EXAMINING QUALITY INDICATOR RATES FOR OLDER HOME CARE CLIENTS WITH DUAL SENSORY IMPAIRMENT (DSI) AND EXPLORING THE HETEROGENEITY WITHIN DSI.

Older adults with impairments in both hearing and vision, called dual sensory impairment (DSI), are at an increased risk of negative health outcomes such as impaired communication and difficulties with mobility. It is unknown whether DSI is associated with potential quality of care issues. This study used a set of home care quality indicators (HCQIs) to examine potential quality issues in older clients (65+) with DSI. Further, it looked to explore how HCQI rates differed based on the geographic region of care and whether the client’s level of hearing and vision impairment was related to certain HCQIs. The HCQIs were generated from data collected using the Resident Assessment Instrument for Home Care and capture undesirable outcomes (e.g., falls, cognitive decline). Higher rates indicate a greater frequency of experiencing the issue. In this sample (n=352,656), the average age was 82.8 years (sd=7.9), the majority were female (63.2%), and 20.5% experienced DSI. Compared to those without DSI, clients with DSI had higher rates across 20 of the 22 HCQIs. The HCQI rates differed by geographic region, with specific regions consistently performing worse than others. Finally, the level of hearing and vision impairment was related to certain HCQIs more than others, for example hearing impairment appeared to be more related to the quality indicator measuring communication difficulty. Overall, the hope is that this information can help to identify some of the potential issues around quality and in turn, assist in continually improving the services being provided to these clients

Vector meson production and nucleon resonance analysis in a coupled-channel approach for energies m_N < sqrt(s) < 2 GeV I: pion-induced results and hadronic parameters

We present a nucleon resonance analysis by simultaneously considering all pion- and photon-induced experimental data on the final states gamma N, pi N, 2 pi N, eta N, K Lambda, K Sigma, and omega N for energies from the nucleon mass up to sqrt(s) = 2 GeV. In this analysis we find strong evidence for the resonances P_{31}(1750), P_{13}(1900), P_{33}(1920), and D_{13}(1950). The omega N production mechanism is dominated by large P_{11}(1710) and P_{13}(1900) contributions. In this first part, we present the results of the pion-induced reactions and the extracted resonance and background properties with emphasis on the difference between global and purely hadronic fits.Comment: 54 pages, 26 figures, discussion extended, typos corrected, references updated, to appear in Phys. Rev.

Effective Lagrangian Approach to the Theory of Eta Photoproduction in the N∗(1535)N^{*}(1535) Region

We investigate eta photoproduction in the $N^{*}(1535)$ resonance region within the effective Lagrangian approach (ELA), wherein leading contributions to the amplitude at the tree level are taken into account. These include the nucleon Born terms and the leading $t$-channel vector meson exchanges as the non-resonant pieces. In addition, we consider five resonance contributions in the $s$- and $u$- channel; besides the dominant $N^{*}(1535)$, these are: $N^{*}(1440),N^{*}(1520),N^{*}(1650)$ and $N^{*}(1710)$. The amplitudes for the $\pi^\circ$ and the $\eta$ photoproduction near threshold have significant differences, even as they share common contributions, such as those of the nucleon Born terms. Among these differences, the contribution to the $\eta$ photoproduction of the $s$-channel excitation of the $N^{*}(1535)$ is the most significant. We find the off-shell properties of the spin-3/2 resonances to be important in determining the background contributions. Fitting our effective amplitude to the available data base allows us to extract the quantity $\sqrt{\chi \Gamma_\eta} A_{1/2}/\Gamma_T$, characteristic of the photoexcitation of the $N^{*}(1535)$ resonance and its decay into the $\eta$-nucleon channel, of interest to precise tests of hadron models. At the photon point, we determine it to be $(2.2\pm 0.2)\times 10^{-1} GeV^{-1}$ from the old data base, and $(2.2\pm 0.1) \times 10^{-1} GeV^{-1}$ from a combination of old data base and new Bates data. We obtain the helicity amplitude for $N^{*}(1535)\rightarrow \gamma p$ to be $A_{1/2}=(97\pm 7)\times 10^{-3} GeV^{-1/2}$ from the old data base, and $A_{1/2}=(97\pm 6)\times 10^{-3} GeV^{-1/2}$ from the combination of the old data base and new Bates data, compared with the results of the analysis of pion photoproduction yielding $74\pm 11$, in the same units.Comment: 43 pages, RevTeX, 9 figures available upon request, to appear in Phys. Rev.

Determination of the E2/M1 Ratio in the \gamma N \to \Delta(1232) Transition from a Simultaneous Measurement of p(\vec{\gamma},p)\pi^0 and p(\vec{\gamma},\pi^+)n

Tagged linearly polarized photons have been used at the Mainz Microtron MAMI for simultaneous measurements of the p(\vec{\gamma},p)\pi^0 and p(\vec{\gamma},\pi^+)n reaction channels to study the \gamma N \to \Delta(1232) transition. The energy dependence of the magnetic dipole M_{1+}^{3/2} and electric quadrupole E_{1+}^{3/2} amplitudes have been extracted from these data in the photon energy range from 270 to 420 MeV. The E2/M1 ratio for the \gamma N \to \Delta(1232) transition has been determined to be - (2.5+-0.1_{stat}+-0.2_{sys}) % at the resonance position delta_{33}=90^0.Comment: 25 pages Latex including 13 postscript figures submitted for publication in Phys. Rev.

A conceptual cellular interaction model of left ventricular remodelling post-MI: dynamic network with exit-entry competition strategy

Abstract Background Progressive remodelling of the left ventricle (LV) following myocardial infarction (MI) is an outcome of spatial-temporal cellular interactions among different cell types that leads to heart failure for a significant number of patients. Cellular populations demonstrate temporal profiles of flux post-MI. However, little is known about the relationship between cell populations and the interaction strength among cells post-MI. The objective of this study was to establish a conceptual cellular interaction model based on a recently established graph network to describe the interaction between two types of cells. Results We performed stability analysis to investigate the effects of the interaction strengths, the initial status, and the number of links between cells on the cellular population in the dynamic network. Our analysis generated a set of conditions on interaction strength, structure of the network, and initial status of the network to predict the evolutionary profiles of the network. Computer simulations of our conceptual model verified our analysis. Conclusions Our study introduces a dynamic network to model cellular interactions between two different cell types which can be used to model the cellular population changes post-MI. The results on stability analysis can be used as a tool to predict the responses of particular cell populations

Consumer and staff perspectives of the implementation frequency and value of recovery and wellbeing oriented practices

Background: Despite advances in our understanding of what mental health systems and services can do to enhance recovery and wellbeing outcomes for people seeking support, there is limited evidence demonstrating that this body of work has translated successfully into mental health service practice. The Collaborative Recovery Model (CRM) is a practice framework that has been designed to support application of recovery and wellbeing oriented principles and practices within mental health service delivery. The aims of this study were to assess consumer and staff perceptions of implementation frequency during service engagement and the value of this approach for assisting recovery within a setting where the CRM approach had been adopted. Methods: The setting was a large Australian community managed mental health organisation. The study involved a cross-sectional analysis of consumer (n = 116) and staff practitioner (n = 62) perspectives. A series of paired sample t-tests assessed for differences between consumer and staff perceptions of the: (i) importance of key practice elements for assisting recovery, and the (ii) frequency that key practice elements are utilised during engagement sessions. Spearman\u27s r correlational analysis explored associations between importance, frequency and helpfulness of sessions. Results: Key practice elements of the model were applied during service interactions at a high level and perceived by the majority of consumers and staff participants as being important or very important for assisting recovery. Significant moderate correlations were found between the extent that practice elements were valued and the level at which they were applied. Higher levels of implementation of CRM practices were associated with higher ratings of perceived session helpfulness. The strongest association was between \u27encouragement to set tasks to complete between support visits\u27 and perceived helpfulness. Conclusions: Consumer and staff responses revealed that the key practice elements of the CRM were frequently implemented during service engagement interactions and were seen as valuable for assisting recovery. The level of agreement between raters suggests firstly, that the key practice elements were apparent and able to be rated as occurring, and secondly that the CRM approach is seen as responsive to consumer needs. The results have implications for translating recovery and wellbeing oriented knowledge into mental health service practice

Evolving cell models for systems and synthetic biology

This paper proposes a new methodology for the automated design of cell models for systems and synthetic biology. Our modelling framework is based on P systems, a discrete, stochastic and modular formal modelling language. The automated design of biological models comprising the optimization of the model structure and its stochastic kinetic constants is performed using an evolutionary algorithm. The evolutionary algorithm evolves model structures by combining different modules taken from a predefined module library and then it fine-tunes the associated stochastic kinetic constants. We investigate four alternative objective functions for the fitness calculation within the evolutionary algorithm: (1) equally weighted sum method, (2) normalization method, (3) randomly weighted sum method, and (4) equally weighted product method. The effectiveness of the methodology is tested on four case studies of increasing complexity including negative and positive autoregulation as well as two gene networks implementing a pulse generator and a bandwidth detector. We provide a systematic analysis of the evolutionary algorithm’s results as well as of the resulting evolved cell models

Embodying the mind and representing the body

Does the existence of body representations undermine the explanatory role of the body? Or do certain types of representation depend so closely upon the body that their involvement in a cognitive task implicates the body itself? In the introduction of this special issue we explore lines of tension and complement that might hold between the notions of embodiment and body representations, which remain too often neglected or obscure. To do so, we distinguish two conceptions of embodiment that either put weight on the explanatory role of the body itself or body representations. We further analyse how and to what extent body representations can be said to be embodied. Finally, we give an overview of the full volume articulated around foundational issues (How should we define the notion of embodiment? To what extent and in what sense is embodiment compatible with representationalism? To what extent and in what sense are sensorimotor approaches similar to behaviourism?) and their applications in several cognitive domains (perception, concepts, selfhood, social cognition)

Weber and church governance: religious practice and economic activity

The debate about the relationship between religion and economic activity in the wake of Weber has been cast largely in terms of belief and values. This article suggests an alternative focus on practice. It argues that taken for granted practices of church governance formed to-hand resources for the organization of economic activity. The argument is developed through an examination of the historical development of church governance practices in the Presbyterian Church of Scotland, with particular emphasis on the way in which theological belief gave rise to practices of accountability and record keeping. In turn such practices contributed to a ‘culture of organization’ which had implications for economic activity. A focus on governance practices can help to illuminate enduring patterns of difference in the organization of economic activity