A Project Planning Guide for Healthcare Facility Owners

According to a recent study, about 30 percent of U.S. real estate projects are canceled midstream, while more than half run up to 190 percent over budget and 220 percent over the initial time estimate. The reasons for this are manifold but poor decisions during the initiation and early planning of the project can be pointed to as main causes. Most poor decisions stem from lack of information, bad judgment, and lack of communication and transparency between what the client expects and what the project team can deliver. Proper project planning procedures and methods will lead to proper contingency planning, management of partner relationships and contracts, management of dynamic change and associated risks that can, and most probably will, occur in the course of the project. The role of the owner cannot be overstated in all of these targets. Historically, the owners of healthcare facilities have a once in a lifetime involvement in the planning, design and construction (or major renovation) of their facility. The interaction with planners, public bodies, architects, engineers, and other entities is a daunting prospect for which an owner will seek help from specialized firms that represent the owner. This guide may serve as a healthcare project planning guide for owners, and in particular CEOs, to navigate the process. It will prepare the owner to recognize the major tasks and decision steps throughout project planning, while keeping the focus on the desired outcome. Any owner should recognize that the slogan: if you dont know what you want, you will not get what you need is as true today as it ever was. This guide will include research, best practices from industry experts, and a case study on the New Orleans public healthcare planning process post-Hurricane Katrina.M.S.Committee Chair: Augenbroe, Godfried; Committee Member: Choudhary, Ruchi; Committee Member: Zimring, Crai

Parkinson\u27s Disease and Forced Exercise in a Community Setting: A Feasibility Study

Parkinson’s disease is a neurodegenerative disorder that increases an individual’s fall risk. In recent studies, an 8-week tandem bike forced exercise program was effective in reducing overall Parkinsonian symptoms. The feasibility of a tandem bike forced exercise program in a community setting has not been studied previously, and no published study has evaluated balance and health outcomes after participation in a forced exercise program. This six week tandem bike forced exercise protocol, conducted in a community setting for individuals with Parkinson’s disease, aimed to assess the feasibility of such a protocol, and to assess resultant balance and health outcomes.https://dune.une.edu/student_posters/1002/thumbnail.jp

Perception of Approaching Motorcycles by Distracted Drivers May Depend on Auxiliary Lighting Treatments: A Field Experiment

A field experiment was conducted in daylight with 32 participants to determine whether left turning drivers’ gap acceptance in front of approaching motorcycles depends on the motorcycle’s forward lighting treatment. Five experimental lighting treatments including a modulated high beam headlamp, or the low beam headlamp plus pairs of low-mounted auxiliary lamps, high-mounted auxiliary lamps, both high- and low-mounted auxiliary lamps, or low-mounted LED lamps were compared to a baseline treatment with only the low beam headlamp illuminated. Participants viewed the approaching traffic stream (including the motorcycle) on an active roadway and indicated when it would be safe (and not safe) to initiate a left turn across the opposing lanes. Participants also shared their attention with a secondary visual distraction task that took their eyes off the forward roadway. Participants did not know that the purpose of the study was to measure their responses to approaching motorcycles. Based on participants’ indications of the last safe moment to turn, the mean temporal safety margin provided to the approaching motorcycle did not differ significantly between any of the experimental lighting treatments and the baseline treatment. However, having either low-mounted auxiliary lamps or modulated high beam lamps on the motorcycle significantly reduced the probability of obtaining a potentially unsafe short safety margin as compared to the baseline lighting treatment. Overall, the results suggest that enhancing the frontal conspicuity of motorcycles with lighting treatments beyond an illuminated low beam headlamp may be an effective countermeasure for daytime crashes involving right-of-way violations

Self-Study In Patient Safety And Quality Improvement To Enhance Student Experience In Interprofessional Case Competition

Objective: The Interprofessional Student Advisory Team (IPSAT) at the University of New England (UNE) organized its 2nd interprofessional student case competition, modeled after the CLARION competition from the University of Minnesota. Completion of an online certificate in patient safety and quality improvement from the Institute for Healthcare Improvement (IHI) Open School was added as a pre-requisite to participation in the 2014 competition. Completion of this program was predicted to improve student preparedness and confidence and facilitate interprofessional teamwork during their case preparation. Conclusions: Survey results indicate an increase in student confidence and preparedness for interprofessional teamwork during the 2014 UNE IPSAT case competition. Survey research was limited by a small number of completed surveys, a delay in IRB approval and unfamiliarity with the IRB suggested survey software. IPSAT student leaders at UNE will continue to require completion of the IHI Open School Basic Certificate as a prerequisite for enrollment in future IPSAT case competitions.https://dune.une.edu/minigrant_ipsat2014/1000/thumbnail.jp

Meeting Report: Summary of IARC Monographs on Formaldehyde, 2-Butoxyethanol, and 1-tert-Butoxy-2-Propanol

An international, interdisciplinary working group of expert scientists met in June 2004 to develop IARC Monographs on the Evaluation of the Carcinogenic Risk of Chemicals to Humans (IARC Monographs) on formaldehyde, 2-butoxyethanol, and 1-tert-butoxy-2-propanol. Each IARC Monograph includes a critical review of the pertinent scientific literature and an evaluation of an agent’s potential to cause cancer in humans. After a thorough discussion of the epidemiologic, experimental, and other relevant data, the working group concluded that formaldehyde is carcinogenic to humans, based on sufficient evidence in humans and in experimental animals. In the epidemiologic studies, there was sufficient evidence that formaldehyde causes nasopharyngeal cancer, “strong but not sufficient” evidence of leukemia, and limited evidence of sinonasal cancer. The working group also concluded that 2-butoxyethanol and 1-tert-butoxy-2-propanol are not classifiable as to their carcinogenicity to humans, each having limited evidence in experimental animals and inadequate evidence in humans. These three evaluations and the supporting data will be-published as Volume 88 of the IARC Monographs

A systematic review of the effectiveness and cost-effectiveness of peer education and peer support in prisons.

BACKGROUND: Prisoners experience significantly worse health than the general population. This review examines the effectiveness and cost-effectiveness of peer interventions in prison settings. METHODS: A mixed methods systematic review of effectiveness and cost-effectiveness studies, including qualitative and quantitative synthesis was conducted. In addition to grey literature identified and searches of websites, nineteen electronic databases were searched from 1985 to 2012. Study selection criteria were: Population: Prisoners resident in adult prisons and children resident in Young Offender Institutions (YOIs). INTERVENTION: Peer-based interventions Comparators: Review questions 3 and 4 compared peer and professionally led approaches. OUTCOMES: Prisoner health or determinants of health; organisational/ process outcomes; views of prison populations. STUDY DESIGNS: Quantitative, qualitative and mixed method evaluations. RESULTS: Fifty-seven studies were included in the effectiveness review and one study in the cost-effectiveness review; most were of poor methodological quality. Evidence suggested that peer education interventions are effective at reducing risky behaviours, and that peer support services are acceptable within the prison environment and have a positive effect on recipients, practically or emotionally. Consistent evidence from many, predominantly qualitative, studies, suggested that being a peer deliverer was associated with positive effects. There was little evidence on cost-effectiveness of peer-based interventions. CONCLUSIONS: There is consistent evidence from a large number of studies that being a peer worker is associated with positive health; peer support services are also an acceptable source of help within the prison environment and can have a positive effect on recipients. Research into cost-effectiveness is sparse. SYSTEMATIC REVIEW REGISTRATION: PROSPERO ref: CRD42012002349

Latent Class Analysis of Antisocial Behavior: Interaction of Serotonin Transporter Genotype and Maltreatment

To improve understanding about genetic and environmental influences on antisocial behavior (ASB), we tested the association of the 44-base pair polymorphism of the serotonin transporter gene (5-HTTLPR) and maltreatment using latent class analysis in 2,488 boys and girls from Wave 1 of the National Longitudinal Study of Adolescent Health. In boys, ASB was defined by three classes (Exclusive Covert, Mixed Covert and Overt, and No Problems) whereas in girls, ASB was defined by two classes (Exclusive Covert, No Problems). In boys, 5-HTTLPR and maltreatment were not significantly related to ASB. However, in girls, maltreatment, but not 5-HTTLPR, was significantly associated with ASB. A significant interaction between 5-HTTLPR and maltreatment was also observed, where maltreated girls homozygous for the short allele were 12 times more likely to be classified in the Exclusive Covert group than in the No Problems group. Structural differences in the latent structure of ASB at Wave 2 and Wave 3 prevented repeat LCA modeling. However, using counts of ASB, 5-HTTLPR, maltreatment, and its interaction were unrelated to overt and covert ASB at Wave 2 and only maltreatment was related to covert ASB at Wave 3. We discuss these findings within the context of sex differences in ASB and relevant models of gene-environment interplay across developmental periods