scholarly journals Current provision of general practitioner services in or alongside emergency departments in England

2021 ◽  
pp. emermed-2020-210539
Author(s):  
Heather Brant ◽  
Sarah Voss ◽  
Katherine Morton ◽  
Alison Cooper ◽  
Michelle Edwards ◽  
...  
Keyword(s):  
Structural Changes ◽  
Relative Effectiveness ◽  
Study Data ◽  
Integrated Models ◽  
Multiple Data ◽  
Significant Difference ◽  
Capital Funding ◽  
On Line ◽  
Gp Services ◽  
Available Information

BackgroundIn 2017, general practitioners in or alongside the emergency department (GPED), an approach that employs GPs in or alongside the ED to address increasing ED demand, was advocated by the National Health Service in England and supported by capital funding. However, little is known about the models of GPED that have been implemented.MethodsData were collected at two time points: September 2017 and December 2019, on the GPED model in use (if any) at 163/177 (92%) type 1 EDs in England. Models were categorised according to a taxonomy as ‘inside/integrated’, ‘inside/parallel’, ‘outside/onsite’ or ‘outside/offsite’. Multiple data sources used included: on-line surveys, interviews, case study data and publicly available information.ResultsAn increase of EDs using GPED was observed from 81% to 95% over the study period. ‘Inside/parallel’ was the most frequently used model: 30% (44/149) in 2017, rising to 49% (78/159) in 2019. The adoption of ‘inside/integrated’ models fell from 26% (38/149) to 9% (15/159). Capital funding was received by 87% (142/163) of the EDs sampled. We identified no significant difference between the GPED model adopted and observable characteristics of EDs of annual attendance, 4-hour wait, rurality and deprivation within the population served.ConclusionThe majority of EDs in England have now adopted GPED. The availability of capital funding to finance structural changes so that separate GP services can be provided may explain the rise in parallel models and the decrease in integrated models. Further research is required to understand the relative effectiveness of the various models of GPED identified.

scholarly journals 198 Current provision of general practitioner services in or alongside emergency departments in England

2020 ◽  
Vol 37 (12) ◽  
pp. 846.2-847
Author(s):  
Heather Brant ◽  
Sarah Voss ◽  
Alison Cooper ◽  
Michelle Edwards ◽  
Delyth Price ◽  
...  
Keyword(s):  
Emergency Departments ◽  
Structural Changes ◽  
Relative Effectiveness ◽  
Study Data ◽  
Integrated Models ◽  
Multiple Data ◽  
Information Models ◽  
Capital Funding ◽  
On Line ◽  
Increasing Demand

Aims/Objectives/BackgroundOne approach to addressing increasing demand in emergency departments (EDs) has been the co-location of general practitioners (GPs) in or alongside the emergency department (ED), known as GPED. This approach was both advocated by the National Health Service (NHS) and supported by capital funding in 2017. However, little is known about the models of GPED that have been implemented as a result.Methods/DesignWe collected data on the model of GPED in use (if any) at 163/177 (92%) of type one EDs in England at two time points: September 2017 and December 2019. Multiple data sources were used including: on-line surveys; interviews; case study data; publicly available information. Models were classified according to an iteratively developed taxonomy as Inside/integrated, Inside/parallel, Outside/onsite, Outside/offsite.Results/ConclusionsThe proportion of EDs using GPED increased from 81% to 95% over the study period. The most common model was ‘Inside/parallel’ to the ED: 30% (44/149) in 2017, rising to 49% (78/159) in 2019. The number of Inside/integrated models dropped from 26% (38/149) to 9% (15/159). 23 sites commenced and four sites ceased GPED provision. 87% (142/163) of the EDs sampled were awarded capital funding. We identified no association between the type of GPED model adopted and the observable characteristics of EDs such as annual attendance, rurality of location and deprivation within the population served.The majority of EDs in England have now adopted GPED. The increase in Inside/parallel models and the reduction in Inside/integrated models is likely to be related to the availability of capital funding to finance structural changes to EDs so that separate GP services could be provided. Further research is required to understand the relative effectiveness of the various models of GPED identified.

scholarly journals Teaching during COVID-19: Perceptions of nursing faulty

2021 ◽  
Vol 11 (6) ◽  
pp. 43
Author(s):  
Jolene J. Lynn ◽  
Peggy Ward-Smith
Keyword(s):  
Structural Changes ◽  
Study Data ◽  
Structured Interviews ◽  
Academic Impact ◽  
Convenience Sample ◽  
Web Based ◽  
Course Content ◽  
Content Analyses ◽  
On Line ◽  
Active Communication

Objective: The COVID-19 pandemic resulted in a significant academic impact for health professions students. As a practice profession, course content in programs of nursing are provided in both web-based or on-line formats and through face-to-face classroom or clinical modalities. In response to social distancing and stay-at-home policies, all course formats became web-based and on-line. This required faculty to transition their course content, assignment, assessment requirements, office hours, and consultations, to an on-line format. Data collected in this qualitative study aimed to describe this experience, from the perspective of undergraduate and graduate nursing faculty teaching in a small, private Midwestern University.Methods: Study data, guided by semi-structured interviews, were collected using a virtual format from a convenience sample of ten nurse educators. Each interview was performed by the same researcher and analyzed separately, by both researchers using content analyses and qualitative research methods.Results: Content analyses identified alterations in course structural changes, flexibility in completion of course requirements, providing course content in smaller sections, and being available for academic and psychological support was needed. These data described the personal and professional experiences of faculty specific to course, clinical, and instructor availability.Conclusions: The necessary adaptations were readily developed and implemented. While the stress and uncertainty associated with change was apparent, clear, pro-active communication resulted in course completion and the ability to maintain the plan of study. Flexibility and adaptability, characteristics inherent in nurses, provided a framework for the necessary changes.

IMPACT ASSESSMENT OF AGRICULTURAL TRANSFORMATION PROJECT ON PRODUCTIVITY AND POVERTY AMONG RICE FARMERS IN KANO STATE, NIGERIA.

2020 ◽  
Vol 4 (2) ◽  
pp. 392-400
Author(s):  
O. S. Balogun ◽  
M. A. Damisa ◽  
O. Yusuf ◽  
O. L. Balogun
Keyword(s):  
Sampling Method ◽  
Insect Pests ◽  
Study Data ◽  
Average Treatment Effect ◽  
Descriptive Statistics ◽  
Rice Farmers ◽  
Agricultural Transformation ◽  
Multi Stage ◽  
Significant Difference ◽  
Late Model

The study was carried out to examine the effect of agricultural transformation on the beneficiary’s productivity and poverty of rice farmers in Kano State Nigeria. A multi-stage sampling method was employed to select 571 respondents for the study. Data were collected through structured questionnaires on respondent’s income, input and output quantities as well as their expenditures. Data were analysis using descriptive statistics, Foster-Greer-Thorbecke (FGT), Propensity score matching and LATE model. Results from the study shows that respondents productivity revealed a significant difference of about 127 kg/ha in rice productivity between participants and non-participants. Also, the LATE estimates revealed an average treatment effect ATE0 of about 222.98kg/ha. Furthermore, the project had a significant effect N11, 321.4 on the participant’s consumption expenditure than the non-participants N9980.60. Moreover, participants were, able to increase their household total expenditures by N34780 per annum. Fluctuations of input/output prices insect pests and inadequate extension visits were all the major constraints faced by the farmers. It was recommended that farmers’ information and sensitization system should be overhauled and improved. Also, attention should be given to well organize extension visits for the farmers from stake holders

scholarly journals The Effect of Perioral Scan and Artificial Skin Markers on the Accuracy of Virtual Dentofacial Integration: Stereophotogrammetry Versus Smartphone Three-Dimensional Face-Scanning

2020 ◽  
Vol 18 (1) ◽  
pp. 229
Author(s):  
Hang-Nga Mai ◽  
Du-Hyeong Lee
Keyword(s):  
Three Dimensional ◽  
Laser Scanner ◽  
Statistical Analyses ◽  
Integrated Models ◽  
Image Integration ◽  
Positional Accuracy ◽  
Significant Difference ◽  
Face Scanning ◽  
Scanning Systems ◽  
Dimensional Face

This study evaluated the effects of different matching methods on the accuracy of dentofacial integration in stereophotogrammetry and smartphone face-scanning systems. The integration was done (N = 30) with different matching areas (n = 10), including teeth image only (TO), perioral area without markers (PN) and with markers (PM). The positional accuracy of the integrated models was assessed by measuring the midline linear deviations and incisal line canting between the experimental groups and laser scanner-based reference standards. Kruskal–Wallis and Mann–Whitney U tests were used for statistical analyses (α = 0.05). The PM method exhibited the smallest linear deviations in both systems; while the highest deviations were found in the TO in stereophotogrammetry; and in PN in smartphone. For the incisal line canting; the canting degree was the lowest in the PM method; followed by that in the TO and the PN in both systems. Although stereophotogrammetry generally exhibited higher accuracy than the smartphone; the two systems demonstrated no significant difference when the perioral areas were used for matching. The use of perioral scans with markers enables accurate dentofacial image integration; however; cautions should be given on the accuracy of the perioral image obtained without the use of markers.

scholarly journals Genetic Deletion of Interleukin-15 Is Not Associated with Major Structural Changes Following Experimental Post-Traumatic Knee Osteoarthritis in Rats

2021 ◽  
Vol 11 (15) ◽  
pp. 7118
Author(s):  
Ermina Hadzic ◽  
Garth Blackler ◽  
Holly Dupuis ◽  
Stephen James Renaud ◽  
Christopher Thomas Appleton ◽  
...  
Keyword(s):  
Articular Cartilage ◽  
Subchondral Bone ◽  
Structural Changes ◽  
Cartilage Damage ◽  
Wild Type ◽  
Significant Difference ◽  
Post Traumatic ◽  
Interleukin 15 ◽  
Joint Trauma ◽  
Surgically Induced

Post-traumatic osteoarthritis (PTOA) is a degenerative joint disease, leading to articular cartilage breakdown, osteophyte formation, and synovitis, caused by an initial joint trauma. Pro-inflammatory cytokines increase catabolic activity and may perpetuate inflammation following joint trauma. Interleukin-15 (IL-15), a pro-inflammatory cytokine, is increased in OA patients, although its roles in PTOA pathophysiology are not well characterized. Here, we utilized Il15 deficient rats to examine the role of IL-15 in PTOA pathogenesis in an injury-induced model. OA was surgically induced in Il15 deficient Holtzman Sprague-Dawley rats and control wild-type rats to compare PTOA progression. Semi-quantitative scoring of the articular cartilage, subchondral bone, osteophyte size, and synovium was performed by two blinded observers. There was no significant difference between Il15 deficient rats and wild-type rats following PTOA-induction across articular cartilage damage, subchondral bone damage, and osteophyte scoring. Similarly, synovitis scoring across six parameters found no significant difference between genetic variants. Overall, IL-15 does not appear to play a key role in the development of structural changes in this surgically-induced rat model of PTOA.

scholarly journals Evidence for diagnosis of early chronic pancreatitis after three episodes of acute pancreatitis: a cross-sectional multicentre international study with experimental animal model

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Péter J. Hegyi ◽  
Alexandra Soós ◽  
Emese Tóth ◽  
Attila Ébert ◽  
Viktória Venglovecz ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Chronic Pancreatitis ◽  
Morphological Changes ◽  
International Study ◽  
Study Data ◽  
Cross Sectional ◽  
Clinical Biomarkers ◽  
Stage Disease ◽  
Significant Difference ◽  
End Stage

AbstractChronic pancreatitis (CP) is an end-stage disease with no specific therapy; therefore, an early diagnosis is of crucial importance. In this study, data from 1315 and 318 patients were analysed from acute pancreatitis (AP) and CP registries, respectively. The population from the AP registry was divided into AP (n = 983), recurrent AP (RAP, n = 270) and CP (n = 62) groups. The prevalence of CP in combination with AP, RAP2, RAP3, RAP4 and RAP5 + was 0%, 1%, 16%, 50% and 47%, respectively, suggesting that three or more episodes of AP is a strong risk factor for CP. Laboratory, imaging and clinical biomarkers highlighted that patients with RAP3 + do not show a significant difference between RAPs and CP. Data from CP registries showed 98% of patients had at least one AP and the average number of episodes was four. We mimicked the human RAPs in a mouse model and found that three or more episodes of AP cause early chronic-like morphological changes in the pancreas. We concluded that three or more attacks of AP with no morphological changes to the pancreas could be considered as early CP (ECP).The new diagnostic criteria for ECP allow the majority of CP patients to be diagnosed earlier. They can be used in hospitals with no additional costs in healthcare.

Determination Of Factors Affecting Father-Baby Attachment

2021 ◽  
Vol 6 (14) ◽  
pp. 1-7
Author(s):  
Emine Serap ÇAĞAN ◽  
Birsen KARACA SAYDAM ◽  
Sinem GÜLÜMSER ATEŞ ◽  
Rabia EKTİ GENÇ ◽  
Esin ÇEBER TURFAN
Keyword(s):  
Cross Sectional Study ◽  
Study Data ◽  
Cross Sectional ◽  
Infant Attachment ◽  
Factors Affecting ◽  
Attachment Figure ◽  
Gynecology And Obstetrics ◽  
Significant Difference ◽  
Package Program ◽  
The Difference

Introduction: The primary attachment figure is mostly defined as the mother, and studies focus on the mother. However, in many babies, basic attachment is just as good with the father as with the mother. It is seen that there are very few studies in the literature investigating the correlations of father-infant attachment relationships.. The aim of this study is to determine the father-infant attachment status and to determine the factors affecting attachment. Method: The population of the cross-sectional study consisted of the spouses of all puerperant women hospitalized in the Gynecology and Obstetrics Clinic between September 1, 2018 and October 1, 2018. The sample size consisted of 156 fathers who agreed to participate in the study. Father identification form and father-infant attachment scale were used to collect the study data. The analysis of the data obtained from the research was carried out on the computer using the SPSS 16.0 package program. Results: 156 fathers participated in the study. The mean age of the fathers is 33.64±6.49, and 38.5% of them have a bachelor's degree. 91.0% of fathers stated that they felt ready for fatherhood. The fathers' Father-Infant Attachment Scale mean score was 82.60±7.72 In the analysis, the difference between the variables and the total score of the scale was found to be statistically insignificant (p>0.05). Discussion and Conclusion: At the end of the study, the bonding process of fathers participating in the study with their babies and the factors affecting this process were evaluated and it was seen that the father-infant attachment scale mean scores of the fathers participating in the study were high and were similar to other studies. In addition, when the basic factors affecting father-infant attachment were compared with the attachment scale mean score, it was found that there was no statistically significant difference.

scholarly journals Gender-specific modulation of short-term neuroplasticity in the visual cortex induced by transcranial direct current stimulation

2008 ◽  
Vol 25 (1) ◽  
pp. 77-81 ◽  
Author(s):  
LEILA CHAIEB ◽  
ANDREA ANTAL ◽  
WALTER PAULUS
Keyword(s):  
Sex Differences ◽  
Visual Cortex ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Cortical Excitability ◽  
Gonadal Hormones ◽  
Study Data ◽  
Short Term ◽  
Direct Current Stimulation ◽  
Significant Difference

Transcranial direct current stimulation (tDCS) is a non-invasive method of modulating levels of cortical excitability. In this study, data gathered over a number of previously conducted experiments before and after tDCS, has been re-analyzed to investigate correlations between sex differences with respect to neuroplastic effects. Visual evoked potentials (VEPs), phosphene thresholds (PTs), and contrast sensitivity measurements (CSs) are used as indicators of the excitability of the primary visual cortex. The data revealed that cathodally induced excitability effects 10 min post stimulation with tDCS, showed no significant difference between genders. However, stimulation in the anodal direction revealed sex-specific effects: in women, anodal stimulation heightened cortical excitability significantly when compared to the age-matched male subject group. There was no significant difference between male and female subjects immediately after stimulation. These results indicate that sex differences exist within the visual cortex of humans, and may be subject to the influences of modulatory neurotransmitters or gonadal hormones which mirror short-term neuroplastic effects.

scholarly journals Morpho-textural changes of the patellar tendon in professional volleyball players: a six month longitudinal study

2019 ◽  
Vol 02 (02) ◽  
pp. 126-126
Author(s):  
de Groot Ferrando A.
Keyword(s):  
Patellar Tendon ◽  
Effect Size ◽  
Repeated Measures ◽  
Structural Changes ◽  
Patellar Tendinopathy ◽  
Average Effect ◽  
Average Effect Size ◽  
Significant Difference ◽  
Volleyball Players ◽  
Textural Changes

Abstract Introduction Tendinopathy is a term used to describe a clinical presentation of pain and dysfunction, which, at times, is accompanied by pathologic structural changes in the tendon matrix. Jumper's knee has been studied for some time, however the etiology is still unknown. The deep fibers of the proximal region are the most affected area in tendinopathies affecting the patellar tendon. Ultrasound (US) scanning may have the greatest sensitivity for confirming clinically diagnosed patellar tendinopathy compared with other imaging techniques such as magnetic resonance. Some studies have found that a minimum of six months is required to observe significant structural changes, although other studies reveal that structural changes can be visible in a shorter period of time. Thus, sonography has been used to evaluate quantitative variables such as thickness, echogenicity, texture measures and the internal tendon matrix. Objective The purpose of this study was to evaluate the sonographic behavior of morpho-textural changes of the patellar tendon in professional male volleyball players over a one year season. Material and Methods This is an observational, longitudinal and analytical study. A sample of 66 patellar tendons from 33 volleyball players of the Spanish super league was recruited, with an average of: 28 years, 86kg and 192cm. An ultrasound scan was performed using the Sonosite Titan ultrasound system, L38, 5–10 MHz, with a cross section of 5mm from the lower pole of the patella. Two depths were analyzed: a.39mm: echogenicity, echogenicity variation, circularity, width and thickness. b.24mm: entropy and contrast. Statistical analysis and analysis of variance (ANOVA) was performed for repeated measures and, in addition, the effect size was calculated with Cohen's d. The confidence interval was 95%. SPSS Statistics software was used. Results For textural variables: contrast increased significantly with an average effect size, and entropy showed no significant difference. Circularity was significantly lower. Width was shown to be significantly greater, with an average effect size, while thickness was reduced significantly. Regarding echogenicity, no significant changes were detected and variation in echogenicity did not show significant changes. Conclusions Imaging analysis could be a potential tool to detect changes in the pattern of patellar tendons. Some morpho-textural changes were found in male volleyball players: the textural contrast variable increases significantly throughout the annual season, meaning that the tendon becomes slightly flatter and loses circularity in its transverse section. The entropy and echogenic parameters obtained from the gray-scale histogram did not reveal any significant changes.

scholarly journals Feedback Environment and Creativity in Education Organizations

2015 ◽  
Vol 3 (2) ◽  
pp. 121
Author(s):  
Ying-Leh Ling ◽  
Fairuz Ismail ◽  
Abdul Ghani Kanesan Abdullah
Keyword(s):  
Quantitative Study ◽  
Positive Relationship ◽  
Pearson Correlation ◽  
Study Data ◽  
Educational Organizations ◽  
Feedback Environment ◽  
High Quality ◽  
Significant Difference ◽  
Inferential Analysis ◽  
The Relationship

This study aims to examine the relationship between feedback environment practices and creativity in the educational organizations. This study is a quantitative study. A total of 40 polytechnic students from Polytechnic Kuching Sarawak are randomly selected to participate in this study. Data were obtained using a set of questionnaire consisting of three parts. The data obtained were analyzed descriptively and inferentially. Inferential analysis involves <em>t</em> test and Pearson correlation. The findings have shown that the level of feedback environment based on students' perception is high. Simultaneously, the level of creativity among the students is also high. The findings indicated that there is no significant difference in feedback environment between genders. Furthermore, the study also showed a significant and positive relationship between feedback environment and students’ creativity. The results of this study have several implications directly to the formation of high-quality students as feedback environment and students’ creativity are interrelated and inseparable in educational organizations.

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