scholarly journals Long Term Implications in Surgical Re-assisting (L.I.S.A. study) During Covid-19 Outbreak: A Retrospective Observational Study on a Rural Population.

2021 ◽  
Author(s):  
Nicolò Fabbri ◽  
Antonio Pesce ◽  
Lisa Uccellatori ◽  
Salvatore Greco ◽  
Francesco D'Urbano ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Operative Management ◽  
Surgical Interventions ◽  
Male Sex ◽  
Non Operative Management ◽  
The Impact ◽  
Colorectal Resections ◽  
Surgical Operations ◽  
Over Time

Abstract BackgroundThe spread of the COVID-19 is having a worldwide impact on surgicaltreatment. Our aim was to investigate the impact of the pandemic in a rural hospital in a lowdensely populated area.MethodsWe investigated the volume and type of surgical operations during the pandemic(March 2020 - February 2021) versus pre-pandemic period (March 2019 - February 2020) aswell as during the first and second pandemic waves compared to the pre-pandemic period.We compared the volume and timing of emergency appendectomy and cholecystectomyduring the pandemic versus pre-pandemic period, the volume, timing and stages of electivegastric and colorectal resections for cancer during the pandemic versus the pre-pandemicperiod.ResultsIn the prepandemic versus pandemic period, 42 versus 24 appendectomies and 174versus 126 cholecystectomies (urgent and elective) were performed. Patients operated onbefore as opposed to during the pandemic were older (58 vs. 52 years old, p=0.006),including for cholecystectomy (73 vs. 66 years old, p=0.01) and appendectomy (43 vs. 30years old, p = 0.04).The logistic regression analysis with regard to cholecystectomy and appendectomy performedin emergency showed that male sex and age were both associated to gangrenous typehistology, both in pandemic and prepandemic period. Finally, we found a reduction in cancerstage I and IIA in pandemic versus prepandemic period, with no increase in the moreadvanced stages.Conclusionsthe reduction in services imposed by governments during the first months oftotal lock down did not justify the whole decrease in surgical interventions in the year of thepandemic. Data suggest that greater "non-operative management" for cases of appendicitisand acute cholecystitis does not lead to an increase in cases operated over time, nor to anincrease in the "gangrenous" pattern, which seems to depend on age advanced and malepopulation.

scholarly journals The Impact of B Corp Certification on Growth

2021 ◽  
Vol 13 (13) ◽  
pp. 7191
Author(s):  
Valerie Paelman ◽  
Philippe Van Cauwenberge ◽  
Heidi Vander Bauwhede
Keyword(s):  
Regression Analysis ◽  
Propensity Score ◽  
Panel Regression ◽  
Medium Term ◽  
Difference In Differences ◽  
Dual Purpose ◽  
Full Effect ◽  
The Impact ◽  
Positive Effect ◽  
Over Time

We empirically test whether B Corp certification affects the short- and medium-term growth rates of sustainable enterprises. These businesses are growing in popularity and prevalence but, due to their hybrid nature, often suffer from external credibility issues and competing internal logics. Because of the rigorous and time-involving audit procedure, B Corp certification potentially sends a credible signal about the sustainable nature of the enterprise to its stakeholders. In addition, the B Corp label could help to straighten out internal tensions and align the company towards its dual purpose. Hence, B Corp certification could contribute to company success. We observe 129 firms that were certified between 2013 and 2018 over a period between six years prior and five years post-certification. Using propensity score matching, we identify 129 non-certified matching companies. On this sample, we conduct a difference-in-differences panel regression analysis to investigate the effect of certification. Our dataset allows us to study how the effects of B Corp certification evolve over time, which was previously untested. Our study documents a positive effect of B Corp certification on turnover growth and also that this effect increases with the time since certification, implying that certification requires some time for its full effect to become apparent.

Gender, mobility and contact

2021 ◽  
Vol 7 (2) ◽  
pp. 142-167
Author(s):  
Catherine E. Travis ◽  
Inas Ghina
Keyword(s):  
Older Women ◽  
High Mobility ◽  
Spontaneous Speech ◽  
Social Changes ◽  
Change Over Time ◽  
Aceh Province ◽  
Rural Variety ◽  
The Impact ◽  
Over Time

Abstract We examine variation in a rural variety of Acehnese spoken in Aceh Province, to better understand the impact of long-term contact with Indonesian and increasing urbanization. The Great Aceh variety is characterized by variable realization of word-final (t) as a dental vs. glottal stop. Analyses of over 2,000 tokens of this variable from a corpus of spontaneous speech from 35 speakers indicate that the variability is relatively stable among men, and among women of high mobility, measured in terms of education, occupation, and time spent outside Great Aceh. Women with low mobility produce the lowest rates of [t̪], and in this group we observe a higher rate of [t̪] by younger than older women, suggesting change over time. We thus find both stability – among those who have long enjoyed high levels of mobility – and change – among those most affected by recent social changes, namely low-mobility women.

scholarly journals Selective non-operative management of abdominal stab wounds is a safe and cost effective strategy: A South African experience

2017 ◽  
Vol 99 (6) ◽  
pp. 490-496 ◽  
Author(s):  
KSS Dayananda ◽  
VY Kong ◽  
JL Bruce ◽  
GV Oosthuizen ◽  
GL Laing ◽  
...  
Keyword(s):  
Point Of Care ◽  
Cost Effective ◽  
Operative Management ◽  
Surgical Interventions ◽  
Stab Wounds ◽  
African Experience ◽  
Negative Laparotomy ◽  
Trauma Service ◽  
Abdominal Stab Wounds ◽  
Non Operative Management

INTRODUCTION Selective non-operative management (SNOM) of abdominal stab wounds is well established in South Africa. SNOM reduces the morbidity associated with negative laparotomies while being safe. Despite steady advances in technology (including laparoscopy, computed tomography [CT] and point-of-care sonography), our approach has remained clinically driven. Assessments of financial implications are limited in the literature. The aim of this study was to review isolated penetrating abdominal trauma and analyse associated incurred expenses. METHODS Patients data across the Pietermaritzburg Metropolitan Trauma Service (PMTS) are captured prospectively into the regional electronic trauma registry. A bottom-up microcosting technique produced estimated average costs for our defined clinical protocols. RESULTS Between January 2012 and April 2015, 501 patients were treated for an isolated abdominal stab wound. Over one third (38%) were managed successfully with SNOM, 5% underwent a negative laparotomy and over half (57%) required a therapeutic laparotomy. Over five years, the PMTS can expect to spend a minimum of ZAR 20,479,800 (GBP 1,246,840) for isolated penetrating abdominal stab wounds alone. CONCLUSIONS Provided a stringent policy is followed, in carefully selected patients, SNOM is effective in detecting those who require further intervention. It minimises the risks associated with unnecessary surgical interventions. SNOM will continue to be clinically driven and promulgated in our environment.

scholarly journals THE IMPACT OF REGIONAL INEQUALITY ON MIGRATION TRENDS IN LATVIA

2021 ◽  
Vol 6 ◽  
pp. 79-91
Author(s):  
Anastasija Jeršova ◽  
Iveta Mietule
Keyword(s):  
Research Methods ◽  
Synthesis Method ◽  
Constructive Method ◽  
Territorial Development ◽  
Integral Index ◽  
Index Method ◽  
Regional Inequalities ◽  
The Impact ◽  
Over Time

The topic of current research and key findings are topical, taking into the consideration the territorial development tendencies of Latvia, which is characterized by the long-term regional inequalities and the tendencies of the migration of the population. The aim of the research is to analyse the impact of the regional inequalities on the migration tendencies of population in Latvia. The following research methods have been used in the research- logically constructive method, content analysis, monographic method, synthesis method, statistical analysis of interrelations, integral index method. Within the research, by using the selected research methods, authors have evaluated the influence of migration indicators-stimulators and indicators-de-stimulators on the migration trends in Latvia over time.

scholarly journals The Influence of Logistics Mode on Cross Border E-commerce Business Scale

2021 ◽  
Vol 235 ◽  
pp. 03006
Author(s):  
Xiaohui Hu
Keyword(s):  
United States ◽  
Regression Analysis ◽  
The United States ◽  
Intermodal Transportation ◽  
Road Transportation ◽  
Cross Border ◽  
Logistics Mode ◽  
Transportation Logistics ◽  
The Impact

China’s cross-border e-commerce companies are facing the problem of high logistics cost caused by excessive reliance on road transportation in domestic logistics link. In the long-term development, crossborder e-commerce companies in the United States have adopted the intermodal transportation logistics mode, which can reduced the domestic logistics costs. In order to study the impact of intermodal-transportation logistics mode on the scale of cross-border e-commerce companies, this paper selects the relevant data of Hub Group, the first intermodal marketing company in North America, makes multiple regression analysis, and draws the following conclusion: the intermodal-transportation logistics mode of highway and railway collaborative transportation is conducive to the expansion of cross-border e-commerce business scale.

Transitions in Technology Mediated Cardiac Rehabilitation and Self-management: A Qualitative Study using the Theoretical Domains Framework (Preprint)

2021 ◽  
Author(s):  
Shreya Tadas ◽  
Claudette Pretorius ◽  
Emma J. Foster ◽  
Trish Gorely ◽  
Stephen J. Leslie ◽  
...  
Keyword(s):  
Cardiac Rehabilitation ◽  
Behaviour Change ◽  
Theoretical Domains Framework ◽  
Self Management ◽  
Normal Life ◽  
Use Of Technology ◽  
Holistic Understanding ◽  
The Impact ◽  
Over Time

BACKGROUND An acute cardiac incident is a life changing event, often necessitating surgery. While surgery has high success rates, rehabilitation, behaviour change, and self-care are critical to long-term health. Recent systematic reviews highlight the potential of technology in this area, but significant shortcomings are also identified, particularly in regard to patient experience. OBJECTIVE To improve future systems this paper explores the experiences of cardiac patients during key phases post-hospitalisation: recuperation, initial rehabilitation and long term self-management. The key objective is to provide a holistic understanding of behavioural factors that impact people across these phases, understand how experiences evolve over time, and provide user-centred recommendations to improve the design of cardiac rehabilitation and self-management technologies. METHODS Semi-structured interviews were conducted with people who attended rehabilitation programs following hospitalisation for an acute cardiac event. Interviews were developed and data is analysed via the Theoretical Domains Framework (TDF), a pragmatic framework that synthesizes prior theories of behaviour change. RESULTS Three phases that arise post-hospitalisation are examined: recuperation, rehabilitation, and long-term self-management. Through these phases we describe the impact of key factors and important changes that occur in patients’ experiences over time, including: a desire for and redefinition of normal life; the need for different types of formal and informal knowledge; the benefits of safe-zoning and connectedness; and the need to recognise capability. The use of the TDF allows us to show how factors that influence behaviour evolve over time and identify potential sources of tension. CONCLUSIONS The paper provides empirically grounded recommendations for the design of technology-mediated cardiac rehabilitation and self-management systems. Key recommendations include the use of technology to support a normal life; leveraging social influences to extend participants’ sense of normality; the use of technology to provide a safe zone; the need to support both emotional and physical wellbeing; and a focus on recognizing capability and providing recommendations that are positive and reinforce this capability.

scholarly journals An Investigation into the Spatial and Temporal Variability of the Meteorological Drought in Jordan

Climate ◽  
2019 ◽  
Vol 7 (6) ◽  
pp. 82 ◽  
Author(s):  
Haitham Aladaileh ◽  
Mohammed Al Qinna ◽  
Barta Karoly ◽  
Emad Al-Karablieh ◽  
János Rakonczai
Keyword(s):  
Regression Analysis ◽  
Hierarchical Clustering ◽  
Linear Regression Analysis ◽  
Meteorological Drought ◽  
Kendall Test ◽  
Spatial And Temporal Variability ◽  
Drought Event ◽  
Mann Kendall Test ◽  
The Impact

Following the impact of droughts witnessed during the last decade there is an urgent need to develop a drought management strategy, policy framework, and action plan for Jordan. This study aims to provide a historical baseline using the standardized precipitation index (SPI) and meteorological drought maps, and to investigate the spatial and temporal trends using long-term historical precipitation records. Specifically, this study is based on the statistical analysis of 38 years of monthly rainfall data, gathered from all 29 meteorological stations that cover Jordan. The Mann–Kendall test and linear regression analysis were used to uncover evidence of long-term trends in precipitation. Drought indices were used for calculating the meteorological SPI on an annual (SPI12), 6-months (SPI6), and 3-months basis (SPI3). At each level, every drought event was characterized according to its duration, interval, and intensity. Then, drought maps were generated using interpolation kriging to investigate the spatial extent of drought events, while drought patterns were temporally characterized using multilinear regression and spatial grouped using the hierarchical clustering technique. Both annual and monthly trend analyses and the Mann–Kendall test indicated significant reduction of precipitation in time for all weather stations except for Madaba. The rate of decrease is estimated at approximately 1.8 mm/year for the whole country. The spatial SPI krig maps that were generated suggest the presence of two drought types in the spatial dimension: Local and national. Local droughts reveal no actual observed trends or repeatable patterns of occurrence. However, looking at meteorological droughts across all time scales indicated that Jordan is facing an increasing number of local droughts. With a probability of occurrence of once every two years to three years. On the other hand, extreme national droughts occur once every 15 to 20 years and last for two or more consecutive years. Linear trends indicated significant increase in drought magnitude by time with a rate of 0.02 (p < 0.0001). Regression analysis indicated that draught in Jordan is time dependent (p < 0.001) rather than being spatially dependent (p > 0.99). Hierarchical clustering was able to group national draughts into three zones, namely the northern zone, the eastern zone, and the southern zone. This study highlights the urgent need for a monitoring program to investigate local and national drought impacts on all sectors, as well as the development of a set of proactive risk management measures and preparedness plans for various physiographic regions.

scholarly journals The Price Impact of Lending Relationships

2015 ◽  
Vol 16 (3) ◽  
pp. 367-389 ◽  
Author(s):  
Ingrid Stein
Keyword(s):  
Strong Relationship ◽  
Price Impact ◽  
Bank Debt ◽  
Relationship Strength ◽  
Borrowing Costs ◽  
Lending Relationships ◽  
Relationship Length ◽  
The Impact ◽  
Over Time

Abstract This study analyzes the impact of bank relationships on a firm’s borrowing costs. We find that a firm’s borrowing costs decrease with relationship strength, proxied by the share of bank debt provided by the lender. Borrowing costs, however, rise with relationship length. While the increase over time is weak on average, bank-dependent borrowers face a substantial premium after several relationship years. Switching the lender initially leads to only a small price discount on average. However, the discount is considerable for borrowers that switch and had a strong relationship with their previous lender. Our results suggest that close lending relationships lead to benefits for the firm, but may also imply hold-up costs in the long term.

Unsolicited Patient Complaints among Otolaryngologists

2019 ◽  
Vol 160 (5) ◽  
pp. 810-817 ◽  
Author(s):  
Ashley M. Nassiri ◽  
James W. Pichert ◽  
Henry J. Domenico ◽  
Mitchell B. Galloway ◽  
William O. Cooper ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Response Rate ◽  
Demographic Data ◽  
Medical Practices ◽  
Patient Complaints ◽  
Male Sex ◽  
Comparative Feedback ◽  
The Impact ◽  
Over Time

Objectives To analyze unsolicited patient complaints (UPCs) among otolaryngologists, identify risk factors for UPCs, and determine the impact of physician feedback on subsequent UPCs. Methods This retrospective study reviewed UPCs associated with US otolaryngologists from 140 medical practices from 2014 to 2017. A subset of otolaryngologists with high UPCs received peer-comparative feedback and was monitored for changes. Results The study included 29,778 physicians, of whom 548 were otolaryngologists. UPCs described concerns with treatment (45%), communication (19%), accessibility (18%), concern for patients and families (10%), and billing (8%). Twenty-nine (5.3%) otolaryngologists were associated with 848 of 3659 (23.2%) total UPCs. Male sex and graduation from a US medical school were statistically significantly associated with an increased number of UPCs ( P = .0070 and P = .0036, respectively). Twenty-nine otolaryngologists with UPCs at or above the 95th percentile received peer-comparative feedback. The intervention led to an overall decrease in the number of UPCs following intervention ( P = .049). Twenty otolaryngologists (69%) categorized as “responders” reduced the number of complaints an average of 45% in the first 2 years following intervention. Discussion Physician demographic data can be used to identify otolaryngologists with a greater number of UPCs. Most commonly, UPCs expressed concern regarding treatment. Peer-delivered, comparative feedback can be effective in reducing UPCs in high-risk otolaryngologists. Implications for Practice Systematic monitoring and respectful sharing of peer-comparative patient complaint data offers an intervention associated with UPCs and concomitant malpractice risk reduction. Collegial feedback over time increases the response rate, but a small proportion of physicians will require directive interventions.

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