Impeding and facilitating factors for the implementation of alcohol interventions in hospitals: a qualitative and exploratory study among Dutch healthcare professionals

Background Non-moderated alcohol use is more prevalent among hospitalized patients compared to the general population. However, many hospitals fail to find and intervene with people with alcohol problems. We aimed to conduct an exploration of impeding and facilitating factors experienced by healthcare professionals in implementation of alcohol interventions in Dutch general hospitals. In addition, we explored the alcohol interventions used in the selected hospitals and involved stakeholders. Methods Through a qualitative study, semi-structured telephone interviews were conducted with twenty healthcare professionals working in or in collaboration with six different general hospitals. Results Healthcare professionals indicated impeding and facilitating factors in the areas of motivation, knowledge and skills, patient characteristics, protocol, internal and external collaboration/support, resources, role suitability and societal support. Five different categories of approaches to identify and intervene with non-moderated alcohol use and 18 involved stakeholders from both inside and outside the hospital were found. Conclusions Implementation of alcohol interventions for patients in Dutch general hospitals still seems to be in its infancy. Respondents emphasized the importance of one clear protocol on how to tackle alcohol problems within their hospital, repeated training on alcohol-related knowledge and skills, (clinical) “champions” that support healthcare professionals and developing and maintaining collaborations with stakeholders within and outside the hospital.

Knowledge retention in oil and gas industry – the case of contract workforce

PurposeThe purpose of this article is to investigate how organization retain the knowledge of Contract Workforce (CWF) and to understand the associated challenges in this regard.Design/methodology/approachAdopting an inductive approach, 15 semi-structured interviews were conducted with senior managers, project heads and consultants working in leading oil and gas companies across eight countries (USA, Australia, UAE, KSA, Pakistan, UK, Thailand and Russia). Thematic analysis was carried out to analyze the data collected.FindingsCWF appears to be a significant source of knowledge attrition and even knowledge loss in the oil and gas sector. There are various risks associated with hiring of CWF, such as hallowing of organizational memory, repeated training of contractors, no knowledge base, workforce shortage among others which can impede the knowledge retention capability of O&G companies in the context of contract workforce. Various knowledge retention strategies for CWF have been revealed, however, there is interplay of various factors such as proportion of CWF deployed, proper resource utilization, cross-functional multi-level teams' involvement and strength of transactional ties. Maintaining strong relationships (Transactional ties) is crucial to maintain a virtual organizational memory (partial knowledge retention) and to follow a adopting a rehired when required policy.Originality/valueThe knowledge retention issue in the context of CWF has not be addressed in past researches. This article attempts to fill this gap.

Deep reinforcement learning for universal quantum state preparation via dynamic pulse control

Accurate and efficient preparation of quantum state is a core issue in building a quantum computer. In this paper, we investigate how to prepare a certain single- or two-qubit target state from arbitrary initial states in semiconductor double quantum dots with only a few discrete control pulses by leveraging the deep reinforcement learning. Our method is based on the training of the network over numerous preparing tasks. The results show that once the network is well trained, it works for any initial states in the continuous Hilbert space. Thus repeated training for new preparation tasks is avoided. Our scheme outperforms the traditional optimization approaches based on gradient with both the higher efficiency and the preparation quality in discrete control space. Moreover, we find that the control trajectories designed by our scheme are robust against stochastic fluctuations within certain thresholds, such as the charge and nuclear noises.

Twenty Months Into the Pandemic: No SARS-CoV-2 Infections Among Health Care Workers Managing COVID-19 Cases in Bhutan

There is no international reporting of SARS-CoV-2 infections in health care workers (HCWs). Estimates suggest that a HCW dies every thirty minutes from COVID-19. This worsened the shortages and burnout of HCWs worldwide. Twenty months into the pandemic, Bhutan recorded over 2600 COVID-19 positive cases and three deaths. About 906 HCWs were directly involved in managing these laboratory confirmed cases but no infections occured amongst this group. This zero infection was possible through the clustered management of positive cases in four national COVID-19 centers, strategic deployment of HCWs, the uninterrupted provision of quality personal protectiPPE and repeated training on the correct use of PPE. This is an exemplary achievement for a small country with limited expertise and resources.

Role of DNA Methylation in Mechanisms of Anterograde Amnesia

Previously, we found that impairment of conditioned food aversion memory consolidation or reconsolidation in snails by NMDA glutamate receptors antagonists led to the induction of amnesia changing over time. In particular, at the later amnesia stages (10 or more days), repeated aversion training for the same food type that was used in the initial training did not induce long-term memory formation. In these animals, long-term aversion memory for a new food type was formed. We characterized this amnesia as specific anterograde amnesia. In the present work, using DNA methyltransferases (DNMT) inhibitors, the DNA methylation processes role in mechanisms of anterograde amnesia and recovery from amnesia was investigated. It was found that in amnestic animals, DNMT inhibitor administration before or after repeated training led to the rapid long-term conditioned food aversion memory formation. It depended on proteins and mRNA synthesis at certain time windows. Thus, protein synthesis inhibitors administration before or immediately after repeated training, or RNA synthesis inhibitor injection after training, prevented memory formation induced by the DNMT inhibitor. The effects of DNMT inhibitors were specific for certain conditioned stimulus, since these inhibitors did not affect amnestic animals training for a new food stimulus. DNMT inhibition during second training removed blockade of these genes' expression, opening up access to them for transcription factors synthesized during training. Thus, this work was the first to study the molecular mechanisms of anterograde amnesia, as well as memory recovery, which can be important for search for pharmacological correction of this neuropsychic pathology.

Surveillance of Biomedical Waste Practices in a Multi Speciality Hospital, its Evaluation and Audit

Aims: To assess the knowledge of Biomedical waste (BMW) categories, colour coding, transport, storage & disposal of Biomedical waste among the healthcare workers. Study Design: Cross sectional. Place and Duration of Study: Multi speciality Hospital, Pune, over the duration of 1 month. Methodology: A predesigned questionnaire containing closed-ended questions was used to conduct this cross sectional study on HCWs. The data related to awareness & knowledge about various aspects of Biomedical waste amongst the Healthcare workers was collected. Results: Out of total 100 Healthcare workers (HCWs), 40 doctors were correctly knowing all the categories of Biomedical waste. 45 doctors & 40 nursing staff (total 85 out of 100 HCWs) could answer correctly the questions on colour coding of BMW. Only 30 doctors & 21 nursing staff could answer correctly about BMW transport. 25 doctors &18 nurses could answer correctly the questions related to BMW storage & disposal. Conclusion: The vigorous & repeated training & evaluation is needed to bridge the observed knowledge gaps amongst the HCWs.

Newly learned novel cues to location are combined with familiar cues but not always with each other

Mature perceptual systems can learn new arbitrary sensory signals (novel cues) to properties of the environment, but little is known about the extent to which novel cues are integrated into normal perception. In normal perception, multiple uncertain familiar cues are combined, often near-optimally (reliability-weighted averaging), to increase perceptual precision. We trained observers to use abstract novel cues to estimate horizontal locations of hidden objects on a monitor. In Experiment 1, four groups of observers each learned to use a different novel cue. All groups benefitted from a suboptimal but significant gain in precision using novel and familiar cues together after short-term training (3 x ~1.5 hour sessions), extending previous reports of novel-familiar cue combination. In Experiment 2, we tested whether two novel cues may also be combined with each other. One pair of novel cues could be combined to improve precision but the other could not, at least not after three sessions of repeated training. Overall, our results provide extensive evidence that novel cues can be learned and combined with familiar cues to enhance perception, but mixed evidence for whether perceptual and decision-making systems can extend this ability to the combination of multiple novel cues with only short-term training.

Switch-like and persistent memory formation in individual Drosophila larvae

Associative learning allows animals to use past experience to predict future events. The circuits underlying memory formation support immediate and sustained changes in function, often in response to a single example. Larval Drosophila is a genetic model for memory formation that can be accessed at molecular, synaptic, cellular, and circuit levels, often simultaneously, but existing behavioral assays for larval learning and memory do not address individual animals, and it has been difficult to form long-lasting memories, especially those requiring synaptic reorganization. We demonstrate a new assay for learning and memory capable of tracking the changing preferences of individual larvae. We use this assay to explore how activation of a pair of reward neurons changes the response to the innately aversive gas carbon dioxide (CO2). We confirm that when coupled to CO2 presentation in appropriate temporal sequence, optogenetic reward reduces avoidance of CO2. We find that learning is switch-like: all-or-none and quantized in two states. Memories can be extinguished by repeated unrewarded exposure to CO2 but are stabilized against extinction by repeated training or overnight consolidation. Finally, we demonstrate long-lasting protein synthesis dependent and independent memory formation.

Coupling between motor cortex and striatum increases during sleep over long-term skill learning

The strength of cortical connectivity to the striatum influences the balance between behavioral variability and stability. Learning to consistently produce a skilled action requires plasticity in corticostriatal connectivity associated with repeated training of the action. However, it remains unknown whether such corticostriatal plasticity occurs during training itself or 'offline' during time away from training, such as sleep. Here, we monitor the corticostriatal network throughout long-term skill learning in rats and find that non-REM (NREM) sleep is a relevant period for corticostriatal plasticity. We first show that the offline activation of striatal NMDA receptors is required for skill learning. We then show that corticostriatal functional connectivity increases offline, coupled to emerging consistent skilled movements and coupled cross-area neural dynamics. We then identify NREM sleep spindles as uniquely poised to mediate corticostriatal plasticity, through interactions with slow oscillations. Our results provide evidence that sleep shapes cross-area coupling required for skill learning.

An Approach for Stabilizing Abnormal Neural Activity in ADHD Using Chaotic Resonance

Reduced integrity of neural pathways from frontal to sensory cortices has been suggested as a potential neurobiological basis of attention-deficit hyperactivity disorder. Neurofeedback has been widely applied to enhance reduced neural pathways in attention-deficit hyperactivity disorder by repeated training on a daily temporal scale. Clinical and model-based studies have demonstrated that fluctuations in neural activity underpin sustained attention deficits in attention-deficit hyperactivity disorder. These aberrant neural fluctuations may be caused by the chaos–chaos intermittency state in frontal-sensory neural systems. Therefore, shifting the neural state from an aberrant chaos–chaos intermittency state to a normal stable state with an optimal external sensory stimulus, termed chaotic resonance, may be applied in neurofeedback for attention-deficit hyperactivity disorder. In this study, we applied a neurofeedback method based on chaotic resonance induced by “reduced region of orbit” feedback signals in the Baghdadi model for attention-deficit hyperactivity disorder. We evaluated the stabilizing effect of reduced region of orbit feedback and its robustness against noise from errors in estimation of neural activity. The effect of chaotic resonance successfully shifted the abnormal chaos-chaos intermittency of neural activity to the intended stable activity. Additionally, evaluation of the influence of noise due to measurement errors revealed that the efficiency of chaotic resonance induced by reduced region of orbit feedback signals was maintained over a range of certain noise strengths. In conclusion, applying chaotic resonance induced by reduced region of orbit feedback signals to neurofeedback methods may provide a promising treatment option for attention-deficit hyperactivity disorder.