scholarly journals Increased Use of Blood Transfusions to Manage Urological Conditions during the COVID-19 Pandemic

2020 ◽  
Vol 104 (11-12) ◽  
pp. 849-852
Author(s):  
Paolo Capogrosso ◽  
Luigi Candela ◽  
Piercarlo Rossi ◽  
Cristian Guarasci ◽  
Fabio Muttin ◽  
...  
Keyword(s):  
Healthcare System ◽  
Negative Impact ◽  
Delayed Diagnosis ◽  
Time Frame ◽  
Blood Transfusions ◽  
Transfusion Rate ◽  
Deferred Treatment ◽  
The North ◽  
Number Of Patients ◽  
The Impact

<b><i>Introduction:</i></b> Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) led to an extensive reorganization of the healthcare system in Italy, with significant deferment of the treatment of urology patients. We aimed to assess the impact of deferred treatment during the SARS-CoV-2 pandemic on the need for blood transfusions in 3 Italian urology departments. <b><i>Methods:</i></b> We reviewed hospital chart data on blood transfusions at the urology units of 3 academic centers in the north of Italy from March to April 2020. Data were compared with values from the same time frame in 2019 (March to April 2019). <b><i>Results:</i></b> We observed significant reductions of the number of patients admitted to the urology units from March to April 2020 (373 vs. 119) and the number of performed surgeries (242 vs. 938) compared to 2019. Though, the number of transfused blood units was comparable between the 2 years (182 vs. 252), we found a greater mean number of blood units transfused per admission in 2020 (0.49 vs. 0.22; <i>p</i> &#x3c; 0.0001). As a whole, the transfusion rate for hematuria was higher in 2020 than in 2019 (36 vs. 7.9%; <i>p</i> &#x3c; 0.0001). <b><i>Discussion/Conclusion:</i></b> The observed increased number of blood transfusions needed throughout the SARS-CoV-2 era could have had a negative impact on both patients and the healthcare system. It is possible to speculate that this is the consequence of a delayed diagnosis and deferred treatment of acute conditions.

scholarly journals Impact of COVID-19 pandemic on the oncologic care continuum: urgent need to restore patients care to pre-COVID-19 era

2021 ◽  
pp. 1-11
Author(s):  
Ernest Osei ◽  
Ruth Francis ◽  
Ayan Mohamed ◽  
Lyba Sheraz ◽  
Fariba Soltani-Mayvan
Keyword(s):  
Cancer Care ◽  
Healthcare Professionals ◽  
Negative Impact ◽  
System Level ◽  
Care Continuum ◽  
Cancer Services ◽  
Number Of Patients ◽  
Prevention Programmes ◽  
Screening And Prevention ◽  
The Impact

Abstract Background: Globally, cancer is the second leading cause of death, and it is estimated that over 18·1 million new cases are diagnosed annually. The COVID-19 pandemic has significantly impacted almost every aspect of the provision and management of cancer care worldwide. The time-critical nature of COVID-19 diagnosis and the large number of patients requiring hospitalisation necessitated the rerouting of already limited resources available for cancer services and programmes to the care of COVID-19 patients. Furthermore, the stringent social distancing, restricted in-hospital visits and lockdown measures instituted by various governments resulted in the disruption of the oncologic continuum including screening, diagnostic and prevention programmes, treatments and follow-up services as well as research and clinical trial programmes. Materials and Methods: We searched several databases from October 2020 to January 2021 for relevant studies published in English between 2020 and 2021 and reporting on the impact of COVID-19 on the cancer care continuum. This narrative review paper describes the impact of the COVID-19 pandemic on the cancer patient care continuum from screening and prevention to treatments and ongoing management of patients. Conclusions: The COVID-19 pandemic has profoundly impacted cancer care and the management of cancer services and patients. Nevertheless, the oncology healthcare communities worldwide have done phenomenal work with joint and collaborative efforts, utilising best available evidence-based guidelines to continue to give safe and effective treatments for cancer patients while maintaining the safety of patients, healthcare professionals and the general population. Nevertheless, several healthcare centres are now faced with significant challenges with the management of the backlog of screening, diagnosis and treatment cases. It is imperative that governments, leaders of healthcare centres and healthcare professionals take all necessary actions and policies focused on minimising further system-level delays to cancer screening, diagnosis, treatment initiation and clearing of all backlogs cases from the COVID-19 pandemic in order to mitigate the negative impact on cancer outcomes.

Big data and artificial intelligence for health system sustainability: The case of Veneto Region

2021 ◽  
pp. 31-52
Author(s):  
Grazia Dicuonzo ◽  
Francesca Donofrio ◽  
Antonio Fusco ◽  
Vittorio Dell’Atti
Keyword(s):  
Artificial Intelligence ◽  
Big Data ◽  
Healthcare System ◽  
Care Delivery ◽  
Research Question ◽  
Health Agency ◽  
Time Frame ◽  
Structured Interviews ◽  
Case Study Methodology ◽  
The Impact

This paper investigates the digitalization challenges facing the Italian healthcare system. The aim of the paper is to support healthcare organizations as they take advantage of the potential of big data and artificial intelligence (AI) to promote sustainable healthcare systems. Both the development of innovative processes in the management of health care activities and the introduction of healthcare forecasting systems are valuable resources for clinical and care activities and enable a more efficient use of inputs in essential-level care delivery. By examining an innovative project developed by the Regional Social Health Agency (ARSS) of Veneto, this study analyses the impact of big data and AI on the sustainability of a healthcare system. In order to answer the research question, we used a case study methodology. We conducted semi-structured interviews with key members of the organizational group involved in the case. The results show that the implementation of AI algorithms based on big data in healthcare both improves the interpretation and processing of data, and reduces the time frame necessary for clinical processes, having a positive effect on sustainability.

Disaster Metrics: Quantitative Estimation of the Number of Ambulances Required in Trauma-Related Multiple Casualty Events

2012 ◽  
Vol 27 (5) ◽  
pp. 445-451 ◽  
Author(s):  
Jamil D. Bayram ◽  
Shawki Zuabi ◽  
Mazen J. El Sayed
Keyword(s):  
Quantitative Estimation ◽  
The United States ◽  
Time Frame ◽  
Quantitative Model ◽  
Time Interval ◽  
Publication Type ◽  
The North ◽  
Number Of Patients ◽  
Minimum Number ◽  
T1 And T2

AbstractIntroductionEstimating the number of ambulances needed in trauma-related Multiple Casualty Events (MCEs) is a challenging task.Hypothesis/ProblemEmergency medical services (EMS) regions in the United States have varying “best practices” for the required number of ambulances in MCE, none of which is based on metric criteria. The objective of this study was to estimate the number of ambulances required to respond to the scene of trauma-related MCE in order to initiate treatment and complete the transport of critical (T1) and moderate (T2) patients. The proposed model takes into consideration the different transport times and capacities of receiving hospitals, the time interval from injury occurrence, the number of patients per ambulance, and the pre-designated time frame allowed from injury until the transfer care of T1 and T2 patients.MethodsThe main theoretical framework for this model was based on prehospital time intervals described in the literature and used by EMS systems to evaluate operational and patient care issues. The North Atlantic Treaty Organization (NATO) triage categories (T1-T4) were used for simplicity.ResultsThe minimum number of ambulances required to respond to the scene of an MCE was modeled as being primarily dependent on the number of critical patients (T1) present at the scene any particular time. A robust quantitative model was also proposed to dynamically estimate the number of ambulances needed at any time during an MCE to treat, transport and transfer the care of T1 and T2 patients.ConclusionA new quantitative model for estimation of the number of ambulances needed during the prehospital response in trauma-related multiple casualty events has been proposed. Prospective studies of this model are needed to examine its validity and applicability.BayramJD, ZuabiS, El SayedMJ. Disaster metrics: quantitative estimation of the number of ambulances required in trauma-related multiple casualty events. Prehosp Disaster Med.2012;27(5):1-7.

scholarly journals Service evaluation for services for younger people with dementia in east locality of north Wales

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S20-S20
Author(s):  
Asha Dhandapani ◽  
Sathyan Soundararajan ◽  
Sharmi Bhattacharyya
Keyword(s):  
Time Frame ◽  
Service Evaluation ◽  
Young Onset ◽  
People With Dementia ◽  
North Wales ◽  
Number Of Patients ◽  
Time To Diagnosis ◽  
Working Age ◽  
The Impact ◽  
Timely Referral

AimsTo evaluate Young-onset dementia (YOD) services in terms of referral, its appropriateness, time to diagnosis and other criteria as per protocol that we have adapted.MethodCase notes of those under 65 referred to Memory service for cognitive assessment between July 2017 and June 2018 were retrospectively reviewed to look at the time to diagnosis, appropriate referrals, post-diagnostic support, etc.ResultCompared to the previous evaluation, the number of patients referred to had increased from 47–48/ year earlier to 63/year. Only 1/3 were appropriate referral over the 10-year period whereas between 2017 and 2018 more than half were appropriate referrals. More than half of them were seen within 12 weeks of referral (35/63 available). Only 132/252 were diagnosed as having some form of dementia in the previous evaluation which was about 13 cases of YOD a year. In contrast, in our new evaluation 19 patients were diagnosed with some form of dementia. Inappropriate referrals had reduced by more than 50%. Appropriateness and timely referral had improved in this time frame.ConclusionDementia is considered ‘young onset’ when it affects people under 65 years of age. It is also referred to as ‘early onset’ or ‘working age’ dementia. However, this is an arbitrary age distinction that is becoming less relevant as increasingly services are realigned to focus on the person and the impact of the condition, not the age. Teaching sessions to educate primary & secondary care clinicians on appropriateness and timely referrals have helped in improving the care for patients with YOD. Services need to be developed further to be able to diagnose & support those with YOD. Repeat evaluations every year would help to inform improvement in quality & appropriateness of referrals.

scholarly journals The Impact of Debt Burden on the Number of Suicides in the Russian Regions

2021 ◽  
Vol 17 (4) ◽  
pp. 97-117
Author(s):  
Svetlana Doroshenko ◽  
◽  
Olga Sanaeva ◽  
◽  
Keyword(s):  
Mental Disorders ◽  
Unemployment Rate ◽  
Rural Areas ◽  
Negative Impact ◽  
Generalized Method Of Moments ◽  
Russian Regions ◽  
Debt Burden ◽  
Suicide Rates ◽  
Number Of Patients ◽  
The Impact

Population size is one of the most important parameters of national social and economic systems. This parameter is controlled by a variety of factors (components) that form ambiguous and complex feedback circuits. The most important issue is the study of the behavioral reactions of the population, which form certain parameters of the dynamics of the population. The authors consider only one behavioral reaction that seems to them to be important – the propensity for suicide, which ultimately leads to the formation of the suicide dynamics and which entails serious socio-economic and demographic losses. We put an emphasis on assessing the impact of financial parameters, namely households’ debt burden, on the suicide rates in the Russian regions. An econometric assessment of the influence of individual debt on the number of suicides among other socio-economic factors (unemployment rate, logarithm of GRP per capita, divorce rate, number of patients with mental disorders, average actual working week, number of alcoholics) was carried out for the regions among rural, urban populations and total. We use panel data for 80 Russian regions covering the period from 2005 to 2018. We apply the generalized method of moments (GMM) using Stata 14 statistical package. The empirical analysis demonstrates negative impact of the amount of individual debt on the number of suicides in the regions of Russia, which contradicts the results of similar studies conducted for developed economies. At the same time, some results obtained earlier in domestic and foreign studies have been confirmed, including an existence of a parabolic (U-shaped) dependence between the length of working hours and the suicide rates in the regions of the Russian Federation. In addition, there is a direct connection between an increase in the committed suicides and an increase in divorce rates and the number of patients with mental disorders. Moreover, we find out that the rise in unemployment rate and alcohol consumption leads to an increase in the number of committed suicides. This effect is especially perceptible among the people living in rural areas

scholarly journals An interrupted time-series analysis of the impact of emergency department reconfiguration on regional emergency department trolley numbers in Ireland from 2005 to 2015

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e029261 ◽  
Author(s):  
Brenda Lynch ◽  
John Browne ◽  
Claire Mary Buckley ◽  
Orla Healy ◽  
Paul Corcoran ◽  
...  
Keyword(s):  
Emergency Department ◽  
Time Series ◽  
Time Series Analysis ◽  
Interrupted Time Series Analysis ◽  
Series Analysis ◽  
North East ◽  
The North ◽  
Number Of Patients ◽  
Geographical Regions ◽  
The Impact

ObjectivesTo understand the impact of emergency department (ED) reconfiguration on the number of patients waiting for hospital beds on trolleys in the remaining EDs in four geographical regions in Ireland using time-series analysis.SettingEDs in four Irish regions; the West, North-East, South and Mid-West from 2005 to 2015.ParticipantsAll patients counted as waiting on trolleys in an ED for a hospital bed in the study hospitals from 2005 to 2015.InterventionThe system intervention was the reconfiguration of ED services, as determined by the Department of Health and Health Service Executive. The timing of these interventions varied depending on the hospital and region in question.ResultsThree of the four regions studied experienced a significant change in ED trolley numbers in the 12-month post-ED reconfiguration. The trend ratio before and after the intervention for these regions was as follows: North-East incidence rate ratio (IRR) 2.85 (95% CI 2.04 to 3.99, p<0.001), South IRR 0.68 (95% CI 0.51 to 0.89, p=0.006) and the Mid-West IRR 0.03 (95% 1.03 to 2.03, p=0.03). Two of these regions, the South and the Mid-West, displayed a convergence between the observed and expected trolley numbers in the 12-month post-reconfiguration. The North-East showed a much steeper increase, one that extended beyond the 12-month period post-ED reconfiguration.ConclusionsFindings suggest that the impacts of ED reconfiguration on regional level ED trolley trends were either non-significant or caused a short-term shock which converged on the pre-reconfiguration trend over the following 12 months. However, the North-East is identified as an exception due to increased pressures in one regional hospital, which caused a change in trend beyond the 12-month post reconfiguration.

scholarly journals Atypical Presentation of Post-Kala-Azar Dermal Leishmaniasis in Bhutan

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Ambika Pradhan ◽  
Tashi Tobgay ◽  
Sithar Dorjee ◽  
Tenzin Wangdi ◽  
Guofa Zhou ◽  
...  
Keyword(s):  
Healthcare System ◽  
Negative Impact ◽  
Indian Subcontinent ◽  
Delayed Diagnosis ◽  
Disease Process ◽  
Health Coverage ◽  
Disease Elimination ◽  
Kala Azar ◽  
Increased Risk ◽  
The Government

This article describes an atypical case of post-kala-azar dermal leishmaniasis associated with complications due to delayed diagnosis and poor case management. The grave consequences of the prolonged disease process that continued for over 2 decades with eventual healing included facial disfigurement, visual impairment, and mental distress both to the patient and the family. The persistent infection within the skin over a lengthy period with likely increased risk of infection spread in the community highlights its potential negative impact on the ongoing leishmaniasis elimination program in the Indian subcontinent. Bhutan is a member of the leishmaniasis elimination network in Asia, and the government continues to invest in maintenance of the national healthcare system. The case study reveals the gaps in the healthcare system with hardships faced by a patient to access quality healthcare and poor patient outcome used as proxy indicators. It also points to the need to enhance access to healthcare to ensure early diagnosis and effective treatment for leishmaniasis patients including those who live in remote areas, in order to achieve the planned disease elimination targets. It also points towards the key challenges faced by a resource poor nation such as Bhutan in achieving universal health coverage and reaching the set goals for disease elimination. The findings underscore the need for a careful review of the national health care system and to address the deficiencies.

scholarly journals The impact of transport infrastructure projects on sustainable development within a major logistics gateway in North West England

2016 ◽  
Vol 7 (1) ◽  
pp. 28-40 ◽  
Author(s):  
Dimitrios Paraskevadakis ◽  
Alan Bury ◽  
Jin Wang ◽  
Jun Ren ◽  
Stephen Bonsall ◽  
...  
Keyword(s):  
Sustainable Development ◽  
Negative Impact ◽  
Transport Infrastructure ◽  
Quality Data ◽  
Infrastructure Development ◽  
Infrastructure Projects ◽  
The Sustainable Development ◽  
North West ◽  
The North ◽  
The Impact

Abstract In the North West of England the issue of a perceived infrastructure gap is of increasing concern. Investment needs to be made to improve the transport infrastructure of the region if it is to be expected to promote the development of its own regional logistics gateway. Funding tools have been set up to address the challenges arising from the imbalance in infrastructure development that exists between regions in the north of the United Kingdom and those in the south. For regions with well developed economies the outlook is promising as the availability of modern transport infrastructure looks set to improve. However, some sources believe that the development of new transport infrastructure will have a negative impact upon sustainable development. It is expected that this will occur in a range of both direct and indirect ways. As a result, it is critical that planning for the creation of new intermodal transport infrastructure, or the upgrading of that which already exists, takes into account the impact that these developments will have on the sustainable development of the host region. A scenario based development methodology is proposed in this paper. It was developed to provide a way to identify potential scenarios that may arise within a given region as a result of transport infrastructure projects. To create significant scenarios the methodology is dependent on the availability of a sufficient quantity of quality data. For this paper that data was collected through a focus group composed of stakeholders from the region in question. This was further supported by the performance of an impact survey using the same group of stakeholders.

Racial and low-income quotas in Brazilian universities: impact on academic performance

2018 ◽  
Vol 45 (1) ◽  
pp. 156-176
Author(s):  
Claudia Bueno Rocha Vidigal
Keyword(s):  
Academic Performance ◽  
Student Performance ◽  
Low Income ◽  
Family Income ◽  
Negative Impact ◽  
Public And Private ◽  
Content Type ◽  
The North ◽  
Significant Difference ◽  
The Impact

Purpose The purpose of this paper is to estimate the impact of racial and low-income quotas on academic performance of students from public and private universities in Brazil. Design/methodology/approach Using propensity score matching applied to student-level data from the National Examination of Student Performance conducted in 2012; this paper identifies the impact of the quota policy on academic performance considering all Brazilian universities. Findings The results indicate that there is no statistically significant difference in academic performance between students admitted under the racial quota and those who had the regular admission (non-quota students). The impact is positive, however, for students from the North region of Brazil and among those with very low family income, whereas a negative impact is observed for those from the Central-West region. In regard to the low-income quota, quota students perform worse than eligible non-quota students as their scores are, on average, 14 percent lower. Similar findings are observed when different subsamples are considered. Originality/value This paper’s main contribution is to provide a broader and more rigorous empirical approach than that presented by the existing literature in order to evaluate the impact of quota policies on academic achievement. Moreover, this study considers all Brazilian institutions whereas previous studies are limited to only one or a few universities.

The effect of industrial competition on employment

2017 ◽  
Vol 27 (4) ◽  
pp. 410-432 ◽  
Author(s):  
Alfonso Mendoza-Velazquez
Keyword(s):  
Employment Growth ◽  
Negative Impact ◽  
Industrial Clusters ◽  
Least Square ◽  
Content Type ◽  
The North ◽  
Industrial Specialization ◽  
The Usa ◽  
Definition Of ◽  
The Impact

Purpose This study investigates the existence of Marshall, Jacob and Porter’s type of externalities in Mexico. We measure the impact of industrial specialization, competition and diversity on employment growth for the period 2004 to 2008. Design/methodology/approach The analysis is based on data from 41 highly dynamic industrial clusters originally obtained by applying Porter’s (1998) methodology. We use a cross-section specification estimated via instrumental variables and two-stage least square estimation (2SLS) to control for endogeneity. Findings On average, we find that industrial specialization exerts a negative impact on employment growth within states and within clusters, indicating that traded industries in Mexico carry very little innovation, operate in early stages of the life cycle, face high costs of employment reassignation or exhibit low adaptability. A negative impact of specialization on employment conforms with Jacobs (1969) type of externalities and confirms what other studies have found in France (Combes, 2000), Korea (Lee et al., 2005) and the USA (Delgado et al., 2014). The authors also find that competition generates more employment. Research limitations/implications Industrial data at the sub-branch level were obtained from the Economic Census (EC) of the National Institute of Geography and Statistics (INEGI). The EC information for 2004 was still not fully compatible with the North America Industry Classification System (NAICS), with 262 of the 309 data at the fourth-digit level aligned to the USA. In addition, industrial information from the EC is recorded every four years, which prevents this study to use panel data techniques and it makes it impossible to use time series methods. Practical implications Policymakers can clearly identify competition forces having a significant impact on employment growth. This can orient policymakers to implement measures to encourage the development of some of these clusters, as well as to identify some of the sources that drive specialization, competition and diversity. Originality/value This paper contributes to the debate on the existence of Marshallian (MAR), Jacobian and Porter externalities. This is the first study using the definition of traded clusters in Mexico, which allows the authors to identify how specialization, competition and diversity forces drive the dynamics of regional employment growth.

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