Results of the home mechanical ventilation national program among adults in Chile between 2008 and 2017

Background Home mechanical ventilation (HMV) is a viable and effective strategy for patients with chronic respiratory failure (CRF). The Chilean Ministry of Health started a program for adults in 2008. Methods This study examined the following data from a prospective cohort of patients with CRF admitted to the national HMV program: characteristics, mode of admission, quality of life, time in the program and survival. Results A total of 1105 patients were included. The median age was 59 years (44–58). Women accounted for 58.1% of the sample. The average body mass index (BMI) was 34.9 (26–46) kg/m2. A total of 76.2% of patients started HMV in the stable chronic mode, while 23.8% initiated HMV in the acute mode. A total of 99 patients were transferred from the children's program. There were 1047 patients on non-invasive ventilation and 58 patients on invasive ventilation. The median baseline PaCO2 level was 58.2 (52–65) mmHg. The device usage time was 7.3 h/d (5.8–8.8), and the time in HMV was 21.6 (12.2–49.5) months. The diagnoses were COPD (35%), obesity hypoventilation syndrome (OHS; 23.9%), neuromuscular disease (NMD; 16.3%), non-cystic fibrosis bronchiectasis or tuberculosis (non-CF BC or TBC; 8.3%), scoliosis (5.9%) and amyotrophic lateral sclerosis (ALS; 5.24%). The baseline score on the Severe Respiratory Insufficiency questionnaire (SRI) was 47 (± 17.9) points and significantly improved over time. The lowest 1- and 3-year survival rates were observed in the ALS group, and the lowest 9-year survival rate was observed in the non-CF BC or TB and COPD groups. The best survival rates at 9 years were OHS, scoliosis and NMD. In 2017, there were 701 patients in the children's program and 722 in the adult´s program, with a prevalence of 10.4 per 100,000 inhabitants. Conclusion The most common diagnoses were COPD and OHS. The best survival was observed in patients with OHS, scoliosis and NMD. The SRI score improved significantly in the follow-up of patients with HMV. The prevalence of HMV was 10.4 per 100,000 inhabitants. Trial registration This study was approved by and registered at the ethics committee of North Metropolitan Health Service of Santiago, Chile (N° 018/2021).

Evaluation of Compilers’ Capability of Automatic Vectorization Based on Source Code Analysis

Automatic vectorization is an important technique for compilers to improve the parallelism of programs. With the widespread usage of SIMD (Single Instruction Multiple Data) extensions in modern processors, automatic vectorization has become a hot topic in the research of compiler techniques. Accurately evaluating the effectiveness of automatic vectorization in typical compilers is quite valuable for compiler optimization and design. This paper evaluates the effectiveness of automatic vectorization, analyzes the limitation of automatic vectorization and the main causes, and improves the automatic vectorization technology. This paper firstly classifies the programs by two main factors: program characteristics and transformation methods. Then, it evaluates the effectiveness of automatic vectorization in three well-known compilers (GCC, LLVM, and ICC, including their multiple versions in recent 5 years) through TSVC (Test Suite for Vectorizing Compilers) benchmark. Furthermore, this paper analyzes the limitation of automatic vectorization based on source code analysis, and introduces the differences between academic research and engineering practice in automatic vectorization and the main causes, Finally, it gives some suggestions as to how to improve automatic vectorization capability.

Exploring online study behaviors of adult learners: A case study focusing on teachers’ professional development program

It requires a lot of energy to support the adoption of online learning by adult learners. Thus, the question of how online learning intersects with adult learning may provide meaningful pathways to understanding online learning per se. This study aims to understand the online study behaviors of teachers enrolled in an online Educational Technology Master’s program. This case study involved a Research Methods course, which was part of an online project for teachers. An online control list form and interviews were used as data collection tools. The results indicated that sharing, problem solving, product development, monitoring, and research were prominent activities that shape the study behaviors. While some of the behaviors in these activities indicated the reshaping of previous study behaviors, other behaviors newly appeared during the program. Characteristics of adult learners, online setting features, and the context of the projects were the main factors that influenced study behaviors. Finally, the implications for better online adult learning experiences are addressed.

The influencing contexts and potential mechanisms behind the use of online self-management support interventions: a realist evaluation (Preprint)

BACKGROUND Self-management can increase self-efficacy and quality of life and improve disease outcomes in patients with chronic conditions. Effective self-management may also help to reduce the pressure on healthcare systems. However, patients need support in dealing with their disease and in developing skills to manage the symptoms, treatment, physical consequences, psychological consequences, and lifestyle changes associated with their condition. Online self-management support programs have helped patients with cardiovascular disease (CVD) and rheumatoid arthritis (RA) but program use was low. OBJECTIVE This study aims to identify the patient-, disease- and program characteristics that determine whether patients use online self-management support programs or not. METHODS A realist evaluation methodology was used to give a comprehensive oversight of context (patient- and disease characteristics), mechanism (program characteristics), and outcome (program use). The relation between context (sex, age, education, employment status, living situation, self-management [measured using PAM-13], quality of life [measured using RAND-36], interaction efficacy [measured using PEPPI-5], diagnosis, physical comorbidity, and time since diagnosis) and outcome (program use) was analyzed through logistic regression analyses. The relation between mechanism (program design, implementation strategies, behavior change techniques) and outcome was analyzed through a qualitative interview study. RESULTS For this study, 68 non-users and 111 users of the online self-management support programs were included, of which 57% were diagnosed with CVD and 43% with RA. Younger age and a lower level of education were associated with program use. An interaction effect was found between program use and diagnosis (CVD or RA) and four quality of life subscales (social functioning, physical role limitations, vitality, and bodily pain). CVD patients with higher self-management and quality of life scores were less likely to use the program, while RA patients with higher self-management and quality of life scores were more likely to use the program. Interviews with ten non-users, ten low-users, and 18 high-users were analyzed to give insight into the relation between mechanisms and outcome. Program use was encouraged by an easy to use, clear, and transparent design and by recommendations from a professional and email reminders. Five behavior change techniques were identified as potential mechanisms to promote program use: tailored information, self-reporting behavior with delayed feedback, giving information on peer behavior, and modeling. CONCLUSIONS This realist evaluation showed that certain patient-, disease-, and program characteristics are associated with the use of online self-management support programs. These results can help developers of future online self-management support programs to tailor the interventions to increase use and effectiveness.

Program Characteristics of Cardiothoracic Surgery Departments Versus Divisions

Background:The organizational structure of cardiothoracic surgery practices varies among different programs throughout the United States (U.S.). We aimed to investigate the characteristics of the top ranked programs within the specialty and the surgeons practicing within each.Methods: The top 50 hospitals for adult cardiology and heart surgery were identified using the US News and World Report 2019-20 ranking. There were 590 hospitals reported on, with 50 top rated programs. Data was collected from each hospital’s website, analyses conducted using SAS 9.4 with statistical significance set at p < 0.05. Results:When comparing cardiothoracic surgery program organizational structures, 21 of the top 50 ranked programs were departments and 24 were divisions within their respective Department of Surgery. Mean number of surgeons was 11 with no statistical difference when analyzed by division versus department. Overall, 9% of practicing cardiothoracic surgeons were female. Between programs that are a department versus division, general thoracic surgery was included in 58% of divisions and 52% of departments (p = ns). Among programs that were departments, approximately 6% of surgeons had attained a Ph.D., while in divisions approximately 4% of surgeons had attained a Ph.D. Conclusions:The top 50 Cardiothoracic Surgery programs in the U.S. have approximately the same number of surgeons within the group and are organized similarly. This study group had a slightly higher percentage of female surgeons than previously noted in cardiothoracic surgery, with general thoracic surgery trending toward higher gender diversity. The presence of physician scientists was low, though similar amongst the study groups.

Resilience Training Programs in Organizational Contexts: A Scoping Review

The importance of resilience for employees' well-being and performance at work has grown steadily in recent years. This development has become even more pronounced through the recent COVID-19 pandemic and its consequences, including major changes in occupational settings. Although there is increasing interest in resilience in general and a growing number of publications focusing on the development of resilience in particular, many questions remain about resilience training, especially in organizational contexts. The purpose of this scoping review is to uncover what is known about resilience training in organizational contexts. A systematic search of four databases for articles published through 2021 was conducted. A total of 48 studies focusing on resilience training programs in organizational contexts were included in this review. The review provides relevant insights into resilience training programs by focusing on program characteristics, target group, study design, and outcomes. Based on the results, the main aspects that concern the development of resilience training programs for organizational settings and requirements for the study design for empirical investigation were summarized. The results of the review highlight possible directions for future research and offer useful insights for resilience-enhancing training programs in organizations.

To Post or Not to Post: Does Applicants’ Social Media Affect Family Medicine Resident Recruitment?

Background and Objectives: Current literature on review of applicant social media (SoMe) content for resident recruitment is scarce. With the recent increase in the use of privacy settings, and the cost of the recruitment process, the aim of this study was to describe the practice and outcomes of review of applicant SoMe in resident recruitment and its association with program director or program characteristics. Methods: This study was part of the 2020 Council of Academic Family Medicine’s Educational Research Alliance (CERA) annual survey of family medicine residency program directors (PDs) in the United States. Results: The overall response rate for the survey was 39.8% (249/626). About 40% of PDs reported reviewing applicant SoMe content. The majority (88.9%) of programs did not inform applicants of their SoMe review practices. The most common findings of SoMe review were that the content raised no concerns (38/94; 40.4%) or was consistent with the application material (34/94; 36.2%). Forty PDs (17.0%) have ever moved an applicant up or down the rank list based on SoMe review. Review of applicant SoMe was not statistically associated with program size, program type, PD age, PD SoMe use, or program SoMe use. Conclusions: SoMe review has not become routine practice in family medicine resident recruitment. The outcome of SoMe review was mostly consistent with the applicant profile without any concerns and only very few changed the ranking order. This calls for more studies to explore the value of SoMe review for resident selection regarding its effect on future performance.