Explore the vast range of titles available.

BackgroundDelayed return to work is common after acute respiratory distress syndrome (ARDS), but has undergone little detailed evaluation. We examined factors associated with the timing of return to work after ARDS, along with lost earnings and shifts in healthcare coverage.MethodsFive-year, multisite prospective, longitudinal cohort study of 138 2-year ARDS survivors hospitalised between 2004 and 2007. Employment and healthcare coverage were collected via structured interview. Predictors of time to return to work were evaluated using Fine and Grey regression analysis. Lost earnings were estimated using Bureau of Labor Statistics data.ResultsSixty-seven (49%) of the 138 2-year survivors were employed prior to ARDS. Among 64 5-year survivors, 20 (31%) never returned to work across 5-year follow-up. Predictors of delayed return to work (HR (95% CI)) included baseline Charlson Comorbidity Index (0.77 (0.59 to 0.99) per point; p=0.04), mechanical ventilation duration (0.67 (0.55 to 0.82) per day up to 5 days; p<0.001) and discharge to a healthcare facility (0.49 (0.26 to 0.93); p=0.03). Forty-nine of 64 (77%) 5-year survivors incurred lost earnings, with average (SD) losses ranging from US$38 354 (21,533) to US$43 510 (25,753) per person per year. Jobless, non-retired survivors experienced a 33% decrease in private health insurance and concomitant 37% rise in government-funded coverage.ConclusionsAcross 5-year follow-up, nearly one-third of previously employed ARDS survivors never returned to work. Delayed return to work was associated with patient-related and intensive care unit/hospital-related factors, substantial lost earnings and a marked rise in government-funded healthcare coverage. These important consequences emphasise the need to design and evaluate vocation-based interventions to assist ARDS survivors return to work.

This study investigates the potential of hemp fiber reinforcement in wood–sodium silicate composites for additive manufacturing. It focuses on the impact of hemp fiber length and content on the rheological, flexural, compression properties, and extrudability of the composite. Composites contained varying amounts of sodium silicate (45, 50, 55 wt%) and hemp fibers of varying lengths (1, 3, 5 mm) and amounts (2.5, 5, 10 wt%) along with wood fibers sifted through a 40-mesh sieve. The study shows that higher sodium silicate content significantly increases viscosity while reducing the motor power needed to extrude the composite. Hemp fiber amount positively affects flexural and compression strength, increasing by 31.2% and 35.6%, respectively, with 5 wt% hemp fiber. This improvement in mechanical properties significantly increases the thermoset-based composite’s potential for various applications. This study also demonstrates for the first time, the feasibility of using the hemp fiber-reinforced wood–sodium silicate composite for additive manufacturing by successfully depositing a multi-layer sample print and determining its bending strength.

The health-related behaviors of adults who were child and adolescent caregivers is a neglected area of research. The purpose of the present study was to: (1) Provide descriptive information on these former young caregivers’ adult health-related behaviors, (2) To compare former young caregivers’ health-related behaviors to non-caregiver samples, and (3) To assess the relationship between former young caregivers’ health-related behaviors and their mental health. Early caregiving was defined as providing assistance with basic and/or instrumental activities of daily living to parents or adult relatives while under the age of 21. Thirty-five female caregivers and 94 female non-caregivers completed a demographic questionnaire and a measure of their health-related behaviors. Former young caregivers and emerging adult non-caregivers showed similar health-related behaviors. Former young caregivers did not differ from community samples of young and middle adult non-caregivers on the overall mean score for their health-related behaviors. The former young caregiver sample differed from the emerging adult non-caregiving sample on only one health-risk behavior, alcohol consumption. Caregivers reported drinking significantly less alcohol over time than the emerging adult non-caregiving sample. Former young caregivers with more regular sleep patterns reported more positive mental health and less depressive symptoms. Former young caregivers who were better able to manage their stress reported more positive mental health and less negative mental health.

The need for improving polymer sustainability is as ubiquitous as the role of polymers in modern society. Interpenetrating polymer network (IPN) design flexibility offers opportunities for improved polymer sustainability while balancing desired polymer properties for various applications. This work investigates the structure-property-processing relationships of IPNs judiciously designed under the framework of the polymer life cycle. Sustainable polymer design was largely considered at the feedstock and manufacturing stages while considering overall polymer performance. Chemicals from bio-based feedstocks were used to design a full simultaneous polybenzoxazine-epoxy IPN, focusing on the effects of monomer and polymer structure on polymer properties. Processing-property relationships were investigated for an additively manufactured full sequential epoxy-methacrylate IPN, and the effects of interconnected versus non-interconnected networks on processing were evaluated. Bio-based structure and greener processing approaches were combined to design a bio-based semi sequential polyester-methacrylate IPN. IPNs were evaluated using spectroscopic, rheological, thermal, thermomechanical, and mechanical characterizations. These findings demonstrate that custom IPN design based on molecular structure and processing approaches can enable tunable polymer properties for broadened applications while simultaneously considering both polymer sustainability and performance.

Survivors of acute lung injury (ALI) require ongoing health care resources after hospital discharge. The extent of such resource use, and associated costs, are not fully understood. For patients surviving at least 2 years after ALI, we evaluated cumulative 2-year inpatient admissions and related costs, and the association of patient- and intensive care unit-related exposures with these costs. Multisite observational cohort study in 13 intensive care units at four academic teaching hospitals evaluating 138 two-year survivors of ALI. Two-year inpatient health care use data (i.e., admissions to hospitals, and skilled nursing and rehabilitation facilities) were collected for patients surviving at least 2 years, via (1) one-time retrospective structured interview with patient and/or proxy, (2) systematic medical record review for nonfederal study site hospitals, and (3) inpatient medical record review for non-study site hospitals, as needed for clarifying patient/proxy reports. Costs are reported in 2013 U.S. dollars. A total of 138 of 142 (97%) 2-year survivors completed the interview, with 111 (80%) reporting at least one inpatient admission during follow-up, for median (interquartile range [IQR]) estimated costs of $35,259 ($10,565-$81,166). Hospital readmissions accounted for 76% of costs. Among 12 patient- and intensive care unit-related exposures evaluated, baseline comorbidity and intensive care unit length of stay were associated with increased odds of incurring any follow-up inpatient costs. Having Medicare or Medicaid (vs. private insurance) was associated with median estimated costs that were 85% higher (relative median, 1.85; 95% confidence interval, 1.01-3.45; P=0.045). In this multisite study of 138 two-year survivors of ALI, 80% had one or more inpatient admission, representing a median (IQR) estimated cost $35,259 ($10,565-$81,166) per patient and $6,598,766 for the entire cohort. Hospital readmissions represented 76% of total inpatient costs, and having Medicare or Medicaid before ALI was associated with increased costs. With the aging population and increasing comorbidity, these findings have important health policy implications for the care of critically ill patients.

Prior work has shown that stress from home and work domains can spill over onto one another (Bolger, DeLongis, Kessler, & Wethington, 1989). Although the stress spillover relationship has been established, it is unknown what may moderate this association. Two potential moderators that have been shown to be helpful in buffering the potentially harmful effects of stress are social support (Cohen & Wills, 1985) and positive reappraisals (Jamieson, Berry Mendes, & Nock, 2013). To test the moderating roles of social support and positive reappraisals in stress spillover, two studies were conducted. In Study 1, data from a national daily diary data set, the National Survey of Daily Experiences (NSDE II; Ryff & Almeida, 2004) was utilized. Based on daily telephone interviews from 330 participants, results provided evidence for home-to-work spillover, but not work-to-home spillover. However, on days when family support was received, greater work stress was related to less home stress, but overall perceived family support exacerbated home-to-work spillover effects. Study 2 tested how experimental manipulations of reappraisals of home and work spillover affect daily spillover effects. In Study 2, 127 participants recruited from an online surveying site (Amazon's Mechanical Turk) were instructed to reappraise home and work spillover as positive, negative, or were placed in a control condition and completed a 10 daily diaries assessing their home and work stressors. Results indicated that only for individuals in the control condition, greater work stress was related to less home stress. For individuals in the negative and positive reappraisal conditions, work stress was not related to home stress. The control condition and the positive reappraisal condition did not significantly differ from one another in work-to-home spillover. Together, findings from Study 1 and 2 suggest that individuals may experience less home stress on days when they have high work stress, and that receiving family support could contribute to this form of domain compensation.

Lulu CEO Alexandra Chong discusses the girls-only app for dating with Deirdre Bolton on Bloomberg Television's 'Money Moves.'

El sector bananero ecuatoriano enfrenta desafíos significativos debido a factores internos y externos, conflictos geopolíticos, fluctuaciones en los costos de producción, y cambios climáticos. Estos elementos impactan en las exportaciones, aunque el sector ha mostrado resiliencia con un incremento del 7.9% en la producción en 2023. Sin embargo, la competitividad continúa siendo un reto en 2024, con presiones para reducir los precios de la fruta en los mercados internacionales. Esta investigación se centra en entender por qué las plantaciones bananeras de Quevedo carecen de una estructura funcional organizacional efectiva, lo cual ha llevado a prácticas informales que afectan el rendimiento productivo. La ausencia de una estructura formal dificulta la asignación adecuada de funciones, la evaluación del desempeño y la consecución de los objetivos organizacionales. Siguiendo una metodología descriptiva, bibliográfica y de campo, se propone diseñar una estructura funcional organizacional que facilite las labores productivas en estas plantaciones. Los objetivos específicos incluyen la identificación de perfiles a partir de actividades definidas en un manual de funciones, así como la valoración de puestos de trabajo para mejorar su competitividad en la industria bananera. Se utilizarán métodos inductivos, deductivos y analíticos, junto con entrevistas para recopilar información relevante. El diseño de una estructura organizacional efectiva es crucial para optimizar el desempeño del personal, establecer jerarquías claras y definir responsabilidades. Una estructura bien diseñada crea un entorno propicio para alcanzar metas y resultados deseados en la industria bananera de Quevedo. Se busca abordar los desafíos actuales del sector bananero, proponiendo soluciones concretas para mejorar la eficiencia y competitividad de las plantaciones en la región de Quevedo, contribuyendo así al crecimiento sostenible de la industria.

El objetivo del trabajo fue obtener información sobre la producción, comercialización y rentabilidad del frijol canario en la Comuna Panyatug del cantón Pangua, provincia de Cotopaxi-Ecuador en el año 2009, con la finalidad de conocer e informar a los productores las fortalezas y amenazas en esta actividad productiva. Para ello se aplicó un muestreo aleatorio simple a 64 productores de frijol, 3 acopiadores rurales y 3 comerciantes mayoristas. Se obtuvieron los costos de producción y rentabilidad así como los márgenes del productor, comercialización, acopiador rural. Los resultados demuestran que los productores tienen experiencia en cultivar el frijol de 5 a 48 años; la superficie dedicada al frijol varía de 0.37 a 5 ha; mantienen una economía de subsistencia y en sus sistemas de producción utilizan 97% de la mano de obra familiar, 100% semilla reciclada, no controlan plagas ni enfermedades y poseen otros cultivos como cebada, mora, trigo y arveja para venta y autoconsumo. Los costos de producción corresponden a 1,172 USD ha-1, la producción media es 725.76 kg ha-1, el precio de venta promedio 1.675 USD el kg seco, generandouna R B/C del 36.18% en 7 meses del ciclo productivo. Los márgenes de comercialización indican que por cada 1 dólar pagado por el consumidor corresponde al productor 0.44 USD y a la intermediación 0.56 USD, ésta última se distribuye para el acopiador rural 0.029 USD, el mayorista comisionista 0.225 USD y para el detallista 0.306 USD.

El objetivo del trabajo fue obtener información sobre la producción, comercialización y rentabilidad del frijol canario en la Comuna Panyatug del cantón Pangua, provincia de Cotopaxi-Ecuador en el año 2009, con la finalidad de conocer e informar a los productores las fortalezas y amenazas en esta actividad productiva. Para ello se aplicó un muestreo aleatorio simple a 64 productores de frijol, 3 acopiadores rurales y 3 comerciantes mayoristas. Se obtuvieron los costos de producción y rentabilidad así como los márgenes del productor, comercialización, acopiador rural. Los resultados demuestran que los productores tienen experiencia en cultivar el frijol de 5 a 48 años; la superficie dedicada al frijol varía de 0.37 a 5 ha; mantienen una economía de subsistencia y en sus sistemas de producción utilizan 97% de la mano de obra familiar, 100% semilla reciclada, no controlan plagas ni enfermedades y poseen otros cultivos como cebada, mora, trigo y arveja para venta y autoconsumo. Los costos de producción corresponden a 1,172 USD ha-1, la producción media es 725.76 kg ha-1, el precio de venta promedio 1.675 USD el kg seco, generandouna R B/C del 36.18% en 7 meses del ciclo productivo. Los márgenes de comercialización indican que por cada 1 dólar pagado por el consumidor corresponde al productor 0.44 USD y a la intermediación 0.56 USD, ésta última se distribuye para el acopiador rural 0.029 USD, el mayorista comisionista 0.225 USD y para el detallista 0.306 USD.