Development and Cost-Effectiveness of a Malnutrition Screening Program in a Skilled Nursing Setting

Malnutrition increases the cost of healthcare and is commonly unrecognized and untreated. These facts are especially true for healthcare settings that provide care to the elderly. Research emphasizes the need for malnutrition prevention in extended care facilities such as skilled nursing facilities (SNFs) so that patients receive timely and appropriate intervention(s). The purpose of this study was to retroactively screen SNF patients using four alternative malnutrition screening tools and to compare results to those from the facility screening tool. A second purpose was to estimate differences in potential Medicare reimbursement based on the number of patients identified at risk for malnutrition/malnourished using each tool. The screening tools were the OakBend Medical Screening tool (facility tool), Mini Nutrition Assessment-Short Form (MNASF), Malnutrition Universal Screening Tool (MUST), Nutrition Risk Screening 2002 (NRS-2002), and Malnutrition Screening Tool (MST). Retrospective data from 200 SNF elder patients aged 65 years and older admitted between March 2017 and March 2018 were used for analysis. Retrospective screening allowed for comparisons among the five tools. Comparison of the number of patients categorized as no risk and at risk/malnourished using the five screening tools and differences in theoretical reimbursement were tested using chi-squared analysis. MNA-SF identified the highest number of at risk patients (n = 181; 90.5%), while MUST identified the fewest (n = 68; 34.0%). MNA-SF produced the highest amount of malnutrition and overall theoretical dollar reimbursement value. For this study, MNA-SF and NRS-2002 showed to be the most appropriate screening tools for SNF setting. In comparison to the OakBend Medical Center screening tool, using numbers from MNASF and NRS-2002 would have generated significantly more dollars in Medicare reimbursement, respectively. In order to ensure maximum reimbursement for skilled nursing care for elders, it is essential to document the risk of malnutrition, and screening is an important first step

Bad drawings of small complete graphs

We show that for $K_5$ (resp.~ $K_{3,3}$) there is a drawing with $i$ independent crossings, and no pair of independent edges cross more than once, provided $i$ is odd with $1\le i\le 15$ (resp.~ $1\le i\le 17$). Conversely, using the deleted product cohomology, we show that for $K_5$ and $K_{3,3}$, if $A$ is any set of pairs of independent edges, and $A$ has odd cardinality, then there is a drawing in the plane for which each element in $A$ cross an odd number of times, while each pair of independent edges not in $A$ cross an even number of times. For $K_6$ we show that there is a drawing with $i$ independent crossings, and no pair of independent edges cross more than once, if and only if $3\le i\le 40$

Making Machine Learning Tangible for UX Designers

There is considerable current research interest in the relationship between machine learning (ML) and user experience design (UX). This comes both from design researchers within the human- computer interaction (HCI) community, who have sought ways for UX designers to work with ML, and data scientists in new types of collaborative practice. The need for a shared language between designers and data scientists has emerged as a key factor, with the creation of boundary objects in the form of sensitising concepts seen as a useful approach. This paper presents original research that responds to the call for such concepts by working directly with UX designers to model aspects of ML technologies in physical form. Our intention is to position designerly abstractions as examples of the type of boundary object able to bridge the domains of UX design and data science and open up new possibilities for the design of ML-driven digital products

Global HCI Curricula: The Case for Creativity

This paper makes the case for the inclusion of experimental creative practice within global HCI curricula. The interface between HCI and creative practice is often found in the discipline of user experience design where students are trained in the various methods, approaches and techniques of designing for digital systems, objects, and interfaces. User experience design has traditionally been seen as at the service of both the people who are intended to use a digital product and the business objectives of the commissioning organisation. Most recently, this has led to a number of negative consequences including the emergence of surveillance capitalism, a flattening of creative possibility, and an arguably damaging prioritisation of human needs above all others. In order to revitalise the discipline, this paper suggests that HCI education needs to widen its scope to encompass conceptual risk taking through several approaches that we detail

Adapting Haptic Feedback for Guided Meditation

Technology supporting meditation is a multimillion-dollar market that continues to grow. There is also strong academic interest to understand and improve the impact technology can have for the user experience of practitioners. However, little work investigates how to modulate haptic feedback to accommodate individual requirements without using biomarkers. In collaboration with a cognitive neuroscience laboratory, we investigated interactions between users and a haptic meditation device through two design research studies. Preliminary evaluations with 20 participants showed a preference for digital over analog interfaces for parametrization of the haptic meditation device. The final study with 21 participants found that the hedonic and pragmatic preferences depend on both the experience of a user and their age. The work gives new insights into designing interfaces for haptic meditation which allow for parametrization of haptic feedback parameters, as well as a variety of options for the parameterization approach

Ming Shan Digital Experience

The Ming Shan Digital Experience is an immersive installation designed to support meditation in the context of a new Taoist center. Its creation confronted current academic literature on digital technology for meditation with the practical and cultural requirements of Taoist practice. Quantitative and qualitative learnings show the effectiveness of multimodal biofeedback on individual and collective meditative experience. Now instated in the Taoist center, the installation opens new perspectives for combining digital technology with ancient practice

Evidence for different thermal ecotypes in range centre and trailing edge kelp populations

Determining and predicting species’ responses to climate change is a fundamental goal of contemporary ecology. When interpreting responses to warming species are often treated as a single physiological unit with a single species-wide thermal niche. This assumes that trailing edge populations are most vulnerable to warming, as it is here where a species’ thermal niche will be exceeded first. Local adaptation can, however, result in narrower thermal tolerance limits for local populations, so that similar relative increases in temperature can exceed local niches throughout a species range. We used a combination of common garden temperature heat-shock experiments (8–32 °C) and population genetics (microsatellites) to identify thermal ecotypes of northeast Atlantic range centre and trailing edge populations of the habitat-forming kelp, Laminaria digitata. Using upregulation of hsp70 as an indicator of thermal stress, we found that trailing edge populations were better equipped to tolerate acute temperature shocks. This pattern was consistent across seasons, indicating that between-population variability is fixed. High genetic structuring was also observed, with range centre and trailing edge populations representing highly distinct clusters with little gene flow between regions. Taken together, this suggests the presence of distinct thermal ecotypes for L. digitata, which may mean responses to future warming are more complex than linear range contractions. © 2019 Elsevier B.V