A Review of the Benefit of Pre-Operative Education Prior to Coronary Artery Bypass Grafting

Coronary Artery Bypass Graft surgery is the most common type of heart surgery performed each year in the United States (U.S. Department of HHS, 2010). If your healthcare provider were to tell you that you needed heart surgery what would be the first thing to come to mind, would it be fear, pain, anxiety, denial? Do you have any idea what this procedure entails or what to expect before, during, or after your hospitalization? Preparation is most often a prerequisite for success. Multiple research studies have shown that proper patient preparation can lead to better patient outcomes, including pain and anxiety reduction, cost savings, reduced mortality and morbidity, as well as greater staff satisfaction. Too often patients are inundated with dozens of pages of information and booklets regarding surgery that they become too overwhelmed to even know where to begin. The purpose of this literature review is to identify the potential benefit(s) of a simplified and concise pre-operative patient education brochure or pamphlet prior to Coronary Artery Bypass Grafting (CA.BG) surgery. The main search engines used included PubMed, CINAHL, SCOPUS, and Google Scholar. If literat11re shows that properly educated patients display better post operative outcomes in terms of anxiety reduction, pain control, and reduced readmission rates, it would seem prudent that for optimal patient outcomes, hospitals and more explicitly surgical departments within the hospitals integrate a tool such as this factor that has a great effect on an individual\u27s recovery is pain. Pain has significant negative effects on breathing, eating, movement, perfusion, emotions, and wound 5 healing. While setting a goal of no pain after surgery is not realistic, teaching patients the different methods to control, express, and minimize their pain is beneficial to healing. This paper will attempt to identify documented benefits of patient education about these factors prior to CABG surgery. Key Words: pre-operative education, Coronary Artery Bypass Grafting (CA.BG), pre-operative anxiety, formal patient education, cardiac surgery education, hospital readmission after cardiac surgery, readmission rate

IP-for-IP or Cash-for-IP? R&D Competition and the Market for Technology

This paper argues that firms use 'IP-for-IP' policies such as cross-licensing to strategically restrict transactions in the market for technology. The commitment to limit trade to reciprocal exchange (barter instead of cash transactions) enables firms to alter the allocation of R&D and soften R&D competition. In particular, it induces firms to focus R&D on their area of expertise. The costs of IP-for-IP are foregone gains from trade. Our analysis of the trade-offs involved shows that IP-for-IP is profitable in industries where firms differ in their capabilities to commercialize IP. Patent complementarities and firm asymmetries further strengthen the optimality of IP-for-IP

IP-for-IP or Cash-for-IP? R&D Competition and the Market for Technology

We analyze how firms might benefit from trading restrictions in the market for technology. We show that restricting trade to reciprocal exchange (“IP-for-IP” barter instead of cash transactions), as in cross-licensing agreements, alters the allocation of R&D resources and reduces overinvestment in R&D. The tighter are the trading restrictions, the higher are the costs that are due to forgone gains from trade. Our analysis of the trade-offs involved shows that firms benefit from IP-for-IP restrictions, compared to both free trade and no trade environments, in industries where: (1) firms differ in their capabilities to commercialize IP; and (2) patent complementarities exist

A Robustness Study for the Extraction of Watertight Volumetric Models from Boundary Representation Data

Geometrically induced topology plays a major role in applications such as simulations, navigation, spatial or spatio-temporal analysis and many more. This article computes geometrically induced topology useful for such applications and extends previous results by presenting the unpublished used algorithms to find inner disjoint (d+1)-dimensional simplicial complexes from a set of intersecting d-dimensional simplicial complexes which partly shape their B-Reps (Boundary Representations). CityGML has been chosen as the input data format for evaluation purposes. In this case, the input data consist of planar segment complexes whose triangulated polygons serve as the set of input triangle complexes for the computation of the tetrahedral model. The creation of the volumetric model and the computation of its geometrically induced topology is partly parallelized by decomposing the input data into smaller pices. A robustness analysis of the implementations is given by varying the angular precision and the positional precision of the epsilon heuristic inaccuracy model. The results are analysed spatially and topologically, summarised and presented. It turns out that one can extract most, but not all, volumes and that the numerical issues of computational geometry produce failures as well as a variety of outcomes

Biogeography of the cosmopolitan terrestrial diatom Hantzschia amphioxys sensu lato based on molecular and morphological data

Until now, the reported diversity of representatives from the genus Hantzschia inhabiting soils from different parts of Eurasia was limited to the few species H. amphioxys, H. elongata and H. vivax and some of their infraspecific taxa. We have studied the morphology, ultrastructure and phylogeny of 25 soil diatom strains, which according to published description would be assigned to "H. amphioxys sensu lato" using 18S rDNA, 28S rDNA and rbcL. We show that strains are made up of seven different species of Hantzschia, including five new for science. Five strains were identified as H. abundans. This species has a slight curvature of the raphe near its external proximal ends. Four of the examined strains were represented by different populations of H. amphioxys and their morphological characteristics fully correspond with its isolectotype and epitype. The main specific features of this species include 21-25 striae in 10 mu m, 6-11 fibulae in 10 mu m, 40-50 areolae in 10 mu m and internal proximal raphe endings bent in opposite directions. H. attractiva sp. nov., H. belgica sp. nov., H. parva sp. nov., H. pseudomongolica sp. nov. and H. stepposa sp. nov. were described based on differences in the shape of the valves, significant differences in dimensions, a lower number of striae and areolae in 10 mu m and the degree and direction of deflection of the internal central raphe endings. Based on the study of the morphological variability and phylogeny of soil Hantzschia-species from different geographical locations we conclude that while some species such as H. amphioxys are truly cosmopolitan in their distributions, some sympatric populations of pseudocryptic taxa exist in the Holarctic

Impact and management of chemotherapy/radiotherapy-induced nausea and vomiting and the perceptual gap between oncologists/oncology nurses and patients: a cross-sectional multinational survey

Purpose: chemotherapy/radiotherapy-induced nausea and vomiting (CINV/RINV) can affect half of oncology patients, significantly impacting daily life. Nausea without vomiting has only recently been thought of as a condition in its own right. As such, the incidence of nausea is often underestimated. This survey investigated the incidence and impact of CINV/RINV in patients compared with estimations of physicians/oncology nurses to determine if there is a perceptual gap between healthcare professionals and patients. Methods: an online research survey of physicians, oncology nurses and patients was conducted across five European countries. Participants had to have experience prescribing/recommending or have received anti-emetic medication for CINV/RINV treatment. Questionnaires assessed the incidence and impact of CINV/RINV, anti-emetic usage and compliance, and attribute importance of anti-emetic medication. Results: a total of 947 (375 physicians, 186 oncology nurses and 386 patients) participated in this survey. The incidence of nausea was greater than vomiting: 60 % of patients reported nausea alone, whereas 18 % reported vomiting. Physicians and oncology nurses overestimated the incidence of CINV/RINV but underestimated its impact on patients' daily lives. Only 38 % of patients reported full compliance with physicians'/oncology nurses' guidelines when self-administering anti-emetic medication. Leading factors for poor compliance included reluctance to add to a pill burden and fear that swallowing itself would induce nausea/vomiting. Conclusions: there is a perceptual gap between healthcare professionals and patients in terms of the incidence and impact of CINV/RINV. This may lead to sub-optimal prescription of anti-emetics and therefore management of CINV/RINV. Minimising the pill burden and eliminating the requirement to swallow medication could improve poor patient compliance with anti-emetic regimens

Patient information in radiation oncology: a cross-sectional pilot study using the EORTC QLQ-INFO26 module

<p>Abstract</p> <p>Background</p> <p>The availability of alternative sources of information, e. g. the internet, may influence the quantity and quality of information cancer patients receive regarding their disease and treatment. The purpose of the present study was to assess perception of information in cancer patients during radiotherapy as well as media preferences and specifically the utilization of the internet.</p> <p>Methods</p> <p>In a cross-sectional, single-centre study 94 patients currently undergoing radiotherapy were asked to complete two questionnaires. The EORTC QLQ-INFO26 module was used to assess the quality and quantity of information received by patients in the areas disease, medical tests, treatment, other services, different places of care and how to help themselves, as well as qualitative aspects as helpfulness of and satisfaction with this information. The importance of different media, in particular the internet, was investigated by a nine-item questionnaire.</p> <p>Results</p> <p>The response rate was n = 72 patients (77%). Patients felt best informed concerning medical tests (mean ± SD score 79 ± 22, scale 0-100) followed by disease (68 ± 21). Treatment (52 ± 24) and different places of care and other services (30 ± 36 and 30 ± 30, respectively) ranked last. 37% of patients were very satisfied and 37% moderately satisfied with the amount of information received, 61% wished more information. Among eight media, brochures, television and internet were ranked as most important. 41% used the internet themselves or via friends or family, mostly for research of classic and alternative treatment options. Unavailability and the necessity of computer skills were most mentioned obstacles.</p> <p>Conclusion</p> <p>In a single-center pilot study, radiotherapy patients indicated having received most information about medical tests and their disease. Patients very satisfied with their information had received the largest amount of information. Brochures, television and internet were the most important media. Individual patient needs should be considered in the development of novel information strategies.</p

Geospatial Data Management Research: Progress and Future Directions

Without geospatial data management, today´s challenges in big data applications such as earth observation, geographic information system/building information modeling (GIS/BIM) integration, and 3D/4D city planning cannot be solved. Furthermore, geospatial data management plays a connecting role between data acquisition, data modelling, data visualization, and data analysis. It enables the continuous availability of geospatial data and the replicability of geospatial data analysis. In the first part of this article, five milestones of geospatial data management research are presented that were achieved during the last decade. The first one reflects advancements in BIM/GIS integration at data, process, and application levels. The second milestone presents theoretical progress by introducing topology as a key concept of geospatial data management. In the third milestone, 3D/4D geospatial data management is described as a key concept for city modelling, including subsurface models. Progress in modelling and visualization of massive geospatial features on web platforms is the fourth milestone which includes discrete global grid systems as an alternative geospatial reference framework. The intensive use of geosensor data sources is the fifth milestone which opens the way to parallel data storage platforms supporting data analysis on geosensors. In the second part of this article, five future directions of geospatial data management research are presented that have the potential to become key research fields of geospatial data management in the next decade. Geo-data science will have the task to extract knowledge from unstructured and structured geospatial data and to bridge the gap between modern information technology concepts and the geo-related sciences. Topology is presented as a powerful and general concept to analyze GIS and BIM data structures and spatial relations that will be of great importance in emerging applications such as smart cities and digital twins. Data-streaming libraries and “in-situ” geo-computing on objects executed directly on the sensors will revolutionize geo-information science and bridge geo-computing with geospatial data management. Advanced geospatial data visualization on web platforms will enable the representation of dynamically changing geospatial features or moving objects’ trajectories. Finally, geospatial data management will support big geospatial data analysis, and graph databases are expected to experience a revival on top of parallel and distributed data stores supporting big geospatial data analysis