Efficacy of a psychoeducational intervention in improving relatives’ knowledge about schizophrenia and reducing rehospitalisation

2001 ◽  
Vol 16 (8) ◽  
pp. 446-450 ◽  
Author(s):  
E. Cassidy ◽  
S. Hill ◽  
E. O’Callaghan
Keyword(s):  
Cost Effective ◽  
Psychoeducational Intervention ◽  
Self Report ◽  
Psychoeducational Group ◽  
Effective Manner ◽  
Before And After ◽  
Matched Case ◽  
And Control ◽  
Hospital Days ◽  
Control Study

SummaryWe sought to establish if a brief psychoeducational intervention for relatives is effective in improving relatives’ knowledge about schizophrenia and reducing rehospitalization. We evaluated 101 relatives of 55 patients with schizophrenia before and after an 8-week psychoeducational group using a self-report method. We also conducted a matched case-control study of the effects on rehospitalisation for 28 of these patients. We calculated the number of hospital days for each index case and control in the 1 and 2 years before and after the intervention.Relatives made significant gains in their knowledge about schizophrenia, particularly about medication. Patients whose relatives attended the group had significantly fewer days in hospital and days per admission compared to controls in the year after the programme but the effect waned in the second year after the intervention. Controls were almost four times more likely to be readmitted at 2 years than cases. Median time to readmission was significantly longer in cases compared to controls. We conclude that a psychoeducational group, which is valued by carers, is effective in increasing their knowledge about schizophrenia as well as reducing and forestalling the rehospitalization of their affected relatives. Such programmes deliver what carers frequently request in a cost-effective manner.

scholarly journals Hospital Readmission in Patients With COVID-19

2021 ◽  
Author(s):  
Neda Rahimian ◽  
Mahshid Heidari ◽  
Nahid Hashemi-Madani ◽  
Nader Tavakoli ◽  
Moammad E Khamseh
Keyword(s):  
Risk Factors ◽  
Hospital Readmission ◽  
Underlying Disease ◽  
Control Groups ◽  
Factors Associated ◽  
Infection Age ◽  
Discharge Plan ◽  
Matched Case ◽  
And Control ◽  
Control Study

Abstract Objective: During the COVID-19 pandemic, the demand for hospital beds has exceeded substantially. Thus, we aimed to conduct this study to identify factors associated with the risk of readmission in order to introduce the best discharge plan for patients with high risk of hospital readmission. Method: This is a multicenter, case-control study included 1357 patients hospitalized with COVID-19 infection. Age-sex-matched case and control groups were paired at 1:2 ratios. COVID-19 readmission rate was assessed. Moreover, Logistic regression analysis was applied to determine the factors associated with readmission. Results: Of the 1357 patients, 99 (7.29%) subjects were readmitted. The most common cause of readmission was respiratory distress. The median (IQR) of the interval between hospital discharge and the second admission was 5 (2-16) days. Upon adjusting with the main risk factors, having at least one underlying disease and being treated with the corticosteroid (GC) were significantly associated with a higher rate of readmission (OR: 2.76, 95% CI :1.30- 5.87) and (OR:8.24, 95% CI :3.72- 18.22), respectively.Conclusion: Identification of Risk factors of COVID 19 readmission will improve resource utilization and patient care.

scholarly journals Gut Microbiota Predict Enterococcus Expansion but Not Vancomycin-Resistant Enterococcus Acquisition

mSphere ◽  
2020 ◽  
Vol 5 (6) ◽  
Author(s):  
Rishi Chanderraj ◽  
Christopher A. Brown ◽  
Kevin Hinkle ◽  
Nicole Falkowski ◽  
Piyush Ranjan ◽  
...  
Keyword(s):  
At Risk ◽  
Gut Microbiota ◽  
Gut Microbiome ◽  
Case Control ◽  
Control Subjects ◽  
Matched Case ◽  
Vancomycin Resistant ◽  
And Control ◽  
Present On Admission ◽  
Control Study

ABSTRACT Vancomycin-resistant Enterococcus (VRE) is a leading cause of hospital-acquired infections and continues to spread despite widespread implementation of pathogen-targeted control guidelines. Commensal gut microbiota provide colonization resistance to VRE, but the role of gut microbiota in VRE acquisition in at-risk patients is unknown. To address this gap in our understanding, we performed a case-control study of gut microbiota in hospitalized patients who did (cases) and did not (controls) acquire VRE. We matched case subjects to control subjects by known risk factors and “time at risk,” defined as the time elapsed between admission until positive VRE screen. We characterized gut bacterial communities using 16S rRNA gene amplicon sequencing of rectal swab specimens. We analyzed 236 samples from 59 matched case-control pairs. At baseline, case and control subjects did not differ in gut microbiota when measured by community diversity (P = 0.33) or composition (P = 0.30). After hospitalization, gut communities of cases and controls differed only in the abundance of the Enterococcus-containing operational taxonomic unit (OTU), with the gut microbiota of case subjects having more of this OTU than time-matched control subjects (P = 0.01). Otherwise, case and control communities after the time at risk did not differ in diversity (P = 0.33) or community structure (P = 0.12). Among patients who became VRE colonized, those having the Blautia-containing OTU on admission had lower Enterococcus relative abundance once colonized (P = 0.004). Our results demonstrate that the 16S profile of the gut microbiome does not predict VRE acquisition in hospitalized patients, likely due to rapid and profound microbiota change. The gut microbiome does not predict VRE acquisition, but it may be associated with Enterococcus expansion, suggesting that these should be considered two distinct processes. IMPORTANCE The Centers for Disease Control and Prevention estimates that VRE causes an estimated 54,000 infections and 539 million dollars in attributable health care costs annually. Despite improvements in hand washing, environmental cleaning, and antibiotic use, VRE is still prevalent in many hospitals. There is a pressing need to better understand the processes by which patients acquire VRE. Multiple lines of evidence suggest that intestinal microbiota may help some patients resist VRE acquisition. In this large case-control study, we compared the 16S profile of intestinal microbiota on admission in patients that did and did not subsequently acquire VRE. The 16S profile did not predict subsequent VRE acquisition, in part due to rapid and dramatic change in the gut microbiome following hospitalization. However, Blautia spp. present on admission predicted decreased Enterococcus abundance after VRE acquisition, and Lactobacillus spp. present on admission predicted Enterococcus dominance after VRE acquisition. Thus, VRE acquisition and domination may be distinct processes.

Bloodless medicine: what to do when you can't transfuse

Hematology ◽  
2014 ◽  
Vol 2014 (1) ◽  
pp. 553-558 ◽  
Author(s):  
Linda M.S. Resar ◽  
Steven M. Frank
Keyword(s):  
Blood Loss ◽  
Autologous Blood ◽  
Adverse Outcomes ◽  
Lessons Learned ◽  
Surgical Patients ◽  
Matched Case ◽  
New Treatment ◽  
And Control ◽  
Control Study ◽  
Better Than

Abstract A better understanding of risks associated with allogeneic blood transfusions (ABTs), along with a growing population of patients who do not accept transfusions, have led to the emergence of new treatment paradigms with “bloodless medicine.” In this chapter, we review prior studies describing management and outcomes in patients who refuse transfusion (referred to as “bloodless patients” herein) and summarize the approaches used at our institution. Bloodless management for surgical patients includes treatment of preoperative anemia, use of autologous blood salvage, and minimizing blood loss with procedures. Other adjuncts for both medical and surgical patients include minimizing blood loss from laboratory testing using pediatric phlebotomy tubes and conservative testing. Anemia can be treated with erythropoiesis-stimulating agents, as well as iron, folate, and B12 when indicated. Although there are limited retrospective studies and no prospective studies to guide management, prior reports suggest that outcomes for surgical patients managed without ABTs are comparable to historic controls. A recent risk-adjusted, propensity-matched, case-control study of outcomes of all hospitalized patients who refused ABT at a large academic health center showed that bloodless management was not an independent predictor of adverse outcomes. Surprisingly, there was a lower overall mortality in the bloodless group and discharge hemoglobin levels were similar for both bloodless and control groups. Further research is now needed to optimize therapy and identify novel interventions to manage bloodless patients. Lessons learned from bloodless patients are likely to benefit all patients given recent evidence suggesting that patients who avoid ABTs do as well, if not better, than those who accept transfusions.

Inspection Manpower Planning for X & S Control Charts

2012 ◽  
Vol 488-489 ◽  
pp. 1624-1630
Author(s):  
Wen An Yang ◽  
Wen He Liao ◽  
Yu Guo
Keyword(s):  
Control Charts ◽  
Cost Effective ◽  
Manpower Planning ◽  
Sampling Interval ◽  
Optimal Number ◽  
Optimization Strategy ◽  
Effective Manner ◽  
Time Required ◽  
The Cost ◽  
And Control

A method of determining the optimal number of inspectors and/or working time required on a specific SPC activity is presented in the study. The issue of inspection manpower planning is handled as a constrained optimization problem. The optimization strategy is not only to minimize the avoidable surplus quality loss due to failure of detecting the out-of-control states but to determine the cost of inspection manpower from the perspective of deploying an appropriate amount of inspection manpower in a cost-effective manner, and meanwhile the values of sample size, sampling interval and control limits of control charts are also determined. The result obtained indicates that the total cost (or loss) can be substantially reduced if implementing control charts was equipped with adequate inspection manpower.

Which Dogs Bite? A Case-Control Study of Risk Factors

PEDIATRICS ◽  
1994 ◽  
Vol 93 (6) ◽  
pp. 913-917
Author(s):  
Kenneth A. Gershman ◽  
Jeffrey J. Sacks ◽  
John C. Wright
Keyword(s):  
Public Health Problem ◽  
Case Control ◽  
German Shepherd ◽  
History Of ◽  
Matched Case ◽  
Specific Factors ◽  
And Control ◽  
Number Case ◽  
Control Study ◽  
Selection Of

Objective. Dog bites cause an estimated 585 000 injuries resulting in the need formedical attention yearly and children are the most frequent victims. This study sought to determine dog-specific factors independently associated with a dog biting a nonhousehold member. Methods. A matched case-control design comprising 178 pairs of dogs was used. Cases were selected from dogs reported to Denver Animal Control in 1991 for a first-bite episode of a nonhousehold member in which the victim received medical treatment. Controls were neighborhood-matched dogs with no history of biting a nonhousehold member, selected by modified random-digit dialing based on the first five digits of the case dog owner's phone number. Case and control dog owners were interviewed by telephone. Results. Children aged 12 years and younger were the victims in 51% of cases. Compared with controls, biting dogs were more likely to be German Shepherd (adjusted odds ratio (ORa) = 16.4, 95% confidence interval (CI) 3.8 to 71.4) or Chow Chow (ORa = 4.0, 95% CI 1.2 to 13.7) predominant breeds, male (ORa 6.2, 95% CI 2.5 to 15.1), unneutered (ORa = 2.6, 95% CI 1.1 to 6.3), residing in a house with ≥1 children (ORa 3.5, 95% CI 1.6 to 7.5), and chained while in the yard (ORa = 2.8, 95% CI 1.0 to 8.1). Conclusions. Pediatricians should advise parents that failure to neuter a dog and selection of male dogs and certain breeds such as German Shepherd and Chow Chow may increase the risk of their dog biting a nonhousehold member, who often may be a child. The potential preventability of this frequent public health problem deserves further attention.

P–251 To collapse or not to collapse blastocysts before vitrification? A matched case-control study on single vitrified-warmed blastocyst transfers

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
B Kovacic ◽  
M Taborin ◽  
V Vlaisavljević ◽  
M Reljič ◽  
J Knez
Keyword(s):  
Sample Size ◽  
Case Control Study ◽  
Survival Rates ◽  
Control Group ◽  
Female Age ◽  
Intact Control ◽  
Matched Case ◽  
And Control ◽  
Matched Case Control Study ◽  
Control Study

Abstract Study question Does laser-induced artificial blastocoel collapse result in better blastocyst cryopreservation survival and higher live birth rate (LBR) in comparison with intact counterparts? Summary answer Compared to vitrification of intact blastocysts, collapsed blastocysts resulted in higher survival and for 5% higher LBR. Neonatal outcomes were comparable in both groups. What is known already Blastocysts have long been considered a stage that is suboptimal for freezing-thawing procedures due to their high fluid content and different cell types. The development of a modified vitrification technique has enabled blastocysts to better survive cryopreservation compared to a slow freezing procedure. Many studies on the optimization of cryopreservation of blastocysts have mentioned the need for artificial collapsing of the blastocoel prior to cryopreservation, thereby reducing the risk of intracellular ice-crystals formation. However, the effectiveness of artificial collapsing on blastocyst survival rate, single vitrified-warmed blastocyst transfer (SVBT) outcome and on safety of such intervention remains to be confirmed. Study design, size, duration A retrospective matched case-control study of transfers of single blastocysts being artificially collapsed (case) or intact (control) before vitrification. A sample size of 306 cycles in both arms was needed to achieve 80% power to detect a difference between the groups of 10% with P < 0.05. Controls were matched to cases on a 1:1 ratio by female age, parity, fresh and frozen cycle protocol, blastocyst age and quality, getting 309 pairs of cases and controls. Participants/materials, setting, methods Artificial collapsing was introduced into clinical practice gradually. In fresh IVF cycles (performed in university clinic from 2012 until 2014) with supernumerary blastocysts, half of the blastocysts were randomly selected before vitrification for laser-induced artificial collapsing. The other half was vitrified in intact form. Only the first transfers of a single vitrified-warmed blastocyst (n = 818) were included in the study. By matching, 309 pairs of collapsed (study) and intact (control) SVBTs were identified. Main results and the role of chance Both groups were comparable by their characteristics in indications, female age, type and length of ovarian hyperstimulation, insemination method in fresh cycle, protocol for warmed blastocyst transfer, blastocyst quality and day of blastocyst vitrification. Survival rates in case and control group ((309/316) 97.8% and (309/323) 95.7%; P = 0.13) were comparable, but optimal survival rates (100% survival and re-expansion after warming) was significantly higher in artificial collapse group ((247/316) 78.2% and (225/323) 69.7%; P = 0.01). Clinical pregnancy rates ((120/309) 38.8% and (110/309) 35.6%; P = 0.4), miscarriage rates ((15/120) 12.5% and (24/110) 21.8%; P = 0.06) and LBR per transfer ((100/309) 32.4% and (85/309) 27.5%; P = 0.19) or LBR per warmed blastocyst ((100/316) 31.6% and (85/323) 26.3%; P = 0.14) were not statistically different between case and control groups. Since the study was powered to detect a 10% difference, the possibility of type 2 error cannot be excluded. Perinatal outcomes were available for 175 live births. There were 10.5% (10/95) preterm births in the study group vs. 16.3% (13/80) in control group (P > 0.05). Birth weights (3,308 g (SD 592 g) vs 3,308 g (SD 738 g) and sex ratio (50.7% vs 49.2% boys) were also comparable between both groups (P > 0.05). There were no major malformations detected in the study population. Limitations, reasons for caution The research is retrospective, but the cycles from both groups were performed in the same time period. The groups were balanced according to all possible confounders. Blastocysts for vitrification were first categorized by quality groups and embryos from each category were randomized for collapsing or for remaining intact. Wider implications of the findings: No significant difference was found in live births by this sample size. Nevertheless, increasing the success by 5% with the introduction of artificial collapsing can be an important step towards optimizing of blastocyst cryopreservation. To confirm a 5% improvement in results, a sample size of > 2500 cases would be needed. Trial registration number The study has been approved by the National Ethics Committee of the Republic of Slovenia (0120–204/2016–2).

An Outbreak of Bloodstream Infections in an Outpatient Hemodialysis Center

2002 ◽  
Vol 23 (12) ◽  
pp. 725-729 ◽  
Author(s):  
Connie S. Price ◽  
Donna Hacek ◽  
Gary A. Noskin ◽  
Lance R. Peterson
Keyword(s):  
Infection Control ◽  
Povidone Iodine ◽  
Bloodstream Infections ◽  
Baseline Period ◽  
Access Site ◽  
Control Programs ◽  
Before And After ◽  
And Control ◽  
Control Study ◽  
Microbiological Data

Objectives:Investigate and control an increase in bloodstream infections (BSIs) in an outpatient hemodialysis center.Patients and Design:A retrospective cohort study was conducted for patients receiving dialysis at the center from February 2000 to April 2001. A case–control study compared microbiological data for all BSIs that occurred during the study period with those for BSIs that occurred during a baseline period Qanuary 1999 to January 2000). BSI rates before and after a 1-month intervention (May 2001) were assessed. A case was defined as a new BSI during the study period.Results:The outbreak was polymicrobial, with approximately 30 species. The baseline BSI rate was 0.7 per 100 patient-months. From February 2000 to April 2001, the BSI rate increased to 4.2 per 100 patient-months. Overall, 75% of the BSIs were associated with central venous catheters (CVCs), but CVC use did not fully explain the increase in BSIs. In January 2000, when the center changed ownership, prepackaged CVC dressing kits and biweekly infection control monitoring were discontinued. Beginning in May 2001, staff were educated on CVC care, chlorhexidine replaced povidone-iodine for cutaneous antisepsis, gauze replaced transparent dressings, antimicrobial ointments containing polyethylene glycol at CVC exit sites were discontinued, and patients with CVCs were educated on cutaneous hygiene. After the intervention period, by October 2001, rates decreased to less than 1 BSI per 100 patient-months.Conclusions:Proper cutaneous antisepsis and access site care is crucial in preventing BSIs in patients receiving hemodialysis. Infection control programs, staff and patient education, and use of optimal antisepsis agents or prepackaged kits are useful toward this end.

scholarly journals Evaluation of serum calcium differences in hypertensive crises and control patients: A randomly matched case‐control study

2021 ◽  
Author(s):  
IfeanyiChukwu O. Onor ◽  
Rose M. Duchane ◽  
Casey J. Payne ◽  
Hannah Naquin Lambert ◽  
DeMaurian M. Mitchner ◽  
...  
Keyword(s):  
Serum Calcium ◽  
Case Control Study ◽  
Case Control ◽  
Matched Case ◽  
Hypertensive Crises ◽  
And Control ◽  
Matched Case Control Study ◽  
Control Study

scholarly journals Connected Audiological Rehabilitation: 21st Century Innovations

2015 ◽  
Vol 26 (09) ◽  
pp. 768-776 ◽  
Author(s):  
Gabrielle H. Saunders ◽  
Theresa H. Chisolm
Keyword(s):  
Cost Effective ◽  
Time Data ◽  
Education Of Patients ◽  
Current State ◽  
Use Of Technology ◽  
Effective Manner ◽  
Store And Forward ◽  
And Control ◽  
Audiologic Rehabilitation ◽  
Selection Of

Background: Tele-audiology provides a means to offer audiologic rehabilitation (AR) in a cost-, resource-, and time-effective manner. If designed appropriately, it also has the capability of personalizing rehabilitation to the user in terms of content, depth of detail, etc., thus permitting selection of the best content for a particular individual. Synchronous/real-time data collection, store and forward telehealth, remote monitoring and mobile health using smartphone applications have each been applied to components of audiologic rehabilitation intervention (sensory management, instruction in the use of technology and control of the listening environment, perceptual and communication strategies training, and counseling). In this article, the current state of tele-audiological rehabilitation interventions are described and discussed. Results: The provision of AR via tele-audiology potentially provides a cost-effective mechanism for addressing barriers to the routine provision of AR beyond provisions of hearing technology. Furthermore, if designed appropriately, it has the capability of personalizing rehabilitation to the user in terms of content, depth of detail, etc., thus permitting selection of the best content for a particular individual. However, effective widespread implementation of tele-audiology will be dependent on good education of patients and clinician alike, and researchers must continue to examine the effectiveness of these new approaches to AR in order to ensure clinicians provide effective evidence-based rehabilitation to their patients. Conclusions: While several barriers to the widespread use of tele-audiology for audiologic rehabilitation currently exist, it is concluded that through education of patients and clinicians alike, it will gain greater support from practitioners and patients over time and will become successfully and widely implemented.

scholarly journals Celebrating the World Breastfeeding Week in the Era of COVID-19 Pandemic in Southern Nigeria: Lessons Learned

2020 ◽  
pp. 46-57
Author(s):  
A. R. Nte ◽  
G. K. Eke
Keyword(s):  
Prevention And Control ◽  
Cost Effective ◽  
Professional Associations ◽  
Lessons Learned ◽  
Infection Prevention And Control ◽  
Religious Activities ◽  
Good Opportunity ◽  
Effective Manner ◽  
Virtual Meetings ◽  
And Control

Background: The annual World Breastfeeding Week (WBW) celebration has been a period of massive interaction with stakeholders through various means and sharing of information related to the promotion, protection and support of breastfeeding since its inception in 1992. However, with the advent of the novel coronavirus disease 2019 (COVID-19) pandemic and subsequent uncertainties about the fate of breastfeeding on one hand, and the imposed measures for COVID-19 infection prevention and control on the other, there was need to modify the traditional way of celebrating the Week to ensure that knowledge about the COVID-19-breastfeeding dyad is communicated to relevant stakeholders while complying with the COVID-19 preventive protocols. Aims: To share experiences and document lessons learned from the celebration of the 2020 WBW which can be reflected upon and used for improving on strategies to protect, promote and support breastfeeding even amidst the restrictions imposed by the protocols for the prevention and control of COVID-19 infection. Place of Study: University of Port Harcourt Teaching Hospital (UPTH), Nigeria. Methodology: The Baby Friendly Hospital Initiative (BFHI) Committee of the UPTH has celebrated the annual WBW every 1st to 7th August for the past 22 years (1997-2019). The reports of events of previous WBW Celebrations were retrieved and the format of the various activities was compared with that of activities for the 2020 WBW Celebration, which took place in the era of COVID-19 pandemic. The findings are presented in tables. Results: Activities for the celebration of WBW in the pre-COVID-19 era usually included physical meetings for the sensitisation of the hospital communities/stakeholders, radio/television sessions, information sharing in various places of religious activities and a rally to interact with the community people. During the COVID-19 pandemic, new strategies for celebration of the WBW were adopted, including among others, virtual meetings, decentralisation of sensitisation of the hospital’s clientele and a physical meeting for the sensitisation of the Hospital Management Committee. Positive outcomes of the 2020 Celebration included the management’s commitment to the promotion, protection and support of breastfeeding, participation in the webinars by stakeholders from within and outside the hospital/Rivers State and establishment of collaborations with several partners. Lesson learned included among others, the celebration of the Week by many stakeholders, the reduced cost of celebration due to the absence of physical meetings and their attendant costs. The personalised invitation of all departments, units and professional associations secured their commitments to breastfeeding. Decentralising the celebration facilitated the adaptation of the messages to the needs of different clienteles and strengthening of members from different departments to promote, protect and support breastfeeding in their work environment. However, the poor participation of the hospital community in the virtual meetings attributable to lack of experience and the cost of participation were setbacks to the targets of the Committee. Conclusion: The era of the COVID-19 pandemic provided a good opportunity to engage stakeholders from within and outside the hospital for the support of breastfeeding as a safe infant feeding option in the midst of COVID-19 and introduced a new normal, the use of virtual meetings to promote, protect and support breastfeeding in a cost effective manner. The celebration of the Week reiterated the role of breastfeeding for ensuring planetary health which was being challenged by the COVID-19 pandemic.

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