scholarly journals Availability, timeliness, documentation and quality of consultations among hospital departments: a prospective, comparative study

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Amir Jarjou’i ◽  
Joseph Mendlovic ◽  
Ziv Dadon ◽  
Marwan Abu Sneineh ◽  
Meir Tabi ◽  
...  
Keyword(s):  
Emergency Room ◽  
Medical Model ◽  
Policy Decision ◽  
Medical Department ◽  
Convenience Sample ◽  
Medical Consultations ◽  
Consultation Request ◽  
Medical Wards ◽  
Key Aspects

Abstract Background Many in-patients require care from practitioners in various disciplines. Consultations most probably have significant implications for hospitalization outcomes. Purpose To determine key aspects of consultations provided by various departments to formulate an optimal policy. Methods This study comprised two methods: first, a questionnaire was completed in 2019 by 127 physicians interns, residents and senior doctors) from the medical and surgical departments (64 from the surgical wards, 43 from the medical wards and 22 from the emergency room and General ICU) regarding the availability, timeliness and documentation rate of the consultations they received from different disciplines. The investigators rounded through the various departments that were included in the study and they accosted a sample of interns, residents and attending physicians, who were then asked to fill the questionnaire. Overall compliance of filling the questionnaire was 95%. Residents accounted for 72% of the filled questionnaires, seniors and interns accounted for 15 and 13% respectively. Second, a convenience sample of 300 electronic records of hospitalized patients (135 from the surgical wards, 129 from the Medical wards and 36 from the emergency room and General ICU) of actually carried out consultations was reviewed for validated indicators of quality for both the consultation request and response. We used a 5-point Likert scale, ranging from poor (1) to superb (5), to grade the measured parameters. Results The availability, timeliness and documentation rate for medical consultations were 4 ± 0.9, 4.1 ± 0.9 and 4.3 ± 0.9 respectively, as compared with surgical consultations 3.2 ± 1.1, 3.4 ± 1.2 and 3.6 ± 1.2 respectively (P < 0.001). The mean time (in hours) from the consultation request till documentation (of the requested consultation) by consultants in the medical and surgical departments was 3.9 ± 5.9 and 10.0 ± 15.6, respectively (P < 0.001). The quality of requests of consultations from the medical and surgical departments was 3.4 ± 1.1 and 2.8 ± 1.2, respectively (P < 0.001). Two different models of consultations are employed: while each medical department adopts several departments for medical consultations, each day’s on-call surgeon provides all the hospital’s surgical consultations. Conclusion We detected significant differences in key aspects of consultations provided by the departments. The medical model of consultations, in which each medical department adopts several other wards to which it provides consulting services upon request, should probably be adopted as a major policy decision by hospitals directors to enhance inter-departmental consultations.

Sergio Leone

2020 ◽  
Author(s):  
Christian Uva
Keyword(s):  
National Identity ◽  
Political Interest ◽  
Current Events ◽  
Classical Models ◽  
Key Aspects ◽  
Sergio Leone

Spectacle, myth, fable. These are the main categories that have traditionally defined Sergio Leone’s cinematic production, but it is necessary to underline how much they are fueled by a profound, layered political interest. Leone’s cinema bears witness to a critical outlook both on the subjects it showcases and on its representational means. Far from any militancy and escaping ideological classifications, Leone’s perspective is problematic and unreconciled: it is grounded in the coexistence of different elements in a state of perennial productive tension and instability. The adjective “political” takes on a deeper meaning when it is used to denote the director’s ability to narrate and interpret key aspects of Italian national identity and history. The abstract quality of his production relies on an original use of different genres, particularly sword-and-sandal and the Spaghetti Western, which allowed Leone to insert frequent symbolic references to both history and then-current events. On the stylistic level, his constant disobedience to classical models and his need to revolutionize forms were motivated by an authorial desire to make films politically, though still within a conception of cinema as an industrial spectacle.

scholarly journals Beneficial Effects of Remote Medical Care for Patients with Hereditary Hemorrhagic Telangiectasia during the COVID-19 Pandemic

2021 ◽  
Vol 10 (11) ◽  
pp. 2311
Author(s):  
Eleonora Gaetani ◽  
Fabiana Agostini ◽  
Luigi Di Martino ◽  
Denis Occhipinti ◽  
Giulio Cesare Passali ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Emergency Room ◽  
Medical Care ◽  
Hereditary Hemorrhagic Telangiectasia ◽  
Iron Supplementation ◽  
Quality Care ◽  
Psychological Status ◽  
Blood Transfusions ◽  
Emergency Room Visits

Background: Hereditary hemorrhagic telangiectasia (HHT) needs high-quality care and multidisciplinary management. During the COVID-19 pandemic, most non-urgent clinical activities for HHT outpatients were suspended. We conducted an analytical observational cohort study to evaluate whether medical and psychological support, provided through remote consultation during the COVID-19 pandemic, could reduce the complications of HHT. Methods: A structured regimen of remote consultations, conducted by either video-calls, telephone calls, or e-mails, was provided by a multidisciplinary group of physicians to a set of patients of our HHT center. The outcomes considered were: number of emergency room visits/hospitalizations, need of blood transfusions, need of iron supplementation, worsening of epistaxis, and psychological status. Results: The study included 45 patients who received remote assistance for a total of eight months. During this period, 9 patients required emergency room visits, 6 needed blood transfusions, and 24 needed iron supplementation. This was not different from what was registered among the same 45 patients in the same period of the previous year. Remote care also resulted in better management of epistaxis and improved quality of life, with the mean epistaxis severity score and the Euro-Quality of Life-Visual Analogue Scale that were significantly better at the end than at the beginning of the study. Discussion: Remote medical care might be a valid support for HHT subjects during periods of suspended outpatient surveillance, like the COVID-19 pandemic.

scholarly journals On Examining the Quality of Spanish Translation in Telephone Surveys: A Novel Test-Retest Approach

2019 ◽  
Vol 8 (4) ◽  
pp. 691-705
Author(s):  
Robert P Agans ◽  
Quirina M Vallejos ◽  
Thad S Benefield
Keyword(s):  
Past Research ◽  
Population Based ◽  
Pilot Test ◽  
Spanish Translation ◽  
Convenience Sample ◽  
Single Item ◽  
Telephone Surveys ◽  
Survey Questions ◽  
Health Related

Abstract Past research has shown that commonly reported cultural group disparities in health-related indices may be attributable to culturally mediated differences in the interpretation of translated survey questions and response scales. This problem may be exacerbated when administering single-item survey questions, which typically lack the reliability seen in multi-item scales. We adapt the test-retest approach for single-item survey questions that have been translated from English into Spanish and demonstrate how to use this approach as a quick and efficient pilot test before fielding a major survey. Three retest conditions were implemented (English-Spanish, Spanish-English, and English-English) on a convenience sample (n = 109) of Latinos and non-Latinos where translated items were compared against an English-English condition that served as our control. Several items were flagged for investigation using this approach. Discussion centers on the utility of this approach for evaluating the Spanish translation of single-item questions in population-based surveys.

scholarly journals Effects of an eHealth Intervention on Patient-Provider Interaction and Functional Health Literacy in Adults With Hypertension

2021 ◽  
Vol 7 ◽  
pp. 237796082110058
Author(s):  
Ronald L. Hickman ◽  
John M. Clochesy ◽  
Marym Alaamri
Keyword(s):  
Health Literacy ◽  
Community Dwelling ◽  
Attention Control ◽  
Functional Health ◽  
Self Management ◽  
Functional Health Literacy ◽  
Convenience Sample ◽  
Management Interventions ◽  
Modifiable Factors

Introduction Hypertension is a life-limiting, chronic condition affecting millions of Americans. Modifiable factors, quality of the patient-provider interaction and functional health literacy, have been linked to effective hypertension self-management. However, there has been limited interventional research targeting these modifiable factors. Electronic hypertension self-management interventions, in particular those incorporating virtual simulation, may positively influence the quality of the patient-provider interaction and functional health literacy status of adults with hypertension. Yet there is a dearth of evidence examining the efficacy of eHealth interventions targeting these modifiable factors of hypertension self-management. Objective Evaluate the effects of two electronic hypertension self-management interventions on the quality of the patient-provider interaction and functional health literacy in adults with hypertension. Methods A convenience sample of community-dwelling adults (>18 years) with hypertension were recruited and randomized to an avatar-based simulation (eSMART-HTN) or a video presentation on hypertension self-management (attention control). Participants were administered questionnaires to capture demographic characteristics, the quality of the patient-provider interaction, and functional health literacy. Questionnaire data were collected at baseline, and then monthly across three months. Two separate repeated measures analysis of covariance models were conducted to assess the effects of the interventions across the time points. Results The sample included 109 participants who were predominately middle-aged and older, nonwhite, and female. Scores for the quality of the patient-provider interaction demonstrated significant within-group changes across time. However, there were no significant differences in the quality of the patient-provider interaction or functional health literacy scores between experimental conditions while adjusting for covariates. Conclusion An avatar-based simulation (eSMART-HTN) intervention proved to have a positive effect on patient-provider interaction compared to an attention control condition. Although the results are promising, future research is needed to optimize the effectiveness of eSMART-HTN and enhance its efficacy and scalability in a larger cohort of adults with hypertension.

K out of N Secret Sharing Scheme for Multiple Color Images with Steganography and Authentication

2016 ◽  
Vol 16 (02) ◽  
pp. 1650010 ◽  
Author(s):  
P. Mohamed Fathimal ◽  
P. Arockia Jansi Rani
Keyword(s):  
Secret Sharing ◽  
Visual Quality ◽  
Color Images ◽  
Pixel Expansion ◽  
Image Sharing ◽  
Digital Ecosystem ◽  
Sharing Scheme ◽  
Text Steganography ◽  
Key Aspects

With our lives trundling toward a fully-digital ecosystem in break-neck speed, today’s encryption and cryptography are facing the challenge of ensuring security and future-readiness of our transactions. When such transactions involve multiple hands, transmission of such data in discrete and recoverable parts (secret shares) guarantees confidentiality. This paper’s objective is to present a foolproof way of multiple secret sharing, eliminating issues such as half-toning and degradation of visual quality of the recovered images. This [Formula: see text] out of [Formula: see text] steganography and authenticated image sharing (SAIS) scheme for multiple color images generates [Formula: see text] relevant shares with the ability to reconstruct the secret images using [Formula: see text] shares and facility to find out any move for appropriation of share cover images. The key aspects of this proposed scheme is to use simple Boolean and arithmetic operations with reduction of computational complexity from [Formula: see text] to [Formula: see text] and to share multiple images without any pixel expansion.

Abstract P258: Racial Disparity in 90-Day Post-Stroke Readmission - An MUSC Perspective

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Pratik Y Chhatbar ◽  
Jihad S Obeid ◽  
Yujing Zhao ◽  
Daniel T Lackland ◽  
Robert J Adams
Keyword(s):  
South Carolina ◽  
Quality Of Care ◽  
African Americans ◽  
Emergency Room ◽  
International Classification Of Diseases ◽  
University Of South Carolina ◽  
Readmission Rates ◽  
Hospital Readmission Rates ◽  
Classification Of Diseases

Background: Readmissions after acute hospitalizations are a cause of both risk and expense, and many of them are potentially preventable. Importantly, risk-standardized hospital readmission rates are sometimes used as a yardstick of the quality of care offered. However, racial variability in readmissions might involve factors beyond quality of care and has not been studied extensively. Objective: To identify differences in readmissions between African Americans and other races and determine preventable readmissions from a pragmatic viewpoint. Methods: We obtained deidentified data from Medical University of South Carolina (MUSC) Electronic Data Warehouse (EDW) on adult admissions with index diagnosis considered as an ischemic stroke (or closely related) using International Classification of Diseases, Ninth Revision (ICD-9) codes 433.x, 434.x, 436.x, 437.x between January 2011 and June 2014. Of these, we determined readmission and reason for readmission over 90-day period. Readmission can be hospital or emergency room readmission. We obtained race as the only linked demographic. Results: Of the 1953 patients admitted with index diagnoses of stroke, 765 (39%), 1148 (59%) and 50 (1%) were African Americans, Caucasians and others, respectively. At 90-days, 256 patients were readmitted as in-patient, of which 128 (50%), 126 (49%) and 2 (1%) were African Americans, Caucasians and others, respectively. On the other hand, 241 patients visited Emergency Room, of which 175 (73%), 65 (26%) and 1 (1%) were African Americans, Caucasians and others, respectively. On adjusting readmissions to index admissions, 17%, 11% and 4% of African Americans, Caucasians and others, respectively, were readmitted in hospital, while 23%, 6% and 2% of African Americans, Caucasians and others, respectively, visited Emergency Room over 90-days period. Conclusions: 90-days readmission rates involve African Americans in a disproportionate manner. This demands further investigation on the etiology of readmission and the care offered.

National Data for Monitoring and Evaluating Racial and Ethnic Health Inequities: Where Do We Go From Here?

2006 ◽  
Vol 33 (4) ◽  
pp. 470-487 ◽  
Author(s):  
Derek M. Griffith ◽  
Ernest Moy ◽  
Thomas M. Reischl ◽  
Elizabeth Dayton
Keyword(s):  
Health Education ◽  
Monitoring And Evaluation ◽  
Public Health Education ◽  
Health Inequities ◽  
Current Data ◽  
Effective Strategies ◽  
Key Aspects ◽  
Health Agenda

The elimination of racial and ethnic health inequities has become a central focus of health education and the national health agenda. The documentation of an increasing gap in life expectancy and other health outcomes suggests the need for more effective strategies to eliminate health inequities, which can be informed by better monitoring and evaluation data. Although the sophistication and volume of health data available have increased dramatically in recent years, this article examines the quality of the current data collected to achieve the goal of eliminating racial and ethnic health inequities. This article explores several key aspects of data to inform addressing inequities including terminology, the role of data, and explanations of the problem. The authors conclude with recommendations for refining data collection to facilitate the elimination of racial and ethnic health inequities and suggest how the Society for Public Health Education can become a more central figure in our national efforts

Raising the Bar on Teacher Quality: Assessing the Impact of Increasing Licensure Exam Cut-Scores

2017 ◽  
Vol 32 (7) ◽  
pp. 969-992
Author(s):  
James V. Shuls
Keyword(s):  
Teacher Quality ◽  
Value Added ◽  
Policy Decision ◽  
Cut Scores ◽  
Praxis Ii ◽  
Trade Offs ◽  
Licensure Exams ◽  
Teacher Workforce ◽  
The Impact

State policy makers are constantly looking for ways to improve teacher quality. An oft tried method is to increase the rigor of licensure exams. This study utilizes state administrative data from Arkansas to determine whether raising the cut-scores on licensure exams would improve the quality of the teacher workforce. In addition, the study explores the trade-offs of such a policy decision. It is concluded that raising the required passing score on the Praxis II would increase the quality of the teacher workforce, as measured by value-added student achievement. This change, however, would be accompanied with an important trade-off as it would reduce the number of minority teachers and potentially lead to negative outcomes in disadvantaged schools.

scholarly journals Association between quality of life and prognosis of candidate patients for heart transplantation: a cross-sectional study

2018 ◽  
Vol 26 (0) ◽  
Author(s):  
Vanessa Silveira Faria ◽  
Ligia Neres Matos ◽  
Liana Amorim Correa Trotte ◽  
Helena Cramer Veiga Rey ◽  
Tereza Cristina Felippe Guimarães
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Heart Transplantation ◽  
Pearson Correlation ◽  
Cross Sectional Study ◽  
Prognostic Scores ◽  
Sectional Study ◽  
Cross Sectional ◽  
Convenience Sample

ABSTRACT Objective: to verify the association between the prognostic scores and the quality of life of candidates for heart transplantation. Method: a descriptive cross-sectional study with a convenience sample of 32 outpatients applying to heart transplantation. The prognosis was rated by the Heart Failure Survival Score (HFSS) and the Seattle Heart Failure Model (SHFM); and the quality of life by the Minnesota Living With Heart Failure Questionnaire (MLHFQ) and the Kansas City Cardiomyopathy Questionnaire (KCCQ). The Pearson correlation test was applied. Results: the correlations found between general quality of life scores and prognostic scores were (HFSS/MLHFQ r = 0.21), (SHFM/MLHFQ r = 0.09), (HFSS/KCCQ r = -0.02), (SHFM/KCCQ r = -0.20). Conclusion: the weak correlation between the prognostic and quality of life scores suggests a lack of association between the measures, i.e., worse prognosis does not mean worse quality of life and the same statement is true in the opposite direction.

scholarly journals Cross cultural adaptation and validation of the ‘9-item patient health questionaire’

2021 ◽  
Vol 31 (Supplement_2) ◽  
Author(s):  
Elisabete Pacheco ◽  
Luiz Miguel Santiago
Keyword(s):  
Quality Of Life ◽  
Cultural Adaptation ◽  
Epidemiological Survey ◽  
Cross Cultural ◽  
Future Health ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Cross Cultural Adaptation ◽  
Patient Health

Abstract Background Quality of life must be studied as a determinant of health. Depressive state must be measured with culturally adapted and population-validated instruments specially in times of COVID19 pandemics in undergraduate health students to avoid future health damages. The European Quality of Life 5 Dimensions (EQ5-D-3L) is validated but the ‘9-Item Patient Health Questionaire’ (PHQ-9) still needed validation for university population, which this study intended to do. Methods With original authors authorization and after cross-cultural adaptation, a cross sectional, observational study, applying the PHQ-9 and EQ-5D-3L to Faculty of Medicine and Faculty Pharmacy of the University of Coimbra (FMUC and FFUC) students, along with an epidemiological survey in a convenience sample using student’s social networks in november 2020. Descriptive, inferential and correlational statistics were performed. Results A size representative sample of 126 participants was studied, of which 72 from FMUC (57.1%) and 54 from FFUC (42.9%). For PHQ-9 (reliability cronbach’s alfa of 0.815, and F test = 38 786, P &lt; 0.001) were found and global score FFUC students and females was higher, P = 0.014 and P = 0.034, respectively. Females also scored worse for item 5 of EQ5D, P &lt; 0.001. PHQ9 and EQ5D correlation of ρ = -0.588, P &lt; 0.001 and PHQ9 and question 5 of EQ5D-3L with PHQ9 of ρ = +0.484, P &lt; 0.001 were found. Conclusions The cultural adaptation and validation of the ‘9-Item Patient Health Questionaire’ (PHQ9) with the European Quality of Life 5 Dimensions (EQ5D-3L) scale, in FMUC and FFUC students population, verified that the PHQ-9 allows to adequately assess the existence of depressive symptoms and that male individuals were in better mental health.

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