scholarly journals Frequency of the requirement of inappropriate uncuffed tracheal tube size for pediatric patients: a retrospective observational analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hiroshi Hanamoto ◽  
Hikaru Nakagawa ◽  
Hitoshi Niwa
Keyword(s):  
Logistic Model ◽  
Oral Surgery ◽  
Leak Rate ◽  
Outcome Variable ◽  
Size Difference ◽  
Air Leakage ◽  
Leak Test ◽  
Endotracheal Tubes ◽  
Explanatory Variables ◽  
Multivariate Logistic Model

Abstract Background The insertion of inappropriately sized uncuffed endotracheal tubes (ETTs) with a tight seal or presence of air leakage may be necessary in children. This study aimed to analyze the frequency of the requirement of inappropriately sized uncuffed ETT insertion, air leakage after the ETT was replaced with one of a larger size, and factors associated with air leakage after ETT replacement. Methods Patients under 2 years of age who underwent oral surgery under general anesthesia with uncuffed ETTs between December 2013 and May 2015 were enrolled. The ETT size was selected at the discretion of the attending anesthesiologists. A leak test was performed after intubation. The ETT was replaced when considered necessary. Data regarding the leak pressure (PLeak) and inspiratory and expiratory tidal volumes were extracted from anesthesia records. We considered a PLeak of 10 < PLeak ≤ 30 cmH2O to be appropriate. The frequencies of the requirement of inappropriately sized ETTs, absence of leakage after ETT replacement, ETT size difference, and leak rate were calculated. A logistic regression was performed, with PLeak, leak rate, and size difference included as explanatory variables and presence of leakage after replacement as the outcome variable. Results Out of the 156 patients enrolled, 109 underwent ETT replacement, with the requirement of inappropriately sized ETTs being observed in 25 patients (23%). ETT replacement was performed in patients with PLeak ≤ 10 cmH2O; leakage was absent after replacement (PLeak < 30 cmH2O) in 52% of patients (25/48). In the multivariate logistic model, the leak rate before ETT replacement was significantly associated with the presence of leakage after replacement (p = 0.021). Conclusions Inappropriately sized ETTs were inserted in approximately 23% of the patients. The leak rate may be useful to guide ETT replacement.

scholarly journals The Determinants of Telehealth Provision: Empirical Evidence from OECD Countries

2021 ◽  
Vol 18 (16) ◽  
pp. 8288
Author(s):  
Fuhmei Wang ◽  
Jung-Der Wang
Keyword(s):  
Health Services ◽  
Health Spending ◽  
Well Being ◽  
Oecd Countries ◽  
Outcome Variable ◽  
Explanatory Variables ◽  
Telehealth Service ◽  
Increase Productivity ◽  
Number Of Individuals ◽  
Health And Well Being

Health services provided through the telecommunications system aim to improve the population’s health and well-being. This research aims to explore what digital, economic, and health factors are associated with the provision of telehealth services, especially in ageing communities. Applying Organization for Economic Cooperation and Development (OECD) countries’ experiences, this research tries to construct a logistic regression model between adopting a telehealth system or not, a binary outcome variable, and a group of potentially explanatory variables. Estimation results showed that there were thresholds for telehealth provision: The demand for telehealth service usually began when the provision of telecommunication accessibility reached 50%, the proportion of elders exceeded 10%, or the proportion of health spending occupied more than 3–5% of the gross domestic product (GDP); the slope of each variable seemed to correspond with an increase in demand for such a provision. A growing number of individuals in OECD countries are now readily served by telehealth systems under the COVID-19 pandemic. These findings could be regarded as a model for other countries for implementing the necessary infrastructure early on when any of these parameters reaches its threshold. Moreover, telehealth applied in developing countries could be elevated for wider populations to access basic health services and for the remote delivery of health care. A rational decision could be made to appropriately use additional resources in telehealth provision. With accessible e-health services, the population’s health could be improved, which in turn would possibly increase productivity and social welfare.

scholarly journals Factor associated with self-reported work-related musculoskeletal disorders in Brazilian adults

2017 ◽  
Vol 51 (suppl 1) ◽  
Author(s):  
Ada Ávila Assunção ◽  
Mery Natali Silva Abreu
Keyword(s):  
Logistic Models ◽  
Population Based ◽  
Brazilian Population ◽  
Outcome Variable ◽  
Cross Sectional ◽  
Significance Level ◽  
Explanatory Variables ◽  
Factors Associated ◽  
Work Related ◽  
And Gender

ABSTRACT OBJECTIVE To describe the prevalence of work-related musculoskeletal disorder (WMSD) and analyze the factors associated with this outcome in the Brazilian population. METHODS In this cross-sectional, population-based study, we use data from the National Survey on Health (PNS) of 2013. The sample was composed of 60,202 Brazilians aged 18 years or older. The outcome variable was the occurrence of self-reported WMSD. Sociodemographic and occupational characteristics, personal resources, and health conditions were investigated as explanatory variables. Analyses were performed with the software Stata 12.0 and considered the weighting imposed by the sampling design of the study. Then, univariate and multivariate binary logistic models were carried out, considering a significance level of 5%. RESULTS The results obtained indicated that the prevalence of WMSD in the Brazilian population was of 2.5%, ranging from 0.2% (Acre) to 4.2% (Santa Catarina). The factors associated with a greater chance of occurrence of WMSD were: female sex (OR = 2.33; 95%CI 1.72–3.15); be temporarily away from work (OR = 2.44; 95%CI 1.41–4.23); be exposed to noise at the workplace (OR = 2.16; 95%CI 1.68–2.77); seniority equal to or greater than 4.5 years at the current job (OR = 1.37; 95%CI 1.09–1.72); participate in volunteer work (OR = 1.65; 95%CI 1.25–2.17); report medical diagnosis of arthritis or rheumatism (OR = 2.40; 95%CI 1.68–3.44); and depression (OR = 2.48; 95%CI 1.86–3.31). On the other hand, factors associated with less chance of WMSD were: not having a partner (OR = 0.73; 95%CI 0.37–0.71) and working in an open environment (OR = 0.51; 95%CI 0.37–0.71). CONCLUSIONS The associated factors and the prevalence found indicate regional and gender differences. Special attention to comorbidities and environmental noise monitoring would benefit the health of workers in the Country.

scholarly journals The Complex Relationship Between Veterinarian Mental Health and Client Satisfaction

2020 ◽  
Vol 7 ◽  
Author(s):  
Jennifer L. Perret ◽  
Colleen O. Best ◽  
Jason B. Coe ◽  
Amy L. Greer ◽  
Deep K. Khosa ◽  
...  
Keyword(s):  
Mental Health ◽  
Client Satisfaction ◽  
Poor Mental Health ◽  
Personal Accomplishment ◽  
Outcome Variable ◽  
Linear Regression Models ◽  
Health States ◽  
Explanatory Variables ◽  
Health Measures ◽  
The Impact

A relatively high risk of poor mental health has been described among Canadian veterinarians, but no published studies have explored the impact that veterinarian mental health may have on veterinary clients and patients. In order to investigate the association between veterinarian mental health and veterinary client satisfaction, veterinarians were randomly sampled and recruited throughout southwestern Ontario, Canada, from November, 2017, through January, 2019. Sixty participating veterinarians completed an enrollment survey that included psychometric scales measuring resilience, perceived stress, anxiety, depression, emotional distress, emotional exhaustion, depersonalization, personal accomplishment, burnout, secondary traumatic stress, and compassion satisfaction. Nine hundred and ninety-five companion animal clients of these veterinarians were recruited in-clinic over 2–3 days and completed a post-appointment survey including the Client Satisfaction Questionnaire. The associations between clients' satisfaction scores (as the outcome variable) and each of the veterinarians' mental health measures (as the explanatory variables) were assessed using separate, multilevel, multivariable linear regression models. The associations between client satisfaction and veterinarian mental health measures were non-linear and complex; in several of the models, relatively higher client satisfaction was unexpectedly associated with poor veterinarian mental health states, while lower client satisfaction was associated with mental health scores suggesting wellness. Given that client satisfaction may impact client adherence to medical recommendations, client loyalty, and business income, the association with veterinarian mental health may have broad implications and warrants further investigation.

Knowledge transfer and managers turnover: impact on team performance

2019 ◽  
Vol 25 (1) ◽  
pp. 69-83 ◽  
Author(s):  
Raffaele Trequattrini ◽  
Maurizio Massaro ◽  
Alessandra Lardo ◽  
Benedetta Cuozzo
Keyword(s):  
Knowledge Transfer ◽  
Performance Improvement ◽  
Team Performance ◽  
Negative Impact ◽  
Research Question ◽  
Qualitative Comparative Analysis ◽  
Sport Performance ◽  
Outcome Variable ◽  
Content Type ◽  
Explanatory Variables

PurposeThe paper aims to investigate the emerging issue of knowledge transfer and organisational performance. The purpose of this paper is to investigate the importance of knowledge transfer in obtaining high and positive results in organisations, in particular, studying the role of managers’ skills transfer and which conditions help to achieve positive performance.Design/methodology/approachThe research analyses 41 cases of coaches that managed clubs competing in the major international leagues in the 2014–2015 season and that moved to a new club over the past five seasons. The authors employ a qualitative comparative analysis (QCA) methodology. According to the research question, the outcome variable used is the team sport performance improvement. As explanatory variables, the authors focus on five main variables: the history of coach transfers; the staff transferred; the players transferred; investments in new players and the competitiveness.FindingsThe overall results show that when specific conditions are realised simultaneously, they allow team performance improvement, even if the literature states that the coach transfers show a negative impact on outcomes. Interestingly, this work reaches contrasting results because it shows the need for the coexistence of combinations of variables to achieve the transferability of managers’ capabilities and performance.Originality/valueThe paper is novel because it presents a QCA that tries to understand which conditions, factors and contexts help knowledge to be transferred and to contribute to the successful run of organisations.

Clinical Efficacy of Jejunojejunostomy Leak Test Using Methylene Blue During Laparoscopic Roux-en-Y Gastric Bypass on Post-Operative Leak Rate

2018 ◽  
Vol 6 (2-3) ◽  
Author(s):  
Masood Amini ◽  
Mohammad Hassan Hashemizadeh ◽  
Masood Sepehrimanesh ◽  
Seyedeh Leila Poorbaghi ◽  
Razieh Naseri Mojarrad ◽  
...  
Keyword(s):  
Methylene Blue ◽  
Gastric Bypass ◽  
Clinical Efficacy ◽  
Leak Rate ◽  
Leak Test

scholarly journals Barriers to cognitive screening in acute stroke units

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Tamar Abzhandadze ◽  
Dongni Buvarp ◽  
Åsa Lundgren-Nilsson ◽  
Katharina S. Sunnerhagen
Keyword(s):  
Acute Stroke ◽  
Care Facility ◽  
Sociodemographic Factors ◽  
Screening Tools ◽  
Outcome Variable ◽  
Cognitive Screening ◽  
Stroke Units ◽  
Explanatory Variables ◽  
Tree Methods ◽  
Selection Operator

AbstractCognitive impairment is common after stroke. However, not all patients with stroke undergo cognitive screening, despite recommendations. The aim of this retrospective, explorative study was to examine the barriers to cognitive screening in acute stroke units. Data were retrieved from two Swedish Stroke registries. The outcome variable was cognitive screening during the stay at acute stroke units. Forty-three candidate explanatory variables were considered for analysis, encompassing sociodemographic factors and stroke-related outcomes during the stay at acute stroke units. The Least Absolute Shrinkage and Selection Operator and decision-tree methods were used. Of the 1120 patients (56% male, mean age: 72 years, 50% with mild stroke), 44% did not undergo cognitive screening. Walking 10 m post-stroke was the most important attribute for decisions regarding cognitive screening. The classification accuracy, sensitivity, and specificity of the model were 70% (95% CI 63–75%), 71% (63–78%), and 67% (55–77%), respectively. Patient-related parameters that influenced cognitive screening with a valid and reliable screening instrument in acute stroke units included new stroke during the hospitalisation, aphasia at admission, mobility problems, impaired verbal output skills, and planned discharge to another care facility. The barriers to cognitive screening were both patient- and organisation-related, suggesting the need for patient-tailored cognitive screening tools as well as the implementation and systematic adherence to guidelines.

scholarly journals Disabled People in Brazil: Risk Question

2018 ◽  
Author(s):  
Paulo de Oliveira
Keyword(s):  
Logistic Model ◽  
Risk Index ◽  
Poverty Rate ◽  
Decent Work ◽  
Visual Disability ◽  
Explanatory Variables ◽  
Number Of Children ◽  
Ordinal Response ◽  
Education Levels ◽  
Production Form

Throughout the world, disabilities people have worse health prospects, lower education levels, lower economic participation, and higher poverty rate in comparative terms to people without disabilities. For disabilities people achieve better, more long-lasting prospects, we must empower these people and remove barriers that restrict them from participating in the community have access to quality education, to find decent work and have their voices heard. In statistical terms, a very useful alternative that can provide support and monitoring of public policies in this area is proposing to be used continuously. A risk index called risk index disabled person who is to assess which factors are associated to this risk, as well as the intensity and direction of each of these factors, yielding a final score that can be sorted or classified according to the probability of people acquire a certain disability. In the Brazilian case, we propose the use of techniques such as binary and ordinal logistic regression to select the most significant factors using criteria such as AIC, BIC and DIC. Calculate the risk probability for different disabilities (see, hear, move and intellectual) and number of disabilities to the dataset Sample of respondents for Full Questionnaire at IBGE 2010 Census. In this work, by using stereotype ordinal logistic model with ordinal response, it was possible to improve the fit quality, to be compared with binary response logistic model. By using ordinal response merged the disability risk for different severity degree and amount of deficiencies. Mains conclusions were: i)the model required a smaller number of explanatory variables was intellectual or mental and greater number was disabilities; ii) the most sensitive adjust was using stereotype ordinal logistic; iii) different disabilities aren&acute;t homogenous as the different predictor variables, and finally; iv) higher incidence of risks were noted visual disability, living in the northeast, female, age 80, yellow race, instruction level until incomplete fundamental, works production form their own consumption and high number of children.

scholarly journals Wellbeing during the first wave of the COVID-19 pandemic among adults in Nigeria: Associations with psychosocial and pandemic-related factors

2021 ◽  
Author(s):  
Olanrewaju Ibikunle Ibigbami ◽  
Olakunle Ayokunmi Oginni ◽  
Ibidunni Olapeju Oloniniyi ◽  
Victor Ugo ◽  
Matthew Ebuka ◽  
...  
Keyword(s):  
Social Support ◽  
Perceived Social Support ◽  
Tertiary Education ◽  
Depression Scale ◽  
Outcome Variable ◽  
Anxiety And Depression ◽  
Physical And Mental Health ◽  
Explanatory Variables ◽  
Perceived Impact ◽  
The Impact

Abstract Background: Psychosocial factors including stress are determinants of wellbeing. However, there is a shortage of information about how these relationships were impacted by the COVID-19 pandemic among adults in Nigeria.Objectives: To determine the associations between wellbeing, and impact of the COVID-19 pandemic, psychological distress (anxiety and depression), and perceived social support among adults in Nigeria during the first wave of the pandemic.Methods: Wellbeing (assessed using the WHO Wellbeing Index) was the outcome variable while the explanatory variables included anxiety and depressive symptoms (assessed using the Hospital Anxiety and Depression Scale), perceived social support (assessed using the Multidimensional Scale of Perceived Social Support) and perceived impact of the pandemic (assessed using perceived disruptions of life-domains). Univariate and multivariate logistic regression models were used to assess the associations between the outcome and explanatory variables. The models were adjusted for sociodemographic profile (highest level of education, employment status and payment status).Results: Low self-perceived impact of the pandemic was significantly associated with higher odds of high wellbeing (AOR: 2.59; 95% CI: 1.69-3.95; p<0.001). Other factors associated with significantly higher odds of high wellbeing were high perceived social support (AOR: 2.40; 95% CI:1.78-3.22; p<0.001) and having tertiary education (AOR: 1.51; 95% CI: 1.07-2.13; p=0.020). In contrast, experiencing anxiety symptoms were significantly associated with lower odds of high wellbeing (AOR: 0.24; 95% CI: 0.14-0.41; p<0.001)).Conclusions: Measures for enhancing the wellbeing of adults resident in Nigeria may include strategies to ameliorate the impact of the pandemic, strengthening social support systems, and promoting optimal physical and mental health.

A multivariate logistic regression model based on 3T mpMRI, clinical, and biopsy parameters for the prediction of prostate cancer extracapsular extension.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 27-27
Author(s):  
Sohrab Afshari Mirak ◽  
Steven Raman
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Regression Model ◽  
Predictive Value ◽  
Logistic Model ◽  
Extracapsular Extension ◽  
Adc Value ◽  
Model Based ◽  
Multivariate Logistic Model ◽  
Patient Size

27 Background: Extracapsular extension (ECE) of prostate cancer (PCa) is a poor prognostic factor associated with progression, recurrence after treatment and increased PCa- related mortality. Accurate staging prior to radical prostatectomy is crucial in avoidance of positive margins and when planning nerve-sparing procedures. This study investigated the predictive value of clinical, biopsy & 3TmpMRI parameters using a multivariate logistic model for per-lesion detection of PCa ECE with wholemount histopathology (WMHP) as reference. Methods: This IRB approved, HIPAA compliant study included 575 patients with 774 true positive PCa lesions, who underwent radical prostatectomy between 7/2010-2/2019. The relationship between pathologic ECE & parameters including clinical; age, prostate specific antigen (PSA) & PSA density (PSAD), biopsy; percentage of positive systematic cores & Gleason score (GS) & 3TmpMRI; prostate volume, number of lesions per patient, size, location, level, PIRADSv2 score, laterality, apparent diffusion coefficient (ADC) value & risk of ECE on MRI was evaluated using bivariate and multivariate analysis. The accuracy of the final model was evaluated using ROC analysis. Results: 27.8% (215/774), 42.9% (332/774) & 29.3% (227/774) of the lesions were PIRADSv2 score 3, 4 & 5 & 59.9% (464/774), 24.7% (191/774) & 17.7% (137/774) were low, intermediate & high risk for ECE, respectively. 23.6% (183/774) of the lesions had ECE on WMHP. On bivariate analysis higher PSA, PSAD, percentage of positive biopsy cores, biopsy GS, size, PIRADSv2 score, ADC value, risk of ECE on MRI, location (posterior), level(midgland & base), bilaterality & lower number of lesions per patient were significant for ECE prediction. The multivariate logistic model included age, PSAD, number of lesions per patient, size, location, level, PIRADSv2 score & risk of ECE on MRI. The AUC for the prediction of ECE for this model was 0.85. Conclusions: This multivariate regression model based on clinical, biopsy & 3TmpMRI parameters have a high predictive value for pathology ECE detection.

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