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Introdução: As instituições de longa permanência para idosos oferecem muitas vantagens para essas pessoas, mas também podemos observar alguns problemas, causados principalmente pela mudança radical em sua rotina, o que pode levar a alterações em seus hábitos, principalmente nos hábitos alimentares. Objetivo: Avaliar o estado nutricional da população idosa institucionalizada no município de Praia Grande/SP. Métodos: A amostra foi composta por 391 sujeitos: 109 homens e 282 mulheres. A avaliação nutricional foi realizada através da Mini Avaliação Nutricional. A avaliação antropométrica consistiu em medidas de massa corporal, estatura, índice de massa corporal, circunferência do braço e circunferência da panturrilha. Resultados: Os resultados revelaram que 49,6% dos idosos avaliados apresentam risco de desnutrição ou desnutrição. Conclusão: Os dados reunidos são preocupantes e refletem a necessidade de construir novas políticas relativas às questões relacionadas ao cuidado no envelhecimento saudável, incluindo assistência qualificada em instituições de longa permanência.

Over the engineering history, environmental and social needs inspire the development and innovation of many wonderful applications. For example, when the industrial robots entered our industrial life, great advances especially in automotive industry where the industrial robots cover about 90 % of the car industry activities started to change our own life. As the number of elderly people is increasing rapidly all over the world, this requires us to focus on their needs as their children left them alone in our busy daily life. Mechatronics and robotics can offer many possibilities to help elderly people by providing smart solutions for their daily needs as well as entertaining them during their lonely long stay at their homes. Many companies are providing smart mobile robots in different platforms (wheeled or walking) to help the elderly people depend on themselves in receiving their food and medicine at prescheduled times. Other companies are interested in providing smart wheel chairs to help the elderly people navigate indoor and outdoor freely and conveniently without any external help. Meanwhile, some companies are providing entertainment robots in different shapes to talk, play and communicate with elderly people in a nice way. The objective of this paper is to explore the mechatronics and robotics capabilities to assist elderly people and to make their life easier, comfortable and self-governing without any external help. This paper will highlight also the effect of the environment and the social needs in inspiring new innovations. As an example, the innovations by Badi Az-Zaman Ismail Al-Jazari, a Muslim scientist, will be investigated. This paper is going to discuss also the idea and the motivation behind two of Al-Jazari’s robotic applications (Although the term robot was not coined at that time). These two devices are the washing hands and the peacock fountain. Although he used to apply mechanical structure and fluid for controlling the motion of the two devices, they were very beautiful and resemble some of the robotic applications nowadays.

Mandatory restrictions on social activities and access to services during the COVID-19 pandemic prevented discharge into the community of consumers from an extended-stay, hospital-based rehabilitat...

BACKGROUND: Despite so much research in high altitude area, our existing knowledge is still lacking on otological effects of long-term stay in high altitude. This pilot study was conducted to compare the hearing thresholds of army soldiers at induction and after completion of one year in high altitude area (HAA). METHODS: Hearing thresholds of 433 soldiers posted in HAA were recorded using pure tone audiometry at the time of induction and second thresholds after one year of stay in high altitude for frequencies of 500Hz, 1KHzs, 2 KHzs and 4 KHzs. The two sets of hearing thresholds for air conduction were compared using paired “t” test for any statistical significance. RESULTS: The mean Pure Tone Audiometry (PTA) thresholds for 433 left ears worsened from 9.43dB to 9.65dB at 500 HZs ; 14.02dB to 14.32dB at 1 KHZs ; 15.04dB to 16.09dB at 2KHzs and 18.63dB to 22.59dB at 4 KHZs. Similarly for right ear, PTA thresholds worsened from 9.43dB to 9.69dB at 500HZs; 13.95dB to 14.34dB at 1 KHZs; 15.38dB to 17.26dB at 2 KHZs and from 18.59dB to 23.06dB at 4KHZs. These results are found to be statistically significant (p

Background Overactive bladder (OAB) is a prevalent condition commonly treated with anticholinergic medications. The extent to which anticholinergic burden is associated with costs and healthcare resource use (HCRU) in the long-stay nursing home (LSNH) setting is currently unknown. Objectives This research evaluated the impact of anticholinergic burden on HCRU and related costs among LSNH residents with OAB. Methods This was a cohort study based on 2013–2015 Minimum Data Set-linked Medicare claims data involving LSNH residents aged ≥ 65 years with OAB and having Parts A, B and D coverage 6 months pre- and ≥ 12 months post-nursing home admission date (index date). Cumulative anticholinergic burden was determined using the Anticholinergic Cognitive Burden scale and defined daily dose. Direct medical costs related to HCRU were examined. HCRU included inpatient, outpatient, emergency room (ER), and physician office visits. Costs and HCRU associated with levels of anticholinergic burden were evaluated using generalized linear models. Results A total of 123,308 LSNH residents with OAB were included in this study. Most residents (87.2%) had some level (12.8%, none; 18.0%, low; 41.9%, moderate; and 27.3%, high) of cumulative anticholinergic burden. Results indicate that all types of resource utilization were higher among those with any level of anticholinergic burden than those with no burden. The outpatient, ER, and physician costs tended to be higher with increasing anticholinergic burden. Conclusions Costs and HCRU patterns reflected increasing trends with anticholinergic burden. Targeted efforts towards reducing anticholinergic burden among LSNH residents with OAB may result in decreases in costs and HCRU. Supplementary Information The online version contains supplementary material available at 10.1007/s41669-021-00281-8.

Objective Excluded from reporting to CMS's Percentage of long-stay residents who got an antipsychotic medication quality-measure are antipsychotics prescribed to nursing home patients with schizophrenia, Tourette's, or Huntington's. Over the 4 years following its 2012 debut, the quality-measure calculated a 27% reduction in inappropriate antipsychotic use but also an 18.3% increase in exclusion claims. This study evaluated the impact of these exclusions on the measure's findings. Methods Claims data for the years 2011–2016 retrospectively identified the prevalence of schizophrenia, Tourette's, and Huntington's in quarterly cohorts of Virginia long-stay residents prescribed antipsychotics. Annualized diagnoses in 2011 were compared with subsequent years using simple logistic regression. Results In 2016, 29% of the antipsychotics prescribed in Virginia nursing homes were to residents with diagnoses of schizophrenia, Tourette's, and Huntington's, a significant 32% increase from 2011. Conclusion Almost 30% of the antipsychotics employed in Virginia nursing homes are excluded from CMS's long-stay antipsychotic quality-measure.

Medicare provides skilled nursing facility (SNF) coverage for short-stay rehabilitation in nursing homes (NHs) at a better rate than Medicaid covers long-term NH care. National trends of increasing Medicare days culminated in 2010/2011 with a reduction to the SNF rates. Before the cuts, NHs that increased SNF days also improved outcomes for long-stay residents, including pain, pressure ulcer, and functional decline outcomes, suggesting spillover effects of SNF days. We replicated the prior study to determine how changes in SNF days and long-stay outcomes related following the rate cut. From 2011 to 2014, SNF days decreased and all three study outcomes improved. Spillover effects were not consistently observed. Decreasing SNF days was associated with increasing percentages of long-stay residents with daily pain and with decreasing percentages of long-stay residents getting pressure ulcers. Research on these associations in more recent years is needed to determine whether they persist and to inform practice.

The characteristics of transformation of the psychophysiological state of servicemen during a long stay in the combat zone have been studied. The psychophysiological status of servicemen, muscular strength and endurance of right and left arms were assessed. The obtained results indicate that the studied contingent was heterogeneous in its psychophysiological status and was divided into two subgroups «better» and «worse». It was found that the studied psychophysiological parameters are described by two orthogonal factors (65%) - the «activation and stress of the body» factor (38%) and the «quality of cognitive processes» factor (27%). The first factor is the most powerful, this indicates a significant role of a serviceman’s stress-resistance in the conditions of long stay in the combat zone. It was found that this factor is also the leading one in the «worse» subgroup, this to a lesser extent can prevent disorder and unpredictability of behavioral reactions of combatants. In the «better» subgroup «quality of cognitive processes» was the leading factor. It plays a significant role in the balanced activity of functional systems of the body responsible for formation of adaptive behavioral responses during long-term action of high-level stressors. The decisive rules for selection of servicemen best suited for carrying out official duties in conditions of high-risk activities have been developed.

Introdução: O processo de envelhecimento da população tem ocorrido juntamente com transformações sociais, econômicas e culturais. A procura por Instituições de Longa Permanência para Idosos (ILPI’s) está aumentando e representando uma nova alternativa de moradia para a pessoa idosa. Objetivo: O presente estudo teve como objetivo avaliar a satisfação dos idosos sobre os atendimentos prestados pelos acadêmicos do curso de fisioterapia durante o estágio curricular nas ILPI’s. Metodologia: A amostra foi constituída por 26 idosos de ambos os gêneros, que participaram dos atendimentos prestados pelos acadêmicos de fisioterapia. Os participantes foram submetidos a uma entrevista individual onde responderam um questionário contendo questões abertas e fechadas. Resultados: Ao analisar os resultados obtidos foi possível observar que 77% dos idosos gostam de realizar fisioterapia, 58% preferem as atividades em grupo, 69% sentiria falta se não houvesse mais atendimentos e 96% declararam satisfeitos. Conclusão: Os dados sugerem considerável contentamento do idoso com o atendimento, além disso os exercícios proporcionaram, além de resultados físicos positivos, uma recuperação da autoestima e do convívio social destes idosos.

This article follows a study of a collection of baby clothes assumed to be of late seventeenth-century date to ascertain whether or not that assumption might be correct. The collection is unusual in containing caps, rare in themselves but also decorated with lace frills in the adult frelange style; a rare pair of sleeves with paned oversleeves; and christening and other items for wear by a swaddled infant which are more common in known collections but here, more unusually, trimmed with Flemish bobbin lace. The article discusses the items in terms of their relationships with each other, their construction, their fabrics and how they were worn. Comparisons with similar and related articles in other collections and in seventeenth-century portraits of adults and children enable the author to conclude that the articles probably do date from the late seventeenth century but from slightly different decades.

Background: One of the main objectives of hospital managements is to control the length of stay (LOS). Successful control of LOS of inpatients will result in reduction in the cost of care, decrease in nosocomial infections, medication side effects, and better management of the limited number of available patients’ beds. The length of stay (LOS) is an important indicator of the efficiency of hospital management by improving the quality of treatment, and increased hospital profit with more efficient bed management. The purpose of this study was to model the distribution of LOS as a function of patient’s age, and the Diagnosis Related Groups (DRG), based on electronic medical records of a large tertiary care hospital. Materials and Methods: Information related to the research subjects were retrieved from a database of patients admitted to King Faisal Specialist Hospital and Research Center hospital in Riyadh, Saudi Arabia between January 2014 and December 2016. Subjects’ confidential information was masked from the investigators. The data analyses were reported visually, descriptively, and analytically using Cox proportional hazard regression model to predict the risk of long-stay when patients’ age and the DRG are considered as antecedent risk factors. Results: Predicting the risk of long stay depends significantly on the age at admission, and the DRG to which a patient belongs to. We demonstrated the validity of the Cox regression model for the available data as the proportionality assumption is shown to be satisfied. Two examples were presented to demonstrate the utility of the Cox model in this regard.

We aimed to build a predictive model with intrinsic factors measured upon admission to skilled nursing facilities (SNFs) post-acute care (PAC) to identify older adults transferred from SNFs to long-term care (LTC) instead of home. We analyzed data from Massachusetts in 23,662 persons admitted to SNFs from PAC in 2013. Explanatory logistic regression analysis identified single “intrinsic predictors” related to LTC placement. To assess overfitting, the logistic regression predictive model was cross-validated and evaluated by its receiver operating characteristic (ROC) curve. A 12-variable predictive model with “intrinsic predictors” demonstrated both high in-sample and out-of-sample predictive accuracy in the receiver operating characteristic ROC and area under the ROC among patients at risk of LTC placement. This predictive model may be used for early identification of patients at risk for LTC after hospitalization in order to support targeted rehabilitative approaches and resource planning.

AIM To review the literature of the benefits of enteral zinc supplementation in preterm population

OBJECTIVES: To longitudinally examine the latent statuses of depressive symptoms and their association with cognitive impairment in older U.S. nursing home (NH) residents. METHOD: Using Minimum Data Set 3.0, newly-admitted, long-stay, older NH residents with depression in 2014 were identified (n = 88,532). Depressive symptoms (Patient Health Questionnaire-9) and cognitive impairment (Brief Interview of Mental Status) were measured at admission and 90 days. Latent transition analysis was used to examine the prevalence of and the transition between latent statuses of depressive symptoms from admission to 90 days, and the association of cognitive impairment with the statuses at admission. RESULTS: Four latent statuses of depressive symptoms were identified: ‘Multiple Symptoms’ (prevalence at admission: 17.3%; 90 days: 13.6%), ‘Depressed mood’ (20.0%; 19.5%), ‘Fatigue’ (27.4%; 25.7%), and ‘Minimal Symptoms’ (35.3%; 41.2%). Most residents remained in the same status from admission to 90 days. Compared to residents who were cognitively intact, those with moderate impairment were more likely to be in ‘Multiple Symptoms’ and ‘Fatigue’ statuses; those with severe impairment had lower odds of belonging to ‘Multiple Symptoms’, ‘Depressed Mood’, and ‘Fatigue’ statuses. CONCLUSION: By addressing the longitudinal changes in the heterogeneous depressive symptoms and the role of cognitive impairment, findings have implications for depression management in older NH residents.

This paper discusses the cleric Nikolaus Graurock († 1493), who came to Rome at a young age to embark upon a remarkable career. His connection to the Hospital and Fraternity of Santa Maria dellʼAnima was the first important support used by this man of legal and diplomatic talents, who thus became acquainted with the customs of the Curia and of Rome and was able to quickly build up a personal network. His membership of the familia of cardinal Latinus Orsini, who came from a family of the high nobility with influence in Rome and Italy, was also fundamental. In the 1450 s, Graurock was one of the key figures – especially in the „Lüneburg Prelate War“ – in the exchange between the Curia and representatives from northern Germany. Thanks to his position, however, Nikolaus Graurock also promoted the careers of others, including relatives. During his long stay in Rome he came into closer contact with those humanists who played an increasingly important role at the papal court from the second half of the 15th century onwards and whose works he later disseminated in Germany. This example of a mid-level cleric thus offers fundamental insights into the career opportunities that Rome and the Curia offered in the 15th century.

This research aims to identify the influence of individual characteristics of people in East Bogor district and the effectiveness of the campaign program Bogor Without Plastic Bag to the community's concern on the environment. This study uses a descriptive quantitative approach, which is conducted in the House of residents in the Ciliwung River basin of East Bogor subdistrict. The results of research based on T test showed that there is no influence between the individual characteristics of the community of Bogor Timur (X1) consisting of age, gender, occupation, education, ethnic, and long stay in Bogor to concern Society in the Environment (Y), except on gender indicator, especially women shows have a partial influence on environmental concern. Meanwhile, based on the effectiveness program campaigns of Bogor without plastic bags (X2) significantly affects the Community's awareness on the environment (Y). The F test result indicates that the variable (X1) and (X2) affect the stimulant of the variable (Y). Result of the calculation of coefficient of determination (R2) of 47.8%, meaning not only the individual characteristics factor of the community and the effectiveness of the Bogor program without plastic bags that affect the Community's awareness of the environment.

The purpose of this study is to examine Physical Therapy (PT) and Occupational Therapy (OT) staffing patterns in nursing homes and understand their relationship with quality performance. Bivariate analyses between PT/OT staffing and facility characteristics were performed to understand staffing patterns and random effects regressions were run to explore the link between therapy staff and quality. Findings suggest PT/OT staff have a positive influence on resident outcomes and therapy staffing patterns significantly differ across provider attributes, including size, profit status, and occupancy rate, among others. The findings can be used to inform policymakers about potential unintended consequences resulting from changes to Medicare reimbursement policies.

The article deals with stress as a physiological reaction of a person that occurs when the body responds to the extreme demands of the environment. When talking about stress, most often mean professional stress associated with problems at work, school, administrative or dispatching service, retirement, physical stress, family problems or the death of a loved one. The concept of stress means complete exhaustion after hard work, a long stay in an unfavorable environment, in fear, a state exceeding the strength of man. Studying at a higher education institution is stressful for most students. Starting from the very beginning of educational activity, stress to some extent constantly pursues the student and is the cause of violations of behavioral, emotional, cognitive, motivational spheres of activity.

Aim To present the European Society of Clinical Oncology current recommendations for the gynecological cancer treatment on the background of the COVID-19 pandemic Materials and methods A literature search was carried out for the most modern literary sources available, published in March and April 2020, based on the experience of several European communities of gynecological oncology We have compiled guidelines from several international communities working with oncological patients for consideration and possible practical application during the ongoing COVID-19 pandemic Results Recommendations for sanitary - epidemiological activities aimed at reducing the risk of infection, as well as the sequence of therapeutic and diagnostic actions in oncogynecological patients, depending on the disease and stage of the tumor process, were presented Factors influencing treatment planning were indicated;a system of measures to provide palliative care for this category of patients was developed Conclusion In the face of the ongoing pandemic, these recommendations can help to choose the optimal tactics for gynecological cancer patients management, and also to ensure the safety of both patients and the medical staff involved in treatment process It is necessary to adhere to preventive and protective measures in conditions of a high infection risk for medical personnel and patients at the stage of outpatient and inpatient care It is necessary to reduce or postpone extended, combined or simultaneous surgical interventions that involve a long stay on the ventilator in the intensive care unit Consideration of alternative methods of conservative therapy is possible In addition, the use of remote consultations helps to resolve tactical issues, avoiding additional infection risks Введение В 2019 -2020 гг мир столкнулся с кризисом вследствие нарастающей пандемии, связанной с разрушительным воздействием коронавирусной инфекциии (COVID-19) Цель исследования Представить современные рекомендации европейского общества клинической онкологии по лечению гинекологического рака в условиях пандемии COVID-19 Материалы и методы Проведен поиск доступных самых современных литературных источников, опубликованных в марте и апреле 2020 года в базах PubMed (https://www ncbi nlm nih gov/pubmed/), Научной электронной библиотеки Elibrary ru (https://elibrary ru/) и сайтах нескольких европейских онкогинекологических сообществ профессиональных Поиск в базах данных проводили по ключевым словам «COVID-19», «cervical cancer», «endometrial cancer», «ovarian cancer», «vulvar cancer» и «vaginal cancer» Мы отобрали и объединили рекомендации, подготовленные несколькими международными сообществами, занимающихся лечением пациентов с онкогенитальной патологией, и предназначенные для рассмотрения и возможного применения на практике во время пандемии COVID-19 Результаты Изложены рекомендации по санитарно-эпидемиологическим мероприятиям, направленным на снижение риска инфицирования;последовательности лечебно-диагностических мероприятий у онкогинекологических больных в зависимости от нозологии и стадии опухолевого процесса Подробно описаны рекомендации при лечении больных с раком шейки матки, раком эндометрия, раком яичников, раком вульвы, раком влагалища Обозначены факторы, влияющие на планирование лечения;предложена система мероприятий по оказанию паллиативной помощи данной категории больных Заключение В условиях продолжающейся пандемии данные рекомендации помогут выбрать оптимальную тактику ведения пациенток с гинекологическим раком, обеспечить безопасность как пациентам, так и участвующему в лечении медперсоналу Необходимо соблюдение мер профилактики и защиты в условиях высокого риска инфицирования медицинским персоналом и пациентами на этапе амбулаторной и стационарной помощи Необходимо сократить либо отложить расширенные, комбинированные или симультанные хирургические вмешательства, предполагающие длительное нахождение наискусственной вентиляции легких (ИВЛ) в условиях реанимационного отделения Возможно рассмотрение альтернативных методов консервативной терапии Кроме того, использование дистанционных консультаций в режиме онлайн, помогает разрешить тактические вопросы, избежав дополнительных рисков инфицирования

Objectives From 2013 to 2016, the Centers for Medicare and Medicaid Services Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents (“the Initiative”) tested a series of clinical interventions and care models, through organizations called Enhanced Care and Coordination Providers (ECCPs), with the goal of reducing avoidable inpatient hospital admissions among long-stay nursing home residents. We identify the effect of the Initiative on the probability and count of acute care transfers [capturing any transfer to the hospital, including hospitalizations (inpatient stays), emergency department visits, and observation stays]. Design We evaluate the effect of the Initiative on the probability and count of all-cause acute care transfers and potentially avoidable acute care transfers and estimate the average effect of the Initiative per resident per year. Setting and Participants We use 2011–2016 data from the Centers for Medicare and Medicaid Services Minimum Data Set, version 3.0, nursing home resident assessments linked with Medicare eligibility and enrollment data and Medicare inpatient and outpatient hospital claims. Our sample is limited to Medicare fee-for-service beneficiaries in participating ECCP facilities and a comparison group of long-stay nursing facility residents. Methods We evaluate the effect of the Initiative on both the probability and count of all-cause acute care transfers and potentially avoidable acute care transfers using difference-in-differences regression models controlling for both resident-level clinical and demographic characteristics as well as facility-level characteristics. Results We found statistically significant evidence of a reduction in both the probability and count of all-cause and potentially avoidable acute care transfers among long-stay nursing facility residents who participated in the Initiative, relative to comparison group residents. Conclusions and Implications The clinical interventions and care models implemented by the ECCPs show that by using staff education, facility leadership and physician engagement, and/or clinical assessment and treatment of residents who experienced a change in condition, it is possible to reduce acute care transfers of nursing facility residents. This could lead to better outcomes and reduced cost of care for this vulnerable patient population.

Japanese long-stay in Thailand has been increased according to economic agreements; meanwhile, there is no data in the official report to second-generation as Thai-Japanese multiracial groups in Thailand. These two groups could be related number of increases because of family relationship reasons. According to developed countries, dismissing this relationship impact could because of racism, nationality, and tourism development issues. This research aimed (1) to study the impact of Japanese long-stay in Thailand (2) to study the current situation from Japanese long-stay tourist and Thai-Japanese multiracial in Thailand (3) to explore the elements of development dimensions from Japanese long-stay tourist and Thai-Japanese multiracial. In-depth interview and Data triangulation were used to analyze the data of similarity and generation perspectives into the data-saturated interpretation. Bangkok (1st province choosing by Japanese) in addition to Japan Embassy Thailand 2018 from 4 Thai-Japanese interviewees, four people of multiracial person family (Japanese long stay or migrant: Japanese first generation) and four specialists with personal safety data in promise. The result showed the current situation of Japanese long-stay tourist and multicultural Thai-Japanese issues. Government image, Economic policy, Good educational system, and having a government long stay center which could develop to Thailand tourism. Multiracial issues could be prepared in legal multiracial nationality status, and support and encourage the education system to social units could decrease conflict situations. Lastly, an ability to hold two nationalities and passports, Family and relationship, and working environment and living freedom were the main decision making of multiracial Thai-Japanese to live in Thailand.

Background: Psychotropic drugs are essential but not devoid of adverse drug reactions (ADRs), which lead to non-compliance and further failure of therapy, hampering the patient’s quality of life. Methods: A cross-sectional, observational study was carried out in a residential nursing home in Pune, India, from October 2018 to March 2019. Psychiatric inpatients of both genders and all ages receiving psychotropic drugs for at least one month were enrolled. Patients who were not alert or oriented enough to give a detailed history and response to a questionnaire, including dementia patients, and those who were not willing to give informed consent were excluded. The ADRs were categorized, and their management was documented using the Udvalg for Kliniske Unders gelser (UKU) side effect rating scale. ADRs were assessed for causality and severity using the WHO-Uppsala Monitoring Centre (WHO-UMC) causality assessment scale and the Modified Hartwig and Siegel scale. Results: In our study, 115 patients (76.6%) experienced 273 adverse drug events. Atypical antipsychotics accounted for the maximum number of ADRs (54.94%; n = 150). The most common ADRs were weight gain, constipation, and tremors. The majority of ADRs were “mild” and had a “possible” causality relationship. Conclusion: The study demonstrated a high incidence of ADRs, which was primarily managed either by reduction of dose or continued drug use with the treatment of side effects.

PurposeThe purpose of the paper is to sought to know the implication of COVID-19 lockdown for food security in NigeriaDesign/methodology/approachThe study examined implication of COVID-19 lockdown for food security. The cross sectional survey research design was employed. Information was elicited from respondents through the social medium (Facebook). The question response format of the instrument was of the five-point Likert scale type. Research data were analysed using one sample t-test and least squares (regression).FindingsThe results show that COVID-19 lockdown can significantly constrain farm labour, transportation and security, while food security can be threatened by insufficient labour, transportation, farmers' morale and farm coordinationResearch limitations/implicationsA major limitation was the restriction to only online data collection method owing to the researcher's inability to administer the instrument physically as a result of the lockdown. This had an implication on randomisation.Social implicationsLong stay of people at home and away from farm activities will threaten food security on the long run and thus, precipitate social vices due to the attendant hunger and deprivationOriginality/valueIn empirical examination of the impact of COVID-19 pandemic lockdown on food security, thereby providing statistical evidence that will be useful in the sensitisation of stakeholders on the need to thread on the part of caution to avoid the possible consequences of restricting farmers' operations through the COVID-19 lockdown.

One of the members of the first German military committee sent to te Ottoman Empire as a result of the Ottoman-German rapprochment during the reigon of Abdulhamit the 2nd was Cavalry Captain Von Hobe. Like the other officers serving the Ottomans and promoted to higher ranks Von hobe Pasha made a name for himself due to his activities related to Istabl-i Amire (The Imperial stables) rather than military reforms. Von Hobe Pasha who used the titles of “Mirahur (Master of the Horse)”, “Commander of Hassa Horse Barns” and “Istabl-i Amire Muduru (The Grand Equerry)” dealt with rearrangement of these institutions and was especially responsible for procuring horses from abroad. His services to the Istabl-i Amire (The Imperial stables), particularly, can be ilucidated by means of the Ottoman archival documents bearing his own seal as well as the documents related to his appointments, promotions and other services. Von Hobe Pasha who was influential in the communication between Abdulhamit the 2nd and German Emperor and sending mutual gifts to one another, dealt also with the officers sent to Germany for training. Von Hobe Pasha who drew attention for bringing forward the financial demands as well as the invitations and feasts he gave, had a lively social life. The “report issue” he experienced with Goltz Pasha and the conflicts with the ambassador were deceisive for him in leaving the country, in spite of his long stay in Istanbul together with his wife. Keywords: The Imperial Stables, master of the horse, Von Hobe Pasha, German, Abdulhamit the 2nd.

It is obvious that the world will be different after the Coronavirus quarantine and all the emotional issues connected with it go down and people get the opportunity to be back to «ordinary life». The process take place in China now (the country faced the social phenomena of universal quarantine and self-isolation) can show the world what problems we are to have after the world opens. Today China stimulates its people to become social again through educational work, money motivation, apply to traditions and other regulations. A long stay at home and a large amount of emotional information obtained from various media have formed new behavioral and psychological stereotypes. In particular, they also influenced people’s perception of other people and society in general. The article aims not only to analyze the world may face when go out of the quarantine and self-isolation period of Coronavirus disaster, but also to recommend some steps cant be taken to level negative social consequences.

Background/Objectives: While malnutrition is prevalent in hospitals, little is known about patients who first become malnourished during the hospital stay. This study aimed to determine the incidence and describe the characteristics of patients who developed hospital-acquired malnutrition (HAM) across five Australian public hospitals. Subjects/Methods: A retrospective clinical audit of hospital data was conducted. Adult patients (aged ≥ 18 years) with a length of stay (LOS) > 14 days in a Metro South Health hospital between July 2015 and January 2019 were eligible. Demographic and clinical data were sourced from hospital data and medical records. Dietitians reviewed the medical records of patients clinically coded with malnutrition to determine HAM incidence. Univariate and logistic regression analyses were used to determine patient descriptors associated with HAM, compared with those not malnourished or those malnourished on admission. Results: A total of 17,717 patients were eligible (45% F, 63 ± 20 years, LOS 24 (15–606) days). HAM incidence in long-stay patients was 1%, with an overall malnutrition prevalence of 18%. Patients with HAM had an ~26 days longer LOS than patients who were malnourished on admission or not malnourished (p 14 days after admission, was in the low end of the published range. HAM was significantly associated with long LOS, transferring between hospitals and developing a cognitive impairment, pressure injury or fall during admission.

Summary Background and aims Children with extended hospital stays are at risk of nutritional deterioration making regular nutrition screening throughout their admission an integral part of the nutrition care pathway. The purpose of this study was to design and validate a simple, quick and universal weekly rescreening tool to identify hospital acquired nutritional deterioration during a child's hospital stay. Methods A prospective, longitudinal sample of children aged 0–16 years admitted to a paediatric tertiary hospital with a length of stay ≥7 days were included in the study. Agreement between nutritional deterioration markers of reduction in weight (kg), body mass index (kg/m2), energy intake (kcal/day) and protein intake (g/day) over a 7-day period and two proposed rescreening questions was determined using sensitivity, specificity, area under the curve and positive and negative predictive values. Results Sixty-one children were included in the study with 224 full 7-day datasets. The sensitivity and specificity of the rescreening question ‘Has the child had reduced nutritional intake in the last 7 days’ for identifying children with a ≥25% reduction in energy intake over the previous 7-day period were 61.9% (95% CI 41.1–82.7) and 82.2% (95% CI 76.9–87.5) respectively. The sensitivity of ‘Has the child lost weight or had poor weight gain’ at detecting weight loss was 71.4% (95% CI 54.7–88.2) and specificity 87.8% (95% CI 83.1–92.5). Conclusion The paediatric nutrition rescreening questions provide a valid and simple tool to detect nutritional deterioration in long stay paediatric patients and should be an integral part of the nutrition care process.

Mission scenarios for piloted Mars mission have traditionally consisted of a landing on Mars followed by a long stay time before the Earth–Mars planetary alignment would allow a minimum energy retu...

This study is the first to investigate intercultural behavioural patterns of long-stay tourists in a culturally unfamiliar leisure holiday destination. Information was collected on-site from forty-four tourists from Europe, the U.S and Australia visiting an internationally popular beach destination in Thailand. A novel approach to data collection involved one-to-one interviews triangulated with a set of dyadic interviews to better understand shared travel experiences. Onsite travel behaviour reflected neighbourhood activities rather than tourist behaviour. Four distinct levels of intercultural adaptation strategies were categorised, ranging from staying in a home comfort zone to adopting the destination as a second home. Classic transaction based marketing strategies for long-stay tourists are inadequate and more attention is needed on destination hospitableness and relationship building.

BackgroundBulky hand-written notes and frequent staff changeovers (due to on-call shift patterns) mean that details of plans for complex or long stay patients can be missed. Muddled verbal handovers are tiresome and things can be forgotten at the end of busy night shift. Wading through paper notes can be unnecessarily time consuming, making onward referral harder and slower, and mistakes more likely if the clinical problem is difficult to understand. Most paediatric patients are discharged before 7 days, so patients that stay longer than this are likely to have more complex medical needs. This project was conducted at a busy London DGH during the Covid-19 pandemic.ObjectivesThe overall objectives of the project are toReduce the amount of time wasted reading through paper notes to understand the clinical history.For all staff to be able to easily understand the clinical problem and execute the next steps of the management planReduce the potential for patient harm through missed clinical plansPrompt teams to consider differentials and alternative management options in challenging clinical scenariosMethodsRetrospective data was analysed to see the numbers of patients admitted for ≥7 days to get an idea of the scope of the problem. Diagnostic data was gathered using a fishbone diagram to explore the issues surrounding the problem. The Model for Improvement method was used to plan and execute the project. Various change ideas were considered as part of this project and a questionnaire was sent to junior doctors within the department to gauge current feelings about difficulties around making referrals for complex patients.ResultsOver an 8 week period, there were between 1–4 patients each week that fulfilled the criteria of admission ≥ 7 days, with the longest staying for 3 weeks. Each of these patients were discussed with at least one referral centre during their admission and several were diagnostically challenging.Paediatric juniors were surveyed to gather objective and subjective data on current practise. 13 people responded;69% had spent >10 minutes going through patient notes prior to making a referral. 75% felt they spent ‘considerable time’ going through patient notes to make a referral, 76% felt it took longer than necessary and 69% felt that despite this they had still missed important parts of the history.A weekly proforma was developed to summarise patient notes for anyone admitted for ≥7 days;this has been developed and improved through a series of Plan-Do-Study-Act cycles and will be introduced alongside restarting the weekly complex patient MDT meeting.ConclusionsInitial data indicates that there are enough patients admitted to the Paediatric ward for ≥7 days on a regular basis to merit an intervention. Feedback from colleagues indicates that navigating complex patient notes is a source of frustration and that there is a need to summarise them more effectively. Progress has been delayed due to the Covid-19 pandemic as the Paediatric ward was closed for several months. However now the ward has re-opened there is opportunity to move this project forward, and implement a positive change.

The interest in lithium-containing ceramics is due to their huge potential as blanket materials for thermonuclear reactors for the accumulation of tritium. However, an important factor in their use is the preservation of the stability of their strength and structural properties when under the influence of external factors that determine the time frame of their operation. This paper presents the results of a study that investigated the influence of the LiTiO2 phase on the increasing resistance to degradation and corrosion of Li2TiO3 ceramic when exposed to aggressive acidic media. Using the X-ray diffraction method, it was found that an increase in the concentration of LiClO4·3H2O during synthesis leads to the formation of a cubic LiTiO2 phase in the structure as a result of thermal sintering of the samples. During corrosion tests, it was found that the presence of the LiTiO2 phase leads to a decrease in the degradation rate in acidic media by 20–70%, depending on the concentration of the phase. At the same time, and in contrast to the samples of Li2TiO3 ceramics, for which the mechanisms of degradation during a long stay in aggressive media are accompanied by large mass losses, for the samples containing the LiTiO2 phase, the main degradation mechanism is pitting corrosion with the formation of pitting inclusions. © 2021 by the authors. Licensee MDPI, Basel, Switzerland. Funding: This research was funded by the Science Committee of the Ministry of Education and Science of the Republic of Kazakhstan (No. AP08855734).