Background/Objective: Nursing homes (NHs) are an important setting for the provision of palliative and endof-life (EOL) care. Excessive reliance on hospitalizations at EOL and infrequent enrollment in hospice are key quality concerns in this setting. We examined the association between communication-among NH providers and between providers and residents/family members-and two EOL quality measures (QMs): in-hospital deaths and hospice use. Design and Methods: We developed two measures of communication by using a survey tool implemented in a random sample of U.S. NHs in 2011-12. Using secondary data (Minimum Data Set, Medicare, and hospice claims), we developed two risk-adjusted quality metrics for in-hospital death and hospice use. In the 1201 NHs, which completed the survey, we identified 54,526 residents, age 65+, who died in 2011. Psychometric assessment of the two communication measures included principal factor and internal consistency reliability analyses. Random-effect logistic and weighted least-square regression models were estimated to develop facility-level risk-adjusted QMs, and to assess the effect of communication measures on the quality metrics. Results: Better communication with residents/family members was statistically significantly ( p = 0.015) associated with fewer in-hospital deaths. However, better communication among providers was significantly ( p = 0.006) associated with lower use of hospice. Conclusions: Investing in NHs to improve communication between providers and residents/family may lead to fewer in-hospital deaths. Improved communication between providers appears to reduce, rather than increase, NH-to-hospice referrals. The actual impact of improved provider communication on residents' EOL care quality needs to be better understood.

This paper presents a cheap and facile strategy for fabricating hybrid superhydrophilic/superhydrophobic arrays on a flexible polydimethylsiloxane (PDMS) film to harvest water from fog efficiently. The hydrophobic PDMS film, which mimics the micro-/nanostructures on a beetle’s back, was selected as the substrate, on which a hydrophilic silicon dioxide (SiO2) colloidal monolayer was fabricated through self-assembly. After reactive ion etching, the silicon dioxide microsphere arrangement changed from pristine hexagonal close packed into hexagonal non-close packed. The silicon dioxide microspheres demonstrated superhydrophilicity and functioned as masks. Patterned grooves were also formed on the PDMS film and displayed superhydrophobicity. The fabricated hybrid superhydrophilic/superhydrophobic array films exhibited extreme wettability contrast and excellent water-harvesting performance of 3660·5 mg/(cm2 h), which is much better than that of bionic surfaces of the Namib Desert beetles’ back reported by others. The bionic flexible films can be reproduced with low cost and can be applied in water-trapping tents, building coverings, water or organic vapor condensers and microfluidic channels.

Mainstream points-to analysis techniques for object-oriented languages rely predominantly on the allocation-site abstraction to model heap objects. We present MAHJONG, a novel heap abstraction that is specifically developed to address the needs of an important class of type-dependent clients, such as call graph construction, devirtualization and may-fail casting. By merging equivalent automata representing type-consistent objects that are created by the allocation-site abstraction, MAHJONG enables an allocation-site-based points-to analysis to run significantly faster while achieving nearly the same precision for type-dependent clients. MAHJONG is simple conceptually, efficient, and drops easily on any allocation-site-based points-to analysis. We demonstrate its effectiveness by discussing some insights on why it is a better alternative of the allocation-site abstraction for type-dependent clients and evaluating it extensively on 12 large real-world Java programs with five context-sensitive points-to analyses and three widely used type-dependent clients. MAHJONG is expected to provide significant benefits for many program analyses where call graphs are required.

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