scholarly journals SP2.1.13Does Health Insurance Status Affect Patient Outcome After Emergency Surgery?

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Samantha Quah ◽  
Hock Ping Cheah ◽  
Kenneth Wong
Keyword(s):  
Emergency Department ◽  
Private Insurance ◽  
Operative Management ◽  
Complication Rates ◽  
Chi Square ◽  
Private Patient ◽  
Public And Private ◽  
Health Insurance Status ◽  
Operative Outcomes ◽  
The Difference

Abstract Aim Under the Australian Medicare Scheme, Australian residents are covered for many hospital-related costs. Patients with private insurance presenting with appendicitis can elect to be admitted as a private patient. Despite the stereotypes, little is known on whether the patients’ health cover actually affect clinical outcomes. This study aims to compare the differences in patient outcomes between public and private patients after undergoing operative management for appendicitis. Methods A multi-centre prospectively collected health service database of all appendicectomies performed over a 16-month period was reviewed. In particular, patient demographics, type of operation, primary surgeon, complications and mortality rates were analysed. Results Of the total of 652 patients who underwent an appendicectomy, 203 patients were private, 444 patients were public, and 5 were overseas patients. During the post-operative period, public patients had higher rates of representation to the Emergency Department (ED) for post-operative symptoms (public 12.8% vs private 4.4%, p 0.0007, two-tailed chi square test). In comparison, the rate of post-operative complications with Clavien-Dindo (CD) score ≥ 2 is similar in both groups (p = 0.18, public 4.5% vs private 2%). There were no mortalities recorded for both groups. Conclusion Public patients have higher representation rates to the emergency department after an appendicectomy however post-operative outcomes are similar in both groups in our health system. The difference in complication rates were not significant with both groups recording low complication rates of under 5%.

Abstract 14721: Impact of Covid-19 on Cardiology Consultation in Tertiary Care Hospital of a Developing Country

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
ghufran adnan ◽  
Osman Faheem ◽  
Maria Khan ◽  
Pirbhat Shams ◽  
Jamshed Ali
Keyword(s):  
Emergency Department ◽  
Tertiary Care ◽  
Reduction Rate ◽  
Care Hospital ◽  
Chi Square ◽  
Coronary Syndrome ◽  
Significant Difference ◽  
Drastic Increase ◽  
Chi Square Test ◽  
The Difference

Introduction: COVID-19 pandemic has overwhelmed the healthcare system of Pakistan. There has been observation regarding changes in pattern of patient presentation to emergency department (ED) for all diseases particularly cardiovascular. The aim of the study is to investigate these changes in cardiology consultations and compare pre-COVID-19 and COVID-19 era. Hypothesis: There is a significant difference in cardiology consultations during COVID era as compared to non-COVID era. Method: We collected data retrospectively of consecutive patients who visited emergency department (ED) during March-April 2019 (non-COVID era) and March-April 2020 (COVID era). Comparison has been made to quantify the differences in clinical characteristics, locality, admission, type, number, and reason of Cardiology consults generated. Results: We calculated the difference of 1351 patients between COVID and non-COVID era in terms of cardiology consults generated from Emergency department, using Chi-square test. Out of which 880 (59%) are male with mean age of 61(SD=15). Analysis shows pronounced augmentation in number of comorbidities [Hypertension(6%), Chronic kidney disease (6%), Diabetes (5%)] but there was 36% drop in total cardiology consultations and 43% reduction rate in patient’s ED visit from other cities during COVID era. There was 60% decrease in acute coronary syndrome presentation in COVID era, but fortuitously drastic increase (30%) in type II myocardial injury has been noted. Conclusion: There is a remarkable decline observed in patients presenting with cardiac manifestations during COVID era. Lack in timely care could have a pernicious impact on outcomes, global health care organizations should issue directions to adopt telemedicine services in underprivileged areas to provide timely care to cardiac patients.

Comparison of 5-FU versus capecitabine in combination with mitomycin or cisplatin in the treatment of anal cancer.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 680-680 ◽  
Author(s):  
Irene S. Yu ◽  
Winson Y. Cheung
Keyword(s):  
Anal Cancer ◽  
Cancer Survival ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Operative Management ◽  
Population Based ◽  
Chi Square ◽  
Curative Intent ◽  
Treatment Groups ◽  
The Difference

680 Background: Capecitabine is used as an alternative fluoropyrimidine to infusional 5-FU in the non-operative management of anal cancer due to its ease of administration. However, its patterns of use and long-term outcomes in the real world are poorly described. Our objectives were to determine the frequency of capecitabine use, compare the difference in outcomes, and examine the difference in treatment-related adverse events between oral and intravenous fluoropyrimidines. Methods: All anal cancer patients who received either capecitabine or infusional 5-FU as part of their curative intent chemoradiotherapy from 2010 to 2013 at any 1 of 6 comprehensive cancer centers in British Columbia were included. Chi-square and Wilcoxon-Mann tests were used to assess for associations between treatment groups and clinical characteristics and outcomes. Results: A total of 237 patients were identified; median age was 59 (IQR 53-67) years, 71 (30%) were men, 202 (85%) had ECOG 0/1, and 12 (5%) were HIV positive. Median total radiation dose was 54 cGy (IQR 50.4-54.0) and 21 (9%) underwent a colostomy prior to chemoradiation. Baseline characteristics were balanced between the two groups with respect to age, gender, ECOG, and HIV status (all p > 0.05). Overall, 155 patients (65%) received capecitabine. Comparing patients who received capecitabine vs 5-FU, overall (69% vs 74%, p = 0.388) and disease-free survival rates (68% vs 71%, p = 0.637) at 5 years from diagnosis were similar between treatment groups. There were no differences with respect to rates of subsequent colostomy (16% vs 23%, p = 0.185) and abdominoperineal resection (11% vs 12%, p = 0.777). However, patients who received capecitabine were less likely to report adverse effects (51% vs 26%, p < 0.001) than those who underwent 5-FU. The capecitabine group had a lower incidence of stomatitis (6% vs 40%, p < 0.001) whereas the 5-FU cohort reported less frequent hand-foot syndrome (1% vs 8%, p = 0.036). Conclusions: This population-based study demonstrates a preference for capecitabine use in place of 5-FU in the curative management of anal cancer. Survival outcomes are similar between the two treatment groups, but capecitabine may be better tolerated.

Institutional facilitation for learning improvement with consideration of students’ voices

2020 ◽  
Vol 15 (5) ◽  
pp. 1117-1128
Author(s):  
Naeem Rakhshanda ◽  
Kazi Asma Shahid ◽  
Manzoor Shabana ◽  
Quraishi Uzma
Keyword(s):  
Private Sector ◽  
Learning Process ◽  
Sampling Technique ◽  
Course Development ◽  
Student Voices ◽  
Chi Square ◽  
Public And Private ◽  
Learning Improvement ◽  
The Difference ◽  
Public And Private Sector

This study investigates the students’ perceptions regarding their voices towards improvement in learning at public and private sector universities in Pakistan. These voices are collected by the Quality Enhancement Cells of the varsities through either technological tools or other ways. To understand how this data is utilized, a self-constructed and validated tool was utilized to get information about four categories; understanding of the term student voices, inquiry of learning process; university facilitation for best learning and implementation of student voices. Using purposive sampling technique, a survey of 112 under graduate students from four fields of studies (social sciences, natural sciences, business administrations and languages) from a Public and Private Sector University each from District Lahore was conducted. Data was analyzed by using SPSS version 22, and t-test and chi-square was performed to measure the difference in institutional facilitation of public and private sector universities. One-way ANOVA was applied to check the effects of student’s status in the class on the inquiry of learning process. The study indicated statistically significant effect of public and private sector on students’ perceptions regarding institutional facilitations for learning improvement. The study also reported the significant effects of student’s status on the inquiry of learning process. It is suggested that further studies need to explore how and where the students’ voices are being used for planning, assessment and course development. Keywords: Institutional facilitation, students’ voice, Higher Education, Pakistan

scholarly journals Institutional facilitation for learning improvement with consideration of students’ voices

2020 ◽  
Vol 12 (4) ◽  
pp. 389-400
Author(s):  
Naeem Rakhshanda ◽  
Asma Shahid Kazi ◽  
Manzoor Shabana ◽  
Quraishi Uzma
Keyword(s):  
Private Sector ◽  
Learning Process ◽  
Sampling Technique ◽  
Course Development ◽  
Student Voices ◽  
Chi Square ◽  
Public And Private ◽  
Learning Improvement ◽  
The Difference ◽  
Public And Private Sector

This study investigates the students’ perceptions regarding their voices towards improvement in learning at public and private sector universities in Pakistan. These voices are collected by the Quality Enhancement Cells of the varsities through either technological tools or other ways. To understand how this data is utilized, a self-constructed and validated tool was utilized to get information about four categories; understanding of the term student voices, inquiry of learning process; university facilitation for best learning and implementation of student voices. Using purposive sampling technique, a survey of 112 under graduate students from four fields of studies (social sciences, natural sciences, business administrations and languages) from a Public and Private Sector University each from District Lahore was conducted. Data was analyzed by using SPSS version 22, and t-test and chi-square was performed to measure the difference in institutional facilitation of public and private sector universities. One-way ANOVA was applied to check the effects of student’s status in the class on the inquiry of learning process. The study indicated statistically significant effect of public and private sector on students’ perceptions regarding institutional facilitations for learning improvement. The study also reported the significant effects of student’s status on the inquiry of learning process. It is suggested that further studies need to explore how and where the students’ voices are being used for planning, assessment and course development. Keywords: Institutional facilitation, students’ voice, Higher Education, Pakistan

Empirical Study On Attributes Leading To Satisfaction Among Bank Customer

2019 ◽  
Vol 118 (7) ◽  
pp. 101-110
Author(s):  
Ms.U.Sakthi Veeralakshmi ◽  
Dr.G. Venkatesan
Keyword(s):  
Service Quality ◽  
Behavioral Intention ◽  
Banking Sector ◽  
Positive Impact ◽  
Quality Performance ◽  
Public And Private ◽  
The Difference ◽  
The Individual ◽  
Private Banking ◽  
Service Gap

This research aims at measuring the service quality in public and private banking sector and identifying its relationship to customer satisfaction and behavioral intention. The study was conducted among 500 bank customers by using revised SERVQUAL instrument with 26 items. Behavioral intention of the customers was measured by using the behavioral intention battery. The researcher has used a seven point likert scaling to measure the expected and perceived service quality (performance) and the behavioral intention of the customer. The instrument was selected as the most reliable device to measure the difference-score conceptualization. It is used to evaluate service gap between expectation and perception of service quality. Modifications are made on the SERVQUAL instrument to make it specific to the Banking sector. Questions were added to the instrument like Seating space for waiting (Tangibility), Parking space in the Bank (Tangibility), Variety of products / schemes available (Tangibility), Banks sincere steps to handling Grievances of the customers (Responsiveness). The findings of the study revealed that the customer’s perception (performance) is lower than expectation of the service quality rendered by banks. Responsiveness and Assurance SQ dimensions were the most important dimensions in service quality scored less SQ gap. The study concluded that the individual service quality dimensions have a positive impact on Overall Satisfaction.

Latin Epigraphy

2015 ◽  
Author(s):  
Francisco Beltrán Lloris
Keyword(s):  
Public And Private ◽  
Roman World ◽  
Significant Distinction ◽  
Latin Epigraphy ◽  
The Difference

This chapter presents a typology of the main types of inscriptions in Latin. The difference between public and private/domestic inscriptions is the most significant distinction to be made when categorizing the enormous mass of surviving epigraphic documents from the Roman world.

How Well were Asthmatic Patients Educated about Their Asthma? A Study at the Emergency Department

2004 ◽  
Vol 16 (1) ◽  
pp. 45-49 ◽  
Author(s):  
P.Y. Lee ◽  
E.M. Khoo
Keyword(s):  
Emergency Department ◽  
Health Care Providers ◽  
Teaching Hospital ◽  
Care Providers ◽  
Self Medication ◽  
Asthmatic Patients ◽  
Management Plans ◽  
Acute Asthma Exacerbation ◽  
The Difference ◽  
Bronchodilator Treatment

70 patients presented with acute asthma exacerbation requiring nebulised bronchodilator treatment at the emergency department of a teaching hospital in Kuala Lumpur, Malaysia, were interviewed over a two-week period in July 2001. The results showed that 45 (64%) patients had not been educated on the nature of asthma; 30 (43%) had not been advised on preventive measures or avoidance of triggers; 54 (77%) were not advised about the medications used and their side effects; 42 (60%) patients did not know the difference between reliever and preventive medications; 37 (53%) were unable to recognize features of worsening asthma and 68 (97%) were not told about the danger of non-prescribed self-medication or traditional medications. Only six (9%) patients were using peak flow meters and were taught self-management plans. The multiple regression results suggest that patients who were followed up at teaching hospital based clinics were better educated on asthma. In conclusion, asthmatic patients are still not educated well about their disease. Health care providers need to put more emphasis on asthma education so that the number of emergency room visits can be reduced. Asia Pac J Public Health 2004; 16(1): 45-49.

scholarly journals Twelve Years of the Italian Program to Enhance Relational and Communication Skills (PERCS)

2021 ◽  
Vol 18 (2) ◽  
pp. 439
Author(s):  
Lidia Borghi ◽  
Elaine C. Meyer ◽  
Elena Vegni ◽  
Roberta Oteri ◽  
Paolo Almagioni ◽  
...  
Keyword(s):  
Communication Skills ◽  
Repeated Measures ◽  
Behavioral Changes ◽  
Chi Square ◽  
Future Directions ◽  
Public And Private ◽  
Learner Centered ◽  
Difficult Conversations ◽  
Booster Sessions ◽  
Before And After

To describe the experience of the Italian Program to Enhance Relations and Communication Skills (PERCS-Italy) for difficult healthcare conversations. PERCS-Italy has been offered in two different hospitals in Milan since 2008. Each workshop lasts 5 h, enrolls 10–15 interdisciplinary participants, and is organized around simulations and debriefing of two difficult conversations. Before and after the workshops, participants rate their preparation, communication, relational skills, confidence, and anxiety on 5-point Likert scales. Usefulness, quality, and recommendation of the program are also assessed. Descriptive statistics, t-tests, repeated-measures ANOVA, and Chi-square were performed. A total of 72 workshops have been offered, involving 830 interdisciplinary participants. Participants reported improvements in all the dimensions (p < 0.001) without differences across the two hospitals. Nurses and other professionals reported a greater improvement in preparation, communication skills, and confidence, compared to physicians and psychosocial professionals. Usefulness, quality, and recommendation of PERCS programs were highly rated, without differences by discipline. PERCS-Italy proved to be adaptable to different hospital settings, public and private. After the workshops, clinicians reported improvements in self-reported competencies when facing difficult conversations. PERCS-Italy’s sustainability is based on the flexible format combined with a solid learner-centered approach. Future directions include implementation of booster sessions to maintain learning and the assessment of behavioral changes.

scholarly journals Reported and unreported potentially important incidental findings in urgent nonenhanced abdominal CT for renal colic

2021 ◽  
Author(s):  
Elena Belloni ◽  
Stefania Tentoni ◽  
Ilaria Fiorina ◽  
Chandra Bortolotto ◽  
Olivia Bottinelli ◽  
...  
Keyword(s):  
Emergency Department ◽  
Health Status ◽  
Pleural Effusion ◽  
Incidental Findings ◽  
Renal Colic ◽  
Legal Issues ◽  
Abdominal Ct ◽  
Significant Difference ◽  
Original Report ◽  
The Difference

PURPOSE: To retrospectively evaluate the prevalence of reported and unreported potentially important incidental findings in consecutive nonenhanced abdominal CTs performed specifically for renal colic in the urgent setting. METHOD: One radiologist, blinded to the finalized report, retrospectively re-evaluated nonenhanced abdominal CTs performed from January through December 2017 on adult patients from the Emergency Department with the specific request of urgent evaluation for renal colic, searching for potentially important incidental findings. RESULTS: The CTs of 312 patients were included in the study. Thirty-eight findings were reported in 38 different CTs, whereas the re-evaluation added 47 unreported findings in 47 different CTs, adding to total of 85 findings (27%). The difference in the proportion of reported and unreported potentially important incidental findings between the original report and re-evaluation was significant (P<.001). No significant difference was found between the age of patients with and without reported findings. The proportion of potentially important findings did not vary significantly among the three shifts neither in the original report nor in the re-evaluation. The most frequent findings, both reported and unreported, were pleural effusion, lymphadenopaties and liver nodules. CONCLUSIONS: Potentially important additional findings are frequently present in urgent nonenhanced abdominal CTs performed for renal colic, and many are not described in the finalized reports. Radiologists should take care not to under report potentially important incidental findings even in the urgent setting because of the possible consequences on the patient’s health status and in order to avoid legal issues, while satisfying the need for timely and efficient reporting.

386 An Exploratory Study of Bedtime Procrastination and Emotional Regulation Strategies in Insomnia compared to healthy individuals

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A153-A153
Author(s):  
Goeun Kim ◽  
Hyojin Nam ◽  
Huisu Jeon ◽  
Sooyeon Suh
Keyword(s):  
Emotional Regulation ◽  
Severity Index ◽  
Ministry Of Education ◽  
Chi Square ◽  
Healthy Group ◽  
Significant Difference ◽  
Regulation Strategies ◽  
The Difference ◽  
The Republic ◽  
Bedtime Procrastination

Abstract Introduction Bedtime Procrastination (BP) is defined as the behavior of voluntarily delaying going to bed, without having external reasons for doing so. Recent research on procrastination behavior suggests that when negative emotions are elevated, procrastination behaviors can be triggered in order to find pleasure to avoid and alleviate them. Procrastination can also occur when there is difficulty regulating emotions. In addition, the reason for bedtime procrastination may be different depending on whether the individuals present with insomnia. According to previous studies, patients with insomnia may exhibit more pronounced negative avoidance of bedtime due to prolonged sleeplessness. Therefore, this study compared the difference between of the bedtime procrastination and the emotional regulation strategies between the insomnia group and the healthy group. Methods This study was conducted in 582 adults (mean age 23.06 ±2.16 years), 81.6% females. Individuals scoring higher than 15 on the Insomnia Severity Index (ISI) were classified into the insomnia group (n=375), and those less than 15 were classified into the healthy group (n=207). Participants completed the Bedtime Procrastination Scale (BPS), Emotional Regulation Strategies Checklist. Data was analyzed using descriptive statistics, chi square test, and independent t tests. Results The insomnia group had significantly higher bedtime procrastination scores than the healthy group (t=-6.241, p&lt;.001), and also the avoidant/distractive regulation style score was significantly higher (t=-1.969, p&lt;.05). In addition, the score of active regulation style was significantly lower in the insomnia group than in the healthy group (t=3.050, p&lt;.01). There was no significant difference between the two groups in the support-seeking regulation style. Conclusion Based on these results, it was confirmed that there was a difference in the bedtime procrastination and the emotional regulation strategies between the insomnia group and the healthy group. Support (if any) This work was supported by the Ministry of Education of the Republic of Korea and the National Research Foundation of Korea(NRF-2018S1A5A8026807)

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