Relationship between inpatient pressure ulcer prevalence and patient satisfaction levels based on US Medicare's Hospital Compare data

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/111811/1/jocn12715.pd

Sustainabilitas Arsitektur Masjid: Evaluasi Konsep “Simple Architecture” sebagai Implementasi Desain Arsitektur Berkelanjutan suatu Kawasan

Makalah ini membahas aspek-aspek “kesederhanaan” (simplicity) sebagai konsep desain bangunan masjid secara berkelanjutan (sustainable) sesuai konteks dengan mengambil studi kasus masjid kawasan Al-Irsyad Satya Kota Baru Parahyangan, Bandung. Masjid sebagai subyek arsitektur dan pusat ibadah menjadi ruang publik yang didesain dari elemen-elemen yang secara ideal mengandung nilai-nilai Islam dan bertujuan mendukung fungsinya. Desain masjid berkonsep simple atau “sederhana” digunakan sebagai alternatif kontemporer untuk mengoptimalisasi fungsi tersebut, meliputi struktur bangunan hingga biaya pemeliharaan (maintenance) sesuai prinsip keberlanjutan. Keterkaitan erat bangunan masjid dengan aktivitas masyarakat berpotensi melibatkan partisipasi masyarakat dan pengelola dalam menerapkan program sustainabilitas sesuai konteks lingkungannya. Metode yang digunakan dalam penelitian ini berbasis pendekatan Grounded Theory secara kualitatif melalui pengumpulan data dari kegiatan observasi, interview dan analisis program keberlanjutan kawasan. Penelitian menemukan keterkaitan konsep “sederhana” yang mendukung sustainabilitas desain sekaligus menggarisbawahi evaluasi konsep desain “sederhana” yang hadir serta faktor pemeliharaan/pengembangan masjid dan kawasan

Estimating quality weights for EQ-5D (EuroQol-5 dimensions) health states with the time trade-off method in Taiwan

Background/PurposeEQ-5D (EuroQol-5 dimensions) is a preference-based measure of health, which is widely used in cost–utility analyses. It has been suggested that each country should develop its own value set. We therefore sought to develop the quality weights of the EQ-5D health states with the time trade-off (TTO) method in Taiwan.MethodsA total of 745 respondents consisting of employees and volunteers in 17 different hospitals were recruited and interviewed. Each of them valued 13 of 73 EQ-5D health states using the TTO method. Based on the three exclusion criteria for valuation data, only 456 (61.21%) respondents were considered eligible for data analysis. The quality weights for all EQ-5D health states were modeled by generalized estimating equations (GEEs).ResultsOver half of the responses were given negative values, and the medical personnel seemed to have a significantly higher TTO value (+0.1) than others after controlling for other predictors. The N3 model (level 3 occurred within at least 1 dimension) yielded an acceptable fit for the observed OTT data [mean absolute error (MAE) = 0.056, R2 = 0.35]. The magnitude of mean absolute differences (MADs) between Taiwan data and those from the UK, Japan, and South Korea ranged from 0.146 to 0.592, but the rank correlation coefficients were all above 0.811.ConclusionThis study reaffirms the differences in health-related preference values across countries. The high proportion of negative values might indicate that we have also partially measured the intensity of fear in addition to the utility of different health states

Properties of the dense cores and filamentary structures in the Vela C molecular cloud

The initial and boundary conditions of the Galactic star formation in molecular clouds are not well understood. In an effort to shed new light on this long-standing problem, we measured properties of dense cores and filamentary structures in the Vela C molecular cloud, observed with Herschel. We applied the getsf extraction method to separate the components of sources and filaments from each other and their backgrounds, before detecting, measuring, and cataloging the structures. The cores and filamentary structures constitute 40% of the total mass of Vela C, most of the material is in the low-density molecular background cloud. We selected 570 reliable cores, of which 149 are the protostellar cores and 421 are the starless cores. Almost 78% of the starless cores were identified with the gravitationally bound prestellar cores. The exponent of the CMF (alpha = 1.35) is identical to that of the Salpeter IMF. We selected 68 filaments with at least one side that appeared not blended with adjacent structures. The filament widths are in the range of 0.15 pc to 0.63 pc, and have a median value of W = 0.3(0.11) pc. The surface densities of filaments are well correlated with their contrasts and linear densities. Within uncertainties of the filament instability criterion, many filaments may well be both supercritical and subcritical. A large fraction of filaments may definitely be considered supercritical, in which are found 94 prestellar cores, 83 protostellar cores, and only 1 unbound starless core. Taking into account the uncertainties, the supercritical filaments contain only prestellar and protostellar cores. Our findings support the idea that there exists a direct relationship between the CMF and IMF and that filaments play a key role in the formation of prestellar cores, which is consistent with the previous Herschel results.Comment: 15 pages, 12 figures, 3 tables, accepted for publication in A&

Effectiveness and minimum effective dose of app-based mobile health interventions for anxiety and depression symptom reduction: Systematic review and meta-analysis

BACKGROUND: Mobile health (mHealth) apps offer new opportunities to deliver psychological treatments for mental illness in an accessible, private format. The results of several previous systematic reviews support the use of app-based mHealth interventions for anxiety and depression symptom management. However, it remains unclear how much or how long the minimum treatment dose is for an mHealth intervention to be effective. Just-in-time adaptive intervention (JITAI) has been introduced in the mHealth domain to facilitate behavior changes and is positioned to guide the design of mHealth interventions with enhanced adherence and effectiveness. OBJECTIVE: Inspired by the JITAI framework, we conducted a systematic review and meta-analysis to evaluate the dose effectiveness of app-based mHealth interventions for anxiety and depression symptom reduction. METHODS: We conducted a literature search on 7 databases (ie, Ovid MEDLINE, Embase, PsycInfo, Scopus, Cochrane Library (eg, CENTRAL), ScienceDirect, and ClinicalTrials, for publications from January 2012 to April 2020. We included randomized controlled trials (RCTs) evaluating app-based mHealth interventions for anxiety and depression. The study selection and data extraction process followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We estimated the pooled effect size using Hedge g and appraised study quality using the revised Cochrane risk-of-bias tool for RCTs. RESULTS: We included 15 studies involving 2627 participants for 18 app-based mHealth interventions. Participants in the intervention groups showed a significant effect on anxiety (Hedge g=-.10, 95% CI -0.14 to -0.06, I2=0%) but not on depression (Hedge g=-.08, 95% CI -0.23 to 0.07, I2=4%). Interventions of at least 7 weeks\u27 duration had larger effect sizes on anxiety symptom reduction. CONCLUSIONS: There is inconclusive evidence for clinical use of app-based mHealth interventions for anxiety and depression at the current stage due to the small to nonsignificant effects of the interventions and study quality concerns. The recommended dose of mHealth interventions and the sustainability of intervention effectiveness remain unclear and require further investigation

The effect of adding a home program to weekly institutional-based therapy for children with undefined developmental delay: A pilot randomized clinical trial

AbstractBackgroundEarly rehabilitation for children with developmental delay without a defined etiology have included home and clinic programs, but no comparisons have been made and efficacy is uncertain. We compared a weekly visit for institutional-based therapy (IT) to IT plus a structured home activity program (HAP).MethodsSeventy children who were diagnosed with motor or global developmental delay (ages 6-48 months and mean developmental age 12.5 months) without defined etiology were recruited (including 45 males and 23 females). The outcomes included the comprehensive developmental inventory for infants and toddlers test and the pediatric evaluation of disability inventory.ResultsChildren who received only IT improved in developmental level by 2.11 months compared with 3.11 months for those who received a combination of IT and HAP (p = 0.000). On all domains of the comprehensive developmental inventory for infants and toddlers test, except for self-help, children who participated in HAP showed greater improvements, including in cognition (p = 0.015), language (p = 0.010), motor (p = 0.000), and social (p = 0.038) domains. Except on the subdomain of self-care with caregiver assistance, the HAP group showed greater improvement in all the pediatric evaluation of disability inventory subdomains (p < 0.05).ConclusionEarly intervention programs are helpful for these children, and the addition of structured home activity programs may augment the effects on developmental progression

COMPARISON OF TORSO TWIST BETWEEN SLAP HIT AND ORDINARY HIT IN SOFTBALL BATTING

Softball batters take advantage of slap hit, by positioning the batters much closer to the first base. The purpose of this study was to compare the difference of torso twist between a slap hit and an ordinary hit in softball batting. Ten female college softball batters performed slap hits and ordinary hits. Reflective markers were placed on specific landmarks for each subject and VICON motion analysis system was used to record the hits. Slap hits showed less backward rotation during the torso wind-up phase while ordinary hit showed more forward rotation during the torso follow-through phase. No difference on trunk rotation was found at impact. The findings of this study suggested that the restricted backward torso twist during the wind-up phase and the limited forward torso twist during the follow-through phase should be taken into consideration in slap hits

Impact of collimator leaf width and treatment technique on stereotactic radiosurgery and radiotherapy plans for intra- and extracranial lesions

<p>Abstract</p> <p>Background</p> <p>This study evaluated the dosimetric impact of various treatment techniques as well as collimator leaf width (2.5 vs 5 mm) for three groups of tumors – spine tumors, brain tumors abutting the brainstem, and liver tumors. These lesions often present challenges in maximizing dose to target volumes without exceeding critical organ tolerance. Specifically, this study evaluated the dosimetric benefits of various techniques and collimator leaf sizes as a function of lesion size and shape.</p> <p>Methods</p> <p>Fifteen cases (5 for each site) were studied retrospectively. All lesions either abutted or were an integral part of critical structures (brainstem, liver or spinal cord). For brain and liver lesions, treatment plans using a 3D-conformal static technique (3D), dynamic conformal arcs (DARC) or intensity modulation (IMRT) were designed with a conventional linear accelerator with standard 5 mm leaf width multi-leaf collimator, and a linear accelerator dedicated for radiosurgery and hypofractionated therapy with a 2.5 mm leaf width collimator. For the concave spine lesions, intensity modulation was required to provide adequate conformality; hence, only IMRT plans were evaluated using either the standard or small leaf-width collimators.</p> <p>A total of 70 treatment plans were generated and each plan was individually optimized according to the technique employed. The Generalized Estimating Equation (GEE) was used to separate the impact of treatment technique from the MLC system on plan outcome, and t-tests were performed to evaluate statistical differences in target coverage and organ sparing between plans.</p> <p>Results</p> <p>The lesions ranged in size from 2.6 to 12.5 cc, 17.5 to 153 cc, and 20.9 to 87.7 cc for the brain, liver, and spine groups, respectively. As a group, brain lesions were smaller than spine and liver lesions. While brain and liver lesions were primarily ellipsoidal, spine lesions were more complex in shape, as they were all concave. Therefore, the brain and the liver groups were compared for volume effect, and the liver and spine groups were compared for shape. For the brain and liver groups, both the radiosurgery MLC and the IMRT technique contributed to the dose sparing of organs-at-risk(OARs), as dose in the high-dose regions of these OARs was reduced up to 15%, compared to the non-IMRT techniques employing a 5 mm leaf-width collimator. Also, the dose reduction contributed by the fine leaf-width MLC decreased, as dose savings at all levels diminished from 4 – 11% for the brain group to 1 – 5% for the liver group, as the target structures decreased in volume. The fine leaf-width collimator significantly improved spinal cord sparing, with dose reductions of 14 – 19% in high to middle dose regions, compared to the 5 mm leaf width collimator.</p> <p>Conclusion</p> <p>The fine leaf-width MLC in combination with the IMRT technique can yield dosimetric benefits in radiosurgery and hypofractionated radiotherapy. Treatment of small lesions in cases involving complex target/OAR geometry will especially benefit from use of a fine leaf-width MLC and the use of IMRT.</p

Serum ApoB levels in depressive patients: associated with cognitive deficits

Cognitive deficits have been regarded as one of the most significant clinical symptoms of depressive disorder. Accumulating evidence has shown that apolipoprotein B (ApoB) levels, which are responsible for inducing neurodegeneration, may be involved in cognitive deficits. This study examines cognitive deficits, and the correlation of serum ApoB levels with cognitive deficits of depressive disorder. 90 depressive patients and 90 healthy controls with matched age and gender were recruited. Cognition was assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Serum ApoB levels in depressive patients were measured by immunoturbidimetric method. Our results showed that depressive patients had lower scores of cognition including RBANS total score and subscales of language and delayed memory (all, p \u3c 0.001) than healthy controls after controlling for the variables. The differences in cognitive functions also passed Bonferroni corrections. Serum ApoB levels were negatively correlated with delayed memory score in depressive patients (r = −0.30, p = 0.01). Furthermore, stepwise multivariate regression analysis indicated that serum ApoB levels independently contributed to delayed memory in depressive patients (t = −2.68, p = 0.01). Our findings support that serum ApoB levels may be involved in delayed memory decline in depressive patients. Depressive patients also experience greater cognitive deficits, especially in delayed memory and language than healthy controls