Measuring patient-perceived quality of care in US hospitals using Twitter

BACKGROUND: Patients routinely use Twitter to share feedback about their experience receiving healthcare. Identifying and analysing the content of posts sent to hospitals may provide a novel real-time measure of quality, supplementing traditional, survey-based approaches. OBJECTIVE: To assess the use of Twitter as a supplemental data stream for measuring patient-perceived quality of care in US hospitals and compare patient sentiments about hospitals with established quality measures. DESIGN: 404 065 tweets directed to 2349 US hospitals over a 1-year period were classified as having to do with patient experience using a machine learning approach. Sentiment was calculated for these tweets using natural language processing. 11 602 tweets were manually categorised into patient experience topics. Finally, hospitals with ≥50 patient experience tweets were surveyed to understand how they use Twitter to interact with patients. KEY RESULTS: Roughly half of the hospitals in the US have a presence on Twitter. Of the tweets directed toward these hospitals, 34 725 (9.4%) were related to patient experience and covered diverse topics. Analyses limited to hospitals with ≥50 patient experience tweets revealed that they were more active on Twitter, more likely to be below the national median of Medicare patients (p<0.001) and above the national median for nurse/patient ratio (p=0.006), and to be a non-profit hospital (p<0.001). After adjusting for hospital characteristics, we found that Twitter sentiment was not associated with Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) ratings (but having a Twitter account was), although there was a weak association with 30-day hospital readmission rates (p=0.003). CONCLUSIONS: Tweets describing patient experiences in hospitals cover a wide range of patient care aspects and can be identified using automated approaches. These tweets represent a potentially untapped indicator of quality and may be valuable to patients, researchers, policy makers and hospital administrators

Pengaruh Pemahaman Wajib Pajak Orang Pribadi Terhadap Penerapan Self Assessment System Pada Kpp Pratama Gorontalo

This research aims to determine the influence of an individual taxpayer understanding of the Self Assessment System implementation on STO Gorontalo. The data in this study were taken from primary data through questionnaires. The number of samples used as subjects in this study were 100 individual taxpayer and using Convenience Sampling techniques. This study uses regression analysis simple. The results showed that the understanding of the individual taxpayer has a significant effect on the implementation of Self Assessment System. The determination coefficient show that 19.8% understanding of individual taxpayers influence the application of the Self Assessment System and the remaining 80.2% is influenced by other variables outside this study

Highly charged ions in Penning traps, a new tool for resolving low lying isomeric states

The use of highly charged ions increases the precision and resolving power, in particular for short-lived species produced at on-line radio-isotope beam facilities, achievable with Penning trap mass spectrometers. This increase in resolving power provides a new and unique access to resolving low-lying long-lived ($T_{1/2} > 50$ ms) nuclear isomers. Recently, the $111.19(22)$ keV (determined from $\gamma$-ray spectroscopy) isomeric state in $^{78}$Rb has been resolved from the ground state, in a charge state of $q=8+$ with the TITAN Penning trap at the TRIUMF-ISAC facility. The excitation energy of the isomer was measured to be $108.7(6.4)$ keV above the ground state. The extracted masses for both the ground and isomeric states, and their difference, agree with the AME2003 and Nuclear Data Sheet values. This proof of principle measurement demonstrates the feasibility of using Penning trap mass spectrometers coupled to charge breeders to study nuclear isomers and opens a new route for isomer searches.Comment: 8 pages, 6 figure

Example of nuclear data center services for geophysics applications

A bibliographic survey of the available experimental data on neutron induced gamma-ray production has been made. Use was made of Data Center on-line search and retrieval capabilities. CINDA was searched for prompt gamma-ray production data covering a large incident neutron energy range, and where possible, EXFOR was used to scan the data and select representative works. From the survey it appears that many measurements will have to be supplemented by theoretical calculations. 13 refs., 2 tabs

Population of isomers in decay of the giant dipole resonance

The value of an isomeric ratio (IR) in N=81 isotones ($^{137}$Ba, $^{139}$Ce, $^{141}$Nd and $^{143}$Sm) is studied by means of the ($\gamma, n)$ reaction. This quantity measures a probability to populate the isomeric state in respect to the ground state population. In ($\gamma, n)$ reactions, the giant dipole resonance (GDR) is excited and after its decay by a neutron emission, the nucleus has an excitation energy of a few MeV. The forthcoming $\gamma$ decay by direct or cascade transitions deexcites the nucleus into an isomeric or ground state. It has been observed experimentally that the IR for $^{137}$Ba and $^{139}$Ce equals about 0.13 while in two heavier isotones it is even less than half the size. To explain this effect, the structure of the excited states in the energy region up to 6.5 MeV has been calculated within the Quasiparticle Phonon Model. Many states are found connected to the ground and isomeric states by $E1$, $E2$ and $M1$ transitions. The single-particle component of the wave function is responsible for the large values of the transitions. The calculated value of the isomeric ratio is in very good agreement with the experimental data for all isotones. A slightly different value of maximum energy with which the nuclei rest after neutron decay of the GDR is responsible for the reported effect of the A-dependence of the IR.Comment: 16 pages, 4 Fig

Decay modes of 250No

The Fragment Mass Analyzer at the ATLAS facility has been used to unambiguously identify the mass number associated with different decay modes of the nobelium isotopes produced via 204Pb(48Ca,xn)(252-x)No reactions. Isotopically pure (>99.7%) 204Pb targets were used to reduce background from more favored reactions on heavier lead isotopes. Two spontaneous fission half-lives (t_1/2 = 3.7+1.1-0.8 us and 43+22-15 us) were deduced from a total of 158 fission events. Both decays originate from 250No rather than from neighboring isotopes as previously suggested. The longer activity most likely corresponds to a K-isomer in this nucleus. No conclusive evidence for an alpha branch was observed, resulting in upper limits of 2.1% for the shorter lifetime and 3.4% for the longer activity.Comment: RevTex4, 10 pages, 5 figures, submitted to PR

WormBase 2007

WormBase (www.wormbase.org) is the major publicly available database of information about Caenorhabditis elegans, an important system for basic biological and biomedical research. Derived from the initial ACeDB database of C. elegans genetic and sequence information, WormBase now includes the genomic, anatomical and functional information about C. elegans, other Caenorhabditis species and other nematodes. As such, it is a crucial resource not only for C. elegans biologists but the larger biomedical and bioinformatics communities. Coverage of core areas of C. elegans biology will allow the biomedical community to make full use of the results of intensive molecular genetic analysis and functional genomic studies of this organism. Improved search and display tools, wider cross-species comparisons and extended ontologies are some of the features that will help scientists extend their research and take advantage of other nematode species genome sequences

Nonmotorized Commuting Behavior of Middle-Income Working Adults in a Developing Country

Although nonmotorized transport (NMT) offers economic, environmental, and health benefits to individuals and communities, understanding nonmotorized travel behavior is a challenging task due to complex interactions of a wide range of factors. While behavioral models offer a conceptual framework to understand human behavior, their use in the study of travel behavior in developing countries is still in its infancy. This study uses three behavioral models—the theory of planned behavior, the theory of triadic influence, and the ecological model of health behavior—to identify potential factors influencing intentions and behavior toward the use of NMT by middle-income working adults, inhabiting the Chittagong City Corporation (CCC) area of Bangladesh. A total of 720 middle-income working adults (aged between 18 and 65 years) were randomly selected and interviewed at major commercial and retail business areas of the CCC. Multiple linear and binary logistic models were developed to quantify the extent of the influence of different factors on nonmotorized mode choice behavior. Results indicated that personal factors (proximal) such as attitude, subjective norm, and behavioral control influence respondents’ intentions and motivation in choosing NMT. However, the current use of NMT was less controlled by intention, while factors associated with the social, cultural, and built environment had (distal) significant influence. The findings of this study could assist urban planners in adopting structural and nonstructural measures to promote NMT use

Evolution and Nucleosynthesis of Massive Stars and Related Nuclear Uncertainties

Properties of atomic nuclei important for the prediction of astrophysical reaction rates are reviewed. In the first part, a recent simulation of evolution and nucleosynthesis of stars between 15 and 25 solar masses is presented. This study is used to illustrate the required nuclear input as well as to give examples of the sensitivity to certain rates. The second part focusses on the prediction of nuclear rates in the statistical model (Hauser-Feshbach) and direct capture (DWBA). Some of the important ingredients are addressed. Discussed in more detail are approaches to predict level densities, parity distributions, and optical alpha+nucleus potentials.Comment: Invited talk at 17th Int. Nucl. Phys. Conf. of the EPS "Nuclear Physics in Astrophysics", Debrecen, Hungary, 2002 (new version: fixed typo in alpha potential parameters; note: the parameters are incorrect in the NPA paper

Geoantineutrino Spectrum, 3He/4He-ratio Distribution in the Earth's Interior and Slow Nuclear Burning on the Boundary of the Liquid and Solid Phases of the Earth's Core

The description problem of geoantineutrino spectrum and reactor antineutrino experimental spectrum in KamLAND, which takes place for antineutrino energy \~2.8 MeV, and also the experimental results of the interaction of uranium dioxide and carbide with iron-nickel and silicaalumina melts at high pressure (5-10 GP?) and temperature (1600-2200C) have motivated us to consider the possible consequences of the assumption made by V.Anisichkin and coauthors that there is an actinid shell on boundary of liquid and solid phases of the Earth's core. We have shown that the activation of a natural nuclear reactor operating as the solitary waves of nuclear burning in 238U- and/or 232Th-medium (in particular, the neutron- fission progressive wave of Feoktistov and/or Teller-Ishikawa-Wood) can be such a physical consequence. The simplified model of the kinetics of accumulation and burnup in U-Pu fuel cycle of Feoktistov is developed. The results of the numerical simulation of neutron-fission wave in two-phase UO2/Fe medium on a surface of the Earth's solid core are presented. The georeactor model of 3He origin and the 3He/4He-ratio distribution in the Earth's interior is offered. It is shown that the 3He/4He ratio distribution can be the natural quantitative criterion of georeactor thermal power. On the basis of O'Nions-Evensen-Hamilton geochemical model of mantle differentiation and the crust growth supplied by actinid shell on the boundary of liquid and solid phases of the Earth's core as a nuclear energy source (georeactor with power of 30 TW), the tentative estimation of geoantineutrino intensity and geoantineutrino spectrum on the Earth surface are given.Comment: 28 pages, 12 figures. Added text, formulas, figures and references. Corrected equations. Changed content of some section