Policy Spotlight Effect in Critical Time-Sensitive Diseases: Evidence from Taiwan

2021 ◽  
Author(s):  
Chih-Yuan Lin ◽  
Li-Chuan Chang ◽  
Yue-Chune Lee
Keyword(s):  
Critical Time ◽  
Spotlight Effect

scholarly journals Policy Spotlight Effect in Critical Time-Sensitive Diseases

2021 ◽  
Author(s):  
Chih-Yuan Lin ◽  
Li-Chuan Chang ◽  
Yue-Chune Lee
Keyword(s):  
Septic Shock ◽  
Health Insurance ◽  
Guideline Adherence ◽  
Major Trauma ◽  
Treatment Guideline ◽  
Critical Time ◽  
Process Quality ◽  
Medical Utilization ◽  
Diagnosis And Treatment ◽  
Spotlight Effect

Abstract Background: Categorization of hospital emergency capability (CHEC) is a policy implemented worldwide to regionalize critical emergent care. The CHEC policy mainly uses time-based indicators as emergency care quality measurements.Objectives: We aimed to explore the CHEC policy spotlight effect on critical time-sensitive diseases with and without the influence of time-based surveillance indicators and guidelines. Research Design: We conducted a nationwide retrospective cohort study between 2005–2011. Regarding critical time-sensitive diseases, our study targeted acute ischemic stroke (AIS), ST-segment elevation myocardial infarction (STEMI), septic shock, and major trauma. We selected diagnosis and treatment guideline adherence as process quality measures and defined medical utilization, upward transfer rate, and short-term mortality rate as outcome indicators. Subjects: The Taiwan National Health Insurance 2005 Longitudinal Health Insurance Database contains one million random cases, including medical records and hospital information. Results: During this 7-year study AIS, STEMI, septic shock, and major trauma, respectively. AIS and STEMI cohorts had significantly higher rates of guideline adherence and better process quality than those of septic shock and major trauma cohorts. Furthermore, AIS and STEMI cohorts had a significant increase in diagnosis costs. Conclusion: The CHEC policy spotlight effect exists in critical time-sensitive diseases with time-based quality indicators. Importantly, disease entities without these indicators may experience decreases in diagnosis and treatment guideline adherence, indirectly jeopardizing their outcomes.

scholarly journals Policy Spotlight Effect In Critical Time-Sensitive Diseases

2021 ◽  
Author(s):  
Chih-Yuan Lin ◽  
Li-Chuan Chang ◽  
Yue-Chune Lee
Keyword(s):  
Septic Shock ◽  
Health Insurance ◽  
Guideline Adherence ◽  
Major Trauma ◽  
Treatment Guideline ◽  
Critical Time ◽  
Process Quality ◽  
Medical Utilization ◽  
Diagnosis And Treatment ◽  
Spotlight Effect

Abstract Background: Categorization of hospital emergency capability (CHEC) is a policy implemented worldwide to regionalize critical emergent care. The CHEC policy mainly uses time-based indicators as emergency care quality measurements.Objectives: We aimed to explore the CHEC policy spotlight effect on critical time-sensitive diseases with and without the influence of time-based surveillance indicators and guidelines. Research Design: We conducted a nationwide retrospective cohort study between 2005–2011. Regarding critical time-sensitive diseases, our study targeted acute ischemic stroke (AIS), ST-segment elevation myocardial infarction (STEMI), septic shock, and major trauma. We selected diagnosis and treatment guideline adherence as process quality measures and defined medical utilization, upward transfer rate, and short-term mortality rate as outcome indicators. Subjects: The Taiwan National Health Insurance 2005 Longitudinal Health Insurance Database contains one million random cases, including medical records and hospital information. Results: During this 7-year study AIS, STEMI, septic shock, and major trauma, respectively. AIS and STEMI cohorts had significantly higher rates of guideline adherence and better process quality than those of septic shock and major trauma cohorts. Furthermore, AIS and STEMI cohorts had a significant increase in diagnosis costs. Conclusion: The CHEC policy spotlight effect exists in critical time-sensitive diseases with time-based quality indicators. Importantly, disease entities without these indicators may experience decreases in diagnosis and treatment guideline adherence, indirectly jeopardizing their outcomes.

A Critical Time for America

2008 ◽  
Author(s):  
Barbara P. Billauer
Keyword(s):  
Critical Time

Radar-aided CSO-control-criteria for an ecological approach

1997 ◽  
Vol 36 (8-9) ◽  
pp. 223-228
Author(s):  
A. Petruck ◽  
F. Sperling
Keyword(s):  
Critical Time ◽  
Integrated Approach ◽  
Control Measures ◽  
Real Time Control ◽  
Sewer System ◽  
Time Control ◽  
Physical Measurements ◽  
Combined Sewer ◽  
Receiving Stream ◽  
Control Criteria

The control strategy of a combined sewer system incorporating three stormwater storage tanks with overflows presented here attempts to consider all aspects of acute CSO effects. These are the hydraulic and the composition components as well as the time factor. The result is an integrated approach, which is not based on the classic emission view (i.e. reduction of volume), but on pollution criteria (i.e. possible harm to the biotic community). The aim is to reduce the exceeding of critical peak values of the CSO components at critical time intervals. Control decisions will be based on continuous measurements in the sewer system and in the receiving stream. Furthermore the measurements are carried out to determine the effects (both hydraulic and chemical) of particular CSO discharges in order to evolve the critical values for the project area. The chemical and physical measurements are accompanied by a biological monitoring programme. Macroinvertebrates are sampled upstream and downstream of outfalls and at a reference site. This allows the evaluation of the control measures on an ecological basis, and thus an assessment of the ecological potential of radar-aided real-time control of the combined sewer systems.

scholarly journals Identifying and bridging the knowledge-to-practice gaps in rehabilitation professionals working with at-risk infants in the public health sector of South Africa: a multimethod study protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e039242
Author(s):  
Pragashnie Govender
Keyword(s):  
Public Health ◽  
South Africa ◽  
At Risk ◽  
Neonatal Intensive Care ◽  
Qualitative Data ◽  
Health Sector ◽  
Critical Time ◽  
Reliability And Validity ◽  
The Public ◽  
Public Health Sector

IntroductionEarly childhood is a critical time when the benefits of early interventions are intensified, and the adverse effects of risk can be reduced. For the optimal provision of early intervention, professionals in the field are required to have specialised knowledge and skills in implementing these programmes. In the context of South Africa, there is evidence to suggest that therapists are ill-prepared to handle the unique challenges posed in neonatal intensive care units and wards with at-risk infants in the first few weeks of life. This is attributed to several reasons; however, irrespective of the causative factors, the need to bridge this knowledge-to-practice gap remains essential.Methods and analysisThis study is a multimethod stakeholder-driven study using a scoping review followed by an appreciative inquiry and Delphi process that will aid in the development, implementation and evaluation of a knowledge translation intervention to bridge knowledge-gaps in occupational and physiotherapists working in the field. Therapists currently working in the public health sector will be recruited for participation in the various stages of the study. The analysis will occur via thematic analysis for qualitative data and percentages and frequencies for descriptive quantitative data. Issues around trustworthiness and rigour, and reliability and validity, will be ensured within each of the phases, by use of a content validity index and inter-rater reliability for the Delphi survey; thick descriptions, peer debriefing, member checking and an audit trail for the qualitative data.Ethics and disseminationThe study has received full ethical approval from the Health Research and Knowledge Management Directorate of the Department of Health and a Biomedical Research Ethics Committee. The results will be published in peer-reviewed academic journals and disseminated to the relevant stakeholders within this study.

scholarly journals Media Bias: A Corpus-based Linguistic Analysis of Online Iranian Coverage of the Syrian Revolution

2020 ◽  
Vol 6 (1) ◽  
pp. 584-600
Author(s):  
Amaal Al-Gamde ◽  
Thora Tenbrink
Keyword(s):  
Critical Time ◽  
Media Bias ◽  
Time Frame ◽  
News Agency ◽  
News Discourse ◽  
Syrian Civil War ◽  
Political Perspective ◽  
Islamic Republic Of Iran ◽  
The Government ◽  
Syrian Revolution

AbstractThis study explores the influence of a government’s ideology on linguistic representation in a news agency that characterizes itself as independent. It focuses on the coverage of the Syrian civil war as reported by the Iranian news agency Fars, addressing the discursive constructions of anti-government powers in relevant online reports released between 2013 and 2015. Since the Islamic Republic of Iran was a major regional ally of the Syrian government, we questioned the extent to which ideological independence could be expected during a politically critical time frame. Taking a corpus-based linguistic approach, the study explores the semantic macrostructures representing the opposition as well as the lexical clusters and keywords characterizing the news discourse. The findings indicate that Fars’ representation of the Syrian Revolution was, to some extent, biased, despite its claimed independence of the government’s political stance. It excluded the Sunni social actors, suppressed the Islamic faction identity of the rebels and depicted the uprising as a war against foreign-backed militants. The rebels were stereotyped in terms of terrorism and non-Syrians. In addition, the analysis reveals Fars’ tendency to emphasize the power of the government, depicting it as the defender of the Arab land and foregrounding the discourse of international conspiracy against Syria. The results of this work project the dimension of media bias caused by the underpinning political perspective of media institutions.

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