Classifying Alarms: Seeking Durability, Credibility, Consistency, and Simplicity

Alongside the development and testing of new audible alarms intended to support International Electrotechnical Commission 60601-1-8, a global standard concerned with alarm safety, the categories of risk that the standard denotes require further thought and possible updating. In this article, we revisit the origins of the categories covered by the standard. These categories were based on the ways that tissue damage can be caused. We consider these categories from the varied professional perspectives of the authors: human factors, semiotics, clinical practice, and the patient or family (layperson). We conclude that while the categories possess many clinically applicable and defensible features from our range of perspectives, the advances in alarm design now available may allow a more flexible approach. We present a three-tier system with superordinate, basic, and subordinate levels that fit both within the thinking embodied in the current standard and possible new developments

Investigating Whether Consuming Meals in a Dining Room Impacts Patients’ Mood, Level of Interaction, and Subsequent Nutrient Intake in a Stroke Rehabilitation Ward.

Background/objectivesMalnutrition is evident in hospitals and stroke patients are at increased risk. Protected mealtimes may help increase nutrient intake especially when patients interact and enjoy the dining room atmosphere. The aim of this research is to investigate if eating in a communal dining room increases nutritional intake compared to eating at the bedside and to investigate whether patient interaction and mood affects patient nutrient intake. Population/methods:A randomised cross-sectional study of 20 patients, assessing a comparison of patient’s mealtime consumption at lunchtime in the dining room and at the beside. Patients’ meals were weighed before and after consumption as well as an estimated percentage of their meals consumed. Patients’ interaction was observed and noted using a modified case report form. The Hammond depression scale was used to score patients’ mood. Patient and staff satisfaction surveys were completed at the end of the study period. Results:There was no significant difference in protein and energy consumption in the dining room (16.4g protein and 379.2kcal) compared to at the bedside (13.2g protein and 333.8kcal), p=0.160 and p=0.110 respectively. Interaction was higher in the dining room. The percentage mealtime consumption increased the more interactive a patient was from a mean of 74% in less interactive patients to 98% in highly interactive patients (p=0.193). There was no significant association between depression score and mealtime consumption. All 19 patients enjoyed eating in the dining room and 14 out of the 19 patients preferred eating in the dining room. Conclusion:Further studies are required to explore how intake can be improved among stroke rehabilitation patients

Lower Extremity Joint Stiffness During Running in Adolescents with Autism Spectrum Disorder

During late adolescence, children undergo rapid skeletal growth changes leaving the child more vulnerable to injury during physical activity. This is consistent for autistic youth, who reportedly enjoy individual activities, such as running, more than team-based sports [1-3]. Inadequate joint stiffness is one of several factors that may influence injury risk [4]. The purpose of this study was to examine lower extremity joint stiffness in autistic and non-autistic matched controls at self-selected and matched running speeds. Twenty-two persons with a confirmed autism spectrum disorder (ASD) diagnosis and seventeen age, sex, and body mass index controls (CON) were enrolled into the study. Position and force data were collected in the Neuromechanics Laboratory using the motion capture system. Participants were asked to complete a series of over-ground running trials at their self-selected speed and a standardized speed of 3.0 m/s. Joint stiffness was calculated as the quotient of the change in joint moment and the change in joint angle during the energy absorption period of stance. Statistical analyses were performed in SPSS (version 27, IBM Corp.). Stiffness and changes in joint moments were analyzed using 2 (group) x 2 (speed) analyses of variance. There were no significant interactions between groups and speeds (p\u3e0.05) for any variable. Persons with ASD had reduced knee and ankle joint stiffness (all p Persons with ASD had reduced lower extremity stiffness, which was due to their reduced joint moments. Decreased joint stiffness by those with ASD could be indicative of a less efficient running style whereby the elastic recoil is not being optimally utilized.https://digitalcommons.odu.edu/gradposters2022_education/1006/thumbnail.jp

Prefrontal microcircuit underlies contextual learning after hippocampal loss

Specific brain circuits have been classically linked to dedicated functions. However, compensation following brain damage suggests that these circuits are capable of dynamic adaptation. Such compensation is exemplified by Pavlovian fear conditioning following damage to the dorsal hippocampus (DH). Although the DH normally underlies contextual fear and fear renewal after extinction, both can be learned in the absence of the DH, although the mechanisms and nature of this compensation are currently unknown. Here, we report that recruitment of alternate structures, specifically the infralimbic and prelimbic prefrontal cortices, is required for compensation following damage to the hippocampus. Disconnection of these cortices in DH-compromised animals and immediate early gene induction profiles for amygdala-projecting prefrontal cells revealed that communication and dynamic rebalancing within this prefrontal microcircuit is critical. Additionally, the infralimbic cortex normally plays a role in limiting generalization of contextual fear. These discoveries reveal that plasticity through recruitment of alternate circuits allows the brain to compensate following damage, offering promise for targeted treatment of memory disorders

Developing employability in higher education music

The development of employability in higher music education concerns students, musicians, educators, administrators and funding bodies, and yet employability is both impossible to measure and poorly defined. This paper sets the context for a set of short papers that explore employability from the perspective of music. Because many of the issues they raise have relevance across the creative industries, this paper discusses research that positions them within this broader context. The paper highlights the need for both the functional (how-to) aspects of employability and those that are cognitive: development of students' cognitive dispositions and their capacity to engage as professionals. As such, the paper argues that employability requires collaborative action on three fronts: enhancement of the ways in which employment outcomes are defined and measured; initiatives that engage students in career- and life-relevant activities; and advocacy work that re-aligns stakeholder perceptions of graduate work and employability itself

Clinical Decision Science: Proof of concept

Clinical decision science, a newly identified area of scholarship, describes how clinical research is used for a patient, within the context of their unique social conditions. We hypothesize that physicians use sociocultural context as an important input to their decision making. We performed a prospective, randomized, double-blind mixed methods study. Family medicine faculty and residents at a community hospital family medicine residency were included in the study. After academic journal club discussing a primary research paper, physicians were asked if they would prescribe medication for a patient who was similar to the subjects in a research paper. However, social and cultural context was given to the cases. The physicians were block randomized into two groups; Group A was given a case with a patient who had a social and cultural context more conducive to lifestyle modification, while group B had a case more conducive to prescribing medication. Primary outcome was whether or not physicians prescribed medication, allowing for a 2x2 table for analysis. We also asked a free response question regarding the reasoning for their decision and performed qualitative analysis. In group A (n=14), no subjects prescribed medication. In group B (n=18), six subjects prescribed medication. (chi-square statistic with Yates correction 9.95, p=0.001). Thematic analysis in group A showed 22 statements related to medical practice or disease characteristics, and 25 statements related to familial relationships and patient preferences. In group B, subjects who prescribed medication made 30 statements related to medical practice, and 13 statements related to patient preference. Subjects who did not prescribe medication made 10 statements related to medical practice, and 1 statement related to patient preference. This study demonstrates social context of individual patients, together with evidence, affects clinical decision and management. We propose further study into how this affects physician decision making, a scholarly field we call Clinical Decision Science

A Mental Health Drop-In Centre Offering Brief Transdiagnostic Psychological Assessment and Treatment in a Paediatric Hospital Setting: A One-Year Descriptive Study

Aim: This study was part of a broader project to examine the acceptability, feasibility and impact of a transdiagnostic mental health drop-in centre offering brief psychological assessment and treatment for children and young people and/or their families with mental health needs in the context of long-term physical health conditions (LTCs). The aims of this investigation were to characterise: (i) the use of such a centre, (ii) the demographics and symptoms of those presenting to the centre, and (iii) the types of support that are requested and/or indicated. Methods: A mental health “booth” was located in reception of a national paediatric hospital over one year. Characteristics of young people with LTCs and their siblings/parents attending the booth were defined. Emotional/behavioural symptoms were measured using standardised questionnaires including the Strengths and Difficulties Questionnaire (SDQ). Participants subsequently received one of four categories of intervention: brief transdiagnostic cognitive behaviour therapy (CBT), referral to other services, neurodevelopmental assessment or signposting to resources. Results: One hundred and twenty-eight participants were recruited. The mean age of young people was 9.14 years (standard deviation: 4.28); 61% identified as white and 45% were male. Over half of young people recruited scored in the clinical range with respect to the SDQ. Presenting problems included: anxiety (49%), challenging behaviour (35%), low mood (22%) and other (15%). Conclusions: A considerable proportion of young people with LTC in a paediatric hospital scored in the clinical range for common mental health problems, indicating a potential for psychological interventions

Viability of MSSM scenarios at very large tan(beta)

We investigate the MSSM with very large tan(beta) > 50, where the fermion masses are strongly affected by loop-induced couplings to the "wrong" Higgs, imposing perturbative Yukawa couplings and constraints from flavour physics. Performing a low-energy scan of the MSSM with flavour-blind soft terms, we find that the branching ratio of B->tau nu and the anomalous magnetic moment of the muon are the strongest constraints at very large tan(beta) and identify the viable regions in parameter space. Furthermore we determine the scale at which the perturbativity of the Yukawa sector breaks down, depending on the low-energy MSSM parameters. Next, we analyse the very large tan(beta) regime of General Gauge Mediation (GGM) with a low mediation scale. We investigate the requirements on the parameter space and discuss the implied flavour phenomenology. We point out that the possibility of a vanishing Bmu term at a mediation scale M = 100 TeV is challenged by the experimental data on B->tau nu and the anomalous magnetic moment of the muon.Comment: 29 pages, 7 figures. v2: discussion in sections 1 and 4 expanded, conclusions unchanged. Matches version published in JHE