Northampton Community College

About: Northampton Community College is a education organization based out in Bethlehem, Pennsylvania, United States. It is known for research contribution in the topics: Population & Poison control. The organization has 3410 authors who have published 4582 publications receiving 130398 citations. The organization is also known as: Northampton County Area Community College.

A review of the evidence for the impact of improving nutritional care on nutritional and clinical outcomes and cost

Abstract: Background: The association between malnutrition and poor clinical outcome is well-established, yet most research has focussed on the role of artificial nutritional support in its management. More recently, emphasis has been placed on the provision of adequate nutritional care, including nutritional screening and the routine provision of food and drink. The aim of this literature review is to establish the evidence for the efficacy of interventions that might result in improvements in nutritional and clinical outcomes and costs. Methods: A structured literature review was conducted investigating the role of nutritional care interventions in adults, and their effects on nutritional and clinical outcomes and costs, in all healthcare settings. Ten databases were searched electronically using keywords relating to nutritional care, patient outcomes and healthcare costs. High quality trials were included where available. Results: Two hundred and ninety-seven papers were identified and reviewed. Of these, only two randomised, controlled trials and six other trials were identified that addressed the major issues. A further 99 addressed some aspects of the provision of nutritional care, although very few formally evaluated nutritional or clinical outcomes and costs. Conclusions: This review reveals a serious lack of evidence to support interventions designed to improve nutritional care, in particular with reference to their effects on nutritional and clinical outcomes and costs. The review suggests that screening alone may be insufficient to achieve beneficial effects and thus more research is required to determine the most cost-effective interventions in each part of the nutritional care pathway, in a variety of healthcare settings and across all age ranges, to impact upon nutritional and clinical outcomes.

The venous leg ulcer quality of life (VLU-QoL) questionnaire: development and psychometric validation.

Abstract: To develop and validate a disease-specific quality of life (QoL) measure, based on the conceptual model of the SKINDEX-29 for patients with a chronic venous leg ulcer (VLU), in-depth interviews, and focus groups of patients (n=36) with VLU were used to generate VLU-specific items. These items were added to selected SKINDEX-29 items that were adapted for use in VLU. Further samples of VLU patients were used for item reduction (n=124) and to assess the psychometric properties of the new tool (n=120). The final VLU-QoL contained 34 items: 17 items adapted from the SKINDEX-29 and 17 VLU-specific items. Factor analysis of the items confirmed the existence of three hypothesized domains: Activities (12 items), Psychological (12 items), and Symptom Distress (10 items). Reliability in terms of internal consistency and test-retest reliability was found to be good. The measure was also found to be valid and responsive to clinical change. The VLU-QoL has good psychometric properties. The instrument's sensitivity to differences in clinical outcome and responsiveness to change in clinical parameters makes it a useful tool to assess the outcomes of treatment from the patients' perspective.

Visual processing levels revealed by response latencies to changes in different visual attributes

Abstract: Visual latencies, and their variation with stimulus attributes, can provide information about the level in the visual system at which different attributes of the image are analysed, and decisions about them made. A change in the colour, structure or movement of a visual stimulus brings about a highly reproducible transient constriction of the pupil that probably depends on visual cortical mechanisms. We measured this transient response to changes in several attributes of visual stimuli, and also measured manual reaction times to the same stimulus changes. Through analysis of latencies, we hoped to establish whether changes in different stimulus attributes were processed by mechanisms at the same or different levels in the visual pathway. Pupil responses to a change in spatial structure or colour are almost identical, but both are ca. 40 ms slower than those to a change in light flux, which are thought to depend largely on subcortical pathways. Manual reaction times to a change in spatial structure or colour, or to the onset of coherent movement, differ reliably, and all are longer than the reaction time to a change in light flux. On average, observers take 184 ms to detect a change in light flux, 6 ms more to detect the onset of a grating, 30 ms more to detect a change in colour, and 37 ms more to detect the onset of coherent motion. The pattern of latency variation for pupil responses and reaction times suggests that the mechanisms that trigger the responses lie at different levels in cortex. Given our present knowledge of visual cortical organization, the long reaction time to the change in motion is surprising. The range of reaction times across different stimuli is consistent with decisions about the onset of a grating being made in V1 and decisions about the change in colour or change in motion being made in V4.

Who has sex with whom? Characteristics of heterosexual partnerships reported in a national probability survey and implications for STI risk

Abstract: Background Sexually transmitted infection (STI) risk is determined both by partner numbers and partnership characteristics. Studies describing only recent partnership(s) overestimate long-term partnerships and underestimate the contribution of casual partnerships to STI transmission in populations. We describe all heterosexual partnerships in the past year in terms of partnership type, age and geographical mixing and how these characteristics relate to condom use. Methods Probability sample survey of 11 161 men and women aged 16–44 resident in Britain, 1999–2001. Computer-assisted self-interviews asked respondents about partner numbers and detailed questions about their three most recent partnerships. We weight these data to represent partnerships for which detailed questions were not asked to present estimates for the population of partnerships. Results Of 15 488 heterosexuals partnerships, 39.1% (95% CI 36.6–41.7%) of men's partnerships were ‘not (yet) regular’ vs 20.0% (95% CI 18.2–21.9%) of women's partnerships. While condoms were used at last sex in 37.1% (95% CI 35.0–39.3%) of men's and 28.8% (95% CI 27.1–30.6%) of women's partnerships, and for 55.3% (95% CI 52.6–58.0%) of first sex with new partners, these proportions declined with age. When partnerships involved an age difference of 5+ years [26.2% (95% CI 23.0–29.6%) of men's and 36.5% (95% CI 33.0–40.1%) of women's partnerships], condoms were less commonly used at first sex than when partners were closer in age [44.1% (95% CI 39.1–48.4%) vs 60.8% (95% CI 57.3–64.2%)]. Sex occurred within 24 h in 23.4% (95% CI 19.7–27.5%) of men's and 10.7% (95% CI 8.3–13.6%) of women's partnerships. Conclusions A substantial minority of partnerships in the population is casual. The proportion of partnerships not protected by condoms is high, especially for partnerships involving larger age differences and people in their 30s and 40s. Condom use with new partners needs to be promoted among all age-groups.

The influence of VAR dimensions on estimator biases

Abstract: Vector AutoRegressions (VARs) have now become the most popular tool of Time Series analysis amongst econometricians. Unfortunately, little is known about the analytic finite-sample properties of parameter estimators for such systems. The asymptotic analysis of VARs published to date does not address questions regarding the influence of the number and nature of the system's variates on parameter estimates. Clearly, both questions will have repercussions on the way VARs are used, and we intend to address them here.We consider the implications of varying the dimensions of VARs on the biases of Maximum Likelihood and Least Squares Estimators (MLE and LSE, respectively). In the purely nonstationary case (k-dimensional random walk), estimator biases are approximately equal to the dimension of the system (k) times the univariate bias, even when the variates are generated independently of each other. We show that the variance too increases with the dimension of the system, hence also raising the Mean Squared Error (MSE) of the estimator. When some stable linear combinations exist, the biases are generally smaller and are asymptotically proportional to the sum of the characteristic roots of the VAR. One source of such combinations is meaningful economic relations that are represented by the cointegration of some of the components of the VAR. Adding economically-irrelevant variables to a VAR is thus shown to have more serious negative consequences in integrated time series than in classical ergodic or cross section analyses. The findings strengthen the case for parsimonious modelling and for the reduction step of the general-to-specific marginalization method. They also support the use of seasonally unadjusted data whenever possible.