scholarly journals 1321 Repeat Colonoscopy: Incidence, Etiology, And Suggestions for Improvement

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
K Bhatti ◽  
H Yousef ◽  
M Aung
Keyword(s):  
Bowel Preparation ◽  
Invasive Procedure ◽  
Operational Definition ◽  
Primary Analysis ◽  
Female Ratio ◽  
Index Procedure ◽  
Hospital Resources ◽  
Repeat Rate ◽  
Definition Of ◽  
Male To Female

Abstract Aim Colonoscopy is an invasive procedure. Repeating such a procedure has many implications in terms of risks, costs, increased workload and strains on hospital resources. The current study reports the incidence and aetiology of repeat colonoscopies and provides recommendations for improvement. Method The current study was conducted at North Cumbria Integrated Care (NCIC) hospitals over a period of 1 year (January 1st to December 31st, 2019). All patients with a label of “Repeat” by JAG software system, were included in the primary analysis. Patients with colonoscopy after 52 weeks of the index procedure, were excluded. Two authors manually assessed the validity of the data and determined “True repeat rate” and aetiology. Results During the study period, 4717 colonoscopies were performed, where 187 were recorded as a repeat. Manual validation showed that true repeat cases were 355/4717 (7.52%). Moreover, 5% of the system labelled cases where not true repeats rather were escalated from sigmoidoscopy to colonoscopy. Analysis of the first 1000 colonoscopies detected 72 cases. Male to female ratio was 47:25 with a mean age of 66.26 ± 11.75(SD). The causes included further management of polyps (n = 30); poor bowel preparation(n = 22); inability to proceed (n = 9); anticoagulation (n = 8) and others (n = 3). Subgroup analyses of the polyp group showed that the reasons for repeating colonoscopy in such cases were appropriate. Conclusions An operational definition of the ‘Repeat coloscopy’ should be clearly established. Although most of the repeat colonoscopies for “further management of polyps” are appropriate, repeat due to poor bowel preparation and anticoagulation are clearly preventable.

Understanding functional illiteracy from a policy, adult education, and cognition point of view: Towards a joint referent framework

2019 ◽  
Vol 30 (2) ◽  
pp. 109-122
Author(s):  
Aleksandar Bulajić ◽  
Miomir Despotović ◽  
Thomas Lachmann
Keyword(s):  
Adult Education ◽  
Operational Definition ◽  
Literacy Skills ◽  
Point Of View ◽  
Industrialized Countries ◽  
Functional Illiteracy ◽  
Scale Levels ◽  
Components Of Reading ◽  
The One ◽  
Definition Of

Abstract. The article discusses the emergence of a functional literacy construct and the rediscovery of illiteracy in industrialized countries during the second half of the 20th century. It offers a short explanation of how the construct evolved over time. In addition, it explores how functional (il)literacy is conceived differently by research discourses of cognitive and neural studies, on the one hand, and by prescriptive and normative international policy documents and adult education, on the other hand. Furthermore, it analyses how literacy skills surveys such as the Level One Study (leo.) or the PIAAC may help to bridge the gap between cognitive and more practical and educational approaches to literacy, the goal being to place the functional illiteracy (FI) construct within its existing scale levels. It also sheds more light on the way in which FI can be perceived in terms of different cognitive processes and underlying components of reading. By building on the previous work of other authors and previous definitions, the article brings together different views of FI and offers a perspective for a needed operational definition of the concept, which would be an appropriate reference point for future educational, political, and scientific utilization.

“The Unconscious” in Current Psychology

2010 ◽  
Vol 15 (3) ◽  
pp. 193-201 ◽  
Author(s):  
Elisabeth Norman
Keyword(s):  
Cognitive Psychology ◽  
Verbal Report ◽  
Psychological Research ◽  
Operational Definition ◽  
The Unconscious ◽  
Apparent Lack ◽  
Unconscious Processing ◽  
Unconscious Processes ◽  
Intermediate States ◽  
Definition Of

A series of vignette examples taken from psychological research on motivation, emotion, decision making, and attitudes illustrates how the influence of unconscious processes is often measured in a range of different behaviors. However, the selected studies share an apparent lack of explicit operational definition of what is meant by consciousness, and there seems to be substantial disagreement about the properties of conscious versus unconscious processing: Consciousness is sometimes equated with attention, sometimes with verbal report ability, and sometimes operationalized in terms of behavioral dissociations between different performance measures. Moreover, the examples all seem to share a dichotomous view of conscious and unconscious processes as being qualitatively different. It is suggested that cognitive research on consciousness can help resolve the apparent disagreement about how to define and measure unconscious processing, as is illustrated by a selection of operational definitions and empirical findings from modern cognitive psychology. These empirical findings also point to the existence of intermediate states of conscious awareness, not easily classifiable as either purely conscious or purely unconscious. Recent hypotheses from cognitive psychology, supplemented with models from social, developmental, and clinical psychology, are then presented all of which are compatible with the view of consciousness as a graded rather than an all-or-none phenomenon. Such a view of consciousness would open up for explorations of intermediate states of awareness in addition to more purely conscious or purely unconscious states and thereby increase our understanding of the seemingly “unconscious” aspects of mental life.

An Analysis of the Demand for Reporting on Internal Control

2000 ◽  
Vol 14 (3) ◽  
pp. 325-341 ◽  
Author(s):  
Heather M. Hermanson
Keyword(s):  
Decision Making ◽  
Financial Reporting ◽  
Internal Control ◽  
Operational Definition ◽  
Financial Statement ◽  
Individual Investors ◽  
Internal Auditors ◽  
Additional Information ◽  
User Groups ◽  
Definition Of

The purpose of this study is to analyze the demand for reporting on internal control. Nine financial statement user groups were identified and surveyed to determine whether they agree that: (1) management reports on internal control (MRIC) are useful, (2) MRICs influence decisions, and (3) financial reporting is improved by adding MRICs. In addition, the paper examined whether responses varied based on: (1) the definition of internal control used (manipulated as broad, operational definition vs. narrow, financial-reporting definition) and (2) user group. The results indicate that financial statement users agree that internal controls are important. Respondents agreed that voluntary MRICs improved controls and provided additional information for decision making. Respondents also agreed that mandatory MRICs improved controls, but did not agree about their value for decision making. Using a broad definition of controls, respondents strongly agreed that MRICs improved controls and provided a better indicator of a company's long-term viability. Executive respondents were less likely to agree about the value of MRICs than individual investors and internal auditors.

Shape Dynamics and the Linking Theory

2018 ◽  
Author(s):  
Flavio Mercati
Keyword(s):  
Phase Space ◽  
Degrees Of Freedom ◽  
Line Element ◽  
Hamiltonian Formulation ◽  
Operational Definition ◽  
Extended Phase Space ◽  
Extended Phase ◽  
Problem Of Time ◽  
Definition Of ◽  
Matter Fields

This chapter explains in detail the current Hamiltonian formulation of SD, and the concept of Linking Theory of which (GR) and SD are two complementary gauge-fixings. The physical degrees of freedom of SD are identified, the simple way in which it solves the problem of time and the problem of observables in quantum gravity are explained, and the solution to the problem of constructing a spacetime slab from a solution of SD (and the related definition of physical rods and clocks) is described. Furthermore, the canonical way of coupling matter to SD is introduced, together with the operational definition of four-dimensional line element as an effective background for matter fields. The chapter concludes with two ‘structural’ results obtained in the attempt of finding a construction principle for SD: the concept of ‘symmetry doubling’, related to the BRST formulation of the theory, and the idea of ‘conformogeometrodynamics regained’, that is, to derive the theory as the unique one in the extended phase space of GR that realizes the symmetry doubling idea.

scholarly journals Disparities between IgG4-related kidney disease and extrarenal IgG4-related disease in a case–control study based on 450 patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Qiaozhu Zeng ◽  
Jingyuan Gao ◽  
Xinyu Zhang ◽  
Aichun Liu ◽  
Zhenfan Wang ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Clinical Laboratory ◽  
Imaging Finding ◽  
Age At Onset ◽  
Female Ratio ◽  
Related Disease ◽  
Igg4 Related Disease ◽  
Peking University ◽  
Chinese Cohort ◽  
Male To Female

AbstractWe aimed to compare the demographic, clinical and laboratory characteristics between IgG4-related kidney disease (IgG4-RKD+) and extrarenal IgG4-related disease (IgG4-RKD−) in a large Chinese cohort, as well as describing the radiological and pathological features of IgG4-RKD+. We retrospectively analyzed the medical records of 470 IgG4-related disease (IgG4-RD) patients at Peking University People’s Hospital from January 2004 to January 2020. The demographic, clinical, laboratory, radiological and pathological characteristics between IgG4-RKD+ and IgG4-RKD− were compared. Twenty IgG4-RD patients who had definite etiology of renal impairment including diabetes, hypertension and etc. were excluded. Among the remained 450 IgG4-RD patients, 53 were diagnosed with IgG4-RKD+ . IgG4-RKD+ patients had older age at onset and at diagnosis. Male to female ratio of IgG4-RKD+ patients is significantly higher. In the IgG4-RKD+ group, the most commonly involved organs were salivary gland, lymph nodes and pancreas. It was found that renal function was impaired in approximately 40% of IgG4-RKD+ patients. The most common imaging finding is multiple, often bilateral, hypodense lesions. Male sex, more than three organs involved, and low serum C3 level were risk factors for IgG4-RKD+ in IgG4-RD patients. These findings indicate potential differences in pathogenesis of these two phenotypes.

scholarly journals P129 The utility of routine operative swab culture in uncomplicated peri-anal abscesses

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Apoorva Khajuria ◽  
Tuba Rahim ◽  
Mariam Baig ◽  
Kai Leong ◽  
Apoorva Khajuria
Keyword(s):  
Inflammatory Bowel Disease ◽  
Perianal Abscess ◽  
Female Ratio ◽  
Incision And Drainage ◽  
Common Presentation ◽  
History Of ◽  
Inflammatory Bowel ◽  
Operative Findings ◽  
The Cost ◽  
Male To Female

Abstract Introduction Despite perianal abscess being a common presentation, certain aspects of its management remain controversial, especially the routine use of intra-operative swab cultures. Methods A retrospective review of patients that underwent incision and drainage procedures for a perianal abscess over a six-month period was undertaken. Results Over 6 months, 50 patients were identified. The male to female ratio was 3:1 and median ASA score was 1. Only 6/50 patients presented with recurrent abscess and 1 patient had history of inflammatory bowel disease. On the basis of operative findings, 39 patients (78%) had uncomplicated abscess (not associated with cellulitis, sinus or fistula); swab cultures were performed in 26 (67%) of these patients. All patients were discharged on the same day; microbiology reports did not impact the treatment and no patients were followed up in clinic post-operatively or presented with recurrence. The number of unnecessary microbiology swabs undertaken in this cohort equates to approximately 52 unnecessary swabs a year. The cost of one swab is £10.10p, which means £520 could potentially be saved annually. Conclusion Routine intra-operative swab cultures do not impact management decisions, add to unnecessary costs and therefore should not be undertaken in uncomplicated or first presentation of peri-anal abscesses.

scholarly journals High rates of gastroesophageal cancers in patients with dyspepsia undergoing upper gastrointestinal endoscopy in Uganda

2021 ◽  
Vol 09 (07) ◽  
pp. E997-E1000
Author(s):  
Ronald Mbiine ◽  
Cephas Nakanwagi ◽  
Olivia Kituuka
Keyword(s):  
Positive Association ◽  
Referral Hospital ◽  
Outcome Variable ◽  
Mulago Hospital ◽  
Upper Gastrointestinal Endoscopy ◽  
Female Ratio ◽  
Mulago National Referral Hospital ◽  
Male To Female ◽  
Upper Gastrointestinal ◽  
National Referral Hospital

Abstract Background and study aims Dyspepsia is the most common presenting symptom in the gastrointestinal clinic of Mulago National Referral hospital. The etiology is essentially not fully described in our patient population. This study was therefore conducted to establish the causes of dyspepsia based on endoscopic diagnosis among patients with dyspepsia seeking care at the National Referral hospital of Uganda. Patients and methods This retrospective study conducted in the endoscopy unit of Mulago hospital reviewed 356 patient endoscopy reports spanning January 2018 to July 2020 with a focus on those with a referral indication of dyspepsia. Age and sex were the independent variables of interest while the endoscopy findings as reported by the endoscopist were the outcome variable of interest. Results Of the 356 endoscopy reports reviewed, 159 met the inclusion criterion of dyspepsia as the indication. Participant mean age was 47.7 years (± 16.53) with the majority (25.79 %) in the fifth decade while the male to female ratio was 1. The majority of patients had organic dyspepsia (90.57 %) while the commonest finding was gastritis 69 (43.4 %). Gastroesophageal cancers represented (18) 11.32 % of all findings. There was a positive association between age > 50 years with gastroesophageal cancers (7.639) as well as age < 50 years and functional dyspepsia (2.794); however, all these were not statistically significant (P = 0.006 and (P = 0.095, respectively). Conclusions Organic/structural dyspepsia comprises over 90 % of investigated dyspepsia with 11 % comprising cancer among patients seeking endoscopy at the National Referral Hospital of Uganda.

scholarly journals The scale of effect depends on operational definition of forest cover—evidence from terrestrial mammals of the Brazilian savanna

2021 ◽  
Author(s):  
Christophe Amiot ◽  
Cyntia Cavalcante Santos ◽  
Damien Arvor ◽  
Beatriz Bellón ◽  
Hervé Fritz ◽  
...  
Keyword(s):  
Forest Cover ◽  
Operational Definition ◽  
Brazilian Savanna ◽  
Terrestrial Mammals ◽  
Scale Of Effect ◽  
Definition Of

scholarly journals Spiritual nursing care: A concept analysis

Curationis ◽  
2012 ◽  
Vol 35 (1) ◽  
Author(s):  
Lydia V. Monareng
Keyword(s):  
Nursing Care ◽  
Concept Analysis ◽  
Operational Definition ◽  
The Body ◽  
Empirical Literature ◽  
Spiritual Needs ◽  
Optimal Care ◽  
Health Crisis ◽  
Group Interviews ◽  
Definition Of

Although the concept ‘spiritual nursing care’ has its roots in the history of the nursing profession, many nurses in practice have difficulty integrating the concept into practice. There is an ongoing debate in the empirical literature about its definition, clarity and application in nursing practice. The study aimed to develop an operational definition of the concept and its application in clinical practice. A qualitative study was conducted to explore and describe how professional nurses render spiritual nursing care. A purposive sampling method was used to recruit the sample. Individual and focus group interviews were audio-taped and transcribed verbatim. Trustworthiness was ensured through strategies of truth value, applicability, consistency and neutrality. Data were analysed using the NUD*IST power version 4 software, constant comparison, open, axial and selective coding. Tech’s eight steps of analysis were also used, which led to the emergence of themes, categories and sub-categories. Concept analysis was conducted through a comprehensive literature review and as a result ‘caring presence’ was identified as the core variable from which all the other characteristics of spiritual nursing care arise. An operational definition of spiritual nursing care based on the findings was that humane care is demonstrated by showing caring presence, respect and concern for meeting the needs not only of the body and mind of patients, but also their spiritual needs of hope and meaning in the midst of health crisis, which demand equal attention for optimal care from both religious and nonreligious nurses.

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