Exploring the effect of language concordance between nurses and Limited English Proficient patients on their health outcomes.

Communication is essential to the medical field. Approximately 350 different languages are spoken in the USA. The commonality of language discordance between patients and health care providers causes poor communication, limited understanding of their condition, and a decrease in the patient’s satisfaction with their care. This literature review explored the effect that a language concurrent healthcare provider has on the health outcomes of LEP patients. LEP is defined as limited English proficiency. METHODS: CINHAL and Pubmed were used. The key terms used were communication barriers, language barriers, nurse, nurses, nursing, and health outcomes. The search revealed 719 articles. Seven articles were included from this search. Two were included from the recommendation function of the literature software Mendeley. Nine articles were included in total. The following filters were used: written in English, research articles, published between 2010-2020, full text, and peer-reviewed and available pdf. Inclusion factors were health outcomes of LEP patients, Health outcomes for patients who used interpreters, language concordance, and patient satisfaction based on language concordance. Seven articles were included based on the inclusion and exclusion criteria. Articles were excluded due to improper patient population, exclusion of language concordance, improper picot question, lack of professional hospital interpretation, or topics not exploring health outcomes of LEP patients. Nine articles were included in the literature review. RESULTS: Three common themes were identified, decreased patient satisfaction, missed points in care, and declining health outcomes. LEP patients had higher chances of being transferred to the ICU, death, and to be misassigned to lower acuity. Absence of crucial discharge information and dis-satisfaction with care were more likely to occur without language concordant care. CONCLUSION: For patients who are LEP, communication is impaired resulting in declining health outcomes, missed points in care, and decreased patient satisfaction. There was some contradiction in health outcomes for patients. Limitations were that interpreter presence and training level were not always known. Research should focus on health outcomes for LEP patients

Analyzing historical and future acute neurosurgical demand using an AI-enabled predictive dashboard

Characterizing acute service demand is critical for neurosurgery and other emergency-dominant specialties in order to dynamically distribute resources and ensure timely access to treatment. This is especially important in the post-Covid 19 pandemic period, when healthcare centers are grappling with a record backlog of pending surgical procedures and rising acute referral numbers. Healthcare dashboards are well-placed to analyze this data, making key information about service and clinical outcomes available to staff in an easy-to-understand format. However, they typically provide insights based on inference rather than prediction, limiting their operational utility. We retrospectively analyzed and prospectively forecasted acute neurosurgical referrals, based on 10,033 referrals made to a large volume tertiary neurosciences center in London, U.K., from the start of the Covid-19 pandemic lockdown period until October 2021 through the use of a novel AI-enabled predictive dashboard. As anticipated, weekly referral volumes significantly increased during this period, largely owing to an increase in spinal referrals (p < 0.05). Applying validated time-series forecasting methods, we found that referrals were projected to increase beyond this time-point, with Prophet demonstrating the best test and computational performance. Using a mixed-methods approach, we determined that a dashboard approach was usable, feasible, and acceptable among key stakeholders

Strong Ultraviolet Pulse From a Newborn Type Ia Supernova

Type Ia supernovae are destructive explosions of carbon oxygen white dwarfs. Although they are used empirically to measure cosmological distances, the nature of their progenitors remains mysterious, One of the leading progenitor models, called the single degenerate channel, hypothesizes that a white dwarf accretes matter from a companion star and the resulting increase in its central pressure and temperature ignites thermonuclear explosion. Here we report observations of strong but declining ultraviolet emission from a Type Ia supernova within four days of its explosion. This emission is consistent with theoretical expectations of collision between material ejected by the supernova and a companion star, and therefore provides evidence that some Type Ia supernovae arise from the single degenerate channel.Comment: Accepted for publication on the 21 May 2015 issue of Natur

Regulating Search Warrant Execution Procedure for Stored Electronic Communications

Electronic communication services, from email, to social media, tomessaging applications, have not only dramatically changed daily life but have also had a profound impact on criminal investigations and procedure.The often large volume of electronically stored information has led to a two-step process for search warrant execution, codified in Federal Criminal Procedure Rule 41. When conducting a search pursuant to Rule 41, law enforcement often retains both responsive items—materials that fall within the scope of the warrant—and nonresponsive materials—intermingled items that can be searched, but ultimately exceed the scope of the warrant. This possession of nonresponsive material creates a tension between the account holder’s privacy interests and the government’s ability to conduct an effective search.Courts and scholars have implemented and proposed a range of approaches for search warrant execution inlight of concerns about sweeping general searches and the practicalities of searching electronically stored information. This Note examines these approaches to regulate search warrant execution procedure in the context of stored electronic communications. This Note also discusses the strengths and shortcomings of these various mechanisms and concludes that Rule 41 should be amended to provide standards for the retention and use of nonresponsive material

INFERENCE-BASED FORENSICS FOR EXTRACTING INFORMATION FROM DIVERSE SOURCES

Digital forensics is tasked with the examination and extraction of evidence from a diverse set of devices and information sources. While digital forensics has long been synonymous with file recovery, this label no longer adequately describes the science’s role in modern investigations. Spurred by evolving technologies and online crime, law enforcement is shifting the focus of digital forensics from its traditional role in the final stages of an investigation to assisting investigators in the earliest phases — often before a suspect has been identified and a warrant served. Investigators need new forensic techniques to investigate online crimes, such as child pornography trafficking on peer-to-peer networks (p2p), and to extract evidence from new information sources, such as mobile phones. The traditional approach of developing tools tailored specifically to each source is no longer tenable given the diversity, volume of storage, and introduction rate of new devices and network applications. Instead, we propose the adoption of flexible, inference-based techniques to extract evidence from any format. Such techniques can be readily applied to a wide variety of different evidence sources without requiring significant manual work on the investigator’s part. The primary contribution of my dissertation is a set of novel forensic techniques for extracting information from diverse data sources. We frame the evaluation using two different, but increasingly important, forensic scenarios: mobile phone triage and network-based investigations. Via probabilistic descriptions of typical data structures, and using a classic dynamic programming algorithm, our phone triage techniques are able to identify user information in phones across varied models and manufacturers. We also show how to incorporate feedback from the investigator to improve the usability of extracted information. For network-based investigations, we quantify and characterize the extent of contraband trafficking on peer-to-peer networks. We suggest various techniques for prioritizing law enforcement’s limited resources. We finally investigate techniques that use system logs to generate and then analyze a finite state model of a protocol’s implementation. The objective is to infer behavior that an investigator can leverage to further law enforcement objectives. We evaluate all of our techniques using the real-world legal constraints and restrictions of investigators