Mortality benefit of building adaptations to protect care home residents against heat risks in the context of uncertainty over loss of life expectancy from heat

We explore methodological issues core to the cost-benefit evaluation of building adaptations designed to protect against heat risks to residents of care homes in England in the context of the uncertainties relating to the loss of life expectancy in heat death. We used building physics modelling to quantify the impact of external window shading on indoor temperatures. We calculated associated heat mortality and loss of life expectancy under three sets of assumptions of life-shortening based on: (Method 1) an England & Wales (E&W) life-table, (Method 2) E&W life-table scaled to match observed average survival of care home residents and (Method 3) assuming that those dying of heat have a life expectancy of six months. External window shading was estimated to reduce mean indoor temperatures by 0.9 °C in a �warm� summer and 0.6 °C in an �average� summer. In a care home of 50 residents, the heat deaths and years of life lost (YLL) averted by such shading were estimated by the three life-expectancy assumptions (Methods 1, 2, 3) to be: 0.07, 0.47 and 0.28 heat deaths and 0.29, 0.76 and 0.14 YLL for the warm year and 0.05, 0.31 and 0.19 heat deaths and 0.20, 0.51 and 0.10 YLL for the average year. Over a 20-year time horizon and assuming an annual discount rate of 3.5%, the monetized benefit of reduced YLL would be around £90,000, £230,000 and £44,000 with the three life-expectancy assumptions. Although this range represents appreciable uncertainty, it appears that modest cost adaptations to heat risk may be justified in conventional cost-benefit terms even under conservative assumptions about life expectancy

Are there independent predisposing factors for postoperative infections following open heart surgery?

<p>Abstract</p> <p>Background</p> <p>Nosocomial infections after cardiac surgery represent serious complications associated with substantial morbidity, mortality and economic burden. This study was undertaken to evaluate the frequency, characteristics, and risk factors of microbiologically documented nosocomial infections after cardiac surgery in a Cardio-Vascular Intensive Care Unit (CVICU).</p> <p>Methods</p> <p>All patients who underwent open heart surgery between May 2006 and March 2008 were enrolled in this prospective study. Pre-, intra- and postoperative variables were collected and examined as possible risk factors for development of nosocomial infections. The diagnosis of infection was always microbiologically confirmed.</p> <p>Results</p> <p>Infection occurred in 24 of 172 patients (13.95%). Out of 172 patients, 8 patients (4.65%) had superficial wound infection at the sternotomy site, 5 patients (2.9%) had central venous catheter infection, 4 patients (2.32%) had pneumonia, 9 patients (5.23%) had bacteremia, one patient (0.58%) had mediastinitis, one (0.58%) had harvest surgical site infection, one (0.58%) had urinary tract infection, and another one patient (0.58%) had other major infection. The mortality rate was 25% among the patients with infection and 3.48% among all patients who underwent cardiac surgery compared with 5.4% of patients who did not develop early postoperative infection after cardiac surgery. Culture results demonstrated equal frequencies of gram-positive cocci and gram-negative bacteria. A backward stepwise multivariable logistic regression model analysis identified diabetes mellitus (OR 5.92, CI 1.56 to 22.42, p = 0.009), duration of mechanical ventilation (OR 1.30, CI 1.005 to 1.69, p = 0.046), development of severe complications in the CICU (OR 18.66, CI 3.36 to 103.61, p = 0.001) and re-admission to the CVICU (OR 8.59, CI 2.02 to 36.45, p = 0.004) as independent risk factors associated with development of nosocomial infection after cardiac surgery.</p> <p>Conclusions</p> <p>We concluded that diabetes mellitus, the duration of mechanical ventilation, the presence of complications irrelevant to the infection during CVICU stay and CVICU re-admission are independent risk factors for the development of postoperative infection in cardiac surgery patients.</p

Unpublished Mediterranean and Black Sea records of marine alien, cryptogenic, and neonative species

To enrich spatio-temporal information on the distribution of alien, cryptogenic, and neonative species in the Mediterranean and the Black Sea, a collective effort by 173 marine scientists was made to provide unpublished records and make them open access to the scientific community. Through this effort, we collected and harmonized a dataset of 12,649 records. It includes 247 taxa, of which 217 are Animalia, 25 Plantae and 5 Chromista, from 23 countries surrounding the Mediterranean and the Black Sea. Chordata was the most abundant taxonomic group, followed by Arthropoda, Mollusca, and Annelida. In terms of species records, Siganus luridus, Siganus rivulatus, Saurida lessepsianus, Pterois miles, Upeneus moluccensis, Charybdis (Archias) longicollis, and Caulerpa cylindracea were the most numerous. The temporal distribution of the records ranges from 1973 to 2022, with 44% of the records in 2020–2021. Lethrinus borbonicus is reported for the first time in the Mediterranean Sea, while Pomatoschistus quagga, Caulerpa cylindracea, Grateloupia turuturu, and Misophria pallida are first records for the Black Sea; Kapraunia schneideri is recorded for the second time in the Mediterranean and for the first time in Israel; Prionospio depauperata and Pseudonereis anomala are reported for the first time from the Sea of Marmara. Many first country records are also included, namely: Amathia verticillata (Montenegro), Ampithoe valida (Italy), Antithamnion amphigeneum (Greece), Clavelina oblonga (Tunisia and Slovenia), Dendostrea cf. folium (Syria), Epinephelus fasciatus (Tunisia), Ganonema farinosum (Montenegro), Macrorhynchia philippina (Tunisia), Marenzelleria neglecta (Romania), Paratapes textilis (Tunisia), and Botrylloides diegensis (Tunisia).peer-reviewe

The Problems faced by Families with Children with ADD/ADHD

The purpose of my thesis is to describe the specific needs of families with children with ADD/ADHD. Attention is given to the way parents perceive their children's difficulties and how these affect the whole family. The theoretical part presents the basic definitions, the historical changes in terminology, the causes of ADD/ADHD and the possibilities of diagnosis and therapy. More over it describes the aspects of the syndrome and the results it may cause. More attention is given to the family and its possibility to intervene. The practical part is based on a questionnaire research, which will focus on the way ADD/ADHD children's parents perceive the children's difficulties, their special needs and experiences. Powered by TCPDF (www.tcpdf.org

Ο Αθάνας και η Ιταλία. Η Ποιητική του Συλλογή «Ιταλικές Μακέτες»

H παρούσα εργασία εξετάζει τη σχέση του ποιητή Γεώργιου Αθανασιάδη-Νόβα (Αθάνα) με την Ιταλία όπως κυρίως αποτυπώνεται μέσα από την ποιητική συλλογή του «Ιταλικές Μακέτες». Από την εν λόγω συλλογή στην οποία ο ποιητής προσφέρει στον αναγνώστη ένα ευχάριστο και συνάμα εκπαιδευτικό ταξίδι στη γείτονα χώρα, αναδεικνύονται και αναλύονται τα ποιήματα εκείνα στα οποία φωτίζεται η στενή ιστορική και πολιτισμική σχέση Ελλάδας-Ιταλίας μέσα στο πέρασμα των αιώνων.This thesis studies George Athanasiadis-Nova (Athana) and his relationship with Italy specifically in the way it is reflected in his collection of poems «Italian Maquettes», which offers the reader a beautiful and educational trip to Italy. From the aforesaid collection, the selected poems were the ones that focused and highlighted the historic and cultural bonds that tied Greece and Italy over the past centuries

Digital Redesign of Problem-Based Learning (PBL) from Face-to-Face to Synchronous Online in Biomedical Sciences MSc Courses and the Student Perspective

PBL is a widely used teaching approach that is increasingly incorporating digital components. Although, by its nature, a face-to-face approach is the preferred mode of delivery, its digital counterpart is gaining ground. The current paper discusses the digital redesign of PBL in an MSc in Biomedical Sciences. Face-to-face and online PBL followed the seven steps of the PBL process, and each case was completed in three sessions. For the delivery of online PBL, collaborative tools were utilized, including CiscoWebex, the online platform for synchronous meetings, and OneDrive, shareable PPT, and Moodle for synchronous and asynchronous self-directed learning. Three cohorts were followed, and students had both face-to-face and online PBL experiences. Student feedback was obtained using focus groups, and data analysis utilized a deductive and inductive approach. Our data indicate that CiscoWebex is a suitable and user-friendly platform for synchronous online PBL. The students enjoyed both formats and stated that online PBL is an effective teaching approach for promoting student learning. In regards to student interaction, the face-to-face mode was preferred, while online PBL was perceived as more organized. The redesign allowed for effective student learning and could pave the way forward for a fully online MSc program in Biomedical Sciences

Video Head Impulse Test (vHIT): Value of Gain and Refixation Saccades in Unilateral Vestibular Neuritis

The aim of this study was to evaluate gain and refixation saccades (covert and overt) using a video head impulse test (vHIT) in the horizontal and vertical planes in patients after the onset of unilateral acute vestibular neuritis (AVN). Thirty-five patients were examined in the acute stage of AVN and at follow-up (range, 6–30 months); a control group of 32 healthy subjects also participated. At onset, the mean gain was significantly lower on the affected side in all of the semi-circular canal planes, mainly in the horizontal canal plane, and saccades (covert and overt) were more prevalent in the horizontal compared to the vertical canal planes. Multi-canal affection occurred more frequently (80% for gain, 71% for saccades) than isolated canal affection. At follow-up, which ranged from 6 to 30 months, the gain was recovered in all of the canals (anterior in 50%, horizontal in 42.8%, and posterior canal in 41.1% of cases), while covert and overt saccades were reduced in the horizontal and vertical planes. However, covert saccades were still recorded in a greater proportion (69%) than overt saccades (57%) in the horizontal plane and at a lower rate in the vertical planes. The compensatory mechanisms after AVN mainly involve the horizontal canal, as the refixation saccades—especially covert ones—were more frequently recorded in the horizontal than vertical canals

The Multifarious Effects of Various Glaucoma Pharmacotherapy on Corneal Endothelium: A Narrative Review

Abstract Corneal endothelium is a single cell layer that is mainly responsible for maintaining corneal clarity. Endothelial damage secondary to toxicity, stress, or genetic predisposition are common and in conjunction with the low regenerative ability of the cells, making their preservation critical for maintaining visual acuity. Patients with glaucoma, who are estimated to be close to 80 million worldwide, have a plethora of reasons for developing endothelial damage, being exposed to a spectrum that extends from various medical and surgical interventions to the disease itself. The wide spectrum of glaucoma pharmacotherapy that has been recently extended by addition of newer classes of medications has been the focus of extensive research on its effects on corneal endothelium. Both basic and clinical research have attempted to shine a light on the complex mechanisms associated with the effects of glaucoma medication on corneal endothelium and to answer the important question as to whether these findings are clinically significant. The aim of this review is to summarize and present current literature of the various findings, both from in vivo and in vitro studies that have focused on the complex relationship between different classes of glaucoma medication and their effect on corneal endothelium

Governing the Climate Adaptation of Care Settings Dataset, 2022

The dataset consists of air temperatures recorded longitudinally and reported at hourly intervals using Hobo MX1101, Hobo MX1102A and Hobo MX2301 devices. The monitoring period covered 1st May 2022 to 30th September 2022 inclusive – the full non-heating season in England. The devices were deployed in 30 care homes across England: eleven in Greater London, nine in the north of England as far north as Newcastle-upon-Tyne, six in the Midlands, and four in the south of England including on the Isle of Wight. The locations monitored consisted of 22 offices (staff-only areas such as manager’s offices, administrator offices, nurse stations), 30 lounges (communal areas such as lounges, dining rooms and lounge/diners), and 30 bedrooms (single rooms, with a range of occupancy – some vacant, some occupied only at night, others occupied 24/7 depending on resident needs). In addition, outdoor temperatures were monitored at each of the 30 care homes