Awareness and practice of patient's rights law in Lithuania

BACKGROUND: Patient's rights law is intended to secure good medical practice, but it can also serve to improve understanding between patients and medical staff if both were aware of their rights. METHODS: Awareness and practice of the new patient's rights law in Lithuanian health care institutions was explored through a survey of 255 medical staff and 451 patients in the four Kaunas city medical units in 2002. Participation rates were 74% and 66%, respectively. RESULTS: Majority of the medical staff (85%) and little over one half of the patients (56%) had heard or read about the Law on Patient's Rights (p < 0.001). Only 50% of professionals compared to 69% of patients thought information for patients about diagnosis, treatment results and alternative treatments is necessary (p < 0.001). A clear discrepancy was indicated between physicians informing the patients (80% – 98% of physicians) and patients actually knowing (37% – 54%) their treatment prognosis, disease complications or possible alternative treatment methods. CONCLUSION: These results suggest a need for awareness-raising among patients to improve the practical implementation of the Patient's Rights Law in Lithuania

The Integration Monitor 2005. The social integration of migrants monitored over time: trend and cohort analyses

In 2004, work started on the development of an Integration Monitor. The Integration Monitor is a project that is being implemented by the Research and Documentation Centre (Wetenschappelijk Onderzoek- en Documentatiecentrum - WODC) of the Ministry of Justice in collaboration with Statistics Netherlands (Centraal Bureau voor de Statistiek - CBS). The object is to develop a tool that can be used to monitor the integration of first and second-generation individuals from ethnic minorities over time. Alongside information from other sources, a monitoring tool of this nature can contribute to a better understanding of the extent to which, and the rate at which, the various ethnic minority groups are able to gain a place for themselves in Dutch society. In comparison with the first Integration Monitor published in 2004, the Integration Monitor 2005 features not only more recent information, but also a number of new integration indicators. The latter are data in terms of crime and entry into higher education. Another new aspect of the Integration Monitor 2005 is the expansion of the analyses made to cover three cohorts of newcomers that came to the Netherlands in 1999, 2000 and 2001 respectively. Through the use of the Social Statistics Database (SSB) [Sociaal Statistisch Bestand] produced by Statistics Netherlands, with its data covering the entire population of the Netherlands, it has been possible, in many cases, to arrive at a detailed breakdown of groups according to their different countries of origin. In addition to a description of the traditional ‘big four’ (Turks, Moroccans, Surinamese and Antilleans/Arubans), we also indicate, where possible, how smaller immigrant populations, which have come to the Netherlands in recent years, are participating in society. Using longitudinal data, the Integration Monitor provides an insight into the progress of integration achieved by large and small origin groups over a longer period and in different domains of society. This is done by featuring trends over time and by monitoring cohorts of newcomers that settled in the Netherlands in a certain year, in order to see how they have fared. The Integration Monitor focuses on actual behaviour and on the actual social positions held by individuals, as opposed to attitudes, perceptions, subjective experience and opinions

Real-time pion propagation in finite-temperature QCD

We argue that in QCD near the chiral limit, at all temperatures below the chiral phase transition, the dispersion relation of soft pions can be expressed entirely in terms of three temperature-dependent quantities: the pion screening mass, a pion decay constant, and the axial isospin susceptibility. The definitions of these quantities are given in terms of equal-time (static) correlation functions. Thus, all three quantities can be determined directly by lattice methods. The precise meaning of the Gell-Mann--Oakes--Renner relation at finite temperature is given.Comment: 25 pages, 2 figures; v2: discussion on the region of applicability expanded, to be published in PR

Correlated N-boson systems for arbitrary scattering length

We investigate systems of identical bosons with the focus on two-body correlations and attractive finite-range potentials. We use a hyperspherical adiabatic method and apply a Faddeev type of decomposition of the wave function. We discuss the structure of a condensate as function of particle number and scattering length. We establish universal scaling relations for the critical effective radial potentials for distances where the average distance between particle pairs is larger than the interaction range. The correlations in the wave function restore the large distance mean-field behaviour with the correct two-body interaction. We discuss various processes limiting the stability of condensates. With correlations we confirm that macroscopic tunneling dominates when the trap length is about half of the particle number times the scattering length.Comment: 15 pages (RevTeX4), 11 figures (LaTeX), submitted to Phys. Rev. A. Second version includes an explicit comparison to N=3, a restructured manuscript, and updated figure

Is the prevalence of psychiatric disorders associated with urbanization?

Objectives In many countries, the total rate of psychiatric disorders tends to be higher in urban areas than in rural areas. The relevance of this phenomenon is that it may help in identifying environmental factors that are important in the pathogenesis of mental disorders. Moreover, urban preponderance suggests that the allocation of funds and services should take urbanization levels into account. Method The Netherlands Mental Health Survey and Incidence Study (NEMESIS) used the Composite International Diagnostic Interview (CIDI) to determine the prevalence of DSM-III-R disorders in a sample of 7,076 people aged 18–64. The sample was representative of the population as a whole. The study population was assigned to five urbanization categories defined at the level of municipalities. The association between urbanization and 12-month prevalence rates of psychiatric disorders was studied using logistic regression taking several confounders into account. Results The prevalence of psychiatric disorders gradually increased over five levels of urbanization. This pattern remained after adjustment for a range of confounders. Comorbidity rates also increased with level of urbanization. Conclusion This study confirms that psychiatric disorders are more common and more complex in more urbanized areas. This should be reflected in service allocation and may help in identifying environmental factors of importance for the aetiology of mental disorders. j Key words population survey – psychiatric epidemiology – mental disorders – urbanizatio

Prevalence of aortic valve stenosis in patients with ST-segment elevation myocardial infarction and effect on long-term outcome

Several studies have shown an association between aortic valve stenosis (AS), atherosclerosis and cardiovascular risk factors. These risk factors are frequently encountered in patients with ST-segment elevation myocardial infarction (STEMI). The aim of this study was to evaluate the prevalence and the prognostic implications of AS in patients presenting with STEMI. A total of 2041 patients (61 +/- 12 years old, 76% male) admitted with STEMI and treated with primary percutaneous coronary intervention were included. Patients with previous myocardial infarction and previous aortic valve replacement were excluded. Echocardiography was performed at index admission. Patients were divided in 3 groups: 1) any grade of AS, 2) aortic valve sclerosis and 3) normal aortic valve. Any grade of AS was defined as an aortic valve area = 85 years, respectively). Patients with AS showed a significantly higher mortality rate when compared to the other two groups (p < 0.001) and AS was independently associated with all-cause mortality, with a HR of 1.81 (CI 95%: 1.02 to 3.22; p = 0.04). In conclusion, AS is not uncommon in patients with STEMI, and concomitant AS in patients with first STEMI is independently associated with all-cause mortality at long-term follow up. (C) 2021 The Author(s). Published by Elsevier Inc.Cardiolog

Influence of chronic obstructive pulmonary disease on atrial mechanics by speckle tracking echocardiography in patients with atrial fibrillation

The present study aimed to examine differences in left- and right atrial characteristics between atrial fibrillation (AF) patients with and without chronic obstructive pulmonary disease (COPD). For this, 420 patients (mean age 68 +/- 10 years, 73% female) with first diagnosis of AF and baseline echocardiography were included. Of these, 143 COPD patients were compared with 277 patients without COPD matched by age, gender and body surface area. Additionally 38 healthy controls without cardiovascular risk factors, matched for age, were included. For all 3 groups, left atrial (LA) volumes and diameter, LA reservoir strain (LASr), left ventricular ejection fraction (LVEF), right atrial (RA) area and diameter, RA reservoir strain (RASr) and tricuspid annular plane systolic excursion were evaluated on transthoracic echocardiography. Baseline characteristics were similar in patients with and without COPD except for smoking and a history of heart failure (42% vs 11%, p < 0.001 and 48% vs 37%, p = 0.036 for COPD and non-COPD patients, respectively). Also, COPD patients less often used beta-blockers (63% vs 75%, p = 0.017). There were no significant differences in LVEF, LA volume and RA area between COPD and non-COPD patients. Compared to the controls, AF patients had impaired LVEF, LASr and RASr. Only RASr was significantly worse in COPD patients as compared to non-COPD patients (15.3% [9.0 to 25.1] vs 19.6% [11.8 to 28.5], p = 0.013). Additionally, a trend towards worse RASr was observed with increasing COPD severity. In conclusion, AF patients with concomitant COPD have more impaired RA function compared to patients without COPD but with similar atrial size and LA function. (C) 2020 The Author(s). Published by Elsevier Inc.Cardiolog

Myocardial work, an echocardiographic measure of post myocardial infarct scar on contrast-enhanced cardiac magnetic resonance

This study investigates the relation of non-invasive myocardial work and myocardial viability following ST-segment elevation myocardial infarction (STEMI) assessed on late gadolinium contrast enhanced cardiac magnetic resonance (LGE CMR) and characterizes the remote zone using non-invasive myocardial work parameters. STEMI patients who underwent primary percutaneous coronary intervention (PCI) were included. Several non-invasive myocardial work parameters were derived from speckle tracking strain echocardiography and sphygmomanometric blood pressure, e.g.: myocardial work index (MWI), constructive work (CW), wasted work (WW) and myocardial work efficiency (MWE). LGE was quantified to determine infarct transmurality and scar burden. The core zone was defined as the segment with the largest extent of transmural LGE and the remote zone as the diametrically opposed segment without LGE. A total of 53 patients (89% male, mean age 58 +/- 9 years) and 689 segments were analyzed. The mean scar burden was 14 +/- 7% of the total LV mass, and 76 segments (11%) demonstrated transmural hyperenhancement, 280 (41%) non-transmural hyperenhancement and 333 (48%) no LGE. An inverse relation was observed between segmental MWI, CW and MWE and infarct transmurality (p < 0.05). MWI, CW and MWE were significantly lower in the core zone compared to the remote zone (p<0.05). In conclusion, non-invasive myocardial work parameters may serve as potential markers of segmental myocardial viability in post-STEMI patients who underwent primary PCI. Non-invasive myocardial work can also be utilized to characterize the remote zone, which is an emerging prognostic marker as well as a therapeutic target. (C) 2021 The Authors. Published by Elsevier Inc.Cardiovascular Aspects of Radiolog

Energy aware approach for HPC systems

International audienceHigh‐performance computing (HPC) systems require energy during their full life cycle from design and production to transportation to usage and recycling/dismanteling. Because of increase of ecological and cost awareness, energy performance is now a primary focus. This chapter focuses on the usage aspect of HPC and how adapted and optimized software solutions could improve energy efficiency. It provides a detailed explanation of server power consumption, and discusses the application of HPC, phase detection, and phase identification. The chapter also suggests that having the load and memory access profiles is insufficient for an effective evaluation of the power consumed by an application. The available leverages in HPC systems are also shown in detail. The chapter proposes some solutions for modeling the power consumption of servers, which allows designing power prediction models for better decision making.These approaches allow the deployment and usage of a set of available green leverages, permitting energy reduction

Structure of boson systems beyond the mean-field

We investigate systems of identical bosons with the focus on two-body correlations. We use the hyperspherical adiabatic method and a decomposition of the wave function in two-body amplitudes. An analytic parametrization is used for the adiabatic effective radial potential. We discuss the structure of a condensate for arbitrary scattering length. Stability and time scales for various decay processes are estimated. The previously predicted Efimov-like states are found to be very narrow. We discuss the validity conditions and formal connections between the zero- and finite-range mean-field approximations, Faddeev-Yakubovskii formulation, Jastrow ansatz, and the present method. We compare numerical results from present work with mean-field calculations and discuss qualitatively the connection with measurements.Comment: 26 pages, 6 figures, submitted to J. Phys. B. Ver. 2 is 28 pages with modified figures and discussion