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The absence of accepted crowding measurement tools that encompass the unique characteristics of pediatric emergency departments (EDs) creates a deficit in advancing efforts to identify and evaluate solutions for this growing problem. In this systematic review, we examined 4 studies that reported on the development and testing of multidimensional pediatric ED crowding measurements. Two investigations involved models (PEDOCS, SOTU-PED) that measured factors indicative or contributory to crowding. this website A third investigation developed a model mapping the flow of patients through the pediatric ED. The final study modeled the magnitude of physician's work load, particularly when this load is high when crowding is likely present, based on patient arrivals, presenting complaints and conditions, and tests ordered. These works from 4 studies on measuring crowding in pediatric EDs show promise, but this field is at an early stage. Future work should concentrate on comparing the utility of crowding measurements across multiple pediatric ED settings.The research aimed at studying the mother's social-hygienic and medical biological risk factors and determining their predictive value. The retrospective case-control study was conducted with 142 pregnant women participating in it. In the case group there were involved 92 mothers whose pregnancy was completed by the birth of a newborn baby suffering from the intrauterine growth restriction. The control group was made of 50 pregnant women, whose pregnancy was completed by the birth of a healthy neonate. The research resulted in specifying the risk factors of high priority the low standards of living (OR 3.61), chronic stress (OR-3.06), sleeping disorder (OR-3.33) and poor nutrition (OR-3.81). As regards the coexisting pathology the following was revealed endocrine pathology (OR-3.27), ischemic heart disease (OR-4.35), arterial hypertension (OR-6.47), iron deficiency anemia (OR-4.11), pathology of respiratory system (OR-3.42), chronic genital inflammatory and infectious processes. The preeclampsia (92%) and low amniotic fluid (89%) were detected to have the high predictive value. The awareness of risk factors allows us to employ the timely measures for the reduction of negative impact on the fetus and neonate.Background Large disparities exist in congenital musculoskeletal disease burden worldwide. The purpose of this study is to examine and quantify the health and economic disparities of congenital musculoskeletal disease by country income level from 1992 to 2017. Methods The Global Burden of Disease database was queried for information on disease burden attributed to "congenital musculoskeletal and limb anomalies" from 1992 to 2017. Gross national income per capita was extracted from the World Bank website. Nonparametric Kruskal-Wallis tests were used to compare morbidity and mortality across years and income levels. The number of avertable DALYs was converted to an economic disparity using the human-capital and value of a statistical life approach. Results From 1992 to 2017, a significant decrease in deaths/100 000 was observed only in upper-middle and high income countries. Northern Africa, the Middle East, and Eastern Europe were disproportionately affected. If the burden of disease in low- and middle- income countries (LMICs) was equivalent to that in high income countries (HICs), 10% of all DALYs and 70% of all deaths attributable to congenital musculoskeletal disease in LMICs could be averted. link2 This equates to an economic disparity of about $2 billion to $3 billion (in 2020 $USD). Conclusion Considerable inequity exists in the burden of congenital musculoskeletal disease worldwide and there has been no change over the last 25 years in total disease burden and geographical distribution. By reducing the disease burden in LMICs to rates found in HICs, a large proportion of the health and economic consequences could be averted.The COVID-19 pandemic has created a pattern of physical distancing worldwide, particularly for adults aged 65+. Such distancing can evoke subjective feelings of negative self-perception of aging (SPA) among older adults, but how this pandemic has influenced such SPA is not yet known. This study, therefore, explored SPA at different time phases of the COVID-19 pandemic to explain the pandemic's impact on SPA among older adults. The analysis employed a sample of 1,990 community-dwelling older adults aged 65 to 95 (mean age = 72.74 years; 43% female) in Switzerland. Data collection from different older adults within one study occurred both before and after Switzerland's first confirmed COVID-19 case. The descriptive analysis revealed that negative SPA increased, and positive SPA decreased, after the Swiss government recommended physical distancing. After the Federal Council decided to ease these measures, negative SPA slightly decreased and positive SPA increased. According to the multivariate analysis, individuals interviewed after the lockdown were more likely to report greater levels of negative SPA and lower levels of positive SPA. Age, income, and living alone also correlated with SPA. The results suggest that the pandemic has affected older adults' subjective views of their own aging, and these findings help illustrate the pandemic's outcomes.Research suggests that different levels of intensity of leisure walking can affect the mental health of older adults. Unfortunately, insufficient evidence exists as to the recommended intensity levels of leisure walking for their health benefits. The purpose of this study was to investigate how leisure walking intensity levels are associated with the mental health and health perceptions of older adults. Using a purposive sampling method, the data of 4,737 adults over the age of 65 were drawn from the 2017 California Health and Interview Survey. The results of analysis of these data showed that older adults who engaged in moderate and vigorous leisure walking reported higher health perceptions than those involved in light leisure walking. In addition, older adults who participated in moderate leisure walking reported higher mental health than those who engaged in light leisure walking. This study suggests that moderate and/or vigorous leisure walking can increase the mental health and health perceptions of older adults.The purpose of this study is to develop candidate common data element (CDE) items related to clinical staff training in long-term care (LTC) homes that can be used to enable international comparative research. This paper is part of the WE-THRIVE (Worldwide Elements to Harmonize Research in Long-Term Care Living Environments) group's initiative which aims to improve international academic collaboration. We followed best practices to develop CDEs by conducting a literature review of clinical staff (i.e., Regulated Nurses, Health Care Aides) training measures, and convening a subgroup of WE-THRIVE experts to review the literature review results to develop suitable CDEs. The international expert panel discussed and critically reflected on the current knowledge gaps from the literature review results. The panel proposed three candidate CDEs which focused on the presence of and the measurement of training. These three proposed CDEs seek to facilitate international research as well as assist in policy and decision-making regarding LTC homes worldwide. This study is a critical first step to develop candidate CDE items to measure staff training internationally. link3 Further work is required to get feedback from other researchers about the proposed CDEs, and assess the feasibility of these CDEs in high and low resourced settings.This study explored self-reported changes in caregiving intensity (CI) and caregiver burden (CB) among informal caregivers due to the COVID-19 pandemic overall and by gender. Informal caregivers for someone age 50+ completed a survey via Amazon's MTurk in June 2020. Participants reported changes in CI and CB due to COVID-19 and provided demographic information. Multinomial logistic regression models assessed changes in CI and CB attributed to the COVID-19 pandemic overall and by gender. The sample (n = 835) was 68.5% male and had an average age of 34 years (SD 9.8); 55.7% had increased CI, and 53.1% had increased CB attributed to the pandemic. Increased CB due to COVID-19 was associated with increased CI (OR 5.67, 95% CI 3.92-8.00). Male caregivers with decreased CI due to COVID-19 were nearly seven times as likely as those with no change in CI to have reduced CB due to COVID-19 (OR 6.91, 95% CI 3.29-14.52). Women with decreased CI due to COVID-19 were over eight times as likely to have reduced CB due to COVID (OR 8.30, 95% CI 2.66-25.91). Results indicate that many caregivers experienced increases in CI and CB since the start of the COVID-19 pandemic, and that these changes are complex and vary by gender.The Safe Functional Motion Test (SFM-5) is a five item performance based clinical assessment tool quantifying habitual daily movement that may increase the risk of osteoporosis and fractures. Fractures are a major cause of hospitalization and contributor to increased health care utilization costs. A sample of 1,700 adults, aged 40 and older, from an osteoporosis specialty clinic were evaluated to determine if the initial SFM-5 score had predictive utility for determining inpatient hospitalization at 12, 24, and 36 months post fracture. When adjusted for sex, age, and prior hospitalization, logistic regression analyses indicated that the SFM-5 score significantly predicted inpatient hospitalization within 12 months, 24 months, and 36 months. For every 10 point decrease in the SFM-5 score, the 1 year risk of hospitalization increased by 24%. The SFM-5 is a tool to use when assessing habitual functional movements and hospitalization risk among high-fracture risk adults.This study analyzed the difference between rural and urban older adults in Thailand regarding the relationship between the knowledge and behavior toward the prevention of contracting COVID-19. Path analysis was used to observe if the performance of protective behaviors was affected by the level of knowledge that older people have about the disease. This study used the Impact of COVID-19 on Older Persons in Thailand survey collected across the five regions of the country. Rural residents benefited from community network of village health volunteers who provided information during the pandemic but, they had disadvantages on accessing newer media sources, mainly the internet, for the latest developments on COVID-19. Rural older adults had a higher level of knowledge about COVID-19 than those in urban areas; no difference was observed regarding their behavior to prevent themselves from being infected. The knowledge-behavior gap was viewed as a mechanism of cognitive avoidance because of overwhelming unprecedented information.Caring expression in nursing is rapidly changing to include the use of sophisticated healthcare technologies. Unfortunately, few nurses participate in developing healthcare technologies. The current study aimed to generate a theory of nursing grounded in the phenomenon of nursing technologies creativity in nursing practice. The study design used a constructivist grounded theory. Sixteen Indonesian nurses selected by purposive sampling were interviewed in-depth. Data analysis used constant comparative analysis through Charmaz's coding process. This study generated two core conceptual categories that included technological creativity and drivers for technological development. Five theoretical statements were developed leading to the Technological Creativity as Caring in Nursing Theory. This theory is a middle-range theory that focuses on technological creativity to express caring for patients, nurses, and management in nursing practice.
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