scholarly journals One-year readmission and Emergency department presentation after an epilepsy admission in people with intellectual disability: a registry-linkage study

2019 ◽  
Vol 4 (3) ◽  
Author(s):  
Peiwen Liao ◽  
Simone Reppermund ◽  
Claire Vajdic ◽  
Julian N Trollor ◽  
Preeyaporn Srasuebkul
Keyword(s):  
Emergency Department ◽  
Intellectual Disability ◽  
Hospital Care ◽  
Hospital Admissions ◽  
Linkage Study ◽  
Index Admission ◽  
Important Indicator ◽  
The Status ◽  
The Impact

Background with rationaleAlthough hospital admissions for epilepsy are common in people with intellectual disability (ID), little is known about the quality of inpatient care and outcomes after admission. To fill this gap, this project examines readmission, an important indicator for the quality of hospital care, and emergency department (ED) presentation after epilepsy admissions in people with ID compared to those without ID. Main AimTo examine whether people with ID have a higher risk of all-cause readmissions and ED presentations after discharge from the index admission (i.e. first admission within the study period) for epilepsy than people without ID. MethodsIn this retrospective data-linkage study, several linked administrative health datasets including but not restricted to hospital admissions, emergency department presentations, disability services and mental health ambulatory care are used to define the cohort, exposure and outcome. The cohort includes patients with and without ID who were admitted to hospital for epilepsy between 2002 and 2014 in New South Wales, Australia. The readmission rates and ED presentations within 28 days, 2-3 months, 4-6 months, and 7-12 months respectively will be compared between patients with and without ID. The effect of a diagnosis of ID on the risk of readmission and ED presentation within a year following the separation from the index admission will be estimated by Poisson regression. Results and conclusionsThe demographics and comorbidity profile of participants at the index epilepsy admission will be presented. Readmission and ED presentation rates within each chunk of follow-up will be calculated by the status of ID and the incidence rate ratio will be provided to estimate the impact of ID on these outcomes. Findings will provide insight into how patients with ID and epilepsy fare in hospital care and help to guide future management of epilepsy in people with ID.

scholarly journals One-Year Readmission and Emergency Department Presentation After an Epilepsy-Related Admission in People with Intellectual Disability: A Registry-Linkage Study

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Peiwen Liao
Keyword(s):  
Emergency Department ◽  
Hospital Admission ◽  
Hospital Admissions ◽  
Healthcare Services ◽  
Linkage Study ◽  
Adjusted Incidence Rate ◽  
One Year ◽  
Service Data ◽  
Patients With Epilepsy ◽  
The Impact

IntroductionIntellectual disability (ID) is a neurodevelopmental condition that affects approximately 1-2% of the population, and epilepsy is a common comorbidity in people with ID. Although hospital admission for epilepsy is also common, little is known about the impact of ID on healthcare use following an epilepsy admission. Objectives and ApproachUsing linked administrative health datasets that included hospital admissions and disability service data, we aimed to examine whether the presence of ID led to greater or lesser use of healthcare services following an epilepsy admission, as represented by all-cause unplanned readmissions and emergency department (ED) presentations. Comparing the rate of readmissions and ED presentations within 30, 90 and 365 days of the first epilepsy admission during the study period, the effect of ID was assessed using Poisson regression. ResultsA total of 18,987 patients had an epilepsy admission between 2005 and 2014, and of these, 3,256 (17.1%) had ID. Compared to patients without ID, patients with ID had a higher risk of unplanned readmissions within each follow-up period (adjusted incidence rate ratio (IRR) with 95% CI: 30 days: 1.48 (1.34, 1.65); 90 days: 1.42 (1.31, 1.54); 365 days: 1.49 (1.40, 1.59)). Differences were also found in the reasons for readmission, including more readmissions for neurological disorders. Similarly, the ED presentation risk was elevated in patients with ID (adjusted IRR: 30 days: 1.34 (1.23, 1.46); 90 days: 1.33 (1.24, 1.42); 365 days: 1.38 (1.30, 1.46)). Conclusion / ImplicationsIn patients with epilepsy, the presence of ID appears to increase the chance of a readmission or ED presentation following a hospital admission for epilepsy, with the reasons for readmission also potentially different. This suggests the potential for improvements in post-admission screening and management.

scholarly journals Emergency department presentation and readmission after index psychiatric admission: a data linkage study

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e018613 ◽  
Author(s):  
Xue Li ◽  
Preeyaporn Srasuebkul ◽  
Simone Reppermund ◽  
Julian Trollor
Keyword(s):  
Emergency Department ◽  
Intellectual Disability ◽  
Service Use ◽  
Data Linkage ◽  
Linkage Study ◽  
Index Admission ◽  
Psychiatric Admission ◽  
Psychiatric Readmission ◽  
Factors Associated ◽  
Drug And Alcohol

ObjectiveTo use linked administrative datasets to assess factors associated with emergency department (ED) presentation and psychiatric readmission in three distinctive time intervals after the index psychiatric admission.DesignA retrospective data-linkage study.SettingCohort study using four linked government minimum datasets including acute hospital care from July 2005 to June 2012 in New South Wales, Australia.ParticipantsPeople who were alive and aged ≥18 years on 1 July 2005 and who had their index admission to a psychiatric ward from 1 July 2007 to 30 June 2010.Outcome measuresORs of factors associated with psychiatric admission and ED presentation were calculated for three intervals: 0–1 month, 2–5 months and 6–24 months after index separation.ResultsIndex admission was identified in 35 056 individuals (51% -males) with a median age of 42 years. A total of 12 826 (37%) individuals had at least one ED presentation in the 24 months after index admission. Of those, 3608 (28%) presented within 0–1 month, 6350 (50%) within 2–5 months and 10 294 (80%) within 6–24 months after index admission. A total of 14 153 (40%) individuals had at least one psychiatric readmission in the first 24 months. Of those, 6808 (48%) were admitted within 0–1 month, 6433 (45%) within 2–5 months and 7649 (54%) within 6–24 months after index admission. Principal diagnoses and length of stay at index admission, sociodemographic factors, Charlson Comorbidity Index score, drug and alcohol comorbidity, intellectual disability and other inpatient service use were significantly associated with ED presentations and psychiatric readmissions, and these relationships varied somewhat over the intervals studied.ConclusionSocial determinants of service use, drug and alcohol intervention, addressing needs of individuals with intellectual disability and recovery-oriented whole-person approaches at index admission are key areas for investment to improve trajectories after index admission.

scholarly journals Assessing the impact of education in atrial fibrillation: A systematic review

2021 ◽  
Vol 20 (Supplement_1) ◽  
Author(s):  
A Cano Valls ◽  
JM Hendriks ◽  
P Sanders ◽  
LL Mont ◽  
C Gallagher
Keyword(s):  
Quality Of Life ◽  
Atrial Fibrillation ◽  
Emergency Department ◽  
Hospital Admissions ◽  
Meta Analysis ◽  
Heart Rhythm ◽  
Educational Interventions ◽  
Eligibility Criteria ◽  
The Impact

Abstract Funding Acknowledgements Type of funding sources: None. Background Atrial Fibrillation (AF) is the most common heart rhythm disorder. Patient education is recommended as part of comprehensive AF management. Despite this the impact of education alone on outcomes in AF populations is unknown. Purpose The aim of this study was to describe the impact of education on clinically relevant outcomes in patient with AF including mortality, hospital admissions, emergency department presentations, stroke and quality of life.  Methods The authors searched Pubmed, Embase, CINAHL, Cochrane database and Psycinfo from inception until September 2019. Studies were included if they were prospective and of randomized controlled or observational design with a minimum follow-up 3 months and published in English. Results A total of 1667 studies were screened with 37 undergoing full text review and 6 meeting eligibility criteria. There was a total of 588 participants with a mean age of 65.63 ± 11.05 and 60.71% were male. A meta-analysis was unable to be performed due to heterogeneity in reporting of outcomes. Two studies examined the impact of education on mortality with no impact evident from either intervention. The impact of education on hospitalisations (all cause – 3 studies, cardiovascular – 1 study and AF - 2 studies) was explored in five studies with no impact on this outcome from any intervention. Similarly, there was no impact of education on emergency department presentations, except for one study in which a video was used in addition to standardised education. There was no impact on stroke from two studies exploring this outcome. There was no evidence of impact of education on general or AF specific quality of life. Conclusions There is little evidence to suggest that educational interventions to date have significantly impacted on death, hospitalisations, emergency department presentations or quality of life in AF populations. There is an urgent need to identify optimal modes and components of educational interventions to improve patient outcomes and reduce health care burden in AF.

Strategic Role of Zakat in Multidimensional Quality of Life in Sijunjung, Indonesia

2018 ◽  
Vol 15 (1) ◽  
pp. 55-72
Author(s):  
Herlin Hamimi ◽  
Abdul Ghafar Ismail ◽  
Muhammad Hasbi Zaenal
Keyword(s):  
Quality Of Life ◽  
Positive Impact ◽  
Wealth Distribution ◽  
Absolute Poverty ◽  
Before And After ◽  
The Status ◽  
Being There ◽  
The Impact

Zakat is one of the five pillars of Islam which has a function of faith, social and economic functions. Muslims who can pay zakat are required to give at least 2.5 per cent of their wealth. The problem of poverty prevalent in disadvantaged regions because of the difficulty of access to information and communication led to a gap that is so high in wealth and resources. The instrument of zakat provides a paradigm in the achievement of equitable wealth distribution and healthy circulation. Zakat potentially offers a better life and improves the quality of human being. There is a human quality improvement not only in economic terms but also in spiritual terms such as improving religiousity. This study aims to examine the role of zakat to alleviate humanitarian issues in disadvantaged regions such as Sijunjung, one of zakat beneficiaries and impoverished areas in Indonesia. The researcher attempted a Cibest method to capture the impact of zakat beneficiaries before and after becoming a member of Zakat Community Development (ZCD) Program in material and spiritual value. The overall analysis shows that zakat has a positive impact on disadvantaged regions development and enhance the quality of life of the community. There is an improvement in the average of mustahik household incomes after becoming a member of ZCD Program. Cibest model demonstrates that material, spiritual, and absolute poverty index decreased by 10, 5, and 6 per cent. Meanwhile, the welfare index is increased by 21 per cent. These findings have significant implications for developing the quality of life in disadvantaged regions in Sijunjung. Therefore, zakat is one of the instruments to change the status of disadvantaged areas to be equivalent to other areas.

Management of non-traumatic epistaxis in adults in the emergency department

2021 ◽  
pp. 1-6
Author(s):  
Ashley Reed ◽  
Martyn Barnes ◽  
Caroline Howard
Keyword(s):  
Emergency Department ◽  
Hospital Admissions ◽  
Interrupted Time Series ◽  
University Teaching ◽  
Attendance Rate ◽  
Interrupted Time Series Analysis ◽  
Current Management ◽  
Emergency Ambulance ◽  
Bed Days ◽  
The Impact

Background/aims Despite epistaxis being a common presentation to emergency departments there is a lack of guidelines, both nationally and internationally, for its management. The authors reviewed the current management of epistaxis and then introduced a new pathway for management to see if care could be improved. The aims were to evaluate the impact of the pathway on reduction of emergency department breaches, emergency ambulance transfers and hospital admissions. Methods The study was an interrupted time series analysis over 29 months and included 903 participants. A pathway for the management of adults with non-traumatic epistaxis was designed and implemented in a university teaching hospital with an emergency department annual attendance rate of 105 495 in 2019–20. Results The pathway led to a 14-minute longer stay in the emergency department, a 5% increase in emergency department breaches, an 8.2% reduction in admissions, a 3.6% reduction in emergency ambulance transfers, a 14.1% increase in nasal cautery and a 3.2% reduction in nasal packing. Conclusions The authors calculate that these results equate to roughly 56 hospital bed days saved, providing better care closer to home for patients, in addition to beneficial knock-on effects for other emergency department and admitted patients.

scholarly journals Perceptions of Certified EFL Teachers Pertaining to Teacher Certification Program in Central Sulawesi, Indonesia

2018 ◽  
Vol 2 (1) ◽  
pp. 1
Author(s):  
Anshari Syafar
Keyword(s):  
Teacher Certification ◽  
Teaching Practices ◽  
Teaching Performance ◽  
Certification Program ◽  
Teachers Perceptions ◽  
Efl Teachers ◽  
The Status ◽  
The Impact ◽  
Central Sulawesi

The state and condition of Indonesian teachers have gradually changed to a better nuance due to the compensation of teacher certification program (TCP). The program has conceivably raised the status of the teachers in social and economic lives. However, the impact of the program on the improvement of overall teacher‘s quality—teaching performance as mandated by Teacher and Lecturer Law remains questionable, and the big question is what and how teachers perceive and act in response to the objective of the program. The program aims not only to increase the teachers‘ salary, but also to improve the quality of their teaching performance based on the teacher standard competence, that is pedagogical, personality, social, and professional competences. Therefore, the study explore and describe certified EFL teachers‘ perceptions concerning benefits of the program on thier social and economic lives, improvement and quality of their teaching practices; perceptions on the ways management ran the program; and expectations for better services of the TCP management. 

scholarly journals Assessing the influence of project management on quality during the early phases of construction projects

2018 ◽  
Vol 9 (1) ◽  
pp. 1584-1592 ◽  
Author(s):  
Žanesa Ljevo ◽  
Mladen Vukomanović ◽  
Suada Džebo
Keyword(s):  
Project Management ◽  
Construction Projects ◽  
Quality Factors ◽  
Important Indicator ◽  
Basic Set ◽  
Quality Of Products ◽  
Amount Of Knowledge ◽  
The Impact ◽  
Early Phases

AbstractAlthough the quality of a process affects the quality of the end product, there is currently an insignificant amount of knowledge about the quality of project management (PM) processes that directly affect the quality of the delivered product (constructed building). This study presents a proposal for modeling the impact of the quality of the PM process on the quality of the constructed building. The quality of the PM process is represented by the main quality factors and product quality indicators. It presents the results of the interviews that were conducted and study cases that were analyzed in Bosnia and Herzegovina with a variety of project participants (with different managerial perspectives) in terms of the indicators of quality of the delivered product. All participants, regardless of managerial perspective, believe that the most important indicator of the quality of products for each phase of the project is “customer satisfaction in the end phase”, the measurement of which is different for each project phase that is presented. The results of the factor analysis of the definition and the planning phases show that 11 variables, namely, the quality factors of the PM process, can be grouped into three new factors, which is described as 66.61% (77.046%) of the basic set of variables.

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