Basic Activities Research Articles

Simulating staff activities in healthcare environments: An empirical multi-agent modeling approach

The layout of the healthcare environment profoundly impacts healthcare efficiency, safety, employee satisfaction, and the sustainability of operations, mainly based on occupant behavior analysis. However, due to the increase in professionalism and interprofessional collaboration among healthcare practitioners and the complexity of the physical environment, existing research tools face challenges in describing and analyzing diverse occupant behaviors. This study aims to offer an empirically grounded multi-agent modeling approach as a research tool to simulate and reproduce occupant behavior within healthcare settings. Employing a design science research method, the proposed approach encompasses four stages: empirical data collection, development of behavioral rules, agent-based modeling, and validation. A continuous 24-h observational study involving doctors, nurses, and auxiliary staff within a trauma intensive care unit is conducted to demonstrate the development and application process. Results show that the proposed modeling approach achieves a simulation deviation of 8.31 % in individual walking distances and a 16.26 % deviation in overall staff spatial visitation frequency compared to real-world observations. We believe that using simple if-then rules to represent events and probability rules to describe other basic activities can simulate complex staff activities in a healthcare environment. Interdisciplinary expert evaluation acknowledged the utility of this approach. This study offers a comprehensive dataset of behaviors and contributes methodologically to evaluating the efficiency of built environment layouts. The innovation in this study lies in its scalability, extending from events and individuals to encompass the all staff in levels of modeling and validation, ensuring a consistent alignment with empirical data at each stage.

Relationship between mortality and vitality in patients with mild cognitive impairment/dementia: An 8-year retrospective study.

The study aimed to investigate the association of vitality, as measured using the vitality index (Vix), with the survival outcomes of older adults with mild cognitive impairment (MCI) or dementia. We analyzed data from 3731 patients in the National Center for Geriatrics and Gerontology - Life Stories of Individuals with Dementia cohort from July 2010 to September 2018. The main focus was to correlate Vix scores with the time from the initial visit to death. Vix was categorized into "moderately to severely impaired" (0-7 points), "mildly impaired" (8-9 points), and "normal" (10 points) groups. Survival outcomes were assessed using a Cox proportional hazards model, adjusted for various factors. We conducted a mediation analysis to evaluate the effect of body mass index (BMI), instrumental activities of daily living (IADL), and basic activities of daily living (BADL) on the association between vitality and mortality. Stratified analysis was also conducted for the Mini-Mental State Examination groups. We included 2740 patients with an average follow-up of 1315 days. The mortality rate was 15.7%. The Vix distribution was 16% at 0-7 points; 40%, 8-9 points; and 44%, 10 points. Patients in the "moderately to severely impaired" category, characterized by lower Vix scores, exhibited notably higher mortality rates. Mediation effects emphasized the significant roles of BMI, IADL, and BADL in influencing survival outcomes. Vitality significantly influences patient survival rates. The association between vitality and mortality seems to be mediated by IADL and BADL, which has significant clinical implications. Geriatr Gerontol Int 2024; 24: 221-228.

The development and training effect of innovative undergraduate dental talents training project: A 6-year retrospective study.

To summarize the development of Innovative Undergraduate Dental Talents Training Project (IUDTTP) and investigate the training effect of this extracurricular dental basic research education activity from 2015 to 2020 to obtain educational implications. The Guanghua School of Stomatology established the IUDTTP in 2015. The authors recorded the development process and analysed the participation situation, training effect, academic performance and overall satisfaction during 2015-2020 through documental analysis, questionnaire and quiz. The t-test, chi-square test and ANOVA were used to test the difference. The educational goal, education module and assessment system of IUDTTP evolved and developed every year. A total of 336 students and 79 mentors attended the IUDTTP from 2015 to 2020, with the participation rate increasing from 45.1% to 73.5%. The participants exhibited favourable basic research abilities, manifesting as the increase of funded projects and published papers and satisfying quiz scores. Almost all students (94.94%) admitted their satisfaction with the IUDTTP. Moreover, the attended students surpassed the non-participants in terms of GPA, the number of acquired scholarships and outstanding graduates (p < .05). Likewise, the enrolment rate of postgraduate participants was significantly higher than non-participants. To date, the training effect indicated that the IUDTTP has fulfilled the education aim. It brought positive effects on promoting research interest, cultivating research capacities and enhancing academic performance. The potential deficiencies of extracurricular educational activities, including inflexibility in schedule and insufficiency in systematisms, may be remedied by more systematic educational settings in the future.

The association between the basal metabolic rate and cardiovascular disease: A two-sample Mendelian randomization study.

Mendelian randomization analysis was applied to elucidate the causal relationship between the basal metabolic rate (BMR) and common cardiovascular diseases. We choose BMR as exposure. BMR is the metabolic rate of the body when the basic physiological activities (blood circulation, breathing and constant body temperature) are maintained. The normal BMR is 1507 kcal/day for men and 1276 kcal/day for women. The dataset was drawn from the public GWAS dataset (GWAS ID: ukb-a-268), collected and analysed by UK biobank, containing 331,307 European males and females. SNPs independently and strongly associated with BMR were used as instrumental variables in the inverse variance weighted analysis. MR-Egger, weighted median, MR pleiotropy residual sum, and outlier methods were also performed, and the sensitivity was evaluated using horizontal pleiotropy and heterogeneity analyses to ensure the stability of the results. An increased BMR is associated with a higher risk of cardiomyopathy (odds ratio [OR] = 2.00, 95% confidence interval [CI], 1.57-2.54, p = 1.87 × 10-8), heart failure (OR = 1.39, 95% CI, 1.27-2.51, p = 8.1 × 10-13), and valvular heart disease (OR = 1.18, 95% CI, 1.10-1.27, p = .00001). However, there was no clear association between BMR and the subtypes of other cardiovascular diseases, such as coronary disease (OR = .96, 95% CI, .85-1.08, p = .48651) and atrial fibrillation (AF) (OR = 1.85, 95% CI, 1.70-2.02, p = 6.28 × 10-44). Our study reveals a possible causal effect of BMR on the risk of cardiomyopathy, heart failure and valvular disease, but not for coronary disease and AF.

Magnetic resonance imaging in the diagnosis of functional changes of the brain in menstrual disorders: a review

INTRODUCTION: Currently, the most common variant of the reproductive system disorders, in particular menstrual cycle disorders, in adolescent girls is oligomenorrhea. In situations after a complete diagnostic screening no organic and endocrine pathology of the reproductive system is detected in this group of patients, it is possible to conduct functional MRI as a method of identifying cause-and-effect relationships and clarifying the pathogenesis of menstrual disorders.OBJECTIVE: To analyze the available foreign and domestic literature to determine the role of magnetic resonance imaging in the diagnosis of functional brain changes in menstrual disorders in adolescent girls.MATERIALS AND METHODS: A search was conducted for scientific publications in the information and analytical systems PubMed and Google Scholar for 2013–2023 by keywords: «resting-state functional MRI» («functional resting MRI»), «oligomenorrhhea» («oligomenorrhea»), «adolescent girls» («teenage girls»), «reproductive system functional disorders» («functional disorders of the reproductive system»), «magnetic resonance imaging» («magnetic resonance imaging»), «diagnostic radiology» («radiation diagnostics»). 46 publications related to the diagnosis of functional brain changes in menstrual disorders in the form of resting state fMRI were analyzed.RESULTS: Resting state fMRI allows us to assess the basic brain activity in the absence of certain sensory or cognitive stimuli and visualize working networks that include various parts of the brain demonstrating synchronous changes in the BOLD-signal at rest. There are a number of patterns of changes in the BOLD-signal that can be observed in various phases of the menstrual cycle, as well as under the influence of stress factors, which makes it possible to visualize the morphological substrate of oligomenorrhea that occurs against the background of the absence of organic and endocrine pathology of the reproductive system in adolescent girls. Currently, there is little data in the scientific literature on the use of functional resting MRI in this cohort of patients, however, this method can have a significant impact on the formation of an individual plan for the correction of reproductive disorders in adolescence, and therefore requires further study.CONCLUSION: The use of fMRI can open up new possibilities in the diagnosis of functional brain disorders in girls with «unexplained» oligomenorrhea.

Manajemen Pendidikan Entrepreneur dalam Meningkatkan Kompetensi Wirausaha Santri pada Pondok Pesantren Riyadlusharfiwalmantiq

This study aims to determine the implications of planning, implementing and evaluating entrepreneurial education on the entrepreneurial competence of students at the Riyadlusharfiwalmantiq Islamic Boarding School. The research method uses a qualitative approach with phenomenological methods, data collection techniques using observation, interviews and documentation techniques. The analysis technique uses SWOT analysis. The validity test used source training and technical triangulation methods. The results of the study indicate that the Entrepreneurship Education plan at the Riyadlusharfiwalmantiq Islamic Boarding School is set out in the form of an entrepreneur learning curriculum, which consists of theory-based learning planning and practice-based planning. Furthermore, it is described in the form of a learning syllabus that contains basic competencies, subject matter, indicators, learning activities, time allocation and assessment. Entrepreneurship education is implemented with two methods, namely theory-based learning and practice-based learning. Evaluation of the results of Entrepreneurship Education is carried out in 2 ways, directly (during the learning process) and post-learning. To examine the evaluation of entrepreneurial education learning using an evaluation model, namely the evaluation of the CIPP (Context, Input, Process, and Product) model. Entrepreneurial competence of students at Riyadlusharfiwalmantiq Islamic Boarding School was formed to have social entrepreneur and corporate entrepreneur competencies. Entrepreneurial education management has implications for students to gain knowledge, skills, and attitudes and aims to make students have the ability and ability to become beginners in entrepreneurship.

Occupational therapy in maternal health: Exploring the Barkin Index of Maternal Functioning as a potential tool.

Transitioning into the role of a mother encompasses many physical and psychosocial changes, affecting the way a woman may function. Maternal health is an emerging area of practice for occupational therapists, and therefore, screening and assessment tools to support work in this area are needed. The Barkin Index of Maternal Functioning (BIMF) is a quantitative outcome measure that is used by health professionals to assess maternal functioning. Currently, its ability to measure occupational performance is unclear. Utilising a mixed methods design, this study analysed the extent to which the BIMF assesses maternal function from an occupational perspective. Thirteen first-time mothers with a baby 12 months of age or younger participated in the study. Results from the BIMF were compared with themes developed from semi-structured qualitative interviews that explored the occupational experiences of first-time mothers. Seven themes were developed from the interviews. The BIMF addressed three themes, including changes to engagement in basic activities of daily living and leisure, transitioning into motherhood, emotions, self-efficacy, and social support. However, four themes were not captured by the BIMF, including changes to partner relationships, identity shift, influence of 'person' factors, and changes to social experiences in early motherhood. Findings suggest that a new tool with a holistic perspective of mothers as occupational beings is needed to be able to identify occupational performance issues and the potential need for occupational therapy support. This study identified key experiences of occupational performance for new mothers.

Association of healthy lifestyle with life expectancy free of five major disabilities in Chinese older adults.

Whether and to what extent multiple healthy lifestyles affect the longevity of people with disabilities, including those in basic activities of daily living, mobility, vision, hearing and cognition, is crucial to policymakers. We aimed to determine the impact of combined lifestyles on life expectancy (LE) lived with and without five disabilities. We recruited participants (n = 15 121 from the China Longitudinal Healthy Longevity Survey between 2008 and 2018. Healthy lifestyle levels were estimated from six factors: smoking, drinking, physical exercise, diet, cognitive activity, and sleep, which we categorised as favourable and unfavourable using the latent class growth mixture model throughout the follow-up period. We used Multi-state Markov models to assess the different disability stages of LE. Of the total LE at age 65, older adults with a favourable lifestyle spent 59.60% (disability-free LE (DFLE) = 10.24 years) without five disabilities in combination, whereas those with unfavourable lifestyle spent 56.74% (DFLE = 7.28 years). Furthermore, the percentage of DFLE was 64.98 (7.71 years) and 68.38 (9.91 years) in males with unfavourable and favourable lifestyle levels, respectively, and 47.92 (6.62 years) and 55.12 (10.30 years) for females. Compared to older adults with low socioeconomic status (SES) and unfavourable lifestyle level, those with lower SES and favourable lifestyle level had more 3.77 years of DFLE, those with higher SES and unfavourable lifestyle level had more 1.94 years, as well as those with higher SES and favourable lifestyle level had more 5.10 years at age 65. Corresponding associations were found separately for each of the five individual disabilities. A favourable lifestyle level was associated with longer total LE along with a higher proportion of DFLE and may contribute to narrowing socioeconomic health inequalities. Policymakers should develop lifestyle interventions and scale up rehabilitation services in primary care, thereby delaying disabilities to later ages, especially in low- and middle-income countries.

Influence of mild cognitive impairment on clinical and functional prognosis in older candidates for cardiac surgery.

In this study, we analyzed the prognostic impact of mild cognitive impairment (MCI) prior to cardiac surgery on 12-month clinical outcomes in older patients. We performed a longitudinal prospective study of 48 patients undergoing cardiac surgery and 26 neurologically healthy participants aged 65 years or older. All participants underwent a neuropsychological assessment. Functional status, quality of life and frailty were assessed in candidates for surgery. One year after surgery, 24 patients remained in the study. Mild cognitive impairment (MCI) was diagnosed in 35% of the patients at baseline. Postsurgical changes in functionality consisted of a tendency toward impaired basic activities of daily living (BADL) in the MCI group and a statistically significant worsening in instrumental activities of daily living (IADL) in women with MCI. Changes in quality of life consisted of a significant improvement in anxiety-depression in the MCI group and a tendency toward greater pain-discomfort in the non-MCI group. Cognitive status significantly declined only in the non-MCI group. Neither group showed significant changes in frailty. Relative risk analysis showed that patients with a diagnosis of MCI at baseline had a higher risk of cognitive decline at follow-up, while those without a diagnosis of MCI at baseline had a lower risk of impaired IADL. No association was found between MCI and resource use. Preoperative impairment in memory, visuospatial and executive functions was significantly associated with loss of quality of life at follow-up. Impairment of memory and visuospatial function was significantly associated with cognitive decline. Preserved memory was associated with a lower risk of impaired BADL at follow-up. The present study provides clue on the impact of MCI in candidates for cardiac surgery. Preoperative detection of cognitive impairment could be highly valuable to help guide pre- and post-operative management.

Defective Assistive Device Involvement in Older Adult Emergency Department Visits.

Many older adults adopt equipment to address physical limitations and reduce dependence on others to complete basic activities of daily living. Although a few prior studies have considered injuries associated with assistive devices for older adults, those studies focused on older adults' health and functional risks for injury. There is limited analysis of older adult injuries involving defective or malfunctioning assistive devices. Data from this study are from the National Electronic Surveillance System All Injury Program which collected data on consumer product-related injuries from a probability sample of 66 hospital Emergency Departments across the United States. Data from 30776 older adult Emergency Department (ED) injury narratives from 2016 to 2020 were coded according to the assistive device involved and whether malfunctioning led to the injury. The study team manually examined all narratives in which the assistive device was coded to have malfunctioned. A total of 10974 older adult ED cases were treated for 12488 injuries involving a defective device. Injuries included 4212 head and neck injuries (eg, concussion), 4317 trunk injuries (eg, hip fractures), and 3959 arm or leg injuries (eg, leg fracture). Of these patients, 4586 were admitted to a hospital ward for further evaluation and treatment. Seventy percent of these patients were injured while using a walker; in contrast, wheelchairs were implicated in only 4% of the above cases. Design flaws were identified in 8158 cases and part breakage/decoupling incidents in 2816 cases. Our findings provide evidence that assistive devices are actively involved in older adult injuries. Further research is needed to reduce injuries associated with assistive devices by educating patients and their careproviders about device use and assembly and developing effective methods for informing manufacturers about malfunctioning devices.

Prevalence of functional dependence and chronic diseases in the community-dwelling Brazilian older adults: an analysis by dependence severity and multimorbidity pattern

BackgroundDespite the advancements in knowledge about health care for older adults, essential gaps persist regarding the effects of chronic diseases as epidemiological markers of the state of functional dependence. This study aimed to identify the prevalence of moderate and severe functional dependence in Brazilian older adults and its association with chronic diseases and verify the multimorbidity patterns by dependence status.MethodsThis cross-sectional analytical study used data from 11,177 community-dwelling Brazilian older adults from the 2013 National Health Survey conducted in Brazil. The dependent variables were moderate and severe functional dependence in basic activities of daily living (BADLs) and instrumental ADLs (IADLs). The independent variables were defined based on the questions applied to measure each morbidity in a self-reported manner and asked, "Has a doctor ever diagnosed you as having (each disease)? Multimorbidity was simultaneously considered present for older adults with ≥ 2 chronic morbidities. The association between functional dependence on BADLs and IADLs separately by severity and the independent variables was verified from crude and adjusted estimates of the point prevalence ratios and their 95% confidence intervals using the regression model Poisson with robust variance. To group diseases into patterns, exploratory factor analysis was used.ResultsThe prevalences of moderate and severe BADL dependence were 10.2% (95% CI, 9.6–10.7) and 4.8% (95% CI, 4.4–5.2), respectively. Moderate and severe IADL dependence prevalences were 13.8% (95% CI, 13.1–14.4) and 15.6% (95% CI, 14.9%–16.2), respectively. When changing the condition from moderate to severe dependence in BADLs, in the presence of other mental illnesses and stroke, the probability of dependence increased more than four times in the case of other mental illnesses and more than five times for stroke. There was a linear trend for dependence severity, both moderate and severe, whereas, for severe dependence on IADLs, this same factor maintained a linear trend toward an increase in probability as the number of diseases simultaneously increased.ConclusionsChronic diseases are associated with functional dependence, with greater emphasis on mental illnesses and stroke in severe disability, considering their acute adverse effects.

Attentional Resources and Independence in Basic and Instrumental Activities of Daily Living in Individuals with Intellectual Disabilities.

The relationship between attentional resources and functionality in individuals with intellectual disabilities (IDs) is clinically relevant. This study aimed to examine the possible relationship between the degree of ID and attentional resources, and to evaluate whether attentional resources predict the performance of basic and instrumental activities of daily living (ADL) in individuals with mild and moderate ID. This study, which employed a descriptive, cross-sectional, observational design, was conducted between July 2019 and May 2020. The sample consisted of 166 individuals divided into three groups: moderate ID, mild ID, and those without ID. These groups were compared for attentional functions (p < 0.001), obtaining an effect size ranging from medium to large. The results indicated that 40% of the variance in basic ADL performance was explained by the age of the participants, degree of disability, and sustained attention in individuals with ID. Additionally, 64% of the variance in instrumental ADL performance was explained by sustained, divided, and executive attention. Therefore, attentional resources appear to be associated with the performance of basic and instrumental ADL in individuals with mild and moderate ID.

The relationship between physical activity, self-efficacy and quality of life in colorectal cancer survivors: a multicenter cross-sectional study

PurposeThis study aimed to investigate the current situation and factors influencing physical activity, self-efficacy, and quality of life in Chinese colorectal cancer survivors. Additionally, this study explored the associations between physical activity, self-efficacy, and quality of life.MethodsA multicenter, cross-sectional study was conducted, involving 173 colorectal cancer survivors with a mean age of 59 years. Self-reported data on basic demographic characteristics, physical activity, self-efficacy, and quality of life were collected.ResultsAmong 173 colorectal cancer survivors, 90 (52.0%) were engaged in manual work. The self-efficacy score was found to be 25.99 ± 7.10, while the global health status score was 54.96 ± 21.56. Global health status was associated with sex, residence, chemoradiotherapy, and monthly income (p < 0.01). The self-efficacy score exhibited a significant positive correlation with quality of life, while demonstrating a negative correlation with symptom scores (p < 0.01). Recreational PA scores were positively associated with global health status (P < 0.05). Self-efficacy, recreational physical activity during winter, and whether the participants underwent chemoradiotherapy explained 29.3% of the variance in quality of life among colorectal cancer survivors.ConclusionsColorectal cancer survivors exhibited low levels of physical activity, self-efficacy, and quality of life. Their health is influenced by self-efficacy, recreational physical activity, and chemoradiotherapy. When developing intervention plans for colorectal cancer survivorship, it is crucial to consider survivors' self-efficacy and the type of physical activity in which they engage.

"In their own words": delineating the contours of dyspnea invisibility in patients with advanced chronic obstructive pulmonary disease from quantitative discourse analysis

BackgroundDyspnea conveys an upsetting or distressing experience of breathing awareness. It heavily weighs on chronic respiratory disease patients, particularly when it persists despite maximal treatment of causative abnormalities. The physical, psychological and social impacts of persistent dyspnea are ill-appreciated by others. This invisibility constitutes a social barrier and impedes access to care. This study aimed to better understand dyspnea invisibility in patients with chronic obstructive pulmonary disease (COPD) through quantitative discourse analysis.MethodsWe conducted a lexicometric analysis (lemmatization, descending hierarchical classification, multicomponent analysis, similarity analysis) of 11 patients' discourses (6 men, severe COPD; immediate postexacerbation rehabilitation) to identify semantic classes and communities, which we then confronted with themes previously identified using interpretative phenomenological analysis (IPA).ResultsClass#1 ("experience and need for better understanding"; 38.9% of semantic forms, 50% of patients) illustrates the gap that patients perceive between their experience and what others see, confirming the importance of dyspnea invisibility in patients' concerns. Class#2 ("limitations"; 28.7% of forms) and Class#3 (management"; 13.1% of forms) point to the weight of daily limitations in performing basic activities, of the need to accept or adapt to the constraints of the disease. These three classes matched previously identified IPA-derived themes. Class#4 ("hospitalization"; 18.2% of forms) points to the importance of interactions with the hospital, especially during exacerbations, which constitutes novel information.ConclusionsLexicometry confirms the importance of dyspnea invisibility as a burden to COPD patients.

Arrhythmias among Older Adults Receiving Comprehensive Geriatric Care: Prevalence and Associated Factors.

Cardiovascular diseases and arrhythmias are medical conditions that increase with age and are associated with significant morbidities and mortality. The aim of the present study was to investigate the prevalence of arrhythmias and clinical associations in the collective of older adults receiving comprehensive geriatric care (CGC). Holter ECG monitoring (HECG) of older patients hospitalized for CGC was analyzed. The prevalence of arrhythmias and the associations between the presence of arrhythmias, patients' characteristics and the functional status regarding basic activities of daily living (assessed by the Barthel index (BI)), walking ability (assessed by the timed up and go test (TUG)), and balance and gait (assessed by the Tinetti balance and gait test (TBGT)) were examined. In the presented study, 626 patients were included (mean age: 83.9 ± 6.6 years, 67.7% were female). The most common arrhythmias detected in HECG were premature ventricular contractions (87.2%), premature atrial contractions (71.7%), and atrial fibrillation (22.7%). Atrial flutter was found in 1.0%, paroxysmal supraventricular tachycardia in 5.8%, non-sustained ventricular tachycardia in 12.5%, first-degree AV block in 0.8%, second-degree AV block type Mobitz I in 0.8%, second-degree AV block type Mobitz II in 0.3%, pause > 2.5 s any cause in 3.5%, and pause > 3 s any cause in 1.6% of the cases. Premature atrial contractions were associated with the female sex (74.8% vs. 65.3%, p = 0.018), whereas in male patients, the following arrhythmias were more common: premature ventricular contractions (91.6% vs. 85.1%, p = 0.029), ventricular bigeminus (8.4% vs. 3.8%, p = 0.021), and non-sustained ventricular tachycardia (17.3% vs. 10.1%, p = 0.014). Atrial fibrillation detected in HECG was more frequent in patients at high risk of falls, indicated by their TBGT score ≤ 18 (24.7% vs. 12.0%, p = 0.006), and premature ventricular contractions were more common in patients unable to walk (TUG score 5) compared to those with largely independent mobility (TUG score 1 or 2) (88.0% vs. 75.0%, p = 0.023). In a logistic regression analysis, atrial fibrillation detected in HECG was identified as a risk factor for a high risk of falls (odds ratio (OR): 2.35, 95% confidence interval (CI): 1.23-4.46). In our study, investigation of HECG of older adults hospitalized for CGC revealed that premature atrial contractions, premature ventricular contractions, and atrial fibrillation were the most common arrhythmias. Premature atrial contractions were found to be more frequent in female patients, while male patients were more prone to premature ventricular contractions. In the investigated population, atrial fibrillation emerged as a risk factor associated with a high risk of falls.

Diferencias en la elección de la modalidad de diálisis entre inmigrantes y españoles en Barcelona

Few studies have analyzed the freedom to choose their renal replacement treatment (RRT) modality in Spain. In a total of 673 patients with ACKD (stage 4 and 5) seen at the outpatient ACKD clinic of Hospital del Mar, Barcelona, Catalonia (Spain) from 2009 to 2020, we retrospectively compared immigrant and Spanish patients in order to analyze the impact of migration on RRT decision-making and its subsequent evolution in advanced CKD (ACKD) consultation and identifies the social and economic needs of this population. One hundred thirteen (16.8%) patients were immigrants and 560 were Spanish (83.2%). Migrants more frequently chose HD at a center (79.5%) than PD (12.5%) compared to Spaniards (HD 55.5% and 25% PD) despite being younger and more independent in basic and instrumental activities of daily living. Immigrant patients started RRT with lower eGFR (8.1 vs. 9.1mL/min/1.73m3) and after a shorter follow-up time in the ACKD consultation than the Spaniards (22 vs. 32 months). The language barrier was associated with a greater choice of center-based HD and active employment status favored the choice of PD. Spanish patients had a significantly higher relative risk of mortality compared with immigrant patients (HR=3.27 [95% CI: 1.17–9.17], p=0.024). However, after adjustment by age, this increased relative risk of mortality disappeared (HR 1.99 [0.69–5.76], p=0.206). Almost 60% individuals were not linked to social services. In conclusion, most immigrants in Barcelona choose center-HD versus DP despite being younger and more independent in basic and instrumental activities of daily living and being in a better condition than Spanish patients. Considering the socioeconomic and cultural needs of the immigrant population we serve is necessary to effectively reduce health inequities.

Взаимосвязь динамики добавленной стоимости базовых и сервисных отраслей в арктических муниципальных образованиях

Economic development of the Arctic is largely determined by the value added of basic economic activities, providing income for other economic entities, including the population, budget, service, etc. Therefore, the study aims to identify the relationships between the economic activity of leading companies and other sectors of the municipal economy. To this end, socio-economic development models of municipalities in the Yamalo-Nenets Autonomous Okrug (YaNAO) were constructed. Basic (mining and construction) and service industries of Yamal (public administration and other service industries) were analysed using the author’s tw-stage approach. In the first stage, the value added of economic activities (both basic and service) of Yamal municipalities was determined. In the second stage, the correlation analysis was used to measure pairwise dependencies of changes in the value added of basic and service industries, while economic and mathematical modelling was applied to calculate the impact coefficients between them. Calculations for four pairs of sub-sectors for municipalities in general showed varying relationships (correlation ranged from 0.456 to 0.819). However, a hypothesis about the significant dependence of changes in the value added of basic and service industries was confirmed for oil and gas municipalities of YaNAO; the Purovsky district can be considered a standard of close correlation relationships. Analysis of the overall coefficients of the impact of basic industries on service industries revealed that the growth of value added in basic industries leads to a 11–17 % increase in the activity of service industries. At the same time, the model specification (based on the grouping of municipalities) of the relationship between basic industries and service activities showed that the impact varies from positive to negative for different groups of territories.

Capacidade funcional e práticas de autocuidado de idosos usuários da atenção primária à saúde e sua associação com indicadores de vulnerabilidade social

Abstract Introduction Public policies for older people encourage interventions aimed at preserving or improving their functional capacity and autonomy. Some of these policies emphasize self-care practices and the strengthening of daily activities, especially in primary healthcare. Objective The objective of this study was to assess the functional capacity and self-care practices of older users of primary healthcare in Brazil and their association with indicators of social vulnerability. Method This is a quantitative, cross-sectional, descriptive, and analytical study conducted with 128 older individuals. Results The results showed that being male, frail, and having diabetes and depression increases the likelihood of having difficulties in basic activities. They also showed that being female, aged over 80 years, frail, having poor self-perception of health, chronic conditions, anemia, osteoarthritis, and depression influence functional outcomes in instrumental activities. Conclusion The characterization of older people regarding sociodemographic data, self-perception of health, chronic conditions, level of frailty, and their relation to functional capacity and self-care is novel and relevant, given the scarcity of scientific studies assessing these aspects as compensatory practices for functional difficulties, as well as the associated factors, especially in older individuals residing in areas with indicators of vulnerability.

Atendimento on-line infantil em tempos de COVID-19

Abstract Objective: This study aims at shedding light on online child psychotherapy using cognitive-behavioral therapy as well as suggesting forms of psychological interventions during a pandemic. Method: Since the beginning of the recent coronavirus (SARS-CoV-2) outbreak, which causes COVID-19, there has been a great concern about a disease that has rapidly spread over the world, bringing about several different socio-economic issues. The fear of contracting the disease has led to safety measures and uncertainties with regard to the future, and it is believed that social isolation has had a direct and psychological impact on both adults and children. This way, we conducted a systematic search for literature review articles. Results: The clinical practice has led to observe that children had their routine interrupted and, consequently, prevented from basic activities such as going to school, being separated from friends, being apart from grandparents, spending the day with their parents, and not to mention, depending on their age, attending online classes in the most varied ways. Conclusion: It is clear that through the use of cognitive-behavioral therapy, forms of psychological interventions can be suggested in the face of the COVID-19 pandemic. Thus, it is clear that effective results are possible with online intervention.

Recognition of Hand Activities for Automatic Generation of Assembly Instructions

The manual generation of instructions for assembly processes requires time and effort. This is especially true for assembly processes that are characterized by a high variance of products at low quantities, as they are typically found in small and medium-sized enterprises (SMEs). Consequently, in SMEs, expert knowledge about the correct assembly of products is often only implicitly available among few experienced workers. Due to demographic changes, capturing this implicit knowledge becomes increasingly relevant to prevent expertise loss. A promising approach to reduce the generation effort is the automatic generation of assembly instructions based on process recordings. In prior work, the authors presented a concept of a system for automated instruction generation. The system processes video recordings of assembly processes with several independent modules for object, hand, and activity recognition and converts the results into assembly instructions. Among the individual processing modules, the hand activity recognition plays a special role, since the recognized activities form an important basis for the final assembly instruction. In this work, the utilization of Graph Convolutional Networks (GCNs) for the recognition of basic hand activities, such as rotating, is presented. Since the system for generating assembly instructions is intended to operate on arbitrary manual assembly use cases, the authors investigate the transferability of the proposed approach by training GCN models on the publicly available Assembly101 dataset and own recordings. The trained models are evaluated on respective test sets, mutually, and on a real-life example to assess the applicability of the proposed approach in practice. The identified challenges for reliable activity detection are discussed and offer important insights for future work.