Academic Service Learning: Bridging the Theory/Practice Gap

This hybrid session/roundtable will provide insight regarding the integration of academic service learning in collegiate curriculum. Nursing and LUCOM faculty will showcase past ASL opportunities, which continue to be community staples. Further discussion will provide insight regarding how academic service learning (ASL) fits in curriculum, the implementation of experiential learning, the importance of working with community partners, and the value of reflection in support of sustainability

Hacking for Good - Workshop Summary

At the 2019 Charleston Library Conference, five facilitators from a diversity of organizations led a pre-conference called Hacking for Good. The goal of the half-day pre-conference was to introduce participants to the “hacking mindset” beyond the traditionally understood technology-driven terminology. In this context, hacking refersred to an approach of identifying a challenge or set of challenges in their respective knowledge organizations and gathering a set of techniques or approaches to address and overcome those challenges. The pre-conference provided a highly interactive and supportive environment to consider all aspects of a workplace challenge related to workflows and personnel and determine the most effective tools to tackle that challenge

Isotopic fractionation of carbon during uptake by phytoplankton across the South Atlantic subtropical convergence

The stable isotopic composition of particulate organic carbon (δ13CPOC) in the surface waters of the global ocean can vary with the aqueous CO2 concentration ([CO2(aq)]) and affects the trophic transfer of carbon isotopes in the marine food web. Other factors such as cell size, growth rate and carbon concentrating mechanisms decouple this observed correlation. Here, the variability in δ13CPOC is investigated in surface waters across the south subtropical convergence (SSTC) in the Atlantic Ocean, to determine carbon isotope fractionation (ϵp) by phytoplankton and the contrasting mechanisms of carbon uptake in the subantarctic and subtropical water masses. Our results indicate that cell size is the primary determinant of δ13CPOC across the Atlantic SSTC in summer. Combining cell size estimates with CO2 concentrations, we can accurately estimate "p within the varying surface water masses in this region. We further utilize these results to investigate future changes in "p with increased anthropogenic carbon availability. Our results suggest that smaller cells, which are prevalent in the subtropical ocean, will respond less to increased [CO2(aq)] than the larger cells found south of the SSTC and in the wider Southern Ocean. In the subantarctic water masses, isotopic fractionation during carbon uptake will likely increase, both with increasing CO2 availability to the cell, but also if increased stratification leads to decreases in average community cell size. Coupled with decreasing δ13C of [CO2(aq)] due to anthropogenic CO2 emissions, this change in isotopic fractionation and lowering of δ13CPOC may propagate through the marine food web, with implications for the use of δ13CPOC as a tracer of dietary sources in the marine environment

Final Technical Report for DOE Grant DE-FG02-02ER83371, Phase II

The purpose of this research was to develop a telerobotic master device consisting of a 7-axis backdrivable robotic arm, and a pressure-sensitive grip-controller integrated with a Compact Remote Console (CRC), thus creating a highly functional teleoperation station targeted to control a 6-axis industrial robotic arm and dexterous robotic hand to be used for demolition work in a nuclear setting. We successfully completed the development of one of the world?s smallest brushless motor controllers due partially to funding through this grant. These controllers are used to drive the motors in the master robotic arm. We also completed the development of an improved model of a highly advanced 4 degree-of-freedom arm ? this same arm is the core component in the teleoperation system. The WAM arm and a 3-axis gimbals were integrated with a commercially available CRC at our consultant?s lab at University of Tennessee. Additional support hardware and software were combined to tie the master control system to an existing industrial robot in the lab. A master controller for a dexterous hand was developed and became an integral part of the gimbals handle. Control algorithms were developed and the software was written and implemented. The entire system was then debugged and tested. Results of the prototype system are promising. The WAM Arm, gimbals, hand controller and CRC were successful integrated. Testing of the system to control the 6-axis industrial arm and prototype dexterous hand showed great potential. Relatively simple tasks were successfully performed at slow speeds. Some of the testing was hampered by problems with the slave dexterous hand. This is a prototype hand being developed by Barrett under a different Phase II program. Potential improvements and advancements to the system include improving the control code, and integration of a 2nd master controller arm in order to drive a 2nd slave arm and hand. In summary, the device is a complex system with advanced features and could be used as a universal platform for efficient controlling of robotic arms performing remote tasks in unstructured and uncertain environments such as those prevalent in environmental clean up

UK Alcohol Treatment trial: client-treatment matching effects

Aim To test a priori hypotheses concerning client–treatment matching in the treatment of alcohol problems and to evaluate the more general hypothesis that client–treatment matching adds to the overall effectiveness of treatment. Design Pragmatic, multi-centre, randomized controlled trial (the UK Alcohol Treatment Trial: UKATT) with open follow-up at 3 months after entry and blind follow-up at 12 months. Setting Five treatment centres, comprising seven treatment sites, including National Health Service (NHS), social services and joint NHS/non-statutory facilities. Treatments Motivational enhancement therapy and social behaviour and network therapy. Measurements Matching hypotheses were tested by examining interactions between client attributes and treatment types at both 3 and 12 months follow-up using the outcome variables of percentage days abstinent, drinks per drinking day and scores on the Alcohol Problems Questionnaire and Leeds Dependence Questionnaire. Findings None of five matching hypotheses was confirmed at either follow-up point on any outcome variable. Conclusion The findings strongly support the conclusion reached in Project MATCH in the United States that client–treatment matching, at least of the kind examined, is unlikely to result in substantial improvements to the effectiveness of treatment for alcohol problems. Possible reasons for this failure to support the general matching hypothesis are discussed, as are the implications of UKATT findings for the provision of treatment for alcohol problems in the United Kingdom

Bridging the impactibility gap in population health management: a systematic review

Objectives Assess whether impactibility modelling is being used to refine risk stratification for preventive health interventions. Design Systematic review. Setting Primary and secondary healthcare populations. Papers Articles published from 2010 to 2020 on the use or implementation of impactibility modelling in population health management, reported with the terms a € intervenability', a € amenability', and a € propensity to succeed' (PTS) and associated with the themes a € care sensitivity', a € characteristic responders', a € needs gap', a € case finding', a € patient selection' and a € risk stratification'. Interventions Qualitative synthesis to identify themes for approaches to impactibility modelling. Results Of 1244 records identified, 20 were eligible for inclusion. Identified themes were a € health conditions amenable to care' (n=6), a € PTS modelling' (n=8) and a € comparison or combination with clinical judgement' (n=6). For the theme a € health conditions amenable to care', changes in practice did not reduce admissions, particularly for ambulatory care sensitive conditions, and sometimes increased them, with implementation noted as a possible issue. For a € PTS modelling', high costs and needs did not necessarily equate to high impactibility and targeting a larger number of individuals with disorders associated with lower costs had more potential. PTS modelling seemed to improve accuracy in care planning, estimation of cost savings, engagement and/or care quality. The a € comparison or combination with clinical judgement' theme suggested that models can reach reasonable to good discriminatory power to detect impactable patients. For instance, a model used to identify patients appropriate for proactive multimorbid care management showed good concordance with physicians (c-statistic 0.75). Another model employing electronic health record scores reached 65% concordance with nurse and physician decisions when referring elderly hospitalised patients to a readmission prevention programme. However, healthcare professionals consider much wider information that might improve or impede the likelihood of treatment impact, suggesting that complementary use of models might be optimum. Conclusions The efficiency and equity of targeted preventive care guided by risk stratification could be augmented and personalised by impactibility modelling

Healthcare providers' views on the acceptability of financial incentives for breastfeeding:a qualitative study

BACKGROUND: Despite a gradual increase in breastfeeding rates, overall in the UK there are wide variations, with a trend towards breastfeeding rates at 6–8 weeks remaining below 40% in less affluent areas. While financial incentives have been used with varying success to encourage positive health related behaviour change, there is little research on their use in encouraging breastfeeding. In this paper, we report on healthcare providers’ views around whether using financial incentives in areas with low breastfeeding rates would be acceptable in principle. This research was part of a larger project looking at the development and feasibility testing of a financial incentive scheme for breastfeeding in preparation for a cluster randomised controlled trial. METHODS: Fifty–three healthcare providers were interviewed about their views on financial incentives for breastfeeding. Participants were purposively sampled to include a wide range of experience and roles associated with supporting mothers with infant feeding. Semi-structured individual and group interviews were conducted. Data were analysed thematically drawing on the principles of Framework Analysis. RESULTS: The key theme emerging from healthcare providers’ views on the acceptability of financial incentives for breastfeeding was their possible impact on ‘facilitating or impeding relationships’. Within this theme several additional aspects were discussed: the mother’s relationship with her healthcare provider and services, with her baby and her family, and with the wider community. In addition, a key priority for healthcare providers was that an incentive scheme should not impact negatively on their professional integrity and responsibility towards women. CONCLUSION: Healthcare providers believe that financial incentives could have both positive and negative impacts on a mother’s relationship with her family, baby and healthcare provider. When designing a financial incentive scheme we must take care to minimise the potential negative impacts that have been highlighted, while at the same time recognising the potential positive impacts for women in areas where breastfeeding rates are low

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Arteriopathy diagnosis in childhood arterial ischemic stroke: results of the vascular effects of infection in pediatric stroke study.

Background and purposeAlthough arteriopathies are the most common cause of childhood arterial ischemic stroke, and the strongest predictor of recurrent stroke, they are difficult to diagnose. We studied the role of clinical data and follow-up imaging in diagnosing cerebral and cervical arteriopathy in children with arterial ischemic stroke.MethodsVascular effects of infection in pediatric stroke, an international prospective study, enrolled 355 cases of arterial ischemic stroke (age, 29 days to 18 years) at 39 centers. A neuroradiologist and stroke neurologist independently reviewed vascular imaging of the brain (mandatory for inclusion) and neck to establish a diagnosis of arteriopathy (definite, possible, or absent) in 3 steps: (1) baseline imaging alone; (2) plus clinical data; (3) plus follow-up imaging. A 4-person committee, including a second neuroradiologist and stroke neurologist, adjudicated disagreements. Using the final diagnosis as the gold standard, we calculated the sensitivity and specificity of each step.ResultsCases were aged median 7.6 years (interquartile range, 2.8-14 years); 56% boys. The majority (52%) was previously healthy; 41% had follow-up vascular imaging. Only 56 (16%) required adjudication. The gold standard diagnosis was definite arteriopathy in 127 (36%), possible in 34 (9.6%), and absent in 194 (55%). Sensitivity was 79% at step 1, 90% at step 2, and 94% at step 3; specificity was high throughout (99%, 100%, and 100%), as was agreement between reviewers (κ=0.77, 0.81, and 0.78).ConclusionsClinical data and follow-up imaging help, yet uncertainty in the diagnosis of childhood arteriopathy remains. This presents a challenge to better understanding the mechanisms underlying these arteriopathies and designing strategies for prevention of childhood arterial ischemic stroke