The Patient Outcomes of Surgery-Hand/Arm (Pos-Hand/Arm): A New Patient-Based Outcome Measure

2004 ◽  
Vol 29 (5) ◽  
pp. 477-485 ◽  
Author(s):  
S. J. CANO ◽  
J. P. BROWNE ◽  
D. L. LAMPING ◽  
A. H. N. ROBERTS ◽  
D. A. MCGROUTHER ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Outcome Measure ◽  
Postal Survey ◽  
Clinical Change ◽  
New Techniques ◽  
Post Surgery ◽  
Before And After ◽  
Three Stages ◽  
Surgical Teams ◽  
Effectiveness Studies

The purpose of this study was to develop and validate a new patient-based outcome measure for hand/arm disorders for use in audit, clinical trials and effectiveness studies. There were three stages. First, we carried out interviews with 40 patients with hand/arm disorders to develop and pilot questionnaire content. Second, in a postal survey with 165 pre- and 181 post-surgery patients, we reduced the number of items and identified scales. Third, in a postal survey with 132 pre- and 204 post-surgery patients we evaluated the psychometric properties of the measure. Findings confirmed the acceptability, reliability, validity and responsiveness to clinical change of the questionnaire. The Patient Outcomes of Surgery-Hand/Arm (POS-Hand/Arm) is a new surgical outcome measure that can be used before and after surgery (29 and 33 items, respectively) to evaluate and compare new techniques, surgical teams and units.

scholarly journals Implementation of a Breast/Reconstruction Surgery Coordinator to Reduce Preoperative Delays for Patients Undergoing Mastectomy With Immediate Reconstruction

2016 ◽  
Vol 12 (3) ◽  
pp. e338-e343 ◽  
Author(s):  
Mehra Golshan ◽  
Katya Losk ◽  
Melissa A. Mallory ◽  
Kristen Camuso ◽  
Linda Cutone ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Cancer Center ◽  
Immediate Reconstruction ◽  
Reconstruction Surgery ◽  
Surgical Services ◽  
Breast Surgeon ◽  
Time Period ◽  
Surgical Teams ◽  
The Impact ◽  
Surgical Clinic

Purpose: Mastectomy with immediate reconstruction (MIR) requires coordination between breast and reconstructive surgical teams, leading to increased preoperative delays that may adversely impact patient outcomes and satisfaction. Our cancer center established a target of 28 days from initial consultation with the breast surgeon to MIR. We sought to determine if a centralized breast/reconstructive surgical coordinator (BRC) could reduce care delays. Methods: A 60-day pilot to evaluate the impact of a BRC on timeliness of care was initiated at our cancer center. All reconstructive surgery candidates were referred to the BRC, who had access to surgical clinic and operating room schedules. The BRC worked with both surgical services to identify the earliest surgery dates and facilitated operative bookings. The median time to MIR and the proportion of MIR cases that met the time-to-treatment goal was determined. These results were compared with a baseline cohort of patients undergoing MIR during the same time period (January to March) in 2013 and 2014. Results: A total of 99 patients were referred to the BRC (62% cancer, 21% neoadjuvant, 17% prophylactic) during the pilot period. Focusing exclusively on patients with a cancer diagnosis, an 18.5% increase in the percentage of cases meeting the target (P = .04) and a 7-day reduction to MIR (P = .02) were observed. Conclusion: A significant reduction in time to MIR was achieved through the implementation of the BRC. Further research is warranted to validate these findings and assess the impact the BRC has on operational efficiency and workflows.

Using the Talk Test to Prescribe and Guide Exercise Intensity: Speaking Your Way to Improved Fitness

2018 ◽  
Author(s):  
Nick Preobrazenski
Keyword(s):  
Exercise Intensity ◽  
Ventilatory Threshold ◽  
Peak Oxygen Consumption ◽  
Individual Level ◽  
Non Invasive ◽  
Before And After ◽  
Small Incidence ◽  
Three Stages ◽  
Physiological Markers ◽  
Healthy Males

Introduction: The Talk Test (TT) is a non-invasive, subjective method of prescribing exercise intensity. The TT involves three stages. When exercisers can speak comfortably, can speak but not comfortably, or cannot speak comfortably, they are in the positive (POS), equivocal (EQ), and negative (NEG) TT stages, respectively. The NEG stage correlates with important physiological markers such as ventilatory threshold and lactate threshold. Given the evidence demonstrating large increases peak oxygen consumption (VO2peak) when training at intensities above these markers, the purpose of the study was to test the hypothesis that the TT is efficacious for improving VO2peak at both the group and individual level in young, healthy males. Methods: 11 healthy males completed a maximal fitness test before and after 4 weeks of training 4 times per week for 30 minutes in the NEG stage. The TT was performed every 2.5 to 5 minutes to ensure that the resistance would be enough to elicit a NEG response. Changes in VO2peak below 2 times a previously established typical error were classified as non-response. Results: Four weeks of training at NEG induced a significant increase (11.5%) in VO2peak (PRE: 45.80 mL/Kg/min ± 4.92; POST 51.07 mL/Kg/min ± 5.45, p < 0.001). Furthermore, only one participant (9.09%) was classified as a non-responder in VO2peak following training. Conclusion: These results suggest that the TT can efficaciously prescribe and guide exercise intensity in young, healthy males, and that training at an intensity that prevents comfortable speech leads to a small incidence of non-response

scholarly journals PENINGKATAN DAYA IMUN KELUARGA MELALUI TOGA BERBASIS KEGIATAN PKK DESA KREBET

2021 ◽  
Vol 5 (1) ◽  
pp. 991
Author(s):  
Nur Chayati ◽  
M. Fariez Kurniawan ◽  
Ambar Relawati
Keyword(s):  
Health Education ◽  
Community Empowerment ◽  
Family Resilience ◽  
Large Area ◽  
Third Stage ◽  
Before And After ◽  
Service Activity ◽  
Three Stages ◽  
Tourism Potential ◽  
Religious Aspects

ABSTRAKKrebet adalah sentra industri batik kayu yang mempunyai potensi kepariwisataan baik dari sisi budaya maupun alamnya. Pemberdayaan kelompok PKK di desa Krebet sangat bermanfaat untuk meningkatkan ketahanan keluarga baik dari segi ekonomi, sosial, budaya maupun agama. Berbagai keterampilan yang diperoleh, akan bisa membekali anggotanya  untuk bisa hidup lebih baik. Kondisi pandemi Covid sangat membutuhkan daya imun yang cukup kuat untuk bisa menangkal virus Covid-19. Hasil need assessment menunjukkan bahwa kelompok PKK memerlukan tambahan informasi tentang Toga. Toga termasuk tanaman yang murah dalam produksinya, tidak membutuhkan lahan yang luas, cocok ditanam baik di dataran rendah maupun tinggi, sudah dikenal masyarakat Indonesia serta cara pengolahan hasil produksi yang mudah untuk skala rumah tangga. Tujuan dari pengabdian masyarakat adalah mengenalkan tentang jenis Toga, manfaat Toga dan pengolahan Toga sederhana. Kegiatan pengabdian masyarakat diikuti oleh 14 peserta diawali pemberian pendidikan kesehatan tentang Toga dan manfaatnya, dan tata cara budidaya Toga. Kegiatan berikutnya adalah praktek mengolah jahe menjadi puding. Evaluasi berdasarkan kuesioner menunjukkan terjadi peningkatan pengetahuan peserta sebelum dan setelah pemberian pendidikan kesehatan. Kata kunci: toga; desa wisata krebet; covid-19; pemberdayaan masyarakat; ketahanan keluarga.ABSTRACTKrebet is the center of the wooden batik industry that has tourism potential both in terms of culture and nature. The main activities carried out by mothers are mostly housewives, and are involved in PKK social activities. The Covid-19 pandemic requires a strong immune system to be able to ward off the Covid-19 virus. The results of the assessment in the area, the agreed skill to be taught to PKK mothers is the cultivation of the Toga plant. Toga is a plant that is cheap to produce, does not require a large area of land, suitable for planting in both the lowlands and highlands, well known to the Indonesian people and  an easy way of processing production for household scale. Empowerment of the PKK group is very useful for increasing family resilience in terms of economic, social, cultural and religious aspects. Various skills obtained will be able to equip its members to be able to live better. This community service activity was attended by 14 participants, carried out in three stages, namely providing health education about Toga and its benefits, as well as procedures for cultivating Toga. The third stage is the practice of how to process the Toga. The evaluation was carried out by giving a questionnaire of knowledge about Toga and skills in practicing how to process Toga results before and after the activity. The results of data analysis showed an increase in participants' knowledge before and after the provision of health education. Keywords: toga; krebet tourism village; covid-19; community empowerment; family resilience

scholarly journals EVALUATION OF RATIONAL USE OF ANTIBIOTIC DRUGS IN SURGERY DEPARTMENT AT A TERTIARY CARE HOSPITAL

2021 ◽  
pp. 145-149
Author(s):  
SREEJA NYAYAKAR ◽  
MANDARA MS ◽  
HEMALATHA M ◽  
LALLAWMAWMI ◽  
MOHAMMED SALAHUDDIN ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Antibiotic Use ◽  
Care Hospital ◽  
Rational Use ◽  
Post Surgery ◽  
Antibiotic Drugs ◽  
Before And After ◽  
Hospital Patients ◽  
Surgery Department

Objective: Antibiotics are the only drug where use in one patient can impact the effectiveness in another, so antibiotic misuse adversely impacts the patients and society. Improving antibiotic use improves patient outcomes and saves money. Antibiotic resistance has been identified as a major threat by the WHO due to the lack of development of new antibiotics and the increasing infections caused by multidrug resistance pathogens became untreatable. Methods: A prospective observational study was conducted for a period of 6 months. Data were collected from prescriptions and inpatient record files at the surgery department of the tertiary care hospital. Patients above age of 18 years of either gender whose prescription containing the antibiotics and patients who are willing to participate in the study were included in the study. Microsoft Excel was used for recording and analyzing the data of recruited subjects. Results: During our study period, we have collected 100 cases as per inclusion criteria, in total collected 100 cases, 52% are male and 48% are female. The mean age and standard deviation of the study population were found to be 46.61±16.12. The most commonly prescribed classification before and after the surgery is cephalosporin’s that is 57%. Results show that in pre-surgery, almost 93% of prescriptions have chosen the drugs as per ASHP guidelines, whereas in post-surgery, 95% of drugs have selected the drug as per ASHP guidelines. Conclusion: Our study has observed that some of the prescriptions are irrationally prescribed so the pharmacist has to take the responsibility to improve the awareness regarding rational prescribing of antibiotics. The national wide monitoring of antibiotics use, national schemes to obtain rational use of antibiotics, reassessing the prescriptions, education to practitioners, and surveys on antibiotics should be implemented.

scholarly journals SP10.1.7 The Important Role of In-Situ Simulation in Preparing Surgeons for the COVID-19 Pandemic

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Pierre Montauban ◽  
Charannya Balakumar ◽  
Jaideep Rait ◽  
Prizzi Zarsadias ◽  
Sara Iqbal ◽  
...  
Keyword(s):  
High Risk ◽  
In Situ Simulation ◽  
Level Of Confidence ◽  
Effective Training ◽  
Before And After ◽  
Quasi Experimental ◽  
Surgical Teams ◽  
Imminent Threat ◽  
The Impact

Abstract Background Effective training is vital when facing viral outbreaks such as the SARS Coronavirus 2 (SARS-CoV-2) outbreak of 2019. The objective of this study was to measure the impact of in-situ simulation on the confidence of the surgical teams of two hospitals in assessing and managing acutely unwell surgical patients who are high-risk or confirmed to have COVID-19. Methods This was a quasi-experimental study with a pretest-posttest design. The surgical teams at each hospital participated in multi-disciplinary simulation sessions to explore the assessment and management of a patient requiring emergency surgery who is high risk for COVID-19. The participants were surveyed before and after receiving simulation training to determine their level of confidence on a Visual Analog Scale (VAS) for the premise stated in each of the nine questions in the survey, which represented multiple aspects of the care of these patients. Results 27 participants responded the pre-simulation survey and 24 the one post-simulation. The level of confidence (VAS score) were statistically significantly higher for all nine questions after the simulation. Specific themes were identified for further training and changes in policy. Conclusion In-situ simulation is an effective training method. Its versatility allows it to be set up quickly as rapid-response training in the face of an imminent threat. In this study, it improved the preparedness of two surgical teams for the challenges of the COVID-19 pandemic.

scholarly journals Variation in end-stage renal disease patient outcomes: what we know, what should we know, and how do we find it out?

1993 ◽  
Vol 3 (11) ◽  
pp. 1738-1747
Author(s):  
P Kurtin ◽  
A R Nissenson
Keyword(s):  
Patient Outcomes ◽  
Outcome Measure ◽  
Disease Patient ◽  
Patient Specific ◽  
Quality Cost ◽  
Current State ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

The size and expense of the ESRD program exceed all predictions made when the program was first initiated. Although the effectiveness of dialytic therapy is unquestioned, its value (quality/cost) is actively debated in this era of constricting resources. To better evaluate the quality of the ESRD program, it is essential to first define and quantitate the outcomes of dialytic care. Although mortality is a convenient outcome measure, it may be affected by many patient-specific as well as other factors that must be considered when evaluating and comparing new and existing technologies or advances. Quality of life is only beginning to be used in depth as an outcome measure, and much work is needed to standardize research methodology and thus move this area forward. The following review describes the current state of knowledge regarding outcomes of ESRD patients and proposes areas for future investigation, which should help increase the understanding of the value of the ESRD program to patients, providers, and payors.

scholarly journals Respiratory Complications Before and After Liver Transplant

2018 ◽  
Vol 34 (5) ◽  
pp. 355-363
Author(s):  
Filipe S. Cardoso ◽  
Constantine J. Karvellas
Keyword(s):  
Critical Care ◽  
Liver Transplant ◽  
Patient Outcomes ◽  
Negative Impact ◽  
Perioperative Period ◽  
Therapeutic Approaches ◽  
Respiratory Complications ◽  
Before And After ◽  
Respiratory Conditions

Respiratory complications before and after liver transplant are common, diverse, and potentially have a negative impact on patient outcomes. In this review, we discuss the most frequent respiratory conditions that patients may develop in the perioperative period. Their prevention and/or treatment may help to maximize the benefit these patients may derive from liver transplant. This review examines diagnostic and therapeutic approaches to these complications for hepatologists, surgeons, and critical care physicians.

scholarly journals Comparing the Effects of Four Instructional Treatments on EFL Students’ Achievement in Writing Classified Ads

2016 ◽  
Vol 9 (3) ◽  
pp. 139
Author(s):  
Farzaneh Khodabandeh
Keyword(s):  
Proficiency Test ◽  
New Techniques ◽  
Advantages And Disadvantages ◽  
Self Study ◽  
Before And After ◽  
Post Test ◽  
Efl Students ◽  
Instructional Treatments ◽  
Junior Students ◽  
And Task

<p>The current study set out to compare the effect of traditional and non-traditional instructional treatments; i.e. explicit, implicit, task-based and no-instruction approaches on students’ abilities to learn how to write classified ads. 72 junior students who have all taken a course in Reading Journalistic Texts at the Payame-Noor University streamed by performing a TOEFL proficiency test. The selected participants were randomly divided into the following four groups; an explicit group which received direct instruction; an implicit group which were instructed indirectly, and the self-study group with no-instruction treatment in comparison to the task-based group which were asked to prepare a classified ad. A pre-test and a post-test were administered before and after the treatment. The moves in classified ads pre- and post- tests were analyzed through descriptive and inferential statistics. The quantitative analysis of the post-tests revealed that the explicit and task-based groups outperformed the implicit and self-study instruction groups. The findings of this research offer English teachers the chance to reconsider their practices and performances through the advantages and disadvantages of the traditional and new techniques which were employed in the current research and combine them to help learners improve their reading and writing skills.</p>

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