Ward round documentation in a major trauma centre: can we improve patient safety?

Our objective was to improve documentation and patient safety in a major trauma centre. A retrospective audit was undertaken in March 2014. Ward round entries for each orthopaedic patients on three dates were assessed against standards and analysed. The audit was repeated in April 2014, and again in August 2014. Thorough documentation is paramount in a major trauma centre. It forms a useful record of the patients hospital stay, is a legal document and is highlighted in national guidelines. It provides a basis for good handover, ensuring continuation of care and maintaining patient safety. Resultant poor compliance with Royal College guidelines in the initial audit led to the production of a new electronic based note keeping system. A meeting was held with all staff prior to introduction. Our initial results gained 75 entries, and none showed full compliance. Mean compliance per entry was 59% (0-81%). The second attempt gained 90 entries, with 30 from the weekend. Mean compliance per entry 97%. Third attempt received 61 entries, with 27 from the weekend. Mean compliance was 96%, meaning that the improvement was being maintained. Recent distressing reports regarding patient highlighted the importance of patient. Our initial audit proved there were many areas lacking in our documentation and improvement was necessary. Prior to introducing electronic systems, the implemented change has produced improvement in documentation, and provides a useful handover tool for staff

Citizen Engagement in Monterey County

This capstone poster covers the topics of principles for public engagement, common barriers to engagement, user experience in government, and personas

Julian Ernst Besag, 26 March 1945 -- 6 August 2010, a biographical memoir

Julian Besag was an outstanding statistical scientist, distinguished for his pioneering work on the statistical theory and analysis of spatial processes, especially conditional lattice systems. His work has been seminal in statistical developments over the last several decades ranging from image analysis to Markov chain Monte Carlo methods. He clarified the role of auto-logistic and auto-normal models as instances of Markov random fields and paved the way for their use in diverse applications. Later work included investigations into the efficacy of nearest neighbour models to accommodate spatial dependence in the analysis of data from agricultural field trials, image restoration from noisy data, and texture generation using lattice models.Comment: 26 pages, 14 figures; minor revisions, omission of full bibliograph

Glueballs and Hybrids (Gluons as Constituents)

After a brief introduction to hybrid and glueball source operators, I summarize recent lattice results for these particles.Comment: 5 pages, contribution to LATTICE-99, corrected glueball mass tabl

BPS Amplitudes, Helicity Supertraces and Membranes in M-Theory

We study BPS dominated loop amplitudes in M-theory on T^2. For this purpose we generalize the concept of helicity supertraces to nine spacetime dimensions. These traces distinguish between various massive supermultiplets and appear as coefficients in their one-loop contributions to n-graviton scattering amplitudes. This can be used to show that only ultrashort BPS multiplets contribute to the R^4 term in the effective action, which was first computed by Green, Gutperle and Vanhove. There are two inequivalent ultrashort BPS multiplets which describe the Kaluza-Klein states and the wrapped membranes that cover the torus a number of times. From the perspective of the type-II strings they correspond to momentum and winding states and D0 or D1 branes.Comment: 15 page

Social Determinants of Smoke Exposure During Pregnancy: Findings From Waves 1 & 2 of the Population Assessment of Tobacco and Health (PATH) Study

Maternal smoking during pregnancy (MSDP) and secondhand smoke (SHS) exposure are associated with a myriad of negative health effects for both mother and child. However, less is known regarding social determinants for SHS exposure, which may differ from those of maternal smoking during pregnancy (MSDP). To identify social determinants for SHS exposure only, MSDP only, and MSDP and SHS exposure, data were obtained from all pregnant women (18–54 years; N = 726) in waves 1 and 2 of the Population Assessment of Tobacco and Health Study (2014–2015). Multiple logistic regressions were conducted using SAS 9.4. Smoke exposure during pregnancy was common; 23.0% reported SHS exposure only, 6.1% reported MSDP only, and 11.8% reported both SHS exposure and MSDP. Results demonstrate that relationships between smoke exposure during pregnancy and social determinants vary by type of exposure. Women at risk for any smoke exposure during pregnancy include those who are unmarried and allow the use of combustible tobacco products within the home. Those who are at higher risk for SHS exposure include those who are younger in age, and those who are earlier in their pregnancy. Those who are at higher risk for maternal smoking include those with fair/poor mental health status and those who believe that others\u27 view tobacco use more positively. These results suggest the need for implementing more comprehensive policies that promote smoke-free environments. Implementing these strategies have the potential to improve maternal and fetal health outcomes associated with tobacco smoke exposure

Radio-telemetry observations of the first 650 km of the migration of Bar-tailed Godwits Limosa lapponica from the Wadden Sea to the Russian Arctic

In 1999 and 2000, 45 Bar-tailed Godwits Limosa lapponica were supplied with radio-transmitters during spring staging on the island Texel in the western Wadden Sea. With the use of Automatic Radio Tracking Stations (ARTS) on Texel and in south Sweden, and hand-held receivers on Texel, it was possible to follow the later part of the stopover period on Texel for 34 birds (76%) and the passage over south Sweden for 26 birds (58%). Thus, the method of automatic tracking of overflying migrating shorebirds works successfully where the migration corridor is narrow and predictable, as in the case with late spring shorebird migration from the Wadden Sea towards arctic Russia. The timing of departure from Texel and passage over south Sweden of radio-marked birds, with median dates of 30 May and 2 June respectively, were in agreement with published data on the spring migration of Siberian-breeding Bar-tailed Godwits L. l. taymyrensis. The individual variation in migration dates was larger than expected, with birds passing south Sweden between 25 May and 10 June, indicating that the time-window for departure might be broader than previously thought. There was no clear difference between males and females in timing of migration. The time difference between departure from Texel and passage over south Sweden (average 3.3 days) indicates that most Bar-tailed Godwits do not embark on the long flight towards Siberia directly from the western Wadden Sea, but are more likely to stop in the more easterly portion of the Wadden Sea before the final take-off. This pattern is similar to what has been found in other shorebirds and geese (e.g. Red Knots Calidris canutus and Dark-bellied Brent Geese Branta bernicla) migrating along the same route.

Graph Theoretic Methods for the Analysis of Data in Developing Systems

A full examination of learning or developing systems requires data analysis approaches beyond the commonplace pre-/post-testing. Drawing on graph theory, three particular approaches to the analysis of data—based on adjacency matrices, affiliation networks, and edit distances—can provide additional insight into data; these methods are applied to student performance in a Calculus course. Data analysis methods based on adjacency matrices demonstrate that learning is not unidimensional, that learning progressions do not always progress monotonically toward desired understandings and also provide insight into the connection between instruction and student learning. The use of affiliation networks supports the concept development theory of Lev Vygotsky and also provides insight into how students’ prior knowledge relates to topics being studied. Careful use of edit distances indicates a likely overestimate of effect sizes in many studies, and also provides evidence that concepts are often created in an ad hoc manner. All of these have implications for curriculum and instruction, and indicate some directions for further inquiry

State Space Analysis and its Connection to the Classroom

Discrete dynamical systems have been used to theoretically model the complex dynamics of classrooms. While time-series analyses of these models has yielded some insights, state space analyses can yield additional insights; this paper will explore state space analyses and their application to classroom situations. One benefit of state space analysis is that it allows simultaneous exploration of multiple time-series, and so can more easily provide information about divergence and convergence of paths. Additionally, state space analysis, more easily than time-series analysis, can provide information about the existence of multiple paths leading toward a desired state. Further, state space analysis can identify different regimes of behaviors, finding boundaries near which there may be divergent behaviors, and also using those regimes to define a (sometimes) relatively small number of archetypical behaviors. This is particularly useful in tracking behaviors at a microgenetic level, since multiple initial conditions may get to the same (or very close) final states, but in dramatically different ways, and these different routes may have implications for future classroom experiences. Because of these advantages, state space analysis can be used to inform attempts at differentiated instruction in a classroom, assist modelers in identifying appropriate parameter scales, and provide guidance for empirical studies of classroom learning. These ideas will be illustrated through state space analysis of an existing model of teacher-student interactions, identifying four regimes of behaviors, and leading to several implications for classroom practice and research