Patients and families as partners in safety, quality, and experiences of care

This case examines the highlights of Vidant Health’s journey to a more intentional focus on patient experience. Organizational inconsistencies lead to a focused long term plan putting a culture of patient centeredness at the core of Vidant’s efforts. The results show a clear and measured improvement in safety, quality and experience overall

Early lexical characteristics of toddlers with cleft lip and palate

pre-printMain Outcome Measures: The groups were compared for size of expressive lexicon reported on the MacArthur Communicative Development Inventory and the percentage of words beginning with obstruents and sonorants produced in a language sample. Differences between groups in the percentage of word initial consonants correct on the language sample were also examined. Results: Although expressive vocabulary was comparable at 13 months of age for both groups, size of the lexicon for the cleft group was significantly smaller than that for the noncleft group at 21 and 27 months of age. Toddlers with cleft palate produced significantly more words beginning with sonorants and fewer words beginning with obstruents in their spontaneous speech samples. They were also less accurate when producing word initial obstruents compared with the noncleft group. Conclusions: Toddlers with cleft palate demonstrate a slower rate of lexical development compared with their noncleft peers. The preference that toddlers with cleft palate demonstrate for words beginning with sonorants could suggest they are selecting words that begin with consonants that are easier for them to produce. An alternative explanation might be that because these children are less accurate in the production of obstruent consonants, listeners may not always identify obstruents when they occur

The Rise of Women, #MeToo and Why It Matters

In light of current political events here in the United States and around the world, such as the #MeToo movement, discussions about toxic masculinity, the tumultuous appointment of Justice Kavanaugh to the U.S. Supreme Court, and a worldwide surge of participation of women in politics, it is obvious that we are living in an important historical period where ideas about gender and power are being debated, reinforced, and challenged. While some political leaders blatantly dismiss gender discrimination and gender-based violence, the global community has recently acknowledged the significance of this issue by awarding the 2018 Nobel Peace Prize to two individuals whose work directly challenges gender oppression. Nadia Murad, a Yazidi rights activist who fights for dignity of trafficked women and children, and Denis Mukwege, a doctor who helps victims of sexual violence in the Democratic Republic of Congo, both have highlighted the rights of individuals whose voices previously have been silenced. Worldwide, people are speaking out about discriminatory and violent practices. Historians will look back at this moment as one where traditional power structures were meaningfully challenged and marginalized voices spoke out about their experiences

Engaging Stakeholders To Extend The Lifecycle Of Hybrid Simulation Models

Developing a simulation model of a complex system requires a significant investment of time, expertise and expense. In order to realize the greatest return on such an investment, it is desirable to extend the lifecycle of the simulation model as much as possible. Existing studies typically end after the `first loop' of the lifecycle, with the computer model suitable for addressing the initial requirements of the stakeholders. We explore extending the modeling lifecycle to a `second loop' by introducing an existing hybrid simulation model to a new group of stakeholders and further developing it to capture new requirements. With the aid of an example application, we explain how the hybrid model facilitated stakeholder engagement by closely reflecting the real world and how the model lifecycle has been successfully extended to maximize the benefit to Eurostar International Limited

Ageing and bisexuality: Case studies from the Looking Both Ways project

This report presents case studies from a research study about ageing and bisexuality. The case studies are freely available for use by others. They could be used: • To generate discussion when training health and social care staff working with older people • To illustrate and personalise issues in report-writing and policy development • To create awareness about the needs of older people in relation to sexuality and care • As a resource for teachers and other educators • To prompt discussions about the impact of people’s earlier life course experiences in later life • To increase the visibility of bisexual people in later life • To increase the representation of older people in bisexuality visibility work • To increase the representation of bisexual people in general LGBT training Case studies describing lesbian, gay, bisexual and transgender (LGBT) people’s experiences as they grow older are often used in training, educational and policy work. They can help bring issues to life by providing real life examples, and can also help people understand experiences that may be very different from their own. However, existing resources focus on the experiences of lesbians and gay men as they grow older. When bisexual people are included, it is often only in relation to their same-sex experiences, not their experiences of being bisexual as they grow older. Looking Both Ways was a research project exploring the experiences of people with bisexual identities or bisexual relationship histories as they grow older. Twelve people (aged 51 to 83) living in England took part in interviews between 2013 and 2015. Half of them identified as bisexual and half did not but had bisexual relationship histories. From these interviews we developed case studies which set out life stories, concerns and support needs in later life. This report provides the case studies and explains the context in which they were created. Details of other, more academic, outputs from the project can be obtained from the authors. For more information about bisexuality or about LGBT ageing in general, see the resources list at the end of this report

Broadening Responsibilities: Consideration Of The Potential To Broaden The Role Of Uniformed Fire Service Employees

What is this report about? This report, commissioned by the National Joint Council for Local Authority Fire and Rescue Services (NJC), aims to identify what impact, if any, firefighters can have on the delivery of emergency medical response and wider community health interventions in the UK. What are the overall conclusions? Appropriately trained and equipped firefighters co-responding1 to targeted, specific time critical medical events, such as cardiac arrest, can improve patient survival rates. The data also indicate that there is support from fire service staff – and a potential need from members of the public, particularly the elderly, isolated or vulnerable – to expand ‘wider work’. This includes winter warmth assessments, Safe and Well checks, community defibrillator training and client referrals when staff believe someone may have dementia, are vulnerable or even, for example, have substance dependencies such as an alcohol addiction. However, there is currently insufficient data to estimate the net benefit of this work

Direct evidence of an efficient energy transfer pathway from jellyfish carcasses to a commercially important deep-water species

Here we provide empirical evidence of the presence of an energetic pathway between jellyfish and a commercially important invertebrate species. Evidence of scavenging on jellyfish carcasses by the Norway lobster (Nephrops norvegicus) was captured during two deployments of an underwater camera system to 250–287 m depth in Sognefjorden, western Norway. The camera system was baited with two Periphylla periphylla (Scyphozoa) carcasses to simulate the transport of jellyfish detritus to the seafloor, hereby known as jelly-falls. N. norveigus rapidly located and consumed a large proportion (>50%) of the bait. We estimate that the energy input from jelly-falls may represent a significant contribution to N. norvegicus energy demand (0.21 to 10.7 times the energy required for the population of N. norvegicus in Sognefjorden). This potentially high energetic contribution from jelly-falls highlights a possible role of gelatinous material in the support of commercial fisheries. Such an energetic pathway between jelly-falls and N. norvegicus could become more important with increases in jellyfish blooms in some regions

International Space Station Permanent Multi-Purpose Module (PMM) Life Extension

No abstract availabl

The Butcher-Oemler Effect in High Redshift X-ray Selected Clusters

We are engaged in a wide-field, multi-colour imaging survey of X-ray selected clusters at intermediate and high redshift. We present blue fractions for the first 8 out of 29 clusters, covering almost a factor of 100 in X-ray luminosity. We find no correlation of blue fraction with redshift or X-ray luminosity. The lack of a correlation with L$_{X}$, places strong constraints on the importance of ram-pressure stripping as a driver of the Butcher-Oemler effect.Comment: 4 pages, 4 figures, to be puplished in the proceedings of the ''Sesto 2001-Tracing Cosmic Evolution with Galaxy Clusters'', Sesto 3-6 July 2001, Italy, eds, Stefano Borgan