synagogue, which is – according to St. Augustine – based on a misunder­standing of the mystery of the Incarnation and the Paschal Mystery. Which is also why, Christ is left crucified for synagogue, which does not see his beauty, but only his scandal. Another metaphor, which Augustine uses to try and describe the Church and its relationship to the people of the Old Covenant, is the image of God and the physical Church building. It is based on the foundation, which is not only Christ, but also the apostles and prophets. Therefore, what determines the belonging to the Church of the Jews, as well as the Gentiles, is their regard to Christ and the prophetic-apostolic tradition. The Church – the building of God is not something newly created, but in determining its identity refers to the tradition of Israel as the chosen people and because, like him, can be called God’s heritage. His rejection by part of Israel, expressed in the crucifixion of Christ, led the di­vision in himself. The primary legacy of Abraham has been split. Some remained the wall of the church, others turned to dust. Thus, St. Augustine teaches two types of Israel: the corporeal, which rejects Christ and the spiritual, which is the true Church. What determines the division within the chosen people, and what is the cause of this rupture, which occurs in it, is a phenomenon referred to by Augustine as the term „physicality” (meaning of the body), consisting of directing the heart towards temporal and earthly values. The physicality and the related closure to God, involves not only the opposi­tion of the Jews against Christ himself, but also of the Church and this is expressed in the various forms of persecution of Christians. This enmity, however, does not mean their complete separation, as Augustine points out that the thread binding the Jewish people to the Church, is their common origin. Although Jews, like Esau, have lost their heritage and their place was taken by Jacob – the true Israel, or the Church, after all, he also comes from Abraham, and belongs to the chosen people. This makes the reciprocal relationship of Jews and Christians not a simple ratio of the persecutor and the persecuted, but has a deeper dimension, which takes place between the dynamics of communication and conflicts, struggles and relationships. It is because of this that, even though Jews do not recognize Christ at the time of his coming, they may still believe in Him if they have already ac­complished the work of salvation, for it is He alone who restores their vision of faith. Therefore, their fate, whose image is the figure of Cain – the persecutor, turns out to be not so much intended as a providential event. The possibility of faith was open not only to the individual repenting (returning from the wrong path) Jews, but also to the whole nation.

How Does Early Feedback in an Online Programming Course Change Problem Solving?

How does early feedback change the programming problem solving in an online environment and help students choose correct approaches? This study was conducted in a sample of students learning programming in an online course entitled Introduction to C++ and OOP (Object Oriented Programming) using the ANGEL learning management system platform. My overall observations on teaching online introductory programming courses for 7 years (2005–2012) convinced me that online students try various ways to solve a problem. I found that some of the students' problem solving approaches generated the correct output but are not straightforward and thus difficult to understand. However, some of the solutions were innovative, challenging, and unique but gave an early impression that they were wrong (before a little investigation). The students apparently used trial-and-error in conjunction with their own logic to get to the correct output. The lack of communication and weak dissemination of information between instructor and students have caused a major problem in selecting a right problem solving approach. In this study, three problem sets are taken from the course text and are discussed in module 1 and module 2 of the term. The problems were to compute the salary of an employee with a given input such as number of hours worked and the hourly rate. In order to learn progressively, students were asked to program an employee's gross pay, net pay with a fixed tax rate, net pay with a variable tax rate, marital status, and overtime pay. The course communication was mainly through discussion boards between students and instructor, e-mails, instructor announcements, and the area where the assignment was to be submitted. In addition, students could call the instructor's cell phone to seek assistance in clarifying programming problems. The present study will show the effectiveness of early feedback in helping students to develop the right programs. Early and consistent feedback to students increases the awareness of potential errors and avoidance of having students choose a wrong path. However, there was an undesirable side effect in giving early feedback which resulted in limiting possible student-innovation. Early feedback seems to have inhibited the creativity of innovative students and thus to have skewed such students radically toward the classroom main stream.

Journal of Diabetes NEWS

<i>Journal of Diabetes</i> NEWS

Robot Path Planning using Dynamic Programming with Accelerating Nodes

Abstract We solve the problem of robot path planning using Dynamic Programming (DP) designed to perform well in case of a sudden path blockage. A conventional DP algorithm works well for real time scenarios only when the update frequency is high i.e. changes can be readily propagated. In case updates are costly, for a sudden blockage the robot continues moving along the wrong path or stands stationary. We propose a modified DP that has nodes with additional processing (called accelerating nodes) to enable different segments of the map to become informed about the blockage rapidly. We further quickly compute an alternative path in case of a blockage. Experimental results verify that usage of accelerating nodes makes the robot follow optimal paths in dynamic environments.

Ethnic Groups at ‘Critical Junctures’: The Laz vs. Kurds

The Turkish Republic emerged onto the world stage as a secular and centralized nation state in the early 1920s from the remnants of the multi-ethnic, multi-religious and multi-lingual Ottoman Empir...

Afghanistan – the “great game” without end?

PurposeThe purpose of this viewpoint is to provide a perspective on political and military leadership in a current geo‐political situation, with some reflections on how this relates to other public services.Design/methodology/approachThis paper makes use of historical and political sources in order to reflect on current aspects of leadership in public services.FindingsThroughout history, Afghanistan has often played a pivotal role between the superpowers of any particular era. In the ancient world, the Greeks of Alexander the Great's Macedonian hegemony: Persians; Mongols under Genghis Khan and his successors; and a host of other groups have vied for control, often leaving ethnic traces within a complex tribal and ethnic makeup in modern Afghanistan. In the nineteenth century it was part of the “Great Game” between Great Britain and Russia; in the twentieth and twenty‐first centuries, there have been both Soviet and NATO incursions; and now, Afghanistan retains a pivotal role between India and Pakistan, China, Iran and former Soviet Republics. NATO is engaged in a task of “declared nation building”, and also to ostensibly make the streets of Western cities safe. But is this not just a “great game” but a “grand illusion”? Afghanistan has often been internally divided, but has never welcomed foreign domination, an experience which tends to bring Afghans together against the invader. Foreign troops, however well intentioned, propping up an unpopular central government, usually leads to resentment and the opposite of what was intended.Originality/valueThis paper links a number of perspectives to assist in the understanding of how and when strategies follow the wrong path.

SYRANT: SYmmetric resource allocation on not-taken and taken paths

In the multicore era, achieving ultimate single process performance is still an issue e.g. for single process workload or for sequential sections in parallel applications. Unfortunately, despite tremendous research effort on branch prediction, substantial performance potential is still wasted due to branch mispredictions. On a branch misprediction resolution, instruction treatment on the wrong path is essentially thrown away. However, in most cases after a conditional branch, the taken and the not-taken paths of execution merge after a few instructions. Instructions that follow the reconvergence point are executed whatever the branch outcome is. We present SYRANT (SYmmetric Resource Allocation on Not-taken and Taken paths), a new technique for exploiting control independence. SYRANT essentially uses the same pipeline structure as a conventional processor. SYRANT tries to enforce the allocation of the exact same resources on the out-of-order execution mechanism (physical register, load/store queue and reorder buffer) for both the taken and not-taken paths. Thus, on a branch misprediction, the result of an instruction already executed on the wrong path after the reconvergence point can be conserved in the same structure when it is data independent. Adding SYRANT on top of an aggressive superscalar execution core allows to improve performance for applications suffering a significant branch misprediction rate. As a side, but important extra contribution, we introduce ABL/SBL a simple and non-intrusive hardware reconvergence detection mechanism. ABL/SBL can be used in a conventional superscalar processor to improve branch prediction accuracy by exploiting the execution of branches along the wrong path.

Masseter muscle termination over the deep surface of the temporal fascia: look out the wrong path

The masticatory muscles have a common embryological origin. Despite numerous anatomical studies their close anatomical relationships are not always accurately described in anatomical treatises. An expansion of the masseter muscle inserted into the deep surface of the superficial temporal aponeurosis has been described. Despite the classical description of two transition bundles (Yoshikawa et al. in Kaibogaku Zasshi 37:206-217, 1962), the literature concerning these fibres has remained difficult to interpret. Given the clinical applications of the lengthening of the temporal muscle in myoplasty, it is important that we have accurate anatomical knowledge of it. We dissected 14 embalmed or untreated anatomical cadaver heads with a sex ratio of 1 in order to analyse the aforementioned fibres and their variations. A radiologic study allowed us to understand the entanglement of the fibres. 10 craniofacial MRI were processed by 3D MPR reconstruction. The fibres were identified as an expansion of the posterior head of the masseter muscle and distinct from the two classically described transition bundles. These were present in all subjects of both sexes. We can systematically describe their origin, trajectory and termination. Fibres belonging to masseter muscle pass up to the zygomatic arch and terminate on the deep surface of the temporal fascia. Awareness of the nature and trajectory of these muscular fibres allows us to avoid taking "wrong path" when approaching the temporal muscle tendon on the coronoid process via the temporal fossa.

Are we taking the wrong path?

Are we taking the wrong path?

In Fascism’s Footprint: The History of “Creeping” and &lt;i&gt;Vineland’s&lt;/i&gt; Poetics of Betrayal

Why have critics of Vineland failed to agree on the nature and scope of the fascist menace looming over the novel? Brad Leithauser’s review typified the book’s negative early reception in claiming that Vineland lacked something “overarchingly malignant” for its characters to combat. Federal agent Brock Vond, while clearly intended as a scaling-down from the operatic portrayal of evil in Gravity’s Rainbow’ s Blicero, looked to Leithauser, “even by cartoon standards, . . . insubstantial,” unable (as his budget line is miraculously cut at the end) to disturb the book’s cloying recurrence to themes of family and home (9, 8). Subsequent, subtler readings noted Pynchon’s reinventions of Orwell, from the 1984 setting to warnings against television’s mind-control and new and improved Thought Police—“Tube Police, Music Police, Good Healthy Shit Police” (313). In more concrete terms, David Thoreen undercut critiques like Leithauser’s by showing Vineland ’s true backdrop of fascist apocalypse to lie in foreboding references to Reagan’s potential invocation of emergency powers and a police state (“Fourth Amendment”). But the surprising trend of recent readings, more rooted in American political philosophy, has been to put Vond’s vision of former radicals as infantilized members of an “extended national Family” on a rational and manageable footing, regarding Vond as extreme but placing him in the broad context of US liberalism’s difficult relationship to community ( VL 269). Thus Jerry Varsava and Cyrus R. K. Patell independently argue for seeing Vond as representative of a communitarianism that is, in Patell’s words, “coercive, majoritarian, and bad”—the wrong path for community to take, they show Pynchon arguing, but far from the accusations of a totalitarian America which Vineland still, however reduced its scale, seems intent to make (Varsava 65, Patell 171).

무인자동차의 경로점 주행 시 장애물 회피를 위한 경로생성 알고리즘

In this paper, an effective path generation algorithm for obstacle avoidance producing small amount of steering action as possible is proposed. The proposed path generation algorithm can reduce unnecessary steering because of the small lateral changes in generated waypoints when UGV (Unmanned Ground Vehicle) encounters obstacles during its waypoint navigation. To verify this, the proposed algorithm and <TEX>$A^*$</TEX> algorithm are analyzed through the simulation. The proposed algorithm shows good performance in terms of lateral changes in the generated waypoint, steering changes of the vehicle while driving and execution speed of the algorithm. Especially, due to the fast execution speed of the algorithm, the obstacles that encounter suddenly in front of the vehicle within short range can be avoided. This algorithm consider the waypoint navigation only. Therefore, in certain situations, the algorithm may generate the wrong path. In this case, a general path generation algorithm like <TEX>$A^*$</TEX> is used instead. However, these special cases happen very rare during the vehicle waypoint navigation, so the proposed algorithm can be applied to most of the waypoint navigation for the unmanned ground vehicle.