Relationship Between Severity of Comorbidities and Self-Perceptions of Aging

An older adult with negative self-perceptions of aging (SPA) can lead to lower self-rated health and a higher risk of mortality. To stay a positive SPA, keep a healthier status is very important. However, evidence also proved that health conditions, like a physical limitation, could predict the level of SPA. Older adults usually have a higher prevalence rate of chronic diseases than the younger population, which can adversely impact them. The purpose of this study is to determine the relationship between the severity of comorbidities and the change of SPA during a time. I examined data in 7,034 people from the 2012 wave Health and Retirement Study (HRS) and followed the respondents who have answer the SPA scale in the leave-behind questionnaire in 2016. The generalized estimating equation was used to analyze the relationship between the severity of comorbidities and SPA in different waves. To measure the severity of comorbidities, a reduced index of the comorbidities severity scale (CmSS) was created to collect the health condition from HRS. Results statistical model shows that an individual with more severity of comorbidities may have a more negative SPA. However, the relationship does not follow through with the times. These findings enhance the previous study that there are relationships between severity of comorbidities and SPA. The benefit of this study is to use a different measurement to identify the severity of comorbidities and extend to more in-depth research.

Association between psychosocial functioning, health status and healthcare access of asylum seekers and refugee children: a population-based cross-sectional study in a German federal state

Background The mental health condition and healthcare needs of asylum seeking and refugee (ASR) children may go unrecognized if barriers to healthcare access exist accompanied by exclusive focus on somatic illness. We analysed the relationship between psychosocial functioning, health status and healthcare access of ASR children. Methods During 2018, 560 ASR adults in 58 collective accommodations in Germany’s 3rd largest federal state were randomly sampled and assessed. The parent-reported Strengths and Difficulties Questionnaire (SDQ) was used to assess child psychosocial functioning. SDQ dimensions (Emotional, Conduct, Peer, Hyperactivity, Prosocial, Total) were compared by demographics (sex, age, region of origin, time since arrival, subjective social status), health status (long-lasting illness, physical limitation, pain) and healthcare access (utilization: paediatrician, specialist, dentist, psychologist, hospital/emergency department, prescribed medicines; and unmet needs: for paediatrician/specialist, reduced spending to cover healthcare cost). Age and sex-adjusted odds ratios (AOR, 95%CI-Confidence Intervals) for scoring in borderline/abnormal ranges in SDQ dimensions were estimated through logistic regression depending on children’ health status and healthcare access. Results We analysed parents’ answers pertaining to 90 children aged 1–17 years old, 57% of which were girls and 58% with (Eastern or Western) Asian nationality. Scoring in the borderline/abnormal range of the SDQ Total Difficulties score was associated with feeling bodily pain (compared to no pain, AOR, 95%CI = 3.14, 1.21–8.10) and with an unmet need for a specialist during the previous year (4.57, 1.09–19.16). Borderline/abnormal SDQ Emotional scores were positively associated with a long-lasting illness (5.25, 1.57–17.55), physical limitation (4.28, 1.49–12.27) and bodily pain (3.00, 1.10–8.22), and negatively associated with visiting a paediatrician (0.23, 0.07–0.78), specialist (0.16, 0.04–0.69), and the emergency department (0.27, 0.08–0.96). Conclusion Poor psychosocial functioning among ASR children is associated with somatic problems, unmet medical needs, and lower healthcare utilisation. Somatic clinical encounters with ASR should include children’ mental health symptomatology assessment, especially in those with worst physical health conditions.

A Heterogeneous RISC-V Processor for Efficient DNN Application in Smart Sensing System

Extracting features from sensing data on edge devices is a challenging application for which deep neural networks (DNN) have shown promising results. Unfortunately, the general micro-controller-class processors which are widely used in sensing system fail to achieve real-time inference. Accelerating the compute-intensive DNN inference is, therefore, of utmost importance. As the physical limitation of sensing devices, the design of processor needs to meet the balanced performance metrics, including low power consumption, low latency, and flexible configuration. In this paper, we proposed a lightweight pipeline integrated deep learning architecture, which is compatible with open-source RISC-V instructions. The dataflow of DNN is organized by the very long instruction word (VLIW) pipeline. It combines with the proposed special intelligent enhanced instructions and the single instruction multiple data (SIMD) parallel processing unit. Experimental results show that total power consumption is about 411 mw and the power efficiency is about 320.7 GOPS/W.

Improving Quality of Life with Percutaneous Coronary Intervention in Chronic Coronary Syndrome Patients with SYNTAX Score of More than 22

Background : The benefit of PCI to improve quality of life (QoL) in chronic coronary syndrome (CCS) is still unclear. Objectives : This study aimed to assess the benefit of percutaneous coronary intervention (PCI) in improving QoL among CCS patients receiving OMT. Methods : We conducted a retrospective cohort study. CCS patients who underwent coronary angiography (CAG) and/or PCI were grouped into OMT plus PCI and OMT groups. The SYNTAX score was used to assess the complexity and severity of coronary artery lesions. The outcome measured was QoL assessed using Seattle Angina Questionnaire (SAQ) and rehospitalization. Results: A total of 57 patients in the OMT plus PCI group and 49 patients in the OMT group were included. The percentage of patients with good QoL was higher in the OMT plus PCI group than OMT only group (64.5% vs. 35.5%; p = 0.007). The OMT plus PCI group revealed a better activities of daily living (85.11 ± 12.46 vs. 12.46 ± 21.87; p = 0.014) and angina stability (84.32 ± 23.63 vs. 71.81 ± 27.89; p = 0.014) than OMT group. Among patients with SYNTAX scores of more than 22, achievement of good QoL was greater in the OMT plus PCI group than the OMT group (80.8% vs. 45.5%; p = 0.025). Conclusion: PCI improved the QoL in CCS patients treated with OMT. Second, OMT plus PCI improves physical limitation and angina stability. For patients with a SYNTAX score of more than 22, OMT plus PCI was correlated with good QoL achievement.

Effect of Surface Oxidation on the Material Loss of InGaAs in Acidic Solutions

Indium gallium arsenide (InGaAs) is one of the candidate materials to overcome the physical limitation of Si due to its excellent electrical properties. The effect of surface oxidation on the etching characteristics of InGaAs surface in acidic solutions were investigated. InGaAs surfaces was etched in HCl/H2O2/H2O (CPM) and HNO3/H2O2/H2O (NPM), while there was no thickness change in diluted HCl or HNO3. The CPM-treated InGaAs surface had a lower etching rate than the NPM-treated one, while etching rate of oxidized layer was higher in diluted HCl than in HNO3. NaCl added in the NPM acts as an etching inhibitor for InGaAs and the etching rate was significantly suppressed. It is thought that Cl− anion inhibits the formation of hydroxyl radical (OH∙) or consumes OH∙ in acidic solution, inhibiting surface oxidation of InGaAs and suppressing its material loss.

Respiratory muscle strength and quality of life in chronic kidney disease patients undergoing hemodialysis

Introduction: Hemodialysis (HD) sessions associated with the chronic kidney disease (CKD) repercussions may cause respiratory muscle impairment and limitations of daily living activities, which may compromise the quality of life. Objective: To evaluate respiratory muscle strength and quality of life in HD patients. Methods: A cross-sectional study involving CKD patients of both sexes undergoing HD. All were evaluated during HD, using an evaluation form containing personal and clinical data, presence of comorbidities, lifestyle (including self-reported physical activity) and vital signs. Respiratory muscle strength was analyzed by maximum inspiratory (MIP) and maximum expiratory (MEP) pressures by manovacuometer and quality of life using the SF-36 questionnaire. Results: Sixty-eight patients were evaluated (69.1% men), with a mean age of 54.9 ± 13.6 years. The MEP% was below of predicted (79.5 ± 25.7) and the MIP% was reduced only in women (77.8 ± 38.7). The MIP% was related to CKD time (p = 0.04) in men. The SF-36 domain that showed the most impairment was physical limitation [25.0 (13.0-67.0)], while mental health was the least impaired domain [72.0 (62.0-84.0)]. Those who reported the practice of physical activity obtained better results in vitality domain (p = 0.01). In the analysis stratified by sex, the functional capacity domain was less compromised in men who practiced self-reported physical activity (p = 0.02). Conclusion: CKD patients undergoing HD had a reduction in MEP relative to predicted, in addition to a greater impairment of MIP in men with longer CKD time and in women alone, although the clinical relevance of this finding is uncertain. Quality of life was more compromised in the physical limitation domain, where those who self-reported physical activity achieved better results in the domains of vitality (total sample) and functional capacity (men).

Mental health, health and healthcare utilization of asylum seeking and refugee children in Germany

Background The mental health condition and healthcare needs of asylum seeking and refugee (ASR) children are essential aspects of health services organization. We describe the relation between psychosocial functioning, health status and healthcare use of ASR children in Germany using a cross-sectional population-based survey. Methods 560 ASR adults in 58 collective accommodations in Germany's 3rd largest federal state were randomly sampled and assessed in 2018 (response rate: 42%). 126 participants answered the Strengths and Difficulties Questionnaire (SDQ) to assess children' psychosocial functioning with higher scores suggesting poorer functioning. SDQ dimensions (Emotional; Conduct; Peer; Hyperactivity; ProSocial; Total) were compared by demographics, health (long-lasting illness, physical limitation, pain) and healthcare use (unmet need for a pediatrician/specialist, hospital/emergency department visits). Age and sex-adjusted odds ratios (AOR, 95%CI, Confidence Intervals) for presenting borderline/abnormal scores for each SDQ dimension were computed using logistic regression models depending on children' health and healthcare use. Results Valid data of 90 ASR children was analyzed: 57% girls; 40% 10-17 years; 58% from East/West Asia; 56% in Germany for more than a year. A borderline/abnormal SDQ Total score was associated with pain (compared to no pain, AOR, 95%CI=3.14, 1.21-8.10) and with an unmet need for a specialist (4.57, 1.09-19.16). High scores (borderline/abnormal) in the SDQ Emotional dimension were positively associated with a long-lasting illness (5.25, 1.57-17.55), physical limitation (4.28, 2.48-12.27) and pain (3.00, 1.10-8.22), and negatively associated with visiting a pediatrician (0.23, 0.07-0.78), a specialist (0.16, 0.04-0.69) and the emergency department (0.27, 0.08-0.96). Conclusions Somatic clinical encounters with ASR children should include the assessment of mental health symptomatology, especially in those with worst physical health conditions. Key messages Among asylum seeking and refugee children, a poor physical condition and unmet medical needs are linked with poorer mental health. Provision of care to this vulnerable group must include mental health.

Adaptive Bike Share: Expanding Bike Share to People with Disabilities and Older Adults

Bike share systems are expanding efforts to be more equitable and accessible to everyone by offering adaptive bicycle options to people who might otherwise be unable to ride. These systems tend to range from the inclusion of electric bikes and standard trikes into the existing systems to offering a more full range of adaptive bicycle options for use at rental location. Surveys of residents living in several low-income communities of color ( n = 1,885) are used to explore the potential need for adaptive bike share options in urban locations. A national survey of cities and bike share operators ( n = 70) is used to document the prevalence and basic models of adaptive bike share programming currently in place. Interviews conducted with bike share representatives in select cities with adaptive bike share programs provide context and details on how specific programs operate. Finally, interviews with adaptive bike share participants ( n = 5) in Portland, Oregon, help to illuminate users’ experiences, including the perceived value and potential improvements for adaptive bike share. This opportunistic combination of data sources indicated that there is an underserved market of people who do not feel they can use existing bike share systems because of some type of physical limitation, but that reaching and serving those people presents substantial hurdles. Current bike share systems are slowly exploring the right way to include accessible options but are challenged by cost, resources, bicycle types, program implementation, and infrastructure.

Peraturan dan Pengendalian: Menjelaskan Penurunan Produksi Pangan di Jawa 1940-1946 dan Kelaparan 1944-1945

The paper discusses the major reasons for the drop in food production in Java during the period of Japanese occupation. Statistics on the acreage and production of six main foodstuff during the year 1940-1946 showed significant reduction of food production in Java after 1942. This reduction is explained as the result of several physical limitation to the production and marketing process of foodstuff. The article explicate several other factors that added to the principal reason for the fall in food production after 1942. The principal reason is laid on the control system of the Javanese rice economy that had reduced the real purchasing price of grain. This resulted in little incentive for peasants to pursue surplus production outside of their household subsistence needs. The only incentive was a negative incentive of forced deliveries.