Feasibility of Implementing a Web-Based Dementia Feeding Skills Training Module for Nursing Home Staff

Background: For an event that occurs three times daily and offers the most opportunity for socialization, mealtimes warrant careful hand feeding implementation by NH staff. PWD may exhibit aversive feeding behaviors that are misinterpreted. This vital misinterpretation can lead to malnutrition in the PWD and increase the risk of mortality. Objective: The goal of this two-month study was to test clinical feasibility and collect pilot data for an intervention to train nursing home (NH) staff via a web-based dementia feeding skills training module with group coaching. The goal of training was to alleviate mealtime difficulties in persons with dementia (PWD) who require mealtime assistance. Methods: Two southeastern US nursing homes were randomized by cluster for implementation of the training module. Pre- and post-tests assessed NH staff knowledge and self-efficacy via web-based module. Meal observations assessed staff feeding skills and PWD behaviors during meal times at baseline, 2 and 8 weeks. Results: Baseline knowledge and self-efficacy scores were similar for both groups. Post-intervention, these scores showed a significant improvement within the intervention group. Feeding skill behaviors trended toward improvement for both groups. Despite increased aversive feeding behaviors in the intervention PWDs, more time was spent feeding and the food intake for the PWDs increased. In the control, aversive feeding behaviors also increased but less time was spent feeding and food intake decreased. Discussion & Conclusions: NH staff increased knowledge and self-efficacy after training. While feeding skill behaviors did not change in either group, with NH staff training, the intervention PWDs were given more time to eat and consumed more food; despite an increase in aversive feeding behaviors. The opposite occurred in the control group. This finding has the potential to negatively impact the morbidity and mortality in this vulnerable population that requires careful hand-feeding. Continued work is needed to test and implement the current clinical practice guidelines in the nursing home setting

Exposure Routes of Copper and their Effects on the Great Pond Snail (Lymnaea stagnalis)

Populations and diversity of freshwater snails are declining in the United States. The current study looks at the different exposure routes (water, sediment and dietary) of copper (Cu) for the great pond snail (Lymneae stagnalis) to determine which route of exposure has the greatest potential for inducing toxic effects and bioaccumulation in snails. L. stagnalis were exposed to environmentally relevant concentrations of Cu through each of the three exposure routes for 28 days and survival, growth (length and wet weight), feeding rates (weekly) and whole body Cu concentrations were measured to estimate potential toxic effects. Overlying water Cu was significantly correlated with snail survival and whole body Cu concentrations. The sediment exposure route had the least toxic effects and lowest snail mortality. The dietary exposure route showed the highest Cu concentrations in snails yet no measurable toxic effects. Regardless of exposure route, feeding rates were not affected by Cu. These findings suggest that elevated levels of Cu in overlying water and food sources may have negative effects on snail population size or lead to elevated Cu body burden.Master of ScienceNatural Resources and EnvironmentUniversity of Michiganhttp://deepblue.lib.umich.edu/bitstream/2027.42/88163/1/Final Thesis_Stephanie NT Aselage.pd

Warrenton, Warren County, North Carolina : an action oriented community diagnosis including secondary data analysis and qualitative data collection

This document is a result of a community diagnosis of Warrenton, North Carolina, a community located in Warren County. A community diagnosis is a research project that aims to assess the strengths and weaknesses of and help identify future directions for a community. In essence, a community diagnosis seeks to understand communities and the people who live and work there. The community diagnosis of Warrenton was completed by five graduate students in the Department of Health Behavior and Health Education, School of Public Health, University of North Carolina at Chapel Hill. In order to better understand Warrenton, the students collected secondary data about the area’s history, economy, demographics, education, income, and health indicators. To gain a more in-depth view of Warrenton, the team of students conducted qualitative interviews with service providers and focus groups with community members. These discussions helped the team further assess community strengths, weaknesses, and future directions. Between November 2000 and March 2001, nine face-to-face interviews and five focus groups were completed. The University of North Carolina’s Institutional Review Board (IRB) approved this interview process. The interviewees and focus group participants were individuals recommended by our preceptor, Mary Marrow, or by other interviewees. After analyzing secondary and qualitative data, the team held a community meeting in Warren County on April 24, 2001 to present the findings. This meeting was planned and conducted with the help of the Warren County Planning Committee, a group of community members and service providers interested in bringing about change in Warrenton and Warren County. Findings were separated into major themes considered to be of importance to the people of Warrenton and Warren County. The team identified Economics, Recreation, Education, Transportation, Sense of Community and Collaboration, Politics and the People, and Race Relations as the themes that emerged from the interviews and focus groups. The purpose of this document is to summarize the findings of the Warrenton Community Diagnosis.Master of Public Healt

A miniaturized mW thermoelectric generator for nw objectives: continuous, autonomous, reliable power for decades.

We have built and tested a miniaturized, thermoelectric power source that can provide in excess of 450 {micro}W of power in a system size of 4.3cc, for a power density of 107 {micro}W/cc, which is denser than any system of this size previously reported. The system operates on 150mW of thermal input, which for this system was simulated with a resistive heater, but in application would be provided by a 0.4g source of {sup 238}Pu located at the center of the device. Output power from this device, while optimized for efficiency, was not optimized for form of the power output, and so the maximum power was delivered at only 41mV. An upconverter to 2.7V was developed concurrently with the power source to bring the voltage up to a usable level for microelectronics

Metal gettering by boron-silicide precipitates in boron-implanted silicon

We show that Fe, Co, Cu, and Au impurities in Si are strongly gettered to boron-silicide precipitates formed by supersaturation B implantation and annealing. Effective binding free energies relative to interstitial solution range form somewhat above 1 to more than 2 eV. The B-Si precipitates formed at temperatures {le}1100{degrees}C lack long range structural order but closely resemble and icosahedral B{sub 3}Si phase in composition, local bonding, and chemical potential. Evidence indicates that the metal atoms go into solution in the B-Si phase, and this is interpreted in terms of the novel bonding and structural characteristics of B-rich icosahedral compounds

Nutrition and dementia care: developing an evidence-based model for nutritional care in nursing homes.

BACKGROUND: There is a growing volume of research to offer improvements in nutritional care for people with dementia living in nursing homes. Whilst a number of interventions have been identified to support food and drink intake, there has been no systematic research to understand the factors for improving nutritional care from the perspectives of all those delivering care in nursing homes. The aim of this study was to develop a research informed model for understanding the complex nutritional problems associated with eating and drinking for people with dementia. METHODS: We conducted nine focus groups and five semi-structured interviews with those involved or who have a level of responsibility for providing food and drink and nutritional care in nursing homes (nurses, care workers, catering assistants, dietitians, speech and language therapists) and family carers. The resulting conceptual model was developed by eliciting care-related processes, thus supporting credibility from the perspective of the end-users. RESULTS: The seven identified domain areas were person-centred nutritional care (the overarching theme); availability of food and drink; tools, resources and environment; relationship to others when eating and drinking; participation in activities; consistency of care and provision of information. CONCLUSIONS: This collaboratively developed, person-centred model can support the design of new education and training tools and be readily translated into existing programmes. Further research is needed to evaluate whether these evidence-informed approaches have been implemented successfully and adopted into practice and policy contexts and can demonstrate effectiveness for people living with dementia

Superhard Phases of Simple Substances and Binary Compounds of the B-C-N-O System: from Diamond to the Latest Results (a Review)

The basic known and hypothetic one- and two-element phases of the B-C-N-O system (both superhard phases having diamond and boron structures and precursors to synthesize them) are described. The attention has been given to the structure, basic mechanical properties, and methods to identify and characterize the materials. For some phases that have been recently described in the literature the synthesis conditions at high pressures and temperatures are indicated.Comment: Review on superhard B-C-N-O phase

An Interprofessional Education Collaborative (IPEC) Competency-focused Workshop to Optimize Team Performance

We aimed to strengthen interprofessional (IP) teams’ competence in collaborative practice through a workshop series. Objectives included: 1) examine personal and professional values, and roles and their impact on collaborative practice, 2) apply relationship building principles to perform effectively as a team, 3) integrate quality improvement tools into work processes to aid team-based care. Published Core Competencies for IP Collaborative Practice delineate professionals\u27 skills in the art and science of working collaboratively, yet few professionals have had training to develop these skills. IP teams from academic and community-based settings, including long-term, acute, and ambulatory care, were recruited to participate in classroom-based workshops. Sixteen faculty from 7 professions developed three, 3-hour workshops. During the sessions, active learning strategies challenged teams to analyze their current practice. Between sessions, teams applied principles in completing application exercises. Session 1 addressed the domains of values/ethics and roles/responsibilities, session 2 addressed communication and teamwork, and session 3 introduced novel tools to evaluate and improve outcomes. Over two years, 42 participants from 10 teams representing 15 professions attended the workshops. Faculty used mixed method evaluations combining novel and existing scales. Participants rated (a) the overall impact of the workshop and (b) expectations for applying new knowledge to enhance team performance on 3-point scales. Mean ratings were high for workshop 1 (2.75, 2.78); 2 (2.82, 2.85); and 3 (2.75, 2.75). Forty-one participants rated themselves as competent on the individual workshop objectives. All participants would recommend the workshop to colleagues. The workshops were well received, resulted in improved self-reported competence, and high intention of applying what they learned to improve patient outcomes. In this age of complex medical systems the key to improved outcomes is better IP teamwork. We plan to offer the workshops semiannually with additional study to assess actual impact on work practice. Objectives: 1) Examine personal and professional values, and roles and their impact on collaborative practice. 2) Apply relationship building principles to perform effectively as a team. 3) Integrate quality improvement tools into work processes to aid team-based care

Approaching disorder-free transport in high-mobility conjugated polymers.

Conjugated polymers enable the production of flexible semiconductor devices that can be processed from solution at low temperatures. Over the past 25 years, device performance has improved greatly as a wide variety of molecular structures have been studied. However, one major limitation has not been overcome; transport properties in polymer films are still limited by pervasive conformational and energetic disorder. This not only limits the rational design of materials with higher performance, but also prevents the study of physical phenomena associated with an extended π-electron delocalization along the polymer backbone. Here we report a comparative transport study of several high-mobility conjugated polymers by field-effect-modulated Seebeck, transistor and sub-bandgap optical absorption measurements. We show that in several of these polymers, most notably in a recently reported, indacenodithiophene-based donor-acceptor copolymer with a near-amorphous microstructure, the charge transport properties approach intrinsic disorder-free limits at which all molecular sites are thermally accessible. Molecular dynamics simulations identify the origin of this long sought-after regime as a planar, torsion-free backbone conformation that is surprisingly resilient to side-chain disorder. Our results provide molecular-design guidelines for 'disorder-free' conjugated polymers.We gratefully acknowledge financial support from the Engineering and Physical Sciences Research Council (EPSRC) through a programme grant (EP/G060738/1) and the Technology Strategy Board (TSB) (PORSCHED project). D. Venkateshvaran acknowledges financial support from the Cambridge Commonwealth Trust through a Cambridge International Scholarship. K. Broch acknowledges post-doctoral fellowship support from the German Research Foundation (DFG). Mateusz Zelazny acknowledges funding from the NanoDTC in Cambridge. The work in Mons was supported by the European Commission / Région Wallonne (FEDER – Smartfilm RF project), the Interuniversity Attraction Pole program of the Belgian Federal Science Policy Office (PAI 7/05), Programme d’Excellence de la Région Wallonne (OPTI2MAT project) and FNRS-FRFC. D.B. and J.C. are FNRS Research Fellows.This is the accepted manuscript. The final version's available from Nature at http://www.nature.com/nature/journal/vaop/ncurrent/full/nature13854.html