Shadowing and Expansivity in Sub-Spaces

We address various notions of shadowing and expansivity for continuous maps restricted to a proper subset of their domain. We prove new equivalences of shadowing and expansive properties, we demonstrate under what conditions certain expanding maps have shadowing, and generalize some known results in this area. We also investigate the impact of our theory on maps of the interval, in which context some of our results can be extended.Comment: 18 page

The analysis of TRICARE Navy obstetric delivery costs within continental United States military treatment facilities

MBA Professional ReportNavy medicine spends approximately $75 million on purchased obstetric (OB) care for Navy personnel and their dependents, a sum that continues to increase each year. The purpose of this research is to compare the cost of Navy OB medical care under TRICARE Prime (civilian sector) with similar care provided in four representative Navy Medical Treatment Facilities (MTF). Specifically, the study will examine (1) the quantity of selected deliveries in TRICARE and four specific MTF catchment areas; (2) the average delivery cost for the different types of Purchased Care (PC) deliveries, and (3) best practice techniques to increase the amount of Direct Care (DC) deliveries care in Navy Medicine. The goal of this study is to compare the benefits and drawbacks of each system to gain insights for providing better and more cost-effective OB care in the Navy.http://archive.org/details/thenalysisoftric1094510397Approved for public release; distribution is unlimited

Are non-slip socks really 'non-slip'? An analysis of slip resistance

Background. Non-slip socks have been suggested as a means of preventing accidental falls due to slips. This study compared the relative slip resistance of commercially available non-slip socks with other foot conditions, namely bare feet, compression stockings and conventional socks, in order to determine any traction benefit. Methods. Phase one involved slip resistance testing of two commercially available non-slip socks and one compression-stocking sample through an independent blinded materials testing laboratory using a Wet Pendulum Test. Phase two of the study involved in-situ testing among healthy adult subjects (n = 3). Subjects stood unsupported on a variable angle, inclined platform topped with hospital grade vinyl, in a range of foot conditions (bare feet, non-slip socks, conventional socks and compression stockings). Inclination was increased incrementally for each condition until slippage of any magnitude was detected. The platform angle was monitored using a spatial orientation tracking sensor and slippage point was recorded on video. Results. Phase one results generated through Wet Pendulum Test suggested that non-slip socks did not offer better traction than compression stockings. However, in phase two, slippage in compression stockings was detected at the lowest angles across all participants. Amongst the foot conditions tested, barefoot conditions produced the highest slip angles for all participants indicating that this foot condition provided the highest slip resistance. Conclusion. It is evident that bare feet provide better slip resistance than non-slip socks and therefore might represent a safer foot condition. This study did not explore whether traction provided by bare feet was comparable to 'optimal' footwear such as shoes. However, previous studies have associated barefoot mobilisation with increased falls. Therefore, it is suggested that all patients continue to be encouraged to mobilise in appropriate, well-fitting shoes whilst in hospital. Limitations of this study in relation to the testing method, participant group and sample size are discussed

Antenatal vaccination against Group B streptococcus: attitudes of pregnant women and healthcare professionals in the UK towards participation in clinical trials and routine implementation

Introduction : Maternal vaccination is increasingly part of antenatal care in the UK and worldwide. Trials of Group B streptococcus (GBS) vaccines are ongoing. This study investigated the attitudes of pregnant women and healthcare profe ssionals towards antenatal vaccination, both in routine care and a clinical trial setting. Material and methods : Survey of 269 pregnant women, 273 midwives/obstetricians and 97 neonatal doctors across seven sites in the UK assessing attitudes towards antenatal vaccinations, knowledge of GBS, a hypothetical GBS vaccine and participation in clinical vaccine trials. Results : Sixty -eight percent of pregnant women intended to receive a vaccine during their current pregnancy (183/269) and 43% (of all respondents, 115/269) reported they would be very/fairly likely to accept a vaccine against GBS despite only 29% (55/269) knowing what GBS was. This increased to 69% after additional information about GBS was provided. Twenty -four percent of pregnant women reported they would be likely to take part in a clinical trial of an unlicensed GBS vaccine. Fifty -nine percent of maternity professionals and 74% of neonatologists would be likely to recommend participation in a GBS vaccine trial to women , with the vast majority (>99%) willing to be involved in such a study . Incentives to take part cited by pregnant women included extra antenatal scans and the opportunity to be tested for GBS. Conclusion : Pregnant women and healthcare professionals were open to the idea of an antenatal GBS vaccine and involvement in clinical trials of such a vaccine. Education and support from midwives would be key to successful implementation

Need-driven dementia-compromised behavior: An alternative view of disruptive behavior

The disruptive behavior of persons with dementia is a problem of considerable clinical interest and growing scientific concern. This paper offers a view of these behaviors as expressions of unmet needs or goals and provides a comprehensive conceptual framework to guide further research and clinical practice. Empiricalfindings and clinical impressions related to wandering, vocalizations and aggression to support and illustrate the framework are presentedPeer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66887/2/10.1177_153331759601100603.pd

Prevalence of physical and verbal aggressive behaviours and associated factors among older adults in long-term care facilities

BACKGROUND: Verbal and physical aggressive behaviours are among the most disturbing and distressing behaviours displayed by older patients in long-term care facilities. Aggressive behaviour (AB) is often the reason for using physical or chemical restraints with nursing home residents and is a major concern for caregivers. AB is associated with increased health care costs due to staff turnover and absenteeism. METHODS: The goals of this secondary analysis of a cross-sectional study are to determine the prevalence of verbal and physical aggressive behaviours and to identify associated factors among older adults in long-term care facilities in the Quebec City area (n = 2 332). RESULTS: The same percentage of older adults displayed physical aggressive behaviour (21.2%) or verbal aggressive behaviour (21.5%), whereas 11.2% displayed both types of aggressive behaviour. Factors associated with aggressive behaviour (both verbal and physical) were male gender, neuroleptic drug use, mild and severe cognitive impairment, insomnia, psychological distress, and physical restraints. Factors associated with physical aggressive behaviour were older age, male gender, neuroleptic drug use, mild or severe cognitive impairment, insomnia and psychological distress. Finally, factors associated with verbal aggressive behaviour were benzodiazepine and neuroleptic drug use, functional dependency, mild or severe cognitive impairment and insomnia. CONCLUSION: Cognitive impairment severity is the most significant predisposing factor for aggressive behaviour among older adults in long-term care facilities in the Quebec City area. Physical and chemical restraints were also significantly associated with AB. Based on these results, we suggest that caregivers should provide care to older adults with AB using approaches such as the progressively lowered stress threshold model and reactance theory which stress the importance of paying attention to the severity of cognitive impairment and avoiding the use of chemical or physical restraints