Stateless Termination Detection

The switches and routers of large scale networks cannot manage a state per user session. The burden of memory management would overwhelm the network. Therefore, it is important to find distributed network algorithms which hold a state only at the initiating node. Termination detection algorithms are particularly interesting, since they can be used in the implementation of other stateless algorithms. The importance of stateless termination detection is apparent in mulitcast trees. Multicast trees are commonly used to multicast messages across the network. In many cases the mulitcast message represents a request sent from the root node that must be answered by all the leaves of the tree. In most networks the leaves could send their answer directly to the root. Unfortunately, the root would have no way of knowing when all the leaves answered the request. Broadcast-echo algorithms are often used in this case, but these algorithms require a state in the internal nodes of the mulitcast tree. Nack oriented protocols are also common, particularly in reliable multicast implementations. These algorithms are optimized for continues downstream information from the source to the destinations rather than for transactional request-reply operations. We present a simple algorithm for termination detection in trees and DAGs which does not require managing a state in the nodes of the graph. The algorithm works even if the graph changes during the execution. For a tree with n nodes, the number of bits added to each message is O(log n). We also discuss how this algorithm may be used in general graphs

Psychometric evaluation of the Pittsburgh sleep quality index in cancer patients

Abstract: This report summarizes findings related to the psychometric properties (internal consistency and construct validity) of the Pittsburgh Sleep Quality Index (PSQI) and discusses issues related to its use based on data from two clinical studies with diverse samples of cancer patients. Subjects completed a questionnaire that included the PSQI, the Schwartz Cancer Fatigue Scale, and specific demographic, disease, and treatment variables. There were complete data on 170 (of 214) cases in Study 1 and 249 (of 259) cases in Study 2. The Cronbach's alpha for the Global Sleep Quality scale was 0.81 in Study 1 and 0.77 in Study 2. A comparison of Global Sleep Quality in two contrasting groups with low and high fatigue yielded statistically significant differences in both samples. Psychometric evaluation supports its internal consistency reliability and construct validity. However, the scoring is rather cumbersome and raises questions regarding level of measurement and appropriate analysis techniques

Applying the Age-Friendly Health System Framework to Long Term Care Settings

Recognizing the growing need for geriatric expert health care, a collaborative of the John A. Hartford Foundation, Institute for Healthcare Improvement (IHI), American Hospital Association, and Catholic Health Association of the United States established the Age-Friendly Health System (AFHS) initiative to increase quality, effective person-centered healthcare for older adults (1-3). Age friendly care follows evidence-based practices, causes no harm and focuses on “what matters” to each older adult, their family and caregivers. The four core elements – the 4Ms framework – provide an evidence-based framework for age-friendly care (Table 1). The 4Ms include “what matters”, “mobility”, “mentation”, and “medications”. The 4Ms are not meant to be implemented individually but rather incorporated together to provide agefriendly care (4)

Evaluating person-centredness for frail older persons in nursing homes before and after implementing a palliative care intervention

Aim: To evaluate person-centeredness in nursing homes from the perspective of frail older persons, before and after implementing an educational intervention about palliative care. Design: A crossover design. Methods: Forty-four older persons living in nursing homes were interviewed. A convergent mixed-method was used to analyse data. Results: The older persons expressed feelings of unsafety related to shortcomings in staff. These shortcomings implied that the responsibilities of everyday activities and making the residents’ existence more bearable were transferred to the next of kin. The dropout rate related to death and not enough energy was considerably high (51%) even though one of the inclusion criteria was to have enough energy to manage a 1-hr interview. This result supports previous research describing the difficulties in retaining older persons in research and indicated that the dose of the intervention was not sufficient to improve person-centred care