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

Theory of imaging a photonic crystal with transmission near-field optical microscopy

While near-field scanning optical microscopy (NSOM) can provide optical images with resolution much better than the diffraction limit, analysis and interpretation of these images is often difficult. We present a theory of imaging with transmission NSOM that includes the effects of tip field, tip/sample coupling, light propagation through the sample and light collection. We apply this theory to analyze experimental NSOM images of a nanochannel glass (NCG) array obtained in transmission mode. The NCG is a triangular array of dielectric rods in a dielectric glass matrix with a two-dimensional photonic band structure. We determine the modes for the NCG photonic crystal and simulate the observed data. The calculations show large contrast at low numerical aperture (NA) of the collection optics and detailed structure at high NA consistent with the observed images. We present calculations as a function of NA to identify how the NCG photonic modes contribute to and determine the spatial structure in these images. Calculations are presented as a function of tip/sample position, sample index contrast and geometry, and aperture size to identify the factors that determine image formation with transmission NSOM in this experiment.Comment: 28 pages of ReVTex, 14 ps figures, submitted to Phys. Rev.

Formation of plasma around a small meteoroid: 1. Kinetic theory

This article is a companion to Dimant and Oppenheim [2017] https://doi.org/10.1002/2017JA023963.This paper calculates the spatial distribution of the plasma responsible for radar head echoes by applying the kinetic theory developed in the companion paper. This results in a set of analytic expressions for the plasma density as a function of distance from the meteoroid. It shows that at distances less than a collisional mean free path from the meteoroid surface, the plasma density drops in proportion to 1/R where R is the distance from the meteoroid center; and, at distances much longer than the mean‐free‐path behind the meteoroid, the density diminishes at a rate proportional to 1/R2. The results of this paper should be used for modeling and analysis of radar head echoes.This work was supported by NSF grant AGS-1244842. (AGS-1244842 - NSF

Spin-exchange relaxation free magnetometry with Cs vapor

We describe a Cs atomic magnetometer operating in the spin-exchange relaxation-free (SERF) regime. With a vapor cell temperature of $103^\circ\rm{C}$ we achieve intrinsic magnetic resonance widths $\Delta B=17 {\rm \mu G}$ corresponding to an electron spin-relaxation rate of $300 {\rm s^{-1}}$ when the spin-exchange rate is $\Gamma_{SE}=14000 {\rm s^{-1}}$. We also observe an interesting narrowing effect due to diffusion. Signal-to-noise measurements yield a sensitivity of about $400\thinspace{\rm pG/\sqrt{Hz}}$. Based on photon shot noise, we project a sensitivity of $40 {\rm pG/\sqrt{Hz}}$. A theoretical optimization of the magnetometer indicates sensitivities on the order of $2 {\rm pG/\sqrt{Hz}}$ should be achievable in a $1 {\rm cm^3}$ volume. Because Cs has a higher saturated vapor pressure than other alkali metals, SERF magnetometers using Cs atoms are particularly attractive in applications requiring lower temperatures.Comment: 8 pages, 6 figures. submitted to PR

Perceived protein needs and measured protein intake in collegiate male athletes: an observational study

<p>Abstract</p> <p>Background</p> <p>Protein needs for athletes are likely higher than those for the general population. However, athletes may perceive their protein needs to be excessively high. The purpose of this research was to compare collegiate athletes' perceived protein needs and measured protein intake to the recommended protein intake (RDI) for healthy adults (i.e. 0.8 g/kg/d) and to the maximum beneficial level for strength-trained athletes (i.e. 2.0 g/kg/day).</p> <p>Methods</p> <p>Perceived protein needs were quantified in 42 strength-trained collegiate male athletes by using a survey that asked the athletes to provide their perception about protein needs in specific quantitative terms (i.e. g/kg/d). Perceived protein needs were also determined by having the athletes select a daylong menu that they perceived to have adequate protein content from a collection of 5 isoenergetic menus, which differed in terms of protein content. Actual protein intake was quantified using 3-day food records and nutrient analysis. Single sample t-tests were used to compare protein intake and perceived protein needs to 0.8 g/kg/day and 2.0 g/kg/day.</p> <p>Results</p> <p>When asked to provide, in quantitative terms, protein needs for athletes, 67% of the athletes indicated "do not know." Of the remaining 33% of athletes, all gave values greater than 2.0 g/kg/d (mean 21.5 ± 11.2 g/kg/d, p = 0.14 vs. 2.0 g/kg/d). Based on the menu selection method for determining perceived protein needs, the athletes indicated that their protein needs were 2.4 ± 0.2 g/kg/d, which was greater than the RDI for protein (p < 0.0001) and tended to be greater than the maximally beneficial protein intake of 2.0 g/kg/d (p = 0.13). Measured protein intake was 2.0 ± 0.1 g/kg/d, which was greater than the RDI (p < 0.0001) but not different from the maximally beneficial protein intake of 2.0 g/kg/d (p = 0.84).</p> <p>Conclusions</p> <p>Male collegiate athletes recognize that their protein needs are higher than that of the general population and consume significantly more protein than recommended in the RDI. However, it also appears that athletes are not aware of objective recommendations for protein intake and may perceive their needs to be excessively high. This study highlights the need for nutrition education in collegiate athletes, in particular nutrition education on macronutrient distribution and protein needs.</p

Inelastic scattering of broadband electron wave packets driven by an intense mid-infrared laser field

Intense, 100 fs laser pulses at 3.2 and 3.6 um are used to generate, by multi-photon ionization, broadband wave packets with up to 400 eV of kinetic energy and charge states up to Xe+6. The multiple ionization pathways are well described by a white electron wave packet and field-free inelastic cross sections, averaged over the intensity-dependent energy distribution for (e,ne) electron impact ionization. The analysis also suggests a contribution from a 4d core excitation in xenon

Gain limits of a Thick GEM in high-purity Ne, Ar and Xe

The dependence of the avalanche charge gain in Thick Gas Electron Multipliers (THGEM) on the purity of Ne, Ar and Xe filling gases was investigated. The gain, measured with alpha-particles in standard conditions (atmospheric pressure, room temperature), was found to considerably drop in gases purified by non-evaporable getters. On the other hand, small N2 admixtures to noble gases resulted in high reachable gains. The results are of general relevance in the operation of gas-avalanche detectors in noble gases, particularly that of two-phase cryogenic detectors for rare events.Comment: 15 pages, 6 figures, submitted to JINS

Oratory

The crafting of persuasive appeals that finds its conditions of possibility in and has the capacity to exceed the context of its production. Sophistic oratory can be read as both a symptom of and a cha llenge to the socioeconomic, politica l, and cu ltural climate of ancient Greece. Emerging out of a society destab ilized by the precarious movement from fragmentation and tyrannical rule toward unification and democracy, sophistic oratory was a force of transformation within the polis. Anticipating the Aristotelian division of rhetoric into forensic, deliberative, and epideictic types, sophistic oratory played an active ro le in the reclamation of property lost in tyrannical rule, the instruction of proper citizenry and just govern ance, and the inculcation of va lues through the praise and blame of prominent figures