Spatial and emotional distances in parent-child relationships: Impacts on human capital development in rural Chinese boarding children.

BACKGROUND: The policy of merging remote rural elementary schools into centralized villages has led to the emergence of boarding schools as an essential means of providing compulsory education in rural areas of China. As boarding children reside in schools for extended periods, parents' influence on their human capital development is inevitably specificity. The development of rural boarding children is a serious social issue in China, and parent-child distance plays a crucial role in affecting the development of children's human capital. OBJECTIVE: While previous studies have focused on the relationship between parental absence and the development of human capital in rural boarding children, this study examines the effects of both spatial and emotional distance between parents and children on the human capital of rural boarding children. PARTICIPANTS AND SETTING: A stratified, multi-stage probabilities proportional to size (PPS) sampling method was used, and self-report questionnaires were completed by 2397 rural boarding children (54.2 % males; ages 12 to 18, M = 14.66, SD = 1.30). METHODS: Children's background, family, and school and teacher characteristics were used as control variables. An OLS regression model was used to assess the effects of parent-child spatial and emotional distance on the human capital of rural boarding children, and a CMP-OLS regression model was used to address endogeneity using parents' self-assessed family economic conditions as instrumental variables. RESULTS: Parent-child spatial distance had a significant positive effect (p < 0.05, p < 0.05), and emotional distance had a significant negative effect (p < 0.05, p < 0.01) on the cognitive and non-cognitive abilities development of rural boarding children. Living with grandparents heightened the negative effect on non-cognitive abilities development. CONCLUSIONS: The findings of this study strengthen the link between parent-child distance and rural boarding children and the moderating impact of living with grandparents on the effect of parent-child distance on rural boarding children's human capital providing new insights for promoting the development of rural boarding children. It also highlights the detrimental effects of emotional neglect on rural boarding children's development. This is important for realizing China's rural revitalization strategy and the healthy development of disadvantaged children in rural areas.

The impact of boarding school on student development in primary and secondary schools: a meta-analysis.

As a long-established model of schooling, the boarding system is commonly practiced in countries around the world. Numerous scholars have conducted a great deal of research on the relationship between the boarding school and student development, but the results of the research are quite divergent. In order to clarify the real effects of boarding school on students' development, this study used meta-analysis to quantify 49 (91 effect sizes) experimental or quasi-experimental studies on related topics at home and abroad. The results find that: (1) Overall, boarding school has no significant predictive effect on student development, with a combined effect size of 0.002 (p > 0.05); (2) Specifically, boarding school has a significant positive predictive effect on students' cognitive development (g = 0.248, p < 0.001), a significant negative predictive effect on students' affective and attitudinal development (g = -0.159, p < 0.05), and no significant predictive effect on students' behavioral development (g = -0.115, p > 0.05) and physical development (g = -0.038, p > 0.05); (3) The relationship between the two is moderated by the school stage and the type of boarding school, but not by the instruments; (4) Compared with primary school students, senior high school students and urban boarding students, the negative predictive effect of boarding system on junior middle school students and rural boarding students is more significant. In addition, there are some limitations in the study, such as the limited number of moderator variables included, the results of the study are easily affected by the quality of the included literature, and the dimensionality of the core variable "student development" is not comprehensive enough. In the future, further validation should be conducted through in-depth longitudinal or experimental studies.

Increasing and sustaining discharges by noon - a multi-year process improvement project.

High hospital occupancy degrades emergency department performance by increasing wait times, decreasing patient satisfaction, and increasing patient morbidity and mortality. Late discharges contribute to high hospital occupancy by increasing emergency department (ED) patient length of stay (LOS). We share our experience with increasing and sustaining early discharges at a 650-bed academic medical center in the United States. Our process improvement project followed the Institute of Medicine Model for Improvement of successive Plan‒Do‒Study‒Act cycles. We implemented multiple iterative interventions over 41 months. As a result, the proportion of discharge orders before 10 am increased from 8.7% at baseline to 22.2% (p < 0.001), and the proportion of discharges by noon (DBN) increased from 9.5% to 26.8% (p < 0.001). There was no increase in balancing metrics because of our interventions. RA-LOS (Risk Adjusted Length Of Stay) decreased from 1.16 to 1.09 (p = 0.01), RA-Mortality decreased from 0.65 to 0.61 (p = 0.62) and RA-Readmissions decreased from 0.92 to 0.74 (p < 0.001). Our study provides a roadmap to large academic facilities to increase and sustain the proportion of patients discharged by noon without negatively impacting LOS, 30-day readmissions, and mortality. Continuous performance evaluation, adaptability to changing resources, multidisciplinary engagement, and institutional buy-in were crucial drivers of our success.

Association between Boarding of Frail Individuals in the Emergency Department and Mortality: A Systematic Review.

(1) Background: Older patients who attend emergency departments are frailer than younger patients and are at a high risk of adverse outcomes; (2) Methods: To conduct this systematic review, we adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guidelines. We systematically searched literature from PubMed, Embase, OVID Medline®, Scopus, CINAHL via EBSCOHost, and the Cochrane Library up to May 2023, while for grey literature we used Google Scholar. No time restrictions were applied, and only articles published in English were included. Two independent reviewers assessed the eligibility of the studies and extracted relevant data from the articles that met our predefined inclusion criteria. The Critical Appraisal Skills Program (CASP) was used to assess the quality of the studies; (3) Results: Evidence indicates that prolonged boarding of frail individuals in crowded emergency departments (Eds) is associated with adverse outcomes, exacerbation of pre-existing conditions, and increased mortality risk; (4) Conclusions: Our results suggest that frail individuals are at risk of longer ED stays and higher mortality rates. However, the association between the mortality of frail patients and the amount of time a patient spends in exposure to the ED environment has not been fully explored. Further studies are needed to confirm this hypothesis.

Price for waiting: the adverse outcomes of boarding critically ill elderly medical patients in the emergency department.

PURPOSE: Boarding, the period in which a patient spends in the emergency department (ED) before admission, may be hazardous to critically ill patients, particularly the elderly. This study investigated the associations of boarding with hospital course, prognosis, and medical expenditure in older patients. METHODS: From January 2019 to December 2021, the medical records of older patients (age ≥ 65) visiting the ED of a tertiary referral hospital who were admitted to the medical intensive care unit (ICU) were retrospectively reviewed. Eligible patients were categorized into two groups according to boarding time with a cutoff set at 6 h. Primary outcomes were in-hospital mortality, ICU/hospital length of stay, and total/average hospitalization cost. Subgroup analyses considered age and disease type. RESULTS: Among 1318 ICU admissions from the ED, 36% were subjected to boarding for over 6 h. Prolonged boarding had a longer ICU (8.9 ± 8.8 vs. 11.2 ± 12.2 days, P < .001) and hospital (17.8 ± 20.1 vs. 22.8 ± 23.0 days, P < .001) stay, higher treatment cost (10.4 ± 13.9 vs. 13.2 ± 16.5 thousands of USD, P = .001), and hospital mortality (19% vs. 25% P = .020). Multivariate regression analysis showed a longer ICU stay in patients aged 65-79 (8.3 ± 8.4 vs. 11.8 ± 14.2 days, P < .001) and cardiology patients (6.9 ± 8.4 vs. 8.8 ± 9.7 days, P = .001). Besides, the treatment cost was also higher for both groups (10.4 ± 14.6 vs. 13.7 ± 17.7 thousands of USD, P = .004 and 8.4 ± 14.0 vs. 11.7 ± 16.6 thousands of USD, P < .001, respectively). CONCLUSION: Extended ED boarding for critically ill medical patients over 65 years old was associated with negative outcomes, including longer ICU/hospital stays, higher treatment costs, and hospital mortality.

Gaps and Opportunities for Strengthening In-School Support for Youth Living With HIV.

OBJECTIVES: With optimized antiretroviral treatment youth living with HIV (YLH) now spend most of their time in schools, making schools an important venue to optimize outcomes. We evaluated school support for YLH. METHODS: We conducted surveys with public secondary/high schools in 3 Kenyan counties (Nairobi, Homa Bay, and Kajiado) to determine policies and training related to HIV. Chi-squared tests and Poisson regression were used to compare policy availability and staff training by county HIV prevalence and school type. RESULTS: Of 512 schools in the 3 counties, we surveyed 100. The majority (60%) of schools surveyed had boarding facilities. The median student population was 406 (IQR: 200, 775). Only half (49%) of schools had medication use policies; more in boarding than day schools (65% vs 30%, p = .003). While most schools (82%) had clinic attendance policies; policy availability was higher in higher HIV prevalence counties (Homa Bay [100%], Nairobi [82%], Kajiado [56%], p < .05). Overall, 64% had confidentiality policies with higher policy availability in higher HIV prevalence regions (p < .05). Few schools had staff trained in HIV-related topics: HIV prevention (37%), HIV treatment (18%), HIV stigma reduction (36%). Few were trained in confidentiality (41%), psychosocial support (40%), or mental health (26%). Compared to day schools, boarding school were more likely to have staff trained in HIV prevention (prevalence ratio: 2.1 [95% confidence interval 1.0, 4.0], p = .037). CONCLUSION: In this survey of Kenyan schools, there were notable gaps in HIV care policy availability and training, despite high HIV burden. Development and implementation of national school HIV policies and staff training as well as strengthening clinic and family support may improve outcomes for YLH.

Characteristics and patient impact of boarding in the pediatric emergency department, 2018-2022.

OBJECTIVES: Boarding admitted patients in the emergency department is an important cause of throughput delays and safety risks in adults, though has been less studied in children. We assessed changes in boarding in a pediatric ED (PED) from 2018 to 2022 and modeled associations between boarding and select quality metrics. METHODS: We performed a retrospective analysis of PED patients admitted to non-psychiatric services, broken into four periods: pre-COVID-19 (Period I, 01/2018-02/2020), early pandemic (II, 03/2020-06/2021), COVID-19 variants (III, 07/2021-06/2022), and non-COVID respiratory viruses (IV, 07/2022-12/2022). Patients were classified as critical (intensive care units (ICU)) or acute care (non-ICU inpatient services) based on their initial bed request. We compared median boarding times with Kruskal-Wallis tests. We assessed the relationship between boarding time and hospital length-of-stay (LOS) through hazard regression models, and the association between boarding time and PED return visit, readmission, and patient safety events through adjusted logistic regressions. RESULTS: Median PED boarding time significantly increased from Period I (acute: 2.4 h; critical: 3.0 h) to Period II (acute: 3.0 h, critical: 4.0 h) to Period III (acute: 4.4 h, critical: 6.6 h) to Period IV (acute: 6.2 h; critical: 9.5 h). On survival analysis, as boarding time increased, hospital LOS increased for acute admissions and decreased for critical admissions. Increased acute care boarding time was associated with higher odds of a filed safety report. CONCLUSIONS: Since July 2021, PED boarding time increased for admitted children across acute and critical admissions. The relationship between acute care boarding and longer hospital LOS suggests a resource-inefficient, self-perpetuating cycle that demands multi-disciplinary solutions.

An initiative to reduce psychiatric boarding in a Cape Town emergency department.

Background: Psychiatric boarding in Emergency Departments (ED) is a global challenge which results in long ED length of stays (LOS) with significant consequences on patient care and staff safety. Aim: This study investigated the impact of an initiative to reduce psychiatric boarding on LOS and readmission rate, as well as explored the relationship between boarding times and LOS. Setting: This study was conducted at Mitchells Plain Hospital, a large district-level hospital in Cape Town. Methods: This cross-sectional study collected data for 24 months, which included a 9-month period prior to the initiative and 16 months thereafter. Data were collected retrospectively from official electronic patient registries. The initiative comprised of inpatient hallway boarding as a full-capacity protocol with the accompanying capacitation of psychiatric wards to accommodate the additional burden. Results: The initiative was associated with a decrease of 95% (p < 0.001) in boarding time, 13% (p < 0.001) in ward LOS and 25% (p < 0.001) in hospital LOS. Ward LOS were found to be independent of ED boarding times. The readmission rate increased from 12% to 18% post intervention. Conclusion: The initiative resulted in a sustainable improvement in boarding times and LOSs. The observational nature of this study precludes concrete conclusions and further investigations into psychiatric inpatient hallway boarding are recommended. Contribution: Inpatient hallway boarding could be a feasible option to reduce the risk. Psychiatric boarding times in the ED are independent of ward LOS, rendering it devoid from any value from a lean and economic perspective.

Missão na Terra das Árvores Tortas: An RPG on the Brazilian Savanna / Missão na Terra das Árvores Tortas: Um jogo de RPG sobre o Cerrado

We created a role-playing game (RPG) about Cerrado, the Brazilian savanna, in order to translate scientific knowledge to the general public and to contribute to environmental education in schools. With this game, we aimed to disseminate knowledge about Cerrado native plant and animal species and the biome phytophysiognomies. The RPG quest involves seed dispersal by animals, thus showing the interdependence between flora and fauna. Moreover, by presenting as fictional characters the big mammals of Cerrado, we expect that the participants experience the threats faced by these animals due to anthropogenic actions. The use of the RPG is an active methodology that mobilizes competences and skills from National Common Curricular Basis (BNCC). In a case study, we report the use of the game in high school classes at a Full-Time State School (CEPI) in the state of Goiás, Brazil, which is a public school in the Cerrado region. The students actively participated in the game, including students with special needs and students that usually do not participate in classes that use traditional teaching methods. Students made positive comments about the game, and were interested in learning more about Cerrado species. We conclude that the Cerrado RPG can be used as an efficient teaching tool.

Diante do desafio de traduzir o conhecimento científico para uma linguagem acessível ao público leigo e de contribuir para a educação ambiental nas escolas, elaboramos um jogo de tabuleiro no formato role-playing game (RPG) sobre o bioma Cerrado. Com esse jogo, objetivamos difundir o conhecimento sobre espécies nativas de plantas e animais do Cerrado e as fitofisionomias do bioma. A missão do jogo envolve a dispersão de sementes por animais e mostra a interdependência entre flora e fauna. Além disso, ao apresentar como personagens fictícios os grandes mamíferos do Cerrado, visamos que os participantes vivenciem as ameaças enfrentadas pela fauna devido a ações antrópicas. O jogo consiste em uma metodologia ativa que mobiliza competências e habilidades da Base Nacional Comum Curricular (BNCC) e está disponibilizado em um formato pronto para ser jogado. Apresentamos um relato de experiência, no qual descrevemos a utilização do jogo em turmas de Ensino Médio em um Centro de Ensino em Período Integral (CEPI) em Goiás, uma escola pública na região do Cerrado. As turmas participaram ativamente do jogo, incluindo estudantes com necessidades especiais e estudantes que não costumam participar de aulas que utilizam métodos tradicionais de ensino. Os estudantes afirmaram terem gostado de jogar e fizeram comentários positivos sobre o jogo, além de demonstrarem interesse em aprender mais sobre plantas e animais do Cerrado. Concluímos que o jogo de RPG do Cerrado pode ser utilizado como uma eficiente ferramenta de ensino.

Transition of care from the emergency department to skilled nursing facility: Retrospective case-control study.

Objective: The primary objective of this study is to describe associations between emergency department (ED)-to-skilled nursing facility (SNF) transition and ED length-of-stay (LOS). The secondary objective is to explore how social determinants of health (SDOH) influence ED-to-SNF transition visit parameters. In 2020, The Centers for Medicare & Medicaid Services issued the "COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers" eliminating the requirement of a 3-day qualifying hospital stay before SNF placement. The waiver allowed ED patients to be transitioned directly to an SNF from the ED. Methods: We conducted a descriptive retrospective case-control study of adult patients who sought care in the University of North Carolina Hospitals (UNCH) ED between March 1, 2020, and March 1, 2022, lived in a non-SNF residence before their ED visit, and were transitioned directly to an SNF from the ED (n 1 = 27), compared with a group seen in the ED and admitted to hospital for SNF placement (n 2 = 54). Results: The ED-to-SNF group experienced a significantly longer ED LOS compared to the ED-to-Inpatient-to-SNF group: 72.8 hours (95% confidence interval [CI], 59.2-86.4) compared to 14.5 hours (95% CI, 12.1-16.9). We found no significant differences in SDOH between the ED-to-SNF group and the ED-to-Inpatient-to-SNF group. Conclusion: Patients who transition from the ED to an SNF experience long ED stays that may adversely affect health and well-being. Transitioning directly from the ED to an SNF may contribute to ED boarding and overcrowding.

Impact of emergency department-based intensive care unit on outcomes of decompensating boarding emergency department patients.

Objectives: Emergency department (ED) boarding, or remaining in the ED after admission before transfer to an inpatient bed, is prevalent. Boarding patients may decompensate before inpatient transfer, necessitating escalation to the intensive care unit (ICU). We evaluated the impact of an ED-ICU on decompensating boarding ED patients. Methods: This is a retrospective single-center observational study. We identified decompensated boarding ED patients necessitating critical care before departure from the ED from October 2012 to December 2021. An automated query and manual chart review extracted data. Three cohorts were defined: pre-ED-ICU implementation (Group 1), post-ED-ICU implementation with ED-ICU care (Group 2), and post-ED-ICU implementation with inpatient ICU admission without ED-ICU care (Group 3). Primary outcome was ICU length of stay (LOS). Secondary outcomes included hospital LOS, in-hospital mortality, and ICU admissions with ICU LOS <24 hours. Between-groups comparisons used multiple regression analysis for continuous variables, χ2 tests and multivariable logistic regression analysis for binary variables, and follow-up contrasts for statistically significant omnibus tests. Results: A total of 1123 visits met inclusion criteria: 225 in Group 1, 780 in Group 2, and 118 in Group 3. Mean ICU LOS was shorter for Group 2 than Group 1 or 3 (47.4 vs 92.3 vs 103.9 hours, P < 0.001). Mean hospital LOS was shorter for Group 2 than Group 1 or 3 (185.1 vs 246.8 vs 257.3 hours, P < 0.01). In-hospital mortality was similar between groups. The proportion of ICU LOS <24 hours was lower for Group 2 than Group 1 or 3 (16.5 vs 27.1 vs 32.2%, P < 0.01). Conclusion: For decompensating boarding ED patients, ED-ICU care was associated with decreased ICU and hospital LOS, similar mortality, and fewer short-stay ICU admissions, suggesting ED-ICU care is associated with downstream resource preservation.

The impact of boarding schools on the development of cognitive and non-cognitive abilities in adolescents.

BACKGROUND: Since China adopted a policy to eliminate rural learning centers, boarding has become an important feature of the current rural student community. However, there is a lack of consensus on the impact of boarding schools on students' cognitive and non-cognitive development. This study investigates the effect of boarding schools on the development of cognitive and non-cognitive abilities of junior high school students in rural northwest China. METHODS: Using a sample of 5,660 seventh-grade students from 160 rural junior high schools across 19 counties, we identify a causal relationship between boarding and student abilities with the instrumental variables (IV) approach. RESULTS: The results suggest that boarding positively influences memory and attention, while it has no significant effect on other cognitive abilities such as reasoning, transcription speed, and accuracy. Furthermore, we find no significant association between boarding and the development of non-cognitive skills. CONCLUSIONS: Given the widespread prevalence of boarding schools in rural regions, our study highlights the growing importance of improving school management to promote the development of students' cognitive abilities and integrating the development of non-cognitive or social-emotional abilities into students' daily routines.

An exploration of ex-boarding school adults' attachment styles and substance use behaviours.

Our study examines the relationship between boarding school attendance, adult attachment styles, parental bonding, and substance use, aiming was to quantitatively investigate if caregiver deprivation caused by boarding contributes to enduring outcomes in adults. In a sample of 149 adults, measures included AUDIT and DUDIT (substance use), Parental Bonding Instrument (parental care), and Experiences in Close Relationships (adult attachment). Pearson's correlation revealed a significant negative association between age at first boarding and anxiety, avoidant attachment styles, and poorer parental care, whilst a significant positive relationship was identified between age at first boarding and perceived parental care. This was supported by a hierarchical regression which demonstrated that the model predicted 29% of the variance in age at first boarding. These results contribute towards the formulation and treatment of ex-boarders and to research considering the effects of boarding school experiences on difficulties in adult life.

Hospitalization patterns for adolescents with eating disorders during COVID-19.

PURPOSE: The purpose of this study was to examine differences in clinical characteristics and hospital length of stay (LOS) for adolescents with eating disorders (EDs) requiring medical stabilization during the pre-COVID-19 and COVID-19 time periods. METHODS: Medical record data were abstracted for patients with EDs hospitalized for medical stabilization between 1/1/2019-2/29/2020 (pre-COVID-19) and 3/1/2020-12/31/2021 (during COVID-19). Patient demographics, clinical characteristics and LOS were compared between COVID-19 eras. Patients were categorized as boarding if they remained hospitalized ≥ 1 day after medical stabilization. Multivariate negative binomial linear regression models were performed to determine incidence rate ratios (IRR) and 95% confidence intervals (95% CI) for factors related to increased LOS. RESULTS: Of the 467 admissions during this study, 120 were pre-COVID-19 and 347 were during COVID-19. Monthly admissions for EDs were higher during COVID-19 versus pre-COVID-19 (15.8 vs. 8.6, p = 0.001). On multivariate analysis, factors associated with increased LOS included admission during COVID-19 (IRR 1.27, 95% CI 1.15-1.40), p = 0.001), boarding (IRR 1.77, 95% CI 1.63-1.93, p = 0.001), public insurance (IRR 1.12, 95% CI 1.01-1.23, p = 0.032), nasogastric tube usage (IRR 1.62, 95% CI 1.48-1.76, p = 0.001), heart rate < 40 beats per minute (IRR 1.21, 95% CI 1.11-1.33, p = 0.001) and abnormal electrocardiogram (IRR 1.25, 95% CI 1.14-1.37, p = 0.001). CONCLUSION: In addition to clinical factors, we found that admission during COVID-19, boarding, and public insurance were associated with increased LOS among patients with EDs. There is a need for greater availability of ED treatment centers to care for patients with EDs after medical stabilization.

The COVID-19 pandemic has had a profound effect on the mental health of young people worldwide. This public health crisis has led to a significant increase in individuals seeking care for an eating disorder. In the United States, hospital admissions for adolescents with eating disorders requiring medical stabilization increased significantly during the COVID-19 pandemic. This study examines differences in the demographic and clinical characteristics of patients with an eating disorder hospitalized pre-COVID-19 and during the COVID-19 pandemic in one pediatric hospital in the United States. We found a significant increase in hospital admissions during the pandemic as well as longer hospital stays. Factors associated with prolonged hospitalizations include those patients with public insurance (Medicaid), nasogastric tube for delivery of nutrition, and low heart rate. We found no difference in demographic factors such as age, gender, and insurance as well as degree of malnutrition and medical severity between the two time periods. The shortage of appropriate eating disorder treatment options upon hospital discharge were especially challenging during the COVID-19 pandemic.

Social Support, Religiosity, Wisdom and Well-Being Among Older Adults in Indonesia.

Purpose: As the population ages, it is critical to understand the elements that contribute to the well-being of older individuals. Prior research suggests that a better sense of mastery and purpose in life may explain at least some of the beneficial link between wisdom, religion, and subjective well-being. This current study seeks to identify a model of older persons' psychological well-being formation in a religious group. Whether psychosocial strengths such as religiosity, social support, and wisdom are directly related to psychological well-being. Self-acceptance, autonomy, positive interpersonal relationships, environmental mastery, personal growth, and a sense of life purpose are all components of psychological well-being. Participants and Methods: This cross-sectional study included 261 participants, 42 men and 219 women aged 60 and up with normal cognitive, hearing, and/or speech functions. Participants lived in The boarding house in South Tapanuli-North Sumatra, Indonesia, for over 6 months. A backward translated Likert scales is used for data collection. The data were analyzed using Structural Equation Model (SEM). Results: The results indicate that social support and religiosity have an effect on psychological well-being through wisdom as a mediator. Conclusion: These findings emphasize the relevance of internal strengths for psychological well-being and give credence to the mediated path model's applicability to older adult communities in Indonesia.

Dataset for developing optimal headway-based bus dispatching strategy during epidemic outbreaks.

This article presents the data utilized in a study focused on identifying an optimal bus dispatching strategy in light of epidemic impacts. The study specifically examines the Xi'an Xiaozhai central business district (CBD) street network, which consists of 33 major signalized intersections and 112 bus stops associated with 12 bus routes. The dataset includes details of intersection and bus stop geospatial data, street segment and intersection design, intersection signal timing plans, bus route operational properties such as dispatching frequencies, fleet sizes, loading bay capacities, and bus-specific parameters. It also encompasses data on passenger boarding and alighting counts, as well as travelers' origin and destination (O-D) locations, routes, and departure times during three time periods: 10:00-11:00 PM, 1:00-2:00 PM, and 7:00-8:00 PM on Monday, June 7, 2021. These times represent off-peak (10:00 PM-1:00 AM the next day), adjacent-to-peak (9:00-11:00 AM, 1:00-4:00 PM, and 8:00-10:00 PM), and peak (7:00-9:00 AM, 11:00 AM-1:00 PM, and 4:00-8:00 PM) periods, respectively. Data collection involves searching government and organizational records, utilizing Alibaba Cloud's Amap platform, conducting onsite measurements, and performing a field survey. The dataset is a valuable resource for studying the integrated operations of various urban mass transit services, including buses, bus rapid transit (BRT), and fixed guideway transit, under both normal and epidemic-affected travel conditions. Additionally, it can be used to investigate multimodal integrated urban passenger services offered by automobiles, transit, ridesharing, and active transportation modes.

Evaluating the Patient Boarding during Omicron Surge in Hong Kong: Time Series Analysis.

The fifth wave of COVID-19 outbreaks in Hong Kong (HK) from January to March 2022 has the highest confirmed cases and deaths compared with previous waves. Severe hospital boarding (to inpatient wards) was noted in various Emergency Departments (EDs). Our objective is to identify factors associated with hospital boarding during Omicron surge in HK. We conducted a retrospective cohort study including all ED visits and inpatient (IP) ward admissions from January 1st to March 31st, 2022. Vector Autoregression model evaluated the effects of a single variable on the targeted hospital boarding variables. Admissions from elderly homes with 6 lag days held the highest positive value of statistical significance (t-stat = 2.827, P < .05) caused prolonged admission waiting time, while medical patients with 4 lag days had the highest statistical significance (t-stat = 2.530, P < .05) caused an increased number of boarding patients. Within one week after impulses, medical occupancy's influence on the waiting time varied from 0.289 on the 1st day to -0.315 on the 7th day. While occupancy of medical wards always positively affected blocked number of patients, and its response was maximized at 0.309 on the 2nd day. Number of confirmed COVID-19 cases was not the sole significant contributor, while occupancy of medical wards was still a critical factor associated with patient boarding. Increasing ward capacity and controlling occupancy were suggested during the outbreak. Moreover, streamlining elderly patients in ED could be an approach to relieve pressure on the healthcare system.

The Mediating Role of Precepts and Meditation on Attachment and Depressive Symptoms in Adolescents.

Research shows that Buddhist precept adherence (i.e., abstaining from killing, stealing, sexual misconduct, lying, and intoxicant use) and meditation practice influence mental health outcomes. This study investigated how Buddhist precept adherence and meditation practice influenced the relationship between insecure attachment and depressive symptoms among Thai adolescents. A total of 453 Thai boarding-school students from 10th-12th grade were recruited from five boarding schools (two purposively selected Buddhist schools and three conveniently selected secular schools). They completed these tools: Experiences in Close Relationships Questionnaire-revised-18, Outcome-Inventory-21: Depression Subscale, Precept Practice Questionnaire, and Inner-Strength-Based Inventory: Meditation. A parallel mediation model analyzed the indirect effects of attachment anxiety and attachment avoidance on depression through precept adherence and meditation practice. The participants' demographics were 16.35 ± 0.96 years, 88% female, and 89.4% Buddhist. The mean scores for attachment anxiety were 2.7 ± 1.1; attachment avoidance, 2.78 ± 1.2; overall regular precept adherence, 20.1 ± 4.4; regular but not daily meditation, 2.94 ± 1.3; and low depressive symptoms, 3.75 ± 3.4. The standardized indirect effects for attachment anxiety (ß = 0.042, 95% CI = 0.022, 0.070) and avoidance (ß = 0.024, 95% CI = 0.009, 0.046) on depressive symptoms through meditation and precept adherence were significant. Meditation practice had a significantly higher indirect effect size than precept adherence.

The Association between Emergency Department Length of Stay and In-Hospital Mortality in Older Patients Using Machine Learning: An Observational Cohort Study.

The association between emergency department (ED) length of stay (EDLOS) with in-hospital mortality (IHM) in older patients remains unclear. This retrospective study aims to delineate the relationship between EDLOS and IHM in elderly patients. From the ED patients (n = 383,586) who visited an urban academic tertiary care medical center from January 2010 to December 2016, 78,478 older patients (age ≥60 years) were identified and stratified into three age subgroups: 60-74 (early elderly), 75-89 (late elderly), and ≥90 years (longevous elderly). We applied multiple machine learning approaches to identify the risk correlation trends between EDLOS and IHM, as well as boarding time (BT) and IHM. The incidence of IHM increased with age: 60-74 (2.7%), 75-89 (4.5%), and ≥90 years (6.3%). The best area under the receiver operating characteristic curve was obtained by Light Gradient Boosting Machine model for age groups 60-74, 75-89, and ≥90 years, which were 0.892 (95% CI, 0.870-0.916), 0.886 (95% CI, 0.861-0.911), and 0.838 (95% CI, 0.782-0.887), respectively. Our study showed that EDLOS and BT were statistically correlated with IHM (p < 0.001), and a significantly higher risk of IHM was found in low EDLOS and high BT. The flagged rate of quality assurance issues was higher in lower EDLOS ≤1 h (9.96%) vs. higher EDLOS 7 h