Overall Perceived Health Predicts Risk of Hospitalizations and Death in Adults With Heart Failure: A Prospective Longitudinal Study

Background Patient overall perception of health may provide an effective early warning for risk of hospitalization and death among heart failure patients. Objective Determine whether overall perceived health predicts all-cause hospitalization or death in heart failure patients after adjusting for confounding factors in a sample of adults with heart failure. Design Prospective, longitudinal, observational study. Settings Three outpatient urban settings in the northeast United States between 2007 and 2010. Participants Adults with chronic Stage C heart failure confirmed by echocardiographic and clinical evidence. Methods A secondary analysis was conducted using data collected on 273 Stage C patients with heart failure. Participants in the parent study were followed for 6 months. Overall perceived health was measured by self-report. Hospitalization and death were assessed from electronic hospital records and confirmed with county death records as needed. Cox proportional hazards models were used to examine the association between perceptions of health and rates of hospitalization and death. Results Patients with poor or fair perceived health had over 5.5 times the rate of death or hospitalization over the 6-month period (hazard ratio; 95% confidence interval: 2.0–15.6; p = 0.001) after controlling for model covariates. The predictive ability of perceived health attenuated over time such that at 30-days patients who reported poor or fair perceived health had only 1.2 times the rate of an event and virtually no difference in event rate by 60-days. Conclusions Overall perceived health is a powerful indicator of impending events and can be a quick tool for prioritizing heart failure patients who are at highest risk of imminent death and hospitalization. Questions about perceived health need to be asked of patients regularly in order to have clinical utility

Meta-analysis and Meta-regression of Cognitive Behavioral Therapy for Psychosis (CBTp) Across Time: The Effectiveness of CBTp has Improved for Delusions

Published research shows small-to-medium effects of Cognitive Behavioral Therapy for Psychosis (CBTp) on reducing psychotic symptoms. Given the on-going development of CBTp interventions, the aim of this systematic review is to examine whether the effectiveness of CBTp has changed across time. MEDLINE, EMBASE, PsycINFO, and CENTRAL were searched for randomized controlled trials examining CBTp interventions targeting positive and/or negative symptoms vs treatment as usual. Four meta-analyses were carried out to examine the effectiveness of CBTp for: positive symptoms; delusions; hallucinations; and negative symptoms. Four meta-regressions examined whether the effectiveness of CBTp changed across time for these groups of symptoms. A total of 28 studies (n = 2698) yielded a pooled g of −0.24 (95% confidence interval [CI] −0.32, −0.16, P < .001) favoring CBTp for positive symptoms, with nonsignificant heterogeneity (Q = 26.87, P = .47; I2 =0%); 13 studies (n = 890) yielded a pooled g of −0.36 (95% CI −0.59, −0.13, P = .002) for delusions, with substantial heterogeneity (Q = 31.99, P = .001; I2 =62%); 16 studies (n = 849) yielded a pooled g of −0.26 (95% CI −0.42, −0.11, P < .001) for hallucinations, with nonsignificant heterogeneity (Q = 18.10, P = .26; I2 =17%); 19 studies (n = 1761) yielded a pooled g of −0.22 (95% CI −0.33, −0.12, P < .001) for negative symptoms, with nonsignificant heterogeneity (Q = 20.32, P = .32, I2 =11%). Meta-regressions indicated a significant effect of year on the effectiveness of CBTp only for delusions (F[1, 11] = 5.99, P = .032; R2 = 0.594); methodological quality did not effect this finding. Findings indicate small-to-medium effects of CBTp for psychotic symptoms, with increasing effectiveness across time for delusions

Notes: Evaluation Of A Filter Bag System For NDF, ADF, And IVDMD Forage Analysis

A new method of determining in vitro dry matter digestibility (IVDMD) as recently developed in which the digestion is conducted with the forage samples in filter bags. Our objective was to compare the filter bag and conventional IVDMD analysis methods using smooth bromegrass (Bromus inermis Leyss.), switchgrass (Panicum virgatum L.), and forage sorghum [Sorghum bicolor (L.) Moench] samples. In addition, the filter bag analysis systems for determining non-sequential neutral and acid detergent fiber (NDF and ADF), respectively, were compared with the non-sequential conventional analysis systems. In the filter bag systems, the forage samples are sealed in filter bags and the analyses are conducted on a batch basis rather than on an individual basis as in the conventional IVDMD and fiber analysis procedures. The filter bag analysis methods produced results similar to the conventional methods and ranked the forage samples in the same relative order

Notes: Evaluation Of A Filter Bag System For NDF, ADF, And IVDMD Forage Analysis

A new method of determining in vitro dry matter digestibility (IVDMD) as recently developed in which the digestion is conducted with the forage samples in filter bags. Our objective was to compare the filter bag and conventional IVDMD analysis methods using smooth bromegrass (Bromus inermis Leyss.), switchgrass (Panicum virgatum L.), and forage sorghum [Sorghum bicolor (L.) Moench] samples. In addition, the filter bag analysis systems for determining non-sequential neutral and acid detergent fiber (NDF and ADF), respectively, were compared with the non-sequential conventional analysis systems. In the filter bag systems, the forage samples are sealed in filter bags and the analyses are conducted on a batch basis rather than on an individual basis as in the conventional IVDMD and fiber analysis procedures. The filter bag analysis methods produced results similar to the conventional methods and ranked the forage samples in the same relative order

Mineral Element Analyses of Switchgrass Biomass: Comparison of the Accuracy and Precision of Laboratories

Mineral concentration of plant biomass can affect its use in thermal conversion to energy. The objective of this study was to compare the precision and accuracy of university and private laboratories that conduct mineral analyses of plant biomass on a fee basis. Accuracy and precision of the laboratories was tested by having all laboratories conduct mineral analyses on subsamples of the same set of standard switchgrass (Panicum virgatum L.) samples and a certified standard. Laboratories differed significantly in both accuracy and precision even though several used the same analysis method indicating that the differences among laboratories were due to within laboratory procedures and quality control. Laboratories should be using sample standards to monitor both precision and accuracy of their mineral analyses. It would be advisable for researchers submitting samples to service laboratories to replicate the unknown samples to determine precision and to include replicated standards among the submitted samples to determine accuracy

Experience with the Canadian Standards Association Offshore Structures Code.

The Canadian Standards Association (CSA) developed a comprehensive Offshore Structures Standard in the early 1990s. The Code has had limited use in Canada, but S471 General Requirements, Design Criteria, the Environment, and Loads has seen international application. The Code is performance-based; setting overall targets for reliability and provides specific guidance on achieving these targets. The provisions in the CSA Standard for ice loads have been reconciled with the Russian codes such as SNiP and VSN. A comparison of the codes has shown that they predict similar ice loads.NRC publication: Ye