Low correlation between self-report and medical record documentation of urinary tract infection symptoms.

BACKGROUND Correlations between symptom documentation in medical records and patient self-report (SR) vary depending on the condition studied. Patient symptoms are particularly important in urinary tract infection (UTI) diagnosis, and this correlation for UTI symptoms is currently unknown. METHODS This is a cross-sectional survey study in hospitalized patients with Escherichia coli bacteriuria. Patients were interviewed within 24 hours of diagnosis for the SR of UTI symptoms. We reviewed medical records for UTI symptoms documented by admitting or treating inpatient physicians (IPs), nurses (RNs), and emergency physicians (EPs). The level of agreement between groups was assessed using Cohen κ coefficient. RESULTS Out of 43 patients, 34 (79%) self-reported at least 1 of 6 primary symptoms. The most common self-reported symptoms were urinary frequency (53.5%); retention (41.9%); flank pain, suprapubic pain, and fatigue (37.2% each); and dysuria (30.2%). Correlation between SR and medical record documentation was slight to fair (κ, 0.06-0.4 between SR and IPs and 0.09-0.5 between SR and EDs). Positive agreement was highest for dysuria and frequency. CONCLUSION Correlation between self-reported UTI symptoms and health care providers' documentation was low to fair. Because medical records are a vital source of information for clinicians and researchers and symptom assessment and documentation are vital in distinguishing UTI from asymptomatic bacteriuria, efforts must be made to improve documentation.

An assessment of self-concept and violence within a delinquent adolescent population

The purpose of this study was to provide further data on the relationship between self-concept and violence focusing on a delinquent adolescent population. Recent research has explored the relationship between self-concept and violence with most of the research being done with adult populations. Within the literature, there are two opposing views on the question of this relationship. The traditional view supports the idea that low self-esteem is a cause of violent behavior while the non-traditional view supports the idea that high self-esteem may be a contributor to violent behavior. ^ Using a sample of 200 delinquent adolescents 100 of whom had committed acts of violence and 100 who had not, a group comparison study was done which addressed the following questions, (1) within a delinquent population of violent and non-violent adolescents, is there a relationship between violence and self-concept? (2) what is that relationship; (3) using the Piers-Harris Children's Self-Concept Scale, can it be determined that attributes such as behavior, anxiety, popularity, happiness, and physical appearance as they relate to self-concept are more predictive than others in determining who within a delinquent population will commit acts of violence. For the purposes of this study, delinquent adolescents were those who had official records of misconduct with either the school or juvenile authorities. Adolescents classified as violent were those who had committed acts such as assault, use of a weapon, use of deadly force, and sexual assault while adolescents classified as non-violent had committed anti-social acts such as, truancy, talking back and rule breaking. ^ The study concluded that there is a relationship between adolescent violence and self-concept. However, there was insufficient statistical evidence that self-concept is a predictor of violence. ^

An examination of spirituality, self efficacy, and smoking cessation among adults in Houston, Texas

Over the past decade there has been a growing interest in the association between spirituality and health outcomes. Little is known about the role of spirituality among adult smokers who are motivated to stop smoking. The purpose of this dissertation is to examine the relations among immutable individual differences, spirituality, and self efficacy among adults motivated to stop smoking. The first paper of this dissertation systematically reviewed literature to measure the concordance between spirituality and smoking status among adults in the United States. The second paper of this dissertation explored the association between spirituality and smoking cessation. We hypothesized that higher levels of spirituality were positively associated with smoking cessation. The third paper of this dissertation examined the association between perceived self efficacy and spirituality. We hypothesized that both high levels of self efficacy and spirituality were positively associated with smoking cessation.^ A total of 152 citations were identified based on the preliminary search of databases and reference lists. After a preliminary title- and abstract-based review, 17 full text articles were retrieved for further assessment. Of these, eight met the criteria for inclusion. Results of the systematic review suggest that there is inconsistent evidence to support or refute an association between spirituality and smoking status among adults.^ Smokers (N = 200) at least 18 years of age enrolled in a minimal contact smoking cessation intervention in Houston, Texas completed questionnaires. To examine our hypotheses we conducted cross-sectional analyses of responses to questions included in selected baseline questions and the final in-person visit three weeks post-quit day. Results of the logistic regression analyses indicated that individuals with higher levels of spirituality and self efficacy were significantly more likely to abstain from smoking. The positive association is also evident when controlling for employment, income, race, education, and nicotine dependence. The interaction between self efficacy and spirituality was not statistically significant in predicting smoking abstinence.^ Recommendations for future research and implications for smoking cessation interventions are discussed. Further research in this area would benefit from using standard measures of abstinence, recruiting larger and more diverse populations, and using longitudinal study designs.^

A STUDY OF THE RELATIONSHIP BETWEEN SELF-ASSESSMENT AND CLINICAL EVALUATION OF HEARING STATUS

The relationship was explored between a subjective measure of hearing status, derived from a functional self-assessment expressed in terms of ability to hear and understand spoken words, and a comparable objective measure of hearing status, obtained from a speech reception test. The Augmentation Survey of the Health and Nutrition Examination Survey of the National Center for Health Statistics provided the necessary data for a sample of 3059 adults. Using chi-square tests for the subsample with the highest level of objectively assessed hearing status, favorable subjective assessments were found to be significantly associated with higher income, lower age group, higher level of educational attainment, greater psychological adjustment, fewer symptoms of depression, and higher self-ratings of overall health. In a linear regression with self-assessment of hearing status as the dependent variable, less than one-quarter of the variation could be explained by objective status and the six explanatory variables.^

HPV knowledge, HPV vaccine awareness and initiation among Hispanics: The role of language, information seeking, and information scanning

Background. Among Hispanics, the HPV vaccine has the potential to eliminate disparities in cervical cancer incidence and mortality but only if optimal rates of vaccination are achieved. Media can be an important information source for increasing HPV knowledge and awareness of the vaccine. Very little is known about how media use among Hispanics affects their HPV knowledge and vaccine awareness. Even less is known about what differences exist in media use and information processing among English- and Spanish-speaking Hispanics.^ Aims. Examine the relationships between three health communication variables (media exposure, HPV-specific information scanning and seeking) and three HPV outcomes (knowledge, vaccine awareness and initiation) among English- and Spanish-speaking Hispanics.^ Methods. Cross-sectional data from a survey administered to Hispanic mothers in Dallas, Texas was used for univariate and multivariate logistic regression analyses. Sample used for analysis included 288 mothers of females aged 8-22 recruited from clinics and community events. Dependent variables of interest were HPV knowledge, HPV vaccine awareness and initiation. Independent variables were media exposure, HPV-specific information scanning and seeking. Language was tested as an effect modifier on the relationship between health communication variables and HPV outcomes.^ Results. English-speaking mothers reported more media exposure, HPV-specific information scanning and seeking than Spanish-speakers. Scanning for HPV information was associated with more HPV knowledge (OR = 4.26, 95% CI = 2.41 - 7.51), vaccine awareness (OR = 10.01, 95% CI = 5.43 - 18.47) and vaccine initiation (OR = 2.54, 95% CI = 1.09 - 5.91). Seeking HPV-specific information was associated with more knowledge (OR = 2.27, 95% CI = 1.23 - 4.16), awareness (OR = 6.60, 95% CI = 2.74 - 15.91) and initiation (OR = 4.93, 95% CI = 2.64 - 9.20). Language moderated the effect of information scanning and seeking on vaccine awareness.^ Discussion. Differences in information scanning and seeking behaviors among Hispanic subgroups have the potential to lead to disparities in vaccine awareness.^ Conclusion. Findings from this study underscore health communication differences among Hispanics and emphasize the need to target Spanish language media as well as English language media aimed at Hispanics to improve knowledge and awareness.^

Self, writing and feminine transactions in Virginia Woolf's Orlando and Clarice Lispector’s The stream of life

Este artículo realiza un acercamiento a Orlando, de Virginia Woolf, y a Agua viva, de Clarice Lispector, como obras que logran escribir la multiplicidad, la fluidez y la contingencia del ser. Jugando con las convenciones de la biografía y la autobiografía respectivamente, estas obras encuentran los medios para presentar un sujeto multidimensional y para mostrar, en particular, cómo la dimensión relacional, forjada por un orden simbólico patriarcal, ha hecho de la mujer el “otro" del hombre; un “otro" que debe ser dominado. Se exploran en este artículo los conceptos de “economía masculina" y “economía femenina" teorizados por Hélène Cixous y se propone al lenguaje poético como un medio capaz de eludir los dictados del falocentrismo. Lo poético, que no puede ser nunca agotado por uno o varios sistemas de significación, brinda la posibilidad de ir más allá de las categorizaciones y de explorar la multiplicidad. Tanto Orlando como Agua viva muestran las estrategias y las esperanzas de personajes y escritoras que ven en el lenguaje poético, en la “escritura femenina" como la entiende Cixous, el potencial de desarticular la “economía masculina" y abrir un nuevo espacio para sujetos diversos, múltiples y complejos.

A Mobile Feedback System for Integrated E-health Platforms to improve Self-Care and Compliance of Diabetes Mellitus Patients

Exploiting the full potential of telemedical systems means using platform based solutions: data are recovered from biomedical sensors, hospital information systems, care-givers, as well as patients themselves, and are processed and redistributed in an either centralized or, more probably, decentralized way. The integration of all these different devices, and interfaces, as well as the automated analysis and representation of all the pieces of information are current key challenges in telemedicine. Mobile phone technology has just begun to offer great opportunities of using this diverse information for guiding, warning, and educating patients, thus increasing their autonomy and adherence to their prescriptions. However, most of these existing mobile solutions are not based on platform systems and therefore represent limited, isolated applications. This article depicts how telemedical systems, based on integrated health data platforms, can maximize prescription adherence in chronic patients through mobile feedback. The application described here has been developed in an EU-funded R&D project called METABO, dedicated to patients with type 1 or type 2 Diabetes Mellitus

Using modular neural networks to model self-consciousness and self-representation for artificial entities

Self-consciousness implies not only self or group recognition, but also real knowledge of one’s own identity. Self-consciousness is only possible if an individual is intelligent enough to formulate an abstract self-representation. Moreover, it necessarily entails the capability of referencing and using this elf-representation in connection with other cognitive features, such as inference, and the anticipation of the consequences of both one’s own and other individuals’ acts. In this paper, a cognitive architecture for self-consciousness is proposed. This cognitive architecture includes several modules: abstraction, self-representation, other individuals'representation, decision and action modules. It includes a learning process of self-representation by direct (self-experience based) and observational learning (based on the observation of other individuals). For model implementation a new approach is taken using Modular Artificial Neural Networks (MANN). For model testing, a virtual environment has been implemented. This virtual environment can be described as a holonic system or holarchy, meaning that it is composed of autonomous entities that behave both as a whole and as part of a greater whole. The system is composed of a certain number of holons interacting. These holons are equipped with cognitive features, such as sensory perception, and a simplified model of personality and self-representation. We explain holons’ cognitive architecture that enables dynamic self-representation. We analyse the effect of holon interaction, focusing on the evolution of the holon’s abstract self-representation. Finally, the results are explained and analysed and conclusions drawn.

Self Learning and self evaluation exercises database in basic mechanics: a theoretical-practical approach

In the School of Mines of the Technical University of Madrid (UPM) the first course of different degrees has been implemented and adapted to the European Higher Educational Area (EHEA). In all of the degrees there is a first semester course which gathers all the contents of basic mechanics: from the first kinematics concepts to the rigid solid plane motion Before the Bologna process took place, the authors had established the final assessment of the theoretical contents through open questions of theoretical-practical character In the present work, the elaboration of a wide database containing theoretical-practical questions that students can access on line is presented. The questions are divided in thirteen different questionnaires composed of a number of questions randomly chosen from a certain group in the database. Each group corresponds to a certain learning objective that the student knows. After answering the questionnaire and checking the grade assigned according to the performance of the student, the pupils can see the correct response displayed on the screen and widely explained by the professors. This represents a 10% of the final grade. As the student can access the questionnaires as many times as they want, the main goal is the self-assessment of each learning objective and therefore, getting the students involved in their own learning process so they can decide how much time they need to acquire the required level.

Self-positioning and mapping of rectangular rooms with sectorized narrowband antennas

A system for simultaneous 2D estimation of rectangular room and transceiver localization is proposed. The system is based on two radio transceivers, both capable of full duplex operations (simultaneous transmission and reception). This property enables measurements of channel impulse response (CIR) at the same place the signal is transmitted (generated), commonly known as self-to-self CIR. Another novelty of the proposed system is the spatial CIR discrimination that is possible with the receiver antenna design which consists of eight sectorized antennas with 45° aperture in the horizontal plane and total coverage equal to the isotropic one. The dimensions of a rectangular room are reconstructed directly from spatial radio impulse responses by extracting the information regarding round trip time (RTT). Using radar approach estimation of walls and corners positions is derived. Tests using measured data were performed, and the simulation results confirm the feasibility of the approach.

Residential self-selection and geographical scales in trip frequency.

Neighbourhood representation and scale used to measure the built environment have been treated in many ways. However, it is anything but clear what representation of neighbourhood is the most feasible in the existing literature. This paper presents an exhaustive analysis of built environment attributes through three spatial scales. For this purpose multiple data sources are integrated, and a set of 943 observations is analysed. This paper simultaneously analyses the influence of two methodological issues in the study of the relationship between built environment and travel behaviour: (1) detailed representation of neighbourhood by testing different spatial scales; (2) the influence of unobserved individual sensitivity to built environment attributes. The results show that different spatial scales of built environment attributes produce different results. Hence, it is important to produce local and regional transport measures, according to geographical scale. Additionally, the results show significant sensitivity to built environment attributes depending on place of residence. This effect, called residential sorting, acquires different magnitudes depending on the geographical scale used to measure the built environment attributes. Spatial scales risk to the stability of model results. Hence, transportation modellers and planners must take into account both effects of self-selection and spatial scales.

The chair of food Banks UPM as a tool of raising awareness and promoting a culture of rational food comsumption

The Chair of Food Banks UPM arises from a cooperation agreement between the Spanish Federation of Food Banks (FESBAL) and the Technical University of Madrid (UPM), with the aim of raising awareness and promoting rational food consumption to avoid food waste, through activities of training, transfer of knowledge and promotion of I+D+i. The aim of this paper is to reflect on the activities carried out during the first year in order to obtain learning lessons and improve the management of activities and resources.

Utilizing the Internet of Things to promote energy awareness and efficiency at discrete production processes: Practices and methodology

El actual contexto de fabricación, con incrementos en los precios de la energía, una creciente preocupación medioambiental y cambios continuos en los comportamientos de los consumidores, fomenta que los responsables prioricen la fabricación respetuosa con el medioambiente. El paradigma del Internet de las Cosas (IoT) promete incrementar la visibilidad y la atención prestada al consumo de energía gracias tanto a sensores como a medidores inteligentes en los niveles de máquina y de línea de producción. En consecuencia es posible y sencillo obtener datos de consumo de energía en tiempo real proveniente de los procesos de fabricación, pero además es posible analizarlos para incrementar su importancia en la toma de decisiones. Esta tesis pretende investigar cómo utilizar la adopción del Internet de las Cosas en el nivel de planta de producción, en procesos discretos, para incrementar la capacidad de uso de la información proveniente tanto de la energía como de la eficiencia energética. Para alcanzar este objetivo general, la investigación se ha dividido en cuatro sub-objetivos y la misma se ha desarrollado a lo largo de cuatro fases principales (en adelante estudios). El primer estudio de esta tesis, que se apoya sobre una revisión bibliográfica comprehensiva y sobre las aportaciones de expertos, define prácticas de gestión de la producción que son energéticamente eficientes y que se apoyan de un modo preeminente en la tecnología IoT. Este primer estudio también detalla los beneficios esperables al adoptar estas prácticas de gestión. Además, propugna un marco de referencia para permitir la integración de los datos que sobre el consumo energético se obtienen en el marco de las plataformas y sistemas de información de la compañía. Esto se lleva a cabo con el objetivo último de remarcar cómo estos datos pueden ser utilizados para apalancar decisiones en los niveles de procesos tanto tácticos como operativos. Segundo, considerando los precios de la energía como variables en el mercado intradiario y la disponibilidad de información detallada sobre el estado de las máquinas desde el punto de vista de consumo energético, el segundo estudio propone un modelo matemático para minimizar los costes del consumo de energía para la programación de asignaciones de una única máquina que deba atender a varios procesos de producción. Este modelo permite la toma de decisiones en el nivel de máquina para determinar los instantes de lanzamiento de cada trabajo de producción, los tiempos muertos, cuándo la máquina debe ser puesta en un estado de apagada, el momento adecuado para rearrancar, y para pararse, etc. Así, este modelo habilita al responsable de producción de implementar el esquema de producción menos costoso para cada turno de producción. En el tercer estudio esta investigación proporciona una metodología para ayudar a los responsables a implementar IoT en el nivel de los sistemas productivos. Se incluye un análisis del estado en que se encuentran los sistemas de gestión de energía y de producción en la factoría, así como también se proporcionan recomendaciones sobre procedimientos para implementar IoT para capturar y analizar los datos de consumo. Esta metodología ha sido validada en un estudio piloto, donde algunos indicadores clave de rendimiento (KPIs) han sido empleados para determinar la eficiencia energética. En el cuarto estudio el objetivo es introducir una vía para obtener visibilidad y relevancia a diferentes niveles de la energía consumida en los procesos de producción. El método propuesto permite que las factorías con procesos de producción discretos puedan determinar la energía consumida, el CO2 emitido o el coste de la energía consumida ya sea en cualquiera de los niveles: operación, producto o la orden de fabricación completa, siempre considerando las diferentes fuentes de energía y las fluctuaciones en los precios de la misma. Los resultados muestran que decisiones y prácticas de gestión para conseguir sistemas de producción energéticamente eficientes son posibles en virtud del Internet de las Cosas. También, con los resultados de esta tesis los responsables de la gestión energética en las compañías pueden plantearse una aproximación a la utilización del IoT desde un punto de vista de la obtención de beneficios, abordando aquellas prácticas de gestión energética que se encuentran más próximas al nivel de madurez de la factoría, a sus objetivos, al tipo de producción que desarrolla, etc. Así mismo esta tesis muestra que es posible obtener reducciones significativas de coste simplemente evitando los períodos de pico diario en el precio de la misma. Además la tesis permite identificar cómo el nivel de monitorización del consumo energético (es decir al nivel de máquina), el intervalo temporal, y el nivel del análisis de los datos son factores determinantes a la hora de localizar oportunidades para mejorar la eficiencia energética. Adicionalmente, la integración de datos de consumo energético en tiempo real con datos de producción (cuando existen altos niveles de estandarización en los procesos productivos y sus datos) es esencial para permitir que las factorías detallen la energía efectivamente consumida, su coste y CO2 emitido durante la producción de un producto o componente. Esto permite obtener una valiosa información a los gestores en el nivel decisor de la factoría así como a los consumidores y reguladores. ABSTRACT In today‘s manufacturing scenario, rising energy prices, increasing ecological awareness, and changing consumer behaviors are driving decision makers to prioritize green manufacturing. The Internet of Things (IoT) paradigm promises to increase the visibility and awareness of energy consumption, thanks to smart sensors and smart meters at the machine and production line level. Consequently, real-time energy consumption data from the manufacturing processes can be easily collected and then analyzed, to improve energy-aware decision-making. This thesis aims to investigate how to utilize the adoption of the Internet of Things at shop floor level to increase energy–awareness and the energy efficiency of discrete production processes. In order to achieve the main research goal, the research is divided into four sub-objectives, and is accomplished during four main phases (i.e., studies). In the first study, by relying on a comprehensive literature review and on experts‘ insights, the thesis defines energy-efficient production management practices that are enhanced and enabled by IoT technology. The first study also explains the benefits that can be obtained by adopting such management practices. Furthermore, it presents a framework to support the integration of gathered energy data into a company‘s information technology tools and platforms, which is done with the ultimate goal of highlighting how operational and tactical decision-making processes could leverage such data in order to improve energy efficiency. Considering the variable energy prices in one day, along with the availability of detailed machine status energy data, the second study proposes a mathematical model to minimize energy consumption costs for single machine production scheduling during production processes. This model works by making decisions at the machine level to determine the launch times for job processing, idle time, when the machine must be shut down, ―turning on‖ time, and ―turning off‖ time. This model enables the operations manager to implement the least expensive production schedule during a production shift. In the third study, the research provides a methodology to help managers implement the IoT at the production system level; it includes an analysis of current energy management and production systems at the factory, and recommends procedures for implementing the IoT to collect and analyze energy data. The methodology has been validated by a pilot study, where energy KPIs have been used to evaluate energy efficiency. In the fourth study, the goal is to introduce a way to achieve multi-level awareness of the energy consumed during production processes. The proposed method enables discrete factories to specify energy consumption, CO2 emissions, and the cost of the energy consumed at operation, production and order levels, while considering energy sources and fluctuations in energy prices. The results show that energy-efficient production management practices and decisions can be enhanced and enabled by the IoT. With the outcomes of the thesis, energy managers can approach the IoT adoption in a benefit-driven way, by addressing energy management practices that are close to the maturity level of the factory, target, production type, etc. The thesis also shows that significant reductions in energy costs can be achieved by avoiding high-energy price periods in a day. Furthermore, the thesis determines the level of monitoring energy consumption (i.e., machine level), the interval time, and the level of energy data analysis, which are all important factors involved in finding opportunities to improve energy efficiency. Eventually, integrating real-time energy data with production data (when there are high levels of production process standardization data) is essential to enable factories to specify the amount and cost of energy consumed, as well as the CO2 emitted while producing a product, providing valuable information to decision makers at the factory level as well as to consumers and regulators.