Improving patient and caregiver new medication education using an innovative teach-back toolkit

Background: Patients and caregivers are often not adequately informed about new medications. Nurses can lead innovations that improve new medication education. Local Problem: Healthcare Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores on medication questions trailed state and national levels in one Midwestern hospital. Methods: This quality improvement project, guided by the Ottawa Model of Research Use and the Always Use Teach-back! innovative toolkit, used a 1-group pre- and post education design with RNs, patients, and caregivers. Intervention: RNs (n = 25) were observed in patient/caregiver education and surveyed in confidence/conviction in the teach-back method before and after education. Patients’ (n = 74) and caregivers’ (n = 33) knowledge was assessed. Results: RNs reported significant increases in conviction in the importance of (P \u3c .0001), confidence in using (P \u3c .0001), and frequency in using (P \u3c .0001) teach-back. With teach-back, both patients and caregivers recalled the purpose and side effects of new medications. Specific HCAHPS scores increased from 6% to 10%. Conclusion: The teach-back method strengthened safe nursing practice and enhanced quality in new medication education

Shear bands in granular flow through a mixing length model

We discuss the advantages and results of using a mixing-length, compressible model to account for shear banding behaviour in granular flow. We formulate a general approach based on two function of the solid fraction to be determined. Studying the vertical chute flow, we show that shear band thickness is always independent from flowrate in the quasistatic limit, for Coulomb wall boundary conditions. The effect of bin width is addressed using the functions developed by Pouliquen and coworkers, predicting a linear dependence of shear band thickness by channel width, while literature reports contrasting data. We also discuss the influence of wall roughness on shear bands. Through a Coulomb wall friction criterion we show that our model correctly predicts the effect of increasing wall roughness on the thickness of shear bands. Then a simple mixing-length approach to steady granular flows can be useful and representative of a number of original features of granular flow.Comment: submitted to EP

Water footprint analysis for the assessment of milk production in Brandenburg (Germany)

The working group "Adaptation to Climate Change" at the Leibniz-Institute for Agricultural Engineering Potsdam-Bornim (ATB) is introduced. This group calculates the water footprint for agricultural processes and farms, distinguished into green water footprint, blue water footprint, and dilution water footprint. The green and blue water demand of a dairy farm plays a pivotal role in the regional water balance. Considering already existing and forthcoming climate change effects there is a need to determine the water cycle in the field and in housing for process chain optimisation for the adaptation to an expected increasing water scarcity. Resulting investments to boost water productivity and to improve water use efficiency in milk production are two pathways to adapt to climate change effects. In this paper the calculation of blue water demand for dairy farming in Brandenburg (Germany) is presented. The water used for feeding, milk processing, and servicing of cows over the time period of ten years was assessed in our study. The preliminary results of the calculation of the direct blue water footprint shows a decreasing water demand in the dairy production from the year 1999 with 5.98×109 L/yr to a water demand of 5.00×109 L/yr in the year 2008 in Brandenburg because of decreasing animal numbers and an improved average milk yield per cow. Improved feeding practices and shifted breeding to greater-volume producing Holstein-Friesian cow allow the production of milk in a more water sustainable way. The mean blue water consumption for the production of 1 kg milk in the time period between 1999 to 2008 was 3.94±0.29 L. The main part of the consumed water seems to stem from indirect used green water for the production of feed for the cows

Impact of social networks, mental health, and sobriety on exercise within a collegiate recovery community

Exercise is especially beneficial for individuals recovering from addiction. In addition to improved physical, emotional, and mental health, exercise is linked to long-term recovery for those overcoming addiction. With nearly 10% of college students in recovery, and many utilizing campus resources such as collegiate recovery communities (CRCs) to support their recovery, it is important to understand the relationship between exercise and the recovery process among college students. The purpose of this study was to use social network analysis and theory to understand exercise behaviors among a group of college students in recovery. The relationship between exercise and sobriety, mental health variables, and social connections was examined among a network of students involved in a CRC. Of the 50 students involved in this network, 40 participated in the study (80% response rate). Logistic regression analysis revealed a significant model (R2 = .598, p \u3c .0001) predicting whether CRC members exercised enough to yield health benefits. Length of sobriety, higher stress, lower depression, having fewer network ties, and being connected directly to others exercising regularly were significant predictor variables in the model. This study supports the relationship between sobriety and exercise, as well as an association between network connections and exercise behaviors. Incorporating exercise opportunities as part of CRC programming to help students stay sober, as well as identifying key target points for intervention within similar groups of students, could be useful in future practice

Relationships Between Self-regulation and use of Parenting Strategies for Eating and Physical Activity Behaviors Among Mexican-Heritage Mothers

It is important to understand theoretically based support behaviors that can promote healthy eating and active living among Mexican-heritage mothers. This study examined the relationship between maternal self-regulation (the capacity to plan, guide, and monitor one’s behavior flexibly in the face of changing circumstances) and use of parenting strategies among mothers residing along the Texas-Mexico border. Mothers (n = 116) were recruited from three geographic regions within Hidalgo County, Texas. A 21-item survey was administered to measure self-regulation through goal setting and limit setting. The Parenting Strategies for Eating and Activity Scale (PEAS) was used to measure parenting strategies such as limit setting, discipline, monitoring, and control. Pearson correlations and multiple linear regression analyses were used to identify relationships between self-regulation (goal setting and impulse control) and parenting strategies. Sociodemographic characteristics of mothers are also reported. On average mothers were 36 years old (SD = 7.44), married (82%), identified as Mexican (90%), and had fewer than 9 years of education (68%). Pearson correlations revealed goal setting to be positively associated with limit setting (r = .246, p \u3c .001), control (r = .203, p = .03), and monitoring (r = .336, p \u3c .001). Regression analyses revealed limit setting (β = .246, p \u3c .001), control (β = .203, p = .03), and monitoring (β = .336, p \u3c .001) as parenting strategies that were associated with goal setting (R2 = 0.12). Findings suggest that programs should include goal setting to facilitate use of parenting strategies to support healthy behaviors that promote healthy eating and physical activity. Emphasizing malleable behaviors rather than deficits in parenting strategies could allow for higher receptivity to behaviors that can promote health in a family context

Calibration of centre-of-mass energies at LEP 2 for a precise measurement of the W boson mass

The determination of the centre-of-mass energies for all LEP 2 running is presented. Accurate knowledge of these energies is of primary importance to set the absolute energy scale for the measurement of the W boson mass. The beam energy between 80 and 104 GeV is derived from continuous measurements of the magnetic bending field by 16 NMR probes situated in a number of the LEP dipoles. The relationship between the fields measured by the probes and the beam energy is defined in the NMR model, which is calibrated against precise measurements of the average beam energy between 41 and 61 GeV made using the resonant depolarisation technique. The validity of the NMR model is verified by three independent methods: the flux-loop, which is sensitive to the bending field of all the dipoles of LEP; the spectrometer, which determines the energy through measurements of the deflection of the beam in a magnet of known integrated field; and an analysis of the variation of the synchrotron tune with the total RF voltage. To obtain the centre-of-mass energies, corrections are then applied to account for sources of bending field external to the dipoles, and variations in the local beam energy at each interaction point. The relative error on the centre-of-mass energy determination for the majority of LEP 2 running is 1.2 x 10^{-4}, which is sufficiently precise so as not to introduce a dominant uncertainty on the W mass measurement.Comment: 79 pages, 45 figures, submitted to EPJ

Determination of the Accuracy of Wire Position Sensors

An energy spectrometer has been installed in the LEP accelerator to determine the beam energy with a relative accuracy of 10-4. A precisely calibrated bending magnet is flanked by 6 beam position monitors (BPM). The beam energy is determined by measuring the deflection angle of the LEP beams and the integrated bending field. An accuracy of less than 10-6 m on the beam position is necessary to reach the desired accuracy on the LEP beam energy. Capacitive wire positioning sensors are used to determine the relative mounting stability of each BPM and to calibrate the beam position monitors. Two-dimensional sensors are attached to each side of every BPM support and provide a position measurement with respect to two stretched wires mounted on either side of the LEP beam pipe. The fixing points of each wire are monitored by additional reference sensors. The position information is digitised via a multiplexed high accuracy digital voltmeter and read out continuously during LEP operations. Wire position sensor accuracy was tested in the laboratory with a laser interferometer, while relative accuracy tests are performed in the LEP environment. Systematic effects of synchrotron radiation on the wire position sensor performance were studied

Modeling the water demand on farms

The decreasing availability of water caused by depletion and climate change combined with a growing world population requires the productive use of water now and in the future. The young researcher group "AgroHyd" at the Leibniz-Institute for Agricultural Engineering Potsdam-Bornim (ATB) is currently modeling the water demand for agricultural processes at the farm scale and developing indicators to link the hydrological and agricultural perspectives. The aim of the group is to increase productivity in agriculture by raising water productivity in plant production and livestock farming. The effects of various agronomic measures, individual and in combination, on water productivity are assessed using several indicators. Scenarios of agricultural measures, climate and diets are used to test to what extent the water demand for food production will increase due to growing global change in different regions of the world

Protein retention on plasma-treated hierarchical nanoscale gold-silver platform

Dense arrays of gold-supported silver nanowires of about 100 nm in diameter grown directly in the channels of nanoporous aluminium oxide membrane were fabricated and tested as a novel platform for the immobilization and retention of BSA proteins in the microbial-protective environments. Additional treatment of the silver nanowires using low-temperature plasmas in the inductively-coupled plasma reactor and an atmospheric-pressure plasma jet have demonstrated that the morphology of the nanowire array can be controlled and the amount of the retained protein may be increased due to the plasma effect. A combination of the neutral gold sublayer with the antimicrobial properties of silver nanowires could significantly enhance the efficiency of the platforms used in various biotechnological processes

The effects of plasma treatment on bacterial biofilm formation on vertically-aligned carbon nanotube arrays

© The Royal Society of Chemistry 2015. Carbon nanotubes (CNTs) can be fabricated with an ordered microstructure by controlling their growth process. Unlike dispersed carbon nanotubes, these vertically-aligned arrays have the ability to support or inhibit bacteria biofilms. Here, we show that by treating the carbon nanotube arrays with plasma, different effects on biofilms of Gram-positive (Bacillus subtilis, Staphylococcus epidermidis) and Gram-negative bacteria (Escherichia coli, Pseudomonas aeruginosa) can be observed