Improving safety in care homes:protocol for evaluation of the Walsall and Wolverhampton care home improvement programme

Abstract Background Improving safety in care homes is becoming increasingly important. Care home residents typically have multiple physical and/or cognitive impairments, and adverse events like falls often lead to hospital attendance or admission. Developing a safety culture is associated with beneficial impacts on safety outcomes, but the complex needs of care home residents, coupled with staffing pressures in the sector, pose challenges for positive safety practices to become embedded at the individual and organisational levels. Staff training and education can positively enforce safety culture and reduce the incidence of harms, but improvement initiatives are often short lived and thorough evaluation is uncommon. This protocol outlines an evaluation of a large-scale care home improvement programme in the West Midlands. Methods The programme will run in 35 care homes across Walsall and Wolverhampton over 24\ua0months, and we anticipate that 30 care homes will participate in the evaluation ( n \u2009=\u20091500 staff). The programme will train staff and managers in service improvement techniques, with the aim of strengthening safety culture and reducing adverse safety event rates. The evaluation will use a pre-post design with mixed methods. Quantitative data will focus on: care home manager and staff surveys administered at several time points and analysis of adverse event rates. Data on hospital activity by residents at participating care homes will be compared to matched controls. Qualitative data on experience of training and the application of learning to practice will be collected via semi-structured interviews with staff ( n \u2009=\u200948 to 64) and programme facilitators ( n \u2009=\u20096), and staff focus groups ( n \u2009=\u200936 to 48 staff). The primary outcome measure is the change in mean score on the safety climate domain of the Safety Attitudes Questionnaire between baseline and programme end. Discussion This mixed methods evaluation of a large-scale care home improvement programme will allow a substantial amount of qualitative and quantitative data to be collected. This will enable an assessment of the extent to which care home staff training can effectively improve safety culture, lower the incidence of adverse safety events such as falls and pressure ulcers, and potentially reduce care home resident\u2019s use of acute services

Construction of a Tn5 mutant library in Xanthomonas cucurbitae

The health and yield of important crop plants around the world is a significant concern when faced with food scarcity in the generations to come. The Xanthomonas bacterial genus can infect more than 400 different plant species including economically important crops such as rice and soy. In Illinois, Xanthomonas cucurbitae can infect pumpkin and winter squash and cause bacterial spot disease (Figure 1) resulting in up to 100% yield loss of pumpkin crops. The disease caused by this pathogen has become one of the most significant threats to production of pumpkins in Illinois, the U.S. and the world. There are several known virulence factors in the Xanthomonas genus that induce pathogenic response in host plants. These include the hypersensitive response and pathogenicity (hrp) gene cluster and quorum-sensing (QS) pathways. Much of the genome of X. cucurbitae, however, is unknown. We aim to identify and understand the function of novel virulence genes in the X. cucurbitae genome by generating a transposonmediated mutant library and analyzing mutants for genes involved in QS response and hrp activity by using a reporter plasmid to allow for screening of the transposon’s effects

Model-Based Inverse Reinforcement Learning from Visual Demonstrations

Scaling model-based inverse reinforcement learning (IRL) to real robotic manipulation tasks with unknown dynamics remains an open problem. The key challenges lie in learning good dynamics models, developing algorithms that scale to high-dimensional state-spaces and being able to learn from both visual and proprioceptive demonstrations. In this work, we present a gradient-based inverse reinforcement learning framework that utilizes a pre-trained visual dynamics model to learn cost functions when given only visual human demonstrations. The learned cost functions are then used to reproduce the demonstrated behavior via visual model predictive control. We evaluate our framework on hardware on two basic object manipulation tasks.Comment: Accepted at the 4th Conference on Robotic Learning (CoRL 2020), Cambridge MA, US

Dietary Regimens Modify Early Onset of Obesity in Mice Haploinsufficient for Rai1

Smith-Magenis syndrome is a complex genomic disorder in which a majority of individuals are obese by adolescence. While an interstitial deletion of chromosome 17p11.2 is the leading cause, mutation or deletion of the RAI1 gene alone results in most features of the disorder. Previous studies have shown that heterozygous knockout of Rai1 results in an obese phenotype in mice and that Smith-Magenis syndrome mouse models have a significantly reduced fecundity and an altered transmission pattern of the mutant Rai1 allele, complicating large, extended studies in these models. In this study, we show that breeding C57Bl/6J Rai1+/−mice with FVB/NJ to create F1 Rai1+/− offspring in a mixed genetic background ameliorates both fecundity and Rai1 allele transmission phenotypes. These findings suggest that the mixed background provides a more robust platform for breeding and larger phenotypic studies. We also characterized the effect of dietary intake on Rai1+/− mouse growth during adolescent and early adulthood developmental stages. Animals fed a high carbohydrate or a high fat diet gained weight at a significantly faster rate than their wild type littermates. Both high fat and high carbohydrate fed Rai1+/− mice also had an increase in body fat and altered fat distribution patterns. Interestingly, Rai1+/− mice fed different diets did not display altered fasting blood glucose levels. These results suggest that dietary regimens are extremely important for individuals with Smith- Magenis syndrome and that food high in fat and carbohydrates may exacerbate obesity outcomes

Citizen journalism: an analysis of news representation in the coverage of Bhutannewsservice.com.

This article analyses the discussion of nationality and ethnicity on a Bhutanese citizen journalism site which is particularly used by members of the Lhotshampa ethnic group. Many of the citizen journalists are based outside Bhutan, either in refugee camps in Nepal or as part of a worldwide diaspora. Writers on the site tackle issues relating to a nation, people, culture, and history, particularly that of Bhutan and the Bhutanese people. By criticizing accepted sources and the mainstream media and re-interpreting Bhutanese history, this group of citizen journalists works to assert the Lhotshampa people as rightful citizens of Bhutan and to re-identify other ethnic groups in power in Bhutan as migrants. Bhutan is argued to be a country where all peoples are migrants, and at the same time, diasporic writers remind their readers of why they left Bhutan and look to a better future in their new countries

Pengalaman Keluarga dalam Melaksanakan Manajemen Diet Stroke Lansia

This study aims to explore family experiences in implementing stroke diet management for older people in the Seririt Community Health Center working area. The method used is a qualitative method with a phenomenological approach. The results of the research show that there are four family experiences in implementing elderly stroke diet management in the Seririt Community Health Center working area, namely support for elderly stroke diet families in providing low-salt food and controlling the elderly's diet, post-stroke malnutrition related to nutritional management in elderly stroke sufferers for improving the nutritional status and improving the patient's metabolic quality, a healthy diet is one of the keys to successful stroke treatment which requires daily support from a healthy diet and nutritional counseling. In conclusion, there are four main themes: family support for elderly stroke diets, post-stroke malnutrition, healthy eating patterns, and nutritional counseling.   Keywords: Family, Elderly, Diet Management of Strok