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The spatial target motion model exhibits a high degree of nonlinearity. This leads to the fact that it is easy to diverge when the conventional Kalman filter is used to track the spatial target. The Unscented Kalman filter can be a good solution to this problem. This is because it conveys the statistical properties of the state vector by selecting sampling points to be mapped through the nonlinear model. In practice, however, the measurement noise is often time-varying or unknown. In this case, the filtering accuracy of the Unscented Kalman filter will be reduced. In order to reduce the influence of time-varying measurement noise on the spatial target tracking, while accurately representing the a posteriori mean and covariance of the spatial target state vector, this paper proposes an adaptive noise factor method based on the Unscented Kalman filter to adaptively adjust the covariance matrix of the measurement noise. In this paper, numerical simulations are performed using measurement models from a space-based infrared satellite and a ground-based radar. It is experimentally demonstrated that the adaptive noise factor method can adapt to time-varying measurement noise and thus improve the accuracy of spatial target tracking compared to the Unscented Kalman filter.

Background: The COVID-19 pandemic necessitated wide-ranging adaptations to the organisation of health systems, and primary care is no exception. This article aims to collate insights on the role of primary care during the pandemic. The gained knowledge helps to increase pandemic preparedness and resilience., Methods: The role of primary care during the pandemic in five European countries (Austria, Denmark, France, Hungary, Italy) was investigated using a qualitative approach, namely case study, based on document analysis and semi-structured interviews. In total, 31 interviews were conducted with primary care providers between June and August 2022. The five country case studies were subjected to an overarching analysis focusing on successful strategies as well as gaps and failures regarding pandemic management in primary care., Results: Primary care providers identified disruptions to service delivery as a major challenge emerging from the pandemic which led to a widespread adoption of telehealth. Despite the rapid increase in telehealth usage and efforts of primary care providers to organise face-to-face care delivery in a safe way, some patient groups were particularly affected by disruptions in service delivery. Moreover, primary care providers perceived a substantial propagation of misinformation about COVID-19 and vaccines among the population, which also threatened patient-physician relationships. At the same time, primary care providers faced an increased workload, had to work with insufficient personal protective equipment and were provided incongruous guidelines from public authorities. There was a consensus among primary care providers that they were mostly sidelined by public health policy in the context of pandemic management. Primary care providers tackled these problems through a diverse set of measures including home visits, implementing infection control measures, refurbishing used masks, holding internal meetings and relying on their own experiences as well as information shared by colleagues., Conclusion: Primary care providers were neither well prepared nor the focus of initial policy making. However, they implemented creative solutions to the problems they faced and applying the learnings from the pandemic could help in increasing the resilience of primary care. Attributes of an integrated health system with a strong primary care component proved beneficial in addressing immediate effects of the pandemic., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Introduction: Loss of physical activity and pulmonary dysfunction with its associated complications represent two of the most important causes of morbidity and mortality following cardiac surgery., Aim: To evaluate whether a physiotherapy program based on respiratory training with or without musculoskeletal mobilization, started preoperatively, may provide a significant improvement in pulmonary and musculoskeletal recovery postoperatively in a sufficiently large sample of patients undergoing elective cardiac surgery., Material and Methods: One-hundred and two patients with similar baseline and preoperative characteristics were assigned to a preoperative respiratory physiotherapy protocol (group R, n = 34), a preoperative respiratory and motor physiotherapy protocol (group R + M, n = 34), or no preoperative specific physiotherapy protocol but only a simplified perioperative standard physiotherapy protocol (control group, C, n = 34). Data on 6-minute walking test, peak expiratory flow, and from blood gas analysis were retrospectively analyzed., Results: As compared with group C, a statistically significant improvement was observed in the two preoperatively treated groups in terms of 1) better pre- (+0.7-0.8 Lt/min, p < 0.05) and postoperative (+1 Lt/min, p < 0.01) peak expiratory flow values; 2) longer pre- (+50-100 m, p < 0.01) and postoperative (+65-170 m, p < 0.01) distance traveled in the 6-minute walking test; 3) better PaO 2 , SaO 2 , pH value in postoperative blood gas measurements ( p < 0.05, for all comparisons); 4) reduction of postoperative length of in-hospital stay ( p < 0.05)., Conclusions: A benefit of combined respiratory and motor physiotherapy protocols can be expected in the groups of patients preoperatively treated, especially with the respiratory one, either before or after cardiac surgery with a faster recovery of physical-functional activities. Specifically, the motor protocol is associated with greater autonomy of running before or after cardiac surgery., Competing Interests: Authors report no conflict of interest., (Copyright © 2020 Polish Society of Cardiothoracic Surgeons (Polskie Towarzystwo KardioTorakochirurgów) and the editors of the Polish Journal of Cardio-Thoracic Surgery (Kardiochirurgia i Torakochirurgia Polska).)

Introduction: Loss of physical activity and pulmonary dysfunction with its associated complications represent two of the most important causes of morbidity and mortality following cardiac surgery. Few studies have investigated the effects of preoperative interventions targeted at improving cardiorespiratory and musculoskeletal function in the postoperative period., Aim: To evaluate whether a physiotherapy program based on respiratory training with or without musculoskeletal mobilization, started preoperatively, may provide a significant improvement in pulmonary and musculoskeletal recovery postoperatively in patients undergoing elective cardiac surgery., Material and Methods: Patients with similar baseline and preoperative characteristics were randomly assigned to a preoperative respiratory physiotherapy protocol (group A), a preoperative respiratory and motor physiotherapy protocol (group B), or no preoperative specific physiotherapy protocol but only a simplified perioperative standard physiotherapy protocol (control group or group C). Group A consisted of 19 patients, group B of 20, group C of 20. Data on 6-minute walking test, peak expiratory flow, and from blood gas analysis were retrospectively analyzed., Results: As compared with group C, a statistically significant improvement was observed in the two preoperatively treated groups A and B in terms of longer pre- and postoperative distance traveled at the 6-minute walking test, better pre- and postoperative peak expiratory flow value, and better PaO 2 and SaO 2 values in postoperative blood gas measurements ( p < 0.05, for all comparisons). A statistically significant reduction of the postoperative length of in-hospital stay was also observed in group B., Conclusions: As compared with the control group, substantially better clinical results for respiratory and musculoskeletal function were found in the groups preoperatively treated with physiotherapeutic protocols immediately before as well as after cardiac surgery., Competing Interests: The authors report no conflict of interest.

Background: Many countries are seeing a dramatic increase in the average age of their clinicians. The literature often highlights the challenges of high replacement costs and the need for strategies to retain older personnel. Less discussed are the potential pitfalls of knowledge acquisition and transfer that accompany this aging issue., Purpose: We propose a conceptual framework for understanding how clinicians' age interact with ability, motivation, and opportunity to predict clinical knowledge transfer and acquisition in health care organizations., Approach: This study integrates life-span development perspectives with the ability-motivation-opportunity framework to develop a number of testable propositions on the interaction between age and clinicians' ability, motivation, and opportunity to acquire and transfer clinical knowledge., Results: We posit that the interaction between ability (the knowledge and skills to acquire knowledge), motivation (the willingness to acquire and transfer knowledge), and opportunity (resources required for acquiring and transferring knowledge) is a determinant of successful knowledge management. We also suggest that clinicians' age-and more specifically, the cognitive and motivational changes that accompany aging-moderates these relationships., Conclusion: This study contributes to existing research by offering a set of testable propositions for future research. These propositions will hopefully encourage empirical research into this important topic and lead to guidelines for reducing the risks of organizational knowledge loss due to aging., Practice Implications: We suggest several ways that health care organizations can tailor managerial practices in order to help capitalize on the knowledge-based resources held by their younger and older clinicians. Such initiatives may affect employees' ability (e.g., by providing specific training programs), motivation (e.g., by expanding subjective perceptions of future time at work), and opportunities (e.g., by providing mentoring, reverse mentoring, and coaching programs) to acquire and transfer knowledge.

Aim: Study aimed to analyse how rehabilitation staff spends working time on specific activities in a neurorehabilitation hospital and to determine the number of direct activities received by patients with different levels of disease severity., Background: Few studies have investigated how clinical staff spends their time on activities in rehabilitation hospitals without considering at the same time all working categories and without reporting the number of direct activities received by patients with respect to their disease severity., Design: Self-reported observational study., Method: Work Sampling Technique was used to record direct, indirect, unit-related and personal activities every 5 min for 2 days., Results: Total of 6,974 activities were recorded over 581 working hours. Physiotherapists and nurses spent 75.2% and 54.8% of their time in direct activities and medical doctors only 25.4%. Total time of direct activities was significantly different among worker categories (p = 0.001) and depended on patients' disease severity (p = 0.020) in a different manner among worker categories (interaction: p = 0.010). This time ranged from almost 4 hr up to 6½ hr for the most severely affected patients., Conclusion: Type of work differed among professionals. Workload greatly depended on degree of patients' disability., Implications for Nursing Management: Nurses and therapists spent most of their time in direct activities with patients. Economic burden of neurorehabilitation may vary greatly depending on disease severity., (© 2018 The Authors. Journal of Nursing Management Published by John Wiley & Sons Ltd.)

Background: Around the world, health reforms are increasingly fostering collaboration and integration among primary care physicians with the aim of facilitating knowledge sharing and evidence-informed decision-making. Although extant research on this topic is abundant, the evidence and results regarding social and organizational factors affecting the formation of knowledge-sharing networks in this setting are inconclusive., Purpose: The aim of this article is to explore multiple theoretical mechanisms explaining the formation of knowledge-sharing networks among primary care physicians across relevant clinical areas., Methodology/approach: The data are collected from two local health authorities in the Italian National Health Service that are responsible for delivering primary care in two Italian regions. Exponential random graph models are used to test the hypotheses., Findings: Our findings indicate that knowledge-sharing networks are highly correlated across clinical areas. In addition, knowledge-sharing networks are highly reciprocal and clustered. We also observe that formal models adopted to foster collaboration have remarkably different effects on the formation of knowledge networks, depending upon the diverse knowledge management approaches adopted in the surveyed local health authorities., Practice Implications: Primary care organizations need to develop and implement knowledge management practices in order to help physicians in identifying knowledge domain experts as well as to support connections through formal groupings and incentives.