From Script to Stage: A Costume Designer’s Perspective

In the process of designing the costumes for a show, it is important to understand the psyche of each of the characters. The completion of thorough research can give valuable insight into the characters, as well as details of the setting of the play. A designer then takes this information, in the form of photographs, journals, period documents, and modern analysis and combines it to achieve a unified vision of the play’s environment. They must then work with the director and other designers to present this vision to the audience. This semester, I had the opportunity to explore this process when I was chosen to design the costumes for URI Theatre’s production of Sam Shepard’s Buried Child, winner of the 1979 Pulitzer Prize for Drama. The play is a chilling and macabre look at American family life. Sam Shepard presents a normal family, but as the play progresses and we learn more about the characters we are forced to challenge that assumption. As we begin to question the normalcy of this fictional family, Shepard challenges his audience to question the façade that every American family presents to the world around them, and whether the normal family even exists. It seems, after all, that every family has that one thing that is not to be talked about. The first part of this semester was spent on the actual design of the show - developing it from vague images and feelings to real clothing for the characters of the show. The second part of the semester was spent both critiquing my work and expanding my knowledge of the themes present in this work. I did this by further analyzing Buried Child along with other works by Sam Shepard

Moving Ahead Amid Fiscal Challenges: A Look at Medicaid Spending, Coverage and Policy Trends

Examines fiscal year 2011 trends in state efforts to control Medicaid spending, reform payment and delivery systems, and prepare for healthcare reform implementation, as well as projections in spending and enrollment growth for fiscal year 2012

Exploring attitudes to technology adoption for cross compliance in Greek and Lithuanian farmers

© The Authors.The fourth agricultural revolution has started with an explosion of online, smart, digital technologies that are now available to support farmers to improve their operations is enabling opportunities for direct integration between agricultural and computer-based systems. However, the wide range of devices and applications available can be overwhelming and the farming community is showing reluctance to adoption of these new technologies. As part of an EU-funded, multi-partner research project we developed, in collaboration with farmers and other stakeholders, a novel on-line system that supports EU farmers and paying agencies to reduce the administrative burden of CAP’s cross compliance record-keeping and inspections. During the co-development phase we interviewed Greek and Lithuanian farmers about their user needs in relation to the novel system and their potential adoption of this new technology. We analysed their qualitative responses and could identify two groups; ‘Optimistic’ and ‘Reluctant’ in relation to their use of novel technologies. In order to achieve up-take of new technologies within the European farming community, we considered these findings using the Theory of Planned Behaviour and concluded that focussing on the ease of adoption and peer usage would encourage the highest adoption rates as opposed to focusing on changing farmer attitudes

Recent Accumulation Variability in Northwest Greenland from Ground-Penetrating Radar and Shallow Cores along the Greenland Inland Traverse

Accumulation is a key parameter governing the mass balance of the Greenland ice sheet. Several studies have documented the spatial variability of accumulation over wide spatial scales, primarily using point data, remote sensing or modeling. Direct measurements of spatially extensive, detailed profiles of accumulation in Greenland, however, are rare. We used 400 MHz ground-penetrating radar along the 1009 km route of the Greenland Inland Traverse from Thule to Summit during April and May of 2011, to image continuous internal reflecting horizons. We dated these horizons using ice-core chemistry at each end of the traverse. Using density profiles measured along the traverse, we determined the depth to the horizons and the corresponding water-equivalent accumulation rates. The measured accumulation rates vary from ~0.1 m w.e. a–1 in the interior to ~0.7 m w.e. a–1 near the coast, and correspond broadly with existing published model results, though there are some excursions. Comparison of our recent accumulation rates with those collected along a similar route in the 1950s shows a ~10% increase in accumulation rates over the past 52 years along most of the traverse route. This implies that the increased water vapor capacity of warmer air is increasing accumulation in the interior of Greenland

Implementation and sustainment of diverse practices in a large integrated health system: a mixed methods study

Background: One goal of health systems seeking to evolve into learning health systems is to accelerate the implementation and sustainment of evidence-based practices (EBPs). As part of this evolution, the Veterans Health Administration (VHA) developed the Innovation Ecosystem, which includes the Diffusion of Excellence (DoE), a program that identifies and diffuses Gold Status Practices (GSPs) across facilities. The DoE hosts an annual Shark Tank competition in which leaders bid on the opportunity to implement a GSP with 6 months of implementation support. Over 750 diverse practices were submitted in cohorts 2 and 3 of Shark Tank; 23 were designated GSPs and were implemented in 31 VA networks or facilities. As part of a national evaluation of the DoE, we identified factors contributing to GSP implementation and sustainment. Methods: Our sequential mixed methods evaluation of cohorts 2 and 3 of Shark Tank included semi-structured interviews with at least one representative from 30/31 implementing teams (N = 78/105 people invited) and survey responses from 29/31 teams (N = 39/47 invited). Interviews focused on factors influencing implementation and future sustainment. Surveys focused on sustainment 1.5-2 years after implementation. The Consolidated Framework for Implementation Research (CFIR) informed data collection and directed content analysis. Ordinal scales were developed inductively to rank implementation and sustainment outcomes. Results: Over 50% of teams (17/30) successfully implemented their GSP within the 6-month implementation period. Despite extensive implementation support, significant barriers related to centralized decision-making, staffing, and resources led to partial (n = 6) or no (n = 7) implementation for the remaining teams. While 12/17 initially successful implementation teams reported sustained use of their GSP, over half of the initially unsuccessful teams (n = 7/13) also reported sustained GSP use 1.5 years after the initial implementation period. When asked at 6 months, 18/27 teams with complete data accurately anticipated their future sustainability based on reported sustainment an average of 1.5 years later. Conclusions: Most teams implemented within 6 months and/or sustained their GSP 1.5 years later. High levels of implementation and sustainment across diverse practices and teams suggest that VHA\u27s DoE is a successful large-scale model of diffusion. Team predictions about sustainability after the first 6 months of implementation provide a promising early assessment and point of intervention to increase sustainability

Approaches to quality improvement in nursing homes: Lessons learned from the six-state pilot of CMS's Nursing Home Quality Initiative

BACKGROUND: In November 2002, the Centers for Medicare & Medicaid Services (CMS) launched a Nursing Home Quality Initiative that included publicly reporting a set of Quality Measures for all nursing homes in the country, and providing quality improvement assistance to nursing homes nationwide. A pilot of this initiative occurred in six states for six months prior to the launch. METHODS: Review and analysis of the lessons learned from the six Quality Improvement Organizations (QIOs) that led quality improvement efforts in nursing homes from the six pilot states. RESULTS: QIOs in the six pilot states found several key outcomes of the Nursing Home Quality Initiative that help to maximize the potential of public reporting to leverage effective improvement in nursing home quality of care. First, public reporting focuses the attention of all stakeholders in the nursing home industry on achieving good quality outcomes on a defined set of measures, and creates an incentive for partnership formation. Second, publicly reported quality measures motivate nursing home providers to improve in certain key clinical areas, and in particular to seek out new ways of changing processes of care, such as engaging physicians and the medical director more directly. Third, the lessons learned by QIOs in the pilot of this Initiative indicate that certain approaches to providing quality improvement assistance are key to guiding nursing home providers' desire and enthusiasm to improve towards a using a systematic approach to quality improvement. CONCLUSION: The Nursing Home Quality Initiative has already demonstrated the potential of public reporting to foster collaboration and coordination among nursing home stakeholders and to heighten interest of nursing homes in quality improvement techniques. The lessons learned from this pilot project have implications for any organizations or individuals planning quality improvement projects in the nursing home setting

Comparative genomics across three ensifer species using a new complete genome sequence of the Medicago symbiont Sinorhizobium (Ensifer) meliloti WSM1022

Here, we report an improved and complete genome sequence of Sinorhizobium (Ensifer) meliloti strain WSM1022, a microsymbiont of Medicago species, revealing its tripartite structure. This improved genome sequence was generated combining Illumina and Oxford nanopore sequencing technologies to better understand the symbiotic properties of the bacterium. The 6.75 Mb WSM1022 genome consists of three scaffolds, corresponding to a chromosome (3.70 Mb) and the pSymA (1.38 Mb) and pSymB (1.66 Mb) megaplasmids. The assembly has an average GC content of 62.2% and a mean coverage of 77X. Genome annotation of WSM1022 predicted 6058 protein coding sequences (CDSs), 202 pseudogenes, 9 rRNAs (3 each of 5S, 16S, and 23S), 55 tRNAs, and 4 ncRNAs. We compared the genome of WSM1022 to two other rhizobial strains, closely related Sinorhizobium (Ensifer) meliloti Sm1021 and Sinorhizobium (Ensifer) medicae WSM419. Both WSM1022 and WSM419 species are high-efficiency rhizobial strains when in symbiosis with Medicago truncatula, whereas Sm1021 is ineffective. Our findings report significant genomic differences across the three strains with some similarities between the meliloti strains and some others between the high efficiency strains WSM1022 and WSM419. The addition of this high-quality rhizobial genome sequence in conjunction with comparative analyses will help to unravel the features that make a rhizobial symbiont highly efficient for nitrogen fixation

Conformational adaptation of Asian macaque TRIMCyp directs lineage specific antiviral activity

TRIMCyps are anti-retroviral proteins that have arisen independently in New World and Old World primates. All TRIMCyps comprise a CypA domain fused to the tripartite domains of TRIM5α but they have distinct lentiviral specificities, conferring HIV-1 restriction in New World owl monkeys and HIV-2 restriction in Old World rhesus macaques. Here we provide evidence that Asian macaque TRIMCyps have acquired changes that switch restriction specificity between different lentiviral lineages, resulting in species-specific alleles that target different viruses. Structural, thermodynamic and viral restriction analysis suggests that a single mutation in the Cyp domain, R69H, occurred early in macaque TRIMCyp evolution, expanding restriction specificity to the lentiviral lineages found in African green monkeys, sooty mangabeys and chimpanzees. Subsequent mutations have enhanced restriction to particular viruses but at the cost of broad specificity. We reveal how specificity is altered by a scaffold mutation, E143K, that modifies surface electrostatics and propagates conformational changes into the active site. Our results suggest that lentiviruses may have been important pathogens in Asian macaques despite the fact that there are no reported lentiviral infections in current macaque populations