scholarly journals Evaluating the impact of an enhanced triage process on the performance and diagnostic yield of oesophageal physiology studies post COVID-19

2021 ◽  
Vol 8 (1) ◽  
pp. e000810
Author(s):  
Rebecca Doyle ◽  
Sebastian Bate ◽  
Jade Devenney ◽  
Sophia Agwaonye ◽  
Margaret Hastings ◽  
...  
Keyword(s):  
Diagnostic Yield ◽  
Acid Reflux ◽  
Recovery Phase ◽  
Attendance Rates ◽  
Oesophageal Motility ◽  
Traffic Light ◽  
Cross Sectional ◽  
Motility Disorders ◽  
Light System ◽  
The Impact

ObjectivesThe COVID-19 pandemic significantly impacted on the provision of oesophageal physiology investigations. During the recovery phase, triaging tools were empirically recommended by national bodies for prioritisation of referrals amidst rising waiting lists and reduced capacity. We evaluated the performance of an enhanced triage process (ETP) consisting of telephone triage combined with the hierarchical ‘traffic light system’ recommended in the UK for prioritising oesophageal physiology referrals.DesignIn a cross-sectional study of patients referred for oesophageal physiology studies at a tertiary centre, data were compared between patients who underwent oesophageal physiology studies 6 months prior to the COVID-19 pandemic and those who were investigated within 6 months after service resumption with implementation of the ETP.Outcome measuresAdjusted time from referral to investigation; non-attendance rates; the detection of Chicago Classification (CC) oesophageal motility disorders on oesophageal manometry and severity of acid reflux on 24 hours pH/impedance monitoring.ResultsFollowing service resumption, the ETP reduced non-attendance rates from 9.1% to 2.8% (p=0.021). Use of the ‘traffic light system’ identified a higher proportion of patients with CC oesophageal motility disorders in the ‘amber’ and ‘red’ triage categories, compared with the ‘green’ category (p=0.011). ETP also reduced the time to test for those who were subsequently found to have a major CC oesophageal motility diagnosis compared with those with minor CC disorders and normal motility (p=0.004). The ETP did not affect the yield or timing of acid reflux studies.ConclusionETPs can effectively prioritise patients with oesophageal motility disorders and may therefore have a role beyond the current pandemic.

scholarly journals Evaluation of a faecal calprotectin care pathway for use in primary care

2016 ◽  
Vol 17 (05) ◽  
pp. 428-436 ◽  
Author(s):  
James Turvill ◽  
Shaun O’Connell ◽  
Abigail Brooks ◽  
Karen Bradley-Wood ◽  
James Laing ◽  
...  
Keyword(s):  
Primary Care ◽  
Clinical Decision Making ◽  
Diagnostic Yield ◽  
Care Pathway ◽  
Gastrointestinal Symptoms ◽  
Clinical Decision ◽  
Traffic Light ◽  
Faecal Calprotectin ◽  
Predictive Values ◽  
Light System

BackgroundNational Institute for Health and Care Excellence have recommended faecal calprotectin (FC) testing as an option in adults with lower gastrointestinal symptoms for whom specialist investigations are being considered, if cancer is not suspected and it is used to support a diagnosis of inflammatory bowel disease (IBD) or irritable bowel syndrome. York Hospital and Vale of York Clinical Commissioning Group have developed an evidence-based care pathway to support this recommendation for use in primary care. It incorporates a higher FC cut-off value, a ‘traffic light’ system for risk and a clinical management pathway.ObjectivesTo evaluate this care pathway.MethodsThe care pathway was introduced into five primary care practices for a period of six months and the clinical outcomes of patients were evaluated. Negative and positive predictive values (NPV and PPV) were calculated. GP feedback of the care pathway was obtained by means of a web-based survey. Comparator gastroenterology activity in a neighbouring trust was obtained.ResultsThe care pathway for FC in primary care had a 97% NPV and a 40% PPV. This was better than GP clinical judgement alone and doubled the PPV compared with the standard FC cut-off (<50 mcg/g), without affecting the NPV. In total, 89% of patients with IBD had an FC>250 mcg/g and were diagnosed by ‘straight to test’ colonoscopy within three weeks. The care pathway was considered helpful by GPs and delivered a higher diagnostic yield after secondary care referral (21%) than the conventional comparator pathway (5%).ConclusionsA care pathway for the use of FC that incorporates a higher cut-off value, a ‘traffic light’ system for risk and supports clinical decision making can be achieved safely and effectively. It maintains the balance between a high NPV and an acceptable PPV. A modified care pathway for the use of FC in primary care is proposed.

scholarly journals Predictors of Psychological Distress and Coronavirus Fears in the First Recovery Phase of the Coronavirus Disease 2019 Pandemic in Germany

2021 ◽  
Vol 12 ◽  
Author(s):  
Miriam Biermann ◽  
Ruben Vonderlin ◽  
Daniela Mier ◽  
Michael Witthöft ◽  
Josef Bailer
Keyword(s):  
Risk Factors ◽  
Online Survey ◽  
Recovery Period ◽  
Health Anxiety ◽  
Somatic Symptoms ◽  
Female Gender ◽  
Recovery Phase ◽  
German Population ◽  
Cross Sectional ◽  
The Impact

Objectives: While previous research has mainly focused on the impact of the first acute phase of the COVID-19 pandemic on mental health, little empirical knowledge exists about depression, anxiety, and somatic symptom levels and possible predictors of symptom levels in the pandemic’s recovery phase. The present study aimed to analyze the mental burden of a convenience ample of the general German population during the first recovery phase of the pandemic and to identify significant predictors of symptom levels.Methods: Standardized measures of anxiety (GAD-2), depression (PHQ-2), somatic symptoms (PHQ-15), and health anxiety, as well as measures of COVID-19 fears and possible vulnerability factors, were administered through a national, cross-sectional online survey (n = 2160, mean age 42.7 years, 75% female), asking participants for their current symptom levels and their symptom levels prior to the COVID-19 pandemic.Results: Our findings show significantly elevated levels of depression, anxiety, somatic symptoms, and health anxiety in the recovery period compared to before the pandemic. The current prevalence rates based on self-reporting were 26.7% for depression, 24.5% for anxiety, and 29% for somatization. The strongest predictors of these symptom reports included domain-specific pre-existing symptom levels, neuroticism, biological COVID-19 risk factors, avoidance of illness information, and younger age. The most important predictors of COVID-19 fears were subjective COVID-19 risk perception, followed by pre-existing health anxiety, the number of biological COVID-19 risk factors, older age, neuroticism, avoidance of illness information and female gender.Discussion: These findings indicate the need for specific psychological programs to help individuals with enhanced psychological and biological vulnerability to cope better with the mental distress experienced during all phases of the ongoing COVID-19 crisis.

Multidisciplinary team decision is rare and decreasing in percutaneous vascular interventions despite positive impact on in-hospital outcomes

VASA ◽  
2019 ◽  
Vol 48 (3) ◽  
pp. 262-269 ◽  
Author(s):  
Christian-Alexander Behrendt ◽  
Tilo Kölbel ◽  
Thea Schwaneberg ◽  
Holger Diener ◽  
Ralf Hohnhold ◽  
...  
Keyword(s):  
Multidisciplinary Team ◽  
Positive Impact ◽  
Cross Sectional Study ◽  
Invasive Treatment ◽  
Cross Sectional ◽  
Hospital Outcomes ◽  
Vascular Intervention ◽  
Medical Specialties ◽  
Team Decision ◽  
The Impact

Abstract. Background: Worldwide prevalence of peripheral artery disease (PAD) is increasing and peripheral vascular intervention (PVI) has become the primary invasive treatment. There is evidence that multidisciplinary team decision-making (MTD) has an impact on in-hospital outcomes. This study aims to depict practice patterns and time changes regarding MTD of different medical specialties. Methods: This is a retrospective cross-sectional study design. 20,748 invasive, percutaneous PVI of PAD conducted in the metropolitan area of Hamburg (Germany) were consecutively collected between January 2004 and December 2014. Results: MTD prior to PVI was associated with lower odds of early unsuccessful termination of the procedures (Odds Ratio 0.662, p < 0.001). The proportion of MTD decreased over the study period (30.9 % until 2009 vs. 16.6 % from 2010, p < 0.001) while rates of critical limb-threatening ischemia (34.5 % vs. 42.1 %), patients´ age (70 vs. 72 years), PVI below-the-knee (BTK) (13.2 % vs. 22.4 %), and rates of severe TASC C/D lesions BTK (43.2 % vs. 54.2 %) increased (all p < 0.001). Utilization of MTD was different between medical specialties with lowest frequency in procedures performed by internists when compared to other medical specialties (7.1 % vs. 25.7 %, p < 0.001). Conclusions: MTD prior to PVI is associated with technical success of the procedure. Nonetheless, rates of MTD prior to PVI are decreasing during the study period. Future studies should address the impact of multidisciplinary vascular teams on long-term outcomes.

Factors Influencing Academic Stress on Students of University of Economics and Business - Vietnam National University

2020 ◽  
Vol 36 (3) ◽  
Author(s):  
Nham Phong Tuan ◽  
Nguyen Ngoc Quy ◽  
Nguyen Thi Thanh Huyen ◽  
Hong Tra My ◽  
Tran Nhu Phu
Keyword(s):  
Academic Stress ◽  
Stress Factors ◽  
Negative Effects ◽  
Cross Sectional ◽  
Stress Scale ◽  
Perceptions And Attitudes ◽  
National University ◽  
Questionnaire Surveys ◽  
The University ◽  
The Impact

The objective of this study is to investigate the impact of seven factors causing academic stress on students of University of Economics and Business - Vietnam National University: Lack of leisure time, Academic performance, Fear of failure, Academic overload, Finances, Competition between students, Relationships with university faculty. Based on the results of a practical survey of 185 students who are attending any courses at the University of Economics and Business - Vietnam National University, the study assesses the impact of stress factors on students. The thesis focuses on clarifying the concept of "stress" and the stress level of students, while pointing out its negative effects on students. This study includes two cross-sectional questionnaire surveys. The first survey uses a set of 16 questions to assess students’ perceptions and attitudes based on an instrument to measure academic stress - Educational Stress Scale for Adolescents (ESSA). The second survey aims to test internal consistency, the robustness of the previously established 7-factor structure. Henceforth, the model was brought back and used qualitatively, combined with Cronbach’s Alpha measurement test and EFA discovery factor analysis. This study was conducted from October 2019 to December 2019. From these practical analyzes, several proposals were made for the society, the school and the students themselves.

The impact of the use of a footrest on the quality of chest compressions. A prospective, randomized, cross-sectional study

2018 ◽  
Vol 31 (3) ◽  
Author(s):  
Jolanta Majer ◽  
Sandra Pyda ◽  
Jerzy Robert Ladny ◽  
Antonio Rodriguez-Nunez ◽  
Lukasz Szarpak
Keyword(s):  
Cross Sectional Study ◽  
Sectional Study ◽  
Chest Compressions ◽  
Cross Sectional ◽  
The Impact

Awareness of symptomatic differences Covid-19, SARS, Swine Flu, Common cold among dental students

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 1026-1033
Author(s):  
Nivedha Valliammai Mahalingam ◽  
Abilasha R ◽  
Kavitha S
Keyword(s):  
Infectious Diseases ◽  
Undergraduate Students ◽  
Common Cold ◽  
Emerging Infectious Diseases ◽  
Dental Students ◽  
Swine Flu ◽  
Viral Diseases ◽  
Surveillance Systems ◽  
Cross Sectional ◽  
The Impact

Enormous successes have been obtained against the control of major epidemic diseases, such as SARS, MERS, Ebola, Swine Flu in the past. Dynamic interplay of biological, socio-cultural and ecological factors, together with novel aspects of human-animal interphase, pose additional challenges with respect to the emergence of infectious diseases. The important challenges faced in the control and prevention of emerging and re-emerging infectious diseases range from understanding the impact of factors that are necessary for the emergence, to development of strengthened surveillance systems that can mitigate human suffering and death. The aim of the current study is to assess the awareness of symptomatic differences between viral diseases like COVID-19, SARS, Swine flu and common cold among dental students that support the prevention of emergence or re-emergence. Cross-sectional type of study conducted among the undergraduate students comprising 100 Subjects. A questionnaire comprising 15 questions in total were framed, and responses were collected in Google forms in SPSS Software statistical analysis. The study has concluded that dental students have an awareness of the symptomatic differences between infectious viral disease. The study concluded that the awareness of symptomatic differences between viral diseases like COVID-19, SARS, Swine flu, Common cold is good among the dental students who would pave the way for early diagnosis and avoid spreading of such diseases. A further awareness can be created by regular webinars, seminars and brainstorming sessions among these healthcare professionals.

Relationship between Code of Corporate Governance and Corporate Financial Performance (An Empirical Study of Food Companies Listed on KSE)

GIS Business ◽  
2017 ◽  
Vol 12 (4) ◽  
pp. 01-09
Author(s):  
Asma Rafique Chughtai ◽  
Afifa Naseer ◽  
Asma Hassan
Keyword(s):  
Corporate Governance ◽  
Stock Exchange ◽  
Securities And Exchange Commission ◽  
Executive Directors ◽  
Agency Conflicts ◽  
Cross Sectional ◽  
Return On Equity ◽  
Governance Practices ◽  
Code Of Corporate Governance ◽  
The Impact

The crucial role that implementation of Code of Corporate Governance plays on protecting the rights of minorities, shareholders, local as well as foreign investors cannot be denied. Companies all over the world are required to implement their respective Code of Corporate Governance for avoiding agency conflicts between companies management and stakeholders and for assuring transparency in accountability. This paper aims at exploring the impact of implementation of corporate governance practices (designed by Securities and Exchange Commission of Pakistan) have on the financial position of companies. For explanatory variables of the study, composition of the board as per the Code of Corporate Governance that comprises of presence of independent, executive and non-executive directors has been taken into consideration. Return on equity has been taken as an indicator of firms profitability i.e. the dependent variable. For this study, companies listed on food producing sector of Karachi Stock Exchange have been screened for excogitation of the relationship. It is an empirical research based on nine years data from 2007–2015. Using Hausman Test for selecting the data analysis technique between Fixed or Random, Fixed Cross Sectional Panel Analysis has been used for analysis of the data collected. Findings indicate that presence of independent, executive and non-executive directors as per the code requirements levies a significant impact on the profitability of companies indicated by return on equity. It is, thus concluded that companies should ensure compliance with code of governance practices to reduce not only the agency issues but also to increase their profitability.

Diversity and the Performance of Selected Financial Institutions of Asia

2018 ◽  
Vol 2 (1) ◽  
pp. 1
Author(s):  
Shafaque Fatima ◽  
Saqib Sharif
Keyword(s):  
Financial Institutions ◽  
Positive Impact ◽  
Financial Institution ◽  
Gender Diversity ◽  
Business Case ◽  
Ordinary Least Squares ◽  
Cross Sectional ◽  
Age Diversity ◽  
The Impact ◽  
Nationality Diversity

Linking with the business case for diversity, this study examines whether the top management team (TMT) and the board of directors (BODs) diversity has a positive impact on financial institution (FI) performance in select countries of Asia least researched domain. We use data from 119 financial institutions across Asia for the year 2015, initially 1,447 institutions; however, incomplete data was excluded from final analysis. We use three proxies for diversity, that is, nationality diversity, gender diversity, and age diversity of TMT and BODs. To investigate the impact of TMT and BODs diversity, cross-sectional ordinary least-squares estimation is applied, using Return on Average Assets (ROAA%) as a measure of performance.  We find that nationality diversity and age diversity is positively and significantly related to FIs performance. Our evidence indicates that executives and board members with diverse exposure and younger age improve FIs profitability. However, there is no significant relationship between gender and FIs performance.

HUBUNGAN PEMBERIAN ASI EKSKLUSIF DENGAN KEJADIAN STUNTING PADA BALITA USIA 1-5 TAHUN DIPUSKESMAS SUKAHENING KECAMATAN SUKAHENING KABUPATEN TASIKMALAYA

2020 ◽  
Vol 13 (2) ◽  
pp. 109
Author(s):  
Yuyun Sarinengsih
Keyword(s):  
Public Health ◽  
Health Center ◽  
Exclusive Breastfeeding ◽  
Growth Failure ◽  
Sampling Technique ◽  
Not Given ◽  
Chi Square ◽  
Cross Sectional ◽  
Public Health Center ◽  
The Impact

ABSTRAKStunting yaitu keadaan gagal tumbuh akibat dari kekurangan gizi kronis. Prevalensi stunting di Kabupaten Tasikmalaya menempati urutan keempat, dimana kecamatan Sukahening menempati urutan pertama tertinggi dengan jumlah 155 balita mengalami stunting. Faktor yang dapat mempengaruhi kejadian stunting yaitu pengasuhan anak yang kurang baik dimana tidak diberikannya ASI secara Ekslusif. Pencegahan stunting yaitu pada 1000 hari kehidupan dimana salah satunya pemberian ASI secara Ekslusif.Penelitian ini bertujuan untuk mengetahui hubungan antara pemberian ASI Ekslusif dengan kejadian stunting pada balita 1-5 tahun di Puskesmas Sukahening Kecamatan Sukahening Kabupaten Tasikmalaya.Jenis Penelitian yang digunakan adalah deskriptif korelasional dengan pendekatan cross-sectional. Populasi total sampling sebanyak 95 responden menggunakan teknik purposive sampling.Hasil Penelitian diperoleh lebih dari setengah responden 51,6% tidak diberikan ASI secara Ekslusif, dan sebagian besar 65,3% balita mengalami stunting. Hasil perhitungan chi-square diperoleh ρ.value (0,000<0,05) maka H0 ditolak sehingga terdapat hubungan antara Pemberian ASI Ekslusif dengan kejadian stunting pada balita 1-5 tahun di Puskesmas Sukahening Kecamatan Sukahening Kabupaten Tasikmalaya.Hasil penelitian ini diharapkan dapat memberi informasi yang bermanfaat dan perlu dilakukan pendidikan kesehatan ulang yang terjadwal terkait nutrisi yang terjangkau dan sehat sehingga dapat meningkatkan cakupan ASI Ekslusif dan dapat menurunkan angka stunting.Kata Kunci : ASI Ekslusif, StuntingDaftar Pustaka : 25 buku (2010-2018)9 jurnal (2013-2019)2 Website (2010-2017) ABSTRACTStunting is a condition of growth failure due to chronic malnutrition. The stunting prevalence in Tasikmalaya Regency was at the fourth place where Sukahening sub-district was at the highest with 155 stunting. Factor that can influence the occurrence of stunting is a poor parenting where exclusive breastfeeding is not given. The best prevention of stunting is on 1000 days of life where exclusive breastfeeding is given. The impact, if the baby is not given exclusive breastfeeding, they will lack of nutrition and also will have an impact on the growth or inappropriate height. This aims of the research is to determine the relationship between exclusive breastfeeding and the incidence of stunting on toddler under 5 years of at Sukahening Public Health Center, Sukahening Sub district, Tasikmalaya Regency. The type of research used is descriptive correlation with a cross-sectional approach. The total samplings were 95 respondents which used purposive sampling technique. The results of the research were obtained more than half of the respondents 51.6% were given exclusive breastfeeding, and most 65.3% of children under five had stunting. The chi-square calculation results obtained that ρ.value (0,000 <0,05) then H0 is rejected so that there is a relationship between exclusive breastfeeding and the incidence of stunting on toddlers under 5 years in Sukahening Public Health Center, Sukahening Sub district, Tasikmalaya Regency. Performed the health education related to affordable and healthy nutrition so that it can increase the coverage of exclusive breastfeeding and can reduce stunting rates. Keywords : Exclusive breastfeeding, Stunting Bibliography : 25 books (2010-2018) 9 journals (2013-2019) 2 Websites (2010-2017) 

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