scholarly journals Intercultural Relations Among Guinean Immigrants Living in Portugal: Testing Multiculturalism, Contact, and Integration Hypotheses

2021 ◽  
Vol 8 (2) ◽  
pp. 225
Author(s):  
Félix Neto
Keyword(s):  
Cultural Identity ◽  
Mental Health Problems ◽  
Average Length ◽  
Perceived Discrimination ◽  
Intercultural Relations ◽  
Sociocultural Adaptation ◽  
Guinea Bissau ◽  
Average Length Of Stay ◽  
Integration Strategy ◽  
Intercultural Adaptation

This study tests several specific predictions derived from three general core hypotheses of intercultural relations (multiculturalism, contact, and integration hypotheses). The participants were 405 migrants from Guinea-Bissau (51 percent women). Their average age was 38 years. The average length of stay in Portugal was 18 years. Data collection involved the completion of questionnaires to measure multicultural ideology, security, cultural identity, contact, perceived discrimination, acculturation strategies, mental health problems, sociocultural adaptation, and tolerance. In concert with the multiculturalism hypothesis, security and cultural identity positively predicted multicultural ideology. The contact hypothesis was partially confirmed given that intercultural contact did not predict perceived discrimination, although contact predicted national identity. Regarding the integration hypothesis, integration strategy predicted psychological and intercultural adaptations, while the predictors of sociocultural adaptation were assimilation and marginalization. Hence, the integration hypothesis obtained partial support for migrants from Guinea-Bissau residing in Portugal. Finally, some implications of the findings are discussed. This study contributes to extending the integration hypothesis to a recently suggested new form of adaptation, intercultural adaptation. Feelings of being secure in the larger society and one’s identity contributes to higher acceptance of diversity.

scholarly journals Intercultural Relations among Ukrainian Immigrants Living in Portugal

2019 ◽  
Vol 18 (5) ◽  
pp. 1-11
Author(s):  
Félix Neto
Keyword(s):  
Average Length ◽  
Perceived Discrimination ◽  
Psychological Adaptation ◽  
Contact Hypothesis ◽  
Intercultural Relations ◽  
Sociocultural Adaptation ◽  
Intercultural Contact ◽  
Low Level ◽  
Positive Attitudes ◽  
Intercultural Adaptation

The purpose of this research was to test specific predictions based on three general hypotheses: the integration hypothesis, the contact hypothesis, and the multiculturalism hypothesis. The sample included 218 Ukrainian immigrants with an average of 39 years. The average length of time residing in Portugal was 10 years. As regards the integration hypothesis, psychological adaptation and intercultural adaptation were predicted by integration, while sociocultural adaptation was only predicted by marginalization. Thus, the integration hypothesis was partially supported for Ukrainian immigrants living in Portugal. The contact hypothesis tended to be supported, as intercultural contact was predicted by higher positive attitudes toward Portuguese, and assimilation. However, integration has not emerged as a significant predictor of intercultural contact. This sample displayed a relatively low level of perceived discrimination. In line with the multiculturalism hypothesis, perceived discrimination was negatively related to tolerance, attitude towards Portuguese, attitude towards other immigrants, and positively related to preference for separation and marginalization. Findings are discussed considering the existing literature.

Loneliness among Chinese Migrants in Portugal

2021 ◽  
Vol 17 (1) ◽  
pp. 196-213
Author(s):  
Félix Neto ◽  
Maria da Conceição Pinto
Keyword(s):  
Mental Health ◽  
Ethnic Identity ◽  
Mental Health Problems ◽  
Average Length ◽  
Perceived Discrimination ◽  
Health Problems ◽  
Sociocultural Adaptation ◽  
Chinese Migrants

Abstract The goal of this research is to explore the acculturation and adaptation factors that are likely to predict the level of loneliness among Chinese migrants residing in Portugal. The sample is constituted by one hundred and eighty-nine participants (25 percent women and 75 percent men) with an average age of 29 years. The average length of sojourn was 8 years. We used the ULS-6 scale to assess loneliness. Other instruments were utilized to evaluate ethnic identity, perceived discrimination, mental health, sociocultural adaptation, and tolerance. In agreement with expectations, ethnic identity negatively predicted loneliness, and perceived discrimination positively predicted loneliness. Lastly, sociocultural adaptation and tolerance negatively predicted loneliness, and mental health problems positively predicted loneliness. The adaptation factors predicted 60 percent of the variance in loneliness. Implications of these findings for reducing migrants’ loneliness are considered.

Predictors of mental health among Angolan migrants living in Portugal

2018 ◽  
Vol 14 (2) ◽  
pp. 146-159 ◽  
Author(s):  
Félix Neto ◽  
Tharina Guse
Keyword(s):  
Mental Health ◽  
Predictive Factors ◽  
Mental Health Problems ◽  
Perceived Discrimination ◽  
Demographic Factors ◽  
Psychosocial Interventions ◽  
Health Problems ◽  
Future Research ◽  
Sociocultural Adaptation ◽  
Content Type

Purpose The purpose of this paper is to examine the determinants of mental health among Angolan migrants living in Portugal. Three research questions guided this work: What is the influence of demographic factors on the mental health of Angolan migrants? What is the influence of acculturation factors on their mental health? What is the influence of adaptation factors on their mental health? Design/methodology/approach The sample consisted of 252 Angolan migrants living in Portugal (50.8 percent females) with a mean age of 36 years. The mean duration of stay in Portugal was 21 years. Findings The predictive factors – demographic, acculturation and adaptation factors – were significantly associated with Angolan migrants’ mental health. However, acculturation and adaptation factors accounted for a larger proportion of the explained variance in mental health problems than demographic factors. The major predictors of mental health problems were sociocultural adaptation, perceived discrimination and loneliness. Implications of the findings for future research and psychosocial interventions are discussed. Originality/value This study shed some light on the predictive factors of mental health problems among adult Angolan immigrants in Portugal, a previously neglected group of migrants in the research literature. Adding to existing knowledge on the mental health outcomes of migration, the findings suggest that, for this group, sociocultural adaptation, perceived discrimination and loneliness were the main predictors of psychological problems, rather than demographic factors. This evidence may be useful in the development of psychosocial interventions and policy to support Angolan migrants in their adaptation to Portuguese culture.

scholarly journals Colonization and Infection With MRSA and CRKP and Its Result in an Increased Mortality Rate Within the Intensive Care and High-Dependency Units in Barbados

2020 ◽  
Vol 41 (S1) ◽  
pp. s173-s174
Author(s):  
Keisha Gustave
Keyword(s):  
Intensive Care ◽  
Length Of Stay ◽  
High Mortality ◽  
Average Length ◽  
Cohort Analysis ◽  
Health Concern ◽  
Queen Elizabeth Hospital ◽  
Surveillance Program ◽  
Average Length Of Stay ◽  
High Dependency

Background: Methicillin-resistant Staphylococcus aureus(MRSA) and carbapenem-resistant Klebsiella pneumoniae (CRKP) are a growing public health concern in Barbados. Intensive care and critically ill patients are at a higher risk for MRSA and CRKP colonization and infection. MRSA and CRKP colonization and infection are associated with a high mortality and morbidly rate in the intensive care units (ICUs) and high-dependency units (HDUs). There is no concrete evidence in the literature regarding MRSA and CRKP colonization and infection in Barbados or the Caribbean. Objectives: We investigated the prevalence of MRSA and CRKP colonization and infection in the patients of the ICU and HDU units at the Queen Elizabeth Hospital from 2013 to 2017. Methods: We conducted a retrospective cohort analysis of patients admitted to the MICU, SICU, and HDU from January 2013 through December 2017. Data were collected as part of the surveillance program instituted by the IPC department. Admissions and weekly swabs for rectal, nasal, groin, and axilla were performed to screen for colonization with MRSA and CRKP. Follow-up was performed for positive cultures from sterile isolates, indicating infection. Positive MRSA and CRKP colonization or infection were identified, and patient notes were collected. Our exclusion criteria included patients with a of stay of <48 hours and patients with MRSA or CRKP before admission. Results: Of 3,641 of persons admitted 2,801 cases fit the study criteria. Overall, 161 (5.3%) were colonized or infected with MRSA alone, 215 (7.67%) were colonized or infected with CRKP alone, and 15 (0.53%) were colonized or infected with both MRSA and CRKP. In addition, 10 (66.6%) of patients colonized or infected with MRSA and CRKP died. Average length of stay of patients who died was 50 days. Conclusions: The results of this study demonstrate that MRSA and CRKP cocolonization and coinfection is associated with high mortality in patients within the ICU and HDU units. Patients admitted to the ICU and HDU with an average length of stay of 50 days are at a higher risk for cocolonization and coinfection with MRSA and CRKP. Stronger IPC measures must be implemented to reduce the spread and occurrence of MRSA and CRKP.Funding: NoneDisclosures: None

scholarly journals Temporal Changes in Central-Line–Associated Bloodstream Infection Time Between Events, 2017–2018 Versus 2015–2016

2020 ◽  
Vol 41 (S1) ◽  
pp. s403-s404
Author(s):  
Jonathan Edwards ◽  
Katherine Allen-Bridson ◽  
Daniel Pollock
Keyword(s):  
Length Of Stay ◽  
Patient Care ◽  
Average Length ◽  
Bloodstream Infections ◽  
Central Line ◽  
Significant Shift ◽  
Care Hospital ◽  
Average Length Of Stay ◽  
Period 2 ◽  
Hospital Bed

Background: The CDC NHSN surveillance coverage includes central-line–associated bloodstream infections (CLABSIs) in acute-care hospital intensive care units (ICUs) and select patient-care wards across all 50 states. This surveillance enables the use of CLABSI data to measure time between events (TBE) as a potential metric to complement traditional incidence measures such as the standardized infection ratio and prevention progress. Methods: The TBEs were calculated using 37,705 CLABSI events reported to the NHSN during 2015–2018 from medical, medical-surgical, and surgical ICUs as well as patient-care wards. The CLABSI TBE data were combined into 2 separate pairs of consecutive years of data for comparison, namely, 2015–2016 (period 1) and 2017–2018 (period 2). To reduce the length bias, CLABSI TBEs were truncated for period 2 at the maximum for period 1; thereby, 1,292 CLABSI events were excluded. The medians of the CLABSI TBE distributions were compared over the 2 periods for each patient care location. Quantile regression models stratified by location were used to account for factors independently associated with CLABSI TBE, such as hospital bed size and average length of stay, and were used to measure the adjusted shift in median CLABSI TBE. Results: The unadjusted median CLABSI TBE shifted significantly from period 1 to period 2 for the patient care locations studied. The shift ranged from 20 to 75.5 days, all with 95% CIs ranging from 10.2 to 32.8, respectively, and P < .0001 (Fig. 1). Accounting for independent associations of CLABSI TBE with hospital bed size and average length of stay, the adjusted shift in median CLABSI TBE remained significant for each patient care location that was reduced by ∼15% (Table 1). Conclusions: Differences in the unadjusted median CLABSI TBE between period 1 and period 2 for all patient care locations demonstrate the feasibility of using TBE for setting benchmarks and tracking prevention progress. Furthermore, after adjusting for hospital bed size and average length of stay, a significant shift in the median CLABSI TBE persisted among all patient care locations, indicating that differences in patient populations alone likely do not account for differences in TBE. These findings regarding CLABSI TBEs warrant further exploration of potential shifts at additional quantiles, which would provide additional evidence that TBE is a metric that can be used for setting benchmarks and can serve as a signal of CLABSI prevention progress.Funding: NoneDisclosures: None

Comparison of Inpatient Standard-of-Care to Outpatient Oritavancin Therapy for Patients With Acute Uncomplicated Cellulitis

2021 ◽  
pp. 089719002110212
Author(s):  
Brandy Williams ◽  
Justin Muklewicz ◽  
Taylor D. Steuber ◽  
April Williams ◽  
Jonathan Edwards
Keyword(s):  
Hospital Readmission ◽  
Average Length ◽  
Hospital Readmissions ◽  
Standard Of Care ◽  
Economic Outcomes ◽  
Day Hospital ◽  
Outpatient Parenteral Antimicrobial Therapy ◽  
Average Length Of Stay ◽  
Observational Cohort ◽  
The Difference

Background: Shifting inpatient antibiotic treatment to outpatient parenteral antimicrobial therapy may minimize treatment for acute bacterial skin and skin structure infections, including cellulitis. The purpose of this evaluation was to compare 30-day hospital readmission or admission due to cellulitis and economic outcomes of inpatient standard-of-care (SoC) management of acute uncomplicated cellulitis to outpatient oritavancin therapy. Methods: This retrospective, observational cohort study was conducted at a 941-bed community teaching hospital. Adult patients 18 years and older treated for acute uncomplicated cellulitis between February 2015 to December 2018 were eligible for inclusion. Information was obtained from hospital and billing department records. Patients were assigned to either inpatient SoC or outpatient oritavancin cohorts for comparison. Results: 1,549 patients were included in the study (1,348 in the inpatient SoC cohort and 201 in the outpatient oritavancin cohort). The average length of stay for patients admitted was 3.6 ± 1.5 days. The primary outcome of 30-day hospital readmission or admission due to cellulitis occurred in 49/1348 (3.6%) patients in the inpatient SoC cohort versus 1/201 (0.5%) in the outpatient oritavancin cohort (p = 0.02). The difference between costs and reimbursement was improved in the outpatient oritavancin group (p < 0.001). Conclusion: Outpatient oritavancin for acute uncomplicated cellulitis was associated with reduction in 30-day hospital readmissions or admissions compared to inpatient SoC. Beneficial economic outcomes for the outpatient oritavancin cohort were observed. Additional studies are required to confirm these findings.

Principles of capacity management, applied in the mental health context

2018 ◽  
Vol 42 (4) ◽  
pp. 438
Author(s):  
Kathryn Zeitz ◽  
Darryl Watson
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Average Length ◽  
Patient Flow ◽  
Waiting Times ◽  
Capacity Management ◽  
Mental Health Setting ◽  
Mental Health Consumer ◽  
Mental Health Consumers ◽  
Flow Improvement

Objective The aim of the paper was to describe a suite of capacity management principles that have been applied in the mental health setting that resulted in a significant reduction in time spent in two emergency departments (ED) and improved throughput. Methods The project consisted of a multifocal change approach over three phases that included: (1) the implementation of a suite of fundamental capacity management activities led by the service and clinical director; (2) a targeted Winter Demand Plan supported by McKinsey and Co.; and (3) a sustainability of change phase. Descriptive statistics was used to analyse the performance data that was collected through-out the project. Results This capacity management project has resulted in sustained patient flow improvement. There was a reduction in the average length of stay (LOS) in the ED for consumers with mental health presentations to the ED. At the commencement of the project, in July 2014, the average LOS was 20.5 h compared with 8.5 h in December 2015 post the sustainability phase. In July 2014, the percentage of consumers staying longer than 24 h was 26% (n = 112); in November and December 2015, this had reduced to 6% and 7 5% respectively (less than one consumer per day). Conclusion Improving patient flow is multifactorial. Increased attendances in public EDs by people with mental health problems and the lengthening boarding in the ED affect the overall ED throughput. Key strategies to improve mental health consumer flow need to focus on engagement, leadership, embedding fundamentals, managing and target setting. What is known about the topic? Improving patient flow in the acute sector is an emerging topic in the health literature in response to increasing pressures of access block in EDs. What does this paper add? This paper describes the application of a suite of patient flow improvement principles that were applied in the mental health setting that significantly reduced the waiting time for consumers in two EDs. What are the implications for practitioners? No single improvement will reduce access block in the ED for mental health consumers. Reductions in waiting times require a concerted, multifocal approach across all components of the acute mental health journey.

scholarly journals Hospital Microbiologic Culture Results to Predict the Use of Anti–methicillin-Resistant Staphylococcus aureus (MRSA)

2020 ◽  
Vol 41 (S1) ◽  
pp. s40-s40
Author(s):  
Hsiu Wu ◽  
Tyler Kratzer ◽  
Liang Zhou ◽  
Minn Soe ◽  
Jonathan Edwards ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Risk Adjustment ◽  
Negative Binomial ◽  
Average Length ◽  
Negative Binomial Regression ◽  
Drug Resistant ◽  
Gram Positive ◽  
Average Length Of Stay ◽  
Control And Prevention ◽  
Hospital Characteristics

Background: To provide a standardized, risk-adjusted method for summarizing antimicrobial use (AU), the Centers for Disease Control and Prevention developed the standardized antimicrobial administration ratio, an observed-to-predicted use ratio in which predicted use is estimated from a statistical model accounting for patient locations and hospital characteristics. The infection burden, which could drive AU, was not available for assessment. To inform AU risk adjustment, we evaluated the relationship between the burden of drug-resistant gram-positive infections and the use of anti-MRSA agents. Methods: We analyzed data from acute-care hospitals that reported ≥10 months of hospital-wide AU and microbiologic data to the National Healthcare Safety Network (NHSN) from January 2018 through June 2019. Hospital infection burden was estimated using the prevalence of deduplicated positive cultures per 1,000 admissions. Eligible cultures included blood and lower respiratory specimens that yielded oxacillin/cefoxitin–resistant Staphylococcus aureus (SA) and ampicillin-nonsusceptible enterococci, and cerebrospinal fluid that yielded SA. The anti-MRSA use rate is the total antimicrobial days of ceftaroline, dalbavancin, daptomycin, linezolid, oritavancin, quinupristin/dalfopristin, tedizolid, telavancin, and intravenous vancomycin per 1,000 days patients were present. AU rates were modeled using negative binomial regression assessing its association with infection burden and hospital characteristics. Results: Among 182 hospitals, the median (interquartile range, IQR) of anti-MRSA use rate was 86.3 (59.9–105.0), and the median (IQR) prevalence of drug-resistant gram-positive infections was 3.4 (2.1–4.8). Higher prevalence of drug-resistant gram-positive infections was associated with higher use of anti-MRSA agents after adjusting for facility type and percentage of beds in intensive care units (Table 1). Number of hospital beds, average length of stay, and medical school affiliation were nonsignificant. Conclusions: Prevalence of drug-resistant gram-positive infections was independently associated with the use of anti-MRSA agents. Infection burden should be used for risk adjustment in predicting the use of anti-MRSA agents. To make this possible, we recommend that hospitals reporting to NHSN’s AU Option also report microbiologic culture results.Funding: NoneDisclosures: None

scholarly journals Biased and unbiased estimation of the average length of stay in intensive care units in the Covid-19 pandemic

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Nathanael Lapidus ◽  
Xianlong Zhou ◽  
Fabrice Carrat ◽  
Bruno Riou ◽  
Yan Zhao ◽  
...  
Keyword(s):  
Intensive Care ◽  
Length Of Stay ◽  
Average Length ◽  
Parametric Method ◽  
Estimation Methods ◽  
Unbiased Estimation ◽  
Bed Occupancy ◽  
Average Length Of Stay ◽  
Discharged Patients ◽  
First Admission

Abstract Background The average length of stay (LOS) in the intensive care unit (ICU_ALOS) is a helpful parameter summarizing critical bed occupancy. During the outbreak of a novel virus, estimating early a reliable ICU_ALOS estimate of infected patients is critical to accurately parameterize models examining mitigation and preparedness scenarios. Methods Two estimation methods of ICU_ALOS were compared: the average LOS of already discharged patients at the date of estimation (DPE), and a standard parametric method used for analyzing time-to-event data which fits a given distribution to observed data and includes the censored stays of patients still treated in the ICU at the date of estimation (CPE). Methods were compared on a series of all COVID-19 consecutive cases (n = 59) admitted in an ICU devoted to such patients. At the last follow-up date, 99 days after the first admission, all patients but one had been discharged. A simulation study investigated the generalizability of the methods' patterns. CPE and DPE estimates were also compared to COVID-19 estimates reported to date. Results LOS ≥ 30 days concerned 14 out of the 59 patients (24%), including 8 of the 21 deaths observed. Two months after the first admission, 38 (64%) patients had been discharged, with corresponding DPE and CPE estimates of ICU_ALOS (95% CI) at 13.0 days (10.4–15.6) and 23.1 days (18.1–29.7), respectively. Series' true ICU_ALOS was greater than 21 days, well above reported estimates to date. Conclusions Discharges of short stays are more likely observed earlier during the course of an outbreak. Cautious unbiased ICU_ALOS estimates suggest parameterizing a higher burden of ICU bed occupancy than that adopted to date in COVID-19 forecasting models. Funding Support by the National Natural Science Foundation of China (81900097 to Dr. Zhou) and the Emergency Response Project of Hubei Science and Technology Department (2020FCA023 to Pr. Zhao).

scholarly journals The Perioperative System: A New Approach to Managing Elective Surgery

1995 ◽  
Vol 23 (5) ◽  
pp. 591-596 ◽  
Author(s):  
R. Kerridge ◽  
A. Lee ◽  
E. Latchford ◽  
S. J. Beehan ◽  
K. M. Hillman
Keyword(s):  
Hospital Discharge ◽  
Elective Surgery ◽  
Average Length ◽  
University Teaching ◽  
Patient Acceptance ◽  
Discharge Process ◽  
Average Length Of Stay ◽  
Elective Surgical Procedures ◽  
Surgery Patient ◽  
Day Of Surgery Admission

A Perioperative Service has recently been introduced at Liverpool Hospital, a 460-bed university teaching hospital. This provides a co-ordinated system for managing all elective surgical patients from the time an admission is booked until hospital discharge. This paper describes the patient assessment, structure and staff requirements, benefits of and problems encountered with this service. The patient's preoperative preparation occurs before hospital admission. Where possible, patients are admitted on the day of procedure, either as a day-only patient, or a day-of-surgery patient. Patients are initially admitted to a specifically designed Perioperative Unit, adjacent to the Operating Theatre Suite. Patients do not enter the surgical wards until after their operation. Planning of the hospital discharge process commences at the time of booking for operation. Introduction of the Perioperative Service was staged process commencing in mid-1992. The hospital admits approximately 6,400 elective surgery cases each year. From July 1992 to December 1994, day-only patients were approximately 45% of these cases. Day-of-surgery admission patients increased from 6% to 35% of all cases over the same period. Appproximately 22% of elective surgical cases were seen in the Perioperative Clinic. As the Perioerative Service became fully operational, the average length of stay for elective surgical procedures fell. There has been a reduction in the areas of cancellations due to unavailablity of beds, inappropriate preparation of patients, and non-attendance of patients for booked procedures. Patient acceptance is high. The existence of a perioperative system facilitates the planning and management of elective surgery with maximum quality and efficiency.

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