scholarly journals The impact of changing risk thresholds on the number of people in England eligible for urgent investigation for possible cancer: an observational cross-sectional study

2021 ◽  
Author(s):  
Sarah F. Moore ◽  
Sarah J. Price ◽  
Sarah Chowienczyk ◽  
Jennifer Bostock ◽  
Willie Hamilton
Keyword(s):  
Cross Sectional Study ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Cross Sectional ◽  
Cancer Services ◽  
Primary Care Patients ◽  
Patient Consultation ◽  
The Mean ◽  
Risk Thresholds ◽  
The Impact

Abstract Background Expediting cancer diagnosis may be achieved by targeted decreases in referral thresholds to increase numbers of patients referred for urgent investigation. Methods Clinical Practice Research Datalink data from England for 150,921 adults aged ≥40 were used to identify participants with features of possible cancer equating to risk thresholds ≥1%, ≥2% or ≥3% for breast, lung, colorectal, oesophago-gastric, pancreatic, renal, bladder, prostatic, ovarian, endometrial and laryngeal cancers. Results The mean age of participants was 60 (SD 13) years, with 73,643 males (49%). In 2016, 8576 consultation records contained coded features having a positive predictive value (PPV) of ≥3% for any of the 11 cancers. This equates to a rate of 5682/100,000 patients compared with 4601/100,000 Suspected Cancer NHS referrals for these cancers from April 2016–March 2017. Nine thousands two hundred ninety-one patient-consultation records had coded features equating to a ≥2% PPV, 8% more than met PPV ≥ 3%. Similarly, 19,517 had features with a PPV ≥ 1%, 136% higher than for PPV ≥ 3%. Conclusions This study estimated the number of primary-care patients presenting at lower thresholds of cancer risk. The resource implications of liberalising this threshold to 2% are modest and manageable. The details across individual cancer sites should assist planning of English cancer services.

What Is the Impact of Prior Authorization on the Incidence of Pediatric Tonsillectomy?

2020 ◽  
pp. 019459982096963
Author(s):  
Vanessa F. Torrecillas ◽  
Kaden Neuberger ◽  
Alexander Ramirez ◽  
Paul Krakovitz ◽  
Jeremy D. Meier
Keyword(s):  
Elective Surgery ◽  
Lag Time ◽  
Cross Sectional Study ◽  
Health Claims ◽  
Third Party ◽  
Prior Authorization ◽  
Cross Sectional ◽  
Before And After ◽  
The Mean ◽  
The Impact

Objective Third-party payers advocate for prior authorization (PA) to reduce overutilization of health care resources. The impact of PA in elective surgery is understudied, especially in cases where evidence-based clinical practice guidelines define operative candidacy. The objective of this study is to investigate the impact of PA on the incidence of pediatric tonsillectomy. Study Design Cross-sectional study. Setting Health claims database from a third-party payer. Methods Any pediatric patient who had evaluation for tonsillectomy from 2016 to 2019 was eligible for inclusion. A time series analysis was used to evaluate the change in incidence of tonsillectomy before and after PA. Lag time from consultation to surgery before and after PA was compared with segmented regression. Results A total of 10,047 tonsillectomy claims met inclusion and exclusion criteria. Female patients made up 51% of claims, and the mean age was 7.9 years. Just 1.5% of claims were denied after PA implementation. There was no change in the incidence of tonsillectomy for all plan types ( P = .1). Increased lag time from consultation to surgery was noted immediately after PA implementation by 2.38 days (95% CI, 0.23-4.54; P = .030); otherwise, there was no significant change over time ( P = .98). Conclusion A modest number of tonsillectomy claims were denied approval after implementation of PA. The value of PA for pediatric tonsillectomy is questionable, as it did not result in decreased incidence of tonsillectomy in this cohort.

The Social and Psychological Impact of Superficial Dermatophytic Infection using Dlqi and Ghq-12: A Cross-Sectional Study in 174 Patients at a Tertiary Care Centre in Southern-East Rajasthan

2021 ◽  
pp. 1-6
Author(s):  
Shivani Saini ◽  
◽  
Agarwal Shail ◽  
Jain Manish ◽  
Yadav Devendra ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Psychological Impact ◽  
Cross Sectional Study ◽  
World Population ◽  
Sectional Study ◽  
Cross Sectional ◽  
Number Of Patients ◽  
The Mean ◽  
The Impact

Background: Dermatophytosis is a common fungal infection affecting 20-25% of the world population. Aims: Our study was aimed to assess its impact on health-related quality of life(QoL), mental health, and various variables. Materials and Methods: A cross-sectional study was done from April 2019 to September 2019 on 174 patients of dermatophytosis of aged more than 16 years with their informed consent. The impact of infection on the quality of life was assessed by using the Dermatology life quality index questionnaire and General health questionnaire-12 was used to assess psychological impact. A visual analogue scale was used to assess the severity of pruritus. Appropriate statistical tests were applied. Results: Males to females ratio was 1.4:1. The age group of 21-30 was having the highest number of patients with the mean age of 27.8±9.97. Most patients had BSA under 10%. The mean value of DLQI and GHQ-12 were found 15.989±7.407 and 2.8563±2.8964, respectively. We found that dermatophytosis had a very large effect on the quality of life as the maximum number of patients(39%) were within this category. The “work and school” part in the questionnaire gained maximum importance(52.8%). The mean VAS score was 6±2.733 with most patients(32.7%) had moderate itching. We found a positive correlation between VAS and DLQI, VAS and GHQ-12, DLQI, and GHQ-12 with the statistical significance. Conclusion: In our study dermatophytosis affected the quality of life as well as the psychological health of patients. Therefore proper treatment of superficial dermatophtytosis is essential to prevent it from further complications

scholarly journals Family size and marital age

2019 ◽  
Vol 25 (5-6) ◽  
pp. 107-11
Author(s):  
Helena Siregar ◽  
Azwin Lubis ◽  
M. Arif Nasution ◽  
Indra Kesuma Nasution ◽  
Thamrin Tanjung
Keyword(s):  
Family Planning ◽  
Family Size ◽  
Occupational Status ◽  
Married Couples ◽  
Simple Random Sampling ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
The Mean ◽  
Age Of Marriage ◽  
The Impact

A cross sectional study about the relationships between family size and marital age and the impact of educatimt, occupation and family planning programme was conducted in the region of South Tapanuli North Sumatera. The study was performed on 246 married couples by simple random sampling of households in the villages Pakantea, Tamiang, Muarasoro and Sumuran, during the period of September 25 up to October 3, 1982. The eariiest age of marriage for women was 14 years, ancl the latest 20 years. Most of the women (68%) married at 15-20 year. The main education of responders were primary school (67%). The occupational status was mostly (90%) farmer. The mean family size under 20 years old was 6.3 and over 20 years, 5.3. Fertility rate under 20 years was still high. Family Planning was not yet widely accepted in this area.

scholarly journals The effect of coffee consumption on serum total cholesterol in the Sami and Norwegian populations

2010 ◽  
Vol 13 (11) ◽  
pp. 1818-1825 ◽  
Author(s):  
Tove Nystad ◽  
Marita Melhus ◽  
Magritt Brustad ◽  
Eiliv Lund
Keyword(s):  
Total Cholesterol ◽  
Serum Cholesterol ◽  
Coffee Consumption ◽  
Cross Sectional Study ◽  
Total Serum ◽  
Total Serum Cholesterol ◽  
Cross Sectional ◽  
Cholesterol Levels ◽  
The Mean ◽  
The Impact

AbstractObjectiveTo assess coffee consumption in the Sami and Norwegian populations and to investigate the impact of unfiltered boiled coffee consumption on serum cholesterol concentrations.DesignA cross-sectional study. Information was collected by self-administrated questionnaires and total serum cholesterol was analysed. Participants were divided into three ethnic groups: Sami I (Sami used as home language in the last three generations), Sami II (at least one Sami identity marker) and Norwegian.SettingIn an area with Sami, Kven/Finnish and Norwegian populations, the SAMINOR study, 2003–2004.SubjectsA total of 5647 men and 6347 women aged 36–79 years.ResultsMore than 90 % of the study populations were coffee drinkers. Only 22 % were unfiltered coffee consumers. Sami I had the highest proportion of participants who consumed nine or more cups of unfiltered coffee per day, although the number of participants was limited. Total coffee consumption was associated with increased total cholesterol for men (P < 0·01) and women (P < 0·0001). For those who drank only unfiltered coffee, a significant association was found only in Norwegian men, adjusted for physical activity in leisure time, BMI and smoking habits (P < 0·001). From the lowest (less than five cups) to the highest (nine or more cups) unfiltered coffee consumption category, the mean total cholesterol levels increased by 0·29 mmol/l in Norwegian men.ConclusionsUnfiltered coffee consumption was lower in the present study compared to previous reports. In general, total coffee consumption was positively associated with total cholesterol levels. However, for unfiltered coffee consumption, an association was found only in Norwegian men.

scholarly journals Delays and Disruptions in Cancer Health Care Due to COVID-19 Pandemic: Systematic Review

2021 ◽  
pp. 311-323
Author(s):  
Rachel Riera ◽  
Ângela Maria Bagattini ◽  
Rafael Leite Pacheco ◽  
Daniela Vianna Pachito ◽  
Felipe Roitberg ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Services ◽  
Methodological Quality ◽  
Data Extraction ◽  
Cross Sectional Study ◽  
Routine Activity ◽  
Cross Sectional ◽  
Cancer Services ◽  
The Impact

PURPOSE There has been noteworthy concern about the impact of COVID-19 pandemic on health services including the management of cancer. In addition to being considered at higher risk for worse outcomes from COVID-19, people with cancer may also experience disruptions or delays in health services. This systematic review aimed to identify the delays and disruptions to cancer services globally. METHODS This is a systematic review with a comprehensive search including specific and general databases. We considered any observational longitudinal and cross-sectional study design. The selection, data extraction, and methodological assessment were performed by two independent reviewers. The methodological quality of the studies was assessed by specific tools. The delays and disruptions identified were categorized, and their frequency was presented. RESULTS Among the 62 studies identified, none exhibited high methodological quality. The most frequent determinants for disruptions were provider- or system-related, mainly because of the reduction in service availability. The studies identified 38 different categories of delays and disruptions with impact on treatment, diagnosis, or general health service. Delays or disruptions most investigated included reduction in routine activity of cancer services and number of cancer surgeries; delay in radiotherapy; and delay, reschedule, or cancellation of outpatient visits. Interruptions and disruptions largely affected facilities (up to 77.5%), supply chain (up to 79%), and personnel availability (up to 60%). CONCLUSION The remarkable frequency of delays and disruptions in health care mostly related to the reduction of the COVID-19 burden unintentionally posed a major risk on cancer care worldwide. Strategies can be proposed not only to mitigate the main delays and disruptions but also to standardize their measurement and reporting. As a high number of publications continuously are being published, it is critical to harmonize the upcoming reports and constantly update this review.

scholarly journals Awareness of Diagnosis and Decision-Making Preferences of Greek Cancer Patients

2020 ◽  
pp. 5-12
Author(s):  
Despoina G Alamanou ◽  
Konstantinos Giakoumidakis ◽  
Dimosthenis G Theodosiadis ◽  
Nikolaos V Fotos ◽  
Elissavet Patiraki ◽  
...  
Keyword(s):  
Decision Making ◽  
Cancer Patients ◽  
Cancer Diagnosis ◽  
Active Role ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Medical Encounter ◽  
The Mean ◽  
The Impact ◽  
The City

Objective: In Greece, the old phenomenon of hiding cancer diagnosis and depriving cancer patients of their right to participate in decisionmaking remains a reality. The aim of this study was to assess the decision-making preferences of Greek cancer patients and their awareness of diagnosis. Methods: It was a cross-sectional study. The sample consisted of 229 adult Greek patients diagnosed with cancer, attending the oncology outpatient department (outpatients) or being hospitalized (inpatients), in one general hospital in Athens. Patients who were aware of cancer diagnosis (n=209) were administered at the Control Preference Scale (CPS), a tool, designed to elicit decision-making preferences. The IBM SPSS program, version 21.0 was used for statistical analysis. Results: One hundred and one patients (52.8%) were males. The mean [±standard deviation (SD)] age was 64.8 (±11.2) years. The vast majority of patients knew they suffered from cancer (n=209, 91.3%). Older patients (p=0.003), those who lived in suburbs of the city (p=0.01), those who had lower educational level (p=0.001), those with lower personal income (p=0.001) and shorter disease duration (p=0.001) stated that were unaware of cancer diagnosis. Seventy five (36.2%) patients chose the shared-decision role in decision-making procedures. Lower age (OR 1.04, 95%, CI: 1.00-1.08, p= 0.05) and higher education level (OR 2, 63, 95%, CI: 1.11-6.29, p=0.03) were significantly associated with the preference of patients to actively participate in decision-making regarding treatment. Conclusions: Although Greek cancer patients are aware of cancer diagnosis and treatment, nowadays, they still seem to hesitate in playing a more active role in the decision-making procedures, which portrays the impact of the dominating paternalistic model of doctor-patient relationship in the Greek medical encounter

scholarly journals Gender Differences in Attitude Towards Pornography Among Youth in Kelantan

2021 ◽  
Vol 6 (1) ◽  
pp. 268-278
Author(s):  
Norazlifah Muhamad ◽  
Azrianii Ab Rahman ◽  
Mohd Ismail Ibrahim ◽  
Razlina Abdul Rahman ◽  
Wan Nor Arifin Wan Mansor ◽  
...  
Keyword(s):  
College Students ◽  
Gender Differences ◽  
Private Colleges ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Mean ◽  
The Impact ◽  
Self Administered Questionnaire

Although the number of pornography exposure is increasing, our understandings on the issues are still lacking. This study aimed to compare gender differences in the attitudes towards pornography among youth in Kelantan. A cross sectional study was conducted using a validated self-administered questionnaire (PORQUE) on 930 college students in both government and private colleges in Kelantan. The mean scores were significantly higher among females for majority of the items assessing non-permissive feelings toward pornography materials (p<0.001), perception on impact of pornography (p<0.05) and perception on factors contributed to pornography (p<0.05). The mean score for majority of the items assessing permissive and perceptions toward pornography materials were significantly higher among males(p<0.001). Females were more non-permissive towards pornography, better perceived the impact of pornography and factors contributed to pornography compared to males. These findings are important as it serve as a guide for the stakeholders to implement pornography intervention for youth in Malaysia.

scholarly journals Changes in perceived knowledge about childbirth among pregnant women participating in the Senses of Birth Intervention in Brazil: A cross-sectional study

2020 ◽  
Author(s):  
Luísa M M Fernandes ◽  
Sônia Lansky ◽  
Bernardo J Oliveira ◽  
Amélia A L Friche ◽  
Christine T. Bozlak ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Low Income ◽  
Cross Sectional Study ◽  
Low Income Countries ◽  
Perceived Knowledge ◽  
Cross Sectional ◽  
Knowledge Domains ◽  
Normal Birth ◽  
The Mean ◽  
The Impact

Abstract Background: Senses of Birth (SoB) is a health education intervention in Brazil that addresses reproductive rights, the benefits and risks of normal birth and cesarean, and use of evidence-based practices (EBP) during labor and childbirth, aiming to reduce unnecessary cesareans in the country. This study evaluates the impact of the SoB intervention on pregnant women’s perceived knowledge about normal birth, cesarean, and use of EBP in childbirth. Method: 1,287 pregnant women answered a structured questionnaire, immediately after their visit to the exhibition, between March 2015 and March 2016, in four cities. To identify the impact of the intervention on women’s perceived knowledge and possible association with socioeconomic and demographic characteristics, statistical analyses were performed including paired T-tests, ANOVA, and logistic and linear regressions. Results: The mean score (MS) of perceived knowledge after the intervention was higher than the mean score before experiencing the SoB for all three knowledge domains: Normal Birth (MS Before= 3.71 x MS After= 4.49), Cesarean (MS Before= 3.54 x MS After= 4.26) and EBPs (MS Before= 3.14 x MS After= 4.14). The results suggest that SoB intervention was more effective for low income women (B = 0.206; p < 0.001 for EBP), women without private health insurance (OR 2.47, 95% CI: 1.49- 4.09 for normal birth), women with private prenatal care (OR 2.42, 95% CI: 1.59- 3.66 for normal birth), women experiencing their first pregnancy (OR 1.92, 95% CI: 1.31-2.82 for EBP; OR 1.37, 95% CI: 1.03-1.84 for normal birth; OR 1.37, 95% CI: 1.03-1.84 for cesarean), and women in their first or second trimester at the time of the intervention (OR 1.64, 95% CI: 1.13-2.39 for EBP; OR 1.48, 95% CI: 1.11-1.97 for normal birth; OR 1.85, 95% CI: 1.40-2.41 for cesarean). Conclusion: The study showed opportunities to increase knowledge among Brazilian pregnant women for the three knowledge domains, and a need to focus the discussion on how to achieve a positive experience of birth using EBP. The intervention gains relevance considering the lack of evidence of the efficacy of non-clinical interventions to reduce unnecessary cesareans in middle and low-income countries targeting women.

scholarly journals The Impact of Pediatric Epilepsy on Children and Families: A Multicenter Cross-Sectional Study

2018 ◽  
Vol 14 (1) ◽  
pp. 323-333 ◽  
Author(s):  
Ahmed Hussein Subki ◽  
Abdel Moniem Mukhtar ◽  
Rakan Salah Al-Harbi ◽  
Abdulaziz Khaled Alotaibi ◽  
Faisal Ghazi Mosaad ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cross Sectional Study ◽  
Pediatric Epilepsy ◽  
Children And Families ◽  
Cross Sectional ◽  
The Family ◽  
The Mean ◽  
The Impact ◽  
Self Administered Questionnaire

Background and Objectives: Epilepsy is considered one of the most prevalent causes of morbidity in children. The aim of this study is to determine how epilepsy impacts the lives of children with epilepsy and their families. Methods: A translated version of the “Impact of Pediatric Epilepsy Scale” (IPES) questionnaire was completed by the 80 mothers of children with epilepsy, recruited at three hospitals in Jeddah, Saudi Arabia This is a validated self-administered questionnaire used to assess the impact of epilepsy on the lives of the child and family, as well as the quality of life (QoL) of the child. Results: The mean age of children epilepsy was 6.32 years (SD = 3.22). The mean IPES score was 6.28 (SD = 8.42) and the mean child’s QoL was 2.85 (SD= 0.83). 87.5% of the mothers rated their child’s QoL as low. IPES score was significantly associated with cause of seizure (β=0.259; 95%-CI= 0.263 - 10.334; p = 0.039). Child’s QoL was significantly associated with frequency of seizure (β=0.251; 95%-CI= 0.016 - 0.568; p= 0.039) and child’s nationality (β=-0.270; 95%-CI -0.252, -0.013; p= 0.031). Conclusions: Pediatric epilepsy may have a greater impact on the lives of the child and the family when it is not comorbid with cerebral palsy. Quality of life tends to be lower for non-Saudi children, and children with more frequent seizures. Therefore, these groups may need more support in managing the impact that epilepsy has on their daily functioning and quality of life.

scholarly journals Evaluation of the impact of intra-operative distractions on teamwork, stress and workload

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
W Aouicha ◽  
M A Tlili ◽  
M Limam ◽  
M Snéne ◽  
M Ben Dhiab ◽  
...  
Keyword(s):  
Daily Basis ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Cross Sectional ◽  
Team Members ◽  
Surgical Workflow ◽  
Global Teamwork ◽  
The Mean ◽  
Teaching Cases ◽  
The Impact

Abstract Background Within the OR, distractions occur on a regular basis, which affects surgical workflow and results in discontinuation of urgent tasks. In addition, engaging into distractions in the OR may not only increase stress and workload, but also impair teamwork performance. This study aimed to observe the occurrence of intra-operative distractions in ORs and to evaluate associations between distractions, teamwork, workload and stress. Methods This observational cross-sectional study was conducted in Sahloul University Hospital; more specifically in four different surgical units: orthopedic, urology, emergency and digestive surgery and over a period of 3 months in 2018. Using validated observation sheets, distractions and teamwork were recorded and rated in real-time during the intraoperative phase of every case. Besides, stress and workload of OR team members were measured at the end of each operation. All ethical considerations were taken into account. Results Fifty cases were observed and 160 participants were included in this study. In total, we recorded 933 distractions that occurred once every 3 minutes, on average. The mean global teamwork score was 3.85 (SD = ±0,67) on a scale of 0 to 6, the mean workload score was 58.60 (±24,27) and the mean stress score was 15.29 (SD = ±4,00). The highest rate of distraction was significantly related to external staff entering or exiting the OR during non-teaching cases (M = 9.43, SD = 3.56; p = 0.006). Surgeons also experienced significantly higher workload with a mean of 66.88 (SD = 25.98,p&lt;0.01). Conclusions This study highlighted a serious problem which is, often, ignored or underestimated. Taking into consideration the results, we recommend the implementation of systemic interventions on a daily basis to reduce the number of distractions in the OR. Key messages Distractions happened in all of the included operations. Stress and workload among nurses got higher as work environment distractions increased.

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