Hospital fall prevention: a systematic review of implementation, components, adherence, and effectiveness.

ObjectivesTo systematically document the implementation, components, comparators, adherence, and effectiveness of published fall prevention approaches in U.S. acute care hospitals.DesignSystematic review. Studies were identified through existing reviews, searching five electronic databases, screening reference lists, and contacting topic experts for studies published through August 2011.SettingU.S. acute care hospitals.ParticipantsStudies reporting in-hospital falls for intervention groups and concurrent (e.g., controlled trials) or historic comparators (e.g., before-after studies).InterventionFall prevention interventions.MeasurementsIncidence rate ratios (IRR, ratio of fall rate postintervention or treatment group to the fall rate preintervention or control group) and ratings of study details.ResultsFifty-nine studies met inclusion criteria. Implementation strategies were sparsely documented (17% not at all) and included staff education, establishing committees, seeking leadership support, and occasionally continuous quality improvement techniques. Most interventions (81%) included multiple components (e.g., risk assessments (often not validated), visual risk alerts, patient education, care rounds, bed-exit alarms, and postfall evaluations). Fifty-four percent did not report on fall prevention measures applied in the comparison group, and 39% neither reported fidelity data nor described adherence strategies such as regular audits and feedback to ensure completion of care processes. Only 45% of concurrent and 15% of historic control studies reported sufficient data to compare fall rates. The pooled postintervention incidence rate ratio (IRR) was 0.77 (95% confidence interval = 0.52-1.12, P = .17; eight studies; I(2) : 94%). Meta-regressions showed no systematic association between implementation intensity, intervention complexity, comparator information, or adherence levels and IRR.ConclusionPromising approaches exist, but better reporting of outcomes, implementation, adherence, intervention components, and comparison group information is necessary to establish evidence on how hospitals can successfully prevent falls

Unraveling Ethics: Reflections from a Community-based Participatory Research Project with Youth

There is limited literature describing the ethical dilemmas that arise when conducting community-based participatory research. The following provides a case example of ethical dilemmas that developed during a multi-method community-based participatory action research project with youth in Calgary, Alberta, Canada. Several ethical dilemmas emerged during the course of the study related to the community in which the research was being undertaken, the recruitment of participants, and the overall research process. As important are possible harm s that may arise when the researcher is no longer involved. These ethical dilemmas and potential solutions are discussed in relation to social work research and community-based practice to raise awareness about the essential role of community in informing ethical research practice

What is the probability of connecting two points ?

The two-terminal reliability, known as the pair connectedness or connectivity function in percolation theory, may actually be expressed as a product of transfer matrices in which the probability of operation of each link and site is exactly taken into account. When link and site probabilities are $p$ and $\rho$, it obeys an asymptotic power-law behavior, for which the scaling factor is the transfer matrix's eigenvalue of largest modulus. The location of the complex zeros of the two-terminal reliability polynomial exhibits structural transitions as $0 \leq \rho \leq 1$.Comment: a few critical polynomials are at the end of the .tex source fil

Dissipationless Collapse of Spherical Protogalaxies and the Fundamental Plane

Following on from the numerical work of Capelato, de Carvalho & Carlberg (1995, 1997), where dissipationless merger simulations were shown to reproduce the "Fundamental Plane" (FP) of elliptical galaxies, we investigate whether the end products of pure, spherically symmetric, one-component dissipationless {\it collapses} could also reproduce the FP. Past numerical work on collisionless collapses have addressed important issues on the dynamical/structural characteristics of collapsed equilibrium systems. However, the study of collisionless collapse in the context of the nature of the FP has not been satisfactorily addressed yet. Our aim in this paper is to focus our attention on the resulting collapse of simple one-component spherical models with a range of different initial virial coefficients. We find that the characteristic correlations of the models are compatible with virialized, centrally homologous systems. Our results strengthen the idea that merging may be a fundamental ingredient in forming non-homologous objects.Comment: 9 pages, 4 Postscript figures, Astronomy & Astrophysics in press (2002). Abstract placement correcte

The usability of ventilators: a comparative evaluation of use safety and user experience

Setup of the testing facilities at the Clinical Skills and Patient Simulation Center at the University of North Carolina School of Medicine, where the simulator room and observation room can be seen. (TIF 9461 kb

PMAS integral field spectroscopy of luminous infrared galaxies. I.- The atlas

In this paper we present PMAS optical (3800-7200A) IFS of the northern hemisphere portion of a volume-limited sample of 11 LIRGs. The PMAS observations typically cover the central ~5kpc and are complemented with HST/NICMOS images. For most LIRGs in our sample, the peaks of the continuum and gas (e.g., Halpha, [NII]) emissions coincide, unlike what is observed in local, strongly interacting ULIRGs. The only exceptions are galaxies with circumnuclear rings of star formation where the most luminous Halpha emitting regions are found in the rings rather than in the nuclei, and the displacements are well understood in terms of differences in the stellar populations. A large fraction of the nuclei of these LIRGs are classified as LINER and intermediate LINER/HII, or composite objects. The excitation conditions of the integrated emission depend on the relative contributions of HII regions and the diffuse emission to the line emission over the PMAS FoV. Galaxies dominated by high surface-brightness HII regions show integrated HII-like excitation. A few galaxies show slightly larger integrated [NII]/Halpha and [SII]/Halpha line ratios than the nuclear ones, probably because of more contribution from the diffuse emission. The Halpha velocity fields over the central few kpc are generally consistent, at least to first order, with rotational motions. The velocity fields of most LIRGs are similar to those of disk galaxies, in contrast to the highly perturbed fields of most local, strongly interacting ULIRGs. The peak of the Halpha velocity dispersion coincides with the position of the nucleus and is likely to be tracing mass. All these results are similar to the properties of z~1 LIRGs, and they highlight the importance of detailed studies of flux-limited samples of local LIRGs. (Abridged)Comment: Accepted for publication in Astronomy and Astrophysic

Dust and gas in luminous infrared galaxies - results from SCUBA observations

We present new data taken at 850 $\mu$m with SCUBA at the JCMT for a sample of 19 luminous infrared galaxies. Fourteen galaxies were detected. We have used these data, together with fluxes at 25, 60 and 100 $\mu$m from IRAS, to model the dust emission. We find that the emission from most galaxies can be described by an optically thin, single temperature dust model with an exponent of the dust extinction coefficient ($k_\lambda \propto \lambda^{-\beta}$) of $\beta \simeq 1.5 - 2$. A lower $\beta\simeq 1$ is required to model the dust emission from two of the galaxies, Arp 220 and NGC 4418. We discuss various possibilities for this difference and conclude that the most likely is a high dust opacity. In addition, we compare the molecular gas mass derived from the dust emission, $M_{dust}$, with the molecular gas mass derived from the CO emission, $M_{CO}$, and find that $M_{CO}$ is on average a factor 3 higher than $M_{dust}$.Comment: 10 pages, 6 figures, latex, with MN-macros, accepted by MNRAS - revised version (changed flux values for some galaxies

Real-time Timbre Remapping with Differentiable DSP

Timbre is a primary mode of expression in diverse musical contexts. However, prevalent audio-driven synthesis methods predominantly rely on pitch and loudness envelopes, effectively flattening timbral expression from the input. Our approach draws on the concept of timbre analogies and investigates how timbral expression from an input signal can be mapped onto controls for a synthesizer. Leveraging differentiable digital signal processing, our method facilitates direct optimization of synthesizer parameters through a novel feature difference loss. This loss function, designed to learn relative timbral differences between musical events, prioritizes the subtleties of graded timbre modulations within phrases, allowing for meaningful translations in a timbre space. Using snare drum performances as a case study, where timbral expression is central, we demonstrate real-time timbre remapping from acoustic snare drums to a differentiable synthesizer modeled after the Roland TR-808

Plan of Rehabilitation for Little River Drainage District, Southeastern Missouri

Excerpts: The Little River Drainage District includes land in the southern parts of Cape Girardeau and Bollinger counties, the eastern parts of Stoddard and Dunklin counties, and the western parts of Scott, New Madrid, and Pemiscot counties. There are 465,350 acres of assessed land within the boundary of the district, embracing a territory approximately ninety miles long with an average width of ten miles. Prior to the construction of the drainage improvements these lands were subject to overflow during times of high water in Castor and Little River and a number of minor creeks. The diversion of those streams to the Mississippi River, at the extreme north part of the district, together with a system of ditches throughout the area, has made possible the cultivation of a large part of the land in the district