Sparse Bayesian Inference with Regularized Gaussian Distributions

Regularization is a common tool in variational inverse problems to impose assumptions on the parameters of the problem. One such assumption is sparsity, which is commonly promoted using lasso and total variation-like regularization. Although the solutions to many such regularized inverse problems can be considered as points of maximum probability of well-chosen posterior distributions, samples from these distributions are generally not sparse. In this paper, we present a framework for implicitly defining a probability distribution that combines the effects of sparsity imposing regularization with Gaussian distributions. Unlike continuous distributions, these implicit distributions can assign positive probability to sparse vectors. We study these regularized distributions for various regularization functions including total variation regularization and piecewise linear convex functions. We apply the developed theory to uncertainty quantification for Bayesian linear inverse problems and derive a Gibbs sampler for a Bayesian hierarchical model. To illustrate the difference between our sparsity-inducing framework and continuous distributions, we apply our framework to small-scale deblurring and computed tomography examples

Geriatric rehabilitation:Development, implementation and evaluation of an integrated care pathway for patients with complex health problems

Older adults who receive rehabilitation therapy in a geriatric rehabilitation care facility after being discharged from hospital and then receive aftercare in their home environment, come into touch with many care providers. This may result in a lack of continuity and coordination of care. A care pathway was developed and implemented in order to improve the integration of care offered by these facilities and care providers. Studies that constitute this dissertation show that after three months, the care pathway is effective in improving the frequency of performing daily activities among patients. The care pathway also resulted in a larger proportion of patients being discharged home after receiving geriatric rehabilitation care, a lower self-rated burden among informal caregivers after three months and cost savings

Skin areas, clinical severity, duration and risk factors of intertrigo : a secondary data analysis

Aim: To describe the skin areas most often affected by intertrigo, the clinical severity and duration of intertrigo and possible risk factors. Materials and methods: Secondary analysis of data from 2013 to 2016 collected by the International Prevalence Measurement of Care Quality in Dutch hospitals, care homes and community care. Results: In total, n = 7865 (mean age 80.1 years) subjects were included in this analysis. The inguinal, breast and gluteal cleft skin areas were most often affected by intertrigo. The skin was often inflamed but not eroded. Strongest associations between intertrigo at inguinal skin and diabetes mellitus (OR 1.8; 95% CI 1.1-3.1), intertrigo at sub mammary folds and urinary incontinence (OR 1.6; 95% CI 0.9-2.9) and between intertrigo at gluteal cleft and urinary incontinence (OR 2.9; 95% CI 1.4-5.2) were observed. Conclusion: The inguinal region, sub mammary folds and gluteal clefts are most often affected by intertrigo. Female sex, urinary incontinence and high BMI seem to enhance intertrigo risk at all of these skin areas

Knowledge and attitude of community nurses on pressure injury prevention : a cross‐sectional study in an Indonesian city

The objectives of this study were to examine the knowledge and attitude of Indonesian community nurses regarding Pressure Injury (PI) prevention. A cross-sectional design was used and included the community nurses permanently working in the Public Health Center (Puskemas) in Bandung, West Java Indonesia. Knowledge was measured using the Pressure Ulcer Knowledge Assessment Tool (PUKAT 2.0). Attitudes were measured using a predesigned instrument which included 11 statements on a five point Likert scale. All data were collected using paper-based questionnaires. The response rate was 100%. Respondents (n = 235) consisted of 80 community nursing program coordinators (34.0%) and 155 community nurses (66.0%). Regarding knowledge, the percentage of correct answers in the total group of community nurses on the PUKAT 2.0 was 30.7%. The theme "Prevention" had the lowest percentage of correct answers (20.8%). Community nurses who had additional PI or wound care training had a higher knowledge score compared with community nurses who did not have additional PI training (33.7% vs 30.3%; Z = -1.995; P = 0.046). The median attitude score was 44 (maximum score 55; range 28-55), demonstrating a positive attitude among participants towards PI prevention. Further, the higher the education status of participants, the more positive the attitudes (H = 11.773; P = 0.003). This study shows that community nurses need to improve their basic knowledge of PI prevention. Furthermore, research should be performed to explore what community nurses need to strengthen their role in PI prevention

Having Fun in Learning Formal Specifications

There are many benefits in providing formal specifications for our software. However, teaching students to do this is not always easy as courses on formal methods are often experienced as dry by students. This paper presents a game called FormalZ that teachers can use to introduce some variation in their class. Students can have some fun in playing the game and, while doing so, also learn the basics of writing formal specifications in the form of pre- and post-conditions. Unlike existing software engineering themed education games such as Pex and Code Defenders, FormalZ takes the deep gamification approach where playing gets a more central role in order to generate more engagement. This short paper presents our work in progress: the first implementation of FormalZ along with the result of a preliminary users' evaluation. This implementation is functionally complete and tested, but the polishing of its user interface is still future work

COVID-19 in a Dutch Nursing Home: A Longitudinal Retrospective Care-Home-Level Case Study on Infection Rate, Survival Rate, and Daily Functioning

During the pandemic, nursing homes in the Netherlands were heavily affected by COVID-19. This study assesses the impact of COVID-19 on infection rate, survival rate, and daily functioning over the course of two years among residents of a nursing home in the Netherlands that was amongst the first nursing homes to be affected by the pandemic. This retrospective study followed 70 residents during a two-year period, starting in March 2020. Data were collected on baseline characteristics of participants and the onset, duration, and sequelae of COVID-19 infections. Primary outcomes were mortality and infection rate. The secondary outcome was daily functioning using the Barthel Index at intervals of six months. Within two years, 44 (62.9%) residents were diagnosed with COVID-19. During this study, 72.7% (n = 32) of the COVID-positive residents died, of which 22 deaths were related to the COVID-19 infection. Overall mortality was 60% (n = 42), while COVID-related mortality was 31.4% (n = 22). COVID-19 and multimorbidity (>3 morbidities) were independent risk factors for mortality. Barthel Index scores showed no significant difference in daily functioning. Overall, a high COVID-19 infection rate was seen and was the most common cause of death. COVID-19 did not affect functional status over time

Uitdagingen in de geriatrische revalidatiezorg: de ontwikkeling van een zorgpad

De geriatrische revalidatiezorg heeft te maken met een aantal uitdagingen op het gebied van coördinatie en continuïteit van de zorg. Om deze uitdagingen aan te pakken is een zorgpad ontwikkeld voor de betrokken organisaties (ziekenhuis, geriatrische revalidatiezorg en eerstelijnszorg). Het doel van dit artikel is het proces van (door)ontwikkeling van dit zorgpad toe te lichten en het resultaat ervan te beschrijven en te bediscussiëren. Het zorgpad is (door)ontwikkeld op basis van de eerste vier stappen van het cyclische implementatiemodel van Grol en Wensing: (1) ontwikkeling voorstel voor verandering; (2) analyse feitelijke zorg; (3) analyse doelgroep en setting; (4) ontwikkeling en selectie van interventies/strategieën. Volgens de betrokken partijen moest het zorgpad zich primair richten op verbetering van de zorgprocessen, waaronder de transfers, overdrachten en communicatie tussen de instellingen. Om dit te bereiken werden via literatuuronderzoek, consultatie van experts, interviews met betrokkenen, en werkgroepen van zorgverleners, patiënten en mantelzorgers, de huidige zorg en bestaande problemen geanalyseerd en oplossingen aangedragen voor verbetering. Dit heeft geresulteerd in een zorgpad waarin afspraken zijn vastgelegd over: (a) triage in het ziekenhuis; (b) betrekken van patiënt en mantelzorger bij (keuzemomenten in) de zorg; (c) tijdige en kwalitatief hoogwaardige overdrachten; en (d) adequate communicatie en afstemming tussen zorgverleners

Obesity and its associated factors in older nursing home residents in three European countries—Secondary data analyses from the “International Prevalence Measurement of Care Quality”

Background: The prevalence of obesity has risen in recent decades and reached epidemic proportions worldwide. The proportion of those living with obesity is also increasing in nursing homes. This could impact the nursing care required, equipment and facilities provided, and morbidity in these settings. Limited evidence exists on clinical consequences of obesity in nursing home residents and their care. Objective: Therefore, the aim was to examine the rate and associated factors of obesity (BMI ≥30; class I (BMI 30.0–34.9 kg/m2), class II (BMI 35.0–39.9 kg/m2), and class III (BMI >40.0 kg/m2)) amongst older nursing home residents in European countries. Methods: We analysed data from 21,836 people who reside in nursing homes in Austria, the Netherlands, and the United Kingdom. They participated in the “International Prevalence Measurement of Care Quality”, a cross sectional study between 2016 and 2019, where trained nurses interviewed the residents, reviewed care records, and conducted clinical examinations. A tested and standardised questionnaire comprised questions on demographic data, measured BMI, medical diagnosis according to ICD‐10, and care dependency. Descriptive and logistic regression analyses were performed. Results: Obesity rates were highest in Austria (17.1%) and lowest in the UK (13.0%) (p = .006). Residents with obesity were younger and less likely to be care dependent or living with dementia and had more often diabetes mellitus, endocrine, metabolic, and skin diseases compared to residents without obesity (p < .05). Most obese residents had obesity class I. Therefore, two subgroups were built (class I vs. class II + III). Residents with obesity class II + III were more frequently care dependent for mobility, getting dressed and undressed, and personal hygiene compared to residents with class I (p < .05). Conclusions: This study identified several factors that are associated with obesity amongst older nursing home residents in selected European countries. Implications for practice: The division into obesity classes is important for planning targeted care according to the individual needs of nursing home residents