PIH20 What Really Matters? A Multi-View Perspective of One Patient's Hospital Experience

ObjectivesTo identify what mattered to a patient and family member (health care recipients) during the patient’s hospital experience and to examine the health care provider’s awareness of what mattered to the recipients.MethodsA qualitative descriptive investigation was undertaken using semi-structured interviews designed to compare multiple perceptions of one patient’s hospital experience. Interviews were undertaken with the patient (post-surgical procedure), family member, and health care providers whom the patient identified as impacting the hospital experience. Interviews were audio recorded and transcribed. A definition of hospital experience was sought from each participant. Additional phrases as presented by the patient and family member were coded and grouped into categories and then salient themes. Phrases as presented by the health care providers were coded, and then allocated to the previously identified themes.ResultsOne patient, his wife and seven health care providers (doctors (2), registered nurses (4) and a patient care orderly (1)) were interviewed. Definitions of what constitutes ‘hospital experience’ differ between the participants. Recipients of care include pre and post hospital admission periods, whereas providers limit hospital experience to admission. Three salient themes emerged from recipient data suggesting; medication management, physical comfort and emotional security are what mattered. Awareness of the significance of these factors differed between the providers and was theme dependent.ConclusionsHospital experience as a term is poorly defined, and definitions differ between recipients and providers of care. Health care providers are not always aware of what matters to the patient and family during their hospital admission

Common plants as indicators of habitat suitability for rare plants; quantifying the strength of the association between threatened plants and their neighbours

Rare plants are vulnerable to environmental change but easy to over-look during survey. Methods are therefore needed that can provide early warnings of population change and identify potentially suitable vegetation that could support new or previously overlooked populations. We developed an indicator species approach based on quantifying the association between rare plants across their British ecological range and their suite of more common neighbours. We combined quadrat data, targeted on six example species selected from the Botanical Society of Britain and Ireland's Threatened Plant Project (TPP), with representative survey data from across Britain. Bayes Theorem was then used to calculate the probability that the rare species would occur given the presence of an associated species that occurred at least once with the rare species in the TPP quadrats. These values can be interpreted as indicators of habitat suitability rather than expectations of species presence. Probability values for each neighbour species are calculated separately and are therefore unaffected by biased recording of other species. The method can still be applied if only a subset of species is recorded, for example, where weaker botanists record a pre-selected subset of more easily identifiable neighbour species. Disadvantages are that the method is constrained by the availability of quadrats currently targeted on rare species and results are influenced by any recording biases associated with existing quadrat data

Developing a Bayesian species occupancy/abundance indicator for the UK National Plant Monitoring Scheme

• The National Plant Monitoring Scheme (NPMS) is a volunteer-based structured plant recording scheme. This report focuses on the development of a new statistical model for the species-level data generated by the NPMS. The aim is ultimately for this to contribute to a new indicator of UK habitat quality. • NPMS surveyors collect data on plant abundance (percentage covers) from small plots targeted at specific habitats. They can participate at different levels, with the level of participation influencing the list of species sought in the field. Typically, surveyors record around 5 small plots in a 1 km square, with each plot being visited twice a year. • NPMS data must be processed in order to accurately represent the information content of the plot surveys. Because surveyors use different lists of species depending on their level, in some cases we need to distinguish between true absences (species on a surveyor’s target list but not reported) and unknown cases (species not on a surveyor’s target list, meaning that absence from a list is not informative). • We present a novel hierarchical statistical model for NPMS species-level data. This model seeks to make maximum use of the data collected, and integrates a standard occupancy modelling approach for plot detections with a Beta distribution model for a species’ non-zero cover data. • We evaluate the proposed model using a variety of different simulated datasets. The performance of the model is assessed in relation to the bias and variance shown relative to the actual parameters used in the data simulations. • The simulations indicate that the model performs as expected under a “perfect” scenario. Smaller datasets induce various biases, many of which can be traced to the fact that, in our simulations, abundance and detectability are closely related. This biases the estimated mean of the underlying cover distribution upwards, and also impacts estimates of the intercept and regression coefficient in the detection sub-model. In real datasets this relationship would likely be less clear-cut, and we do not expect these biases to affect species’ relative annual trend estimates. • Finally, we apply the model to NPMS data collected between 2015 and 2018 for 86 grassland species. The model estimates ecologically sensible mean cover values for the species analysed. However, mean plot occupancies tended to centre on 0.5, suggesting that many species may not yet have sufficient data for mean occupancy to be well estimated. • A novel combined abundance/occupancy indicator has been developed for NPMS data in a Bayesian framework. The simulation tests and applications to real data explored in this report indicate that the model performs well in ideal scenarios; biases in less data-rich scenarios can largely be explained by relationships between abundance and detectability. These are likely to be less clear-cut in real datasets, and future work will explore how additional covariates describing a species’ detectability could be incorporated. Extending the model to create annual indices, and considering how these may be aggregated, will also be required for the future creation of a habitat quality indicator using NPMS data

A short guide to using British and Irish plant occurrence data for research

A check list of things to ask when using British and Irish plant occurrence data for analyses. Note that many of the issues discussed here may also apply to datasets of animal occurrence data, and to data from other territories

Simple methods for improving the communication of uncertainty in species’ temporal trends

Temporal trends in species occupancy or abundance are a fundamental source of information for ecology and conservation. Model-based uncertainty in these trends is often communicated as frequentist confidence or Bayesian credible intervals, however, these are often misinterpreted in various ways, even by scientists. Research from the science of information visualisation indicates that line ensemble approaches that depict multiple outcomes compatible with a fitted model or data may be superior for the clear communication of model-based uncertainty. The discretisation of continuous probability information into frequency bins has also been shown to be useful for communicating with non-specialists. We present a simple and widely applicable approach that combines these two ideas, and which can be used to clearly communicate model-based uncertainty in species trends (or composite indicators) to stakeholders. We also show how broader ontological uncertainty can be communicated via trend plots using risk-of-bias visualisation approaches developed in other disciplines. The techniques are demonstrated using the example of long-term plant distributional change in Britain, but are applicable to any temporal data consisting of averages and associated uncertainty measures. Our approach supports calls for full transparency in the scientific process by clearly displaying the multiple sources of uncertainty that can be estimated by researchers

Effects of Methylene Blue and Polyethelene Glycol on Facial Nerve Axotomy Recovery

poster abstractInjury and disease are common factors affecting peripheral nerves and can lead to loss of function. Recovery time after an injury is slow and not very efficient in humans. Treatment methods involving methylene blue (MB) and polyethylene glycol (PEG) have shown combinational effects in sciatic nerve axotomies. We are using behavior analysis of eye blink reflex and vibrissae orientation and movement as a measurement of rate of functional recovery. We will have treatment groups of both cut and crush rats. For each group we will be testing the effect of PEG/MB or no treatment control groups. The results of these treatment groups are significant to finding treatment options for clinical use

Confined granular packings: structure, stress, and forces

The structure and stresses of static granular packs in cylindrical containers are studied using large-scale discrete element molecular dynamics simulations in three dimensions. We generate packings by both pouring and sedimentation and examine how the final state depends on the method of construction. The vertical stress becomes depth-independent for deep piles and we compare these stress depth-profiles to the classical Janssen theory. The majority of the tangential forces for particle-wall contacts are found to be close to the Coulomb failure criterion, in agreement with the theory of Janssen, while particle-particle contacts in the bulk are far from the Coulomb criterion. In addition, we show that a linear hydrostatic-like region at the top of the packings unexplained by the Janssen theory arises because most of the particle-wall tangential forces in this region are far from the Coulomb yield criterion. The distributions of particle-particle and particle-wall contact forces $P(f)$ exhibit exponential-like decay at large forces in agreement with previous studies.Comment: 11 pages, 11 figures, submitted to PRE (v2) added new references, fixed typo