Organizational Structural and Cultural Variables as Predictors of Quality in Federally Approved Nursing Homes.

The purpose of this study was to determine the extent to which nursing home organizational structure and cultural variables were related to the outcomes reported by the Health Care Finance Administration public use data set (HCFA-NHCD). A second purpose was to examine the effects of a new style of nursing home management called the Eden Alternative™ concept. A related purpose was to test the usefulness of the HCFA-NHCD in predicting the quality of care for residents in federally approved nursing homes. Secondary data analysis was conducted on the HCFA-NHCD, as published in December 2001. Descriptive statistics and measures of association were used to assess the degree of relationship between the organizational structure and culture variables and the eight clinical health indicators of the HCFA-NHCD. Multiple regression analyses were conducted to measure the impact of the organizational structure and culture variables on the quality of care for residents in federally approved nursing homes. When compared with previously collected statistics, these findings suggest that there is a nationwide trend towards smaller nursing homes; smaller Eden homes were associated with a higher level of individualized attention. Smaller Eden homes with council representation had better scores on a majority of the eight clinical health indicators when compared to their counterparts with no council representation. Council representation was inversely related to a nursing homes\u27 reliance on RN and LPLVN services. However, a regression model assessing the impact of organizational structure and cultural variables on the quality of care for residents in federally approved nursing homes had very limited predictive power (R2=2.2%). The findings of this study suggest that quality improvements in the HCFA-NHCD are needed in order to better serve families

ΦCrAss001 represents the most abundant bacteriophage family in the human gut and infects Bacteroides intestinalis

peer-reviewedCrAssphages are an extensive and ubiquitous family of tailed bacteriophages, predicted to infect bacteria of the order Bacteroidales. Despite being found in ~50% of individuals and representing up to 90% of human gut viromes, members of this viral family have never been isolated in culture and remain understudied. Here, we report the isolation of a CrAssphage (ΦCrAss001) from human faecal material. This bacteriophage infects the human gut symbiont Bacteroides intestinalis, confirming previous in silico predictions of the likely host. DNA sequencing demonstrates that the bacteriophage genome is circular, 102 kb in size, and has unusual structural traits. In addition, electron microscopy confirms that ΦcrAss001 has a podovirus-like morphology. Despite the absence of obvious lysogeny genes, ΦcrAss001 replicates in a way that does not disrupt proliferation of the host bacterium, and is able to maintain itself in continuous host culture during several weeks

PRT simulation in an immersive virtual world

Immersive virtual world environments, such as Second LifeTM (SL), have the potential to dramatically improve the process of analyzing usability within technically correct system simulations, long before the system is built. We report our findings with the SL simulation of a Personal Rapid Transit (PRT) system. The SL model and simulation were done according to the original technical specifications. In interacting with this simulation, the system designers were able to identify several usability issues that would have gone unnoticed in a non-immersive simulation environment. Namely: (1) a problem with the design of the offramp to the station; (2) further requirements for the design of the top of the vehicles, so that the suspended track is out of direct sight of the people inside; (3) further safety requirements for dealing with unexpected obstacles along the path. While all of these issues would have been identified upon deployment of the physical prototype, the contribution of our work is to show how usability issues like these can now be identified much earlier, using simulations in a virtual world. Copyright © 2008 ICST

Tracking transplanted bone marrow stem cells and their effects in the rat MCAO stroke model.

In this study, rat bone marrow stromal stem cells (BMSCs) were tracked after IV administration to rats with experimental stroke caused by middle cerebral artery occlusion (MCAO). In addition, the effects of BMSC treatment on blood cell composition, brain glia and sensorimotor behavior was studied and compared to that which occurred spontaneously during the normal recovery process after stroke. We found that the vast majority of radiolabeled or fluorescently labeled BMSCs traveled to and remained in peripheral organs (lungs, spleen, liver) 3 days after IV injection in the MCAO rat. Once in the circulation, BMSCs also produced rapid alterations in host blood cell composition, increasing both neutrophil and total white blood cell count by 6 hours post-injection. In contrast, few injected BMSCs traveled to the brain and almost none endured there long term. Nonetheless, BMSC treatment produced dramatic changes in the number and activation of brain astroglia and microglia, particularly in the region of the infarct. These cellular changes were correlated with a marked improvement in performance on tests of sensory and motor function as compared to the partial recovery of function seen in PBS-injected control rats. We conclude that the notable recovery in function observed after systemic administration of BMSCs to MCAO rats is likely due to the cellular changes in blood and/or brain cell number, activation state and their cytokine/growth factor products

Retreating to nature : rethinking 'therapeutic landscapes'

There is a long history of removing oneself from ‘society’ in order to recuperate or repair. This paper considers a yoga and massage retreat in Southern Spain, and what opportunities this retreat experience might offer for recuperation and the creation of healthy bodies. The paper positions ‘nature’ as an active participant, and as ‘enrolled’ in the experiences of the retreat as a ‘therapeutic landscape’, and questions how and what particular aspects of yoga practice (in intimate relation with place) give rise to therapeutic experiences

Perceptions Of School By Two Teenage Boys With Asperger Syndrome And Their Mothers: A Qualitative Study

This qualitative study aimed to develop an understanding of the challenges faced by teenage boys with Asperger syndrome and their mothers. A case study approach was used to collect data from two 13-year-old boys who have Asperger syndrome and their mothers in Queensland, Australia. Data were collected through the use of semi¬structured interviews. The words of the boys and their mothers provide a valuable insight into the personal experiences and feelings of the par¬ticipants. An inductive approach to data analysis identified four themes: (1) developmental differences; (2) problems associated with the general characteristics of Asperger syndrome (i.e. communication and social difficulties, restricted range of interests, a need for routine); (3) stress; and (4) 'masquerading'. The first three themes relate strongly to the current literature, but the emergence of masquerading is of particular interest in developing a fuller understanding of the experiences of individuals with Asperger syndrome at school