A service evaluation of the fathers’ peer support group on a neonatal intensive care unit (NICU)

The following study evaluates a fathers' peer support group facilitated on a tertiary neonatal intensive care unit (NICU). Within the group, the experiences of fathers with an infant on the NICU was explored. Data was collected from eight fathers and analysed using thematic analysis. Four key themes emerged: (1) the “ups and downs” of the NICU journey, (2) the “balance between two worlds”; juggling NICU and life outside, (3) being “an important member of the family”; feeling seen, included and cared for and (4) “I'm not alone”; the benefits of the shared experience. The study concluded that the peer group was a valued form of support during which fathers were facilitated to meet other NICU dads, share their NICU journey and learn from the experiences of others. Recommendations for setting up a NICU fathers' peer support group are provided.     

Risk factors related to the severity of COVID-19 in Wuhan

Objective: To evaluate the characteristics at admission of patients with moderate COVID-19 in Wuhan and to explore risk factors associated with the severe prognosis of the disease for prognostic prediction.Methods: In this retrospective study, moderate and severe disease was defined according to the report of the WHO-China Joint Mission on COVID-19. Clinical characteristics and laboratory findings of 172 patients with laboratory-confirmed moderate COVID-19 were collected when they were admitted to the Cancer Center of Wuhan Union Hospital between February 13, 2020 and February 25, 2020. This cohort was followed to March 14, 2020. The outcomes, being discharged as mild cases or developing into severe cases, were categorized into two groups. The data were compared and analyzed with univariate logistic regression to identify the features that differed significantly between the two groups. Based on machine learning algorithms, a further feature selection procedure was performed to identify the features that can contribute the most to the prediction of disease severity.Results: Of the 172 patients, 112 were discharged as mild cases, and 60 developed into severe cases. Four clinical characteristics and 18 laboratory findings showed significant differences between the two groups in the statistical test (P<0.01) and univariate logistic regression analysis (P<0.01). In the further feature selection procedure, six features were chosen to obtain the best performance in discriminating the two groups with a linear kernel support vector machine. The mean accuracy was 91.38%, with a sensitivity of 0.90 and a specificity of 0.94. The six features included interleukin-6, high-sensitivity cardiac troponin I, procalcitonin, high-sensitivity C-reactive protein, chest distress and calcium level.Conclusions: With the data collected at admission, the combination of one clinical characteristic and five laboratory findings contributed the most to the discrimination between the two groups with a linear kernel support vector machine classifier. These factors may be risk factors that can be used to perform a prognostic prediction regarding the severity of the disease for patients with moderate COVID-19 in the early stage of the disease.     

Adenovirus vector-based vaccine for infectious diseases

Replication-incompetent adenovirus (Ad) vectors have been widely used as gene delivery vehicles in both gene therapy studies and basic studies for gene function analysis due to their highly advantageous properties, which include high transduction efficiencies, relatively large capacities for transgenes, and high titer production. In addition, Ad vectors induce moderate levels of innate immunity and have relatively high thermostability, making them very attractive as potential vaccine vectors. Accordingly, it is anticipated that Ad vectors will be used in vaccines for the prevention of infectious diseases, including Ebola virus disease and acquired immune deficiency syndrome (AIDS). Much attention is currently focused on the potential use of an Ad vector vaccine for coronavirus disease 2019 (COVID-19). In this review, we describe the basic properties of an Ad vector, Ad vector-induced innate immunity and immune responses to Ad vector-produced transgene products. Development of novel Ad vectors which can overcome the drawbacks of conventional Ad vector vaccines and clinical application of Ad vector vaccines to several infectious diseases are also discussed.     

Informing a home time measure reflective of quality of life: A data driven investigation of time frames and settings of health care utilization

Objective

To evaluate short- and long-term measures of health care utilization—days in the emergency department (ED), inpatient (IP) care, and rehabilitation in a post-acute care (PAC) facility—to understand how home time (i.e., days alive and not in an acute or PAC setting) corresponds to quality of life (QoL).

Data Sources

Survey data on community-residing veterans combined with multipayer administrative data on health care utilization.

Study Design

VA or Medicare health care utilization, quantified as days of care received in the ED, IP, and PAC in the 6 and 18 months preceding survey completion, were used to predict seven QoL-related measures collected during the survey. Elastic net machine learning was used to construct models, with resulting regression coefficients used to develop a weighted utilization variable. This was then compared with an unweighted count of days with any utilization.

Principal Findings

In the short term (6 months), PAC utilization emerged as the most salient predictor of decreased QoL, whereas no setting predominated in the long term (18 months). Results varied by outcome and time frame, with some protective effects observed. In the 6-month time frame, each weighted day of utilization was associated with a greater likelihood of activity of daily living deficits (0.5%, 95% CI: 0.1%–0.9%), as was the case with each unweighted day of utilization (0.6%, 95% CI: 0.3%–1.0%). The same was true in the 18-month time frame (for both weighted and unweighted, 0.1%, 95% CI: 0.0%–0.3%). Days of utilization were also significantly associated with greater rates of instrumental ADL deficits and fair/poor health, albeit not consistently across all models. Neither measure outperformed the other in direct comparisons.

Conclusions

These results can provide guidance on how to measure home time using multipayer administrative data. While no setting predominated in the long term, all settings were significant predictors of QoL measures.     

The experiences and perceptions of newly qualified nurses in the UK: An integrative literature review

AimThis integrative review aimed to develop an understanding of the experiences and perceptions of newly qualified nurses in the United Kingdom (UK).BackgroundIn the transitional period following registration, newly qualified nurses may feel socially isolated and overwhelmed by increases in accountability, workplace pressures and the psychological demands of the role. Despite this, the experiences and perceptions of newly qualified nurses remains an under-researched area in the UK, with much of the existing research having been conducted internationally.MethodAn integrative framework methodology was used as a basis for the literature review. The methodology comprised of five stages: problem identification, literature search, data evaluation, data analysis and presentation of the findings. 20 papers were assessed for quality and analysed thematically.ResultsData were synthesised under four themes: Preparation for real-world practice, the transition experience, growing into the role and preceptorship and support from the wider team.ConclusionThe review suggests that newly qualified nurses require on-going support post qualification. Workplace culture appears to have a significant impact on the transition experience. The review provides further evidence in relation to the experiences of newly qualified nurses in the UK context. The review may help to inform the development of strategies to support and retain newly qualified nurses in an ever-changing health care environment.     

支持向量机在水源水化学耗氧量预测中的应用

目的应用支持向量机预测水中化学耗氧量(COD)浓度。方法基于研究地区的水质监测数据,运用支持向量机算法构建水质预测模型,并对某水厂水源水中COD月均浓度进行了预测。结果建模以后预测结果显示,训练集的均方误差MSE=0.039 4,相关系数R=0.805 4,平均相对误差MRE=4.22%;两组测试集样本的相对误差分别为8.89%和0.98%。结论该模型的预测性能良好,简便易行,可以为水质预测提供新思路。     

儿童造口肠管支撑架的研制与应用

<正>目前,扩张造口肠管的方法有很多,过去采取手指扩肛,但多次手指扩肛常给患儿带来痛苦,影响治疗效果,同时也增加了医护人员劳动强度,而且对于疤痕挛缩造成造口狭窄的患儿有一定困难[1]。现在大多使用的金属扩肛器柔韧性差,若用力不当,易造成肠穿孔,而且扩肛期间起不到引流气体、液体的作用,同时扩肛器温度低,给患儿带来不适,易造成肠收缩,为此,我们设计了一款儿童造口肠管支撑架,既有效减少反复扩造瘘口引起的肠管水肿甚至出血,又能避免