Suchergebnisse

Home health performance gained visibility with the publication of Home Health Compare and the Home Health Value-Based Payment demonstration. Both provide incentives for home health agencies (HHA) to invest in quality improvements. The objective of this study is to identify the association between quality initiatives adopted by HHAs and improved performance. A 2018 national survey of 7459 HHAs, yielding a sample of 1192 eligible HHAs, provided information about 23 quality initiatives, which was linked to 5 composite Super Quality Measures (SQMs): ADL/pain, self-treatment, timely care, hospitalizations, and patient experience. Exclusions for missing data and outliers yielded a final analytical sample of 903 HHAs. Regression models estimated associations between quality initiatives and SQMs. The relationships between sixteen of the SQM/quality initiative pairs were positively associated with improvement and 7 were negatively associated. Web-based technologies for staff and care-givers improved performance but deteriorated patient experience. Web support-groups for staff and review of HHC rankings reduced hospitalization rates. While this study offers insights for quality improvement, a limitation may be a lack of sensitivity to the nuances of quality improvement implementation. Therefore, this study should be viewed as hypothesis-generating concerning initiatives likely to have the greatest potential meriting further investigation.

Fachleute zeigen in übergreifenden Beiträgen und anhand von konkreten Fallbeispielen sowohl aus Deutschland wie aus anderen Teilen Europas, Asiens, Australiens und den USA, wie der ökologische Fußabdruck im Alltag der Bibliothek verringert werden kann und was Nachhaltigkeit für die soziale Verantwortung von Bibliotheken in ihrer Rolle als gesellschaftliche Multiplikatoren bedeutet.

The operations of the operators are important for nuclear safety, but conventional operating experience feedback and common data-driven methods make it difficult to explicitly find valuable information hidden in these operational sequences that can help the operator to provide advice at the operational level. During the nuclear power plant (NPP) operation, a large amount of historical operating data is accumulated, which records the operational sequences of the operators and the state parameters of equipment. Therefore, this paper proposes the use of association rule techniques to mine the NPP operating data to discover the operational characteristics of operators and reveal their possible impact on the NPP operation. This work helps to improve the operational performance of operators and prevent human-factor events. To this end, the concept of state switching values for describing the operating states of NPPs is proposed to enable the proposed method to be adapted to different practical application scenarios. A sequence segmentation method is proposed to be able to transform historical NPP operating data into a sequence data set for association rule mining. Furthermore, an ensemble algorithm based on sequence pattern mining and sequence rule mining and its postprocessing method are designed. The empirical study was carried out using 20 batches of historical operating data of the cold start-up. A total of 164 original association rules are generated using the proposed method and were analyzed by experts. The recommendations were made for 4 different cases that would improve the operational performance of the operators.

This paper deals with the special contribution of the Local Associations for the Elderly in Israel. There are 124 such associations, who develop and operate a variety of services for the elderly people in the community, in cooperation with the local municipalities and the government.

ABSTRACT The present study described the characteristics of individuals who use Primary Health Care (PHC) services and evaluated the association between the high assessment of PHC attributes, from the perspective of users, with health conditions and the use of health services in Brazil. This work is a cross-sectional study that analyzed data from the 2019 National Health Survey, in which 9,562 adults responded to the Primary Care Assessment Tool (PCATool). The association between high PHC assessment (general score ≥ 6.6) and health conditions and the use of services was tested, and it was found that the adult users who most use public PHC are between 40 and 59 years of age, women, with a low level of education, and brown. Those who best evaluated PHC were individuals who used the same service, who sought out services in the last 2 weeks, and who had been hospitalized. The greater use of health services points to a better assessment of PHC.

Breakups are a normative and frequent part of the romantic experience. In this longitudinal study, we followed 144 adolescents (mean age = 16.57) for a period of 4 years and examined the extent to which level of depressive symptoms predicts the intensity of breakup distress during emerging adulthood and, further, the extent to which breakup distress reported during emerging adulthood is associated with the quality of a current romantic relationship. The findings suggest that higher levels of depressive symptoms during adolescence can lead to more difficulty in recovering from breakup in early emerging adulthood. In addition, experiencing greater breakup distress during emerging adulthood was associated with greater difficulty in handling a current romantic relationship. This association was, however, found only among women. The gender distinctive reaction to breakup distress among emerging adults is discussed.

After 1927, the issues of the proceedings have the title: Discussion of labor laws and their administration (OCoLC)#10105432. 1949 on, the issues of the proceedings have the title: Labor laws and their administration (OCoLC)#1590458. ; Mode of access: Internet.

Abstract
Memory is a complex cognitive process composed of several subsystems, namely short- and long-term memory and working memory (WM). Previous research has shown that adequate interaction between subsystems is crucial for successful memory processes such as encoding, storage, and manipulation of information. However, few studies have investigated the relationship between different subsystems at the behavioral and neural levels. Thus, here we assessed the relationship between individual WM abilities and brain activity underlying the recognition of previously memorized auditory sequences. First, recognition of previously memorized versus novel auditory sequences was associated with a widespread network of brain areas comprising the cingulate gyrus, hippocampus, insula, inferior temporal cortex, frontal operculum, and orbitofrontal cortex. Second, we observed positive correlations between brain activity underlying auditory sequence recognition and WM. We showed a sustained positive correlation in the medial cingulate gyrus, a brain area that was widely involved in the auditory sequence recognition. Remarkably, we also observed positive correlations in the inferior temporal, temporal-fusiform, and postcentral gyri, brain areas that were not strongly associated with auditory sequence recognition. In conclusion, we discovered positive correlations between WM abilities and brain activity underlying long-term recognition of auditory sequences, providing new evidence on the relationship between memory subsystems. Furthermore, we showed that high WM performers recruited a larger brain network including areas associated with visual processing (i.e., inferior temporal, temporal-fusiform, and postcentral gyri) for successful auditory memory recognition.

AbstractStudies on the assessment of indoor air pollutants in terms of concentration and characterization in the Gulf Cooperation Council (GCC) countries have been recently carried out. This review assesses the health effects associated with indoor air pollution exposures in GCC, including other air pollutants (siloxanes, flame retardants, synthetic phenolic antioxidants) which were not explored in a previous study. In addition, the influence of ventilation conditions due to different indoor environments was also investigated. It was revealed that there is a lack of human health assessment studies on most indoor air pollutants in almost all GCC countries, except the United Arab Emirates, Kingdom of Saudi Arabia and Kuwait, where few attempts were made for some specific pollutants. Commonly reported plausible health effects potentially associated with indoor air pollution were related to respiratory symptoms and sick building syndrome (SBS). Many of the current health assessment studies in GCC countries were based on predictions and/or estimates of exposures rather than clinically based observational studies. Measured ventilation levels and indoor air velocities in most buildings failed to meet the American Society of Heating, Refrigerating and Air-conditioning Engineers (ASHRAE) threshold limits of 8 L/s/p and 0.18–0.25 m/s, respectively. Additionally, limited studies have investigated respiratory symptoms and SBS potentially attributable to poor ventilation in the region. It is highly recommended that future indoor air quality (IAQ) studies in GCC should focus more on epidemiologic and intervention studies.