scholarly journals Investigating the characteristics and needs of frequently admitting hospital patients: a cross-sectional study in the UK

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e035522
Author(s):  
Reem Kayyali ◽  
Gill Funnell ◽  
Bassel Odeh ◽  
Anuj Sharma ◽  
Yannis Katsaros ◽  
...  
Keyword(s):  
Hospital Readmissions ◽  
Cross Sectional Study ◽  
Postal Questionnaire ◽  
University Hospital ◽  
Sectional Study ◽  
Care Needs ◽  
Post Discharge ◽  
Cross Sectional ◽  
Medical Needs ◽  
The Past

ObjectivesThis study forms the user requirements phase of the OPTIMAL project, which, through a predictive model and supportive intervention, aims to decrease early hospital readmissions. This phase aims to investigate the needs and characteristics of patients who had been admitted to hospital ≥2 times in the past 12 months.SettingThis was a cross-sectional study involving patients from Croydon University Hospital (CUH), London, UK.ParticipantsA total of 347 patients responded to a postal questionnaire, a response rate of 12.7%. To meet the inclusion criteria, participants needed to be aged ≥18 and have been admitted ≥2 times in the previous 12 months (August 2014–July 2015) to CUH.Primary and secondary outcomesTo profile patients identified as frequent admitters to assess gaps in care at discharge or post-discharge. Additionally, to understand the patients’ experience of admission, discharge and post-discharge care.ResultsThe range of admissions in the past 12 months was 2–30, with a mean of 2.8. At discharge 72.4% (n=231/347) were not given a contact for out-of-hours help. Regression analysis identified patient factors that were significantly associated with frequent admissions (>2 in 12 months), which included age (p=0.008), being in receipt of care (p=0.005) and admission due to a fall (p=0.01), but not receiving polypharmacy. Post-discharge, 41.8% (n=145/347) were concerned about being readmitted to the hospital. In the first 30 days after discharge, over half of patients (54.5% n=189/347) had no contact from a healthcare professional.ConclusionConsidering that social care needs were more of a determinant of admission risk than medical needs, rectifying the lack of integration, communication and the under-utilisation of existing patient services could prevent avoidable problems during the transition of care and help decrease the likelihood of hospital readmission.

scholarly journals Peripartum Hysterectomies over a Fifteen-year Period

2021 ◽  
Vol 43 (01) ◽  
pp. 003-008
Author(s):  
Alessandra Dorigon ◽  
Sérgio Hofmeister Martins-Costa ◽  
José Geraldo Lopes Ramos
Keyword(s):  
Placenta Accreta ◽  
Placenta Previa ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Southern Brazil ◽  
Sectional Study ◽  
Porto Alegre ◽  
Cross Sectional ◽  
The Past ◽  
Previous Cesarean

Abstract Objective To determine the indications and outcomes of peripartum hysterectomies performed at Hospital de Clínicas de Porto Alegre (a university hospital in Southern Brazil) during the past 15 years, and to analyze the clinical characteristics of the women submitted to this procedure. Methods A cross-sectional study of 47 peripartum hysterectomies from 2005 to 2019. Results The peripartum hysterectomies performed in our hospital were indicated mainly due to placenta accreta or suspicion thereof (44.7% of the cases), puerperal hemorrhage without placenta accreta (27.7%), and infection (25.5%). Total hysterectomies accounted for 63.8% of the cases, and we found no difference between total versus subtotal hysterectomies in the studied outcomes. Most hysterectomies were performed within 24 hours after delivery, and they were associated with placenta accreta, placenta previa, and older maternal age. Conclusion Most (66.0%) patients were admitted to the intensive care unit (ICU). Those who did not need it were significantly older, and had more placenta accreta, placenta previa, or previous Cesarean delivery.

scholarly journals Perception of Japanese Physicians about Human Papillomavirus Vaccine

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S325-S325
Author(s):  
Tomohiro Katsuta ◽  
Charlotte Moser ◽  
Paul Offit ◽  
Kristen Feemster
Keyword(s):  
Human Papillomavirus ◽  
Influenza Vaccine ◽  
Cross Sectional Study ◽  
Postal Questionnaire ◽  
Human Papillomavirus Vaccine ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Past ◽  
Papillomavirus Vaccine ◽  
Passive Attitude

Abstract Background Current vaccination coverage of Human Papillomavirus vaccine (HPVV) in Japan is less than 1% because the Ministry of Health, Labour and Welfare (MHLW) suspended its proactive recommendations for HPVV in 2013 after some reports of possible adverse events following immunization. We evaluated the perception of Japanese physicians about HPVV in order to consider the appropriate countermeasure to improve HPVV coverage in Japan. Methods We conducted a cross-sectional study using a postal questionnaire targeting 330 Japanese physicians (78 pediatricians, 225 internists and 27 obstetricians-gynecologists (OB-GYNs)) in Kawasaki, Japan in 2016. The questionnaire comprised questions about education frequency, physicians’ perception and recommendation behavior related to adolescent vaccines (HPVV, diphtheria tetanus toxoid (DT) and inactivated influenza vaccine (IIV)). Results Valid responses were obtained from 148 (44.9%) physicians (pediatricians 80.8%, internists 31.6% and OB-GYNs 51.9%). Very few (8.0%) of physicians provided HPVV during the past month. Only 21.3% of physicians educated aggressively about HPVV, which was significantly less frequently than DT (61.7%) and IIV (88.6%). Similarly, 53.1% of physicians recommended HPVV aggressively, which was significantly less frequently than DT (83.1%) and IIV (80.3%). We found no significant differences in the frequency of HPVV education or recommendation by pediatricians, internists and OB/GYNs (22.4% vs. 16.9% vs. 35.7% and 54.8% vs. 47.9% vs. 71.5%, respectively). However, 90.0% of physicians answered that if MHLW were to reinstate its HPVV recommendation, they would more aggressively recommend HPVV for adolescents. Conclusion Although Japanese physicians were cautious about HPVV and infrequently provided education or made a recommendation for HPVV compared with other adolescent vaccines, our survey suggested such a passive attitude could be improved by the MHLW resuming its proactive recommendation in Japan. Disclosures All authors: No reported disclosures.

scholarly journals Korelasi Tingkat Kepatuhan Konsumsi Obat Antiepilepsi Menggunakan Kuesioner MGLS (Morisky, Green, Levine Adherence Scale) dengan Frekwensi Kejang Pasien Epilepsi

2021 ◽  
pp. 121
Author(s):  
Iin Ernawati ◽  
Wardah Rahmatul Islamiyah
Keyword(s):  
Drug Therapy ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Sectional Study ◽  
Brain Disorder ◽  
Cross Sectional ◽  
The Past ◽  
Adherence Scale ◽  
The Relationship ◽  
Moderate Positive Correlation

Epilepsy is a chronic non-communicable brain disorder that can affect people of all ages. AED (antiepileptic drug) is the main therapy for most epilepsy patients with the overall goal being to prevent seizures without causing side effects. One measure of management of drug therapy in epilepsy is the decrease / loss of seizures, so that the frequency of seizures is one of the measures to achieve end-outcome. This study was an observational cross sectional study conducted on outpatients in Airlangga University Hospital, which aims to look at the relationship between the level of adherence using antiepileptic drugs with the incidence of seizures in epilepsy patients. The level of adherence with AED consumption in this study used the MGLS questionnaire (Morisky, Green, Levine Adherence Scale). The level of adherence based on the MGLS questionnaire was divided into 3 levels including low, medium or medium obedient and high compliant. The seizure events in epilepsy patients observed were the presence or absence of seizures during the past month, the data of which were obtained from patient or family interviews and from diary seizures. The results of the study of 40 respondents found that there was a moderate positive correlation between the level of adherence measured using the MGLS questionnaire whose majority level of adherence was moderate with the occurrence of seizures in epilepsy patients (r = 0.423 with p = 0.006 <0.05.

scholarly journals Prevalence of and Risk Factors for Nonprescription Antibiotic Use among Individuals Presenting to One Hospital in Saudi Arabia after the 2018 Executive Regulations of Health Practice Law: A Cross-Sectional Study

Antibiotics ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 923
Author(s):  
Ali Mohsen Al-Hazmi ◽  
Ahmed Arafa ◽  
Haytham Sheerah ◽  
Khalid Saeed Alshehri ◽  
Khalid Alwalid Alekrish ◽  
...  
Keyword(s):  
Risk Factors ◽  
Saudi Arabia ◽  
Antibiotic Resistance ◽  
Sex Education ◽  
Antibiotic Use ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Past

Antibiotic resistance is a worldwide public health emergency. Nonprescription antibiotic use is a chief cause of antibiotic resistance. The Saudi Government, as a consequence, imposed in 2018 executive regulations to prevent the distribution of antibiotics without a prescription. Herein, we aimed to investigate the prevalence of and risk factors for nonprescription antibiotic use among individuals presenting to one hospital in Saudi Arabia after enacting these regulations. This cross-sectional study was conducted on people, aged ≥18 years, who presented to the primary healthcare clinics of King Khalid University Hospital in Riyadh during the period between 1/1/2019 and 28/2/2019. Participants were asked to fill out a self-administrated questionnaire assessing their nonprescription antibiotic use during the past year in addition to sociodemographic information. Then, logistic regression analyses were performed to calculate the odds ratios (ORs) and corresponding 95% confidence intervals (CIs) for age, sex, education, and nationality of any nonprescription antibiotic use compared with no use within the past year. Out of 463 participants, 62.9% were females, 67.4% were <40 years, and 93.7% were Saudi citizens. Overall, 30.5% of participants reported nonprescription antibiotic use during the past year (19.7% one to two times and 10.8% more than two times). Male and non-Saudi participants were more likely to report any nonprescription antibiotic use, with HRs (95% CIs) of 1.99 (1.30, 3.04) and 3.81 (1.73, 8.35), respectively. The main reasons behind nonprescription antibiotic use were having previous experience with a health condition (69.2%), inaccessibility of healthcare (26.6%), and recommendation from a relative or a friend (16.1%). A major limitation of this study was that it included individuals attending one hospital. Individuals who seek medical consultation could be dissimilar to those who do not see doctors regarding nonprescription antibiotic use.

Prevalence of Thyroid Diseases in an Occupationally Radiation Exposed Group: A Cross-Sectional Study in a University Hospital of Southern Italy

2019 ◽  
Vol 19 (6) ◽  
pp. 803-808 ◽  
Author(s):  
Luigi Vimercati ◽  
Luigi De Maria ◽  
Francesca Mansi ◽  
Antonio Caputi ◽  
Giovanni M. Ferri ◽  
...  
Keyword(s):  
Ionizing Radiation ◽  
Healthcare Workers ◽  
Southern Italy ◽  
Cross Sectional Study ◽  
Thyroid Diseases ◽  
University Hospital ◽  
Control Group ◽  
Sectional Study ◽  
Cross Sectional ◽  
Exposed Workers

Background: Thyroid diseases occur more frequently in people exposed to ionizing radiation, but the relationship between occupational exposure to ionizing radiation and thyroid pathologies still remains unclear. Objective: To evaluate the prevalence of thyroid diseases in healthcare workers exposed to low-level ionizing radiation compared with a control group working at the University Hospital of Bari, Southern Italy, and living in the same geographical area, characterized by mild iodine deficiency. Methods: We ran a cross-sectional study to investigate whether healthcare workers exposed to ionizing radiation had a higher prevalence of thyroid diseases. Four hundred and forty-four exposed healthcare workers (241 more exposed, or “A Category”, and 203 less exposed, or “B Category”) and 614 nonexposed healthcare workers were enrolled during a routine examination at the Occupational Health Unit. They were asked to fill in an anamnestic questionnaire and undergo a physical examination, serum determination of fT3, fT4 and TSH, anti-TPO ab and anti-TG ab and ultrasound neck scan. Thyroid nodules were submitted to fine needle aspiration biopsy when indicated. Results: The prevalence of thyroid diseases was statistically higher in the exposed workers compared to controls (40% vs 29%, adPR 1.65; IC95% 1.34-2.07). In particular, the thyroid nodularity prevalence in the exposed group was approximately twice as high as that in the controls (29% vs 13%; adPR 2.83; IC95% 2.12-3.8). No statistically significant association was found between exposure to ionizing radiation and other thyroid diseases. Conclusion: In our study, mild ionizing radiation-exposed healthcare workers had a statistically higher prevalence of thyroid diseases than the control group. The results are likely due to a closer and more meticulous health surveillance programme carried out in the ionising radiation-exposed workers, allowing them to identify thyroid alterations earlier than non-exposed health staff.

Psychopathological Factors Associated With Burnout in Intensive Care Nurses: A Cross-Sectional Study

2021 ◽  
pp. 107839032199972
Author(s):  
Erman Yıldız
Keyword(s):  
Intensive Care ◽  
Emotional Exhaustion ◽  
Cross Sectional Study ◽  
Personal Accomplishment ◽  
University Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Anxiety Depression ◽  
The Relationship

BACKGROUND: Although previous studies have separately revealed that parameters such as anxiety, depression, and secondary traumatic stress (STS) are associated with burnout, there is still a limited understanding of the relationship between anxiety, depression, and STS and burnout in intensive care unit (ICU) nurses. AIMS: To investigate the relationship between levels of burnout, anxiety, depression, and STS in ICU nurses. METHOD: A cross-sectional study was conducted with ICU nurses ( N = 164) from a university hospital in eastern Turkey. The participants completed the anxiety, depression, STS, and burnout scales along with the descriptive characteristics form. The data were analyzed using descriptive statistics, correlation, and logistic regression analysis. RESULTS: The mean scores for STS, anxiety, depression, and burnout were 40.60 ± 13.77, 17.14 ± 12.90, 13.28 ± 9.75 and 41.39 ± 14.87, respectively. The results showed that, in the ICU nurses, anxiety, depression, and STS components explained 61% of emotional exhaustion, 38% of depersonalization, and 13% of personal accomplishment. CONCLUSIONS: While the present findings supported the paradigm that burnout in ICU nurses is associated with STS, anxiety, and depression, they also revealed some details about the psychopathological factors associated with burnout. These details were as follows: (1) individuals who resorted to avoidance as a component of STS on a high level were more likely to experience emotional exhaustion and depersonalization, (2) individuals with severe depressive symptoms were more likely to experience a decrease in their personal accomplishment, and (3) individuals with anxiety symptoms were more likely to experience both emotional exhaustion and personal accomplishment.

Malaria among migrants in a university hospital in Colombia during 2018: A case series

2020 ◽  
pp. 004947552098130
Author(s):  
Fabián R Carreño-Almánzar ◽  
Adán Coronado-Galán ◽  
Sonia A Cala-Gómez ◽  
Agustín Vega-Vera
Keyword(s):  
Latin American ◽  
Previous History ◽  
Case Series ◽  
Cross Sectional Study ◽  
Imported Malaria ◽  
University Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
History Of ◽  
Clinical Profiles

Imported malaria has increased in Colombia since 2015 and has been attributed to migrants coming from Venezuela. We present a series of malaria cases, nested in a retrospective cross-sectional study between 2017 and 2018, aimed at calculating the prevalence of medical diseases among immigrants in a University Hospital in Colombia. Among 154 immigrants admitted for medical causes between 2017 and 2018, 8 were diagnosed with malaria, all due to Plasmodium vivax. Of these, seven had uncomplicated malaria, five had a previous history of malaria, one was critically ill, but none died. We highlight that, similar to other case series of imported malaria, Latin American migrants were young, with similar clinical profiles, having a low proportion of severe cases, and P. vivax was the most frequent cause.

scholarly journals Current understanding and implementation of ‘care navigation’ across England: a cross-sectional study of NHS clinical commissioning groups

2019 ◽  
Vol 69 (687) ◽  
pp. e675-e681 ◽  
Author(s):  
Stephanie Tierney ◽  
Geoff Wong ◽  
Kamal R Mahtani
Keyword(s):  
Cross Sectional Study ◽  
Descriptive Statistics ◽  
Sectional Study ◽  
Cross Sectional ◽  
Long Term Conditions ◽  
Health And Wellbeing ◽  
Medical Needs ◽  
Social Prescribing ◽  
Evaluation Of Care

BackgroundCare navigation is an avenue to link patients to activities or organisations that can help address non-medical needs affecting health and wellbeing. An understanding of how care navigation is being implemented across primary care is lacking.AimTo determine how ‘care navigation’ is interpreted and currently implemented by clinical commissioning groups (CCGs).Design and settingA cross-sectional study involving CCGs in England.MethodA questionnaire was sent to all CCGs inviting them to comment on who provided care navigation, the type of patients for whom care navigation was provided, how individuals were referred, and whether services were being evaluated. Responses were summarised using descriptive statistics.ResultsThe authors received usable responses from 83% of CCGs (n = 162), and of these >90% (n = 147) had some form of care navigation running in their area. A total of 75 different titles were used to describe the role. Most services were open to all adult patients, though particular groups may have been targeted; for example, people who are older and those with long-term conditions. Referrals tended to be made by a professional, or people were identified by a receptionist when they presented to a surgery. Evaluation of care navigation services was limited.ConclusionThere is a policy steer to engaging patients in social prescribing, using some form of care navigator to help with this. Results from this study highlight that, although this type of role is being provided, its implementation is heterogeneous. This could make comparison and the pooling of data on care navigation difficult. It may also leave patients unsure about what care navigation is about and how it could help them.

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