The Use of the Nursing Interventions Classification in Identifying the Workload of a Nursing Team in a Pediatric Oncology Center

The activities/interventions performed by the nursing team and the time required for their performance have become a widely discussed topic due to their impact on the quality of patient safety and staff working conditions. Nursing Interventions Classification (NIC) was used as a more accurate indicator as it identified activities/interventions. This study analyzed the workload distribution of nursing team in a pediatric oncology center.

How the shadow economy can be detected in National Accounts

The paper examines how indicators of the shadow economy correspond to the National Accounts values. More precisely, we focus on household accounts assuming that the shadow economy should be visible in the difference between household income and consumption, as household (disposable) income is grossly underreported. Household consumption seems therefore to be a more accurate indicator in this context, as most shadow economy income is eventually spent on consumption. This implies that household savings figures should be negatively related to the values of the shadow economy; consequently, if the values relating to the shadow economy are high, savings should be low, or even negative, and vice versa. We verify this hypothesis using European cross-country data covering the years 1991–2017 with the application of MIMIC model calculations as a point of reference. The estimation results lend very little support to the hypothesis assuming that the shadow economy depresses household savings, even though we can otherwise explain comparatively well the cross-country variation in household savings and consumption growth rates.

Partial Daylight Autonomy (DAp): A New Lighting Dynamic Metric to Optimize the Design of Windows for Seasonal Use Spaces

Nowadays, daylight dynamic metrics are the most useful indicators to quantify the use of natural light, with daylight autonomy (DA) being one of the most widespread among all of them. This metric represents the percentage of the occupied time throughout the year in an indoor space when daylight reaches the minimum illuminance level to develop a specific task. Accordingly, the higher the percentage of DA, the shorter the switching on time of electric lighting. However, this metric considers for its calculations all business days of a whole standard year, and is thus not an accurate indicator for seasonal use spaces such as school classrooms. In this context, a variant of this metric is proposed, namely partial daylight autonomy (DAp), which is a non-lineal derivation of DA that considers those seasonal use spaces, helping to define the real percentage of indoor daylight use in order to properly quantify the accurate switching on time of electric lighting and therefore its energy consumption. As deduced from the analysis, the more precise results provided by DAp reach divergences close to 10% in comparison with the original conception of DA. Thus, this metric serves to estimate more accurately the impact on energy consumption if an electric lighting control system is implemented through lux meters. This new proposal has been monitored under real sky conditions in a test cell, providing converging results with those observed in the simulation process.

Re-evaluating Renal Angina Index: An Authentic, Evidence-Based Instrument for Acute Kidney Injury Assessment: Critical Appraisal

Background/Introduction: Renal angina index (RAI) used to calculate and accurately predict risk for the development of acute kidney injury (AKI) has been heavily explored. AKI is traditionally diagnosed by an increase in serum creatinine (SCr) concentration or oliguria, both of which are neither specific nor sensitive, especially among children. An RAI score may be calculated by combining objective signs of kidney dysfunction (such as SCr) and patient context, such as AKI risk factors, thus potentially serving as a more accurate indicator for AKI.Objective: Due to the propitious and novel nature of RAI, this editorial commentary aims to analyze the current literature on RAI and determine how well RAI serves as a predictor of AKI outcomes.Method: A comprehensive literature search was conducted in PubMed/Medline and Google Scholar between January 2012 and July 2020. Literature included the prognostic aspect of early prediction of AKI in the pediatric and adult population via RAI.Results: The initial literature search included 149 studies, and a total of 10 studies reporting the outcomes of interest were included. The overall sample size across these studies was 11,026. The predictive ability of RAI had a pooled (95% CI) sensitivity of 79.21%, specificity of 73.22%, and negative predictive value of 94.83%.Conclusion: RAI shows benefit in the prediction of AKI among adult and pediatric populations. However, there is a lack of sufficient data, and further prospective studies are needed in pediatric populations to use RAI as a principal AKI indicator among clinicians.

Uterine leiomyoma in women of reproductive age: pregnancy and childbirth management (Literature review)

The article presents a review of the current literature on the problem of uterine leiomyoma (UL) in women of reproductive age during pregnancy and childbirth. We studied the main issues of uterine leiomyoma etiology and pathogenesis, as one of the leading causes of reproductive dysfunction and possible complications during pregnancy and childbirth.UL is the most common tumor of the female genitalia and occurs in 20–30% of women of reproductive age. It is impossible to determine a more accurate indicator of this pathology, given the asymptomatic course of more than 70% of cases and irregular consultations by obstetricians and gynecologists.There is evidence that uterine leiomyoma is associated with infertility in only 5–10% of cases, but only 2–3% of cases when all other causes are ruled out. The submucosal node has the most adverse effect on fertility and reduces the implantation frequency by 72% and increases the miscarriage risk by 60%. Subserous LM affects fertility to a lesser extent than submucosal LM, but large nodules can lead to infertility requiring surgical treatment. An individual approach to the treatment of women with intramural LM is required, as there is insufficient data on the node effect on fertility.The most common complications of pregnancy, childbirth and the postpartum period in women with uterine leiomyoma in 22–58% of cases are late preeclampsia, fetoplacental insufficiency, anemia of pregnancy, fetal growth restriction, incorrect position and presentation of the fetus. Pregnancy also adversely affects UL, leading to acute secondary changes and rapid tumor growth, which in turn can lead to severe obstetric complications.

Use of the journal impact factor for assessing individual articles: Statistically flawed or not?

Most scientometricians reject the use of the journal impact factor for assessing individual articles and their authors. The well-known San Francisco Declaration on Research Assessment also strongly objects against this way of using the impact factor. Arguments against the use of the impact factor at the level of individual articles are often based on statistical considerations. The skewness of journal citation distributions typically plays a central role in these arguments. We present a theoretical analysis of statistical arguments against the use of the impact factor at the level of individual articles. Our analysis shows that these arguments do not support the conclusion that the impact factor should not be used for assessing individual articles. Using computer simulations, we demonstrate that under certain conditions the number of citations an article has received is a more accurate indicator of the value of the article than the impact factor. However, under other conditions, the impact factor is a more accurate indicator. It is important to critically discuss the dominant role of the impact factor in research evaluations, but the discussion should not be based on misplaced statistical arguments. Instead, the primary focus should be on the socio-technical implications of the use of the impact factor.

Association of Zinc and Copper Status with Cardiovascular Diseases and their Assessment Methods: A Review Study

Cardiovascular disease (CVD) is the leading cause of mortality, morbidity, and financial losses and has a high prevalence across the world. Several studies have investigated the association between various CVD types with zinc and copper status as the essential minerals for the human body, proposing contradictory and similar results. This narrative review aimed to survey the correlations between zinc and copper status in the human body and some risk factors of CVD, as well as the assessment methods of zinc and copper status in the human body. According to the reviewed articles, zinc and copper deficiency may increase the risk of coronary heart disease, valvular regurgitation, and myocardial lesions, cardiac hypertrophy. Furthermore, it could lead to the expanded mitochondrial compartments of the heart, acute and chronic heart failure, and elevation of inflammation markers, such as interleukin-1 (IL-1) and IL-6. Two methods are primarily used for the assessment of zinc and copper in the human body, including the direct method (measurement of their concentrations) and indirect method (determining the activity of zinc- and copper-containing enzymes). Both these methods are considered reliable for the assessment of the zinc and copper levels in healthy individuals. Serum or plasma levels of these elements are also commonly used for the assessment of the correlation between zinc and copper status and CVD. But, which one is a more accurate indicator in relation to CVD is not yet clear; therefore, further studies are required in this field.

The Acceleration Index as a Test-Controlled Reproduction Number: Application to COVID-19 in France*

We show that the acceleration index, a novel indicator that measures acceleration and deceleration of viral spread (Baunez et al. 2020a,b), is essentially a test-controlled version of the reproduction number. As such it is a more accurate indicator to track the dynamics of an infectious disease outbreak in real time. We indicate a discrepancy between the acceleration index and the reproduction number, based on the infectivity and test rates and we provide a formal decomposition of this difference. When applied to French data for the ongoing COVID-19 pandemic, our decomposition shows that the reproduction number consistenly underestimates the resurgence of the pandemic since the summer of 2020, compared to the acceleration index which accounts for the time-varying volume of tests. From the comparison that we present here follows that the acceleration index is a sufficient statistic to track the pandemic’s propagation, as it captures in real time the sizeable time variation featured by viral circulation.JEL Classification NumbersI18; H12

An audit of COPD: diagnosis and management in general practice

IntroductionCOPD is a spectrum of disorders primarily caused by smoking and characterised by progressive, not fully reversible airflow obstruction with a forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ratio <0.7.MethodsFrom November 2016 to March 2017 we audited patients with COPD in five general practices in Hull and East Riding, UK. We looked at deviation from the locally agreed guidelines. We extracted data on severity, exacerbations, medication and eosinophil count.ResultsWe assessed 1088 records. Median age was 70.9 years; 577 (53%) were male. About two-thirds of patients on the COPD register have an FEV1/FVC ratio in the diagnostic range for COPD, however, 388 (36%) out of 1088 had a ratio of ≥0.7. In the patients with a ratio of ≥0.7, 259 (67%) out of 388 had an FEV1 <80% of predicted. Patients with frequent exacerbations were more likely to be prescribed inhaled corticosteroid (ICS)-containing inhalers (incidence rate ratio of 2). FEV1 % predicted was a poor indicator of exacerbation frequency; however, the presence of elevated blood eosinophil counts (EOS) on at least two occasions was highly predictive of exacerbations. When ICSs, FEV1, EOS were examined in combination, they were highly significant predictors for exacerbations.ConclusionFEV1 maybe a more accurate diagnostic parameter in primary care. Historical evidence of blood eosinophilia is a better predictor than FEV1. The combination of biomarkers may prove more accurate indicator of future exacerbation frequency, leading to targeted intervention.