Barriers to promoting mobility in hospitalized older adults

Hospitalized older adults who do not receive sufficient mobility are more likely to sustain negative health outcomes, including higher rates of mortality and institutionalization. Accordingly, the purpose of the current secondary data analysis was to examine the nurse-promoted mobility of hospitalized older adults and the association between nurses’ barriers and nurse-promoted mobility. In addition, the relationship among patient severity of illness, proxy levels for function, and nurse-promoted mobility was examined. The final study sample included 61 nurses working in medical units caring for a total of 77 older adults. Findings suggest nurse knowledge gaps and attitude barriers could potentially influence the type and frequency of mobility they promote in older patients. A relationship was found between older patients with impaired mobility using assistive devices for mobility at home, and those at high risk for falls and nurses promoting more sedentary activity (e.g., chair sitting, walking in the room). Interestingly, nurses promoted significantly more sedentary mobility for patients with physical therapy orders

Accuracy of screening tools for Pap smears in general practice

Background: Data extraction tools (DETs) are increasingly being used for research and audit of general practice, despite their limitations. Objective: This study explores the accuracy of Pap smear rates obtained with a DET compared to that of the Pap smear rate obtained with a manual file audit. Method: A widely available DET was used to establish the rate of Pap smears in a large multi-general practice (multi-GP) in regional New South Wales followed by a manual audit of patient files. The main outcome measure was identification of possible discrepancies between the rates established. Results: The DET used significantly underestimated the level of cervical screening compared to the manual audit. In some instances, the patient file contained phone/specialist record of Pap smear conducted elsewhere, which accounted for the failure of the DET to detect some smears. Those patients who had Pap smears whose pathology codes differed between time intervals, i.e. from different pathology providers or from within the same provider but using a different code, were less likely to have had their most recent Pap smear detected by the DET (p \u3c 0.001). Conclusion: Data obtained from DETs should be used with caution as they may not accurately reflect the rate of Pap smears from electronic medical records

A New Expression for the Gain-Noise Relation of Single-Carrier Avalanche Photodiodes With Arbitrary Staircase Multiplication Regions

We propose a simple expression to relate the total excess noise factor of a single-carrier multiplication staircase avalanche photodiode (APD) to the excess noise factor and gain given by the individual conduction band discontinuities. The formula is valid when electron impact ionization dominates hole impact ionization; hence, it is especially suited for staircase APDs with In-rich multiplication regions, as opposed, for example, to GaAs/AlGaAs systems where hole ionization plays an important role. The formula has been verified by accurate means of numerical simulations based on a newly developed nonlocal history dependent impact ionization model

The effects of superoxide dismutase-rich melon pulp concentrate on inflammation, antioxidant status and growth performance of challenged post-weaning piglets

Piglets can often suffer impaired antioxidant status and poor immune response during post-weaning, especially when chronic inflammation takes place, leading to lower growth rates than expected. Oral administration of dietary antioxidant compounds during this period could be a feasible way to balance oxidation processes and increase health and growth performance. The aim of the trial was to study the effects of an antioxidant feed supplement (melon pulp concentrate) that contains high concentration of the antioxidant superoxide dismutase (SOD) on inflammation, antioxidant status and growth performance of lipopolysaccharide (LPS) challenged weaned piglets. In total, 48 weaned piglets were individually allocated to four experimental groups in a 2 72 factorial design for 29 days. Two different dietary treatments were adopted: (a) control (CTR), fed a basal diet, (b) treatment (MPC), fed the basal diet plus 30 g/ton of melon pulp concentrate. On days 19, 21, 23 and 25 half of the animals within CTR and MPC groups were subjected to a challenge with intramuscular injections of an increasing dosage of LPS from Escherichia coli (serotype 0.55:B5) (+) or were injected with an equal amount of PBS solution ( 12). Blood samples were collected at the beginning of the trial and under the challenge period for interleukin 1\u3b2, interleukin 6, tumour necrosis factor \u3b1, haptoglobin, plasma SOD activity, total antioxidant capacity, reactive oxygen species, red blood cells and plasma resistance to haemolysis, and 8-oxo-7, 8-dihydro-2\u2019-deoxyguanosine. Growth performance was evaluated weekly. A positive effect of melon pulp concentrate was evidenced on total antioxidant capacity, half-haemolysis time of red blood cells, average daily gain (ADG) and feed intake, while LPS challenge increased pro-inflammatory cytokines and haptoglobin serum concentrations, with a reduced feed intake and gain : feed (G : F). The obtained results show that oral SOD supplementation with melon pulp concentrate ameliorates the total antioxidant capacity and the half-haemolysis time in red blood cell of post-weaning piglets, with positive results on growing performance

Optimization of GaAs/AlGaAs staircase avalanche photodiodes accounting for both electron and hole impact ionization

A recently developed nonlocal history dependent model for electron and hole impact ionization is used to compute the gain and the excess noise factor in avalanche photodiodes featuring heterojunctions of III-V compound semiconductors while accounting for both carriers. The model has been calibrated with measurements by our group, as well as on noise versus gain data from the literature. We explore the avalanche photodiode design trade-offs related to the number of GaAs/AlGaAs conduction band steps for X-ray spectroscopy applications

Multidimensional prognostic index and the risk of fractures: an 8-year longitudinal cohort study in the Osteoarthritis Initiative

Summary: In this longitudinal study, with a follow-up of 8 years, multidimensional prognostic index (MPI), a product of the comprehensive geriatric assessment, significantly predicted the onset of fractures in older people affected by knee osteoarthritis. Purpose: Frailty may be associated with higher fracture risk, but limited research has been carried out using a multidimensional approach to frailty assessment and diagnosis. The present research aimed to investigate whether the MPI, based on comprehensive geriatric assessment (CGA), is associated with the risk of fractures in the Osteoarthritis Initiative (OAI) study. Methods: Community-dwellers affected by knee OA or at high risk for this condition were followed-up for 8 years. A standardized CGA including information on functional, nutritional, mood, comorbidity, medication, quality of life, and co-habitation status was used to calculate the MPI. Fractures were diagnosed using self-reported information. Cox’s regression analysis was carried out and results are reported as hazard ratios (HRs), with their 95% confidence intervals (CIs), adjusted for potential confounders. Results: The sample consisted of 4024 individuals (mean age 61.0 years, females = 59.0%). People with incident fractures had a significant higher MPI baseline value than those without (0.42 ± 0.18 vs. 0.40 ± 0.17). After adjusting for several potential confounders, people with an MPI over 0.66 (HR = 1.49; 95%CI: 1.11–2.00) experienced a higher risk of fractures. An increase in 0.10 point in MPI score corresponded to an increase in fracture risk of 4% (HR = 1.04; 95%CI: 1.008–1.07). Higher MPI values were also associated with a higher risk of non-vertebral clinical fractures. Conclusion: Higher MPI values at baseline were associated with an increased risk of fractures, reinforcing the importance of CGA in predicting fractures in older people affected by knee OA. © 2021, The Author(s)

Experimental and simulation analysis of carrier lifetimes in GaAs/AlGaAs Avalanche Photo-Diodes

Extensive experimental characterization and TCAD simulation analysis have been used to study the dark current in Avalanche Photo-Diodes (APDs). The comparison between the temperature dependence of measurements and simulations points out that SRH generation/recombination is responsible for the observed dark current. After the extraction of the carrier lifetimes in the GaAs layers, they have been used to predict the APD collection efficiency of the photo-generated currents under realistic operation conditions and as a function of the photogeneration position inside the absorption layer

Modeling Approaches for Gain, Noise and Time Response of Avalanche Photodiodes for X-Rays Detection

We report on a suite of modeling approaches for the optimization of Avalanche Photodiodes for X-rays detection. Gain and excess noise are computed efficiently using a non-local/history dependent model that has been validated against full-band Monte Carlo simulations. The (stochastic) response of the detector to photon pulses is computed using an improved Random-Path-Length algorithm. As case studies, we consider diodes consisting of AlGaAs/GaAs multi-layers with separated absorption and multiplication regions. A superlattice creating a staircase conduction band structure is employed in the multiplication region to keep the multiplication noise low. Gain and excess noise have been measured in devices fabricated with such structure and successfully compared with the developed models