scholarly journals Clinical and Economic Outcomes of Thyroid and Parathyroid Surgery in Children

2008 ◽  
Vol 93 (8) ◽  
pp. 3058-3065 ◽  
Author(s):  
Julie Ann Sosa ◽  
Charles T. Tuggle ◽  
Tracy S. Wang ◽  
Daniel C. Thomas ◽  
Leon Boudourakis ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Low Income ◽  
Hospital Costs ◽  
High Volume ◽  
Income Group ◽  
Economic Outcomes ◽  
Complication Rates ◽  
Cross Sectional ◽  
Specific Complication ◽  
Low Income Families

Abstract Context: Clinical and economic outcomes after thyroidectomy/parathyroidectomy in adults have demonstrated disparities based on patient age and race/ethnicity; there is a paucity of literature on pediatric endocrine outcomes. Objective: The objective was to examine the clinical and demographic predictors of outcomes after pediatric thyroidectomy/parathyroidectomy. Design: This study is a cross-sectional analysis of Healthcare Cost and Utilization Project–National Inpatient Sample hospital discharge information from 1999–2005. All patients who underwent thyroidectomy/parathyroidectomy were included. Bivariate and multivariate analyses were performed to identify independent predictors of patient outcomes. Subjects: Subjects included 1199 patients 17 yr old or younger undergoing thyroidectomy/parathyroidectomy. Main Outcome Measures: Outcome measures included in-hospital patient complications, length of stay (LOS), and inpatient hospital costs. Results: The majority of patients were female (76%), aged 13–17 yr (71%), and White (69%). Whites were more often in the highest income group (80% vs. 8% for Hispanic and 6% for Black; P < 0.01) and had private/HMO insurance (76% vs. 10% for Hispanic and 5% for Black; P < 0.001) rather than Medicaid (13% vs. 32% for Hispanic and 41% for Black; P < 0.001). Ninety-one percent of procedures were thyroidectomies and 9% parathyroidectomies. Children aged 0–6 yr had higher complication rates (22% vs. 15% for 7–12 yr and 11% for 13–17 yr; P < 0.01), LOS (3.3 d vs. 2.3 for 7–12 yr and 1.8 for 13–17 yr; P < 0.01), and higher costs. Compared with children from higher-income families, those from lower-income families had higher complication rates (11.5 vs. 7.7%; P < 0.05), longer LOS (2.7 vs. 1.7 d; P < 0.01), and higher costs. Children had higher endocrine-specific complication rates than adults after parathyroidectomy (15.2 vs. 6.2%; P < 0.01) and thyroidectomy (9.1 vs. 6.3%; P < 0.01). Conclusions: Children undergoing thyroidectomy/parathyroidectomy have higher complication rates than adult patients. Outcomes were optimized when surgeries were performed by high-volume surgeons. There appears to be disparity in access to high-volume surgeons for children from low-income families, Blacks, and Hispanics.

Inpatients’ experience and the associated factors: A cross-sectional study at Lung hospital, Son La, in 2020

2021 ◽  
Vol 05 (04) ◽  
pp. 110-116
Author(s):  
Huu Thang Nguyen ◽  
◽  
Thi Nguyet Minh Doan ◽  
Thanh Huong Tran ◽  
Hai Thanh Pham
Keyword(s):  
Low Income ◽  
Associated Factors ◽  
Income Group ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Related Factors ◽  
Cross Sectional ◽  
Middle Income ◽  
Medical Facilities ◽  
Middle Income Group

Objectives: Medical facilities with an autonomous tendency always try to serve positive and pleasant experiences to improve the brand name, increase patient satisfaction and loyalty. A descriptive cross-sectional study was conducted on 245 inpatients at Lung Hospital in Son La province in 2020. To describe the current situation of the inpatient's experience at Lung Hospital in Son La province by 2020 and its related factors. Methods: This was a cross-sectional study conducted on 245 inpatients at Son La Lung Hospital Results: The study showed that the total score of inpatients’ experience ranged from 22 points to 57 points and the mean of it was 39.7 (6.13) points. Subject's experience scores were divided into 2 groups, the satisfied group accounted for 32.7% and the percentage of the unsatisfied group was 67.3%. As compared to men, a higher total score of women was (OR: 1.134; 95% CI: 0.284-0.997). The urban area group’s score was 1,190 times higher than that of those who live in rural and mountainous areas (95% CI: 1,010 - 1,400). The middle-income group had more positive experience than the low-income group (OR: 1.180; 95% CI: 1.010 - 1.370). Conclusions: Our research showed that gender, living area and economic condition affected the total score of inpatients’ experience at the Lung hospital. Keywords: Patient experiences, inpatient treatment, hospital, associated factors

scholarly journals Usage of telecommunication technology in perpetration of sexual assault- A study conducted on reported victims in a Tertiary Medical College Hospital OCC

2021 ◽  
Vol 9 (2) ◽  
pp. 3-7
Author(s):  
Iffath Farooqui ◽  
Md Shamsul Islam ◽  
Rahat Amin Chowdhury ◽  
ATM Hasibul Hasan
Keyword(s):  
Communication Technology ◽  
Low Income ◽  
Socioeconomic Development ◽  
Smart Phone ◽  
Cross Sectional Study ◽  
Sexual Assaults ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
Low Income Families

The sexual assaults and its consequences are increasing along with socioeconomic development of the country. Rise of modern communication technology add fuel to the flame. This descriptive cross-sectional study aimed to evaluate the role of communication technology in sexual assaults in Bangladesh. There were 87 victims included in this study. All were female of 6 years to 40 years of age, mean age was 15.67 (± 6.69) year. Most of the victims were below 20 years of age and came from low income families. About 76% mobile used were smart phone. Among them 46% were owned by the victims herself, 26% gifted by the assailants to the victims. Talking through mobile (37%) was the main communication route between the assailants and the victims; followed by direct verbal (31%), mixed verbal and mobile talking (26%) and others (6%). Regarding methods of communication, they only talk in 42% cases and 36% cases used mixed method (talking, SMS and video chatting). The assailant paid all the costs in 62% cases. Mobile phone came as a blessing in communication, but inchoate use makes it a curse to our society. Parents should be cautious about their children's mobile usage (especially smart phone) daily. Government also should make some policy on using mobile technology by the younger citizens. CBMJ 2020 July: Vol. 09 No. 02 P: 03-07

scholarly journals Low Socioeconomic Status Is Associated With Increased Complication Rates: Are Risk Adjustment Models Necessary in Cervical Spine Surgery?

2019 ◽  
Vol 10 (6) ◽  
pp. 748-753 ◽  
Author(s):  
Alexander M. Lieber ◽  
Anthony J. Boniello ◽  
Yehuda E. Kerbel ◽  
Philip Petrucelli ◽  
Venkat Kavuri ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Low Socioeconomic Status ◽  
Risk Adjustment ◽  
Hospital Costs ◽  
Income Group ◽  
Complication Rates ◽  
Cervical Spine Surgery ◽  
Spine Care ◽  
Anterior Discectomy And Fusion ◽  
Income Quartile

Study Design: Retrospective cohort study. Objectives: The objective of this study was to determine whether lower socioeconomic status was associated with increased resource utilization following anterior discectomy and fusion (ACDF). Methods: The National Inpatient Sample database was queried for patients who underwent a primary, 1- to 2-level ACDF between 2005 and 2014. Trauma, malignancy, infection, and revision surgery were excluded. The top and bottom income quartiles were compared. Demographics, medical comorbidities, length of stay, complications, and hospital cost were compared between patients of top and bottom income quartiles. Results: A total of 69 844 cases were included. The bottom income quartile had a similar mean hospital stay (2.04 vs 1.77 days, P = .412), more complications (2.45% vs 1.77%, P < .001), and a higher mortality rate (0.18% vs 0.11%, P = .016). Multivariate analysis revealed bottom income quartile was an independent risk factor for complications (odds ratio = 1.135, confidence interval = 1.02-1.26). Interestingly, the bottom income quartile experienced lower mean hospital costs ($17 041 vs $17 958, P < .001). Conclusion: Patients in the lowest income group experienced more complications even after adjusting for comorbidities. Therefore, risk adjustment models, including socioeconomic status, may be necessary to avoid potential problems with access to orthopedic spine care for this patient population.

scholarly journals DOES BREASTFEEDING DURATION INFLUENCE FAMILY FOOD INSECURITY?

2018 ◽  
Vol 23 (suppl_1) ◽  
pp. e6-e6
Author(s):  
Peter Wong ◽  
Rosemary Moodie ◽  
David Dai ◽  
Jonathon Maguire ◽  
Catherine Birken ◽  
...  
Keyword(s):  
Public Policy ◽  
Food Insecurity ◽  
Low Income ◽  
Family Income ◽  
Cross Sectional Study ◽  
Research Network ◽  
Breastfeeding Duration ◽  
Cross Sectional ◽  
Adequate Food ◽  
Low Income Families

Abstract BACKGROUND Across all demographics, families without consistent access to adequate food place children at health risk. Consequences may persist beyond early life into adulthood. Public policy positions breastfeeding, the ideal nutrition for infants, as an important solution to reducing family food insecurity (FFI). However, few studies have investigated the association between breastfeeding duration and FFI. OBJECTIVES To evaluate the association between total breastfeeding duration and FFI in Canadian urban children. DESIGN/METHODS A cross-sectional study was conducted of children aged 0–2 years, from a practice-based child research network. Total breastfeeding duration was collected from parent-reported questionnaires. FFI was measured using 2-item food insecurity and validated 1-item NutriSTEP screens. Multivariable regression analysis was performed adjusting for pre-specified covariates. RESULTS Among 3838 children, the mean total breastfeeding duration was 10.6 months (SD=6.7). Families with food insecurity (14.7%) had increased odds of younger mothers, more males and older and more children. In adjusted model, breastfeeding duration was not associated with FFI (OR 0.99; 95% CI 0.98, 1.01). Low-income families were 9 times more likely to be family food insecure than high-income families (p=0.00). CONCLUSION Contrary to public policy, our study found no association between breastfeeding and family food insecurity (FFI). However, other factors may predominate, in particular family income and structure. Given the detrimental impact of FFI, further research is needed to understand the role of infant feeding practices within the larger political, policy and cultural framework.

Social capital and related socio-demographic variation in women of reproductive age: A population-based study

2016 ◽  
Vol 61 (2) ◽  
pp. 247-259 ◽  
Author(s):  
Azam Baheiraei ◽  
Fatemeh Bakouei ◽  
Eesa Mohammadi ◽  
Reza Majdzadeh ◽  
Seyed Mostafa Hosseni
Keyword(s):  
Social Capital ◽  
Low Income ◽  
Family Income ◽  
Population Based ◽  
Cross Sectional Study ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Cross Sectional ◽  
The Social ◽  
Low Income Families

In this population-based cross-sectional study of women of reproductive age in Tehran, Iran, the social capital integrated questionnaire and socio-demographic questionnaire were used. The highest mean scores were related to social cohesion and inclusion dimension (55.72 ± 11.94) and the lowest mean scores to groups and networks dimension (31.78 ± 19.43). Stepwise multiple linear regressions showed the significant association between dimensions of social capital and certain socio-demographic variables, particularly family income. Policy makers should help low-income families by designing effective interventions for improving the status of social capital in this group, because it is considered one of the social determinants of health.

scholarly journals Public Policies, Women's Employment after Childbearing, and Child Well-Being

2011 ◽  
Vol 11 (1) ◽  
Author(s):  
Elizabeth Washbrook ◽  
Christopher J Ruhm ◽  
Jane Waldfogel ◽  
Wen-Jui Han
Keyword(s):  
Low Income ◽  
Parental Leave ◽  
Public Policies ◽  
Well Being ◽  
Work Participation ◽  
Child Care Subsidies ◽  
Cross Sectional ◽  
Work Requirements ◽  
Maternal Work ◽  
Low Income Families

Abstract In this paper, we consider three U.S. public policies that potentially influence the work decisions of mothers of infants—parental leave laws, exemptions from welfare work requirements, and child care subsidies for low-income families. We estimate the effects of these policies on the timing of work participation after birth, and on a range of outcomes in the subsequent four years, using a group difference-in-difference technique suitable for analysis of cross-sectional data. We find that the three policies affect early maternal work participation, but obtain no evidence of significant consequences for child well-being.

scholarly journals Prevalence of substance use in Bangladesh

2020 ◽  
Vol 32 (1) ◽  
pp. 1-8
Author(s):  
Md Faruq Alam ◽  
Mekhala Sarkar ◽  
Mohammad Tariqul Alam ◽  
Helal Uddin Ahmed ◽  
Avra Das Bhowmik ◽  
...  
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Low Income ◽  
Sampling Technique ◽  
Income Group ◽  
Cross Sectional Study ◽  
Cluster Sampling ◽  
Statistical Parameters ◽  
Cross Sectional ◽  
Middle Income

The prevalence of substance use is on rising trend in the country. This two-stage nationwide multicentric community based cross sectional study was conducted by National Institute of Mental Health (NIMH), Dhaka during the period of September 2017 to July 2018 to determine the prevalence of substance use as well as to identify the proportion of users used different substances and to find out socio-demographic correlates of substance use in Bangladesh. The sample were collected by cluster sampling technique. In the first stage data were collected from 19692 respondents aged between 7 years and above in 140 clusters through face-to-face interview using semi-structured questionnaires to collect information by trained data collector. Diagnoses of substance use were made in the second stage of interview by research psychiatrists following DSM-5 diagnostic criteria of mental disorders. Descriptive and inferential statistics of the collected data was done using standard statistical parameters. SPSS programme (Version 23) was used to summarize and to analyze the data. The results showed that, the prevalence of substance use was found as 3.3% among the population 18 years and above. Prevalence of substance use was 4.8% in male and 0.6% in female. Most frequently used substances include cannabis in (42.7%), alcohol in 27.5%, amphetamine (yaba) in 15.2%, opioid in 5.3% and sleeping pills in 3.4% users. Among professions of substance users 6.7% were labors, 5.7% unemployed, 4.3% business men, 3.8% farmers and 3.5% service holders. Extremes of social classes were found as increased users of substances such as people with low income 3.2% and people with high income 3.8% using as against 2.6% in middle income group. The data of this community survey will be used for planning of mental health services in Bangladesh. Bang J Psychiatry June 2018; 32(1): 1-8

scholarly journals Factors influencing household energy choices in the Kumasi Metropolitan area of Ghana

2020 ◽  
Vol 9 (1) ◽  
pp. 74-90
Author(s):  
Emmanuel Adjei-Danso ◽  
Emmanuel Yamoah Tenkorang ◽  
Patrick Osei-Kufuor
Keyword(s):  
Low Income ◽  
Distribution Systems ◽  
Primary Energy ◽  
Cross Sectional ◽  
Household Energy ◽  
Environmental Consequences ◽  
New Energy ◽  
Low Income Families ◽  
Cross Sectional Design ◽  
Energy Choice

Reforms in the energy sector are expected to bring about essential efciency gains, which could result in energy diversifcation and welfare improvements among households. However, there are other unintended social and environmental consequences associated with the process. One signifcant social concern is the likely impact on how low-income families access new energy. The study used a cross-sectional design to undertake a comparative analysis of domestic energy choices. Data was collected from 405 households’ decision makers. An interview schedule and a guide were used for the data collection. The results showed that modern fuels are by far the most predominant source of energy for high and medium class residential households in Kumasi. However, residents in low-class areas preferred to use biomass fuel as their primary energy choice. Contextual variations revealed that general factors such as afordability and accessibility of energy source were exogenous determinants of energy choice. The fndings of the study also lend support to the energy ladder hypothesis that household income is a signifcant determinant of household energy choice. Further, social and demographic factors are critical determinants of cooking fuel type in residential zones. The study recommends the promotion of modern fuels through developing dependable energy distribution systems, and public education campaigns by the Energy Commission of Ghana.

scholarly journals Stigmatization towards cancer among university students in Malaysia

2021 ◽  
Author(s):  
Maria Justine ◽  
Meor Syazwan Jafri ◽  
Angelbeth Joanny ◽  
Aiman Nadia Akmar
Keyword(s):  
Cancer Screening ◽  
University Students ◽  
Low Income ◽  
Online Survey ◽  
Personal Responsibility ◽  
Income Group ◽  
Cross Sectional Study ◽  
Health Science ◽  
Cross Sectional ◽  
Level Of Agreement

Introduction: Stigmatization towards cancer is a barrier to early cancer screening and treatment. This study was conducted to determine the level of cancer stigma among Malaysian university students in Malaysia with different sociodemographic backgrounds.Methods: This cross-sectional study recruited 400 students (mean age, SD = 22.22 ± 1.67 years) from a selected university in Malaysia. Data were collected from October 2019 to February 2020 through an online survey. The Cancer Stigma Scale (CASS) was used in assessing the levels of cancer stigma among university students with different courses and social backgrounds. The CASS was used in assessing multiple aspects of cancer stigma, including severity, personal responsibility, awkwardness, avoidance, policy opposition, and financial discrimination.Results: Data were analyzed using SPSS (version 23). Results showed that the stigmatization level toward cancer among university students varied across the six subscales. Items regarding the severity of a cancer diagnosis showed the highest level of agreement (32–52%; M = 3.05, SD = 0.96), whereas the item ‘avoiding someone with cancer’ showed the lowest agreement, 7–10% (Mean = 1.85, SD = 0.97). Stigma was significantly higher in young students, males, non-health science students, students in the junior year level, students without family histories of cancer, and the low-income group (p < 0.05).Conclusion: These findings may provide a benchmark of stigmatization level among university students in Malaysia and may be a valuable basis for delivering information and education on cancer screening and treatment.

scholarly journals Thresholds for Surgery and Surgical Outcomes for Patients with Primary Hyperparathyroidism: A National Survey of Endocrine Surgeons

1998 ◽  
Vol 83 (8) ◽  
pp. 2658-2665 ◽  
Author(s):  
Julie Ann Sosa ◽  
Neil R. Powe ◽  
Michael A. Levine ◽  
Robert Udelsman ◽  
Martha A. Zeiger
Keyword(s):  
Primary Hyperparathyroidism ◽  
Clinical Outcomes ◽  
High Volume ◽  
Urinary Calcium ◽  
Complication Rates ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Primary Operation ◽  
Surgeon Experience ◽  
Low Volume

abstract A 1991 NIH Consensus Development Conference statement provided recommendations for the management of patients with asymptomatic and minimally symptomatic primary hyperparathyroidism (1° HPT), but adherence to these guidelines has not been documented. We conducted a cross-sectional survey of North American members of the American Association of Endocrine Surgeons inquiring about surgeon and 1° HPT patient characteristics, thresholds for surgery, and clinical outcomes. Multivariate regression was used to assess the relationship of physician characteristics to practice patterns and outcomes. Of 190 surgeons surveyed, 147 (77%) responded; 109 provided complete responses (57%). These surgeons spend 66% of their time in patient care and perform an average of 33 (range, 1–130) parathyroidectomies/yr. More than 72% of 1° HPT patients who underwent surgery were asymptomatic or minimally symptomatic. High volume surgeons (&gt;50 cases/yr) had significantly lower thresholds for surgery with respect to abnormalities in preoperative creatinine clearance, bone densitometry changes, and levels of intact PTH and urinary calcium compared to their low volume colleagues (1–15 cases/yr). Overall reported surgical cure rates were 95.2% after primary operation and 82.7% after reoperation. Compared to high volume surgeons, low volume endocrine surgeons had significantly higher complication rates after primary operation (1.9% vs. 1.0% respectively; P &lt; 0.01) and reoperation (3.8% vs. 1.5%; P &lt; 0.001) as well as higher in-hospital mortality rates (1.0% vs. 0.04%; P &lt; 0.05). Endocrine surgeons operate on a large number of asymptomatic or minimally symptomatic 1° HPT patients. Even among a group of highly experienced surgeons who typically see patients after referral from endocrinologists, clinical outcomes and criteria for surgery vary widely and appear to be associated with surgeon experience. Their criteria for surgery diverge from NIH guidelines. These results implore the endocrine community to examine the evidential basis for decisions made in the management of 1° HPT.

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