Staff engagement for practice change in long-term care: evaluating the Feasible and Sustainable Culture Change Initiative (FASCCI) model

Context: Interventions aimed at increasing the provision of person-centred care in long-term care (LTC) homes, that do not address contextual and system issues, most often fail. Promoting positive change in LTC homes requires requires a multilevel, systems approach. Objectives: Evaluate the effectiveness of the Feasible and Sustainable Culture Change Initiative (FASCCI) model for improving the provision of person-centred mealtime practices in a LTC home. Methods: A single-group, time series design was used to assess the impact of the FASCCI model for change on outcome measures across four time periods (pre-intervention, 2-month, 4-month and 6-month follow-up). Differences in scores from baseline were assessed utilizing Wilcoxon signed-rank tests. Interviews (n = 21) were also conducted to examine treatment fidelity and to ascertain the study participants’ perceptions of the process for making improvements using the FASCCI model. Findings: We observed increases in care staff’s capacity to consistently provide relational and person-centred care during mealtimes. Mealtime environment scores started increasing immediately following the intervention, with statistically significant improvements in all mealtime environment scales by six-months, including: the physical environment (W = 55.00, p = 0.008); social environment (W = 55.00, p = 0.008); relationship-centred care (W = 45.00, p = 0.014); and overall quality of dining environment (W = 55.00, p = 0.010). Analysis of data from qualitative interviews demonstrated that use of the FASCCI model resulted in improved team leadership, communication, and collaborative decision-making. Limitations: Generalizability is limited due to the small sample size and use of convenience sampling methods. Implications: Outcomes indicate that the FASCCI model seems promising in its ability to improve PCC mealtime practices in LTC homes and is worthy of a larger scale study. The results further demonstrate the value of supportive team environments in quality dementia care

Identification. The missing link between joint attention and imitation

In this paper we outline our hypothesis that human intersubjective engagement entails identifying with other people. We tested a prediction derived from this hypothesis that concerned the relation between a component of joint attention and a specific form of imitation. The empirical investigation involved “blind” ratings of videotapes from a recent study in which we tested matched children with and without autism for their propensity to imitate the self-/other-orientated aspects of another person's actions. The results were in keeping with three a priori predictions, as follows: (a) children with autism contrasted with control participants in spending more time looking at the objects acted upon and less time looking at the tester; (b) participants with autism showed fewer “sharing” looks toward the tester, and although they also showed fewer “checking” and “orientating” looks, they were specifically less likely to show any sharing looks; and, critically, (c) within each group, individual differences in sharing looks (only) were associated with imitation of self–other orientation. We suggest that the propensity to adopt the bodily anchored psychological stance of another person is essential to certain forms of joint attention and imitation, and that a weak tendency to identify with others is pivotal for the developmental psychopathology of autism

GABA\u3csub\u3eB\u3c/sub\u3e Receptor Attenuation of GABA\u3csub\u3eA\u3c/sub\u3e Currents in Neurons of the Mammalian Central Nervous System

Ionotropic receptors are tightly regulated by second messenger systems and are often present along with their metabotropic counterparts on a neuron\u27s plasma membrane. This leads to the hypothesis that the two receptor subtypes can interact, and indeed this has been observed in excitatory glutamate and inhibitory GABA receptors. In both systems the metabotropic pathway augments the ionotropic receptor response. However, we have found that the metabotropic GABAB receptor can suppress the ionotropic GABAA receptor current, in both the in vitro mouse retina and in human amygdala membrane fractions. Expression of amygdala membrane microdomains in Xenopus oocytes by microtransplantation produced functional ionotropic and metabotropic GABA receptors. Most GABAA receptors had properties of α‐subunit containing receptors, with ~5% having ρ‐subunit properties. Only GABAA receptors with α‐subunit‐like properties were regulated by GABAB receptors. In mouse retinal ganglion cells, where only α‐subunit‐containing GABAA receptors are expressed, GABAB receptors suppressed GABAA receptor currents. This suppression was blocked by GABAB receptor antagonists, G‐protein inhibitors, and GABAB receptor antibodies. Based on the kinetic differences between metabotropic and ionotropic receptors, their interaction would suppress repeated, rapid GABAergic inhibition

Retrieval of subpixel snow covered area, grain size, and albedo from MODIS

We describe and validate a model that retrieves fractional snow-covered area and the grain size and albedo of that snow from surface reflectance data (product MOD09GA) acquired by NASA\u27s Moderate Resolution Imaging Spectroradiometer (MODIS). The model analyzes the MODIS visible, near infrared, and shortwave infrared bands with multiple endmember spectral mixtures from a library of snow, vegetation, rock, and soil. We derive snow spectral endmembers of varying grain size from a radiative transfer model specific to a scene\u27s illumination geometry; spectra for vegetation, rock, and soil were collected in the field and laboratory. We validate the model with fractional snow cover estimates from Landsat Thematic Mapper data, at 30 m resolution, for the Sierra Nevada, Rocky Mountains, high plains of Colorado, and Himalaya. Grain size measurements are validated with field measurements during the Cold Land Processes Experiment, and albedo retrievals are validated with in situ measurements in the San Juan Mountains of Colorado. The pixel-weighted average RMS error for snow-covered area across 31 scenes is 5%, ranging from 1% to 13%. The mean absolute error for grain size was 51 μm and the mean absolute error for albedo was 4.2%. Fractional snow cover errors are relatively insensitive to solar zenith angle. Because MODSCAG is a physically based algorithm that accounts for the spatial and temporal variation in surface reflectances of snow and other surfaces, it is capable of global snow cover mapping in its more computationally efficient, operational mode

Graduate Brass Quintet Recital

Kemp Recital Hall Thursday April 12, 2001 6:30p.m

Estimating body composition in adolescent sprint athletes : comparison of different methods in a 3 years longitudinal design

A recommended field method to assess body composition in adolescent sprint athletes is currently lacking. Existing methods developed for non-athletic adolescents were not longitudinally validated and do not take maturation status into account. This longitudinal study compared two field methods, i.e., a Bio Impedance Analysis (BIA) and a skinfold based equation, with underwater densitometry to track body fat percentage relative to years from age at peak height velocity in adolescent sprint athletes. In this study, adolescent sprint athletes (34 girls, 35 boys) were measured every 6 months during 3 years (age at start = 14.8 +/- 1.5yrs in girls and 14.7 +/- 1.9yrs in boys). Body fat percentage was estimated in 3 different ways: 1) using BIA with the TANITA TBF 410; 2) using a skinfold based equation; 3) using underwater densitometry which was considered as the reference method. Height for age since birth was used to estimate age at peak height velocity. Cross-sectional analyses were performed using repeated measures ANOVA and Pearson correlations between measurement methods at each occasion. Data were analyzed longitudinally using a multilevel cross-classified model with the PROC Mixed procedure. In boys, compared to underwater densitometry, the skinfold based formula revealed comparable values for body fatness during the study period whereas BIA showed a different pattern leading to an overestimation of body fatness starting from 4 years after age at peak height velocity. In girls, both the skinfold based formula and BIA overestimated body fatness across the whole range of years from peak height velocity. The skinfold based method appears to give an acceptable estimation of body composition during growth as compared to underwater densitometry in male adolescent sprinters. In girls, caution is warranted when interpreting estimations of body fatness by both BIA and a skinfold based formula since both methods tend to give an overestimation

Prem Baby Triple P: a randomised controlled trial of enhanced parenting capacity to improve developmental outcomes in preterm infants

Background Very preterm birth (gestation) is associated with motor, cognitive, behavioural and educational problems in children and maternal depression and withdrawal. Early interventions that target parenting have the greatest potential to create sustained effects on child development and parental psychopathology. Triple P (Positive Parenting Program) has shown positive effects on child behaviour and adjustment, parenting practices and family functioning. Baby Triple P for Preterm infants, has been developed to target parents of very preterm infants. This study tests the effectiveness of Baby Triple P for Preterm infants in improving child and parent/couple outcomes at 24 months corrected age (CA). Methods/Design Families will be randomised to receive either Baby Triple P for Preterm infants or Care as Usual (CAU). Baby Triple P for Preterm infants involves 4 × 2 hr group sessions at the hospital plus 4 × 30 min telephone consultations soon after transfer (42 weeks C.A.). After discharge participants will be linked to community based Triple P and intervention maintenance up to 24 months C.A. Assessments will be: baseline, post-intervention (6 weeks C.A.), at 12 and 24 months C.A. The primary outcome measure is the Infant Toddler Social & Emotional Assessment (ITSEA) at 24 months C.A. Child behavioural and emotional problems will be coded using the mother-toddler version of the Family Observation Schedule at 24 months C.A. Secondary outcome will be the Bayley Scales of Infant and Toddler Development (BSID III) cognitive development, language and motor abilities. Proximal targets of parenting style, parental self-efficacy, parental mental health, parental adjustment, parent-infant attachment, couple relationship satisfaction and couple communication will also be assessed. Our sample size based on the ITSEA, has 80% power, predicted effect size of 0.33 and an 85% retention rate, requires 165 families are required in each group (total sample of 330 families). Discussion This protocol presents the study design, methods and intervention to be analysed in a randomised trial of Baby Triple P for Preterm infants compared to Care as Usual (CAU) for families of very preterm infants. Publications of all outcomes will be published in peer reviewed journals according to CONSORT guidelines

Total and positronium formation cross sections for positron scattering from H2O and HCOOH

Total and positronium formation cross sections have been measured for positron scattering from H2O and HCOOH using a positron beam with an energy resolution of 60 meV (full-width at half-maximum (FWHM)). The energy range covered is 0.5–60 eV, including an investigation of the behavior of the onset of the positronium formation channel using measurements with a 50 meV energy step, the result of which shows no evidence of any channel coupling effects or scattering resonances for either molecule

Inter- and Intramolecular Experimental and Calculated Equilibrium Isotope Effects for (silox)₂(ᵗBu₃SiND)TiR + RH (silox = ᵗBu₃SiO): Inferred Kinetic Isotope Effects for RH/D Addition to Transient (silox)₂Ti=NSiᵗBu₃

This article discusses inter- and intramolecular experimental and calculated equilibrium isotope effects