Search results for: readmission rates

Authors: Chan Hui-Ya, Ding Shin-Tan

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Background and Aim: The discharge planning is considered helpful to reduce the hospital length of stay and readmission rate, and then increased satisfaction with healthcare for patients and professionals. In order to decrease the waiting time of long-term care and boost the care quality of patients after discharge from the hospital, the Ministry of Health and Welfare department in Taiwan initiates a program “discharge planning connects with long-term care 2.0 services” in 2017. The purpose of this study is to investigate the outcome of the pilot of this program in a medical center. Methods: By purpose sampling, the study chose five wards in a medical center as pilot units. The researchers compared the beds of service, the numbers of cases which were transferred to the long-term care center and transferred rates per month between the pilot units and the other units, and analyze the basic data, the long-term care service needs and the approval service items of cases transfer to the long-term care center in pilot units. Results: From June to September 2017, a total of 92 referrals were made, and 51 patients were enrolled into the pilot program. There is a significant difference of transferring rate between the pilot units and the other units (χ = 702.6683, p < 0.001). Only 20 cases (39.2% success rate) were approved to accept the parts of service items of long-term care in the pilot units. The most approval item was respite care service (n = 13; 65%), while it was third at needs ranking of service lists during linking services process. Among the reasons of patients who cancelled the request, 38.71% reasons were related to the services which could not match the patients’ needs and expectation. Conclusion: The results indicate there is a requirement to modify the long-term care services to fit the needs of cases. The researchers suggest estimating the potential cases by screening data from hospital informatics systems and to hire more case manager according the service time of potential cases. Meanwhile, the strategies shortened the assessment scale and authorized hospital case managers to approve some items of long-term care should be considered.

Keywords: discharge planning, long-term care, case manager, patient care

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Authors: Umar Farouk Abbas, Danjuma Mustapha, Hamisu Idi

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It is now a known fact that quality is an important issue in manufacturing industries. A control chart is an integrated and powerful tool in statistical process control (SPC). The mean µ and standard deviation σ parameters are estimated. In general, the multivariate exponentially weighted moving average (MEWMA) and multivariate cumulative sum (MCUSUM) are used in the detection of small shifts in joint monitoring of several correlated variables; the charts used information from past data which makes them sensitive to small shifts. The aim of the paper is to compare the performance of Shewhart xbar, MEWMA, and MCUSUM control charts in terms of their false rates when parameters are estimated with autocorrelation. A simulation was conducted in R software to generate the average run length (ARL) values of each of the charts. After the analysis, the results show that a comparison of the false alarm rates of the charts shows that MEWMA chart has lower false alarm rates than the MCUSUM chart at various levels of parameter estimated to the number of ARL0 (in control) values. Also noticed was that the sample size has an advert effect on the false alarm of the control charts.

Keywords: average run length, MCUSUM chart, MEWMA chart, false alarm rate, parameter estimation, simulation

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Authors: Lei Zhou, Chao Li, Ruiqi Ren, Dan Li, Yali Wang, Daxin Ni, Zijian Feng, Qun Li

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Background: Since the first human infection with avian influenza A(H7N9) case was reported in China on 31 March 2013, five epidemics have been observed in China through February 2013 and September 2017. Though the overall mortality rate of H7N9 has remained as high as around 40% throughout the five epidemics, the specific mortality rate in Mainland China varied by provinces. We conducted a descriptive analysis of mortality rates of H7N9 cases to explore the various severity features of the disease and then to provide clues of further analyses of potential factors associated with the severity of the disease. Methods: The data for analysis originated from the National Notifiable Infectious Disease Report and Surveillance System (NNIDRSS). The surveillance system and identification procedure for H7N9 infection have not changed in China since 2013. The definition of a confirmed H7N9 case is as same as previous reports. Mortality rates of H7N9 cases are described and compared by time and location of reporting, age and sex, and genetic features of H7N9 virus strains. Results: The overall mortality rate, the male and female specific overall rates of H7N9 is 39.6% (608/1533), 40.3% (432/1072) and 38.2% (176/461), respectively. There was no significant difference between the mortality rates of male and female. The age-specific mortality rates are significantly varied by age groups (χ²=38.16, p < 0.001). The mortality of H7N9 cases in the age group between 20 and 60 (33.17%) and age group of over 60 (51.16%) is much higher than that in the age group of under 20 (5.00%). Considering the time of reporting, the mortality rates of cases which were reported in the first (40.57%) and fourth (42.51%) quarters of each year are significantly higher than the mortality of cases which were reported in the second (36.02%) and third (27.27%) quarters (χ²=75.18, p < 0.001). The geographic specific mortality rates vary too. The mortality rates of H7N9 cases reported from the Northeast China (66.67%) and Westeast China (56.52%) are significantly higher than that of H7N9 cases reported from the remained area of mainland China. The mortality rate of H7N9 cases reported from the Central China is the lowest (34.38%). The mortality rates of H7N9 cases reported from rural (37.76%) and urban (38.96%) areas are similar. The mortality rate of H7N9 cases infected with the highly pathogenic avian influenza A(H7N9) virus (48.15%) is higher than the rate of H7N9 cases infected with the low pathogenic avian influenza A(H7N9) virus (37.57%), but the difference is not statistically significant. Preliminary analyses showed that age and some clinical complications such as respiratory failure, heart failure, and septic shock could be potential risk factors associated with the death of H7N9 cases. Conclusions: The mortality rates of H7N9 cases varied by age, sex, time of reporting and geographical location in mainland China. Further in-depth analyses and field investigations of the factors associated with the severity of H7N9 cases need to be considered.

Keywords: H7N9 virus, Avian Influenza, mortality, China

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Authors: Diteboho Xaba, Kolentino Mpeta, Tlotliso Qejoe

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This paper assesses the in-sample forecasting of the South African exchange rates comparing a linear ARIMA model and a SETAR model. The study uses a monthly adjusted data of South African exchange rates with 420 observations. Akaike information criterion (AIC) and the Schwarz information criteria (SIC) are used for model selection. Mean absolute error (MAE), root mean squared error (RMSE) and mean absolute percentage error (MAPE) are error metrics used to evaluate forecast capability of the models. The Diebold –Mariano (DM) test is employed in the study to check forecast accuracy in order to distinguish the forecasting performance between the two models (ARIMA and SETAR). The results indicate that both models perform well when modelling and forecasting the exchange rates, but SETAR seemed to outperform ARIMA.

Keywords: ARIMA, error metrices, model selection, SETAR

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Authors: Margaret Schmuhl, Michelle Cubellis

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Violence against women (VAW) is a widespread social problem affecting nearly two million women in the United States each year. Recently, feminist criminologists have sought to examine patriarchy as a guiding framework for understanding violence against women. Literature on VAW often examines measures of structural gender equality, often overlooking ideological patriarchy which is necessary for structural inequality to remain unchallenged. Additionally, empirical literature generally focuses on extreme forms of VAW, rape, and femicide, often neglecting more common types of violence. This literature, under the theoretical guidance of the Liberal, Radical, and Marxist feminist traditions, finds mixed support for the relationship of patriarchy and VAW. Explanations for these inconsistencies may include data availability, and the use of different operationalizations of structural patriarchy. Research is needed to examine fuller operationalizations of patriarchy in social institutions and to extend this theoretical framework to the criminal justice response to VAW (i.e., clearance rates). This study examines sexual violence clearance rates under the theoretical guidance of these feminist traditions using incident- and county-level data from National Incident Based Reporting System and other sources in multilevel modelling. The findings suggest mixed support for the feminist hypotheses and that patriarchy and gender equality differentially affect arrest clearance rates and clearance through exceptional means for sexual violence.

Keywords: clearance rates, gender equality, multilevel modelling, patriarchy, sexual victimization, violence against women

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Authors: Aude Gounelle, Gloria Senfaute, Ludivine Saint-Mard, Thomas Chartier

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The long-term deformation rates of faults are not fully captured by Probabilistic Seismic Hazard Assessment (PSHA). PSHA that use catalogues to develop area or smoothed-seismicity sources is limited by the data available to constraint future earthquakes activity rates. The integration of faults in PSHA can at least partially address the long-term deformation. However, careful treatment of fault sources is required, particularly, in low strain rate regions, where estimated seismic hazard levels are highly sensitive to assumptions concerning fault geometry, segmentation and slip rate. When integrating faults in PSHA various constraints on earthquake rates from geologic and seismologic data have to be satisfied. For low strain rate regions where such data is scarce it would be especially challenging. Faults in PSHA requires conversion of the geologic and seismologic data into fault geometries, slip rates and then into earthquake activity rates. Several approaches exist for translating slip rates into earthquake activity rates. In the most frequently used approach, the background earthquakes are handled using a truncated approach, in which earthquakes with a magnitude lower or equal to a threshold magnitude (Mw) occur in the background zone, with a rate defined by the rate in the earthquake catalogue. Although magnitudes higher than the threshold are located on the fault with a rate defined using the average slip rate of the fault. As high-lighted by several research, seismic events with magnitudes stronger than the selected magnitude threshold may potentially occur in the background and not only at the fault, especially in regions of slow tectonic deformation. It also has been known that several sections of a fault or several faults could rupture during a single fault-to-fault rupture. It is then essential to apply a consistent modelling procedure to allow for a large set of possible fault-to-fault ruptures to occur aleatory in the hazard model while reflecting the individual slip rate of each section of the fault. In 2019, a tool named SHERIFS (Seismic Hazard and Earthquake Rates in Fault Systems) was published. The tool is using a methodology to calculate the earthquake rates in a fault system where the slip-rate budget of each fault is conversed into rupture rates for all possible single faults and faultto-fault ruptures. The objective of this paper is to compare the SHERIFS method with one other frequently used model to analyse the impact on the seismic hazard and through sensibility studies better understand the influence of key parameters and assumptions. For this application, a simplified but realistic case study was selected, which is in an area of moderate to hight seismicity (South Est of France) and where the fault is supposed to have a low strain.

Keywords: deformation rates, faults, probabilistic seismic hazard, PSHA

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Authors: Yusuf Kaygısız, Necmetti̇n Maraşlı

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Aluminum alloys are produced and used at various areas of industry and especially in the aerospace industry. The advantages of these alloys over traditional iron-based alloys are lightweight, corrosion resistance, and very good thermal and electrical conductivity. The aim of this work is to experimentally investigate the effect of growth rates on the eutectic spacings (λ), microhardness, tensile strength and electrical resistivity in Al–30wt.%Cu–6wt.%Mg eutectic alloy. Al–Cu–Mg eutectic alloy was directionally solidified at a constant temperature gradient (G=8.55 K/mm) with different growth rates, 9.43 to 173.3 µm/s by using a Bridgman-type furnace. The dependency of microstructure, microhardness, tensile strength and electrical resistivity for directionally solidified the Al-Cu-Mg eutectic alloy were investigated. Eutectic microstructure is consisting of regular Al2CuMg lamellar and Al2Cu rod phases with in the α (Al) solid solution matrix. The lamellar eutectic spacings were measured from transverse sections of the samples. It was found that the value of microstructures decrease with the increase the value the growth rates. The microhardness, tensile strength and electrical resistivity of the alloy also were measured from sample and relationships between them were experimentally analyzed by using regression analysis. According to present results, values tensile strength and electrical resistivity increase with increasing growth rates.

Keywords: directional solidification, aluminum alloys, microstructure, electrical properties, hardness test

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Authors: Vinko Vidučić, Ljiljana Vidučić, Damir Boras

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The goals of the research include the determination of the characteristics of SMEs finance in Croatia, as well as the determination of indirect growth rates of the information model of the entrepreneurs` perception of business environment. The research results show that cost of finance and access to finance are most important constraining factor in setting up and running the business of small entrepreneurs in Croatia. Furthermore, small entrepreneurs in Croatia are significantly dissatisfied with the administrative barriers although relatively to a lesser extent than was the case in the pre-crisis time. High collateral requirement represents the main characteristic of bank lending concerning SMEs followed by long credit elaboration process. Formulated information model has defined the individual impact of indirect growth rates of the remaining variables on the model’s specific variable.

Keywords: business environment, information model, indirect growth rates, SME finance

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Authors: Xuan Tran

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The purpose of this paper is to present a comprehensive dynamic model for pricing strategies in the hotel competition to find a win-win situation for the competitive set. By utilizing the Cobb-Douglas utility model, the study establishes room rates by analyzing the price elasticity of demand across a competitive set of four hotels, with a focus on occupancy rates. To further enhance the analysis, game theory is applied to identify the best response for each competitive party, which illustrates the optimal pricing strategy for each hotel in the competitive landscape. This approach offers valuable insights into how hotels can strategically adjust their room rates in response to market conditions and competitor actions. The primary contributions of this research include as follows: (1) advantages for both individual hotels and the broader competitive hotel market, (2) benefits for hotel management overseeing multiple brands, and (3) positive impacts on the local community.

Keywords: dynamic model, game theory, best response, Cobb-Douglas

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Authors: T. Bouchabchoub, A. Bendahmane, A. Haouriqui, N. Attou

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This paper presents simulation results of Forex predicting model equations in order to give approximately a prevision of interest rates. First, Hall-Taylor (HT) equations have been used with Taylor rule (TR) to adapt them to European and American Forex Markets. Indeed, initial Taylor Rule equation is conceived for all Forex transactions in every States: It includes only one equation and six parameters. Here, the model has been used with Hall-Taylor equations, initially including twelve equations which have been reduced to only three equations. Analysis has been developed on the following base macroeconomic variables: Real change rate, investment wages, anticipated inflation, realized inflation, real production, interest rates, gap production and potential production. This model has been used to specifically study the impact of an inflation shock on macroeconomic director interest rates.

Keywords: interest rate, Forex, Taylor rule, production, European Central Bank (ECB), Federal Reserve System (FED).

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Authors: Joanna Stawska

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The main objective of this article is to examine the impact of interest rates on investments in Poland in the context of financial crisis. The paper also investigates the dependence of bank loans to enterprises on interbank market rates. The article studies the impact of interbank market rate on the level of investments in Poland. Besides, this article focuses on the research of the correlation between the level of corporate loans and the amount of investments in Poland in order to determine the indirect impact of central bank interest rates through the transmission mechanism of monetary policy on the real economy. To achieve the objective we have used econometric and statistical research methods like: econometric model and Pearson correlation coefficient. This analysis suggests that the central bank reference rate inversely proportionally affects the level of investments in Poland and this dependence is moderate. This is also important issue because it is related to preparing of Poland to accession to euro area. The research is important from both theoretical and empirical points of view. The formulated conclusions and recommendations determine the practical significance of the paper which may be used in the decision making process of monetary and economic authorities of the country.

Keywords: central bank, financial crisis, interest rate, investments

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Authors: Nini Johana Marin Rodriguez

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This paper applies DCC, EWMA and OGARCH models to compare the dynamic correlations between exchange rates, oil prices, exchange rates and stock markets to examine the time-varying conditional correlations to the daily oil prices and index returns in relation to the US dollar/local currency for developed (Canada and Mexico) and emerging Latin American markets (Brazil, Chile, Colombia and Peru). Changes in correlation interactions are indicative of structural changes in market linkages with implications to contagion and interdependence. For each pair of stock price-exchange rate and oil price-US dollar/local currency, empirical evidence confirms of a strengthening negative correlation in the last decade. Methodologies suggest only two events have significatively impact in the countries analyzed: global financial crisis and Europe crisis, both events are associated with shifts of correlations to stronger negative level for most of the pairs analyzed. While, the first event has a shifting effect on mainly emerging members, the latter affects developed members. The identification of these relationships provides benefits in risk diversification and inflation targeting.

Keywords: crude oil, dynamic conditional correlation, exchange rates, interdependence, stock prices

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Authors: Klaudia Krogulec

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The concept and the meaning of safety is largely undermined in International and EU refugee law. While the Geneva Convention 1951 concentrates mainly on the principle of non-refoulment (no-return) and the idea of physical safety of refugees, countries continue to implement harmful readmission agreements that presume ‘safe countries’ for the hosting and return of the refugees. This research intends to use discourse analysis of the legal provisions and interviews with Syrian refugees, NGO workers, and refugee lawyers in Tukey to understand what ‘safety’ actually means and how law shapes the experiences of Syrians in Turkey (the country that hosts the largest population of Syrians and is a key partner of the EU-Turkey Agreement 2016). The preliminary findings reveal the competing meanings of safety (rights-based vs state interests approach). As the refugee policies continue to prioritize state interests/safety over human safety and human rights, it is extremely important to provide recommendations on how ‘safety’ should be defined in the refugee law in the future.

Keywords: human rights law, refugee law, human safety, EU-turkey agreement

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Authors: Lyndsey Kim

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We utilized country-level data on suicide rates from 1985 through 2015 provided by the WHO to explore global trends as well as country-specific trends. First, we find that up until 1995, there was an increase in suicide rates globally, followed by a steep decline in deaths. This observation is largely driven by the data from Europe, where suicides are prominent but steadily declining. Second, men are more likely to commit suicide than women across the world over the years. Third, the older generation is more likely to commit suicide than youth and adults. Finally, we turn to Durkheim’s theory and use it as a lens to understand trends in suicide across time and countries and attempt to identify social and economic events that might explain patterns that we observe. For example, we discovered a drastically different pattern in suicide rates in the US, with a steep increase in suicides in the early 2000s. We hypothesize this might be driven by both the 9/11 attacks and the recession of 2008.

Keywords: suicide trends, current events, data analysis, world health organization, durkheim theory

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Authors: Tejasvi Parupudi, Mochen Li, Lakshya Mittal, Ignacio G. Camarillo, Raji Sundararajan

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With breast cancer becoming a global pandemic, it is very important to assess a woman’s risk profile accurately in a timely manner. Providing an estimate of the risk of developing breast cancer to a woman gives her an opportunity to consider options to decrease this risk. Women at low risk may be suggested yearly screenings whereas women with a high risk of developing breast cancer would be candidates for aggressive surveillance. Fortunately, there is a set of risk factors that are used to predict the probability of a woman being diagnosed with breast cancer in the future. Studying risk factors and understanding how they correlate to cancer is important for early diagnosis, prevention and reducing mortality rates. The effect of crucial risk factors among black and white women was compared in this study. The various risk factors analyzed include breast density, age, cancer in a first-degree relative, menopausal status, body mass index (BMI) and prior breast cancer diagnosis, etc. Breast density, age at first full-term birth and BMI were utilized in this study as important risk factors for the comparison of incidence rates between women of black and white races in the USA. Understanding the differences could lead to the development of solutions to reduce disparity in mortality rates among black women by improving overall access to care.

Keywords: big data, breast cancer, risk factors, incidence rates, mortality, race

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Authors: Aime Philombe Zapji Ymele

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Servicing public debt is a significant budgetary burden. In the sense that the payment of interest charges is a liability on the balance sheet of the public budget and affects fiscal policy. Interest charges can sometimes become a burden if they crowd out private activities. In order to analyse and understand the determinants of the debt burden and its impact on the sustainability of public finances, the present work focuses on OECD countries. It is noted from the literature that the factors that determine interest charges are macroeconomic (inflation, GDP growth, and interest rates) and public finances (primary balance and public debt). After analysing a panel of 33 OECD countries and using ordinary least squares (OLS), we find that public debt, inflation, and long-term interest rates are positively correlated with interest charges. An increase in any of these variables leads to an increase in debt charges. On the other hand, a growth in GDP is negatively associated with interest charges. Indeed, an increase in GDP generates enough revenue to meet the repayment of debt charges. According to the empirical analysis, we can say that, despite the large and growing debt-to-GDP ratio of major OECD countries, interest charges are not a threat to the sustainability of public finances. However, it is important for these countries to reduce the ratio of public debt to GDP because, in the face of the many challenges (health, aging population, etc.) that are looming on the horizon, an increase in interest rates could bring with it considerable burdens that would threaten the budgetary balance of these states.

Keywords: interest charges, sustainability, public debt, interest rates

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Authors: Stephanie A. Schauder, Gosia Sylwestrzak

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Overweight and obese women report avoiding preventive care due to fear of weight-related bias from medical professionals. Gynecological exams, due to their sensitive and personally invasive nature, are especially susceptible to avoidance. This research investigates the association between body mass index (BMI) and screening rates for breast and cervical cancer using claims data from 1.3 million members of a large health insurance company. Because obesity is associated with increased cancer risk, screenings for these cancers should increase as BMI increases. However, this paper finds that the distribution of cancer screening rates by BMI take an inverted U-shape with underweight and obese members having the lowest screening rates. For cervical cancer screening, those in the target population with a BMI of 23 have the highest screening rate at 68%, while Obese Class III members have a screening rate of 50%. Those in the underweight category have a screening rate of 58%. This relationship persists even after controlling for health and demographic covariates in regression analysis. Interestingly, there is no association between BMI and BRCA (BReast CAncer gene) genetic testing. This is consistent with the narrative that stigma causes avoidance because genetic testing does not involve any assessment of a person’s body. More work must be done to determine how to increase cancer screening rates in those who may feel stigmatized due to their weight.

Keywords: cancer screening, cervical cancer, breast cancer, weight stigma, avoidance of care

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Authors: Zapji Ymele Aime Philombe

Abstract:

Servicing public debt is a significant budgetary burden in the sense that the payment of interest charges is a liability on the balance sheet of the public budget and affects fiscal policy. Interest charges can sometimes become a burden if they crowd out private activities. In order to analyse and understand the determinants of the debt burden and its impact on the sustainability of public finances, the present work focuses on OECD countries. It is noted from the literature that the factors that determine interest charges are macroeconomic (inflation, GDP growth and interest rates) and public finances (primary balance and public debt). After analysing a panel of 33 OECD countries and using ordinary least squares (OLS), we find that public debt, inflation and long-term interest rates are positively correlated with interest charges. An increase in any of these variables leads to an increase in debt charges. On the other hand, a growth in GDP is negatively associated with interest charges. Indeed, an increase in GDP generates enough revenue to meet the repayment of debt charges. According to the empirical analysis, we can say that, despite the large and growing debt-to-GDP ratio of major OECD countries, interest charges are not a threat to the sustainability of public finances. However, it is important for these countries to reduce the ratio of public debt to GDP because, in the face of the many challenges (health, aging population, etc.) that are looming on the horizon, an increase in interest rates could bring with it considerable burdens that would threaten the budgetary balance of these states.

Keywords: interests charges, public debt, sustainability, interest rates

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Authors: Iulia Crisan

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Objective: The present study investigates the cross-cultural validity of three North-American performance validity indicators (PVTs) by comparing base rates of failure (BRF) in Romanian and Canadian disability applicants. Methods: Three PVTs (Test of Memory Malingering Trial 1 [TOMM-1], Rey Fifteen Item Test free recall [Rey-15 FR], and Rey FR+Recognition [Rey COMB]) were administered to a heterogeneous Romanian clinical sample (N Ro =54) and a similar Canadian sample (N Can = 52). Patients were referred for assessment to determine the severity of their cognitive deficits. Results: We compared the BRF in both samples at various cutoffs. BRF on TOMM-1 at ≤ 43 was similar (Ro = 33.3% vs. Can = 40.4%); at ≤40, Ro = 22.2% vs. Can = 25.0%. Likewise, comparable BRF were observed on Rey-15 FR at ≤ 8 (Ro = 7.4% vs. Can = 11.5%) and ≤ 11 (Ro = 27.8% vs. Can = 23.1%). However, the Romanian sample produced significantly higher failure rates on the Rey COMB at variable cutoffs (p <.05), possibly because Romanian patients were significantly older than the Canadian sample. Conclusion: Our findings offer proof of concept for the cross-cultural validity of the TOMM and Rey-15 FR. At the same time, they serve as a reminder that the generalizability of PVT cutoffs to different populations should not be assumed but verified empirically. Employing the TOMM as a criterion measure for newly developed PVTs is discussed.

Keywords: performance validity indicators, cross-cultural validity, failure base rates, clinical samples, cognitive dysfunction, TOMM-1, Rey-15, Rey COMB

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Authors: Mohamed M. Bumadian, D. James Gilmour

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Three bacterial species were isolated from the River Wye (Derbyshire, England) and identified using 16S rRNA gene sequencing as Serratia proteamaculans, Aeromonas hydrophila and Klebsiella pneumoniae. Respiration rates of the strains were measured in order to determine the metabolic activity under salt stress. The highest respiration rates of all three strains were found at 0.17 M and 0.5 M NaCl and then the respiration rate decreased with increasing concentrations of NaCl. In addition, the effect of increasing concentrations of NaCl on malate dehydrogenase activity was determined using cell-free extracts of the three strains. Malate dehydrogenase activity was stimulated at NaCl concentrations up to 0.5 M, and a small level of activity remained even at 3.5 M NaCl. The pH optimum of the malate dehydrogenase in cell-free extracts of all strains was higher than pH 7.5.

Keywords: fresh water, halotolerant pathogenic bacteria, 16S rRNA gene, cell-free extracts, respiration rates, malate dehydrogenase

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Authors: Colin O’Hare, Zili Zho, Thomas Sneddon

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The Australian superannuation system has received high praise for its participation rates and level of funding in retirement yet it is only 25 years old. In recent years, with increasing longevity and persistent lower rates of investment return, how adequate will the funds accumulated through a superannuation system be? In this paper we take Australia as a case study and build a stochastic model of accumulation and decummulation of funds and determine the expected number of years a fund may last an individual in retirement.

Keywords: component, mortality, stochastic models, superannuation

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Authors: Michael Adebayo, Saheed Lawal

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The Comprehensive Geriatric Assessment (CGA) is the multidimensional tool used to assess elderly, frail patients either on admission to hospital care or at a community level in primary care. It is a tool designed with the aim of using a holistic approach to managing patients. A Cochrane review of CGA use in 2011 found that the likelihood of being alive and living in their own home rises by 30% post-discharge. RCTs have also discovered 10–15% reductions in readmission rates and reductions in institutionalization, and resource use and costs. Past audit cycles at King’s College Hospital, Denmark Hill had shown inconsistent evidence of CGA completion inpatient discharge summaries (less than 50%). Junior Doctors in the Health and Ageing (HAU) wards have struggled to sustain the efforts of past audit cycles due to the quick turnover in staff (four-month placements for trainees). This 7th cycle created a multi-faceted approach to solving this problem amongst staff and creating lasting change. Methods: 1. We adopted multidisciplinary team involvement to support Doctors. MDT staff e.g. Nurses, Physiotherapists, Occupational Therapists and Dieticians, were actively encouraged to fill in the CGA document. 2. We added a CGA Document Pro-forma to “Sunrise EPR” (Trust computer system). These CGAs were to automatically be included the discharge summary. 3. Prior to assessing uptake, we used a spot audit questionnaire to assess staff awareness/knowledge of what a CGA was. 4. We designed and placed posters highlighting domains of CGA and MDT roles suited to each domain on geriatric “Health and Ageing Wards” (HAU) in the hospital. 5. We performed an audit of % discharge summaries which include CGA and MDT role input. 6. We nominated ward champions on each ward from each multidisciplinary specialty to monitor and encourage colleagues to actively complete CGAs. 7. We initiated further education of ward staff on CGA's importance by discussion at board rounds and weekly multidisciplinary meetings. Outcomes: 1. The majority of respondents to our spot audit were aware of what a CGA was, but fewer had used the EPR document to complete one. 2. We found that CGAs were not being commenced for nearly 50% of patients discharged on HAU wards and the Frailty Assessment Unit.

Keywords: comprehensive geriatric assessment, CGA, multidisciplinary team, quality of life, mortality

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Authors: Mohsen Torabi, Nader Karimi, Kaili Zhang

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This work aims to provide a comprehensive study on the heat transfer and entropy generation rates of a horizontal channel partially filled with a porous medium which experiences internal heat generation or consumption due to exothermic or endothermic chemical reaction. The focus has been given to the local thermal non-equilibrium (LTNE) model. The LTNE approach helps us to deliver more accurate data regarding temperature distribution within the system and accordingly to provide more accurate Nusselt number and entropy generation rates. Darcy-Brinkman model is used for the momentum equations, and constant heat flux is assumed for boundary conditions for both upper and lower surfaces. Analytical solutions have been provided for both velocity and temperature fields. By incorporating the investigated velocity and temperature formulas into the provided fundamental equations for the entropy generation, both local and total entropy generation rates are plotted for a number of cases. Bifurcation phenomena regarding temperature distribution and interface heat flux ratio are observed. It has been found that the exothermicity or endothermicity characteristic of the channel does have a considerable impact on the temperature fields and entropy generation rates.

Keywords: entropy generation, exothermicity or endothermicity, forced convection, local thermal non-equilibrium, analytical modelling

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Authors: Recep Kesli, Onur Turkyilmaz, Cengiz Demir

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Objective: Autoimmune collagen diseases occur with the immune reactions against the body’s own cell or tissues which cause inflammation and damage the tissues and organs. In this study, it was aimed to compare seropositivity rates and patterns of the anti-nuclear antibodies (ANA) in the diagnosis of four different autoimmune collagen tissue diseases (Rheumatoid Arthritis-RA, Systemic Lupus Erythematous-SLE, Scleroderma-SSc and Sjogren Syndrome-SS) with each other. Methods: One hundred eighty-eight patients applied to different clinics in Afyon Kocatepe University ANS Practice and Research Hospital between 11.07.2014 and 14.07.2015 that thought the different collagen disease such as RA, SLE, SSc and SS have participated in the study retrospectively. All the data obtained from the patients participated in the study were evaluated according to the included criteria. The historical archives belonging to the patients have been screened, assessed in terms of ANA positivity. The obtained data was analysed by using the descriptive statistics; chi-squared, Fischer's exact test. The evaluations were performed by SPSS 20.0 version and p < 0.05 level was considered as significant. Results: Distribution rates of the totally one hundred eighty-eight patients according to the diagnosis were found as follows: 82 (43.6%) were RA, 38 (20.2%) were SLE, 22 (11.7%) were SSc, and 46 (24.5%) were SS. Distribution of ANA positivity rates according to the collagen tissue diseases were found as follows; for RA were 54 (65,9 %), for SLE were 36 (94,7 %), for SSc were 18 (81,8 %), and for SS were 43 (93,5 %). Rheumatoid arthritis should be evaluated and classified as a different class among all the other investigated three autoimmune illnesses. ANA positivity rates were found as differently higher (91.5 %) in the SLE, SSc, and SS, from the RA (65.9 %). Differences at ANA positivity rates for RA and the other three diseases were found as statistically significant (p=0.015). Conclusions: Systemic autoimmune illnesses show broad spectrum. ANA positivity was found as an important predictor marker in the diagnosis of the rheumatologic illnesses. ANA positivity should be evaluated as more valuable and sensitive a predictor diagnostic marker in the laboratory findings of the SLE, SSc, and SS according to RA.

Keywords: antinuclear antibody (ANA), rheumatoid arthritis, scleroderma, Sjogren syndrome, systemic lupus Erythemotosus

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Authors: Zachary Bernard, Dorothy Dillard

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Background: Haitian Creole women in Sussex County, Delaware, experience significant disparities in breast cancer outcomes, exacerbated by cultural, linguistic, and socioeconomic barriers. The Chanpyons Credible Messenger Intervention was developed to address these disparities through culturally tailored education, logistical support, and the engagement of trusted community members as credible messengers. Method: This mixed-methods study combined quantitative analysis of screening rates pre- and post-intervention, using demographic data from 85 participants, with qualitative interviews to explore participants' perceptions, barriers, and experiences. Results: Of the participants, 22.35% had received a mammogram before the program, compared to 50.59% after its implementation, marking a significant increase in screening rates. Women with private insurance had higher up-to-date screening rates (78.95%) compared to uninsured women (36.36%). Qualitative findings revealed that credible messengers effectively built trust, addressed cultural misconceptions, and alleviated fear, empowering women to prioritize preventive care. Conclusion: The study demonstrates the success of culturally specific interventions in increasing breast cancer screening rates and reducing health disparities. The Chanpyons model highlights the importance of integrating community-driven approaches in public health programs, offering a replicable framework for addressing similar challenges in underserved populations.

Keywords: breast cancer, community engagement, Haitian Creole women, credible messengers, health disparities, preventive care

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Authors: S. Madhusudhan, G. V. Vaniprabha

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Worldwide statistics have shown that smoking contributes significantly to mortality, with nicotine, being more addictive. Smoking causes more than 7,00,000 deaths/year in India. Compared to the general population, the prevalence of smoking is found to be much higher among people with psychotic disorders and, more so in schizophrenia. Schizophrenic patients who smoke tend to have higher frequency of heavy smoking, with rates ranging from 60% to as high as 80%. Hence, smokers with psychiatric disorders suffer higher rates of morbidity and mortality secondary to smoking related illnesses.

Keywords: brief intervention, nicotine dependence, schizophrenia

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Authors: Wisam Ismail, Brendan Wooler, Penelope McManus

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Introduction: The public perception of implants has been damaged in the wake of recent negative publicity and increasingly we are finding patients wanting to avoid them. Planned lipo-modelling to enhance the volume of a Latissimus dorsi flap is a viable alternative to silicone implants and maintains a Totally Autologous Technique (TAT). Here we demonstrate that when compared to an Implant Assisted Technique (IAT), a TAT offers patients many benefits that offset the requirement of more operations initially, with reduced short and long term complications, reduced symmetrisation surgery and reduced revision rates. Methods. Data was collected prospectively over 7 years. The minimum follows up was 3 years. The technique was generally standardized in the hand of one surgeon. All flaps were extended LD flaps (ELD). Lipo-modelling was performed using standard techniques. Outcome measures were unplanned secondary procedures, complication rates, and contralateral symmetrisation surgery rates. Key Results Were: Lower complication rates in the TAT group (18.5% vs. 33.3%), despite higher radiotherapy rates (TAT=49%, IAT=36.8%), TAT was associated with lower subsequent symmetrisation rates (30.6% vs. 50.9%), IAT had a relative risk of 3.1 for subsequent unplanned procedure, Autologous patients required an average of 1.76 sessions of lipo-modelling, Conclusions: Using lipo-modelling to enable totally autologous LD reconstruction offers significant advantages over an implant assisted technique. We have shown a lower subsequent unplanned procedure rate, lower revision surgery, and less contralateral symmetrisation surgery. We anticipate that a TAT will be supported by patient satisfaction surveys and long-term patient-reported cosmetic outcome data and intended to study this.

Keywords: breast, Latissimus dorsi, lipomodelling, reconstruction

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Authors: Lei Zhang, Tingting Xu, Jun He, Zhenyu Yan

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Email marketing is one of the most important segments of online marketing. It has been proved to be the most effective way to acquire and retain customers. The email content is vital to customers. Different customers may have different familiarity with a product, so a successful marketing strategy must personalize email content based on individual customers’ product affinity. In this study, we build our personalized email marketing strategy with three types of emails: nurture, promotion, and conversion. Each type of email has a different influence on customers. We investigate this difference by analyzing customers’ open rates, click rates and opt-out rates. Feature importance from response models is also analyzed. The goal of the marketing strategy is to improve the click rate on conversion-type emails. To build the personalized strategy, we formulate the problem as a reinforcement learning problem and adopt a Q-learning algorithm with variations. The simulation results show that our model-based strategy outperforms the current marketer’s strategy.

Keywords: email marketing, email content, reinforcement learning, machine learning, Q-learning

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Authors: P. C. Tewari, Parveen Kumar

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The paper describes the availability analysis of milling system of a rice milling plant using probabilistic approach. The subsystems under study are special purpose machines. The availability analysis of the system is carried out to determine the effect of failure and repair rates of each subsystem on overall performance (i.e. steady state availability) of system concerned. Further, on the basis of effect of repair rates on the system availability, maintenance repair priorities have been suggested. The problem is formulated using Markov Birth-Death process taking exponential distribution for probable failures and repair rates. The first order differential equations associated with transition diagram are developed by using mnemonic rule. These equations are solved using normalizing conditions and recursive method to drive out the steady state availability expression of the system. The findings of the paper are presented and discussed with the plant personnel to adopt a suitable maintenance policy to increase the productivity of the rice milling plant.

Keywords: availability modeling, Markov process, milling system, rice milling plant

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Authors: Malory Beaujolais

Abstract:

Chlordecone is an organochlorine pesticide with a bishomocubane structure which led to high stability in organic matter. Microbial fuel cell is a type of electrochemical system that can convert organic matters into electricity thanks to electroactive bacteria. This technique has been used with mangrove swamp from Martinique to try to reduce chlordecone rates. Those experiments led to characterize the behavior of the electroactive biofilm formed at the cathode, without added redox mediator. The designed bioelectrochemical system seems to provide the necessary conditions for chlordecone degradation.

Keywords: bioelectrochemistry, bioremediation, chlordecone, mangrove swamp

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