Restraint Free in 2023

This EBP project evaluated if in hospitalized adult patients on Sands 800 does the use of a restraint management bundle decrease the use of restraints during the inpatient admission compared to current restraint practices. In the SICU, restraint usage is an initial response instead of last intervention. This culture of care concerns nurses and providers. It was hypothesized that decrease restraint usage and time in restraints will allow the patient to remain safer by evaluating usage of restraint alternatives, cost savings, patient mobility, and clinical staff understanding of appropriate restraint usage. The SICU was educated on the least restrictive device, which in this project was soft mitts. In-services and poster included the restraint wheel that provided alternatives to restraints. The team prioritized peer support and chart review. Restrained patients were reported to leadership daily with a focus on restraint use greater than 72 hours. Twice-daily audits verified orders and nursing documentation then were reported at shift change. The RGH results showed 636 orders for non-violent restraint orders across 17 units with 96.7 average restraint time in hours June 1, 2023 to June 11, 2023. SICU restraint use decreased since the implementation of restraint education and restraint alternative wheel. Prior to implementation, 38 total patients restrained in March decreased to 28 restrained in August 2023. From the results, the hypotheses was supported. An increased availability of alternatives and types of alternatives as well as education for staff members would continue the culture change.https://scholar.rochesterregional.org/nursingresearchday_2023/1011/thumbnail.jp

Optimization viewpoint on Kalman smoothing, with applications to robust and sparse estimation

In this paper, we present the optimization formulation of the Kalman filtering and smoothing problems, and use this perspective to develop a variety of extensions and applications. We first formulate classic Kalman smoothing as a least squares problem, highlight special structure, and show that the classic filtering and smoothing algorithms are equivalent to a particular algorithm for solving this problem. Once this equivalence is established, we present extensions of Kalman smoothing to systems with nonlinear process and measurement models, systems with linear and nonlinear inequality constraints, systems with outliers in the measurements or sudden changes in the state, and systems where the sparsity of the state sequence must be accounted for. All extensions preserve the computational efficiency of the classic algorithms, and most of the extensions are illustrated with numerical examples, which are part of an open source Kalman smoothing Matlab/Octave package.Comment: 46 pages, 11 figure

Modeling Spinal Muscular Atrophy in Drosophila

Spinal Muscular Atrophy (SMA), a recessive hereditary neurodegenerative disease in humans, has been linked to mutations in the survival motor neuron (SMN) gene. SMA patients display early onset lethality coupled with motor neuron loss and skeletal muscle atrophy. We used Drosophila, which encodes a single SMN ortholog, survival motor neuron (Smn), to model SMA, since reduction of Smn function leads to defects that mimic the SMA pathology in humans. Here we show that a normal neuromuscular junction (NMJ) structure depends on SMN expression and that SMN concentrates in the post-synaptic NMJ regions. We conducted a screen for genetic modifiers of an Smn phenotype using the Exelixis collection of transposon-induced mutations, which affects approximately 50% of the Drosophila genome. This screen resulted in the recovery of 27 modifiers, thereby expanding the genetic circuitry of Smn to include several genes not previously known to be associated with this locus. Among the identified modifiers was wishful thinking (wit), a type II BMP receptor, which was shown to alter the Smn NMJ phenotype. Further characterization of two additional members of the BMP signaling pathway, Mothers against dpp (Mad) and Daughters against dpp (Dad), also modify the Smn NMJ phenotype. The NMJ defects caused by loss of Smn function can be ameliorated by increasing BMP signals, suggesting that increased BMP activity in SMA patients may help to alleviate symptoms of the disease. These results confirm that our genetic approach is likely to identify bona fide modulators of SMN activity, especially regarding its role at the neuromuscular junction, and as a consequence, may identify putative SMA therapeutic targets

What More Do Bodies Know? Moving with the Gendered Affects of Place

This article focuses on what bodies know yet which cannot be expressed verbally. It starts with a problem encountered during conventional interviewing in an ex-mining community in south Wales when some teen girls struggled to speak. This led us to focus on the body, corporeality and movement in improvisational dance workshops. By slowing down and speeding up video footage from the workshops, we notice movement patterns and speculate about how traces of gendered body-movement practices developed within mining communities over time become actualised in girls’ habitual movement repertoires. Inspired by the works of Gilles Deleuze, Felix Guattari and Erin Manning, a series of cameos (room dancing; the hold; the wiggle; the leap and dance of the not-yet) are presented. We speculate about relations between the actual movements we could see, the in-act infused with the history of place and the virtual potential of what movement

Fortifying or fragmenting the state? The political economy of the drug trade in Shan State, Myanmar, 1988-2012

Over the past twenty-five years, the government of Myanmar (Burma) has consolidated control over large parts of Shan State, neutralizing much of the threat posed by armed groups and strengthening its hold over revenue extraction. During this period Myanmar has retained its position as the world's second largest producer of illicit opium, much of which is converted into heroin within the country's borders. This article explores the relationship between state-building processes and the illicit opium/heroin economy in Shan State since 1988. The author has four aims. First, to reassess the theoretical assumptions that equate illicit economies with state fragility and demonstrate instead why illicit drug economies can become embedded in processes of conflict reduction and state consolidation. Second, to explain why establishing control over Shan State has become so important to the Myanmar government's state-building ambitions. Third, to analyze how the state's engagement with the drug trade has become a vital part of its attempts to consolidate control, in terms of financing military expansion and brokering deals with strongmen who are able to govern local populations. Finally, to assess how these strategies embody a form of “negotiated statehood” in which the state's growing control has been defined by attempts to manage, rather than monopolize, the means of coercion and extraction

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements

Nigerian London: re-mapping space and ethnicity in superdiverse cities

This paper explores the idea of ‘superdiversity’ at the city level through two churches with different approaches to architectural visibility: the hypervisible Universal Church of the Kingdom of God and the invisible Igbo Catholic Church, both in North London, guide our exploration of invisible Nigerian London. Although Nigerians have lived in London for over 200 years, they live beneath the radar of policy and public recognition rather than as a vital and visible element of superdiversity. This paper argues that we can trace the journeys composing Nigerian London in the deep textures of the city thus making it visible, but this involves re-mapping space and ethnicity. It argues that visibility is vital in generating more open forms of urban encounter and, ultimately, citizenship

Rupture and Rhythm: A Phenomenology of National Experiences

This article investigates how people make sense of ruptures in the flow of everyday life as they enter new experiential domains. Shifts in being-in-time create breaks in the natural attitude that offer the opportunity to register national—or, for example, religious, gender, or class—experiences. People interpret ruptures in perception and proprioception by drawing connections with domains in which similar or contrasting kinds of disruption are evident. Normalizing the transition, rhythm—as both cadence and overall flow—helps people adjust to new circumstances, align action, and smooth subsequent ruptures. Based on extensive qualitative fieldwork, I examine the specific case of how novice and experienced tea ceremony practitioners in Japan move into, interpret, and normalize action within tea spaces

Modelling human choices: MADeM and decision‑making

Research supported by FAPESP 2015/50122-0 and DFG-GRTK 1740/2. RP and AR are also part of the Research, Innovation and Dissemination Center for Neuromathematics FAPESP grant (2013/07699-0). RP is supported by a FAPESP scholarship (2013/25667-8). ACR is partially supported by a CNPq fellowship (grant 306251/2014-0)

26th Annual Computational Neuroscience Meeting (CNS*2017): Part 3 - Meeting Abstracts - Antwerp, Belgium. 15–20 July 2017

This work was produced as part of the activities of FAPESP Research,\ud Disseminations and Innovation Center for Neuromathematics (grant\ud 2013/07699-0, S. Paulo Research Foundation). NLK is supported by a\ud FAPESP postdoctoral fellowship (grant 2016/03855-5). ACR is partially\ud supported by a CNPq fellowship (grant 306251/2014-0)