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Search Results: 1 - 10 of 6588 matches for " Douglas Conrad "
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Innovation in patient-centered care: lessons from a qualitative study of innovative health care organizations in Washington State
Reed Peter,Conrad Douglas A,Hernandez Susan E,Watts Carolyn
BMC Family Practice , 2012, DOI: 10.1186/1471-2296-13-120
Abstract: Background Growing interest in the promise of patient-centered care has led to numerous health care innovations, including the patient-centered medical home, shared decision-making, and payment reforms. How best to vet and adopt innovations is an open question. Washington State has been a leader in health care reform and is a rich laboratory for patient-centered innovations. We sought to understand the process of patient-centered care innovation undertaken by innovative health care organizations – from strategic planning to goal selection to implementation to maintenance. Methods We conducted key-informant interviews with executives at five health plans, five provider organizations, and ten primary care clinics in Washington State. At least two readers of each interview transcript identified themes inductively; final themes were determined by consensus. Results Innovation in patient-centered care was a strategic objective chosen by nearly every organization in this study. However, other goals were paramount: cost containment, quality improvement, and organization survival. Organizations commonly perceived effective chronic disease management and integrated health information technology as key elements for successful patient-centered care innovation. Inertia, resource deficits, fee-for-service payment, and regulatory limits on scope of practice were cited as barriers to innovation, while organization leadership, human capital, and adaptive culture facilitated innovation. Conclusions Patient-centered care innovations reflected organizational perspectives: health plans emphasized cost-effectiveness while providers emphasized health care delivery processes. Health plans and providers shared many objectives, yet the two rarely collaborated to achieve them. The process of innovation is heavily dependent on organizational culture and leadership. Policymakers can improve the pace and quality of patient-centered innovation by setting targets and addressing conditions for innovation.
Passion for Beauty: A Model for Learning  [PDF]
Conrad Hughes
Creative Education (CE) , 2012, DOI: 10.4236/ce.2012.33053
Abstract: This essay investigates the idea that effective teaching entails a passion for the beauty of the subject matter being taught. The first part gives a summative overview of the last 72 years of constructivism with references to educational research and discussion on content, cognition and attitudes. This overview is set against the problem of increasing pressure on students and teachers in an age where university places are difficult to secure and students are not always motivated. The second part of the essay investigates the issue of student motivation. Forced learning will be discussed, the problems of trying to cater for student motivation through pedagogy and curriculum, and finally the idea of the muse, arguing that the most effective learning must involve some degree of passion for the subject from the teacher that the student integrates and appropriates. The conclusion of the essay considers passion for beauty as the core element of good learning and how this should be valorized openly and not seen as opposing constructivist pedagogy.
Mass-to-Energy Conversion, the Astrophysical Mechanism  [PDF]
Conrad Ranzan
Journal of High Energy Physics, Gravitation and Cosmology (JHEPGC) , 2019, DOI: 10.4236/jhepgc.2019.52030
Abstract: A new interpretation of the relativistic equation relating total-, momentum-, and mass-energies is presented. With the aid of the familiar energy-relationship triangle, old and new interpretations are compared. And the key difference is emphasized—apparent relativity versus intrinsic relativity. Mass-to-energy conversion is then brought about by adopting a three-part strategy: 1) Make the motion relative to the universal space medium. This allows the introduction of the concept of intrinsic energy (total, kinetic, and mass energies) as counterpart to the apparent version. 2) Recognize that a particle’s mass property diminishes with increase in speed. This means introducing the concept of intrinsic mass (which varies with intrinsic speed). 3) Impose a change in the particle’s gravitational environment. Instead of applying an electromagnetic accelerating force or energy in order to alter the particle’s total energy, there will simply be an environmental change. Thus, it is shown how to use relativity equations and relativistic motion—in a way that exploits the distinction between apparent and innate levels of reality—to explain the mass-to-energy-conversion mechanism. Moreover, the mechanism explains the 100-percent conversion of mass to energy; which, in turn, leads to an explanation of the mechanism driving astrophysical jets.
Mucus Distribution Model in a Lung with Cystic Fibrosis
Sara Zarei,Ali Mirtar,Forest Rohwer,Douglas J. Conrad,Rebecca J. Theilmann,Peter Salamon
Computational and Mathematical Methods in Medicine , 2012, DOI: 10.1155/2012/970809
Abstract: Cystic fibrosis (CF) is the most common autosomal recessive disease in Caucasians with a reported incidence of 1 in every 3200 live births. Most strikingly, CF is associated with early mortality. Host in flammatory responses result in airway mucus plugging, airway wall edema, and eventual destruction of airway wall support structure. Despite aggressive treatment, the median age of survival is approximately 38 years. This work is the first attempt to parameterize the distributions of mucus in a CF lung as a function of time. By default, the model makes arbitrary choices at each stage of the construction process, whereby the simplest choice is made. The model is sophisticated enough to fit the average CF patients' spirometric data over time and to identify several interesting parameters: probability of colonization, mucus volume growth rate, and scarring rate. Extensions of the model appropriate for describing the dynamics of single patient MRI data are also discussed. 1. Introduction Cystic fibrosis is caused by mutations in the cystic fibrosis transmembrane regulator (CFTR) ion channel gene. The defective gene results in abnormally thick, sticky mucus that affects the lungs, the digestive system, and the circulatory system. CF patients eventually face severe breathing problems, inadequate digestion, and malabsorption of nutrients. They experience intermittent pulmonary exacerbations characterized by dyspnea, cough, sputum production, and sinusitis as a result of a buildup of mucus plugs and microbial biofilms [1]. Over time, these airway infections will cause airway scarring, remodeling, and ultimately respiratory failure. Our hypothesis is that this scarring, and ultimate remodeling, is primarily due to the contact between the lung lining and the mucus which contains inflammatory cytokines known to induce scars in lung tissue cultures. While the presence of virulent microbes in this mucus is also sure to play a role, such role is again mediated by contact between mucous biofilm and lung tissue. Many of the choices (assumptions) in the model below are predicated on the hypothesis that the distribution of mucus is the key observational variable for a mathematical description of the state of a CF patient. Mathematical modeling has proved to be useful in the study of chronic diseases such as hepatitis B, lupus, kidney nephritis, mitral regurgitation, and cancer. There, have been quantitative simulations of these diseases based on experimentally validated mathematical models. These models provide an opportunity for the researcher, and eventually the
Malignant Progression in Two Children with Multiple Osteochondromas
Gregory A. Schmale,Douglas S. Hawkins,Joe Rutledge,Ernest U. Conrad III
Sarcoma , 2010, DOI: 10.1155/2010/417105
Abstract: Multiple Osteochondromas (MO) is a disease of benign bony growths with a low incidence of malignant transformation. Secondary chondrosarcoma in children is rare even in children with MO. Making a diagnosis of malignancy in low-grade cartilage tumors is challenging and requires consideration of clinical, radiographic, and histopathological factors. We report two cases of skeletally immature patients with MO who presented with rapidly enlarging and radiographically aggressive lesions consistent with malignant transformation. Both underwent allograft reconstruction of the involved site with no signs of recurrence or metastatic disease at a minimum of four-year follow-up.
Malignant Progression in Two Children with Multiple Osteochondromas
Gregory A. Schmale,Douglas S. Hawkins,Joe Rutledge,Ernest U. Conrad III
Sarcoma , 2010, DOI: 10.1155/2010/417105
Abstract: Multiple Osteochondromas (MO) is a disease of benign bony growths with a low incidence of malignant transformation. Secondary chondrosarcoma in children is rare even in children with MO. Making a diagnosis of malignancy in low-grade cartilage tumors is challenging and requires consideration of clinical, radiographic, and histopathological factors. We report two cases of skeletally immature patients with MO who presented with rapidly enlarging and radiographically aggressive lesions consistent with malignant transformation. Both underwent allograft reconstruction of the involved site with no signs of recurrence or metastatic disease at a minimum of four-year follow-up. 1. Introduction Multiple Osteochondromas (MO) is an autosomal dominant disease of benign osseous tumors occurring primarily in the metaphyseal regions of the appendicular long bones and the flat bones of the axial skeleton. The risk of malignant progression has been estimated to range from 1 to 25% of patients with MO [1–6], though more likely at the lower end of this range [7]. The cases of chondrosarcoma reported in association with MO are typically found in patients between the third and fifth decade [2, 8]. Chondrosarcoma is rare in children, including children and adolescents with MO [8–11]. Approximately 80% of patients with MO have an identifiable mutation in one of two genes, EXT1 and EXT2, on chromosomes 8 and 11, respectively?[12–21]. These two genes are believed to code for transmembrane glycosyltransferases responsible, at least in part, for the regulation of heparan sulfate proteoglycans involved in cell signaling and chondrocyte proliferation and differentiation [12, 13, 22, 23]. The pathogenesis of osteochondromas is unclear. A routine aberrancy in the perichondrial groove of Ranvier?[24] may be the functional hit that when coupled with haploinsufficency of EXT1 or EXT2 provides the second-hit necessary for development of an osteochondroma?[12]. For patients with MO, the haploinsufficiency is due to a mutation present in all chondrocytes; for those with isolated osteochondromas, the mutation may originate in a chondrocyte residing in the abnormal region of the groove of Ranvier. The loss of heterozygosity for the EXT loci that occurs in chondrosarcomas?[15, 25, 26] supports a two-hit mutational model at EXT1 and EXT2 for malignant transformation. Diagnosing sarcomatous progression of an osteochondroma is challenging, as the histology may reveal only subtle changes of malignancy?[2, 27]. Additional factors supporting a diagnosis of malignancy include growth beyond that
Oncoselectivity in Oncolytic Viruses against Colorectal Cancer  [PDF]
Steven J. Conrad, Karim Essani
Journal of Cancer Therapy (JCT) , 2014, DOI: 10.4236/jct.2014.513118
Abstract:

In humans colorectal cancer (CRC) is a significant cause of morbidity and mortality. New treatment options are urgently needed to supplement existing therapies. Replication-competent oncolytic viruses (RCOVs) for the treatment of cancerous tumorsin vivois a relatively new therapeutic modality with great but largely unrealized potential against CRC. In the context of oncolytic virus safety, oncoselectivity is an important criterion. It is at the conceptual intersection of viral replication strategy and tumor cell biology that RCOVs acquire their oncoselectivity, and thus their safety. Every aspect of tumor molecular biology which distinguishes it from normal, non-neoplastic cells is a potential target for exploitation. In the first section of this review we will provide an explanation of some of the successful and widely used strategies for improving oncoselectivity in wild-type viruses to make them more suitable as RCOVs. In the second section we will describe some of the characteristics of CRC biology which can be exploited to provide oncoselectivity against CRC. Throughout the review examples of successfully-engineered RCOVs which embody the approach or strategy under discussion are noted. By showing what has been done, we hope to highlight what is possible and what remains to be done to generate oncoselective RCOVs for use against CRC in humans.

Report on BrainChild hydrocephalus conference
Conrad Johanson
Fluids and Barriers of the CNS , 2007, DOI: 10.1186/1743-8454-4-4
Abstract: Investigators from several hydrocephalus research groups met at the Brown Medical School in Providence, Rhode Island to discuss ways to more effectively integrate the biophysical and biochemical phenomena associated with the brain, cerebrospinal fluid (CSF) and cerebrovascular fluids; and the epithelial and endothelial membranes that demarcate these compartments. The two-day meeting on November 14th and 15th was sponsored by the BrainChild Foundation of Carefree, Arizona and hosted by Neurosurgery chief John Duncan and Conrad Johanson in the Department of Neurosurgery at Rhode Island Hospital.Following the opening presentation on the aging choroid plexus-CSF system by conference organizer C. Johanson, there were talks by Gerald Silverberg, Deborah Grzybowski (Ohio State) and Ed Stopa, on the topics of compromised toxic metabolite clearance in NPH, new preparations for studying the arachnoid membrane, and the destruction of the cerebral vessels in Alzheimer's disease, respectively. The afternoon session began with discussion by Pat McAllister (Wayne State) of glial responses to NPH that can impact the cerebrovascular system and intracranial pulsatility. Per Eide from Norway talked about biophysical/biochemical linkage analysis from simultaneous ICP monitoring and microdialysis. Stony Brook investigators Mike Egnor and Mark Wagshul discussed the notch filter hypothesis (cerebral Windkessel mechanism) and flow MRI exploration of pulsatile intracranial CSF movements. Concluding the presentations were Joe Madsen and E-H. Park from Harvard who updated the group on genes of mechano-biological interest and the analysis of wave amplitude pressures in NPH.Several 'up-and-coming' CSF/blood-brain barrier researchers also attended the conference: Erin McCormack, John Donahue, Carolyn Black, Laurel Fleming and Kelley Deren.BrainChild Foundation president, Curt Stewart, challenged the group to come together more effectively to translate the animal model findings into better hydroc
On sensitivity calculations for neutrino oscillation experiments
Conrad, Jan
High Energy Physics - Phenomenology , 2007, DOI: 10.1016/j.nima.2007.06.026
Abstract: Calculations of sensitivities of future experiments are a necessary ingredient in experimental high energy physics. Especially in the context of measurements of the neutrino oscillation parameters extensive studies are performed to arrive at the optimal configuration. In this note we clarify the definition of sensitivity as often applied in these studies. In addition we examine two of the most common methods to calculate sensitivity from a statistical perspective using a toy model. The importance of inclusion of uncertainties in nuisance parameters for the interpretation of sensitivity calculations is pointed out.
Validity as an action concept in IO psychology
Conrad Schmidt
South African Journal of Industrial Psychology , 2006, DOI: 10.4102/sajip.v32i4.251
Abstract: In this article it is proposed that conventional conceptions of validity as applied in the field of Industrial and Organisational Psychological (IOP) assessment tend to emphasise technical aspects that result in an unintended separation of science and practice when implemented. An alternative conception of validity as an action concept is presented. It is noted that such a conception has been implicit in the field for some time and that the ideal of integrating science and practice, which stands so central to Industrial and Organisational (IO) Psychology, is promoted by it.
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