Factors influencing hospital readmission and length of stay of Vietnamese patients with type 2 diabetes and cardiac disease

Background: Increased hospital readmission and longer stays in the hospital for patients with type 2 diabetes and cardiac disease can result in higher healthcare costs and heavier individual burden. Thus, knowledge of the characteristics and predictive factors for Vietnamese patients with type 2 diabetes and cardiac disease, at high risk of hospital readmission and longer stays in the hospital, could provide a better understanding on how to develop an effective care plan aimed at improving patient outcomes. However, information about factors influencing hospital readmission and length of stay of patients with type 2 diabetes and cardiac disease in Vietnam is limited. Aim: This study examined factors influencing hospital readmission and length of stay of Vietnamese patients with both type 2 diabetes and cardiac disease. Methods: An exploratory prospective study design was conducted on 209 patients with type 2 diabetes and cardiac disease in Vietnam. Data were collected from patient charts and patients' responses to self-administered questionnaires. Descriptive statistics, bivariate correlation, logistic and multiple regression were used to analyse the data. Results: The hospital readmission rate was 12.0% among patients with both type 2 diabetes and cardiac disease. The average length of stay in the hospital was 9.37 days. Older age (OR= 1.11, p< .05), increased duration of type 2 diabetes (OR= 1.22, p< .05), less engagement in stretching/strengthening exercise behaviours (OR= .93, p< .001) and in communication with physician (OR= .21, p< .001) were significant predictors of 30-dayhospital readmission. Increased number of additional co-morbidities (β= .33, p< .001) was a significant predictor of longer stays in the hospital. High levels of cognitive symptom management (β= .40, p< .001) significantly predicted longer stays in the hospital, indicating that the more patients practiced cognitive symptom management, the longer the stay in hospital. Conclusions: This study provides some evidence of factors influencing hospital readmission and length of stay and argues that this information may have significant implications for clinical practice in order to improve patients' health outcomes. However, the findings of this study related to the targeted hospital only. Additionally, the investigation of environmental factors is recommended for future research as these factors are important components contributing to the research model.

Editorial of "International Journal of Critical Indigenous Studies Volume 4, Number 2, 2011"

This special edition of the International Journal of Critical Indigenous Studies focuses upon the work scholars within the growing discipline of Aboriginal and Torres Strait Islander health studies. The lamentable state of Indigenous health in Australia is reflected in Indigenous populations elsewhere, especially where settler colonialism has left an indelible mark. This special edition therefore speaks to where Indigenous health outcomes and the efficacy of remedies are causing concern. Common to all is the demand that Indigenous people are placed front and centre of all attempts to improve health outcomes and that improvements are sought in culturally sensitive ways. Terry Dunbar presents findings from a research study that set out to investigate the Indigenous experiences of health and family services in the Northern Territory, Australia. The study asserts that cultural security is an integral and vital element of any policy that will impact upon Indigenous peoples. Dunbar concludes by arguing that in seeking positive change with regard to cultural security or otherwise, the most vociferous champions of that change are likely to be the Aboriginal communities affected. The article by Bronwyn Fredericks, Karen Adams, Sandra Angus and Melissa Walker also highlights the need to involve Aboriginal and Torres Strait Islander people, in this case women, in the design and development of strategies affecting their lives. Utilising routine communication methods such the ‘talking circle’ and the process referred to as ‘talkin’ up’, where women ‘talk back’ to one another about issues of personal importance, the article argues that the health strategy which emerged through these consultation approaches was more accurately informed by and responsive to women’s health need. Indeed, the resulting strategy reflected the women’s sense of themselves and the clear direction they felt their health services and polices should take.

Preparation of 1-acyl-2-succinyl glycero-3-phosphorylcholine and evidence against its involvement in succinate dehydrogenase action

1-Acyl-2-succinyl glycero-3-phosphorylcholine (GPC) was synthesized and its properties described. Although 1-acyl-2-succinyl GPC is a good substrate for succinate dehydrogenase, experiments on the incorporation of [2,3-14C]succinate into mitochondrial lipids gave no evidence to indicate that it is an intermediate in the enzymic oxidation of succinate to fumarate, as has been suggested earlier.

Time-domain criteria for theL_{2}-stability of nonstationary feedback systems

Criteria for the L2-stability of linear and nonlinear time-varying feedback systems are given. These are conditions in the time domain involving the solution of certain associated matrix Riccati equations and permitting the use of a very general class of L2-operators as multipliers.

Proekt tipovogo 2-kh kvartirnogo pereselencheskogo doma

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Crystal structure from packing studies: application to the triclinic structure of the cyclic hexapeptide cyclo-(gly-tyr-gly)2

The paper describes a novel method of finding the position and orientation of a relatively rigid molecule in the unit cell from criteria concerning allowed contact distances between atoms. On application to the crystal structure of a hexapeptide, C25H31N6O8.2H2O, it was possible to solve the structure from this starting point, by a series of SFLS refinements with an increasingly larger number of reflexions at successive stages. The packing analysis succeeded, even though the water molecules were not included to start with.

Equivalent rate 1/2 quasi-cyclic codes

Chen et al. [1] give a list of quasi-cyclic (2m,m) codes which have the largest minimum distance of any quasi-cyclic code, for various values ofm. We present the weight distribution of these codes. It will be seen that many of the codes found by Chen et al. [1] are equivalent in the sense of having identical weight distributions.

On energy-momentum tensors as sources of spin-2 fields

The improvement terms in the generalised energy-momentum tensor of Callan, Coleman and Jackiw can be derived from a variational principle if the Lagrangian is generalised to describe coupling between ‘matter’ fields and a spin-2 boson field. The required Lorentz-invariant theory is a linearised version of Kibble-Sciama theory with an additional (generally-covariant) coupling term in the Lagrangian. The improved energy-momentum tensor appears as the source of the spin-2 field, if terms of second order in the coupling constant are neglected.

A new mode of ring cleavage of 2,3-dihydroxybenzoic acid in Tecoma stans (L.). Partial purification and properties of 2,3-dihydroxybenzoate 2,3-oxygenase.

2,3-Dihydroxybenzoic acid has been shown to be oxidized via the 3-oxoadipate pathway in the leaves of Tecoma stans. The formation of 2-carboxy-cis,cis-muconic acid, a muconolactone, 3-oxoadipic acid and carbon dioxide during its metabolism has been demonstrated using an extract of Tecoma leaves. The first reaction of the pathway, viz., the conversion of 2,3-dihydroxybenzoate to 2-carboxy-cis,cis-muconic acid has been shown to be catalysed by an enzyme designated as 2,3-dihydroxybenzoate 2,3-oxygenase. The enzyme has been partially purified and a few of its properties studied. The enzyme is very labile with a half-life of 3--4 h. It is maximally active with 2,3-dihydroxybenzoate as the substrate and does not exhibit any activity with catechol, 4-methyl catechol, 3,4-dihydroxybenzoic acid, etc. However, 2,3-dihydroxy-p-toluate and 2,3-dihydroxy-p-cumate are also oxidized by the enzyme by about 38% and 28% respectively, compared to 2,3-dihydroxybenzoate. Sulfhydryl reagents inhibit the enzyme reaction and the inhibition can be prevented by preincubation of the enzyme with the substrate. Substrate also affords protection to the enzyme against thermal inactivation. Sulfhydryl compounds strongly inhibit the reaction and the inhibition cannot be prevented by preincubation of the enzyme with its substrates. Data on the effect of metal ions as well as metal chelating agents suggest that copper is the metal cofactor of the enzyme. Evidence is presented which suggests that iron may not be participating in the overall catalytic mechanism.

Komplexe von Lanthanidnitraten mit 2-Methylpyridin-1-oxid

Complexes of lanthanide nitrates with 2-methylpyridine-1-oxide of the formuleLn(2-MePyO)3(NO3)3 whereLn=Nd, Sm, Tb, Dy and Yb and La(2-MePyO)3(NO3)3·2H2O have been prepared and characterized by chemical analyses, IR spectral, conductance andDTA data. IR spectral data have been interpreted in terms of the coordination of the ligand to the metal through the oxygen of the N–O group. Conductance and IR spectral data show that all the nitrate groups are bidentate and that two of the nitrate groups are bound to the metal in a different manner than the other.

Skhematicheskiĭ plan 2-ogo agronomicheskogo uchastka, Khersonskiĭ okrug

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Control of Regiochemistry in Photodimerization through Micellar Preorientational Effect: 2-Substituted Naphthalenes

Photodimerization of 2-substituted naphthalenes in organic solvents has been well explored. In contrast to their behavior in organic solvents, in anionic and cationic micellar media enhanced reactivity and pronounced regioselectivity are observed. Reactivity enhancement in micellar media is attributed to the local concentration effect. Enhanced reactivity in CTAC and DTAC compared to CTAB micelles is attributed to the counterion effect, and the regioselective photodimerization observed in anionic and cationic micelles leading exclusively to the cis dimer or the products derived therefrom is rationalized on the basis of the preorientational effect of micelles.

Thermodynamic properties of the system toluene-1,2-dichloroethane

Data on heats of mixing at 30 'C, vapor-liquid equilibrium, latent heats of vaporization at 686 mmHg, and vapor pressures for the system toluene-l,2-dichloroethane are presented.