Post-Discharge Nutrition Care Instructions for Malnourished Adults

Malnutrition remains an insidious yet common ailment among hospitalized adults, with prevalence estimates ranging from 4-45%. Multiple studies confirm the adverse effects of malnutrition, which include prolonged length of stay, readmissions, higher hospitalization costs, and mortality. Malnutrition is frequently associated with chronic disease. For nutrition interventions to be successful, they must continue to support the long-term nutritional needs of patients beyond the hospital stay. Few studies, however, examine the receipt of recommendations for oral nutrition supplementation (ONS) or basic nutrition care instructions at the time of discharge. There is a need to better understand what post-discharge nutrition care instructions are documented in the electronic medical record (EMR) and how they are communicated to patients once they leave the hospital. This study sought to describe the malnourished adult patient population and the standard of nutrition-focused discharge care they receive at Christiana Hospital in Newark, DE. The investigation revealed that a majority of these patients received inappropriate or inadequate nutrition care instructions at time of discharge. Preliminary survey data suggest that some patients may be unaware of their malnutrition diagnosis, and may receive care instructions that are never documented. Clinician education and redesign of nutrition care options in the EMR may aid in the provision of discharge instructions to treat and prevent malnutrition after patients leave the hospital

A transparent 3D printed device for assembling droplet hydrogel bilayers (DHBs)

We report a new approach for assembling droplet hydrogel bilayers (DHBs) using a transparent 3D printed device. We characterise the transparency of our platform, confirm bilayer formation using electrical measurements and show that single-channel recordings can be obtained using our reusable rapid prototyped device. This method significantly reduces the cost and infrastructure required to develop devices for DHB assembly and downstream study

Optically assembled droplet interface bilayer (OptiDIB) networks from cell-sized microdroplets

We report a new platform technology to systematically assemble droplet interface bilayer (DIB) networks in user-defined 3D architectures from cell-sized droplets using optical tweezers. Our OptiDIB platform is the first demonstration of optical trapping to precisely construct 3D DIB networks, paving the way for the development of a new generation of modular bio-systems

A Model Description for the Transition from Multiprofessional to Interprofessional Courses

Transitioning from multiprofessional to interprofessional courses requires a commitment on behalf of the faculty of the programs represented within these courses. Through the development of advisory committees, creation and implementation of curricula, obtainment of pre- and post-test data and course evaluations this transition can be achieved. The Pathologists’ Assistant Department at Rosalind Franklin University of Medicine and Science is currently involved in a transition of many of its students’ courses from multiprofessional to interprofessional; one such example is the Neuroscience course which combines Pathologists’ Assistant, Physical Therapy, and Podiatry students. This transition includes the formation of an advisory group, review of course objectives, participation by faculty from each program represented in the course, the collaborative development of syllabi and exams, having students work in interprofessional teams analyzing case studies relevant to each profession, and involvement in a demonstration laboratory. This presentation will focus on our model currently being used atRosalindFranklinUniversityin transitioning from multiprofessional to interprofessional courses. We will discuss our successes and also the challenges we face in this transition process. Learning Objectives: At the end of this session, participants will: 1. Discuss the components involved in transitioning from multiprofessional to interprofessional courses. 2. Identify potential barriers in the transition process

Investigating the missing data mechanism in quality of life outcomes: a comparison of approaches

Background: Missing data is classified as missing completely at random (MCAR), missing at random (MAR) or missing not at random (MNAR). Knowing the mechanism is useful in identifying the most appropriate analysis. The first aim was to compare different methods for identifying this missing data mechanism to determine if they gave consistent conclusions. Secondly, to investigate whether the reminder-response data can be utilised to help identify the missing data mechanism. Methods: Five clinical trial datasets that employed a reminder system at follow-up were used. Some quality of life questionnaires were initially missing, but later recovered through reminders. Four methods of determining the missing data mechanism were applied. Two response data scenarios were considered. Firstly, immediate data only; secondly, all observed responses (including reminder-response). Results: In three of five trials the hypothesis tests found evidence against the MCAR assumption. Logistic regression suggested MAR, but was able to use the reminder-collected data to highlight potential MNAR data in two trials. Conclusion: The four methods were consistent in determining the missingness mechanism. One hypothesis test was preferred as it is applicable with intermittent missingness. Some inconsistencies between the two data scenarios were found. Ignoring the reminder data could potentially give a distorted view of the missingness mechanism. Utilising reminder data allowed the possibility of MNAR to be considered.The Chief Scientist Office of the Scottish Government Health Directorate. Research Training Fellowship (CZF/1/31

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A Transdisciplinary Approach to Eliminate Cancer Disparities: An Overview of Community Engagement and Outreach Efforts in an National Institute of Health Center for Excellence

Creating health equity and eliminating health disparities are considered national priorities for improving the health of Americans (U.S. Department of Health and Human Services, n.d.). Health disparities are a primary public health concern, yet are complex phenomena and challenging to research (Harper & Lynch, 2005). The National Institute on Minority Health and Health Disparities (NIMHD), under the National Institute of Health (NIH), is committed to finding solutions to achieve this goal through the creation of interdisciplinary Centers of Excellence. In 2009, the University of South Florida (USF) and Moffitt Cancer Center (Moffitt) received a NIMHD Exploratory Center of Excellence award to collaboratively create the Center for Equal Health (CEH). The Center for Equal Health investigates cancer health disparities, their origins, and potential solutions for the reduction and ultimate elimination of health inequities among racial/ethnic minorities and the medically underserved. Currently in its fourth year, the purpose of the center is to utilize a transdisciplinary approach (basic, clinical, and population sciences) to develop novel interventions and solutions for the reduction and elimination of cancer health disparities among minority and underserved communities in Florida through science, practice, and policy. Specifically, the center’s vision is to achieve health equity in the community through cancer research, education, and training. To fulfill this vision, CEH is organized into four cores: 1) Administration, 2) Research, 3) Research, Training, and Education, and 4) Community Engagement and Outreach. This paper specifically describes the community-based education and training initiatives, specifically the Community Health Worker training, talking circles, science tours, community research council, and podcasts/media outreach, of the Community Engagement and Outreach Core (CEOC). The processes of the activities of the CEOC and lessons learned are highlighted with the primary goal of sharing a successful model of community engagement

Sampling-based Algorithms for Optimal Motion Planning

During the last decade, sampling-based path planning algorithms, such as Probabilistic RoadMaps (PRM) and Rapidly-exploring Random Trees (RRT), have been shown to work well in practice and possess theoretical guarantees such as probabilistic completeness. However, little effort has been devoted to the formal analysis of the quality of the solution returned by such algorithms, e.g., as a function of the number of samples. The purpose of this paper is to fill this gap, by rigorously analyzing the asymptotic behavior of the cost of the solution returned by stochastic sampling-based algorithms as the number of samples increases. A number of negative results are provided, characterizing existing algorithms, e.g., showing that, under mild technical conditions, the cost of the solution returned by broadly used sampling-based algorithms converges almost surely to a non-optimal value. The main contribution of the paper is the introduction of new algorithms, namely, PRM* and RRT*, which are provably asymptotically optimal, i.e., such that the cost of the returned solution converges almost surely to the optimum. Moreover, it is shown that the computational complexity of the new algorithms is within a constant factor of that of their probabilistically complete (but not asymptotically optimal) counterparts. The analysis in this paper hinges on novel connections between stochastic sampling-based path planning algorithms and the theory of random geometric graphs.Comment: 76 pages, 26 figures, to appear in International Journal of Robotics Researc

Designing an information system for updating land records in Bangladesh: action design ethnographic research (ADER)

Open Access. This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.This article has been made available through the Brunel Open Access Publishing Fund.Information Systems (IS) has developed through adapting, generating and applying diverse methodologies, methods, and techniques from reference disciplines. Further, Action Design Research (ADR) has recently developed as a broad research method that focuses on designing and redesigning IT and IS in organizational contexts. This paper reflects on applying ADR in a complex organizational context in a developing country. It shows that ADR requires additional lens for designing IS in such a complex organizational context. Through conducting ADR, it is seen that an ethnographic framework has potential complementarities for understanding complex contexts thereby enhancing the ADR processes. This paper argues that conducting ADR with an ethnographic approach enhances design of IS and organizational contexts. Finally, this paper aims presents a broader methodological framework, Action Design Ethnographic Research (ADER), for designing artefacts as well as IS. This is illustrated through the case of a land records updating service in Bangladesh

How acceptable are antiretrovirals for the prevention of sexually transmitted HIV? A review of research on the acceptability of oral pre-exposure prophylaxis and treatment as prevention

Recent research has demonstrated how antiretrovirals (ARVs) could be effective in the prevention of sexually transmitted HIV. We review research on the acceptability of oral pre-exposure prophylaxis (PrEP) and treatment as prevention (TasP) for HIV prevention amongst potential users. We consider with whom, where and in what context this research has been conducted, how acceptability has been approached, and what research gaps remain. Findings from 33 studies show a lack of TasP research, PrEP studies which have focused largely on men who have sex with men (MSM) in a US context, and varied measures of acceptability. In order to identify when, where and for whom PrEP and TasP would be most appropriate and effective, research is needed in five areas: acceptability of TasP to people living with HIV; motivation for PrEP use and adherence; current perceptions and management of risk; the impact of broader social and structural factors; and consistent definition and operationalisation of acceptability which moves beyond adherence