Assessing disparities in engagement in a post-discharge virtual visit follow-up program.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 100-100
Author(s):  
Abdullateef Abdulkareem ◽  
Nathan Handley ◽  
Samantha Burdette ◽  
Adam Binder
Keyword(s):  
Socioeconomic Status ◽  
Language Proficiency ◽  
English Language ◽  
Urban Setting ◽  
Transitions Of Care ◽  
Area Deprivation ◽  
Patient Portal ◽  
Post Discharge ◽  
The Impact

100 Background: Transitions of care are a frequent focus of quality improvement initiatives. In attempt to improve upon the transitions of care for oncology patients, our institution implemented a post discharge virtual visit follow-up program. Previous studies have suggested that socioeconomic status impacts engagement in technology based interventions. Herein, we report the impact of socio-economic status based on area deprivation index (ADI) on engagement with the program. Methods: All patients admitted to the elective chemotherapy service were included. Retrospective analysis of characteristics of each participant was conducted. Data included eligibility (access to the internet, appropriate device, English language proficiency, ability to set up video visit and a patient portal account) for video visit, interest in participating, completion of the visit and any interventions performed during the visit. In addition, ADI was calculated for each individual. Patients were classified into quartiles based on ADI (quartiles increased with ADI). Chi squared testing was performed to assess whether socioeconomic status affected enrollment in video visits. Simple descriptive analysis was also performed. Results: One hundred seven unique patients were included for review. Of these, 33 (31%), 39 (36%), 16 (15%) and 19 (18%) were in quartile(Q) 1, 2, 3 and 4 respectively. Eligibility per quartile was 29 (88%), 34(87%), 13(81%), and 15(83%). ADI quartile did not significantly affect virtual visit eligibility (p = .50). A total of 91 patients (85%) were eligible for video visits; of these, 46 patients declined. Of the 46 patients that declined 9 (19%), 20 (43%), 8 (17%), and 9 (19%) were in Q1, Q2, Q3 and Q4 respectively. Fifteen patients cited technology issues as reasons for declining telehealth visits - 10 (67%) from Q1 and Q2 and 5 (33%) from Q3 and Q4. The vast majority cited lack of interest as reason for declining. Conclusions: ADI as a measure of socioeconomic status did not significantly affect eligibility for or enrollment in video visits. This may be explained by more ubiquitous access to internet services in a large urban setting. Current research is currently being conducted to understand patient barriers to engagement in virtual visits.

scholarly journals Impact of pharmacist-conducted anticoagulation patient education and telephone follow-up on transitions of care: a randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lamis R. Karaoui ◽  
Elsy Ramia ◽  
Hanine Mansour ◽  
Nisrine Haddad ◽  
Nibal Chamoun
Keyword(s):  
Tertiary Care ◽  
Intervention Group ◽  
Bleeding Event ◽  
Transitions Of Care ◽  
Control Group ◽  
Published Data ◽  
Post Discharge ◽  
Readmission Rates ◽  
The Impact

Abstract Background There is limited published data in Lebanon evaluating the impact of supplemental education for anticoagulants use, especially DOACs, on clinical outcomes such as bleeding. The study aims to assess the impact of pharmacist-conducted anticoagulation education and follow-up on bleeding and readmission rates. Methods This study was a randomized, non-blinded interventional study conducted between August 2017 and July 2019 in a tertiary care teaching Lebanese hospital. Participants were inpatients ≥18 years discharged on an oral anticoagulant for treatment. Block randomization was used. The control group received the standard nursing counseling while the intervention group additionally received pharmacy counseling. Phone call follow-ups were done on day 3 and 30 post-discharge. Primary outcomes included readmission rates and any bleeding event at day 3 and 30 post-discharge. Secondary outcomes included documented elements of education in the medical records and reported mortality upon day 30 post-discharge. Results Two hundred patients were recruited in the study (100 patients in each study arm) with a mean age of 73.9 years. In the pharmacist-counseled group, more patients contacted their physician within 3 days (14% versus 4%; p = 0.010), received explicit elements of education (p < 0.001) and documentation in the chart was better (p < 0.05). In the standard of care group, patients were more aware of their next physician appointment date (52% versus 31%, p < 0.001). No difference in bleeding rates at day 3 and 30 post-discharge was observed between the groups. Conclusions Although pharmacist-conducted anticoagulation education did not appear to reduce bleeding or readmission rates at day 30, pharmacist education significantly increased patient communication with their providers in the early days post-discharge. Trial registration Lebanon Clinical Trial Registry LBCTR2020033424. Retrospectively registered. Date of registration: 06/03/2020.

‘I'm Telling You … The Language Barrier is the Most, the Biggest Challenge’: Barriers to Education among Karen Refugee Women in Australia

2012 ◽  
Vol 56 (2) ◽  
pp. 126-141 ◽  
Author(s):  
Paula G. Watkins ◽  
Husna Razee ◽  
Juliet Richters
Keyword(s):  
Language Proficiency ◽  
English Language ◽  
Language Education ◽  
Well Being ◽  
English Language Education ◽  
Barriers To Education ◽  
Refugee Women ◽  
Education Participation ◽  
And Gender ◽  
The Impact

This article examines factors influencing English language education, participation and achievement among Karen refugee women in Australia. Data were drawn from ethnographic observations and interviews with 67 participants between 2009 and 2011, collected as part of a larger qualitative study exploring the well-being of Karen refugee women in Sydney. Participants unanimously described difficulty with English language proficiency and communication as the ‘number one’ problem affecting their well-being. Gendered, cultural and socio-political factors act as barriers to education. We argue that greater sensitivity to refugees' backgrounds, culture and gender is necessary in education. Research is needed into the combined relationships between culture and gender across pre-displacement, displacement and resettlement and the impact of these factors on post-immigration educational opportunities. Training is needed to sensitise educators to the complex issues of refugee resettlement. The paper concludes with recommendations for service provision and policy.

Feasibility of telemedicine in the management strategy of patients with lymphoma amid the COVID-19 pandemic in Spain, a prospective study (Preprint)

2021 ◽  
Author(s):  
Raul Cordoba ◽  
Alberto Lopez-Garcia ◽  
Daniel Morillo ◽  
Maria-Angeles Perez-Saenz ◽  
Elham Askari ◽  
...  
Keyword(s):  
Prospective Observational Study ◽  
Digital Health ◽  
Hematologic Malignancies ◽  
Patient Portal ◽  
Health Strategy ◽  
Potential Risk Factors ◽  
Hospital Visits ◽  
A Prospective Study ◽  
The Impact

BACKGROUND Recurrent hospital visits were potential risk factors for COVID-19 contagion. OBJECTIVE The aims of this prospective observational study was to analyze the consequences of COVID-19 pandemic in the health care of patients with lymphoma and the impact of telemedicine strategies such as the patient portal in their management. METHODS All data were obtained from the electronic medical record (EMR). Variables such as age, sex, matter of the visit, use of patient’s portal, changes in management, impact in clinical trials and suffering from COVID-19 contagion were recorded. RESULTS 290 patients were attended in the lymphoma clinic accomplishing 437 appointments. The median age was 66 years (range 18-94), and 157 (54.13%) were male. Of them, 109 out of 290 (37.58%) were aged older then 70 years. Regarding number of visits, 214 patients (73.79%) had only 1 visit to the hospital. Only 23 patients (7.93%) didn’t have access to patient’s portal. During the follow-up, only 7 patients (2.41%) suffered from COVID-19, with a median age of 66 years (51-80). CONCLUSIONS Telemedicine such as patient’s portal are feasible strategies in the management of patients with lymphoma during the COVID-19 pandemic, with a reduction of in-person visits to hospital and a very low contagion rate. This experience allowed us to continue with a new digital health strategy in the follow up of patients with hematologic malignancies. CLINICALTRIAL Not registered.

scholarly journals The Impact of Blended Learning on the Twelfth Grade Students’ English Language Proficiency

2021 ◽  
Author(s):  
Omar Hussein Al Noursi
Keyword(s):  
Blended Learning ◽  
Language Proficiency ◽  
English Language ◽  
English Language Proficiency ◽  
Successful Implementation ◽  
Learning Approach ◽  
Significant Difference ◽  
Twelfth Grade ◽  
The Impact ◽  
Experimental Group

The blended learning approach utilizes modern technologies and electronic media in teaching to create a technology-based environment. However, it is not an exclusive online environment because the teacher and the students have to be present in a traditional face-to-face classroom. It is widely believed that adopting a blended learning approach will enable learners to have quality educational opportunities and improve their performance. The incentive for conducting the research is to evaluate the effect of the blended learning approach on high school students’ English proficiency. Specifically, the study aimed at answering the question: is there a significant difference in the Twelfth-Grade students’ English language proficiency as measured by IELTS due to the model of delivery (Blended learning model and the traditional delivery model)? To achieve the study’s goal, the researcher applied the experimental method and used IELTS to measure language proficiency. The study sample selected purposively consisted of 63 male twelfth-grade students in one of the private schools in Al Ain, United Arab Emirates (UAE). The study sample was assigned to two groups: the experimental group taught using blended learning consisted of 31 students, and the control group led by the traditional method consisted of 32 students. The results showed statistically significant differences at the level of (a&lt;0.01) between the means of the results of the two groups on the post achievement test in favor of the experimental group. These results illustrated the impact of adopting the blended learning approach in an English Foreign Language (EFL) setting on students’ achievement in standardized tests. However, the successful implementation of blended learning largely depends on how responsible and committed students are towards active learning.

scholarly journals What happens to international students’ english after one semester at university?

2008 ◽  
Vol 31 (1) ◽  
pp. 4.1-4.17
Author(s):  
Neomy Storch ◽  
Kathryn Hill
Keyword(s):  
International Students ◽  
Language Proficiency ◽  
English Language ◽  
Language Skills ◽  
English Language Proficiency ◽  
Background Information ◽  
Language Test ◽  
First Semester ◽  
Number Of Factors ◽  
The Impact

There is a common expectation, particularly amongst international students, that studying in an English-medium university should automatically produce a significant improvement in their English language skills. However, there is growing evidence to suggest that this is not necessarily the case.This paper reports on a study which investigated the impact of one semester of study at a university on the English language proficiency of a sample of 40 international students. This was measured by comparing the students’ scores on a diagnostic English language test at the beginning and end of their first semester. A comparison of discourse measures of writing in terms of fluency, complexity and accuracy was also undertaken. Background information, including details of ESL support, if any, was collected for all participants via questionnaires, and interviews were conducted with a subset of the participants.It was found that studying in an English-medium university generally led to an improvement in English language proficiency. The paper identifies a number of factors which appear to support language development, as well as factors that may inhibit it.

Abstract 19771: Persistent Thrombocytopenia after Myocardial Infarction is Associated with Increased Short- and Long-Term Mortality

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Anirudh Kumar ◽  
Salim Virani ◽  
Scott Bassett ◽  
Mahboob Alam ◽  
Ravi Hira ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Bleeding Complications ◽  
Group Differences ◽  
Long Term Outcomes ◽  
Post Discharge ◽  
Short And Long Term ◽  
The Impact ◽  
Long Term Mortality

Background: Thrombocytopenia (TCP) occurs commonly in patients hospitalized with acute myocardial infarction (AMI). It is unclear whether persistent TCP after discharge among AMI survivors is associated with worse outcomes. Methods: We examined the impact of persistent post-discharge TCP on outcomes in a registry of consecutive AMI patients hospitalized between January 2004 and December 2007. In-hospital (IH) TCP was defined by a nadir platelet count < 150 x 109/L. Resolved TCP was defined as IH TCP which resolved within 3 months after discharge while persistent TCP was defined as IH TCP which did not resolve within 3 months. Results: Of 842 patients hospitalized for a first AMI, we examined data on 617 hospital survivors who had follow-up within 3 months of discharge and documented long-term outcomes. Of those, 474 (76.8%) patients did not experience IH TCP while 42 (6.8%) and 101 (16.4%) had persistent and resolved TCP, respectively (Table). Patients with persistent TCP were older, had worse comorbidities, and were more likely to have TCP at baseline and discharge. There were no inter-group differences in infarct size, major bleeding complications, revascularization, or ejection fraction at discharge. Mortality following discharge was higher at all time-points among AMI patients with persistent TCP compared to patients with resolved or without IH TCP (Figure). Patients with resolved TCP had comparable mortality to those without IH TCP. Conclusion: Persistent TCP within 3 months after hospital discharge for AMI is associated with significantly increased short- and long-term mortality compared to patients with recovered TCP or without IH TCP.

scholarly journals Omani Students’ Perceptive of Communicative Language Teaching Approach in Higher Education in Oman: Its Practice

Proceedings ◽  
2018 ◽  
Vol 2 (21) ◽  
pp. 1333
Author(s):  
Mouza Said Al Kalbani ◽  
Josu Solabarrieta ◽  
Ahmad Bin Touq
Keyword(s):  
Higher Education ◽  
Foreign Language ◽  
Language Proficiency ◽  
Classroom Practice ◽  
English Language ◽  
Language Teaching ◽  
Communicative Language Teaching ◽  
Teaching Approach ◽  
Clear Understanding ◽  
The Impact

This study aimed to analyze and understand learners’ attitudes towards Communicative Language Teaching (CLT) approach in a foreign language context in higher education in Oman. In the literature review, learners’ attitudes play a strong role in determining the success of innovations in instructional practices (Savignon and Wang 2003). In addition to that, this study is considered as an evaluative study to explore teachers’ implication of CLT and the impact of this implication on students “communicative competence”, which is considered as an ultimate goal of communicative language teaching in a foreign langue context (FL). The importance of this study is due to its significance to come up with a clear understanding of Omani learners’ beliefs considering teaching and learning process. It also aims to specify the impact of CLT as an effective teaching approach in English as a foreign language (EFL) among higher education students and to specify any difficulties or challenges that might hinder CLT implementation in the Omani context. To achieve this, a quantitative study had been used to collect data from both teachers and learners. The participants of this study were 631 students (189 male and 391 female) who were enrolled in Intensive English language programs (IELP) in Foundation Institute (FI) in two Universities (210 students from public university and 421 students from private university) and those participants were from three different English proficiency levels (247 level 1, 155 level 2 and 229 level 3). The analysis revealed that students perceived classroom’s practice to be more oriented towards using strategic and grammatical competence and less towards sociolinguistic and intercultural competences. Additionally, Omani learners reported statistically significant correlation between CLT practice. The students’ gender, language proficiency and education context affected how students perceived classroom practice.

scholarly journals Impact of Socioeconomic Status on Return to Work after Acute Ankle Fracture

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0020
Author(s):  
Alessandra L. Falk ◽  
Regina Hanstein ◽  
Chaiyaporn Kulsakdinun
Keyword(s):  
Socioeconomic Status ◽  
Return To Work ◽  
Low Socioeconomic Status ◽  
Ankle Fracture ◽  
Low Ses ◽  
Insurance Status ◽  
Low Socioeconomic ◽  
The Impact ◽  
Zip Code

Category: Ankle; Trauma Introduction/Purpose: Socioeconomic status has been recognized throughout the medical literature, both within orthopedics and beyond, as a factor that influences outcomes after surgery, and can result in substandard care. Within the foot and ankle subspecialty, there is limited data regarding socioeconomic status and post-operative outcomes, with the current literature focusing on outcomes for diabetic feet. However, ankle fractures are among the most common fractures encountered by orthopedic surgeons. While a few studies have explored the impact of ankle fractures on employment and disability status, the effect of socioeconomic status on return to work post operatively has not yet been investigated. The purpose of this study was to determine the impact of low socioeconomic status on return to work. Methods: We retrospectively reviewed 592 medical charts of patients with CPT code 27766, 27792, 27814, 27822, 27823, 27827, 27829, 27826, 27828 from 2015-2018. Included were patients >18 yrs of age who sustained an acute ankle fracture, were employed prior to the injury, and with information on return to work after ankle surgery, zip code, race, ethnicity and insurance status. Excluded were patients who were not employed prior to their injury. Socioeconomic status was either defined by insurance status - Medicaid/Medicare, commercial, or workman’s compensation -, or by assessing socioeconomic status (SES) using medial household per capita income by zip code as generated and reported by the US National Census Bureau’s 2013-2017 American Community Survey 5-Year Estimates. The national dataset was divided into quartiles with the lowest quartile defined as low SES. Patients who had income that fell within this income category were classified as low SES. Results: 174 patients were included with an average follow-up of 10.2months. 22/174 (12.6%) patients didn’t return to work post-operatively. Univariate analysis identified non-sedentary work to decrease the likelihood of return to work (HR:0.637; p=0.03). Patients with a low SES were more prevalent in the no return group compared to the return to work group (86% vs 60%; p=0.028). 95% of patients with low SES were a minority compared to 56% with average/high SES (p<0.005). Patients with low SES had a higher BMI (p=0.026), a longer hospitalization (p=0.04) and more wound complications (p=0.032). Insurance type didn’t affect return to work (p=0.158). Patients with workman’s compensation had a longer follow-up time and a longer time to return to work compared to other insurances (p<0.005 for each comparison). Conclusion: Low socioeconomic status based on income, not insurance type, affected return to work after an ankle fracture ORIF. Patients with workman’s compensation took a longer time to return to work compared to other insurance types. These findings warrants the need to consider socioeconomic status when allocating resources to treat these patients.

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