Harmonic Gradience in Greek Rap Rhymes

This study investigates the gradience in mismatch acceptability in Greek rap Imperfect Rhyme. We consider that the rhyme domains of a rhyming pair are in a Base-Reduplicant correspondence relationship, requiring segmental identity in Place of Articulation, Manner of Articulation and voicing, and manifesting a gradient acceptability of featural mismatches. Analysis shows that voicing mismatches are highly marked in Greek rap rhyme, implying a high perceptual salience, which seems to be language-specific. Mismatches only in Place of Articulation seem to be the most harmonic and frequent mismatch pattern, while Harmony and similarity decrease in inverse proportion to the number of mismatching features. Mismatches in Greek rap rhyme are, in principle, accepted between unmarked corresponding consonants. Obstruents, mainly Stops mismatch in Place of Articulation, and Coronals mismatch in Manner of Articulation. In general, mainly Coronal Obstruents and, to a lesser extent, Nasals are involved in mismatches. Due to the attested high avoidance of voicing mismatches, which are acoustically non-salient, we propose that, in Standard Modern Greek, perceptual salience is not purely phonetic, as it seems to be also based on the language-specific phonological grammar

Perspectives of Intensive Care patients and family members on competencies for Advanced Intensive Care nurses in Europe

BackgroundOne output from the International Nursing Advanced Competency-based Training for Intensive Care (INACTIC) collaboration is a set of core competencies for advanced practice Intensive Care Unit (ICU) nurses across Europe. Some European countries, such as the UK, have identified such competencies, however, these advanced practice roles are rarely practiced across the rest of Europe. The INACTIC competencies were developed with an expert panel of 184 ICU nurses from 20 countries. It is also important to examine what patients and relatives with experience of intensive care felt about these competencies. AimTo examine the views of recovered ICU patients and relatives regarding the INACTIC competencies.MethodsThree patient and relative focus groups were conducted in England (n=5), Scotland (n=4) and Greece (n=4) to discuss a lay version of the INACTIC competencies. Discussions were open ended, followed a topic guide, recorded and transcribed verbatim. Analysis followed a conventional thematic approach, with the findings discussed iteratively among the authors.ResultsThe feedback from across the focus groups resulted in three themes: 1) the importance of nurses being empowered to advocate for the patient; 2) the centrality of communication; and, 3) the impact of variability in ICU practices. There was a notable difference with the Greek focus group; because of restricted family visiting policies, relatives did not feel encouraged to participate in patient care.ConclusionsThe perspectives of patients and relatives largely aligned with the consensus of the INACTIC expert panel. Local differences in ICU experience highlight the changes that some ICUs would need to make for the INACTIC competencies to be embedded

International variation in the management of severe COVID-19 patients

Background: There is little evidence to support the management of severe COVID-19 patients. Methods: To document this variation in practices, we performed an online survey (April 30-May 25, 2020) on behalf of the European Society of Intensive Care Medicine (ESICM). A case vignette was sent to ESICM members. Questions investigated practices for a previously healthy 39-year-old patient presenting with severe hypoxemia from COVID-19 infection. Results: A total of 1132 ICU specialists (response rate 20%) from 85 countries (12 regions) responded to the survey. The survey provides information on the heterogeneity in patient's management, more particularly regarding the timing of ICU admission, the first line oxygenation strategy, optimization of management, and ventilatory settings in case of refractory hypoxemia. Practices related to antibacterial, antiviral, and anti-inflammatory therapies are also investigated. Conclusions: There are important practice variations in the management of severe COVID-19 patients, including differences at regional and individual levels. Large outcome studies based on multinational registries are warranted.publishersversionpublishe

Symptoms of burnout in intensive care unit specialists facing the COVID-19 outbreak

Background: The COVID-19 pandemic has resulted in an unprecedented healthcare crisis with a high prevalence of psychological distress in healthcare providers. We sought to document the prevalence of burnout syndrome amongst intensivists facing the COVID-19 outbreak. Methods: Cross-sectional survey among intensivists part of the European Society of Intensive Care Medicine. Symptoms of severe burnout, anxiety and depression were collected. Factors independently associated with severe burnout were assessed using Cox model. Results: Response rate was 20% (1001 completed questionnaires were returned, 45 years [39–53], 34% women, from 85 countries, 12 regions, 50% university-affiliated hospitals). The prevalence of symptoms of anxiety and depression or severe burnout was 46.5%, 30.2%, and 51%, respectively, and varied significantly across regions. Rating of the relationship between intensivists and other ICU stakeholders differed significantly according to the presence of anxiety, depression, or burnout. Similar figures were reported for their rating of the ethical climate or the quality of the decision-making. Factors independently associated with anxiety were female gender (HR 1.85 [1.33–2.55]), working in a university-affiliated hospital (HR 0.58 [0.42–0.80]), living in a city of > 1 million inhabitants (HR 1.40 [1.01–1.94]), and clinician’s rating of the ethical climate (HR 0.83 [0.77–0.90]). Independent determinants of depression included female gender (HR 1.63 [1.15–2.31]) and clinician’s rating of the ethical climate (HR 0.84 [0.78–0.92]). Factors independently associated with symptoms of severe burnout included age (HR 0.98/year [0.97–0.99]) and clinician’s rating of the ethical climate (HR 0.76 [0.69–0.82]). Conclusions: The COVID-19 pandemic has had an overwhelming psychological impact on intensivists. Follow-up, and management are warranted to assess long-term psychological outcomes and alleviate the psychological burden of the pandemic on frontline personnel.publishersversionpublishe

Strategies of Screening and Treating Post-Extubation Dysphagia: An Overview of the Situation in Greek-Cypriot ICUs

Post-extubation dysphagia (PED) can lead to serious health problems in critically ill patients. Contrasting its high incidence rate of 12.4% reported in a recent observational study, many ICUs lack routine bedside screening, likely due to limited awareness. This study aimed to establish baseline data on the current approaches and the status of perceived best practices in PED screening and treatment, as well as to assess awareness of PED. A nationwide cross-sectional, online survey was conducted in all fourteen adult ICUs in the Republic of Cyprus in June 2018, with a 100% response rate. Over 85% of ICUs lacked a standard screening protocol for PED. The most commonly reported assessment methods were cough reflex testing and the water swallow test. Treatment approaches included muscle strengthening exercises without swallowing and swallowing exercises. Only 28.6% of ICUs acknowledged PED as a common issue. The study identified significant gaps in awareness and knowledge regarding PED screening and treatment in Greek-Cypriot ICUs. Urgent implementation of comprehensive dysphagia education programs within the units is necessary, and interdisciplinary collaboration among nurses, intensivists, and speech and language therapists is crucial to improve the quality of care provided

Strategies of Screening and Treating Post-Extubation Dysphagia: An Overview of the Situation in Greek-Cypriot ICUs

Post-extubation dysphagia (PED) can lead to serious health problems in critically ill patients. Contrasting its high incidence rate of 12.4% reported in a recent observational study, many ICUs lack routine bedside screening, likely due to limited awareness. This study aimed to establish baseline data on the current approaches and the status of perceived best practices in PED screening and treatment, as well as to assess awareness of PED. A nationwide cross-sectional, online survey was conducted in all fourteen adult ICUs in the Republic of Cyprus in June 2018, with a 100% response rate. Over 85% of ICUs lacked a standard screening protocol for PED. The most commonly reported assessment methods were cough reflex testing and the water swallow test. Treatment approaches included muscle strengthening exercises without swallowing and swallowing exercises. Only 28.6% of ICUs acknowledged PED as a common issue. The study identified significant gaps in awareness and knowledge regarding PED screening and treatment in Greek-Cypriot ICUs. Urgent implementation of comprehensive dysphagia education programs within the units is necessary, and interdisciplinary collaboration among nurses, intensivists, and speech and language therapists is crucial to improve the quality of care provided

Dependence of long-term persistence properties of precipitation on spatial and regional characteristics

<p>The long-term persistence (LTP), else known in hydrological science as the Hurst phenomenon, is a behaviour observed in geophysical processes in which wet years or dry years are clustered to respective long time periods. A common practice for evaluating the presence of the LTP is to model the geophysical time series with the Hurst-Kolmogorov process (HKp) and estimate its Hurst parameter <i>H</i> where high values of <i>H</i> indicate strong LTP.</p> <p>We estimate <i>H</i> of the mean annual precipitation using instrumental data from approximately 1 500 stations which cover a big area of the earth’s surface and span from 1916 to 2015. We regress the <i>H</i> estimates of all stations on their spatial and regional characteristics (i.e. their location, elevation and Köppen-Geiger climate class) using a random forest algorithm. Furthermore, we apply the Mann-Kendall test under the LTP assumption (MKt-LTP) to all time series to assess the significance of observed trends of the mean annual precipitation.</p> <p>To summarize the results, the LTP seems to depend mostly on the location of the stations, while the predictive value of the fitted regression model is good. Thus when investigating for LTP properties we recommend that the local characteristics should be considered. Additionally, the application of the MKt-LTP suggests that no significant monotonic trend can characterize the global precipitation. Dominant positive significant trends are observed mostly in main climate type D (snow), while in the other climate types the percentage of stations with positive significant trends was approximately equal to that of negative significant trends. Furthermore, 50% of all stations do not exhibit significant trends at all.</p