In this article we consider the problem of estimating location and scale parameters of the Maxwell distribution from both frequentist and Bayesian points of view. Additionally, some properties of the distribution, namely, stochastic ordering, Rényi and Shannon entropies, and order statistics, are derived. Behavior of the estimators from different frequentist approaches, namely, maximum likelihood, method of moments, least square’s, and weighted least square as well as Bayes estimators of parameters, is compared with respect to bias, mean squared errors, and the coverage percentage extracted from bootstrap confidence intervals. The existence and uniqueness of the maximum likelihood estimators are also discussed. The Bayes estimators and the associated credible intervals are obtained using importance sampling technique under squared error loss function. A gamma prior is used for the scale parameter and a uniform prior for the location parameter. An example with flood-level data is used to illustrate applicability of procedures discussed.

Export PURPOSE: The purpose of this study was to examine pressure injury prevention and management (PIPM) practices in an academic acute care setting. Specific aims were to (1) develop and examine key stakeholder engagement regarding PIPM practices, (2) develop a valid/reliable gap analysis instrument, and (3) conduct a gap analysis of current PIPM practices. DESIGN: Mixed-methods convergent design and participatory action research. SUBJECTS AND SETTING: A nurse-led council (Council) of key stakeholders from a large academic university healthcare setting was developed. The gap analysis was conducted in a southern gulf coast level I trauma academic acute care hospital in the Southeastern United States. METHODS: A multidisciplinary key stakeholder Council with 27 members was developed to accomplish study aims using the participatory action research approach to train, promote, and foster key stakeholder engagement in all aspects of the research process. The Pressure Injury Prevention Gap Analysis Instrument (PIPGAI) was developed and psychometrically tested. A gap analysis of PIPM practices across a level I trauma academic acute care hospital was conducted using the PIPGAI. RESULTS: The PIPGAI was developed using 2019 Pressure Ulcer/Injury Clinical Practice Guideline recommendations, an integrative literature review/appraisal, a concept map, and Council input. The overall PIPGAI content validity index of 0.95 demonstrated excellent content validity. The individual item content validity index scores ranged from 0.62 to1.0. Low-scoring items (0.62-0.75) were deleted or revised. Interrater reliability was demonstrated by percentage of agreement (62%-79%). Using a modified Delphi approach, items of disagreement were summarized and discussed until 100% consensus was achieved. A gap analysis of PIPM practices was conducted resulting in a cumulative score of 267/553 (48%), indicating gaps in PIPM practices. Fifty (73%) items had content present; 37 of 58 (64%) items had minimal detail, and 36 of 58 (62%) items were difficult or required notable effort to accomplish. Fifty items (63%) had a total score of 4 or less and were identified as a gap (range: 0-7). CONCLUSIONS: The main outcome of this study was an innovative and evidence-based gap analysis process. The study provides (1) a model for key stakeholder engagement, (2) a valid/reliable gap analysis instrument, and (3) a method to evaluate PIPM practices.

PURPOSE: The purpose of this study was to examine ostomy complications and health-related quality of life (QOL) in individuals with an ostomy who wear an ostomy support belt/garment. DESIGN: A mixed-methods descriptive study. SUBJECTS AND SETTING: Two hundred two community-living adults with an ostomy were recruited using an industry distribution list. The target sample had no geographic restrictions. METHODS: Descriptive analysis was conducted for all outcomes. Participants were separated into groups depending on type of ostomy belt or belt/garment worn or none. All categorical data were summarized using percentages and numerical data using mean ± standard deviation. Association between categorical factors was evaluated using a χ² test and proportions of occurrences from 2 groups were compared using a 2-proportion z-test. The mean outcomes for 2 or more groups were compared using t tests or analysis of variance (ANOVA), respectively. If ANOVA showed difference among groups, post hoc analysis of group means was conducted using Tukey's Honestly Significant Difference (HSD) test. RESULTS: Two hundred two respondents completed the survey. Of the 174 participants who responded to the survey question on leakage, 157 (90%) reported experiencing leakage and 135 (77.59%) reported rash or skin irritation. Comparison of whether participants had ever experienced a leakage event was not significantly different across groups (P = .3663). Those who wore an ostomy support belt/garment reported leakage less often (less than once a month) versus respondents who wore other types of belts or no belt (n = 49, 73.13% vs n = 53, 59.55%; P = .0388). Of the 174 participants who responded to the peristomal skin question, 135 (77.59%) participants reported peristomal skin complications. Significantly fewer participants who wore an ostomy support belt/garment reported having peristomal skin irritation compared to those who wore other types of belts or no belt (69.01% vs 84.16%; P = .0080). The mean cumulative total City of Hope Quality of Life (COH QOL) Ostomy score for all participants was 6.45 ± 1.36 out of 10, with the psychosocial domain scoring the lowest at 5.67 ± 1.30 out of 10. No significant differences were observed in mean QOL domain and total scores by those who wore an ostomy support belt/garment, other type of belt/garment, and none. When comparing COH QOL mean scores and leakage frequency of more/less once a month, those who reported leakage more often had significantly worse QOL scores in all 4 domains as well as total scores: physical (P = .0008), psychological (P = .0154), social (P = .0056), spiritual (P = .0376), and total COH QOL score (P = .0018). CONCLUSION: This study provides important information related to ostomy complications and QOL associated with wearing an ostomy belt or belt/garment. The use of an ostomy support belt/garment may offer an additional intervention to decrease frequency of leakage and peristomal skin irritation and improve QOL.

The accuracy and precision of iMET-XQ (InterMET Inc., Grand Rapids, MI, USA) temperature measurements in ten different locations on an off-the shelf rotary-wing unmanned aerial vehicle (rw-UAV) were assessed, as a function of atmospheric conditions. The rw-UAV hovered near an instrumented South Alabama Mesonet tower. The mean ± standard deviation of all the temperature differences between the tower and the ten iMET-XQ sensors for all experiments are −0.23 °C ±0.24 °C. Both the UAV and the environment influence the accuracy and precision of the iMET-XQ temperature measurements. Heat generated by the electronic components within the UAV body has a significant influence on the iMET-XQ temperature measurements, regardless of solar radiation conditions, and is highly dependent on wind direction. Electronic components within the UAV body heat up and can cause sensors downwind from the UAV body to record temperatures that are too warm, even if the sensors are aspirated by propeller wash. iMET-XQ sensors placed on rotor arms not near UAV body heat sources, and properly aspirated by propeller wash, perform well. Measurements from iMET-XQ sensors suspended below the UAV are also accurate. When using an off-the-shelf UAV for atmospheric temperature sensing, the electronic components inside the body of the UAV must be properly located. It is recommended that multiple sensors are placed on the UAV. Sensor redundancy will mitigate data loss in case of malfunction during flight and the identification of poorly performing sensors.

Purpose: Amyotrophic lateral sclerosis (ALS) impacts bulbar and respiratory musculature, which may contribute to impaired swallow function (dysphagia) and respiratory–swallow coordination. The purpose of this pilot study was to examine if respiratory–swallow coordination in individuals with ALS was perturbed compared to healthy controls. We further explored relationships between measures of respiratory function and self-reported swallowing outcomes on respiratory–swallow coordination.Method: We employed a cross-sectional design with eight participants with ALS and eight age- and sex-matched healthy participants. Respiratory inductance plethysmography and a nasal cannula were used to capture respiratory–swallow phase patterns during a standardized clinical swallow examination. The advantageous respiratory–swallow phase pattern was defined if exhalation surrounded the swallow (E–E). Spirometry was used to capture indices of respiratory function (forced vital capacity % predicted, peak cough flow [PCF]). Validated questionnaires were used to collect information regarding ALS-related bulbar functional status and swallowing-related concerns.Results: Compared to the matched healthy cohort, individuals with ALS demonstrated higher rates of non–E-E respiratory–swallow phase patterning and worse bulbar/swallow dysfunction. Group (ALS), swallow tasks, and PCF were significantly associated with respiratory–swallow phase pattern.Conclusions: These preliminary findings support altered respiratory–swallow phase patterning in ALS. Future work should employ an instrumental assessment to quantify swallowing physiology and elucidate the relationship between perturbed respiratory–swallow coordination and swallowing function.

Temperature measurements of InterMET Inc. aluminum-coated iMET-XQ sensors were tested in an outdoor setting under a variety of solar radiation and wind speed conditions. Twelve unshielded sensors were mounted side-by-side on the tower of a South Alabama Mesonet weather station next to a reference sensor on the tower. The iMET-XQ temperatures were most precise and accurate in solar radiation values that were close to zero, regardless of wind speed. Under overcast conditions, wind speeds of 2 m s⁻¹ were sufficient to obtain precise and accurate temperature measurements. During the day-time, aspiration of wind speeds higher than or equal to 3 m s⁻¹ is sufficient. An iMET-XQ was placed in a radiation shield next to the tower reference sensor to test the need for a radiation shield. A second iMET-XQ was placed unshielded on the tower. The iMET-XQ sensors with aluminum coating do not need to be shielded, but they do need to be aspirated. It is recommended that, when taking temperature measurements using unmanned aerial vehicles (UAV) with iMET-XQ sensors, the UAV either fly at 3 m s⁻¹, be embedded in winds of those speeds, or to use the propeller wash of the UAV to aspirate the sensors.