A survey of the needs of eighth grade pupils in the Samuel Adams District (Jeffries Point, East Boston)

This item was digitized by the Internet Archive. Thesis (M.A.)--Boston Universityhttps://archive.org/details/asurveyofneedsof00hea

The prevention of patient falls in healthcare settings, with particular emphasis on the effect of bedrail use on falls and injury as part of multi-faceted interventions

This doctoral statement links previously published original research and places this in the context of the wider literature. Analysis of a national database identified over 200,000 patient falls, including 1,000 fractures, reported from hospitals in England and Wales during 2005/06, leading to excess morbidity, mortality, healthcare costs, litigation, distress and anxiety. Mean falls rates for acute hospitals were 4.8 falls per 1,000 occupied bed days, falls were most likely to be reported as occurring between 10:00 and 12:00, and in relation to bed occupancy, patients aged over 85 years and males were at greatest risk. Although the only such study on a national scale, its findings were congruent with earlier smaller studies. A cluster randomised trial of multifactorial interventions carried out in acute and rehabilitation wards for older people identified a significant reduction in rate of falls between intervention and control groups (incident rate ratio 0.59 95% CI 0.49-0.70). The use of a ward-based multidisciplinary approach and several components of the intervention were found in review of other successful trials of hospital falls prevention. A systematic review identified that both routine bedrail use and unselective bedrail elimination appear to increase the risk of falls and injury, and that direct injury from bedrails, including fatal entrapment, is primarily related to outdated equipment design, and poor fitting and maintenance. The dominant orthodoxy in the literature that bedrails are harmful and unacceptable appears to have become detached from the empirical evidence and patients’ views. A multi-hospital overnight survey of bedrail use found 25.7% of patients had full bedrails raised, with immobility the most significant factor associated with bedrail use on logistic regression (OR 62.5 95% CI 27.4-142.8). These findings were disseminated through publications for the National Patient Safety Agency and through additional journal publications, and influenced policy in UK hospitals and internationally.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Genetic Analyses of Days Open Using a Random Regression Model

The purpose of this study was to investigate the feasibility of using a linear random regression model for the analysis of female fertility as expressed by days open. The analysis provided insight about the kind and amount of variation over the trajectory for age at calving from 24 to 72 mo. Correlations between permanent environmental effects changed from positive to negative values with greater distance between days open in young cows and days open in older cows; r(24,36)=0.88, r(24,72)=-.65. The random regression animal model proved to be a better alternative to a repeatability animal model for prediction of breeding values for days open. Random regression enables breeders to pick the optimum age at calving to select female replacements with enhanced fertility or fewer days open per lactation. Further research is needed to evaluate the advantages of using random regression model on the genetic analysis of days open

Joint Genetic Analysis of Conception and Maintenance of Pregnancy in Dairy Cattle Using a Linear-Threshold Model

A joint analysis of days open and calving success was implemented to further enhance the identification of cows with greater genetic merit for reproductive performance. Calving success is a categorical trait with similar genetic variation as days open and is analyzed jointly with days open to make effective use of the positive genetic correlation between these two traits. The joint analysis can identify cows with greater genetic merit for conception at an earlier stage of lactation and greater success at maintenance of pregnancy. The joint analysis also enhances the reliability of detecting true genetic differences between cows for fertility because it makes more effective use of all data

Population parameter estimates for performance and reproductive traits in Polish Large White nucleus herds

Performance test records from on-farm tests of young Polish Large White boars and reproductive records of Polish Large White sows from 94 nucleus farms during 1978 to 1987 were used to estimate population parameters for the measured traits. The number of boar performance records after editing was 114,347 from 3,932 sues, 21,543 dams, 44,493 litters and 1,075 herd-year-seasons. Reproductive performance records of sows involved 41,080 litters from 2,348 sires, 18,683 dams and 1,520 herd-year-seasons. Both data sets were analyzed by using restricted maximum-likelihood programs. The model used for the pedormance records included fixed herd-year-seasons, random sires, dams and error effects, and covariances for the year of birth of sire and year of birth of dam. The model used for the reproduction data set was the same as the performance data with parity as an additional fiied effect. Estimated heritabilities were .27, .29, .26, .07, .06, .06 for average daily gain standardized to 180 d (ADG), backfat thickness standardized to 110 kg BW (BF), days to 110 kg (DAYS), litter size at birth born alive (NBA), litter size at 21 d (N21) and litter weight at 21 d (W21). respectively. Estimated common environmental effects for the same traits were .09, .lo, .09, .06, .07 and .OS, respectively. Genetic correlations were .68 (NBA and W21) and .80 (N21 and W21). The respective phenotypic correlations were .23, -.99, -.20, .88, .75, .86. These population parameters for Polish Large White pigs are similar to those for breeds in other countries

A home-based comprehensive care model in patients with Multiple Sclerosis: A study pre-protocol.

Background Disability is prevalent in individuals with multiple sclerosis (MS), leading to difficulty in care access, significant caregiver burden, immense challenges in self-care and great societal burden. Without highly coordinated, competent and accessible care, individuals living with progressive MS experience psychological distress, poor quality of life, suffer from life-threatening complications, and have frequent but avoidable healthcare utilizations. Unfortunately, current healthcare delivery models present severe limitations in providing easily accessible, patient-centered, coordinated comprehensive care to those with progressive MS. We propose a home-based comprehensive care model (MAHA) to address the unmet needs, challenges, and avoidable complications in individuals with progressive MS with disabling disease. Objective The article aims to describe the study design and methods used to implement and evaluate the proposed intervention. Method The study will use a randomized controlled design to evaluate the feasibility of providing a 24-month, home-based, patient-centered comprehensive care program to improve quality of life, reduce complications and healthcare utilizations overtime (quarterly) for 24 months. A transdisciplinary team led by a MS-Comprehensivist will carry out this project. Fifty MS patients will be randomly assigned to the intervention and usual care program using block randomization procedures. We hypothesize that patients in the intervention group will have fewer complications, higher quality of life, greater satisfaction with care, and reduced healthcare utilization. The proposed project is also expected to be financially sustainable in fee-for-service models but best suited for and gain financial success in valued-based care systems. Discussion This is the first study to examine the feasibility and effectiveness of a home-based comprehensive care management program in MS patients living with progressive disability. If successful, it will have far-reaching implications in research, education and practice in terms of providing high quality but affordable care to population living with severe complex, disabling conditions

Helping hands? Gesture and self-repair in schizophrenia

Howes C, LaVelle M, Healey P, Hough J, McCabe R. Helping hands? Gesture and self-repair in schizophrenia. In: Proceedings of the Resources and Processing of Linguistic and Extra-Linguistic Data from People with Various Forms of Cognitive/Psychiatric Impairments (RaPID-2016). 2016

Associations of common breast cancer susceptibility alleles with risk of breast cancer subtypes in BRCA1 and BRCA2 mutation carriers

Peer reviewedPublisher PD

Association of pregnancy complications/risk factors with the development of future long-term health conditions in women : overarching protocol for umbrella reviews

Acknowledgments Patient representatives and MuM-PreDiCT team. Funding This work was funded by the Strategic Priority Fund 'Tackling multimorbidity at scale' programme (grant number-MR/W014432/1) delivered by the Medical Research Council and the National Institute for Health and Care Research in partnership with the Economic and Social Research Council and in collaboration with the Engineering and Physical Sciences Research Council.Peer reviewedPublisher PD