Nutritional status in elderly people admitted to community residential homes: comparisons between two cohorts

The aim was to describe nutritional status and socio-demographic and medical data in people who were newly admitted to community residential homes (cohort 2), and to compare the results with a previous study performed in the same municipality four years earlier (cohort 1). One hundred and twenty-seven people, 65 years of age, or older, newly admitted to residential homes in a municipality in the southern part of Sweden, were consecutively included. Nutritional status was assessed, using a combination of anthropometry and serum protein measurements and by Mini Nutritional Assessment (MNA). The results showed that 32% of the residents in cohort 2 were assessed as protein-energy malnourished (PEM), compared with 38% in cohort 1. Body mass index, psychological stress or acute disease, and reduced fluid intake were items in MNA which had power to predict PEM. Residents in cohort 2, diagnosed as having severe medical diseases, increased as well as residents with neuropsychological problems. Simultaneously, the number living in residential homes decreased, as compared to cohort 1. These differences indicate that the admission criteria have changed between cohorts 1 and 2

An action principle for the quantization of parametric theories and nonlinear quantum cosmology

By parametrizing the action integral for the standard Schrodinger equation we present a derivation of the recently proposed method for quantizing a parametrized theory. The reformulation suggests a natural extension from conventional to nonlinear quantum mechanics. This generalization enables a unitary description of the quantum evolution for a broad class of constrained Hamiltonian systems with a nonlinear kinematic structure. In particular, the new theory is applicable to the quantization of cosmological models where a chosen gravitational degree of freedom acts as geometric time. This is demonstrated explicitly using three cosmological models: the Friedmann universe with a massless scalar field and Bianchi type I and IX models. Based on these investigations, the prospect of further developing the proposed quantization scheme in the context of quantum gravity is discussed.Comment: 14 page

Neutrino oscillations: Quantum mechanics vs. quantum field theory

A consistent description of neutrino oscillations requires either the quantum-mechanical (QM) wave packet approach or a quantum field theoretic (QFT) treatment. We compare these two approaches to neutrino oscillations and discuss the correspondence between them. In particular, we derive expressions for the QM neutrino wave packets from QFT and relate the free parameters of the QM framework, in particular the effective momentum uncertainty of the neutrino state, to the more fundamental parameters of the QFT approach. We include in our discussion the possibilities that some of the neutrino's interaction partners are not detected, that the neutrino is produced in the decay of an unstable parent particle, and that the overlap of the wave packets of the particles involved in the neutrino production (or detection) process is not maximal. Finally, we demonstrate how the properly normalized oscillation probabilities can be obtained in the QFT framework without an ad hoc normalization procedure employed in the QM approach.Comment: LaTeX, 42 pages, 1 figure; v2: minor clarifications, matches published version; v3: Corrected the discussion of the conditions under which an oscillation probability can be sensibly defined in the QFT approach (sec. 5.2.4

Effects of antenatal care visits and health facility delivery on women's choice to circumcise their daughters in sub-Saharan Africa: evidence from demographic and health surveys.

BACKGROUND: This study examines the association between maternal healthcare service utilisation and circumcision of daughters in sub-Saharan Africa (SSA). METHODS: This study is based on a cross-sectional study design that draws on analysis of pooled data from current demographic and health surveys conducted between 2010 and 2019 in 12 countries in SSA. Both bivariate and multivariable binary logistic regression models were employed. RESULTS: Mothers who had four or more antenatal care visits were less likely to circumcise their daughters compared with those who had zero to three visits. Mothers who delivered at a health facility were less likely to circumcise their daughters than those who delivered at home. With the covariates, circumcision of daughters increased with increasing maternal age but decreased with increasing wealth quintile and level of education. Girls born to married women and women who had been circumcised were more likely to be circumcised. CONCLUSIONS: This study established an association between maternal healthcare service utilisation and circumcision of girls from birth to age 14 y in SSA. The findings highlight the need to strengthen policies that promote maternal healthcare service utilisation (antenatal care and health facility delivery) by integrating female genital mutilation (FGM) information and education in countries studied

Impact of COVID-19 on maternal healthcare in Africa and the way forward.

Background The impact of COVID-19 is weighing heavily on many African countries. As of November 14th 2021, 6,109,722 cases had been recorded with 151,173 deaths and 2.5% case fatality rate. Studies reveal substantial morbidity and socioeconomic impacts when accessing quality maternal healthcare including fear of infection and the containment measures in place, including social distancing and community containment. The pandemic has put additional strain on healthcare systems that are overburdened and under-resourced even in normal times and has exposed the vulnerabilities of high-risk population groups in addressing critical healthcare concerns. This study presents a mini review of how COVID-19 has disrupted maternal healthcare in Africa, and it further proposes ways to improve the situation. Main body COVID-19 has disrupted antenatal, skilled birth, and postnatal family planning services. Women and girls are vulnerable to the impact of COVID-19 on several fronts and represent a group whose needs including antenatal, skilled birth, and postnatal family planning services have been disrupted, leading to unmet needs for contraception and an increase in unintended pregnancies. Restricted travel due to the fear and anxiety associated with contracting COVID-19 has resulted in delays in accessing prompt skilled care and essential healthcare services such as pregnancy care, immunisation, and nutritional supplementation. Misconceptions relating to COVID-19 have prompted concerns and created distrust in the safety of the healthcare system. Innovative measures are required to address these obstacles and ensure women are not denied access to available, accessible, acceptable, and quality maternal healthcare services in spite of COVID-19. Conclusions In the immediate term while physical distancing measures remain in force, deliberate effort must be made to provide evidence-based guidelines, good practice and expert advice that addresses the unique sexual and reproductive health context of African countries. Efforts to train and motivate healthcare providers to adopt online, remote approaches such as use of telemedicine, and expand the involvement of frontline maternal healthcare providers to deliver information on the availability of services through phone-based referral networks, culturally appropriate social media, community radio and folklore messaging strategies are critical to mobilise and secure community confidence in the safety of sexual and reproductive health and maternal care services

Iterative maximum-likelihood reconstruction in quantum homodyne tomography

I propose an iterative expectation maximization algorithm for reconstructing a quantum optical ensemble from a set of balanced homodyne measurements performed on an optical state. The algorithm applies directly to the acquired data, bypassing the intermediate step of calculating marginal distributions. The advantages of the new method are made manifest by comparing it with the traditional inverse Radon transformation technique

Preventing Advanced Persistent Threats in Complex Control Networks

An Advanced Persistent Threat (APT) is an emerging attack against Industrial Control and Automation Systems, that is executed over a long period of time and is difficult to detect. In this context, graph theory can be applied to model the interaction among nodes and the complex attacks affecting them, as well as to design recovery techniques that ensure the survivability of the network. Accordingly, we leverage a decision model to study how a set of hierarchically selected nodes can collaborate to detect an APT within the network, concerning the presence of changes in its topology. Moreover, we implement a response service based on redundant links that dynamically uses a secret sharing scheme and applies a flexible routing protocol depending on the severity of the attack. The ultimate goal is twofold: ensuring the reachability between nodes despite the changes and preventing the path followed by messages from being discovered.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

A risk assessment scale for the prediction of pressure sore development: reliability and validity

Background. The ability to assess the risk of a patient developing pressure sores is a major issue in pressure sore prevention. Risk assessment scales should be valid, reliable and easy to use in clinical practice. Aim. To develop further a risk assessment scale, for predicting pressure sore development and, in addition, to present the validity and reliability of this scale. Methods. The risk assessment pressure sore (RAPS) scale, includes 12 variables, five from the re-modified Norton scale, three from the Braden scale and three from other research results. Five hundred and thirty patients without pressure sores on admission were included in the study and assessed over a maximum period of 12 weeks. Internal consistency was examined by item analysis and equivalence by interrater reliability. To estimate equivalence, 10 pairs of nurses assessed a total of 116 patients. The underlying dimensions of the scale were examined by factor analysis. The predictive validity was examined by determination of sensitivity, specificity and predictive value. Results. Two variables were excluded as a result of low item–item and item–total correlations. The average percentage of agreement and the intraclass correlation between raters were 70% and 0·83, respectively. The factor analysis gave three factors, with a total variance explained of 65·1%. Sensitivity, specificity and predictive value were high among patients at medical and infection wards. Conclusions. The RAPS scale is a reliable scale for predicting pressure sore development. The validity is especially good for patients undergoing treatment in medical wards and wards for infectious diseases. This indicates that the RAPS scale may be useful in clinical practice for these groups of patients. For patients undergoing surgical treatment, further analysis will be performed.måsjekke

Maternal healthcare utilsation and complete childhood vaccination in sub-Saharan Africa: a cross-sectional study of 29 nationally representative surveys

Objective The objective of the study was to examine the association between maternal healthcare utilisation and complete childhood vaccination in sub-Saharan Africa. Design Our study was a cross-sectional study that used pooled data from 29 countries in sub-Saharan Africa. Participants A total of 60 964 mothers of children aged 11–23 months were included in the study. Outcome variables The main outcome variable was complete childhood vaccination. The explanatory variables were number of antenatal care (ANC) visits, assistance during delivery and postnatal care (PNC). Results The average prevalence of complete childhood vaccination was 85.6%, ranging from 67.0% in Ethiopia to 98.5% in Namibia. Our adjusted model, children whose mothers had a maximum of three ANC visits were 56% less likely to have complete vaccination, compared with those who had at least four ANC visits (adjusted OR (aOR)=0.44, 95% CI 0.42 to 0.46). Children whose mothers were assisted by traditional birth attendant/other (aOR=0.43, 95% CI 0.41 to 0.56) had lower odds of complete vaccination. The odds of complete vaccination were lower among children whose mothers did not attend PNC clinics (aOR=0.26, 95% CI 0.24 to 0.29) as against those whose mothers attended. Conclusion The study found significant variations in complete childhood vaccination across countries in sub-Saharan Africa. Maternal healthcare utilisation (ANC visits, skilled birth delivery, PNC attendance) had significant association with complete childhood vaccination. These findings suggest that programmes, interventions and strategies aimed at improving vaccination should incorporate interventions that can enhance maternal healthcare utilisation. Such interventions can include education and sensitisation, reducing cost of maternal healthcare and encouraging male involvement in maternal healthcare service utilisation