What drives inflation perceptions? A dynamic panel data analysis

At the moment of the euro cash changeover, inflation perceptions in the euro area deviated from measured inflation, and in some euro-area Member States in a persistent way. In recent years, a growing body of literature has developed on the factors that might explain this deviation. This paper formally tests various explanations advanced in this literature. It adopts a cross-country perspective at the level of the euro area which is empirically implemented through a dynamic panel data model. Inflation perceptions are found to be highly persistent (the autoregressive term is large and statistically highly significant). In contrast to much of the - descriptive - literature, an index of "out-of-the-pocket expenditure" is found not to explain inflation perceptions better than does the all-items HICP index. As suggested by psychological experiments, inflation expectations seem to contribute to the formation of inflation perceptions, although to a limited extent. Prices of residential real estate contribute significantly to inflation perceptions, suggesting that households have a broader view of the cost of living when forming inflation perceptions. Our results have implications for policy, for the further research agenda and for the development of statistics. In particular, the persistence of inflation perceptions makes us think that communication efforts prior to euro introduction are essential to anchor perceptions. Once perceptions increase, it will be much harder to bring them back in line with measured inflation.inflation, perceived inflation, dynamic panel data model, euro cash changeover, D�hring, Mordonu

Virtual Nursing: An Innovative Approach to Support Bedside Nurses and Patient Care

Introduction and Context Virtual nursing has shown promise in healthcare by enhancing patient admission and discharge processes. Studies highlight that implementing virtual nursing roles increases patient and provider satisfaction while improving financial and quality care metrics. At a non-profit Midwestern hospital, nurses pinpointed workflow, throughput, and efficiency challenges particularly between the Emergency Department (ED) and inpatient units. Implementation Strategy Virtual RN (VRN) committees were established at local and regional levels and were instrumental in implementing and evaluating a pilot program. The committees conducted multiple Plan-Do-Study-Act cycles refining the intervention, focusing on virtual nursing roles dedicated to admissions and discharges. A critical part involved assessing the need and availability of virtual nursing support, determined to be most critical between 0900-2100 Tuesdays-Thursdays—key periods of high patient influx. To streamline admission and discharge processes, the program utilized specially developed workflows. Outcomes and Impact Over 13 weeks, 64 patient admissions (n=64) and 169 discharges (n=169) occurred. Weekly admissions were stable, (1-6), with a notable peak of 17 (Week 20). In contrast, discharges were higher and more variable, peaking at 20 (Week 16), and seldom falling below 9. Admissions involved approximately 1,920 minutes (32 hours) of time, and discharges accounted for 5,070 minutes (about 84.5 hours), totaling 6,990 minutes, or approximately 116.5 hours of nurse time redirected back to bedside care. Processes were integrated into workflows, with feedback from bedside nurses on areas for improvement relayed back to the VRN team. Insights The virtual nursing initiative streamlined admissions and discharges, significantly boosting throughput and operational efficiency, while reallocating valuable nursing hours to direct patient care. Implications This project underscores the broader implications of integrating virtual nursing roles at Advocate Health, showcasing its scalability and potential for advancing innovative care delivery. Lessons learned include the importance of targeted deployment during peak times and the effectiveness of continuous feedback loops in refining processes

A Wellness Initiative: Mindfulness Training for Unlicensed Assistive Personnel to Promote Self-Care and Enhanced Well-Being

Background: Burnout leads to decreased staff engagement, productivity, and high attrition rates. The nursing staff most impacted are Unlicensed Assistive Personnel (UAP); therefore, to combat burnout, resilience is to be cultivated. Resilience begins with self-care, which is nurturing the self: mind, body, and soul to safeguard well-being. Objectives: This project provided mindfulness training as a wellness initiative to promote self-care skills and enhance well-being among the UAP within a healthcare facility. Methods: This project followed an evidenced-based quality improvement practice framework ( Mindful Self-Care Scale-Brief and IHI- Well-Being Assessment Survey) and used a pre-post-test design to compare self-care and well-being after a mindfulness training program. Results: Nine female UAPs participated in the intervention; seven completed the pre- and post-Mindful Self-Care Scale-B (MSCS-B) and the IHI- Well-Being Assessment Survey. The MSCS-B pre and post-intervention mean scores were favorable for self- care: pre-intervention means = 83.25 (SD =17.351); post-intervention means = 88.57 (SD = 7.525), and paired sample t-test showed an increase in self-care behaviors and proved statistically significant with a p-value \u3c 0.1. The IHI-Well-being Assessment showed no significance statistically. Conclusion: This intervention suggests mindfulness training promotes self-care and may enhance well-being. Self-care benefits are essential to the UAP to build resilience and prevent burnout. Healthcare organizations must embrace mindfulness training as it lends itself to a shift in culture: Better patient interaction, quality of care, and communication, as well as a decreased attrition rate. This step is a start for continued study of mindfulness in the UAP

Impact of Multidisciplinary Rounds on Adult Inpatient Length of Stay A Quality Improvement Initiative

Background and/or Rationale: Multiple factors influence patient’s length of a stay (LOS). Studies examining patient demographics, hospital characteristics, and diagnoses indicate that older age, certain diagnoses, and admission to critical care units are associated with longer LOS. Local Problem: At a non-profit hospital in the Midwest, nurses identified challenges in achieving reductions in the budgeted LOS for adults admitted to inpatient units. Method: To reduce budgeted LOS, multidisciplinary rounds (MDRs) were optimized through a methodical approach involving direct observation, process mapping, and root cause analysis. A Length of Stay Committee was established, standardizing MDR practices and integrating these into workflows. The Quality Improvement (QI) team conducted Plan-Do-Study-Act (PDSA) cycles focusing on afternoon scheduling of MDRs, proactive identification of patients for next-day discharge, and implementation of a real-time communication tool, enhancing team coordination. These interventions aimed to streamline discharge processes, effectively reducing LOS. Key metrics were selected for each PDSA cycle, validating forward progression, driving the next cycle of change. Results/Conclusion: Results indicate a significant improvement in the LOS for adult in-patients from January 2023 to April 2024. Initially, the adult LOS varied, peaking at around 4.6 days in June 2023 and decreasing to approximately 3.5 days by April 2024. This downward trend closely approached the target LOS, particularly from December 2023, consistently nearing or meeting targets. These improvements correlate with the implementation of enhanced MDRs, and other strategic operational changes aimed at increasing efficiency. Implications: The project utilized budgeted LOS metrics, facilitated by strong collaboration between care management, nursing, finance, and physicians optimizing outcomes. The interdisciplinary partnership enhanced communication and response effectiveness. The use of multiple PDSA cycles allowed for adaptive, real-time responses, while a centralized discharge tracker tool enabled effective discharge planning. Preliminary results and ongoing enhancements, such as incorporating a virtual RN for admissions and discharge support, suggest this model\u27s potential for broader application

Prevalence of obstructive sleep apnoea in REM behaviour disorder:response to continuous positive airway pressure therapy

Objectives: Rapid eye movement behaviour disorder (RBD) is a parasomnia in which there is loss of muscle atonia during rapid eye movement (REM) sleep, resulting in dream enactment. The aims of this study were to determine the prevalence of obstructive sleep apnoea (OSA) in RBD patients and determine whether continuous positive airway pressure (CPAP) therapy improved RBD symptoms in patients with concomitant RBD and OSA.Methods: A questionnaire was mailed to 120 patients identified from a tertiary sleep centre with RBD meeting full International Classification for Sleep Disorders-3 (ICSD-3) criteria. Patients were diagnosed as having OSA if they had an apnoea-hypopnea index (AHI) ≥ 5. The questionnaire focused on CPAP-use, compliance and complications. Standard statistical analysis was undertaken using SPSS (v.21, IBM).Results: One hundred and seven of the potential participants (89.2%) had an OSA diagnosis. Out of 72 who responded to the questionnaire, (60%) 27 patients were using CPAP therapy. CPAP therapy improved RBD symptoms in 45.8% of this group. Despite this positive response to treatment in nearly half of CPAP-users, there was no significant difference in subjective or objective CPAP compliance between those who reported RBD improvement and those who did not. Subjective compliance with CPAP was over-reported, with mean usage being 7.17 ± 1.7 h per night compared to objective mean compliance of 5.71 ± 1.7.Conclusions: OSA is a very common co-morbidity of RBD. CPAP therapy might improve self-reported RBD symptoms further, in addition to standard RBD treatment. However, further research into its topic is necessary.</p

Health indicators associated with poor sleep quality among university students

Objective To associate the sleep quality of Brazilian undergraduate students with health indicators. Method A cross-sectional study was developed with a random sample of 662 undergraduate students from Fortaleza, Brazil. The demographic data, Pittsburgh Sleep Quality Index and health data indicators (smoking, alcoholism, sedentary lifestyle, nutritional condition and serum cholesterol) were collected through a self-administered questionnaire. Blood was collected at a clinical laboratory. In order to estimate the size of the associations, a Poisson Regression was used. Results For students who are daily smokers, the occurrence of poor sleep was higher than in non-smokers (p<0.001). Prevalence rate values were nevertheless close to 1. Conclusion The likelihood of poor sleep is almost the same in smokers and in alcoholics

Efficacy of a behavioral self-help treatment with or without therapist guidance for co-morbid and primary insomnia -a randomized controlled trial

BackgroundCognitive behavioral therapy is treatment of choice for insomnia, but availability is scarce. Self-help can increase availability at low cost, but evidence for its efficacy is limited, especially for the typical insomnia patient with co-morbid problems. We hypothesized that a cognitive behaviorally based self-help book is effective to treat insomnia in individuals, also with co-morbid problems, and that the effect is enhanced by adding brief therapist telephone support.MethodsVolunteer sample; 133 media-recruited adults with insomnia. History of sleep difficulties (mean [SD]) 11.8 [12.0] years. 92.5% had co-morbid problems (e.g. allergy, pain, and depression). Parallel randomized (block-randomization, n ≥ 21) controlled "open label" trial; three groups-bibliotherapy with (n = 44) and without (n = 45) therapist support, and waiting list control (n = 44). Assessments before and after treatment, and at three-month follow-up. Intervention was six weeks of bibliotherapeutic self-help, with established cognitive behavioral methods including sleep restriction, stimulus control, and cognitive restructuring. Therapist support was a 15-minute structured telephone call scheduled weekly. Main outcome measures were sleep diary data, and the Insomnia Severity Index.ResultsIntention-to-treat analyses of 133 participants showed significant improvements in both self-help groups from pre to post treatment compared to waiting list. For example, treatment with and without support gave shorter sleep onset latency (improvement minutes [95% Confidence Interval], 35.4 [24.2 to 46.6], and 20.6 [10.6 to 30.6] respectively), and support gave a higher remission rate (defined as ISI score below 8; 61.4%), than bibliotherapy alone (24.4%, p's &lt; .001). Improvements were not seen in the control group (sleep onset latency 4.6 minutes shorter [-1.5 to 10.7], and remission rate 2.3%). Self-help groups maintained gains at three-month follow-up.ConclusionsParticipants receiving self-help for insomnia benefited markedly. Self-help, especially if therapist-supported, has considerable potential to be as effective as individual treatment at lower cost, also for individuals with co-morbid problems.</p

Discovery of Dual-Action Membrane-Anchored Modulators of Incretin Receptors

The glucose-dependent insulinotropic polypeptide (GIP) and the glucagon-like peptide-1 (GLP-1) receptors are considered complementary therapeutic targets for type 2 diabetes. Using recombinant membrane-tethered ligand (MTL) technology, the present study focused on defining optimized modulators of these receptors, as well as exploring how local anchoring influences soluble peptide function.Serial substitution of residue 7 in membrane-tethered GIP (tGIP) led to a wide range of activities at the GIP receptor, with [G(7)]tGIP showing enhanced efficacy compared to the wild type construct. In contrast, introduction of G(7) into the related ligands, tGLP-1 and tethered exendin-4 (tEXE4), did not affect signaling at the cognate GLP-1 receptor. Both soluble and tethered GIP and GLP-1 were selective activators of their respective receptors. Although soluble EXE4 is highly selective for the GLP-1 receptor, unexpectedly, tethered EXE4 was found to be a potent activator of both the GLP-1 and GIP receptors. Diverging from the pharmacological properties of soluble and tethered GIP, the newly identified GIP-R agonists, (i.e. [G(7)]tGIP and tEXE4) failed to trigger cognate receptor endocytosis. In an attempt to recapitulate the dual agonism observed with tEXE4, we conjugated soluble EXE4 to a lipid moiety. Not only did this soluble peptide activate both the GLP-1 and GIP receptors but, when added to receptor expressing cells, the activity persists despite serial washes.These findings suggest that conversion of a recombinant MTL to a soluble membrane anchored equivalent offers a means to prolong ligand function, as well as to design agonists that can simultaneously act on more than one therapeutic target

Generalised geometrical CP violation in a T' lepton flavour model

We analyse the interplay of generalised CP transformations and the non-Abelian discrete group T \u2032 and use the semi-direct product G f = T \u2032 caH CP, as family symmetry acting in the lepton sector. The family symmetry is shown to be spontaneously broken in a geometrical manner. In the resulting flavour model, naturally small Majorana neutrino masses for the light active neutrinos are obtained through the type I see-saw mechanism. The known masses of the charged leptons, lepton mixing angles and the two neutrino mass squared differences are reproduced by the model with a good accuracy. The model allows for two neutrino mass spectra with normal ordering (NO) and one with inverted ordering (IO). For each of the three spectra the absolute scale of neutrino masses is predicted with relatively small uncertainty. The value of the Dirac CP violation (CPV) phase \u3b4 in the lepton mixing matrix is predicted to be \u3b4 = \u3c0/2 or 3\u3c0/2. Thus, the CP violating effects in neutrino oscillations are predicted to be maximal (given the values of the neutrino mixing angles) and experimentally observable. We present also predictions for the sum of the neutrino masses, for the Majorana CPV phases and for the effective Majorana mass in neutrinoless double beta decay. The predictions of the model can be tested in a variety of ongoing and future planned neutrino experiments