Session II Nursing Presentation 1: Stall the Fall

Results of a DNP project on preventing falls in older adults by training non-clinical caregiver

The influence of relatives on the efficiency and error rate of familial searching

We investigate the consequences of adopting the criteria used by the state of California, as described by Myers et al. (2011), for conducting familial searches. We carried out a simulation study of randomly generated profiles of related and unrelated individuals with 13-locus CODIS genotypes and YFiler Y-chromosome haplotypes, on which the Myers protocol for relative identification was carried out. For Y-chromosome sharing first degree relatives, the Myers protocol has a high probability (80 - 99%) of identifying their relationship. For unrelated individuals, there is a low probability that an unrelated person in the database will be identified as a first-degree relative. For more distant Y-haplotype sharing relatives (half-siblings, first cousins, half-first cousins or second cousins) there is a substantial probability that the more distant relative will be incorrectly identified as a first-degree relative. For example, there is a 3 - 18% probability that a first cousin will be identified as a full sibling, with the probability depending on the population background. Although the California familial search policy is likely to identify a first degree relative if his profile is in the database, and it poses little risk of falsely identifying an unrelated individual in a database as a first-degree relative, there is a substantial risk of falsely identifying a more distant Y-haplotype sharing relative in the database as a first-degree relative, with the consequence that their immediate family may become the target for further investigation. This risk falls disproportionately on those ethnic groups that are currently overrepresented in state and federal databases.Comment: main text: 19 pages, 4 tables, 2 figures supplemental text: 2 pages, 5 tables all together as single fil

Solution Biases and Pheromone Representation Selection in Ant Colony Optimisation.

Combinatorial optimisation problems (COPs) pervade human society: scheduling, design, layout, distribution, timetabling, resource allocation and project management all feature problems where the solution is some combination of elements, the overall value of which needs to be either maximised or minimised (i.e., optimised), typically subject to a number of constraints. Thus, techniques to efficiently solve such problems are an important area of research. A popular group of optimisation algorithms are the metaheuristics, approaches that specify how to search the space of solutions in a problem independent way so that high quality solutions are likely to result in a reasonable amount of computational time. Although metaheuristic algorithms are specified in a problem independent manner, they must be tailored to suit each particular problem to which they are applied. This thesis investigates a number of aspects of the application of the relatively new Ant Colony Optimisation (ACO) metaheuristic to different COPs. The standard ACO metaheuristic is a constructive algorithm loosely based on the foraging behaviour of ant colonies, which are able to find the shortest path to a food source by indirect communication through pheromones. ACO’s artificial pheromone represents a model of the solution components that its artificial ants use to construct solutions. Developing an appropriate pheromone representation is a key aspect of the application of ACO to a problem. An examination of existing ACO applications and the constructive approach more generally reveals how the metaheuristic can be applied more systematically across a range of COPs. The two main issues addressed in this thesis are biases inherent in the constructive process and the systematic selection of pheromone representations. The systematisation of ACO should lead to more consistently high performance of the algorithm across different problems. Additionally, it supports the creation of a generalised ACO system, capable of adapting itself to suit many different combinatorial problems without the need for manual intervention

A Place in the Sunshine State : Community, Preservation, and the Parliament House

A Place in the Sunshine State, is a thesis project focused on the Parliament House Motor Inn in Orlando, Florida. This project nominated the Parliament House Motor Inn for inclusion on the National Register of Historic Places. This nomination was completed using both oral histories and more traditional historical source material. The Parliament House Motor Inn was evaluated using National Register Bulletins and the Secretary of the Interior\u27s Standards for Preservation. This nomination was presented to give voice to a long-underrepresented community within the national narrative of the United States, along with giving the Parliament House the recognition it deserves as an integral institution within the gay community. This nomination sheds new light onto early gay life in Orlando and concludes that Parliament House is a significant historic and cultural resource. This conclusion is vital to the preservation of LGBT history; it allows for a more complex interpretation of Orlando and central Florida history and helps to recognize LGBT history and the sites associated with them. This thesis also discusses Parliament House and its role as a site of the intersections between gay community and identity creation, place making, and the intricate history of the southern United States

Identity-Related Dysfunction: Integrating Clinical and Developmental Perspectives

Recent changes to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders highlight the importance of identity dysfunction within several psychiatric diagnoses. Despite a long-standing tradition of identity research and theory in the developmental literature, there is limited work establishing intersections between clinical and developmental conceptualizations of identity problems. The relative lack of integration between decades of clinical and developmental work is unfortunate, and likely limits progress in both areas. In this commentary, the authors argue for greater interdisciplinary collaboration and highlight contributions from developmental and clinical theories, which, if integrated, could enhance identity scholarship. The developmental psychopathology perspective is introduced as an ideal framework to promote these goals

Contextualized Treatment in Traumatic Brain Injury Inpatient Rehabilitation: Effects on Outcomes During the First Year after Discharge

Objective To evaluate the effect of providing a greater percentage of therapy as contextualized treatment on acute traumatic brain injury (TBI) rehabilitation outcomes. Design Propensity score methods are applied to the TBI-Practice-Based Evidence (TBI-PBE) database, a database consisting of multi-site, prospective, longitudinal observational data. Setting Acute inpatient rehabilitation. Participants Patients enrolled in the TBI-PBE study (n=1843), aged 14 years or older, who sustained a severe, moderate, or complicated mild TBI, receiving their first IRF admission in the US, and consented to follow-up 3 and 9 months post discharge from inpatient rehabilitation. Interventions Not applicable. Main Outcome Measures Participation Assessment with Recombined Tools-Objective- -17, FIMTM Motor and Cognitive scores, Satisfaction with Life Scale and Patient Health Questionnaire-9. Results Increasing the percentage of contextualized treatment during inpatient TBI rehabilitation leads to better outcomes, specifically in regard to community participation. Conclusions Increasing the proportion of treatment provided in the context of real-life activities appears to have a beneficial impact on outcome. Although the effect sizes are small, the results are consistent with other studies supporting functional-based interventions effecting better outcomes. Furthermore, any positive findings, regardless of size or strength, are endorsed as important by consumers (survivors of TBI). While the findings do not imply that decontextualized treatment should not be used, when the therapy goal can be addressed with either approach, the findings suggest that better outcomes may result if the contextualized approach is used

Interventions to improve water supply and quality, sanitation and handwashing facilities in healthcare facilities, and their effect on health care associated infections in low-income and middle-income countries: a systematic review and supplementary scoping review

Introduction Healthcare-associated infections (HCAIs) are the most frequent adverse event compromising patient safety globally. Patients in healthcare facilities (HCFs) in low-income and middle-income countries (LMICs) are most at risk. Although water, sanitation and hygiene (WASH) interventions are likely important for the prevention of HCAIs, there have been no systematic reviews to date. Methods As per our prepublished protocol, we systematically searched academic databases, trial registers, WHO databases, grey literature resources and conference abstracts to identify studies assessing the impact of HCF WASH services and practices on HCAIs in LMICs. In parallel, we undertook a supplementary scoping review including less rigorous study designs to develop a conceptual framework for how WASH can impact HCAIs and to identify key literature gaps. Results Only three studies were included in the systematic review. All assessed hygiene interventions and included: a cluster-randomised controlled trial, a cohort study, and a matched case-control study. All reported a reduction in HCAIs, but all were considered at medium high risk of bias. The additional 27 before-after studies included in our scoping review all focused on hygiene interventions, none assessed improvements to water quantity, quality or sanitation facilities. 26 of the studies reported a reduction in at least one HCAI. Our scoping review identified multiple mechanisms by which WASH can influence HCAI and highlighted a number of important research gaps. Conclusions Although there is a dearth of evidence for the effect of WASH in HCFs, the studies of hygiene interventions were consistently protective against HCAIs in LMICs. Additional and higher quality research is urgently needed to fill this gap to understand how WASH service

Family Involvement in Traumatic Brain Injury Inpatient Rehabilitation: A Propensity Score Analysis of Effects on Outcomes During the First Year After Discharge

Objective To evaluate the effect of family attendance at inpatient rehabilitation therapy sessions on traumatic brain injury (TBI) patient outcomes at discharge and up to 9 months postdischarge. Design Propensity score methods are applied to the TBI Practice-Based Evidence database, a database consisting of multisite, prospective, longitudinal, and observational data. Setting Nine inpatient rehabilitation centers in the United States. Participants Patients (N=1835) admitted for first inpatient rehabilitation after an index TBI. Intervention Family attendance during therapy sessions. Main Outcome Measures Participation Assessment for Recombined Tools-Objective-17 (Total scores and subdomain scores of Productivity, Out and About, and Social Relations), Functional Independence Measure, Satisfaction with Life Scale, and Patient Health Questionnaire-9. Results Participants whose families were in attendance for at least 10% of the treatment time were more out and about in their communities at 3 and 9 months postdischarge than participants whose families attended treatment less than 10% of the time. Although findings varied by propensity score method, improved functional independence in the cognitive area at 9 months was also associated with increased family attendance. Conclusions Family involvement during inpatient rehabilitation may improve community participation and cognitive functioning up to 9 months after discharge. Rehabilitation teams should engage patients’ families in the rehabilitation process to maximize outcomes