Notes

Accounting for not-at-random missingness by way of imputation stacking.
There is a stark contrast between rising long-term care (LTC) demands and limited financing capacity in many ageing societies. Despite the theoretical potential of private insurance in LTC financing reforms, the reality is that the market remains remarkably underdeveloped. This study adopts a novel two-phase approach to quantitatively examine the market demand for private long-term care insurance (LTCI) in Hong Kong, one of the world's super-ageing societies. In order to examine people's preferences regarding private LTCI in Hong Kong, which has been exploring alternative LTC financing mechanisms to relieve the overburdened public system, we conducted a discrete choice experiment (DCE) in 2019 to elicit the preferences of a representative sample of 410 middle-aged adults. At first, we used data from the US National Longterm Care Survey to perform an actuarial projection for Hong Kong. In the first phase, we computed the indicative premiums based on various attributes of hypothetical private LTCI products. Undertaken in the second phase and using two econometric techniques, the DCE suggested that the most preferred hypothetical LTCI product in Hong Kong was associated with the following features 1) a monthly benefit level of HK$20,000 or HK$25,000, 2) 3% inflation protection, and 3) 15 years of contribution. These attributes led to a monthly premium of HK$1237 (US$160)/HK$1546 (US$200) for men and HK$2150 (US$278)/HK$2687 (US$348) for women. Furthermore, we also found that the preference for LTCI products varied across people with different socioeconomic and health characteristics. These insights could inform initial market segmentation, LTCI product design, and targeted marketing in the future. This paper concludes with cautious optimism regarding the market demand for private LTCI in Hong Kong, and recommends concrete policy instruments to nurture the LTCI market, including information campaign, premium subsidies, and tax benefits.
Total joint arthroplasty is one of the most commonly performed orthopaedic procedures globally. Telerehabilitation has recently been used as a supplement or an alternative to face-to-face rehabilitation services among patients after total joint arthroplasty.

To synthesise the evidence on the effectiveness of internet-based telerehabilitation regarding pain relief, range of motion, physical function, health-related quality of life, self-efficacy, psychological well-being/problems, and satisfaction among patients after total joint arthroplasty.

An integrative review was conducted using defined search periods, databases, and search terms. This review adopted a five-stage approach problem identification, literature search, data evaluation, data analysis and presentation. Studies published in English and Chinese were included. The Mixed Methods Appraisal Tool was used to assess the quality of included studies.

Twenty-two eligible studies with 1,179 participants were included in this review. Nineteen of theapists and surgeons as a team. The mobile app is an accessible and flexible delivery medium for telerehabilitation. Robust randomised controlled trials are warranted to enhance the quality of evidence on the effectiveness of mobile app-based telerehabilitation and nurse-delivered program. Qualitative components are suggested to be included in future research. Psychological outcomes should also be measured.
Internet-based telerehabilitation appears to be effective for and accepted by patients after total joint arthroplasty. Telerehabilitation could be delivered by nurses in collaboration with physiotherapists and surgeons as a team. The mobile app is an accessible and flexible delivery medium for telerehabilitation. Robust randomised controlled trials are warranted to enhance the quality of evidence on the effectiveness of mobile app-based telerehabilitation and nurse-delivered program. Qualitative components are suggested to be included in future research. Psychological outcomes should also be measured.
Systematic use of pain intensity scales is considered a prerequisite for treatment of pain in hospitalized children, but already a decade ago, attention was called to the lack of robust evidence supporting the presumed positive association between their use and desired outcomes.

To re-evaluate the evidence supporting the association between the use of pain scales and patient and process outcomes in hospitalized children.

Systematic literature review.

The online databases PubMed and Cumulative Index of Nursing and Allied Health Literature (CINAHL) were searched from inception to April 15, 2020.

We performed single screening of all records followed by duplicate screening of full texts of interest with a disagreement procedure in place. Studies where the authors evaluated outcomes from the use of self-report or behavioral-based pain scales in children 0-18 years in a hospital setting were included. Emergency care settings were excluded.

In a majority of the 32 included studies, complex interventions that are meaningful for the child (for example reduced pain intensity or improved function) are urgently needed. Tweetable abstract Limited #research supports association between use of pediatric #pain scales and patient outcomes @_randida @PainPearl.Insanity assessment requires the evaluation of the psychopathological condition that underlies the mens rea. Psychopathological evaluation may be quite challenging due to (i) absence of biomarkers; (ii) low inter-rater reliability; (iii) presence of cognitive bias. This intrinsic low reliability of forensic psychiatric diagnosis does impact on insanity assessment, leading to arbitrary and unjust legal outcomes for the examinee. Thus, strategies to improve the reliability of insanity evaluation are strongly needed. A multidisciplinary approach has been proposed as a way to enrich clinical diagnosis with reliable and biologically founded data, thus minimizing subjectivity, reducing controversies and increasing inter-subject concordance in insanity assessment. By discussing a real case, here we show how the convergence of multiple indices can produce evidence that cannot be denied without introducing logical fallacies. Buparlisib concentration Applying this approach, the forensic discussion will move from the presence/absence of psychopathology to the impact of psychopathology on insanity. This article illustrates how a multidisciplinary evaluation, which integrates neuroscientific methods with the classical insanity assessment, may lead to a more accurate approach in insanity evaluation. Critically, this approach will minimize the impact of cognitive bias on insanity opinion and thus result in an improvement of the whole criminal justice process.The age estimation of the hand bones by means of X-ray examination is a pillar of the forensic age estimation. Since the associated radiation exposure is controversial, the search for ionizing radiation-free alternatives such as MRI is part of forensic research. The aim of the current study was to use the Greulich-Pyle (GP) atlas on MR images of the hand and wrist to provide reference values for assessing the age of the hand bones. 3T hand MR images of 238 male participants between the ages of 13 and 21 were acquired using 3D gradient echo sequences (VIBE, DESS). Two readers rated the images using the X-ray-based GP atlas method. A descriptive analysis and a transitional analysis were used for the statistical processing of the data. The agreement between and within the raters was assessed. In addition, a comparison was made with the chronological age and with X-ray studies. The descriptive analysis and the transition analysis showed similar results. Both evaluations showed good agreement with X-ray studies. The comparison with the chronological age showed a difference of 0.37 and 0.54 years for the two readers. The age estimate based on the cross-validated transition analysis showed a mean error of -0.28 years. Inter- and intra-rater agreement were good. In summary, it can be concluded that age estimation of hand bones with MR images is routinely applicable with the GP atlas as an alternative without ionizing radiation. However, in order to reduce the estimation error, a multi-factorial assessment based on examinations of several body regions is still recommended.The first Geneva Conventions were signed in 1864 and this initial effort to put humanity in war has since developed into a network of international conventions and customary rules which include the dead as a group that must be protected during and following armed conflicts. During the First and Second World Wars, parties to the conflict were obliged to recover the dead from battlefields, document identifying marks including the collection of identification discs, and to bury the body in a marked grave. Those parties' signatory to the laws regulating war at the time, could not have predicted the millions of losses of civilians and combatants resulting in the thousands of casualties left unrecovered at the end of both world wars. The prolonged requirement to recover, identify and bury newly-found World War dead is managed differently by each country; albeit with no universal approach that acknowledges the need to integrate the moral imperative of dignified post-war care of the dead with rapidly changing technology and equally rapidly ageing of families of the missing. The International Committee of the Red Cross is a longtime actor in providing humanitarian service to soldiers and civilians in war. This includes expertise in the legal framework regulating armed conflict, in the provision of a central system to aid in tracing those who go missing during war, including those from the world wars, and in the growing field of humanitarian forensics. This paper will discuss the applicable international frameworks for the protection world war dead, while promoting the ICRC's role as resource and advocate.Screening of seized cocaine powders is routinely performed by means of colour tests. An alternative fast screening technique is Mid-InfraRed (MIR) spectroscopy. In the context of smuggling cases, however, drugs are often processed to circumvent detection. In this study, the current screening techniques (cocaine colour test and MIR spectroscopy using libraries and chemometrics) were applied to five smuggling cases. For each case, all samples were first screened with a cocaine colour test and MIR analysis, followed by confirmation analyses with GC-MS and GC-FID to identify and quantify cocaine and cutting agents. Finally, Scanning Electron Microscopy-Energy Dispersive X-ray spectroscopy (SEM-EDX) analyses were performed for additional characterization. All smuggling samples tested negative, both on-site as in the laboratory, for cocaine with the cocaine colour test. Four smuggling cases consisted of coloured samples. Consequently the colour test result was influenced because discolouration of the test showed alur test and/or MIR spectroscopy. It can be concluded that the outcome of screening techniques such as colour tests and MIR spectroscopy is only presumptive and should always be confirmed.Post-mortem swabs for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) RNA detection have been recommended by several Scientific Committees and Institutions as a standard procedure for post-mortem assessment of potential Coronavirus Disease-19 (COVID-19) related deaths. To date there is no data about the SARS-CoV-2 RNA detectability period in human bodies after death. The present case documents the persistence of SARS-CoV-2 RNA in the upper respiratory tract 35-days after death. Post-mortem swabs could be used as a valuable tool in preventive evaluation of the risks-benefits ratio associated with autopsy execution. SARS-CoV-2 RNA post-mortem detection could have a key diagnostic role in deaths lacking medical assistance, unattended deaths, and patients with multiple comorbidities. Based on the present report, staged post-mortem swabs should be performed even after a long post-mortem interval.
Website: https://www.selleckchem.com/products/BKM-120.html