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1.
Phys Chem Chem Phys ; 26(3): 2478-2485, 2024 Jan 17.
Artículo en Inglés | MEDLINE | ID: mdl-38170468

RESUMEN

Different morphologies and sizes of α-Fe2O3 were prepared by a coprecipitation method using polyvinylpyrrolidone as a dispersant. In the preparation process, homogeneous and dispersed nanoscale FeOOH particles were first obtained by the coprecipitation method, and then the FeOOH particles were calcined at high temperature to form α-Fe2O3. The growth and aggregation of the α-Fe2O3 particles at different calcination temperatures resulted in α-Fe2O3 powders with diversiform morphologies (nanoscale microsphere, pinecone ellipsoidal, polyhedral, and quasi-spherical structures). By analyzing the SEM images, it was inferred that the polyhedral structure of α-Fe2O3 particles was formed by the accumulation of rhomboid sheet structures and high-temperature growth. In terms of the magnetic properties, the samples belonged to the class of canted antiferromagnetic materials, and the morphology, particle size, and crystallite size of the α-Fe2O3 particles were important factors affecting the coercivity. Among these, when the calcination temperature was increased from 700 °C to 800 °C, the growth rate of the particle size was significantly faster than that of the crystallite size, and the coercivity increased substantially from 1411 Oe to 2688 Oe.

2.
Analyst ; 148(9): 2021-2034, 2023 May 02.
Artículo en Inglés | MEDLINE | ID: mdl-36970954

RESUMEN

Blood analysis through complete blood count is the most basic medical test for disease diagnosis. Conventional blood analysis requires bulky and expensive laboratory facilities and skilled technicians, limiting the universal medical use of blood analysis outside well-equipped laboratory environments. Here, we propose a multiparameter mobile blood analyzer combined with label-free contrast-enhanced defocusing imaging (CEDI) and machine vision for instant and on-site diagnostic applications. We designed a low-cost and high-resolution miniature microscope (size: 105 mm × 77 mm × 64 mm, weight: 314 g) that comprises a pair of miniature aspheric lenses and a 415 nm LED for blood image acquisition. The analyzer, adopting CEDI, can obtain both the refractive index distributions of the white blood cell (WBC) and hemoglobin spectrophotometric information, enabling the analyzer to supply rich blood parameters, including the five-part WBC differential count, red blood cell (RBC) count, and mean corpuscular hemoglobin (MCH) quantification with machine vision algorithms and the Lambert-Beer law. We have shown that our assay can analyze a blood sample within 10 minutes without complex staining, and measurements (30 samples) from the analyzer have a strong linear correlation with clinical reference values (significance level of 0.0001). This study provides a miniature, light weight, low-cost, and easy-to-use blood analysis technique that overcomes the challenge of simultaneously realizing FWD count, RBC count, and MCH analysis using a mobile device and has great potential for integrated surveillance of various epidemic diseases, including coronavirus infection, invermination, and anemia, especially in low- and middle-income countries.


Asunto(s)
Pruebas Hematológicas , Hemoglobinas , Recuento de Células Sanguíneas/métodos , Pruebas Hematológicas/métodos , Recuento de Eritrocitos/métodos , Recuento de Leucocitos , Hemoglobinas/análisis
3.
BMC Geriatr ; 23(1): 421, 2023 07 10.
Artículo en Inglés | MEDLINE | ID: mdl-37430231

RESUMEN

BACKGROUND: Social frailty is associated with Fear of Falling (FoF) and health-related quality of life (HrQoL). However, how social frailty simultaneously influences FoF and HrQoL remains unclear. The study aims to understand the links between social frailty, FoF, and HrQoL in older adults and the mediating role of FoF in the relations between social frailty and HrQoL. METHODS: In this cross-sectional survey, 1,933 community-dwelling older adults from Changhua County, Taiwan, were interviewed using a self-administrated questionnaire. In total, 1,251 participants with complete data were included for analysis. Data were analyzed using the SPSS PROCESS macro. A simple mediation was employed using social frailty as the independent variable, FoF as the mediator variable, and HrQoL as the outcome variable. RESULTS: Social frailty was associated with HrQoL and indirectly with HrQoL through FoF, and FoF was directly associated with HrQoL. Of the 5-item social frailty index, "going out less frequently" was correlated with HrQoL and indirectly with HrQoL through FoF. Individuals who felt unhelpful toward family or friends had the worst physical HrQoL and did not talk to someone daily had the most negative influence on mental HrQoL. CONCLUSIONS: Social frailty can directly and indirectly, through FoF decrease HrQoL. It also emphasizes the importance of social connectivity in reducing the risk of falls. This study points to the need for social connectivity and fall prevention programs as essential components of strategies to enhance the health and well-being of community-dwelling older adults.


Asunto(s)
Accidentes por Caídas , Miedo , Fragilidad , Anciano , Humanos , Accidentes por Caídas/prevención & control , Estudios Transversales , Fragilidad/diagnóstico , Fragilidad/epidemiología , Vida Independiente , Calidad de Vida
4.
BMC Public Health ; 23(1): 2409, 2023 12 04.
Artículo en Inglés | MEDLINE | ID: mdl-38049759

RESUMEN

BACKGROUND: This study aimed to validate the Chinese version of the Health Literacy Assessment Scale for Adolescents (HAS-A) and conduct a comparative analysis of adolescent health literacy between Taiwan and other countries. METHODS: The Chinese version of the HAS-A was completed by 2,312 adolescents in the fifth and sixth grades of a primary school. Psychometric properties were examined using consistent internal reliability and confirmatory factor analysis. These assessments were compared with the results from different regions to explore health literacy inequality. RESULTS: Construct validity was good, and internal consistency was acceptable. The scale, particularly regarding communication health literacy, was associated with parents' socioeconomic status, and family income had a more significant impact on children's health literacy than community income. Health literacy disparities appear in different countries, with Taiwan exhibiting the lowest level of communication health literacy. CONCLUSION: The results indicate that the HAS-A is a valuable tool for assessing the health literacy of 10-11-year-old adolescents and can uncover health literacy inequality among different regions.


Asunto(s)
Alfabetización en Salud , Niño , Humanos , Adolescente , Alfabetización en Salud/métodos , Taiwán , Salud del Adolescente , Reproducibilidad de los Resultados , Encuestas y Cuestionarios , Psicometría
5.
BMC Palliat Care ; 22(1): 91, 2023 Jul 10.
Artículo en Inglés | MEDLINE | ID: mdl-37424005

RESUMEN

BACKGROUND: Studies indicated that patients with advance directives (ADs) have a generally better quality of life near death. Yet, the concept of ADs is relatively new in East Asian countries. This study examined the associations between health literacy, pro-individualism in end-of-life (EOL) decisions (i.e., EOL pro-individualism), and master-persistence personality traits with the willingness to complete ADs. METHODS: The data is from a representative data of 1478 respondents from the 2022 Taiwan Social Change Survey. Generalized structural equation modeling (GSEM) was used to conduct path analysis. RESULTS: Nearly half of the respondents (48.7%) were willing to complete ADs. Health literacy has direct and indirect effects through EOL pro-individualism values on the willingness to complete ADs. Noncognitive factors such as mastery-persistence personality traits and EOL pro-individualism values enhanced the willingness to complete ADs. CONCLUSION: A personalized communication strategy, mindful of personality dimensions and cultural values, can address individual fears and concerns, promoting the benefits of advance care planning (ACP). These influences can provide a roadmap for healthcare providers to customize their approach to ACP discussions, improving patient engagement in AD completion.


Asunto(s)
Planificación Anticipada de Atención , Alfabetización en Salud , Cuidado Terminal , Humanos , Taiwán , Calidad de Vida , Directivas Anticipadas , Personalidad
6.
Cancer Control ; 29: 10732748221132522, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36192670

RESUMEN

OBJECTIVES: Breast cancer is the most common cancer among women in Taiwan, and treatment and coping with the disease become prominent features in a survivor's life. Here, we examined Taiwanese survivors' perceived causes of breast cancer, the influence of support networks on their perceptions, and the behavioral changes they made to prevent recurrences. METHODS: In this qualitative study, we used an explanatory approach involving semi-structured in-depth interviews based on grounded theory. We recruited (via physician referrals) 29 survivors aged ≥20 who had received their initial diagnosis at least 6 months earlier. RESULTS: Although the participants had made behavioral changes in many areas of their lives after diagnosis, most still believed that "stress and emotions" were the most crucial factor in causing cancer. They strongly emphasized reducing stress levels to prevent recurrences. However, when maintaining healthy behaviors became stressful, they chose to level off healthy lifestyles for the sake of their emotional well-being. They made career changes to improve their quality of life yet continued to experience a deep fear of recurrence. Adopting behavioral changes leading to healthy lifestyles and following regular follow-ups helped to reduce their anxiety concerning recurrence. CONCLUSION: The participants' behavioral changes were strongly associated with the perceived causes of cancer. Health-promotion programs aimed at breast cancer prevention should focus on participants' subjective perception of the cause of cancer.


Asunto(s)
Neoplasias de la Mama , Supervivientes de Cáncer , Neoplasias de la Mama/terapia , Supervivientes de Cáncer/psicología , Femenino , Humanos , Calidad de Vida/psicología , Recurrencia , Sobrevivientes/psicología , Taiwán/epidemiología
7.
Public Health Nutr ; 25(9): 2465-2474, 2022 09.
Artículo en Inglés | MEDLINE | ID: mdl-35582995

RESUMEN

OBJECTIVE: To explore the factors influencing Taiwanese adolescents' consumption of sugar-sweetened beverages (SSB) and sugary snacks from a socio-ecological perspective. DESIGN: This study adopted a qualitative design by using face-to-face, in-depth interviews guided by a semistructured questionnaire. SETTING: Eight junior high schools in New Taipei City and Changhua County, Taiwan, September to November 2018. PARTICIPANTS: Fifty-nine participants aged 12-14 years participated in this study. RESULTS: Reflexive thematic analysis was used to analyse the data. This study identified four themes to address the multifaceted factors that influence adolescents' consumption of SSB and sugary snacks. At the intrapersonal level, physiological factors, psychological factors, individual economic factors and taste preferences were mentioned in connection with people's consumption of SSB and sugary snacks. Positive or negative influences of parents, siblings, peers and teachers on SSB and sugary snack intake were identified at the interpersonal level. The availability of SSB and sugary snacks at home, their availability in vending machines or in school stores in the school environment and participants' access to convenience stores and hand-shaken drink shops in the broader community influenced SSB and sugary snack consumption. Additionally, food culture and food advertising were identified as influencing societal factors. CONCLUSIONS: Overall, this qualitative study determined not only that the consumption of SSB and sugary snacks is influenced by intrapersonal factors but also that interpersonal, environmental and societal factors affect adolescents' increased sugar intake. The findings are helpful to broaden the options for designing and developing interventions to decrease SSB and sugary snack consumption by adolescents.


Asunto(s)
Bocadillos , Bebidas Azucaradas , Adolescente , Bebidas , Humanos , Instituciones Académicas , Azúcares
8.
Public Health Nutr ; : 1-19, 2022 Jul 19.
Artículo en Inglés | MEDLINE | ID: mdl-35851091

RESUMEN

OBJECTIVE: Sugar-sweetened beverages (SSBs) are linked to increased metabolic risk. However, the sex differences in the relationship between SSB intake and adverse health effects remain unclear. Therefore, the present study examined the association between SSB consumption and metabolic risks among working-age males and females from Taiwanese communities. DESIGN: A community-based study utilized data from a comprehensive health screening project conducted by the Public Health Bureau in Changhua County, Taiwan. Metabolic risks included waist circumference, systolic blood pressure, diastolic blood pressure, total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL), and fasting glucose level using serum tests. SETTING: Participants were recruited in Changhua County, Taiwan. PARTICIPANTS: Between 2005 and 2014, 92,724 citizens participated in the health screening; our data analysis included 75,278 respondents between 30 and 64. RESULTS: The results showed that the frequency of SSB consumption was associated with abnormal waist circumference and elevated total cholesterol, triglycerides, LDL, and glucose in both men and women. Increased SSB consumption frequency was associated with elevated glucose and hypertension in women. Even a slight increase in SSB intake frequency was related to raising the metabolic risks. Similar patterns were evident when models included body mass index (BMI); however, the associations were attenuated. In the BMI-stratified subgroup analysis, the relationship between SSB consumption and metabolic risks was more pronounced in participants without obesity. CONCLUSION: The present study suggests that SSB consumption carries metabolic risk among working-age Taiwanese, particularly women and those without obesity. Health promotion programs should raise awareness of the health hazards associated with SSBs.

9.
BMC Geriatr ; 22(1): 11, 2022 01 03.
Artículo en Inglés | MEDLINE | ID: mdl-34979931

RESUMEN

BACKGROUND: Researchers have emphasized the importance of examining how different factors affect men's and women's functional status over time. To date, the literature is unclear about whether sex affects the rate of change in disability in middle to older age. Researchers have further emphasized the importance of examining how different factors affect men's and women's functional status over time. We examined (a) sex differences in disability trends and (b) the determinants of the rate of change in disability for men and women 50 years and older. METHODS: This study utilized the Taiwan Longitudinal Study on Aging Survey, a nationally representative database (four waves of survey data 1996-2007, N = 3429). We modeled and compared the differences in disability trends and the influences of determinants on trends among men and women using multiple-indicator and multiple-group latent growth curves modeling (LGCM). Equality constraints were imposed on 10 determinants across groups. RESULTS: Once disability began, women progressed toward greater disability 18% faster than men. Greater age added about 1.2 times the burden to the rate of change in disability for women than men (p < 0.001). More comorbidities also added significantly more burden to baseline disability and rate of change in disability among women than men (p < 0.001), but women benefited more from higher education levels in lower baseline disability and slower rate of change. Having a better social network was associated with lower baseline disability among women only (p < 0.05). For both men and women, physically active leisure-time activities were beneficial in lower baseline disability (p men and women < 0.001) and rate of change in disability (p men < 0.01; p women < 0.05), with no significant differences between groups. CONCLUSIONS: Age may widen the sex gap in the rate of change in disability. However, both sexes benefit from participating in leisure-time activities. Promoting health literacy improves health outcomes and physical function among women.


Asunto(s)
Personas con Discapacidad , Anciano , Envejecimiento , Femenino , Humanos , Actividades Recreativas , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios
10.
Appetite ; 168: 105663, 2022 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-34455023

RESUMEN

This study was performed to investigate the predictors of sugar-sweetened beverage (SSB) consumption in adolescents, including knowledge of SSBs, self-efficacy, and perceived benefits and barriers, using the structural equation modeling approach. This cross-sectional study was conducted from March to June 2019 in New Taipei City, Taiwan. The participants were 633 adolescents from 23 classes at three junior high schools in New Taipei City. A structured self-administered questionnaire was developed for data collection. The overall model predicted SSB consumption well, suggesting that SSB consumption was associated with self-efficacy and perceived barriers and benefits. Self-efficacy was the strongest predictor of SSB consumption. Both perceived barriers and self-efficacy sequentially and fully mediated the effect of knowledge on SSB consumption. This study confirms that self-efficacy is associated with SSB intake in both male and female adolescents. However, knowledge of SSBs was not associated with SSB consumption. Relying on nutritional education alone may not be adequate to change SSB consumption. The results suggest that future health promotion programs should improve self-efficacy to decrease SSB consumption in adolescents.


Asunto(s)
Bebidas Azucaradas , Adolescente , Bebidas , Estudios Transversales , Femenino , Humanos , Análisis de Clases Latentes , Masculino , Autoeficacia
11.
BMC Palliat Care ; 21(1): 171, 2022 Oct 06.
Artículo en Inglés | MEDLINE | ID: mdl-36203170

RESUMEN

BACKGROUND: Few studies have explored gender differences in the attitudes toward advanced care planning and the intention to withhold life-sustaining treatments (LSTs) involving severe dementia in Asian countries. We examined gender differences in the attitude toward the Patient Autonomy Act (PAA) in Taiwan and how the gender differences in these attitudes affect the intention to withhold LSTs for severe dementia. We also investigated self-other differences in the intention to withhold LSTs between genders. METHODS: Between March and October 2019, a structured questionnaire was distributed to hospitalized patients' family members through face-to-face contact in an academic medical center. Exploratory factor analysis and independent and paired-sample t-tests were used to describe gender differences. Mediation analyses controlled for age, marital status, and education level were conducted to examine whether the attitude toward the PAA mediates the gender effect on the intention to withhold LSTs for severe dementia. RESULTS: Eighty respondents filled out the questionnaire. Exploratory factor analysis of the attitude toward the PAA revealed three key domains: regarding the PAA as (1) promoting a sense of abandonment, (2) supporting patient autonomy, and (3) contributing to the collective good. Relative to the men, the women had lower average scores for promoting a sense of abandonment (7.48 vs. 8.94, p = 0.030), higher scores for supporting patient autonomy (8.74 vs. 7.94, p = 0.006), and higher scores for contributing to the collective good (8.64 vs. 7.47, p = 0.001). Compared with the women, the men were less likely to withhold LSTs for severe dementia (15.84 vs. 18.88, p = 0.01). Mediation analysis revealed that the attitude toward the PAA fully mediated the gender differences in the intention to withhold LSTs for severe dementia. Both men and women were more likely to withhold LSTs for themselves than for their parents. Compared with the women, the men were more likely to withhold resuscitation for themselves than for their parents (p = 0.05). Women were more likely to agree to enteral tube feeding and a tracheotomy for their husbands than for themselves; men made consistent decisions for themselves and their wives in those LST scenarios. CONCLUSION: Gender influences the attitude toward advanced care planning and consequently affects the intention to withhold LSTs, indicating that there may be a difference in how men and women perceive EOL decision-making for severe dementia in Taiwan. Further studies are warranted.


Asunto(s)
Demencia , Cuidado Terminal , Demencia/terapia , Femenino , Humanos , Intención , Cuidados para Prolongación de la Vida , Masculino , Padres , Factores Sexuales , Esposos
12.
J Adolesc ; 94(1): 81-91, 2022 01.
Artículo en Inglés | MEDLINE | ID: mdl-35353406

RESUMEN

INTRODUCTION: Adolescents with obesity are more likely to be isolated by peers, but whether they also choose to disengage from their peers remains unclear. METHODS: This study examined a sample of 646 adolescents between the age of 13 and 16 across 34 classrooms in 3 junior high schools in Taiwan, with data collected from May to June 2019. The sociometric network nomination method assessed peer relationships, such as unpopularity, unsociability, and alienation. Multilevel models were applied to explore the extent to which the class-level prevalence of overweight and obesity and peer support moderate the relationship between student-level obesity and peer relationships. RESULTS: Overall, students with obesity were more likely to experience unpopularity, unsociability, and alienation from their peers in classroom settings (adjusted odds ratio [AOR] = 1.904, 2.208, 2.777, p < .05). Regardless of their obesity status, students in high classroom peer support were less likely to report unsociability (AOR = 0.124, p < .05). No cross-level interactions were observed, indicating that students with obesity did not experience a reduction of peer rejection in high peer support classrooms. Neither did obese students in classrooms with higher rates of overweight and obesity. CONCLUSIONS: Students with obesity were more likely to experience interpersonal problems. Classroom peer support can increase peer acceptance for typical students but has no beneficial influence on adolescents with weight problems. Classroom peer support needs to be directed to become adequate support for students with obesity.


Asunto(s)
Obesidad Infantil , Alienación Social , Adolescente , Humanos , Obesidad Infantil/epidemiología , Grupo Paritario , Instituciones Académicas , Estudiantes
13.
Clin Anat ; 34(6): 867-871, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-33908670

RESUMEN

Carotid artery webs are shelf-like protrusions of intimal fibrous tissue arising from the posterior wall of the carotid bulb, found to have a 2.3% prevalence in the United States. Previous studies have demonstrated its association with ipsilateral anterior circulation stroke. The aim of this study is to assess the prevalence of carotid webs in the largest US epidemiologic study to date, and to further characterize the clinical features of carotid web patients. We assembled a cohort of 1467 adult patients with CT angiogram neck from January 1, 2011 to January 1, 2017. CT angiograms were reviewed for diagnosis of carotid web. Demographic and clinical details of web patients were obtained. Differences in demographics and CT angiogram indication between patients with and without carotid web were assessed using appropriate statistical tests. Twenty-four (24/1467 = 1.6%) carotid web patients were identified (mean age: 63 years; 62.5% female; 50% African American). Twelve (12/24 = 50%) had ipsilateral anterior circulation stroke. Of them, 8 were deemed cryptogenic. Four (4/24 = 16.7%) web patients had at least one recurrent stroke in the ipsilateral anterior circulation. One case was reported on the radiology report at the time the study was initially performed. This study confirms a prevalence of 1.6% in our urban, North American cohort. Among carotid web patients, there was a high incidence of ipsilateral anterior circulation stroke, the majority of which were classified as cryptogenic. This study affirms the importance of the diagnosis of carotid web, especially in cryptogenic stroke patients, as a potential unrecognized stroke risk factor.


Asunto(s)
Arterias Carótidas/anomalías , Accidente Cerebrovascular Isquémico/epidemiología , Anciano , Arterias Carótidas/diagnóstico por imagen , Angiografía por Tomografía Computarizada , Femenino , Humanos , Accidente Cerebrovascular Isquémico/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Prevalencia , Estados Unidos/epidemiología
14.
J Stroke Cerebrovasc Dis ; 30(4): 105618, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33482571

RESUMEN

Recurrent episodes of neurological dysfunction and white matter lesions in a young adult raise suspicion for multiple sclerosis (MS). However, occlusive retinopathy, hearing loss and absence of CSF oligoclonal bands are atypical for MS and should make the clinician consider an alternative diagnosis. We describe a man with hearing loss, visual signs and symptoms, and an accumulating burden of brain lesions, who was treated for a clinical diagnosis of MS for nearly two decades. Genetic testing revealed a unifying diagnosis.


Asunto(s)
Secuenciación del Exoma , Pérdida Auditiva Unilateral/etiología , Enfermedad de la Hemoglobina SC/diagnóstico , Hemoglobinas Anormales/genética , Leucoencefalopatías/etiología , Esclerosis Múltiple/diagnóstico , Trastornos de la Visión/etiología , Errores Diagnósticos , Predisposición Genética a la Enfermedad , Pérdida Auditiva Unilateral/diagnóstico , Pérdida Auditiva Unilateral/fisiopatología , Enfermedad de la Hemoglobina SC/complicaciones , Enfermedad de la Hemoglobina SC/genética , Humanos , Leucoencefalopatías/diagnóstico por imagen , Leucoencefalopatías/fisiopatología , Imagen por Resonancia Magnética , Masculino , Esclerosis Múltiple/complicaciones , Esclerosis Múltiple/tratamiento farmacológico , Fenotipo , Valor Predictivo de las Pruebas , Trastornos de la Visión/diagnóstico , Trastornos de la Visión/fisiopatología , Adulto Joven
15.
Geriatr Nurs ; 42(5): 1012-1018, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34256149

RESUMEN

The FES-I is widely used to measure the fear of falling. However, studies linking the Chinese version of the FES-I to frailty and quality of life among older adults are still limited. Thus, this study examined the association of the full 16-item FES-I and the 7-item short FES-I with fall history, physical frailty, and quality of life among older Taiwanese adults. A total of 751 community-dwelling older adults in Taipei City participated in this study. Data analyses included logistic and linear regression models. The 16-item and the short FES-I were strongly correlated (Spearman rho = 0.963), and both scales are reliable. The 7-item FES-I was positively associated with fall history and physical frailty and negatively associated with the physical (b = -0.65, p < 0.001) and mental (b = -0.59, p < 0.001) components of health-related quality of life, independent of physical frailty. Thus, the short FES-I can be used to increase the feasibility of health screenings of older adults in Chinese-speaking contexts.


Asunto(s)
Accidentes por Caídas , Fragilidad , Accidentes por Caídas/prevención & control , Anciano , Miedo , Humanos , Vida Independiente , Calidad de Vida , Reproducibilidad de los Resultados , Encuestas y Cuestionarios
16.
J Formos Med Assoc ; 119(1 Pt 1): 34-41, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30876787

RESUMEN

BACKGROUND: Evidence regarding the impact of early palliative family conferences (PFCs) and decision to withdraw life-sustaining treatment (DTW) on healthcare costs in an intensive care unit (ICU) setting is inconsistent. METHODS: We retrospectively analyzed patients who died in an ICU from 2013 to 2016. PFCs held within 7 days after ICU admission and DTWs were verified by reviewing medical records and claims data. Comparisons were first made between patients with and without DTWs, and secondly, between DTW patients with and without PFCs within 7 days. Propensity score matching methods were used to examine the difference in costs between patients with and without DTWs and PFCs within 7 days. RESULTS: Of the 579 patients included, those with DTWs (n = 73) had a longer ICU stay than those without (n = 506) (12.9 ± 7.1 vs. 8.4 ± 9.6 days, p < 0.001). The DTW patients were more likely to have a "do-not-resuscitate" order (p < 0.001) and PFCs within 7 days (p < 0.001) and had lower healthcare costs (USD 7358 ± 4116 vs. 8669 ± 9,535, p = 0.038). After matching, healthcare cost reduction for patients with DTWs, compared with those without DTWs, was USD 3467 [95% CI, 915-6019] (p < 0.001). Compared with DTW patients without PFCs within 7 days, the costs for DTW patients with PFCs within 7 days further reduced to USD 3042 [95%CI, 1358-4725] (p < 0.001). CONCLUSION: Palliative family conferences held within 7 days after ICU admission with decisions to withdraw life-sustaining treatments significantly lowered healthcare costs.


Asunto(s)
Familia , Costos de la Atención en Salud/estadística & datos numéricos , Unidades de Cuidados Intensivos/estadística & datos numéricos , Relaciones Profesional-Familia , Órdenes de Resucitación , Anciano , Anciano de 80 o más Años , Comunicación , Toma de Decisiones , Femenino , Humanos , Tiempo de Internación/estadística & datos numéricos , Cuidados para Prolongación de la Vida , Modelos Logísticos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Taiwán , Privación de Tratamiento/estadística & datos numéricos
17.
Chaos ; 29(3): 033120, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30927850

RESUMEN

Numerous well-known processes of complex systems such as spreading and cascading are mainly affected by a small number of critical nodes. Identifying influential nodes that lead to broad spreading in complex networks is of great theoretical and practical importance. Since the identification of vital nodes is closely related to propagation dynamics, a novel method DynamicRank that employs the probability model to measure the ranking scores of nodes is suggested. The influence of a node can be denoted by the sum of probability scores of its i order neighboring nodes. This simple yet effective method provides a new idea to understand the identification of vital nodes in propagation dynamics. Experimental studies on both Susceptible-Infected-Recovered and Susceptible-Infected-Susceptible models in real networks demonstrate that it outperforms existing methods such as Coreness, H-index, LocalRank, Betweenness, and Spreading Probability in terms of the Kendall τ coefficient. The linear time complexity enables it to be applied to real large-scale networks with tens of thousands of nodes and edges in a short time.

18.
J Formos Med Assoc ; 118(2): 619-627, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-30119949

RESUMEN

PURPOSE: The health of physicians can have a strong impact on the quality and safety of the health care they provide. Studies have shown a link between work stress, burnout, and depression. The aim of this study was to examine the association between malpractice dispute experiences and the well-being of physicians. METHODS: We conducted a cross-sectional survey to collect information about the malpractice experiences of primary care physicians in 2004. Data on sociodemographic and clinical characteristics and SF-36 measures were also collected. We used propensity score matching to estimate the association of medical malpractice experience with the general health, mental health, and vitality of physicians. RESULTS: Among the 1206 primary care physicians who completed the survey (response rate of 13.4%), 25.2% reported having ever experienced a malpractice dispute. After adjustment for baseline variables, physicians who had experienced a malpractice dispute had significantly worse health-related quality of life with regard to general health [-4.85; 95% confidence interval (CI), -7.61 to -1.80; P = 0.0016], mental health (-2.68; 95% CI, -5.03 to -0.34; P = 0.0252), and vitality (-3.28; 95% CI, -6.10 to -0.47; P = 0.0224). The effects were particularly strong among physicians specializing in surgery or obstetrics and gynecology. CONCLUSION: The results reveal that a malpractice dispute can have a long-term negative effect on the health of physicians. Harm reduction programs for physicians involved in malpractice disputes should be implemented.


Asunto(s)
Disentimientos y Disputas , Mala Praxis/estadística & datos numéricos , Médicos de Atención Primaria/psicología , Calidad de Vida , Adulto , Estudios Transversales , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Puntaje de Propensión , Encuestas y Cuestionarios , Taiwán
19.
Sensors (Basel) ; 19(19)2019 Sep 24.
Artículo en Inglés | MEDLINE | ID: mdl-31554229

RESUMEN

The fields of human activity analysis have recently begun to diversify. Many researchers have taken much interest in developing action recognition or action prediction methods. The research on human action evaluation differs by aiming to design computation models and evaluation approaches for automatically assessing the quality of human actions. This line of study has become popular because of its explosively emerging real-world applications, such as physical rehabilitation, assistive living for elderly people, skill training on self-learning platforms, and sports activity scoring. This paper presents a comprehensive survey of approaches and techniques in action evaluation research, including motion detection and preprocessing using skeleton data, handcrafted feature representation methods, and deep learning-based feature representation methods. The benchmark datasets from this research field and some evaluation criteria employed to validate the algorithms' performance are introduced. Finally, the authors present several promising future directions for further studies.


Asunto(s)
Aprendizaje Profundo , Algoritmos , Humanos , Aprendizaje Automático
20.
Sensors (Basel) ; 19(5)2019 Feb 27.
Artículo en Inglés | MEDLINE | ID: mdl-30818796

RESUMEN

Although widely used in many applications, accurate and efficient human action recognition remains a challenging area of research in the field of computer vision. Most recent surveys have focused on narrow problems such as human action recognition methods using depth data, 3D-skeleton data, still image data, spatiotemporal interest point-based methods, and human walking motion recognition. However, there has been no systematic survey of human action recognition. To this end, we present a thorough review of human action recognition methods and provide a comprehensive overview of recent approaches in human action recognition research, including progress in hand-designed action features in RGB and depth data, current deep learning-based action feature representation methods, advances in human⁻object interaction recognition methods, and the current prominent research topic of action detection methods. Finally, we present several analysis recommendations for researchers. This survey paper provides an essential reference for those interested in further research on human action recognition.


Asunto(s)
Reconocimiento de Normas Patrones Automatizadas/métodos , Visión Ocular/fisiología , Percepción Visual/fisiología , Algoritmos , Actividades Humanas , Humanos , Movimiento (Física) , Esqueleto/fisiología , Encuestas y Cuestionarios
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