Local interaction Strategies and Capacity for Better Care in Nursing Homes: A Multiple Case Study

To describe relationship patterns and management practices in nursing homes (NHs) that facilitate or pose barriers to better outcomes for residents and staff. Methods: We conducted comparative, multiple-case studies in selected NHs (N = 4). Data were collected over six months from managers and staff (N = 406), using direct observations, interviews, and document reviews. Manifest content analysis was used to identify and explore patterns within and between cases. Results: Participants described interaction strategies that they explained could either degrade or enhance their capacity to achieve better outcomes for residents; people in all job categories used these 'local interaction strategies'. We categorized these two sets of local interaction strategies as the 'common pattern' and the 'positive pattern' and summarize the results in two models of local interaction. Conclusions: The findings suggest the hypothesis that when staff members in NHs use the set of positive local interaction strategies, they promote inter-connections, information exchange, and diversity of cognitive schema in problem solving that, in turn, create the capacity for delivering better resident care. We propose that these positive local interaction strategies are a critical driver of care quality in NHs. Our hypothesis implies that, while staffing levels and skill mix are important factors for care quality, improvement would be difficult to achieve if staff members are not engaged with each other in these ways.National Institutes of Health 2 R01NR003178-04A2Claude A. Pepper Older American's Independence Center AG-11268Paul A. Beeson Award NIA AG024787VA Health Services Research and Development EDU 08-417John A. Hartford Building Academic Geriatric Nursing Claire M. Fagin FellowshipBusiness Administratio

AIRE expands: new roles in immune tolerance and beyond

More than 15 years ago, mutations in the autoimmune regulator (AIRE) gene were identified as the cause of autoimmune polyglandular syndrome type 1 (APS1). It is now clear that this transcription factor has a crucial role in promoting self-tolerance in the thymus by regulating the expression of a wide array of self-antigens that have the commonality of being tissue-restricted in their expression pattern in the periphery. In this Review, we highlight many of the recent advances in our understanding of the complex biology that is related to AIRE, with a particular focus on advances in genetics, molecular interactions and the effect of AIRE on thymic selection of regulatory T cells. Furthermore, we highlight new areas of biology that are potentially affected by this key regulator of immune tolerance

Research reports: 1990 NASA/ASEE Summer Faculty Fellowship Program

A collection of technical reports on research conducted by the participants in this program is presented. The topics covered include: human-computer interface software, multimode fiber optic communication links, electrochemical impedance spectroscopy, rocket-triggered lightning, robotics, a flammability study of thin polymeric film materials, a vortex shedding flowmeter, modeling of flow systems, monomethyl hydrazine vapor detection, a rocket noise filter system using digital filters, computer programs, lower body negative pressure, closed ecological systems, and others. Several reports with respect to space shuttle orbiters are presented

Photoluminescence modification by high-order photonic band with abnormal dispersion in ZnO inverse opal

We measured the angle- and polarization-resolved reflection and photoluminescence spectra of ZnO inverse opals. Significant enhancement of spontaneous emission is observed. The enhanced emission not only has good directionality but also can be linearly polarized. A detailed theoretical analysis and numerical simulation reveal that such enhancement is caused by the abnormal dispersion of a high-order photonic band. The frozen mode at a stationary inflection point of a dispersion curve can strongly modify the intensity, directionality and polarization of spontaneous emission.Comment: 22 pages, 11 figures, figures modified, references added, more explanation adde