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Alarm calls produced by basal prey have a well-known informative value. In multi-predator communities, mesopredators, when faced with top predators, may emit alarm calls that could inform basal prey about their lowered predation risk. To test this unexplored possibility, we conducted one field and one mesocosm experiment in which we simulated alarm and non-alarm calls from little owls (Athene noctua) as mesopredators and measured their effects on grasshoppers as prey of little owls but not of top predators. In the field experiment, we found that grasshopper species were significantly more abundant in patches where we simulated either the presence of scared little owls (alarm treatment) or no owls (control treatment) compared to patches where the presence of non-scared little owls (non-alarm treatment) was simulated. In the mesocosm experiment, locusts (Locusta migratoria) moved significantly more to exposed areas when we simulated the presence of scared little owls (alarm treatment) or of a granivorous bird (control treatment), while they moved to sheltered areas when we simulated the presence of non-scared owls (non-alarm treatment). These results show that prey could cue on predators' calls to assess their predation risk and make decisions, revealing unprecedented potential ecological consequences of alarm calls in invertebrate communities.
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Cadeia Alimentar , Gafanhotos , Comportamento Predatório , Animais , Gafanhotos/fisiologia , Estrigiformes/fisiologia , Vocalização AnimalRESUMO
Species worldwide are experiencing anthropogenic environmental change, and the long-term impacts on animal cultural traditions such as vocal dialects are often unknown. Our prior studies of the yellow-naped amazon (Amazona auropalliata) revealed stable vocal dialects over an 11-year period (1994-2005), with modest shifts in geographic boundaries and acoustic structure of contact calls. Here, we examined whether yellow-naped amazons maintained stable dialects over the subsequent 11-year time span from 2005 to 2016, culminating in 22 years of study. Over this same period, this species suffered a dramatic decrease in population size that prompted two successive uplists in IUCN status, from vulnerable to critically endangered. In this most recent 11-year time span, we found evidence of geographic shifts in call types, manifesting in more bilingual sites and introgression across the formerly distinct North-South acoustic boundary. We also found greater evidence of acoustic drift, in the form of new emerging call types and greater acoustic variation overall. These results suggest cultural traditions such as dialects may change in response to demographic and environmental conditions, with broad implications for threatened species.
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Amazona , Vocalização Animal , Animais , Amazona/fisiologia , Espécies em Perigo de Extinção , Densidade Demográfica , Conservação dos Recursos NaturaisRESUMO
BACKGROUND: High-need, high-cost Medicare patients can have difficulties accessing office-based primary care. Home-based primary care (HBPC) can reduce access barriers and allow a clinician to obtain valuable information not obtained during office visit, possibly leading to reductions in hospital use. OBJECTIVE: To determine whether HBPC for high-need, high-cost patients reduces hospitalizations and Medicare inpatient expenditures. DESIGN: We conducted a matched retrospective cohort study using a difference-in-differences analysis to examine patients 2 years before and 2 years after their first home visit (HBPC group). PARTICIPANTS: The study included high-need, high-cost fee-for-service Medicare patients without prior HBPC use, of which 55,303 were new HBPC recipients and 156,142 were matched comparison patients. INTERVENTION: Receipt of at least two HBPC visits and, within 6 months of the index HBPC visit, a majority of a patient's primary care visits in the home. MAIN MEASURES: Total and potentially avoidable hospitalizations and Medicare inpatient expenditures. KEY RESULTS: HBPC reduced total hospitalization rates, but the marginal effects were not statistically significant: a reduction of 11 total hospitalizations per 1000 patients in the first year (- 0.6%, p = 0.19) and 14 in the second year (- 0.7%, p = 0.16). However, HBPC reduced potentially avoidable hospitalization rates in the second year. The estimated marginal effect was a reduction of 6 potentially avoidable hospitalizations per 1000 patients in the first year (- 1.6%, p = 0.16) and 11 in the second (- 3.1%, p = 0.01). The estimated effect of HBPC was a small decrease in inpatient expenditures of $24 per patient per month (- 1.1%, p = 0.10) in the first year and $0 (0.0%, p = 0.99) in the second. CONCLUSIONS: After high-need, high-cost patients started receiving HBPC, they did not experience fewer total hospitalizations or lower inpatient spending but may have had lower rates of potentially avoidable hospitalizations after 2 years.
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Serviços de Assistência Domiciliar , Medicare , Idoso , Humanos , Estados Unidos/epidemiologia , Atenção Primária à Saúde , Estudos Retrospectivos , Hospitais , HospitalizaçãoRESUMO
BACKGROUND: The management of blood supply depends, among other factors, on the effective remobilization of first-time donors (FTDs). This study investigates the efficacy of telephone calls to increase second donation rates. STUDY DESIGN AND METHODS: A randomized controlled trial was conducted on 418 first-time blood donors. In the telephone group (TG, n = 206), men were contacted 9-10 and women 13-14 weeks after their first donation. They were asked about satisfaction and intention to return, and offered an appointment. The primary outcome was the return rate within 6 months after the first donation. RESULTS: The mean age was 28.8 ± 10.0 years and 59.9% of FTDs were female. In the TG, 89.3% were reached. Approximately 50% of each group had donated a second time by 24.2 weeks for the control group (CG) and 14.8 weeks for the TG. The six-month return rate was 65.0% in the TG and 54.3% in the CG (95%-CI [0.9%; 20.6%]; p = .033). The restricted mean time to return within 6 months was 19.4 weeks in the CG compared to 17.2 weeks in the TG (95%-CI [0.7; 3.7]; p = .004). The intervention effect tended to be larger in men than in women. DISCUSSION: Contacting FTDs by phone after their first donation increases the six-month return rate and reduces the interval to a second donation. Male donors appear to be more receptive to this intervention. Whether the effect of the intervention helps to establish a donor identity in the long term should be the subject of further studies.
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Doadores de Sangue , Telefone , Humanos , Feminino , Masculino , Adulto , Adulto Jovem , Fatores de Tempo , Inquéritos e QuestionáriosRESUMO
BACKGROUND: The purpose of this study was to understand how transplant infectious disease (TID) physicians assess a potential donor with known or suspected infection and describe posttransplant management. METHODS: We designed a survey of 10 organ offer scenarios and asked questions pertaining to organ acceptability for transplantation and management posttransplant. The survey was distributed to TID clinicians via transplant society listservs and email. Responses were recorded in REDCap, and descriptive statistics were employed. RESULTS: One hundred thirteen infectious disease physicians responded to the survey, of whom 85 completed all cases. Respondents were generally in agreement regarding organ acceptability, although some divergence was seen when evaluating lungs from donors with influenza, tuberculosis, or multidrug-resistant Acinetobacter infection. Posttransplant management showed more variation. Areas of optimization were identified: (1) Further understanding of where risk-mitigation strategies within the donor offer process may improve donor acceptability and therefore organ utilization; (2) importance of recipient considerations in assessing degree of infectious risk; and (3) gaps in evidenced-based data regarding optimal posttransplant management of recipients. CONCLUSION: Evaluation of donor offers by TID clinicians is a complex process. Although the survey does not itself serve to make recommendations regarding best practices, it highlights areas where generation of data to inform acceptance and management practices may allow for improved organ utilization and recipient management.
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Transplante de Órgãos , Doadores de Tecidos , Humanos , Inquéritos e Questionários , Transplante de Órgãos/efeitos adversos , Obtenção de Tecidos e Órgãos/métodos , Doenças Transmissíveis , Seleção do Doador/normas , Seleção do Doador/métodos , Transplantados/estatística & dados numéricosRESUMO
Promptly calling for assistance in an anaesthetic emergency is important. However, emergency call systems are not present in all locations where anaesthesia is administered, and in those that do have an emergency call system, the call button is often obscured by other equipment or in an unfamiliar location. Placing a red stripe from the ceiling, down the wall, to the emergency call button significantly reduces delays in activating an emergency call, demonstrating a simple but effective system change to the layout of operating theatres.
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Anestesia , Salas Cirúrgicas , Humanos , Anestesia/métodos , Sistemas de Comunicação entre Serviços de Emergência , Fatores de Tempo , Serviços Médicos de Emergência/métodosRESUMO
Short-term exposure to air pollution has previously been studied in relation to certain neurological disorders, but there is still a lack of convincing data linking air pollution to epileptic seizures. The study's goal was to investigate how exposure to ambient nitrogen dioxide (NO2) affected the number of patients seeking assistance at the Wuhan Emergency Medical Center due to epileptic seizures. We gathered data on medical emergency calls (MECs), daily ambient air pollution concentrations (SO2, NO2, PM2.5, PM10, CO, and O3), and meteorological variables in Wuhan, China, spanning from January 1, 2017, to November 30, 2019. To investigate the potential influence of ambient nitrogen dioxide on MECs for epileptic seizures, we carried out a time-series investigation using the general additive model (GAM). Additionally, analyses stratified by season, age, and gender were performed. A total of 8989 records of MECs for epileptic seizures were enrolled in our study during the period. Statistical analysis indicates that a rise of 10 µg/m3 in NO2 concentration is linked to a 0.17% increase in daily MECs for epileptic seizures (95% confidence interval [CI]: 0.02%, 0.32%). Furthermore, people aged 14-59 years were more susceptible(2.25%, P < 0.05). The short-term effects of NO2 exposure on daily MECs for epileptic seizures were stronger in warm seasons than in cool seasons (0.55% vs. -0.10%, P < 0.0001). Our findings suggests that short-term exposure to ambient NO2 was positively correlated with daily MECs for epileptic seizures in Wuhan, China. Additionally, we observed that these associations were stronger in patients aged above 14 but under 60 years and the warmer seasons (from April to September).
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Poluentes Atmosféricos , Epilepsia , Dióxido de Nitrogênio , Humanos , Pessoa de Meia-Idade , Dióxido de Nitrogênio/análise , Adulto , Adolescente , Masculino , Feminino , Adulto Jovem , China/epidemiologia , Poluentes Atmosféricos/análise , Poluentes Atmosféricos/efeitos adversos , Idoso , Criança , Pré-Escolar , Lactente , Estações do Ano , Recém-Nascido , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Idoso de 80 Anos ou mais , Convulsões/induzido quimicamente , Exposição Ambiental/análise , Exposição Ambiental/efeitos adversosRESUMO
BACKGROUND: Utilization of video calls on hospital wards to facilitate involvement of and communication with family members is still limited. A deeper understanding of the needs and expectations of family members regarding video calls on hospital wards is necessary, to identify potential barriers and facilitate video calls in practice. AIM: The aim of this study was to explore the views, expectations and needs of a patient's family members regarding the use of video calls between family members, patients and healthcare professionals, during the patient's hospital admission. METHODS: A qualitative study was carried out. Semi-structured interviews with family members of patients admitted to two hospitals were conducted between February and May 2022. Family members of patients admitted to the surgical, internal medicine and gynaecological wards were recruited. RESULTS: Twelve family members of patients participated. Family members stated that they perceive video calls as a supplemental option and prefer live visits during hospital admission. They expected video calls to initiate additional moments of contact with healthcare professionals, e.g. to join in medical rounds. When deploying video calls, family members mentioned that adequate instruction and technical support by nurses should be available. CONCLUSION: Family members considered video calls valuable when visiting is not possible or to participate in medical rounds or other contacts with healthcare professionals outside of visiting hours. IMPLICATIONS: Family members need to be supported in options and use of video calls on hospital wards. Additional knowledge about actual participation in care through video calls is needed as well as the effect on patient, family and healthcare professional outcomes. IMPACT: Using video calls on hospital wards can provide family members with flexible alternatives for contact and promote family involvement. REPORTING METHOD: COREQ guidelines. PATIENT OR PUBLIC CONTRIBUTION: Family members of patients admitted to hospital have contributed by sharing their perspectives in interviews. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: Family members perceive additional value from the use of video calls on hospital wards. For family, use of video calls needs to be facilitated with clear instruction materials and support. TRIAL AND PROTOCOL REGISTRATION: Amsterdam UMC Medical Ethics Review Committee (ref number W21_508 # 21.560).
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Família , Pesquisa Qualitativa , Humanos , Família/psicologia , Feminino , Masculino , Pessoa de Meia-Idade , Adulto , Idoso , Relações Profissional-Família , Idoso de 80 Anos ou mais , Visitas a Pacientes/psicologia , Comunicação , Hospitalização , Comunicação por Videoconferência , Admissão do PacienteRESUMO
OBJECTIVES: In this study we aimed to explore EMCC triage of suspected and confirmed stroke patients to gain more knowledge about the initial phase of the acute stroke response chain. Accurate dispatch at the Emergency Medical Communication Center (EMCC) is crucial for optimal resource utilization in the prehospital service, and early identification of acute stroke is known to improve patient outcome. MATERIALS AND METHODS: We conducted a descriptive retrospective study based on data from the Emergency Department and EMCC records at a comprehensive stroke center in Oslo, Norway, during a six-month period (2019-2020). Patients dispatched with EMCC stroke criteria and/or discharged with a stroke diagnosis were included. We identified EMCC true positive, false positive and false negative stroke patients and estimated EMCC stroke sensitivity and positive predictive value (PPV). Furthermore, we analyzed prehospital time intervals and identified patient destinations to gain knowledge on ambulance services assessments. RESULTS: We included 1298 patients. EMCC stroke sensitivity was 77% (95% CI: 72 - 82%), and PPV was 16% (95% CI: 14 - 18%). EMCC false negative stroke patients experienced an increased median prehospital delay of 11 min (p < 0.001). Upon arrival at the scene, 68% of the EMCC false negative patients were identified as suspected stroke cases by the ambulance services. Similarly, 68% of the false positive stroke patients were either referred to a GP, out-of-hours GP acute clinic, local hospitals or left at the scene by the ambulance services, indicating that no obvious stroke symptoms were identified by ambulance personnel upon arrival at the scene. CONCLUSIONS: This study reveals a high EMCC stroke sensitivity and an extensive number of false positive stroke dispatches. By comparing the assessments made by both the EMCC and the ambulance service, we have identified specific patient groups that should be the focus for future research efforts aimed at improving the sensitivity and specificity of stroke recognition in the EMCC.
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Ambulâncias , Acidente Vascular Cerebral , Humanos , Triagem , Estudos Retrospectivos , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/terapia , TelefoneRESUMO
Law enforcement officers are frequent first responders to people experiencing mental health or suicide crises. Yet, as communities consider expanding crisis response options, we know very little about the nature of these calls that could inform decision making about which crisis response is best suited for the situation. This study is an exploratory, descriptive assessment of contextual factors, both individual and situational, of mental health and suicide crisis calls. Our dataset includes 166 calls to 9-1-1 related to a mental health emergency or suicide crisis. The majority were calls related to suicide (125 calls, 75%), which included more contextual factors than mental health crisis calls. Most calls resulted in the subject being transferred to the local emergency department (60%) or were resolved on scene (12%). Police use of force was rare, and no arrests were reported. The implications of these findings for communities developing alternatives to law enforcement crisis response are discussed.
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Aplicação da Lei , Suicídio , Humanos , Saúde Mental , Intervenção em Crise , PolíciaRESUMO
OBJECTIVES: Cleft lip and palate (CLP) represents complex congenital anomalies that necessitate a comprehensive approach to care, involving multiple healthcare disciplines. The primary aim of the study is to explore the content of periodic telephone support calls between parents/caregivers of children with CLP and pediatric dentist during sustained anticipatory guidance. DESIGN: The qualitative analysis was conducted with the available telephonic recordings that was obtained from the STOP database. 40 recordings of 8 children were used for this study. The recorded interviews were translated and transcribed verbatim and analysed using the thematic content analysis method. RESULTS: The four major themes that were addressed by the dentist were the general health of the baby, oral health and development, surgery-related concerns and emotional support. It was also observed that the parents demonstrated a positive shift in oral health related behaviour significantly improving their child's oral hygiene practices. CONCLUSIONS: The telephonic support calls offer valuable insights into the concerns and topics the parents of children with CLP are eager to discuss. These calls not only address general concerns, receiving emotional support from the professionals, demonstrate the health related behavior shift that takes place during SAG and reassures parents of their support.
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OBJECTIVE: To establish prevalence and associations of provision of nursing home visits (NHV) and home visits (HV) by early-career specialist GPs. Of particular interest were associations of rurality with performing NHVs and HVs. METHODS: A cross-sectional study. DESIGN: A questionnaire-based study. SETTING: Australian general practice. PARTICIPANTS: Early-career specialist GPs, practising in Australia, who attained Fellowship between January 2016 and July 2018, inclusive, having completed GP training in NSW, the ACT, Eastern Victoria or Tasmania. MAIN OUTCOME MEASURES: Current provision of NHV and HV. RESULTS: NHV were provided by 34% of participants (59% in rural areas) and HV by 41% of participants (60% in rural areas). Remote, rural or regional practice location, as compared to major-city practice, was strongly associated with performing NHV as an early-career specialist GP; multivariable OR 5.87 (95% CI: 2.73, 12.6), p < 0.001, and with the provision of HV; multivariable OR 3.64 (95% CI: 1.63, 8.11), p = 0.002. Rurality of GP training (prior to attaining Fellowship) was significantly univariably associated with providing NHV and with providing HV as an early-career specialist GP. On multivariable analyses, these were no longer statistically significant. CONCLUSION: Early-career specialist GPs located in regional/remote areas are more likely than their urban colleagues to provide NHV and HV.
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Clínicos Gerais , Visita Domiciliar , Casas de Saúde , Humanos , Estudos Transversais , Feminino , Masculino , Casas de Saúde/estatística & dados numéricos , Clínicos Gerais/estatística & dados numéricos , Visita Domiciliar/estatística & dados numéricos , Inquéritos e Questionários , Prevalência , Serviços de Saúde Rural/estatística & dados numéricos , Adulto , Pessoa de Meia-Idade , Austrália , TasmâniaRESUMO
BACKGROUND: Timely goals-of-care (GOC) discussions are essential for end-of-life planning, particularly during acute hospital admissions, where ambiguity often persists. Frailty, prevalent in the ageing population and linked to adverse outcomes, underscores the need to align treatment strategies with quality of life. Recognising frailty as a trigger for GOC discussions during rapid response calls (RRCs) is critical for efficient resource management and improving patient outcomes. METHODS: This single-centre retrospective cohort study included all hospitalised patients aged ≥65 years admitted between September 2021 and June 2023 who experienced an RRC. Frailty was assessed using the Clinical Frailty Scale (CFS) during the RRC. The primary outcome was to investigate whether frailty, specifically assessed by the CFS as screened during an RRC, could be a suitable clinical trigger for initiating GOC discussions. We also aimed to identify the proportion of patients with frailty (CFS score: ≥5) and predictors at the time of RRC, resulting in recommendations for GOC discussions. RESULTS: Among 4954 patients, 1685 (34.0%) were classified as frail (CFS score: ≥5). Recommendations increased with frailty levels (nonfrail [CFS score: 1-4]: 6.6%, mildly frail [CFS score: 5]: 19.3%, moderate-to-severely frail [CFS score: 6-9]: 32.2%; p < 0.001). Frailty independently increased the probability of GOC recommendations during an RRC (area under the receiver operating characteristic curve = 0.71). The CFS cut-off point for GOC recommendations was ≥5. The presence of frailty was associated with higher odds of receiving GOC recommendations for mildly frail (CFS score: 5; odds ratio [OR] = 2.53; 95% confidence interval: 1.96-3.27) and moderate-to-severely frail (CFS score: 6-9; OR = 4.69; 95% confidence interval: 3.81-5.78) compared to nonfrail patients. CONCLUSION: Frailty, identified during an RRC, served as a robust trigger for GOC recommendations, highlighting the importance of tailored proactive discussions before episodes of deterioration. Higher levels of frailty (CFS score: ≥5) demonstrate practical markers for aiding clinicians with proactive GOC discussions.
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BACKGROUND: The Emergency Medical Service (EMS) in Germany is increasingly challenged by strongly rising demand. Speculations about a greater utilisation for minor cases have led to intensive media coverage, but empirical evidence is lacking. We investigated the development of low-acuity calls from 2018 to 2021 in the federal state of Berlin and its correlations with sociodemographic characteristics. METHODS: We analysed over 1.5 million call documentations including medical dispatch codes, age, location and time using descriptive and inferential statistics and multivariate binary logistic regression. We defined a code list to classify low-acuity calls and merged the dataset with sociodemographic indicators and data on population density. RESULTS: The number of emergency calls (phone number 112 in Germany) increased by 9.1% from 2018 to 2021; however, the proportion of low-acuity calls did not increase. The regression model shows higher odds of low-acuity for young to medium age groups (especially for age 0-9, OR 1.50 [95% CI 1.45-1.55]; age 10-19, OR 1.77 [95% CI 1.71-1.83]; age 20-29, OR 1.64 [95% CI 1.59-1.68] and age 30-39, OR 1.40 [95% CI 1.37-1.44]; p < 0.001, reference group 80-89) and for females (OR 1.12 [95% CI 1.1-1.13], p < 0.001). Odds were slightly higher for calls from a neighbourhood with lower social status (OR 1.01 per index unit increase [95% CI 1.0-1.01], p < 0.05) and at the weekend (OR 1.02 [95% CI 1.0-1.04, p < 0.05]). No significant association of the call volume with population density was detected. CONCLUSIONS: This analysis provides valuable new insights into pre-hospital emergency care. Low-acuity calls were not the primary driver of increased EMS utilisation in Berlin. Younger age is the strongest predictor for low-acuity calls in the model. The association with female gender is significant, while socially deprived neighbourhoods play a minor role. No statistically significant differences in call volume between densely and less densely populated regions were detected. The results can inform the EMS in future resource planning.
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Emergências , Serviços Médicos de Emergência , Humanos , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto Jovem , Adulto , Berlim/epidemiologia , Serviço Hospitalar de Emergência , Alemanha/epidemiologia , Estudos RetrospectivosRESUMO
BACKGROUND: Heart failure is common and is associated with high rates of hospitalization. Home care support clinics/hospitals (HCSCs) and enhanced HCSCs were introduced in Japan in 2006 and 2012, respectively. OBJECTIVE: This study aimed to examine the effect of post-discharge care by conventional or enhanced HCSCs on readmission, compared with general clinics. DESIGN: Retrospective cohort study using the Japanese nationwide health insurance claims database. PARTICIPANTS: Participants were ≥65 years of age, admitted for heart failure and discharged between July 2014 and August 2015 and received a home visit within a month following the discharge (n=12,393). MAIN MEASURES: The exposure was the type of medical facility that provides post-discharge home healthcare: general clinics, conventional HCSCs, and enhanced HCSCs. The primary outcome was all-cause readmission for 6 months after the first visit; the incidence of emergency house calls was a secondary outcome. We used a competing risk regression using the Fine and Gray method, in which death was regarded as a competing event. KEY RESULTS: At 6 months, readmissions were lower in conventional (38%) or enhanced HCSCs (38%) than general clinics (43%). The adjusted subdistribution hazard ratio (sHR) of readmission was 0.87 (95% CI: 0.78-0.96) for conventional and 0.86 (0.78-0.96) for enhanced HCSCs. Emergency house calls increased with conventional (sHR: 1.77, 95% CI:1.57-2.00) and enhanced HCSCs (sHR: 1.93, 95% CI: 1.71-2.17). CONCLUSIONS: Older Japanese patients with heart failure receiving post-discharge home healthcare by conventional or enhanced HCSCs had lower readmission rates, possibly due to compensation with more emergency house calls. Conventional and enhanced HCSCs may be effective in reducing the risk of rehospitalization. Further studies are necessary to confirm the medical functions performed by HCSCs.
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Insuficiência Cardíaca , Serviços de Assistência Domiciliar , Humanos , Readmissão do Paciente , Alta do Paciente , Assistência ao Convalescente , Estudos Retrospectivos , Japão/epidemiologia , Insuficiência Cardíaca/epidemiologia , Insuficiência Cardíaca/terapiaRESUMO
BACKGROUND: Patients experiencing systemic patterns of disadvantage, such as racial/ethnic minorities and those with limited English proficiency, are underrepresented in research. This is particularly true for large pragmatic trials of potentially sensitive research topics, such as advance care planning (ACP). It is unclear how phone outreach may affect research participation by underrepresented individuals. OBJECTIVE: To assess the effect of phone outreach, in addition to standard mail survey recruitment, in a population-based ACP pragmatic trial at three academic health systems in California. DESIGN: Retrospective cohort study PATIENTS: Primary care patients with serious illness were mailed a survey in their preferred language. Patients who did not initially respond by mail received up to three reminder phone calls with the option of survey completion by phone. MAIN MEASURES: Effect of phone outreach on survey response rate associated with respondent demographic characteristics (e.g., Social Vulnerability Index [SVI], range 0 (low) to 1 (high)). RESULTS: Across the health systems, 5998 seriously ill patients were mailed surveys. We obtained completed surveys from 1215 patients (20% response rate); 787 (65%) responded after mail alone and 428 (35%) participated only after phone outreach. Patients recruited after phone outreach compared to mail alone were more socially vulnerable (SVI 0.41 v 0.35, P < 0.001), were more likely to report being a racial/ethnic minority (35% v 28%, P = 0.006), and non-English speaking (16% v 10%, P = 0.005). Age and gender did not differ significantly. The inclusion of phone outreach resulted in a sample that better represented the baseline population than mail alone in racial/ethnic minority (28% mail alone, 30% including phone outreach, 36% baseline population), non-English language preference (10%, 12%, 15%, respectively), and SVI (0.35, 0.37, 0.38, respectively). CONCLUSIONS: Phone outreach for a population-based survey in a pragmatic trial concerning a potentially sensitive topic significantly enhanced recruitment of underrepresented seriously ill patients.
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Planejamento Antecipado de Cuidados , Etnicidade , Humanos , Estudos Retrospectivos , Grupos Minoritários , Inquéritos e Questionários , TelefoneRESUMO
Animal vocalisations encode a wide range of biological information about the age, sex, body size, and social status of the emitter. Moreover, vocalisations play a significant role in signalling the identity of the emitter to conspecifics. Recent studies have shown that, in the African penguin (Spheniscus demersus), acoustic cues to individual identity are encoded in the fundamental frequency (F0) and resonance frequencies (formants) of the vocal tract. However, although penguins are known to produce vocalisations where F0 and formants vary among individuals, it remains to be tested whether the receivers can perceive and use such information in the individual recognition process. In this study, using the Habituation-Dishabituation (HD) paradigm, we tested the hypothesis that penguins perceive and respond to a shift of ± 20% (corresponding to the natural inter-individual variation observed in ex-situ colonies) of F0 and formant dispersion (ΔF) of species-specific calls. We found that penguins were more likely to look rapidly and for longer at the source of the sound when F0 and formants of the calls were manipulated, indicating that they could perceive variations of these parameters in the vocal signals. Our findings provide the first experimental evidence that, in the African penguin, listeners can perceive changes in F0 and formants, which can be used by the receiver as potential cues for the individual discrimination of the emitter.
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Spheniscidae , Animais , Vocalização Animal , Especificidade da Espécie , Acústica , SomRESUMO
Heterospecific eavesdropping of alarm information is an anti-predator adaptation in the wild as it improves the monitoring of shared predators and hence provides opportunities to avoid predators. Our current understanding of heterospecific eavesdropping information is based primarily on studies of bird, primate, or ungulate populations in the wild, whereas little is known regarding the ability of domesticated species to respond to alarm signals from wild individuals. Using sound playback experiments, we assessed the behavioral responses of free-range domestic chickens (Gallus gallus domesticus) in Hainan to alarm calls (test playback) and songs (control playback) of wild Japanese tits (Parus minor). The results revealed that free-range domestic chickens showed greater vigilance to the alarm calls of Japanese tits than to the songs of Japanese tits, especially their alarm calls for Siberian chipmunks (Tamias sibiricus). Furthermore, individual-foraging single chickens were significantly more vigilant than those foraging collectively in groups. Our findings suggest that free-range domestic chickens are as capable as wild birds in responding to heterospecific alarm calls and are likely to be able to distinguish between different types of heterospecific alarm calls.
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Passeriformes , Vocalização Animal , Animais , Animais Selvagens , Galinhas , Sciuridae , Vocalização Animal/fisiologiaRESUMO
Alarm signals have evolved to communicate pertinent threats to conspecifics, but heterospecifics may also use alarm calls to obtain social information. In birds, mixed-species flocks are often structured around focal sentinel species, which produce reliable alarm calls that inform eavesdropping heterospecifics about predation risk. Prior research has shown that Neotropical species innately recognize the alarm calls of a Nearctic sentinel species, but it remains unclear how generalizable or consistent such innate signal recognition of alarm-calling species is. We tested for the responses to the alarm calls of a Neotropical sentinel forest bird species, the dusky-throated antshrike (Thamnomanes ardesiacus), by naive resident temperate forest birds across three continents during the winter season. At all three sites, we found that approaches to the Neotropical antshrike alarm calls were similarly frequent to the alarm calls of a local parid sentinel species (positive control), while approaches to the antshrike's songs and to non-threatening columbid calls (negative controls) occurred significantly less often. Although we only tested one sentinel species, our findings indicate that temperate forest birds can recognize and adaptively respond globally to a foreign and unfamiliar tropical alarm call, and suggest that some avian alarm calls transcend phylogenetic histories and individual ecological experiences.
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Passeriformes , Vocalização Animal , Animais , Vocalização Animal/fisiologia , Filogenia , Florestas , Passeriformes/fisiologia , Comportamento PredatórioRESUMO
Donor-derived infections in solid organ transplantation can be prevented by risk stratification of donors based on available information, and inquiries surrounding possible or diagnosed infection are common questions posed to transplant infectious disease subspecialists. This article outlines the five key steps in addressing a donor call from a transplant team in a systematic approach, focusing on donor and recipient-specific factors, transmissibility and treatment of possible infections, and the likelihood of a patient's future organ offers and mortality remaining on the waitlist. These principles are then applied to five donor call cases, in which we review the key takeaway points and supporting literature. These cases can be used as a resource for teaching with trainees.