How People Experience the Hospital to Home Project

Many individuals who experience chronic homelessness with complex medical and mental health issues use the Emergency Room often. A new program called the Hospital to Home Program (HHP) has been created for people who have at least one chronic health condition, have been to the emergency room five or more times in the previous year, and have a history of chronic homelessness. This qualitative research project sought to explore the participant’s experiences of the HHP as there has been no qualitative research done with the program currently. Seven participants were asked open-ended questions to elicit responses about their quality of life being in the program, about their housing, and what Guild Incorporated has helped with. The findings indicate that the participants were all housed, they felt their overall quality of life was better, and they reported some of the barriers they previously faced and are currently facing. It was found that participants of the HHP enjoy being in the program and feel they have benefited greatly from the services

How People Experience the Hospital to Home Project

Many individuals who experience chronic homelessness with complex medical and mental health issues use the Emergency Room often. A new program called the Hospital to Home Program (HHP) has been created for people who have at least one chronic health condition, have been to the emergency room five or more times in the previous year, and have a history of chronic homelessness. This qualitative research project sought to explore the participant’s experiences of the HHP as there has been no qualitative research done with the program currently. Seven participants were asked open-ended questions to elicit responses about their quality of life being in the program, about their housing, and what Guild Incorporated has helped with. The findings indicate that the participants were all housed, they felt their overall quality of life was better, and they reported some of the barriers they previously faced and are currently facing. It was found that participants of the HHP enjoy being in the program and feel they have benefited greatly from the services

Characterization of the mouse KCNQ1OT1 noncoding RNA

For a small group of important developmental genes, there is preferential silencing of either the maternal or paternal allele. This process of preferential expression is called \u27genomic imprinting\u27. Imprinted genes often cluster in imprinted domains. Interestingly, many imprinting domains are associated with a non-coding RNA (ncRNA) that may regulate imprinted gene expression across the entire domain. Disruptions in imprinting can have severe consequences for growth and development. To understand the complex regulation of genomic imprinting, studies are required to determine how early embryos set up a hierarchy of events that will establish imprinting across large chromosomal domains. The goal of this project is to characterize the mouse Kcnq1ot1 ncRNA and its role in imprinted gene regulation. My findings indicate that the Kcnq1ot1 ncRNA terminates at 463 kb from the transcriptional start site, and that this length is conserved in various tissues and developmental stages. This extends the boundary between the Kcnq1ot1 and H19 domains, downstream of Th, between 464 and 617 kb. shRNA and siRNA depletion of the Kcnq1ot1 transcript at 43 kb and 460 kb, respectively, indicates that Kcnq1ot1 is one continuous transcript as opposed to having multiple start sites along the length. In addition, the Kcnq1ot1 transcript originates from the imprinting control region (ICR), as deletion of the paternal ICR, which contains the Kcnq1ot1 promoter, results in loss of amplification along the entire length of the transcript. To determine whether the Kcnq1ot1 ncRNA regulates domain-wide imprinting during early embryogenesis, RNA interference was employed to deplete Kcnq1ot1 in embryonic and extraembryonic stem cells. Loss of \u3e90% of the Kcnq1ot1 transcript had no effect on imprinted expression in the domain, nor on imprinted methylation at the Kcnq1ot1 ICR, suggesting that transcription itself may play a more important role than the transcript per se. Results from this study will lead to a better understanding of the role that long ncRNAs play in establishing and/or maintaining imprinted gene regulation across imprinting domains, as well as their role in human imprinted disorders

An Image-Based Tool to Examine Joint Congruency at the Elbow

Post-traumatic osteoarthritis commonly occurs as a result of a traumatic event to the articulation. Although the majority of this type of arthritis is preventable, the sequence and mechanism of the interaction between joint injury and the development of osteoarthritis (OA) is not well understood. It is hypothesized that alterations to the joint alignment can cause excessive and damaging wear to the cartilage surfaces resulting in OA. The lack of understanding of both the cause and progression of OA has contributed to the slow development of interventions which can modify the course of the disease. Currently, there have been no reported techniques that have been developed to examine the relationship between joint injury and joint alignment. Therefore, the objective of this thesis was to develop a non-invasive image-based technique that can be used to assess joint congruency and alignment of joints undergoing physiologic motion. An inter-bone distance algorithm was developed and validated to measure joint congruency at the ulnohumeral joint of the elbow. Subsequently, a registration algorithm was created and its accuracy was assessed. This registration algorithm registered 3D reconstructed bone models obtained using x-ray CT to motion capture data of cadaveric upper extremities undergoing simulated elbow flexion. In this way, the relative position and orientation of the 3D bone models could be visualized for any frame of motion. The effect of radial head arthroplasty was used to illustrate the utility of this technique. Once this registration was refined, the inter-bone distance algorithm was integrated to be able to visualize the joint congruency of the ulnohumeral joint undergoing simulated elbow flexion. The effect of collateral ligament repair was examined. This technique proved to be sensitive enough to detect large changes in joint congruency in spite of only small changes in the motion pathways of the ulnohumeral joint following simulated ligament repair. Efforts were also made in this thesis to translate this research into a clinical environment by examining CT scanning protocols that could reduce the amount of radiation exposure required to image patient’s joints. For this study, the glenohumeral joint of the shoulder was examined as this joint is particularly sensitive to potential harmful effects of radiation due to its proximity to highly radiosensitive organs. Using the CT scanning techniques examined in this thesis, the effective dose applied to the shoulder was reduced by almost 90% compared to standard clinical CT imaging. In summary, these studies introduced a technique that can be used to non-invasively and three-dimensionally examine joint congruency. The accuracy of this technique was assessed and its ability to predict regions of joint surface interactions was validated against a gold standard casting approach. Using the techniques developed in this thesis the complex relationship between injury, loading and mal-alignment as contributors to the development and progression of osteoarthritis in the upper extremity can be examined

The Structure of Citizen Bystander Offering Behaviors Immediately After the Boston Marathon Bombing

In April of 2013, two pressure cooker bombs detonated near the finish line of the Boston Marathon. The resulting crowdsourced criminal investigation has been subject to intense scrutiny. What has not been discussed are the offering behaviors of Twitter users immediately following the detonations. The hashtag #BostonHelp offers a case study of what emergent, computer-mediated groups offer victims of a crisis event. Through creative appropriation of at-hand technologies (CAAT), this emergent group organized online offering and information about tangible resources on the ground. In this case, #BostonHelp participants harnessed blogs, social media, Google Forms, and pre-existing services to organize help for those in need. The resulting structure stabilized and became a symbol of the response itself. This case study offers an analysis of the structure created by computer-mediated crowds. We conclude with a discussion of trying to design, or even detect these behaviors at the start of a crisis response

The Technology Crisis in US-based Emergency Management: Toward a Well-Connected Future

For many years, CI has tried to show the value of computational techniques for response to hazard events but has yet to see success outside of post-hoc analyses. Meanwhile, emergency management (EM) has been struggling to cope with the impact of computation. This duality wherein we know technology can be useful yet also complicates EM (and has not yet been fully integrated into EM) is what we dub the technology crisis in EM. To begin to address this crisis and revitalize CI, we argue that it is necessary to develop an inventory of what technologies EM is competent with and to design training that can extend that competency. This research reports a survey of EM Practitioners in the United States. We offer one of the first inventories of EM technologies and technological skills and identify how current EM technological integration issues are a crisis

An Anthropometric Assessment of the Proximal Hamate Autograft for Scaphoid Proximal Pole Reconstruction

© 2019 American Society for Surgery of the Hand Purpose: Fragmentation of the scaphoid proximal pole secondary to avascular necrosis presents a difficult reconstructive problem. This anthropometric study assesses the utility of the ipsilateral proximal hamate for complete osteochondral scaphoid proximal pole reconstruction. Methods: Twenty-nine cadaveric specimens underwent computed tomography scanning and 3-dimensional reconstruction of the carpus and distal radius. Scaphoid height was measured and a third of its height was used to simulate resection of the proximal scaphoid pole and extent of hamate autograft required. The proximal scaphoid and hamate were divided into 6 sections, and compared using an iterative point-to-point distance algorithm. Average distance between the scaphoid and the hamate surfaces was determined. An interbone algorithm was used to assess radioscaphoid joint congruency and articular contact surface of the native scaphoid compared with the scaphoid reconstructed with hamate autograft. Results: The mean height of scaphoid proximal pole excision and proximal hamate autograft height was 9.3 mm. Comparing the morphology of the native scaphoid and hamate autografts, the absolute distances were the largest in the volar radioscaphoid, dorsal radioscaphoid, and dorsal scaphocapitate segments. Without osteotomy, the hamate autograft may cause impaction in the dorsal-radial aspect of the distal radius. The hamate autograft also shifted the articular contact point of the radioscaphoid joint toward the dorsal-radial position. Nine hamate autografts were classified as poor-fitting. Poor-fitting specimens had a greater radial styloid to distal radioulnar joint distance. These specimens also had wider hamates and scaphoids in the radial-ulnar dimension and wider scaphoids in the volar-dorsal dimension. Lunate type did not correspond to anthropometric fit. Conclusions: The proximal hamate osteochondral graft was poor fitting in 31% of cases (9 of 29 specimens). Wrists with radial-ulnar hamate width less than 10 mm, radial-ulnar scaphoid width less than 10 mm, and volar-dorsal scaphoid width less than 16 mm demonstrate better anthropometric fit. Clinical relevance: This study provides an anthropometric assessment of the recently described proximal hamate autograft, a new bone graft option for proximal scaphoid pole reconstruction

Graduate Keynote. Golf Grip Force Evaluation in Individuals with and without Hand Arthritis Using a New Wearable Sensor Technology

BACKGROUND Hand osteoarthritis (H-OA) is the most common type of osteoarthritis largely affecting individuals over 45. H-OA involves pain, loss of grip strength and limiting participation in recreational activities such as golf. Currently, a number of ‘arthritic’ grips are designed using joint protection principles to ‘reduce hand forces and tight gripping’. However, no comprehensive examinations in their effectiveness have been conducted. HYPOTHESIS The purpose of this study is to systematically analyse the hand forces produced from various golf grips and arthritis grips at the distal-phalanges of the hand-grip interface in individuals with and without hand arthritis using new wearable sensor technology. METHODS The finger forces in the hand were measured using Pressure Profiles FingerTPS system for participant’s bottom gripping hand thumb, index, middle and ring fingers. The participants performed 3 golf shots using a real ball on artificial turf with 12, mid-iron clubs fitted with various types of standard and arthritis grips. RESULTS Preliminary results of 4 healthy participants demonstrated that serrated style golf grips designed for players with arthritis produced some of the highest forces. Also, players with larger hand length measures produce higher forces in smaller diameter grips and small hand length measures in larger diameter grips. DISCUSSION These preliminary results demonstrate the possibility that ‘arthritic’ golf grips are not appropriately designed for the given user along with the potential relationship between grip geometry and hand size to finger forces. In better understanding the mechanics of arthritis and its relation to sports, the design of more advanced sporting equipment can be developed

Making Maps Available for Play: Analyzing the Design of Game Cartography Interfaces.

Maps in video games have grown into complex interactive systems alongside video games themselves. What map systems have done and currently do have not been cataloged or evaluated. We trace the history of game map interfaces from their paper-based inspiration to their current smart phone-like appearance. Read- only map interfaces enable players to consume maps, which is sufficient for wayfinding. Game cartography interfaces enable players to persistently modify maps, expanding the range of activity to support planning and coordination. We employ thematic analysis on game cartography interfaces, contributing a near-exhaustive catalog of games featuring such interfaces, a set of properties to describe and design such interfaces, a collection of play activities that relate to cartography, and a framework to identify what properties promote the activities. We expect that designers will find the contributions enable them to promote desired play experiences through game map interface design