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Purpose The patient-centred management of people with cognitive impairment admitted to acute health care facilities can be challenging. The TOP5 intervention utilises carers' expert biographical and social knowledge of the patient to facilitate personalised care. The purpose of this paper is to explore whether involvement of carers in the TOP5 initiative could improve patient care and healthcare delivery. Design/methodology/approach A small-scale longitudinal study was undertaken in two wards of one acute teaching hospital. The wards admitted patients with cognitive impairment, aged 70 years and over, under geriatrician care. Data for patient falls, allocation of one-on-one nurses ("specials"), and length-of-stay (LOS) over 38 months, including baseline, pilot, and establishment phases, were analysed. Surveys of carers and nursing staff were undertaken. Findings There was a significant reduction in number of falls and number of patients allocated "specials" over the study period, but no statistically significant reduction in LOS. A downward trend in complaints related to communication issues was identified. All carers ( n=43) completing the feedback survey were satisfied or very satisfied that staff supported their role as information provider. Most carers (90 per cent) felt that the initiative had a positive impact and 80 per cent felt that their loved one benefitted. Six months after implementation of the initiative, 80 per cent of nurses agreed or strongly agreed that it was now easier to relate to carers of patients with cognitive impairment. At nine-ten months, this increased to 100 per cent. Originality/value Actively engaging carers in management of people with cognitive impairment may improve the patient, staff, and carer journeys, and may improve outcomes for patient care and service delivery.

Fifty clinically suspected cases of neonatal septicemia were studied for evaluating the role of sepsis screen. Sensitivity and specificity of C-reactive protein test, micro-ESR, gastric aspirate cytology for polymorphs and toxic granules in neutrophils were studied singly and in combinations of two and three tests. Positive blood culture was obtained in only 20% cases, thereby underlying the need for a sepsis screen in the diagnosis of neonatal septicemia, especially in areas where adequate micro-biological facilities are lacking.

Model-free Reinforcement Learning (RL) offers an attractive approach to learn control policies for highdimensional systems, but its relatively poor sample complexity often necessitates training in simulated environments. Even in simulation, goal-directed tasks whose natural reward function is sparse remain intractable for state-of-the-art model-free algorithms for continuous control. The bottleneck in these tasks is the prohibitive amount of exploration required to obtain a learning signal from the initial state of the system. In this work, we leverage physical priors in the form of an approximate system dynamics model to design a curriculum for a model-free policy optimization algorithm. Our Backward Reachability Curriculum (BaRC) begins policy training from states that require a small number of actions to accomplish the task, and expands the initial state distribution backwards in a dynamically-consistent manner once the policy optimization algorithm demonstrates sufficient performance. BaRC is general, in that it can accelerate training of any model-free RL algorithm on a broad class of goal-directed continuous control MDPs. Its curriculum strategy is physically intuitive, easy-to-tune, and allows incorporating physical priors to accelerate training without hindering the performance, flexibility, and applicability of the model-free RL algorithm. We evaluate our approach on two representative dynamic robotic learning problems and find substantial performance improvement relative to previous curriculum generation techniques and naïve exploration strategies. Aeronautics and Astronautics,