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ture updates anticipated.
A sudden unexpected death has significant negative impacts on patients, family caregivers, and medical staff in hospice/palliative care. This study aimed to clarify the incidence and associated factors of sudden unexpected death according to four definitions in advanced cancer patients.
We performed a prospective cohort study in 23 inpatient hospices/palliative care units in Japan. Advanced cancer patients aged ≥18years who were admitted to inpatient hospices/palliative care units were included. The incidence and associated factors of sudden unexpected death were evaluated in all enrolled patients according to four definitions (a) rapid decline death, defined as a sudden death preceded by functional decline over 1-2days; (b) surprise death, defined if the primary responsible palliative care physician answered "yes" to the question, "Were you surprised by the timing of the death?"; (c) unexpected death, defined as a death that occurred earlier than the physicians had anticipated; and (d) performance status (PS)-defined sudden death, defined as a death that occurred within 1week of functional status assessment with an Australia-modified Karnofsky PS ≥50.
Among 1896 patients, the incidence of rapid decline death was the highest (30-day cumulative incidence 16.8%, 95% CI 14.8-19.0%), followed by surprise death (9.6%, 8.1-11.4%), unexpected death (9.0%, 7.5-10.8%), and PS-defined sudden death (6.4%, 5.2-8.0%). Male sex, liver metastasis, dyspnea, malignant skin lesion, and fluid retention were significantly associated with the occurrence of sudden unexpected death.
Sudden unexpected death is not uncommon even in inpatient hospices/palliative care units, with range of 6.4-16.8% according to the different definitions.
Sudden unexpected death is not uncommon even in inpatient hospices/palliative care units, with range of 6.4-16.8% according to the different definitions.
Anthropometry-based equations are commonly used to estimate infant body composition. However, existing equations were designed for newborns or adolescents. We aimed to (a) derive new prediction equations in infancy against air-displacement plethysmography (ADP-PEA Pod) as the criterion, (b) validate the newly developed equations in an independent infant cohort and (c) compare them with published equations (Slaughter-1988, Aris-2013, Catalano-1995).
Cambridge Baby Growth Study (CBGS), UK, had anthropometry data at 6 weeks (N=55) and 3 months (N=64), including skinfold thicknesses (SFT) at four sites (triceps, subscapular, quadriceps and flank) and ADP-derived total body fat mass (FM) and fat-free mass (FFM). Prediction equations for FM and FFM were developed in CBGS using linear regression models and were validated in Sophia Pluto cohort, the Netherlands, (N=571 and N=447 aged 3 and 6 months, respectively) using Bland-Altman analyses to assess bias and 95% limits of agreement (LOA).
CBGS equations consisted of sex, age, weight, length and SFT from three sites and explained 65% of the variance in FM and 79% in FFM. In Sophia Pluto, these equations showed smaller mean bias than the three published equations in estimating FM mean bias (LOA) 0.008 (-0.489, 0.505) kg at 3 months and 0.084 (-0.545, 0.713) kg at 6 months. Mean bias in estimating FFM was 0.099 (-0.394, 0.592) kg at 3 months and -0.021 (-0.663, 0.621) kg at 6 months.
CBGS prediction equations for infant FM and FFM showed better validity in an independent cohort at ages 3 and 6 months than existing equations.
CBGS prediction equations for infant FM and FFM showed better validity in an independent cohort at ages 3 and 6 months than existing equations.The combination of complex perception, defense, and camouflage mechanisms is a pivotal instinctive ability that equips organisms with survival advantages. selleck kinase inhibitor The simulations of such fascinating multi-stimuli responsiveness, including thigmotropism, bioluminescence, color-changing ability, and so on, are of great significance for scientists to develop novel biomimetic smart materials. However, most biomimetic color-changing or luminescence materials can only realize a single stimulus-response, hence the design and fabrication of multi-stimuli responsive materials with synergistic color-changing are still on the way. Here, a bioinspired multi-stimuli responsive actuator with color- and morphing-change abilities is developed by taking advantage of the assembled cellulose nanocrystals-based cholesteric liquid crystal structure and its water/temperature response behaviors. The actuator exhibits superfast, reversible bi-directional humidity and near-infrared (NIR) light actuating ability (humidity 9 s; NIR light 16 s), accompanying with synergistic iridescent appearance which provides a visual cue for the movement of actuators. This work paves the way for biomimetic multi-stimuli responsive materials and will have a wide range of applications such as optical anti-counterfeiting devices, information storage materials, and smart soft robots.
This study aimed to explore the experiences and perceptions of nursing home staff and residents of unauthorised covert administration of medication. Prior studies identify that covert medication administration (crushing medication to administer in food or drink) is common in nursing home settings. Still, few recognise that this practice may occur without consultation or clinical authorisation.
An exploratory qualitative study was conducted with nursing home staff and residents as part of a more extensive mixed-methods study on medication omissions and clinical decision-making.
We conducted a qualitative study using focus groups and semi-structured interviews across four geographical areas in New Zealand to better understand nursing home staff and residents' experiences and perspectives on covert administration. Semi-structured interviews took place with 11 Clinical managers/leads and one senior Registered Nurse; role specific focus groups were held with Registered Nurses (n=6), Health Care Assistants (nration of medications is an ongoing practice, using New Zealand nursing homes as an example. The results emphasise that nursing home staff and residents are aware that this practice carries ethical and clinical risks and requires a certified process to legitimise its authorised form.