Is training doctors in medical certification effective? Evidence from a prospective study in the Philippines

2021 ◽  
pp. 183335832110592
Author(s):  
Jomilynn Rebanal ◽  
Tim Adair ◽  
Lene Mikkelsen
Keyword(s):  
Large Scale ◽  
Causes Of Death ◽  
Assessment Tool ◽  
International Classification Of Diseases ◽  
The Philippines ◽  
Long Term Effects ◽  
Medical Certification ◽  
The Impact

Background Correct certification of causes of death by physicians according to International Classification of Diseases (ICD) rules is essential to generate mortality statistics of the quality needed to guide public health policy debates and reliably monitor the impact of health interventions. Several efforts to train doctors have been undertaken in the Philippines to improve Medical Certification of Causes of Death (MCCOD). However, there is very little evidence about the long-term effects of training interventions for medical certification. Objective To test whether there were measurable long-term impacts of this large-scale training intervention for improving medical certification and reducing different types of certification errors. Method We assessed the quality of 2100 MCCOD completed before face-to-face training with those written by the same doctors 6 months after the training. An assessment tool was used to evaluate the quality of MCCOD. Results Less than 1% of the 2100 MCCOD assessed prior to the training were completely error-free, increasing to 19.2% 6 months after the training. On average, the number of errors per certificate fell from 2.2 pre-training to 1.3, six months after training. Importantly, there was a 38% decrease in writing ill-defined causes on the last line, which is particularly important for the policy utility of data. Conclusion Training doctors in correct medical certification can have a long-term impact on medical certification practices. Implications Shorter, more focused, trainings that address the most common medical certification errors could have an even greater impact on medical certification practices.

scholarly journals COVID-19 and cardiovascular comorbidity: novel approaches to reduce mortality

2021 ◽  
Vol 20 (4) ◽  
pp. 2953
Author(s):  
S. S. Bunova ◽  
P. I. Okhotnikova ◽  
Yu. P. Skirdenko ◽  
N. A. Nikolaev ◽  
O. A. Osipova ◽  
...  
Keyword(s):  
Large Scale ◽  
Mutual Influence ◽  
Inpatient Mortality ◽  
Long Term Effects ◽  
Cardiovascular Comorbidity ◽  
Novel Approaches ◽  
The Impact ◽  
Cvd Mortality

Cardiovascular diseases (CVDs) remain the leading cause of death worldwide and significantly affect patient quality of life and socioeconomic status. Numerous reports consistently demonstrate that CVDs are a major risk factor for severe course of coronavirus disease 2019 (COVID-19), including higher risks of hospitalizations and inpatient mortality. In the context of the current pandemic, managing patients with CVDs requires special attention from doctors. There are now more and more reports of the long-term effects of COVID-19. The long-term effects on cardiovascular system of millions of COVID-19 survivors are currently unknown. The aim of the review was to systematize the accumulated knowledge about the mutual influence of COVID-19 and CVDs. The features of CVD impact on the course and outcomes of COVID-19, as well as the reasons for the worsening of CVD course in patients with COVID-19 are considered. The impact of redistribution of health care resources and large-scale isolation measures on the management of patients with CVDs is discussed. The review also presents the most relevant data on long COVID. Predictors of a long-term disease course were identified for risk stratification in order to timely implement preventive measures and develop an individualized treatment. The authors focused on finding novel approaches to reduce CVD mortality during a pandemic.

Long-term Effects of Different Humidification Systems on Endotracheal Tube Patency

2004 ◽  
Vol 100 (4) ◽  
pp. 782-788 ◽  
Author(s):  
Samir Jaber ◽  
Jérôme Pigeot ◽  
Redouane Fodil ◽  
Salvatore Maggiore ◽  
Alain Harf ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Endotracheal Tube ◽  
Heated Humidifier ◽  
Long Term Effects ◽  
Moisture Exchanger ◽  
Acoustic Reflection ◽  
Heat And Moisture ◽  
The Impact

Background Accumulation of mucous secretions in an endotracheal tube (ETT) increases its resistance, and the amount of deposit may be affected by the quality of humidification and heating of the inspired gas. Methods The authors assessed the impact of two humidification systems, a heated humidifier (HH) and a hygroscopic-hydrophobic heat and moisture exchanger (HME), on the ETT patency in patients selected to require mechanical ventilation for more than 48 h. This comparison was performed over two consecutive periods and used the acoustic reflection method, which characterizes the amount and site of ETT obstruction and allows estimating ETT inner volume and resistance. Measurements were performed three times a week over the period of mechanical ventilation. Comparisons were performed at mid duration and at the end of the mechanical ventilation period. Results The HH was used in 34 patients, and the HME was used in 26 patients. The two groups had similar severity and duration of mechanical ventilation. At mid duration of mechanical ventilation (5.5 +/- 3.3 vs. 4.8 +/- 3.3 days; P = 0.4), no difference was observed in ETT volume and resistance between the two groups. At the end of the study period (10.5 +/- 5.8 vs. 9.6 +/- 6.3 days of mechanical ventilation; P = 0.4), ETT volume was reduced to a greater extent with HME than with HH (-3.3 +/- 2.9 vs. -5.1 +/- 2.5%; P = 0.008), and ETT resistance increased significantly more with the HME than with the HH (8.4 +/- 12.2 vs. 19.4 +/- 17.7%; P = 0.001). Conclusion Prolonged use of humidification systems results in progressive reduction of ETT patency, and to a greater extent with HMEs than with HHs.

scholarly journals A Qualitative Study Exploring the Impact and Effects Following Hospital Discharge of COVID-19

2021 ◽  
Vol 1 (3) ◽  
pp. 216-222
Author(s):  
Abigail Reay ◽  
Avinash Aujayeb ◽  
Catherine Dotchin ◽  
Ellen Tullo ◽  
John Steer ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Hospital Discharge ◽  
Psychological Effects ◽  
Functional Abilities ◽  
Long Term Effects ◽  
Structured Interviews ◽  
Discharge From Hospital ◽  
The Impact

Introduction: Research into the long-term effects of coronavirus disease 2019 (COVID-19) continues at an unprecedented pace. Many physical long-term symptoms of COVID-19 have been reported and include headache, fatigue, muscle pain and breathlessness, etc. Psychological effects are not dissimilar to survivors of SARS. There is limited qualitative research exploring the mental health impacts and experiences of hospitalized COVID-19 inpatients. Methods: A prospective qualitative study is planned to explore patient experiences post hospital discharge following a diagnosis of COVID-19. The research aims to gain an understanding of how COVID-19 affects quality of life (QoL) and functional abilities. Patients discharged from the hospital will be invited to take part in semi-structured interviews discussing their experiences of hospitalization and the impact of COVID-19 on their QoL. Interviews will be conducted at three and six months following discharge from hospital. This study will provide important qualitative insight and may inform clinical interventions and commissioning decisions. Trial registration: The study has Research Ethics Committee (REC) and Health Research Authority (HRA) approvals obtained from Health and Care Research Wales (HCRW) [IRAS project ID 293196].

The Effect of Private Customer-Manager Social Engagement Upon Online Booking Behavior

2020 ◽  
pp. 193896552097533
Author(s):  
Saram Han ◽  
Christopher K. Anderson
Keyword(s):  
Social Engagement ◽  
Large Scale ◽  
Term Effect ◽  
Third Party ◽  
Travel Agency ◽  
Long Term Effects ◽  
Individual Level ◽  
Customer Manager ◽  
The Impact

Owing to the impact of third-party commissions upon hotel profitability, many hotel brands have actively engaged in book direct campaigns, but to date, no large-scale longitudinal effort has been conducted to systematically evaluate direct booking behavior (i.e., direct versus online travel agency [OTA]). In this study, we use three years of transactional data from a large hotel brand to evaluate booking channel choices. To address the dynamic nature of the longitudinal individual-level data, we use a hidden Markov model (HMM), allowing us to evaluate both short- and long-term effects. Using the HMM, we evaluate the latent loyalty status of customers through their observed online booking channel behavior (i.e., direct versus OTA). As a result, we find that customer–manager engagement through guest satisfaction surveys (and managerial responses to those surveys) has a long-term effect on consumer propensities to book direct, gradually increasing customer loyalty to the brand. Specifically, we find that positive customer feedback signals a greater willingness to book direct in subsequent purchases. Moreover, managerial responses to the satisfied customer result in greater tendency to remain loyal and book direct. Second, the membership program tier of the customer has a significant short-term effect on the consumer’s propensity to book direct. Low-loyalty customers’ direct booking tendency increases as soon as they join the membership program. These findings not only illustrate the impact of membership status upon channel choice but also indicate the effect of the customer’s voice and the resulting managerial response upon booking behaviors over time.

Ban, Boom, and Echo! Entrepreneurship and Initial Coin Offerings

2020 ◽  
pp. 104225872094011 ◽  
Author(s):  
Cristiano Bellavitis ◽  
Douglas Cumming ◽  
Tom Vanacker
Keyword(s):  
Large Scale ◽  
Entrepreneurial Finance ◽  
Long Term Effects ◽  
Market Selection ◽  
Short Term ◽  
Regulatory Approach ◽  
Short And Long Term ◽  
Initial Coin Offerings

Regulatory spillovers occur when regulation in one country affects either the expected regulatory approach and/or entrepreneurial finance markets in other countries. Drawing on institutional theory, we investigate the global implications of a regulatory spillover on entrepreneurship. We argue that regulatory spillovers have both short- and long-term effects on the number and quality of entrepreneurial finance initiatives such as Initial Coin Offerings (ICOs). Based on a large-scale sample of ICOs in 108 countries, we find that a regulatory ban of ICOs in one country causes a short-term increase in the number of low-rated ICOs in other countries and a long-term drop in the number of ICOs, especially low-rated, which increases the average ICO rating. That is, a restrictive regulation triggered a process of increased market selection.

Systematic Review: Investigating the Impact of COVID-19 on Mental Health Outcomes of Individuals With ADHD

2021 ◽  
pp. 108705472110509
Author(s):  
Julie T. Behrmann ◽  
Julie Blaabjerg ◽  
Josefine Jordansen ◽  
Kristine M. Jensen de López
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Methodological Quality ◽  
Negative Impact ◽  
Positive Outcomes ◽  
Long Term Effects ◽  
Psychological Difficulties ◽  
The Impact

Background: According to the WHO, the COVID-19 pandemic could have a negative impact on the mental health of individuals, such as an exacerbation of existing difficulties. Individuals with ADHD may be specifically challenged by the pandemic. Aims: To provide a systematic review of evidence regarding the COVID-19’s impact on mental health of individuals with ADHD during the COVID-19 lockdown. Methods: This registered review (PROSPERO ID CRD42021238770) adhered to Prisma guidelines. Systematic searches in electronic databases PubMed and PsycINFO were carried out. A total of 12 studies covering 3,028 subjects were included. Results: COVID-19 pandemic is associated with increased ADHD symptoms and psychological difficulties. Some studies reported that individuals experienced positive outcomes. The methodological quality of the studies was low to moderate. Conclusion: COVID-19 can affect the mental health of individuals with ADHD negatively, although methodological limitations should be considered. Further research should generate knowledge about long-term effects impact of the pandemic and about appropriate support.

Recombinant Erythropoietin and Survival in Myelodysplastic Syndromes.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 2539-2539 ◽  
Author(s):  
Pellegrino Musto
Keyword(s):  
Overall Survival ◽  
Clinical Outcome ◽  
Myelodysplastic Syndromes ◽  
Causes Of Death ◽  
Lower Percentage ◽  
Recombinant Erythropoietin ◽  
Long Term Effects ◽  
Published Evidence ◽  
The Impact

Abstract Several reports have recently raised the question of whether the use of recombinant erythropoietin (r-EPO) may influence clinical outcome and survival of neoplastic patients who receive this drug along with the therapy for their disease. r-EPO is frequently employed for the treatment of anemia in myelodysplastic syndromes (MDS). The efficacy of r-EPO in these patients have been extensively investigated in terms of improvement of Hb levels and quality of life parameters and its use is now recommended in selected settings of MDS. However, there is very small published evidence about the long term effects of r-EPO in patients with MDS and, above all, about its possible relationship with survival. In particular, low-risk MDS, which generally do not receive cytostatic treatments, represent an interesting model to evaluate the impact of r-EPO on the natural history of these diseases. We performed a retrospective analysis on our patients with MDS which was focused on determining overall survival and causes of death in relationship to the use or not of r-EPO. Between 1986 and 2001, 346 patients affected by MDS were identified in our database. Among them, we selected 169 anemic (Hb < 10 g/dl) patients with well defined diagnosis of MDS according to FAB criteria (excluding CMMoL and RAEB-T), low-intermediate IPSS score (retrospectively assessed) and regular follow-up. Ninety-nine patients belonged to the pre-r-EPO era or had never received r-EPO for other reasons. Seventy patients had instead received r-EPO for at least 8 weeks during the course of their disease. The two groups (r-EPO no/r-EPO yes) resulted comparable for age, type of diagnosis, additional treatments, Hb levels and transfusion requirement. Among patients who received r-EPO, 22 (31.4%) achieved an hematological erythroid improvement (HI-E), according to IWG criteria. In these patients the drug was given for 5–51 months (median 19). There was no difference between the two groups in terms of leukemic evolution (19% vs 21% at 4 years) and causes of death (infections, hemorrhages, second tumors, cardiovascular events). No death could be directly attributable to r-EPO. Median overall survival was also not statistically different between patients who had received (45 months) or not (41 months) r-EPO. However, when survival was analysed according to response to r-EPO, it was found significantly longer (p < 0.02) in responders (median 54 months) than in non-responders (median 37 months), as well as than in subjects who had never received the drug. Such a difference was not modified by the time (early, during the first year from diagnosis, or later) of r-EPO administration. Response to r-EPO was associated with baseline lower levels of endogenous EPO, lower percentage of marrow blasts and higher Hb values. At multivariate analysis, however, response to r-EPO maintained an independent favourable prognostic value on survival. This is the first large study focused on the long-term clinical outcome of MDS analysed according to the role of r-EPO. Our data indicate that the prolonged administration of this drug is safe and that response to r-EPO is significantly associated with better survival in MDS patients.

ANALYSIS OF THE IMPACT OF MINDFULNESS ON QUALITY OF LIFE IN PATIENTS WITH MULTIPLE SCLEROSIS: SYSTEMATIC REVIEW

2021 ◽  
Vol 9 (06) ◽  
pp. 378-388
Author(s):  
Vitória Mallmann Fedeger ◽  
Erica Pedri ◽  
Rosiane Guetter Mello ◽  
Alexandre Leal Laux
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Systematic Review ◽  
Long Term Effects ◽  
General Quality ◽  
Detailed Assessment ◽  
The Impact ◽  
Brazilian Studies

This study aimed to investigate the impact of the mindfulness-based interventions program on the quality of life of patients with Multiple Sclerosis. A systematic review was carried out based on the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyzes). For an updated perspective on the topic, the selected articles were published from March 2014 to March 2019. Thus, 10 articles were included in the review and were thoroughly compared. A detailed assessment was carried out to measure the impact of the mindfulness protocol both on the general quality of life and on its specific domains. It can be observed that there is some homogeneity of the results regarding the benefits of the practice of mindfulness in the patients’ general quality of life. Moreover, there was greater evidence of the effects of meditative practice on the psychological domain when compared to the physical domain. Hence, the present study considers the mindfulness program a viable tool to address quality of life in patients with Multiple Sclerosis. The lack of Brazilian studies in the area is highlighted. Also, further studies to evaluate the practice of mindfulness continuously, such as cohort studies, are necessary to elucidate the long-term effects of the protocol. 

scholarly journals The Efficiency of Spa Rehabilitation in Chronic Ischemic Stroke Patients—Preliminary Reports

2021 ◽  
Vol 11 (4) ◽  
pp. 501
Author(s):  
Bogumiła Pniak ◽  
Justyna Leszczak ◽  
Jadwiga Kurczab ◽  
Aleksandra Krzemińska ◽  
Joanna Pięta ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Ischemic Stroke ◽  
Rehabilitation Program ◽  
Stroke Onset ◽  
Long Term Effects ◽  
Functional Efficiency ◽  
The Impact

Background: Rehabilitation-oriented therapy after a stroke must continue in various forms as a life-long effort. Aim: The study investigated the impact of spa rehabilitation on the quality of life and functional efficiency in patients after an ischemic stroke at a chronic stage of recovery. Methods: The assessment was carried out in a spa resort in southeastern Poland. It involved 32 patients with strokes who participated in a three-week rehabilitation program. Three examinations were performed: upon admission, on the day of discharge and at a two-month follow-up. The quality of life and functional efficiency were assessed with the WHOQOL-BREF and Barthel Index. Results: The quality of life was significantly higher in Exam II compared with Exam I (p < 0.001), and improvement was retained at the follow-up. The Barthel scores were higher in Exam II compared with Exam I (79.84 vs. 68.59), while the differences between the scores in Exams II and III were small (p = 0.039). Conclusions: Three-week spa rehabilitation seems to favorably affect the functional efficiency and quality of life after a stroke. The effects appear to be long-term. The gender, age and time from stroke onset do not seem to impact short-term effects. However, long-term effects are related to the time from stroke onset.

SUMBER-SUMBER RESILIENSI PADA REMAJA AKHIR YANG MENGALAMI KEKERASAN DARI ORANGTUA PADA MASA KANAK-KANAK

Psibernetika ◽  
2018 ◽  
Vol 11 (1) ◽  
Author(s):  
Devina Calista ◽  
Garvin Garvin
Keyword(s):  
Late Adolescents ◽  
Long Term Effects ◽  
Short Term ◽  
Parental Affection ◽  
Resilience Factors ◽  
Childhood Violence ◽  
Past Experiences ◽  
The Impact ◽  
Depth Interviews

<p><em>Child abuse by parents is common in households. The impact of violence on children will bring short-term effects and long-term effects that can be attributed to their various emotional, behavioral and social problems in the future; especially in late adolescence that will enter adulthood. Resilience factors increase the likelihood that adolescents who are victims of childhood violence recover from their past experiences</em><em>,</em><em> become more powerful individuals and have a better life. The purpose of this study was to determine the source of resilience in late adolescents who experienced violence from parents in their childhood. This research uses qualitative research methods with in-depth interviews as a method of data collection. The result shows that the three research participants have the aspects of "I Have", "I Am", and "I Can"; a participant has "I Can" aspects as a source of resilience, and one other subject has no source of resilience. The study concluded that parental affection and acceptance of the past experience have role to the three sources of resilience (I Have, I Am, and I Can)</em></p><p><em> </em></p><p><strong><em>Keyword : </em></strong><em>Resilience, adolescence, violence, parents</em></p>

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