Family Consultation To Reduce Early Hospital Readmissions Among Patients With End-Stage Renal Disease: A Randomized Clinical Trial

Background: The U.S. Centers for Medicare and Medicaid Services have mandated reducing early hospital readmissions (i.e., within 30 days of discharge) to both improve patient care and reduce expenses. Patients with end-stage renal disease (ESRD) have relatively high early readmission rates, due in part to their complex medical regimens but also cognitive impairment, health literacy problems, and lack of social support. We developed a brief family consultation intervention to address these problems and tested its ability to reduce early readmissions among patients with ESRD. Method: 120 hospitalized adults with ESRD (M age = 57.5 years; 50% male; 86% Black, 12% White) were recruited from an urban, inpatient nephrology unit. Patients were randomized to family consultation (FC; n = 60) or treatment-as-usual (TAU) control (n = 60) conditions. Family consultations, conducted either bedside or via telephone, were conducted with 57 of the 60 assigned patients and covered psychoeducation about cognitive and behavioral risk factors for readmission and how to compensate for them. Blinded medical record review was conducted later to determine readmissions within 30 days. Results: Chi-square tests and logistic regressions tested intervention effects. Per protocol analyses (excluding three FC patients who received no consultation) indicated that FC reduced early readmission (18%) after discharge, compared to TAU (32%; χ = 3.13, p = .039), and reduced any early hospital return visit (emergency department, brief observation, or readmission) compared to TAU (28% vs. 47%; χ = 4.31, p = .019). Intent-to-treat analyses revealed that FC marginally reduced readmission (20%) compared to TAU (32%; χ = 2.13, p = .077), but FC still significantly reduced any hospital visit (32%) compared to TAU (47%; χ = 2.83, p = .046). Discussion: A brief psychosocial intervention with family members can decrease readmissions in patients with ESRD, thereby improving health outcomes and reducing costs

Anger Expression: Evaluating The Construct Validity Of Several Emotion Regulation Measures

Researchers have used the Anger Expression Inventory (AEI), Ambivalence of Emotional Expression Questionnaire (AEQ), and Toronto Alexithymia Scale 20 (TAS) self-report measures to draw conclusions about relationships between emotion regulation and many other variables, but there is an insufficient amount of validation evidence about these measures. After first filling out the self-report measures, 75 participants with chronic low back pain completed a videotaped anger induction paradigm, in order to provoke the naturalistic experience of anger. Participants were next given the opportunity to express their anger to the experimenter, in either a guided or unguided condition. We then coded the videos to rate the amount of anger and anxiety expressed by the participants both verbally and non-verbally. Correlations among the predictor variables and behavioral variables showed that Anger-Out and TAS were positively correlated with anger, and Anger-In and AEQ were independent of anger. The findings support the validity of Anger-Out, suggest that Anger-In and TAS measure slightly different constructs that than theorized, and calls into question the validity of the AEQ

Innovation Is Key for Technology-Based Outreach

The Ohio State University (OSU) funded an outreach and engagement grant to design the Gardeners\u27 Toolshed, a garden center kiosk. The kiosk represented a unique opportunity for OSU to introduce itself to the citizens of Ohio in the area of gardening and pest management. The kiosk is a touch-screen-enabled computer with specific content in 14 areas ranging from plants to water gardens. This project was piloted in a garden center in southwest Ohio for just over 1 year. A user survey revealed they were quite pleased with the overall user interface, appearance, and informational content of the kiosk

A conceptual design of a large aperture microwave radiometer geostationary platform

A conceptual design of a Large Aperture Microwave Radiometer (LAMR) Platform has been developed and technology areas essential to the design and on-orbit viability of the platform have been defined. Those technologies that must be developed to the requirement stated here for the LAMR mission to be viable include: advanced radiation resistant solar cells, integrated complex structures, large segmented reflector panels, sub 3 kg/m(exp 2) areal density large antennas, and electric propulsion systems. Technology areas that require further development to enhance the capabilities of the LAMR platform (but are not essential for viability) include: electrical power storage, on-orbit assembly, and on-orbit systems checkout and correction

Final STS-35 Columbia descent BET products and results for LaRC OEX investigations

Final STS-35 'Columbia' descent Best Estimate Trajectory (BET) products have been developed for Langley Research Center (LaRC) Orbiter Experiments (OEX) investigations. Included are the reconstructed inertial trajectory profile; the Extended BET, which combines the inertial data and, in this instance, the National Weather Service atmospheric information obtained via Johnson Space Center; and the Aerodynamic BET. The inertial BET utilized Inertial Measurement Unit 1 (IMU1) dynamic measurements for deterministic propagation during the ENTREE estimation process. The final estimate was based on the considerable ground based C-band tracking coverage available as well as Tracking Data and Relay Satellite System (TDRSS) Doppler data, a unique use of the latter for endo-atmospheric flight determinations. The actual estimate required simultaneous solutions for the spacecraft position and velocity, spacecraft attitude, and six IMU parameters - three gyro biases and three accelerometer scale factor correction terms. The anchor epoch for this analysis was 19,200 Greenwich Mean Time (GMT) seconds which corresponds to an initial Shuttle altitude of approximately 513 kft. The atmospheric data incorporated were evaluated based on Shuttle derived considerations as well as comparisons with other models. The AEROBET was developed based on the Extended BET, the measured spacecraft configuration information, final mass properties, and the final Orbiter preoperation databook. The latter was updated based on aerodynamic consensus incrementals derived by the latest published FAD. The rectified predictions were compared versus the flight computed values and the resultant differences were correlated versus ensemble results for twenty-two previous STS entry flights

A comprehensive review of full cost accounting methods and their applicability to the automotive industry

Full cost accounting has been applied in many industrial settings that include the oil and gas, energy, chemical and waste management industries. Presently, it is not known how it can be applied in an automotive industry context. Therefore, the objective of this paper is to review existing full cost accounting methods and identify an appropriate approach for the automotive sector. This literature review of 4381 papers extracted ten full cost accounting methods with a diverse level of development and consistency in application. Based on a careful examination and critical analysis of each approach and existing automotive sustainability measures, the Sustainability Assessment Model developed by British Petroleum and Aberdeen University has been proposed as a well-developed and potentially practical tool for automotive applications. The Sustainability Assessment Model can be used by both academics and practitioners to translate a range of conflicting sustainability information into a monetary unit score. This is an effective way of communicating trade-offs and outcomes for complex and multi-disciplinary sustainable decisions in the automotive sector. It measures a broad range of economic, environmental, resource and social effects (internal and external), which is currently lacking in existing automotive systems. Its other strengths are the ability to provide both monetary and physical metrics for sustainability assessment, its flexibility and the ability to combine multiple sustainability dimensions. Furthermore, this paper provides helpful clues for researchers interested in exploring full cost accounting in the future by reviewing, analysing and synthesising the broad range of relevant sources from diverse fields in this topic area

4-(4-Chloro­phen­yl)-4-hy­droxy­piperidinium benzoate

In the title salt, C11H15ClNO+·C7H5O2 −, the dihedral angle between the mean planes of the chloro­phenyl ring of the cation and the benzene ring of the anion is 74.4 (1)°. In the cation, the six-membered piperazine ring adopts a chair conformation. The crystal packing is stabilized by inter­molecular N—H⋯O and O—H⋯O hydrogen bonds, and weak inter­molecular C—H⋯O, C—H⋯Cl and C—H⋯π inter­actions

[3-(5-Hy­droxy-5H-dibenzo[a,d]cyclo­hepten-5-yl)prop­yl]dimethyl­ammonium 3-carboxyprop-2-enoate

In the cation of the title salt, C20H24NO+·C4H3O4 −, the N atom in the dimethyl­ammonium group is protonated. The dihedral angle between the mean planes of the two six-membered rings fused to the cyclo­hepten-5-yl ring is 54.4 (1)°. An intra­molecular O—H⋯O hydrogen bond occurs in the anion. The crystal packing is stabilized by inter­molecular O—H⋯O and N—H⋯(O,O) hydrogen bonds and weak C—H⋯O inter­actions, forming a two-dimensional network

4-(1H-Benzimidazol-2-ylmeth­oxy)-3-meth­oxy­benzaldehyde tetra­hydrate

In the title compound, C16H14N2O3·4H2O, the dihedral angle between the mean planes of the benzimidazole ring system and benzene ring is 2.9 (1)°. The aldehyde group is disordered over two sets of sites with refined occupancies of 0.559 (4) and 0.441 (4). In the crystal, extensive inter­molecular O—H⋯O, O—H⋯N and N—H⋯O hydrogen bonds in concert with weak π–π stacking inter­actions [centroid–centroid distances = 3.6104 (9), 3.6288 (9) and 3.9167 (10) Å] create a three-dimensional network

Ethyl 2-amino-4,6-bis­(4-fluoro­phen­yl)cyclo­hexa-1,3-diene-1-carboxyl­ate

In the title compound, C21H19F2NO2, the cyclo­hexa-1,3-diene ring is in a distorted envelope conformation. The dihedral angles between the mean planes of the diene moiety and the two fluoro­phenyl rings are 42.8 (2) and 75.0 (5)°. The two fluoro­phenyl rings are inclined to one another by 87.0 (3)°. In the crystal, intra­molecular N—H⋯O hydrogen bonds and weak N—H⋯O and N—H⋯F inter­molecular inter­actions are observed forming an infinite two-dimensional network along [011]