United Hospital Fund

Engage skilled nursing facilities (SNFs) in a Learning Collaborative to reduce risks of polypharmacy and inappropriate medications. The project aimed to reduce use of the targeted medications by 15% among long-term care residents.

Indian willow (Salix tetrasperma) is an agriculturally useful tree which occurs over a wide geographic area across South Asia and bears importance. So far, this species has never been studied for molecular genetic diversity. The present study was, therefore, carried out to assess the genetic diversity and population structure analysis using RAPD and ISSR molecular markers in diverse genotypes from five populations covering North India. The mean number of effective alleles, Shannon information index and gene diversity i.e., 1.38 ± 0.013, 0.35 ± 0.010 and 0.23 ± 0.007, respectively were obtained with RAPD + ISSR markers. The analysis of molecular variance generated by RAPD + ISSR revealed a higher genetic variation (87%) within population as compared to that of among population (13%). Nei genetic distance was maximum (0.185) between Jammu and Kashmir and Punjab populations. Significant Mantel correlation (r=0.551,) was obtained between RAPD and ISSR markers. Bayesian clustering pattern obtained through STRUCTURE software showed four gene pools. Based on the genetic information obtained with regards to Indian willow by combining the RAPD and ISSR marker systems, it is proposed that an individual tree be selected within populations rather than among populations for the improvement of economic traits of Indian willow alongwith conservation of entire ecological populations.

Lettuce is one of the major leafy vegetables used in salads, soups and occasionally lightly cooked. Leaf lettuce has garnered a central role in human nutrition, as it combines pleasing organoleptic properties with a rich content of nutraceutical compounds. Leaf lettuce can bring about a diversification in the tomato/bell pepper production system in the summer season. The cultivation of lettuce has already started picking up in Himachal Pradesh in summers. The produce from hilly areas are available at time when these cannot be grown in the plains due to high temperature, thus bringing lucrative returns to the growers. Twenty two diverse genotypes of lettuce were evaluated in Randomized Complete Block Design (RCBD) with three replications at KVK, Kandaghat, including standard check cultivar, Solan Kriti, to ascertain the extent of variability. The observations were recorded on various morphological and horticultural traits in leaf lettuce. On the basis of studies, it was concluded that genotypes viz., KGT-1, Lettuce C1, KGT-5 and LS-2 Selection-3, performed better in terms of yield and other horticultural traits over the standard check, Solan Kriti. So, these genotypes offer an ample scope for their release in the mid hill conditions of Himachal Pradesh after multilocational testing.

Background The purpose of this study was to develop and administer surveys that assess patient and family caregiver experiences with care transitions and examine the psychometric properties of the surveys. The surveys were designed to ask about 1) the transitional care services that matter most to patients and their caregivers and 2) care outcomes, including the overall quality of transitional care they received, patient self-reported health, and caregiver effort/stress. Methods Survey items were developed based on a review of the literature, existing surveys, focus groups, site visits, stakeholder and expert input, and patient and caregiver cognitive interviews. We administered mail surveys with telephone follow up to patients recently discharged from 43 U.S. hospitals. Patients identified the caregivers who helped them during their hospital stay (Time 1 caregiver) and when they were home (Time 2 caregiver). Time 1 and Time 2 caregivers were surveyed by telephone only. The psychometric properties of the survey items and outcome composite measures were examined for each of the three surveys. Items that performed poorly across multiple analyses, including those with low variability and/or a high missing data, were dropped except when they were conceptually important. Results The analysis datasets included responses from 9282 patients, 1245 Time 1 caregivers and 1749 Time 2 caregivers. The construct validity of the three proposed outcome composite measures—Overall Quality of Transitional Care (patient and caregiver surveys), Patient Overall Health (patient survey) and Caregiver Effort/Stress (caregiver surveys) —was supported by acceptable exploratory factor analysis results and acceptable internal consistency reliability. Site-level reliability was acceptable for the two patient outcome composite measures, but was low for Caregiver Effort/Stress (< 0.70). In all surveys, the Overall Quality of Transitional Care outcome composite measure was significantly correlated with other outcome composite measures and most of the single-item measures. Conclusions Overall, the final patient and caregiver surveys are psychometrically sound and can be used by health systems, hospitals, and researchers to assess the quality of care transitions and related outcomes. Results from these surveys can be used to improve care transitions, focusing on what matters most to patients and their family caregivers.