Does Initiation of Early Nutrition Support Improve with Physician Education?

ObjectiveTo determine the effectiveness of physician education on achieving earlier initiation of nutrition support, and to determine the effects of early nutrition support on patient outcomes of hospital length of stay (LOS), intensive care unit (ICU) LOS, and days on mechanical ventilation.DesignThis was a prospective study evaluating the effectiveness of Nestle Nutrition\u27s Nourish Now™ program in acheiving earlier enteral nutrition in ICU patients at Methodist University Hospital in Memphis, TN. The effect of early enteral feeding on the patient outcomes of length of hospital stay, length of ICU stay, and days on mechanical ventilation were also examined.Subjects 150 patients were included in the patient subject population. 31 ICU healthcare professionals attended the education.Results Average hours patients remained NPO (nil per os or nothing by mouth ) in the pre-education group was 51.41 hours compared to 43.77 hours in the post-education group (p=0.439). Patients who received early initiation of nutrition support experienced shorter hospital LOS (p=0.046), shorter ICU LOS (p=0.229), and fewer days on mechanical ventilation (p=0.526).Conclusion Early nutrition support was significantly related to a shorter hospital LOS. Although not significant, early nutrition support was associated with a shorter ICU LOS and fewer days spent on mechanical ventilation, and physician education was associated with earlier initiation of nutrition support

Borrowing or Stealing: The Language and Moral Development of Criminals and Noncriminals

The present study was undertaken (1) to compare the connotative meanings criminals attach to a sampling of concepts with those meanings attached by noncriminals, and (2) to examine the possible relationship between moral development and criminal behavior. One hundred thirty four male subjects completed the Wide Range Achievement Test- Revised (Reading Section); a personal data sheet; the Ammons Quick Test-Form I; the Criminal Semantic Inventory; the Test for Criminal Cognitions; and the Sociomoral Reflection Questionnaire. Subjects were divided into four groups (Noncriminals, Against Person Group, Against Property Group, and Against Statute Group) on the basis of history of criminal conviction. A one-way MANOVA was conducted on each of the 16 concepts under investigation. Significant differences were found for five concepts. In addition, criminals were found to differ significantly from noncriminals on level of moral development

Education of Children with Disabilities: Voices from Around the World

Education of Children with Disabilities: Voices from Around the World combines research on children with disabilities and women/girls with disabilities. These projects provided opportunities to interview disability professionals, policy-makers and persons with disabilities from around the world with the purpose of learning about needs, issues and services, in diverse countries. A unique international analysis, this research compares various cultural responses on the education of children with disabilities emphasizing the girl child. Discussion includes findings based on 177 interviews of disability professionals from over 57 countries including the stated reasons and consequences of lost educational opportunities. Techniques locating participants included internet searches, literature reviews, and personal referrals. Interviewees were selected based on their experiences with childhood disabilities and/or women and girls with disabilities. Many interviewees were persons with disabilities who shared their personal experiences. Through a qualitative analysis of the interviews some of the most prevalent themes that emerged were the importance of education and the disproportionate negative effect of disability on females. To measure the strength of these themes, an electronic survey was created using a Likert scale to measure the strength of agreement of each participant with the issues identified. Survey ratings added quantitative confirmation to the rich qualitative interviews. The education themes identified include school exclusion and barriers to education with a particular focus on the girl child, education quality and inclusive education

Leadership Behaviour and Upward Feedback: Findings from a Longitudinal Intervention

A sample of 48 managers and 308 staff members of a community health care organization took part in a study to investigate the influence of participating in an upward feedback program on leadership behaviour, both as indicated be self-ratings and subordinates’ ratings. The research design consisted of three measurement points within one year. The intervention included managers receiving upward feedback and a management skills workshop. The results showed a negative effect of the program on leadership behaviour as rated by the staff. Furthermore, managers reduced their self-ratings in the condition where they participated in both a feedback session and an management skills workshop

Statistical Viewer: a tool to upload and integrate linkage and association data as plots displayed within the Ensembl genome browser

BACKGROUND: To facilitate efficient selection and the prioritization of candidate complex disease susceptibility genes for association analysis, increasingly comprehensive annotation tools are essential to integrate, visualize and analyze vast quantities of disparate data generated by genomic screens, public human genome sequence annotation and ancillary biological databases. We have developed a plug-in package for Ensembl called "Statistical Viewer" that facilitates the analysis of genomic features and annotation in the regions of interest defined by linkage analysis. RESULTS: Statistical Viewer is an add-on package to the open-source Ensembl Genome Browser and Annotation System that displays disease study-specific linkage and/or association data as 2 dimensional plots in new panels in the context of Ensembl's Contig View and Cyto View pages. An enhanced upload server facilitates the upload of statistical data, as well as additional feature annotation to be displayed in DAS tracts, in the form of Excel Files. The Statistical View panel, drawn directly under the ideogram, illustrates lod score values for markers from a study of interest that are plotted against their position in base pairs. A module called "Get Map" easily converts the genetic locations of markers to genomic coordinates. The graph is placed under the corresponding ideogram features a synchronized vertical sliding selection box that is seamlessly integrated into Ensembl's Contig- and Cyto- View pages to choose the region to be displayed in Ensembl's "Overview" and "Detailed View" panels. To resolve Association and Fine mapping data plots, a "Detailed Statistic View" plot corresponding to the "Detailed View" may be displayed underneath. CONCLUSION: Features mapping to regions of linkage are accentuated when Statistic View is used in conjunction with the Distributed Annotation System (DAS) to display supplemental laboratory information such as differentially expressed disease genes in private data tracks. Statistic View is a novel and powerful visual feature that enhances Ensembl's utility as valuable resource for integrative genomic-based approaches to the identification of candidate disease susceptibility genes. At present there are no other tools that provide for the visualization of 2-dimensional plots of quantitative data scores against genomic coordinates in the context of a primary public genome annotation browser

Adjusting for covariates on a slippery slope: linkage analysis of change over time

BACKGROUND: We analyzed the Genetic Analysis Workshop 13 (GAW13) simulated data to contrast and compare different methods for the genetic linkage analysis of hypertension and change in blood pressure over time. We also examined methods for incorporating covariates into the linkage analysis. We used methods for quantitative trait loci (QTL) linkage analysis with and without covariates and affected sib-pair (ASP) analysis of hypertension followed by ordered subset analysis (OSA), using variables associated with change in blood pressure over time. RESULTS: Four of the five baseline genes and one of the three slope genes were not detected by any method using conventional criteria. OSA detected baseline gene b35 on chromosome 13 when using the slope in blood pressure to adjust for change over time. Slope gene s10 was detected by the ASP analysis and slope gene s11 was detected by QTL linkage analysis as well as by OSA analysis. Analysis of null chromosomes, i.e., chromosomes without genes, did not reveal significant increases in type I error. However, there were a number of genes indirectly related to blood pressure detected by a variety of methods. CONCLUSIONS: We noted that there is no obvious first choice of analysis software for analyzing a complicated model, such as the one underlying the GAW13 simulated data. Inclusion of covariates and longitudinal data can improve localization of genes for complex traits but it is not always clear how best to do this. It remains a worthwhile task to apply several different approaches since one method is not always the best

A novel approach for measuring residential socioeconomic factors associated with cardiovascular and metabolic health

Individual-level characteristics, including socioeconomic status, have been associated with poor metabolic and cardiovascular health; however, residential area-level characteristics may also independently contribute to health status. In the current study, we used hierarchical clustering to aggregate 444 US Census block groups in Durham, Orange, and Wake Counties, NC, USA into six homogeneous clusters of similar characteristics based on 12 demographic factors. We assigned 2254 cardiac catheterization patients to these clusters based on residence at first catheterization. After controlling for individual age, sex, smoking status, and race, there were elevated odds of patients being obese (odds ratio (OR) = 1.92, 95% confidence intervals (CI) = 1.39, 2.67), and having diabetes (OR = 2.19, 95% CI = 1.57, 3.04), congestive heart failure (OR = 1.99, 95% CI = 1.39, 2.83), and hypertension (OR = 2.05, 95% CI = 1.38, 3.11) in a cluster that was urban, impoverished, and unemployed, compared with a cluster that was urban with a low percentage of people that were impoverished or unemployed. Our findings demonstrate the feasibility of applying hierarchical clustering to an assessment of area-level characteristics and that living in impoverished, urban residential clusters may have an adverse impact on health

Rapid Analysis of Legume Root Nodule Development Using Confocal Microscopy

This article discusses the rapid analysis of legume root nodule development using confocal microscopy