ObjectiveTo identify and synthesise existing literature exploring the impact of relational and informational continuity of care on preferred place of death, hospital admissions and satisfaction for ...palliative care patients in qualitative, quantitative and mixed methods literature.DesignA mixed methods rapid review.MethodsPUBMED, PsychINFO, CINAHL were searched from June 2008 to June 2018 in order to identify original peer reviewed, primary qualitative, quantitative or mixed methods research exploring the impact of continuity of care for people receiving palliative care. Synthesis methods as outlined by the Cochrane Qualitative and Implementation Methods Group were applied to qualitative studies while meta-analyses for quantitative data were planned.OutcomesThe impact of interventions designed to promote continuity of care for people receiving palliative care on the following outcomes was explored: achieving preferred place of death, satisfaction with care and avoidable hospital admissions.Results18 eligible papers were identified (11 qualitative, 6 quantitative and 1 mixed methods papers). In all, 1951 patients and 190 family caregivers were recruited across included studies. Meta-analyses were not possible due to heterogeneity in outcome measures and tools used. Two studies described positive impact on facilitating preferred place of death. Four described a reduction in avoidable hospital admissions. No negative impacts of interventions designed to promote continuity were reported. Patient satisfaction was not assessed in quantitative studies. Participants described a significant impact on their experiences as a result of the lack of informational and relational continuity.ConclusionsThis rapid review highlights the impact that continuity of care can have on the experiences of patients receiving palliative care. The evidence for the impact of continuity on place of death and hospital admissions is limited. Methods for enhancing, and recording continuity should be considered in the design and development of future healthcare interventions to support people receiving palliative care.
Reliable techniques for screening large numbers of plants for root traits are still being developed, but include aeroponic, hydroponic and agar plate systems. Coupled with digital cameras and image ...analysis software, these systems permit the rapid measurement of root numbers, length and diameter in moderate (typically <1000) numbers of plants. Usually such systems are employed with relatively small seedlings, and information is recorded in 2D. Recent developments in X-ray microtomography have facilitated 3D non-invasive measurement of small root systems grown in solid media, allowing angular distributions to be obtained in addition to numbers and length. However, because of the time taken to scan samples, only a small number can be screened (typically <10 per day, not including analysis time of the large spatial datasets generated) and, depending on sample size, limited resolution may mean that fine roots remain unresolved. Although agar plates allow differences between lines and genotypes to be discerned in young seedlings, the rank order may not be the same when the same materials are grown in solid media. For example, root length of dwarfing wheat (Triticum aestivum L.) lines grown on agar plates was increased by ~40% relative to wild-type and semi-dwarfing lines, but in a sandy loam soil under well watered conditions it was decreased by 24-33%. Such differences in ranking suggest that significant soil environment-genotype interactions are occurring. Developments in instruments and software mean that a combination of high-throughput simple screens and more in-depth examination of root-soil interactions is becoming viable.
In a society increasingly dominated by zero-tolerance thinking, Punishing Schools argues that our educational system has become both the subject of legislative punishment and an instrument for the ...punishment of children. William Lyons and Julie Drew analyze the connections between state sanctions against our schools (the diversion of funding to charter schools, imposition of unfunded mandates, and enforcement of dubious forms of teacher accountability) and the schools' own infliction of punitive measures on their students—a vicious cycle that creates fear and encourages the development of passive and dependent citizens.
In this in-depth examination of community policing in Seattle, William T. Lyons, Jr. explores the complex issues associated with the establishment and operation of community policing, an increasingly ...popular method for organizing law enforcement in this country.
Stories about community policing appeal to a nostalgic vision of traditional community life. Community policing carries with it the image of a safe community in which individual citizens and businesses are protected by police they know and who know them and their needs. However, it also carries an image of community based in partnerships that exclude the least advantaged, strengthen the police, and are limited to targeting those disorders feared by more powerful parts of the community and most amenable to intervention by professional law enforcement agencies.
The author argues that the politics of community policing are found in the construction of competing and deeply contested stories about community and the police in environments characterized by power inbalances. Community policing, according to the author, colonizes community life, increasing the capacity of the police department to shield itself from criticism, while manifesting the potential for more democratic forms of social control as evidenced by police attention to individual rights and to impartial law enforcement.
This book will be of interest to sociologists and political scientists interested in the study of community power and local politics as well as criminologists interested in the study of police.
William T. Lyons, Jr. is Assistant Professor of Political Science, University of Akron. He previously worked for the Seattle Police Department.
We have studied the structure of the protein species and the protein–protein interactions in solutions containing two apoferritin molecular forms, monomers and dimers, in the presence of Na
+ and Cd
...2+ ions. We used chromatographic, and static and dynamic light scattering techniques, and atomic force microscopy (AFM). Size-exclusion chromatography was used to isolate these two protein fractions. The sizes and shapes of the monomers and dimers were determined by dynamic light scattering and AFM. Although the monomer is an apparent sphere with a diameter corresponding to previous x-ray crystallography determinations, the dimer shape corresponds to two, bound monomer spheres. Static light scattering was applied to characterize the interactions between solute molecules of monomers and dimers in terms of the second osmotic virial coefficients. The results for the monomers indicate that Na
+ ions cause strong intermolecular repulsion even at concentrations higher than 0.15
M, contrary to the predictions of the commonly applied Derjaguin–Landau–Verwey–Overbeek theory. We argue that the reason for such behavior is hydration force due to the formation of a water shell around the protein molecules with the help of the sodium ions. The addition of even small amounts of Cd
2+ changes the repulsive interactions to attractive but does not lead to oligomer formation, at least at the protein concentrations used. Thus, the two ions provide examples of strong specificity of their interactions with the protein molecules. In solutions of the apoferritin dimer, the molecules attract even in the presence of Na
+ only, indicating a change in the surface of the apoferritin molecule. In view of the strong repulsion between the monomers, this indicates that the dimers and higher oligomers form only after partial denaturation of some of the apoferritin monomers. These observations suggest that aggregation and self-assembly of protein molecules or molecular subunits may be driven by forces other than those responsible for crystallization and other phase transitions in the protein solution.
Inside Assisted Living Eckert, J. Kevin; Carder, Paula C; Morgan, Leslie A ...
2009, 2009-06-15
eBook
Assisted living is the fastest-growing alternative to skilled nursing care for frail older persons in the United States. The expectations, settings, and missions of these residences are varied, ...making it difficult for prospective residents and their families to anticipate what it would be like to live in them. This book is a unique portal into the real world of assisted living and the key issues facing consumers, providers, and policy makers.
Drawing on in-depth interviews with residents, their family members, staffers, and administrators, Inside Assisted Living opens the window on day-to-day life in six different types of assisted living residence. From “Miss Helen at Valley Glen Home” to “Mr. Sidney at Laurel Ridge,” the detailed profiles of individuals show the commonalities among the residences while highlighting the positive and negative aspects of each. The voices of those living, visiting, and working in the homes clarify the important local (social relations, staff dynamics, leadership) and national (funding, regulation, aging-in-place) challenges presented by assisted living.
Introductory and concluding chapters synthesize new findings that cross the six settings and reflect issues vital to all participants. The book also features an appendix detailing the research process involved in creating the profiles.
High-resolution optical interferometry was used to investigate the effects of forced solution convection on the crystal growth kinetics of the model protein lysozyme. Most experiments were conducted ...with 99.99% pure protein solutions. To study impurity effects, ∼1% of lysozyme dimer (covalently bound) was added in some cases. We show that the unsteady kinetics, corresponding to bunching of growth steps, can be characterized by the Fourier components of time traces of the growth rate. Specific Fourier spectra are uniquely determined by the solution conditions (composition, temperature, and flow rate) and the growth layer source activity. We found that the average step velocity and growth rate increase by ∼10% with increasing flow rate, as a result of the enhanced solute supply to the interface. More importantly, faster convective transport results in lower fluctuation amplitudes. This observation supports our rationale for system-dependent effects of transport on the structural perfection of protein crystals. We also found that solution flow rates >500 μm/s result in stronger fluctuations while the average growth rate is decreased. This can lead to growth cessation at low supersaturations. With the intentionally contaminated solutions, these undesirable phenomena occurred at about half the flow rates required in pure solutions. Thus, we conclude that they are due to enhanced convective supply of impurities that are incorporated into the crystal during growth. Furthermore, we found that the impurity effects are reduced at higher crystal growth rates. Since the exposure time of terraces is inversely proportional to the growth rate, this observation suggests that the increased kinetics instability results from impurity adsorption on the interface. Finally, we provide evidence relating earlier observations of “slow protein crystal growth kinetics” to step bunch formation in response to nonsteady step generation.
What Do You Want to Be? Thomas, Bill; Kruse, Jerry
Juniata voices,
01/2018, Volume:
18
Journal Article
Kruse: It turns out that, unbeknownst to each of us, Bill and I were involved in the other's nomination for the Beachley awards, and so we thought it would be special for us to share this speech ...together because so much of our professional lives have been intertwined. Thomas: When I was leaving industry to start teaching, we had four young children. Just know it's not a complete list! Shortly after we returned to campus, we presented at one of the early Scholarship of Teaching and Learning (SoTL) brown bag lunches.
Genome-wide association study (GWAS) has become an obvious general approach for studying traits of agricultural importance in higher plants, especially crops. Here, we present a GWAS of 32 ...morphologic and 10 agronomic traits in a collection of 615 barley cultivars genotyped by genome-wide polymorphisms from a recently developed barley oligonucleotide pool assay. Strong population structure effect related to mixed sampling based on seasonal growth habit and ear row number is present in this barley collection. Comparison of seven statistical approaches in a genome-wide scan for significant associations with or without correction for confounding by population structure, revealed that in reducing false positive rates while maintaining statistical power, a mixed linear model solution outperforms genomic control, structured association, stepwise regression control and principal components adjustment. The present study reports significant associations for sixteen morphologic and nine agronomic traits and demonstrates the power and feasibility of applying GWAS to explore complex traits in highly structured plant samples.
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