For patients with advanced chronic illness, does enrollment in a palliative care program promote healthcare cost savings at end-of life compared to those not enrolled in a pall iative care program?

Background: The recognition that care for the clinically ill, as they advance through the illness trajectory, is expensive and contributes to the health care spending crisis reinforces the need for cost effective programs that address patient goals and preferences, symptom management and coordination of care while continuing to provide high-quality, cost-effective care Methods: The objective of this literature review is to determine if enrollment in a palliative care program for patients with advanced chronic illness, promotes healthcare cost savings at end-of life compared to those not enrolled in a palliative care program? Various charge structures and costs were compared in an assortment of settings between patients who received palliative care and patients who received usual care Results: Through reducing lengths of stay, providing palliative care consultation to avoid unnecessary testing and procedures as well as through care coordination these cost savings result in a viable program with statistically significant health care savings to the hospital and patient. Palliative care services can be provided in a number of settings to a wide population of patients suffering from chronic illness in variety of phases. Health care savings have been found in the inpatient setting, home setting and outpatient setting as discussed in the literature review to follow Conclusions: Although palliative care is rarely profitable on its own, when associated with a hospital, studies have been found to support both financially and through patient outcomes the existence of a palliative care program. Palliative care programs have shown to be an important alternative to those with chronic illness as well as include cost saving opportunitie

Organic small molecule field-effect transistors with Cytop(TM) gate dielectric: eliminating gate bias stress effects

We report on organic field-effect transistors with unprecedented resistance against gate bias stress. The single crystal and thin-film transistors employ the organic gate dielectric Cytop(TM). This fluoropolymer is highly water repellent and shows a remarkable electrical breakdown strength. The single crystal transistors are consistently of very high electrical quality: near zero onset, very steep subthreshold swing (average: 1.3 nF V/(dec cm2)) and negligible current hysteresis. Furthermore, extended gate bias stress only leads to marginal changes in the transfer characteristics. It appears that there is no conceptual limitation for the stability of organic semiconductors in contrast to hydrogenated amorphous silicon.Comment: 4 pages, 3 figures, to be published in Appl. Phys. Let

Experimental Test of Momentum Cooling Model Predictions at COSY and Conclusions for WASA and HESR

The High-Energy Storage Ring (HESR) of the future International Facility for Antiproton and Ion Research (FAIR) at GSI in Darmstadt is planned as an anti-proton cooler ring in the momentum range from 1.5 to 15 GeV/c. An important and challenging feature of the new facility is the combination of highly dense phase space cooled beams with internal targets. A detailed numerical and analytical approach to the Fokker-Planck equation for longitudinal filter cooling including the beam - target interaction has been carried out to demonstrate the stochastic cooling capability. To gain confidence in the model predictions a series of experimental stochastic cooling studies with the internal target ANKE at COSY have been carried out. A remarkable agreement between model and experiment was achieved. On this basis longitudinal stochastic cooling simulations were performed to predict the possibilities and limits of cooling when the newly installed WASA Pellet-target is operated.Comment: 17 pages, 11 figures, Talk given at Symposium on Meson Physics at COSY-11 and WASA-at-COSY, Cracow, Poland, 17-22 Jun 200

Novel variations in spatial relations between the facial nerve and superficial temporal and maxillary veins

Variations in the relationship of the retromandibular vein to the facial nerve have been widely reported due to their relevance for surgical approaches in parotid, osteotomy and mandibular condyle surgery. In the context of the retromandibular retroparotid approach, remaining deep to the retromandibular vein is advised to decrease the likelihood of encountering the facial nerve during mandibular condyle surgery. In the present report, an unusual variant of the superficial temporal vein lying superficial to the facial nerve is described. This represents a variation of the venous branching pattern within the parotid gland, whereby the superficial temporal vein joins the maxillary vein inferior to its usual communication. These findings are discussed in the context of commonly used surgical approaches to the mandible for condylar trauma or osteotomy surgery

High precision beam momentum determination in a synchrotron using a spin resonance method

In order to measure the mass of the eta meson with high accuracy using the d+p -> 3He+eta reaction, the momentum of the circulating deuteron beam in the Cooler Synchrotron COSY of the Forschungszentrum Juelich has to be determined with unprecedented precision. This has been achieved by studying the spin dynamics of the polarized deuteron beam. By depolarizing the beam through the use of an artificially induced spin resonance, it was possible to evaluate its momentum p with a precision of dp/p < 10-4 for a momentum of roughly 3 GeV/c. Different possible sources of error in the application of the spin resonance method are discussed in detail and its possible use during a standard experiment is considered.Comment: 10 pages, 6 figures, 2 tables, published versio

Operative Verfahren bei hohen kryptoglandulären Analfisteln: Systematische Übersicht und Metaanalyse

Purpose: Perianal fistulas, and specifically high perianal fistulas, remain a challenge for surgical treatment. Many techniques have been and are still being developed to improve the outcome after surgery. A systematic review and meta-analysis was performed for surgical treatment of high cryptoglandular perianal fistulas. Methods: Medline (Pubmed, Ovid), Embase and The Cochrane Library databases were searched for relevant randomized controlled trials on surgical treatments for high cryptoglandular perianal fistulas. Two independent reviewers selected articles for inclusion based on title, abstract and outcomes described. The main outcome measurement was the recurrence/healing rate. Secondary outcomes were continence status, quality of life and complications. Results: The number of randomized trials available was low. Fourteen studies could be included in the review. A meta-analysis could only be performed for the mucosal advancement flap versus the fistula plug, and did not show a result in favour of either technique in recurrence or complication rate. The mucosal advancement flap was the most investigated technique but did not show any advantage over any other technique. Other techniques identified in randomized studies were seton treatment, medicated seton treatment, fibrin glue, autologous stem cells, island flap anoplasty, rectal wall advancement flap, ligation of the intersphincteric fistula tract, sphincter reconstruction, sphincter-preserving seton and techniques combined with antibiotics. None of these techniques seemed superior to each other. Conclusions: The best surgical treatment for high cryptoglandular perianal fistulas could not be identified. More randomized controlled trials are needed to find the best treatment. The mucosal advancement flap is the most investigated technique available

THE ACCUSED IS ENTERING THE COURTROOM: THE LIVE-TWEETING OF A MURDER TRIAL.

© 2017 Informa UK Limited, trading as Taylor & Francis GroupThe use of social media is now widely accepted within journalism as an outlet for news information. Live tweeting of unfolding events is standard practice. In March 2014, Oscar Pistorius went on trial in the Gauteng High Court for murder. Hundreds of journalists present began live-tweeting coverage, an unprecedented combination of international interest, permission to use technology and access which resulted in massive streams of consciousness reports of events as they unfolded. Based on a corpus of Twitter feeds of twenty-four journalists covering the trial, this study analyses the content and strategies of these feeds in order to present an understanding of how microblogging is used as a live reporting tool. This study shows the development of standardised language and strategies in reporting on Twitter, concluding that journalists adopt a narrow range of approaches, with no significant variation in terms of gender, location, or medium. This is in contrast to earlier studies in the field (Awad, 2006, Hedman, 2015; Kothari, 2010; Lariscy, Avery, Sweetser, & Howes, 2009 Lasorsa, 2012; Lasorsa, Lewis, & Holton, 2011; Sigal, 1999, Vis, 2013).Peer reviewe