Face identification proficiency test designed using item response theory.

Measures of face-identification proficiency are essential to ensure accurate and consistent performance by professional forensic face examiners and others who perform face-identification tasks in applied scenarios. Current proficiency tests rely on static sets of stimulus items and so cannot be administered validly to the same individual multiple times. To create a proficiency test, a large number of items of "known" difficulty must be assembled. Multiple tests of equal difficulty can be constructed then using subsets of items. We introduce the Triad Identity Matching (TIM) test and evaluate it using item response theory (IRT). Participants view face-image "triads" (N = 225) (two images of one identity, one image of a different identity) and select the different identity. In Experiment 3, university students (N = 197) showed wide-ranging accuracy on the TIM test, and IRT modeling demonstrated that the TIM items span various difficulty levels. In Experiment 3, we used IRT-based item metrics to partition the test into subsets of specific difficulties. Simulations showed that subsets of the TIM items yielded reliable estimates of subject ability. In Experiments 3a and b, we found that the student-derived IRT model reliably evaluated the ability of non-student participants and that ability generalized across different test sessions. In Experiment 3c, we show that TIM test performance correlates with other common face-recognition tests. In summary, the TIM test provides a starting point for developing a framework that is flexible and calibrated to measure proficiency across various ability levels (e.g., professionals or populations with face-processing deficits).

Face recognition accuracy of forensic examiners, superrecognizers, and face recognition algorithms.

Achieving the upper limits of face identification accuracy in forensic applications can minimize errors that have profound social and personal consequences. Although forensic examiners identify faces in these applications, systematic tests of their accuracy are rare. How can we achieve the most accurate face identification: using people and/or machines working alone or in collaboration? In a comprehensive comparison of face identification by humans and computers, we found that forensic facial examiners, facial reviewers, and superrecognizers were more accurate than fingerprint examiners and students on a challenging face identification test. Individual performance on the test varied widely. On the same test, four deep convolutional neural networks (DCNNs), developed between 2015 and 2017, identified faces within the range of human accuracy. Accuracy of the algorithms increased steadily over time, with the most recent DCNN scoring above the median of the forensic facial examiners. Using crowd-sourcing methods, we fused the judgments of multiple forensic facial examiners by averaging their rating-based identity judgments. Accuracy was substantially better for fused judgments than for individuals working alone. Fusion also served to stabilize performance, boosting the scores of lower-performing individuals and decreasing variability. Single forensic facial examiners fused with the best algorithm were more accurate than the combination of two examiners. Therefore, collaboration among humans and between humans and machines offers tangible benefits to face identification accuracy in important applications. These results offer an evidence-based roadmap for achieving the most accurate face identification possible.

Magnet journey: a quality improvement project­implementation of family visitation in the PACU.

PURPOSE: Over the years, patient- and family-centered care has been a focus of many researchers in the postanesthesia care unit (PACU) setting. Despite evidence pointing to the benefits and positive outcomes of partnering with family in patient care in pediatric and adult PACUs, this practice has not gained popularity in the adult PACUs of many hospitals. The purpose of this project was to test and validate the benefits of including families as partners in care in the PACU. DESIGN: A pre/post exploratory design using survey methodology was used. METHODS: Survey questionnaires were administered to patients, family, and nursing staff before and after the implementation of a patient visitation program. FINDINGS: Patient and family satisfaction increased after implementation of the family visitation program. Nursing satisfaction with and openness to family visitation also increased. CONCLUSIONS: Results provide the evidence base to implement an open visitation policy that has been made permanent as a standard of care practiced in all the PACU sites throughout the health system.

Forensic facial examiners versus super-recognizers: Evaluating behavior beyond accuracy.

We evaluated the detailed, behavioral properties of face matching performance in two specialist groups: forensic facial examiners and super-recognizers. Both groups compare faces to determine identity with high accuracy and outperform the general population. Typically, facial examiners are highly trained; super-recognizers rely on natural ability. We found distinct behaviors between these two groups. Examiners used the full 7-point identity judgment scale (-3: "different"; +3: "same"). Super-recognizers' judgments clustered toward highly confident decisions. Examiners' judgments for same- and different-identities were symmetric across the scale midpoint (0); super-recognizers' judgments were not. Examiners showed higher identity judgment agreement than super-recognizers. Despite these qualitative differences, both groups showed insight into their own accuracy: more confident people and those who rated the task to be easier tended to be more accurate. Altogether, we show to better understand and interpret judgments according to the nature of someone's facial expertise, evaluations should assess more than accuracy.

De-Implementation of Detrimental Feeding Practices in Childcare: Mixed Methods Evaluation of Community Partner Selected Strategies.

This pilot evaluated strategies to decrease detrimental feeding practices in early care and education, which are hypothesized to compete with evidence-based feeding and obesity prevention practices. This study made two key comparisons: (1) a between-site comparison of sites receiving (a) no implementation or de-implementation strategies (i.e., Basic Support; B), (b) implementation strategies only (i.e., Enhanced Support; E), and (c) implementation and de-implementation strategies (i.e., De-implementation + Enhanced Support; D + E) and (2) a within-site pre-post comparison among sites with D + E. At nutrition lessons, the D + E group had more Positive Comments (Hedege's g = 0.60) and higher Role Model fidelity (Hedege's g = 1.34) compared to the E group. At meals, assistant teachers in the D + E group had higher Positive Comments than in the B group (g = 0.72). For within-group comparisons, the D + E group decreased Negative Comments (t(19) = 2.842, p = 0.01), increased Positive Comments (t(20) = 2.314, p = 0.031), and improved use of the program mascot at nutrition lessons (t(21) = 3.899, p = 0.001). At meals, lead teachers' Negative Comments decreased (t(22) = 2.73, p = 0.01). Qualitative data identified strengths and opportunities for iteration. Despite a COVID interruption, mid-point comparisons and qualitative feedback suggest promise of the de-implementation strategy package.

Semantic integration of clinical laboratory tests from electronic health records for deep phenotyping and biomarker discovery.

Electronic Health Record (EHR) systems typically define laboratory test results using the Laboratory Observation Identifier Names and Codes (LOINC) and can transmit them using Fast Healthcare Interoperability Resource (FHIR) standards. LOINC has not yet been semantically integrated with computational resources for phenotype analysis. Here, we provide a method for mapping LOINC-encoded laboratory test results transmitted in FHIR standards to Human Phenotype Ontology (HPO) terms. We annotated the medical implications of 2923 commonly used laboratory tests with HPO terms. Using these annotations, our software assesses laboratory test results and converts each result into an HPO term. We validated our approach with EHR data from 15,681 patients with respiratory complaints and identified known biomarkers for asthma. Finally, we provide a freely available SMART on FHIR application that can be used within EHR systems. Our approach allows readily available laboratory tests in EHR to be reused for deep phenotyping and exploits the hierarchical structure of HPO to integrate distinct tests that have comparable medical interpretations for association studies.

Integrating the older/special needs adoptive child into the family.

This qualitative, grounded theory study investigated 11 families who reported having successfully integrated into their family unit at least one older/special needs adoptee. The theory that emerged through the constant comparative methodology consisted of two categories (Decision to Adopt and Adjustment) and a core category (Developing a Sense of Family). The two categories and core category comprised a process that was informed by the Family Narrative Paradigm and culminated in the successful integration of the child or children into the existing family unit. Parental perceptions that appeared to facilitate this process included: (a) finding strengths in the children overlooked by previous caregivers, (b) viewing behavior in context, (c) reframing negative behavior, and (d) attributing improvement in behavior to parenting efforts.

Randomized, Prospective Comparison of Ursodeoxycholic Acid for the Prevention of Gallstones after Sleeve Gastrectomy.

BACKGROUND: Several studies have examined the role of ursodeoxycholic acid (UDCA) for the prevention of cholelithiasis (gallstones) following rapid weight loss from restrictive diets, vertical band gastroplasty, and Roux-en-Y gastric bypass. However, to date, there have been no prospective, controlled studies examining the role of UDCA for the prevention of gallstones following sleeve gastrectomy (SG). This study was conducted to identify the effectiveness of UDCA for prevention of gallstones after SG. METHODS: Following SG, eligible patients were randomized to a control group who did not receive UDCA treatment or to a group who were prescribed 300 mg UDCA twice daily for 6 months. Gallbladder ultrasounds were performed preoperatively and at 6 and 12 months postoperatively. Patients with positive findings preoperatively were excluded from the study. Compliance with UDCA was assessed. RESULTS: Between December 2011 and April 2013, 37 patients were randomized to the UDCA treatment arm and 38 patients were randomized to no treatment. At baseline, the two groups were similar. At 6 months, the UDCA group had a statistically significant lower incidence of gallstones (p = 0.032). Analysis revealed no significant difference in gallstones between the two groups at 1 year (p = 0.553 and p = 0.962, respectively). The overall gallstone formation rate was 29.8%. CONCLUSIONS: The incidence of gallstones is higher than previously estimated in SG patients. UDCA significantly lowers the gallstone formation rate at 6 months postoperatively.

Family-provider alliance program in intensive care units.

This nonrandomized controlled study evaluated the effects of Family-Provider Alliance Program on nurses' perception of therapeutic alliance, job satisfaction, and quality of care. A total of 275 nurses were included in the study: 206 nurses in the ICUs participated in the Program and 69 in the control group did not. Mean postinterventional Kim Alliance Scale-Provider score was improved not only in the experimental group (+0.87; p = .01), but also in the control group (+1.37; p = .016). However, Empowerment subscale mean score was improved in the experimental group alone (+0.34; p = .006). Hierarchical multiple regression analyses indicated that family-nurse therapeutic alliance explained 7.2% and 11.4% of the variance in nurses' job satisfaction and perceived quality of care, respectively. The Program was marginally effective in improving nurses' perception of family empowerment. The quality of family-nurse therapeutic alliance predicted small to moderate fractions of the variance in nurses' job satisfaction and perceived quality of care.