scholarly journals Acetaminophen poisonings in Chilean healthcare settings: a 20-year story that does not end

2021 ◽  
Vol 11 (4) ◽  
pp. 1086-1094
Author(s):  
Tamara Sanhueza-Aroca ◽  
Samuel Verdugo-Silva ◽  
Erwin Olate-Fica ◽  
Luisa Rivas ◽  
Claudio Muller-Ramirez
Keyword(s):  
Multivariate Logistic Regression Model ◽  
Over The Counter ◽  
Public And Private ◽  
Female Patients ◽  
Healthcare Settings ◽  
Health Authorities ◽  
Study Results ◽  
Icd 10 ◽  
Public And Private Hospitals ◽  
Age Range

Background: Acetaminophen (Paracetamol) is one of the most used and prescribed anti-inflammatory and analgesic drugs worldwide. It has become one of the main drugs related to accidental and intentional overdoses in many countries, including Chile. The objective of this work was to characterize acetaminophen poisonings occurred in Chile between the years 2001 and 2020. Methods: A retrospective study of acetaminophen poisonings among patients who were hospitalized in Chilean public and private hospitals was carried out between the years 2001 and 2020. Data was obtained from the Medical Outcome Statistical Report database. Inclusion criteria were cases of patients who were admitted into either public or private healthcare settings with diagnosis of acetaminophen poisoning according to the WHO ICD-10. Statistical analyses were run to establish associations between variables selected in the study. Results: A total of 2,929 cases were included in the study. 77 % of the cases corresponded to female patients (p<0.05). Patients’ age range went from 0 to 81 years old. Adolescents and young adults resulted more involved in reported cases during the 2001-2020 period (p<0.001). During the first period of the study, accidental poisonings were more commonly reported, however in the recent years intentional cases increased their occurrence, especially among female patients (p<0.05).  A multivariate logistic regression model considered as statistically significant (p<0.05) the interaction between the variables age, gender and year of the event. Conclusion: The present study identified a large number of acetaminophen poisonings reported in Chile during the 2001-2020 period. Cases were characterized including patients’ gender, age, and poisoning intent. Health authorities should consider these findings as an opportunity to improve public health associated with the use and misuse of over-the-counter drugs, including acetaminophen

scholarly journals The second national hospital costing study: Background, results and implications

1998 ◽  
Vol 21 (3) ◽  
pp. 241 ◽  
Author(s):  
Brett Oates ◽  
Jo Murray ◽  
Don Hindle
Keyword(s):  
National Study ◽  
National Hospital ◽  
Private Hospitals ◽  
Public And Private ◽  
Health Authorities ◽  
Costing Study ◽  
Public And Private Hospitals

The costing of hospital outputs, and especially of acute admitted patients categorisedby DRG, has been the focus of considerable attention in the last decade. Manyindividual hospitals now routinely estimate the costs of their main products, severalState and Territory health authorities undertake periodic multi-site studies, and therehave been a few one-off national studies.This paper summarises the methods and results of the most recent national study,which measured costs at a sample of public and private hospitals around Australiafor the 1996?97 financial year. We briefly describe the main results and note someimplications.

scholarly journals Hospitalizations for Stroke in France During the COVID-19 Pandemic Before, During, and After the National Lockdown

Stroke ◽  
2021 ◽  
Vol 52 (4) ◽  
pp. 1362-1369
Author(s):  
Anne-Sophie Mariet ◽  
Maurice Giroud ◽  
Eric Benzenine ◽  
Jonathan Cottenet ◽  
Adrien Roussot ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Significant Drop ◽  
Public And Private ◽  
Stroke Units ◽  
Hospitalization Rates ◽  
Health Authorities ◽  
Future Challenges ◽  
Medical Emergencies ◽  
Public And Private Hospitals ◽  
Ischemic Attack

Background and Purpose: In France, the entire population was put under a total lockdown from March 17 to May 11, 2020 during the peak of the coronavirus disease 2019 (COVID-19) pandemic. Whether the lockdown had consequences on the management of medical emergencies such as stroke and transient ischemic attack (TIA) has yet to be fully evaluated. This article describes hospitalization rates for acute stroke in 2 French regions that experienced contrasting rates of COVID-19 infection, before, during, and after the nationwide lockdown (January to June 2020). Methods: All patients admitted for acute stroke/TIA into all public and private hospitals of the 2 study regions were included. Data were retrieved from the National Hospitalization Database (PMSI). In the most affected region (Grand-Est), the hospitalization rates observed in April 2020 were compared with the rates in the same period in the least affected region (Occitanie) and in the 3 prior years (2017–2019). Results: There was a significant decline in hospitalization rates for stroke/TIA within the region most affected by COVID-19 during the month of April 2020 compared with previous years, while no significant change was seen in the least affected region. After lockdown, we observed a fast rebound in the rate of hospitalization for stroke/TIA in the most affected region, contrasting with a slower rebound in the least affected region. In both regions, patients with COVID-19 stroke more frequently had ischemic stroke, a nonsignificant greater prevalence of diabetes, they were less frequently admitted to stroke units, and mortality was higher than in patients without COVID-19. Conclusions: Our results demonstrates a significant drop in stroke/TIA hospitalizations and a fast recovery after the end of the French lockdown in the most affected region, while the least affected region saw a nonsignificant drop in stroke/TIA hospitalizations and a slow recovery. These results and recommendations could be used by the health authorities to prepare for future challenges.

scholarly journals Predicting the 14-Day Hospital Readmission of Patients with Pneumonia Using Artificial Neural Networks (ANN)

2021 ◽  
Vol 18 (10) ◽  
pp. 5110
Author(s):  
Shu-Farn Tey ◽  
Chung-Feng Liu ◽  
Tsair-Wei Chien ◽  
Chin-Wei Hsu ◽  
Kun-Chen Chan ◽  
...  
Keyword(s):  
Neural Network ◽  
Early Stage ◽  
Characteristic Curve ◽  
Patient Discharge ◽  
Ann Model ◽  
Healthcare Settings ◽  
High Area ◽  
Icd 10 ◽  
Artificial Neural ◽  
Artificial Neural Network Ann

Unplanned patient readmission (UPRA) is frequent and costly in healthcare settings. No indicators during hospitalization have been suggested to clinicians as useful for identifying patients at high risk of UPRA. This study aimed to create a prediction model for the early detection of 14-day UPRA of patients with pneumonia. We downloaded the data of patients with pneumonia as the primary disease (e.g., ICD-10:J12*-J18*) at three hospitals in Taiwan from 2016 to 2018. A total of 21,892 cases (1208 (6%) for UPRA) were collected. Two models, namely, artificial neural network (ANN) and convolutional neural network (CNN), were compared using the training (n = 15,324; ≅70%) and test (n = 6568; ≅30%) sets to verify the model accuracy. An app was developed for the prediction and classification of UPRA. We observed that (i) the 17 feature variables extracted in this study yielded a high area under the receiver operating characteristic curve of 0.75 using the ANN model and that (ii) the ANN exhibited better AUC (0.73) than the CNN (0.50), and (iii) a ready and available app for predicting UHA was developed. The app could help clinicians predict UPRA of patients with pneumonia at an early stage and enable them to formulate preparedness plans near or after patient discharge from hospitalization.

scholarly journals Exploring patterns in psychiatric outpatients’ preferences for involvement in decision-making: a latent class analysis approach

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ingunn Mundal ◽  
Mariela Loreto Lara-Cabrera ◽  
Moisés Betancort ◽  
Carlos De las Cuevas
Keyword(s):  
Decision Making ◽  
Depressive Disorder ◽  
Latent Class ◽  
Psychiatric Patients ◽  
Mental Healthcare ◽  
Psychological Reactance ◽  
Psychiatric Outpatients ◽  
Public And Private ◽  
Level Of Education ◽  
Healthcare Settings

Abstract Background Shared decision-making (SDM), a collaborative approach that includes and respects patients’ preferences for involvement in decision-making about their treatment, is increasingly advocated. However, in the practice of clinical psychiatry, implementing SDM seems difficult to accomplish. Although the number of studies related to psychiatric patients’ preferences for involvement is increasing, studies have largely focused on understanding patients in public mental healthcare settings. Thus, investigating patient preferences for involvement in both public and private settings is of particular importance in psychiatric research. The objectives of this study were to identify different latent class typologies of patient preferences for involvement in the decision-making process, and to investigate how patient characteristics predict these typologies in mental healthcare settings. Methods We conducted latent class analysis (LCA) to identify groups of psychiatric outpatients with similar preferences for involvement in decision-making to estimate the probability that each patient belonged to a certain class based on sociodemographic, clinical and health belief variables. Results The LCA included 224 consecutive psychiatric outpatients’ preferences for involvement in treatment decisions in public and private psychiatric settings. The LCA identified three distinct preference typologies, two collaborative and one passive, accounting for 78% of the variance. Class 1 (26%) included collaborative men aged 34–44 years with an average level of education who were treated by public services for a depressive disorder, had high psychological reactance, believed they controlled their disease and had a pharmacophobic attitude. Class 2 (29%) included collaborative women younger than 33 years with an average level of education, who were treated by public services for an anxiety disorder, had low psychological reactance or health control belief and had an unconcerned attitude toward medication. Class 3 (45%) included passive women older than 55 years with lower education levels who had a depressive disorder, had low psychological reactance, attributed the control of their disease to their psychiatrists and had a pharmacophilic attitude. Conclusions Our findings highlight how psychiatric patients vary in pattern of preferences for treatment involvement regarding demographic variables and health status, providing insight into understanding the pattern of preferences and comprising a significant advance in mental healthcare research.

scholarly journals Influence of pharmaceutical marketing mix strategies on physicians’ prescribing behaviors in public and private hospitals, Dessie, Ethiopia: a mixed study design

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Abel Demerew Hailu ◽  
Birhanu Demeke Workneh ◽  
Mesfin Haile Kahissay
Keyword(s):  
Study Design ◽  
Marketing Mix ◽  
Pharmaceutical Marketing ◽  
Depth Information ◽  
Second Phase ◽  
Private Hospitals ◽  
Public And Private ◽  
Qualitative Design ◽  
Prescribing Behavior ◽  
Public And Private Hospitals

Abstract Background Prescription drugs constitute the primary source of revenue for the pharmaceutical industry. Most pharmaceutical companies commit a great deal of time and money to market in hopes of convincing physicians about their products. The objective of this study is to assess perceived influence of pharmaceutical marketing mix strategies on physicians’ prescribing behaviors in hospitals, Dessie, Ethiopia. Methods Mixed methods sequential explanatory design was employed in two public and three private hospitals. A cross-sectional study design was employed by including (136) physicians working in public and private hospitals. Percentage, mean, standard deviation, and multiple linear regressions were computed using Statistical Package for Social Science. In the second phase, the phenomenological design was employed to fully explore in-depth information. Purposive sampling was used to select key informants and 14 in-depth interviews were conducted by the principal investigator. Content analysis was performed using Nvivo 11 plus and interpretation by narrative strategies. Results The overall perceived influence of pharmaceutical marketing mix strategies in physicians’ prescribing behavior was 55.9%. The influence of promotion, product, place and price strategy perceived by physicians in their prescribing behavior was 83 (61%), 71(52.2%), 71 (52.2%), 80 (58.8%) respectively. There was a statistically significant difference among marketing mix strategies (β = 0.08, p = < 0.001). Determinants on the influence of physicians’ prescribing behavior were specialty (p = 0.01) and working areas (p = 0.04). The qualitative design also generates additional insights into the influence of pharmaceutical marketing mix strategies on physician prescribing behavior. Conclusions More than half of physicians perceived that pharmaceutical marketing mix strategies influence their prescribing behavior. The qualitative design also revealed that pharmaceutical marketing mix strategies influenced physicians prescribing behavior. Strengthening the regulation and maintaining ethical practice would help to rationalize the physicians’ prescribing practice.

scholarly journals The role of the nurse in the neonatal intensive care unit: between the ideal, the real and the possible

2011 ◽  
Vol 19 (2) ◽  
pp. 301-308 ◽  
Author(s):  
Liciane Langona Montanholi ◽  
Miriam Aparecida Barbosa Merighi ◽  
Maria Cristina Pinto de Jesus
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Public And Private ◽  
Public And Private Hospitals ◽  
The City ◽  
Social Phenomenology ◽  
The Ideal

The nurse is one of the professionals responsible for the care directed toward the physical, mental and social development of newborns in the Neonatal Intensive Care Unit. This study aimed to comprehend the experience of nurses working in a Neonatal Intensive Care Unit. Data collection was performed in 2008, through interviews with 12 nurses working in public and private hospitals of the city of São Paulo. The units of meaning identified were grouped into three categories: Developing actions; Perceiving their actions and Expectations. The analysis was based on social phenomenology. It was concluded that the overload of activities, the reduced number of staff, the lack of materials, equipment and the need for professional improvement are the reality of the work of the nurse in this sector. To supervise the care is the possible; integral care of the newborn, involving the parents, is the ideal desired.

Experiences of intensive care unit nurses with COVID-19 patients

2021 ◽  
Vol 55 ◽  
Author(s):  
Claudete Aparecida Conz ◽  
Vanessa Augusta Souza Braga ◽  
Rosianne Vasconcelos ◽  
Flávia Helena Ribeiro da Silva Machado ◽  
Maria Cristina Pinto de Jesus ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Physical Space ◽  
Physical And Mental Health ◽  
Public And Private ◽  
Professional Recognition ◽  
Public And Private Hospitals ◽  
Training And Support ◽  
Continuous Use ◽  
Intensive Care Unit Nurses

ABSTRACT Objective: To understand the experiences of intensive care unit nurses who provide care to patients with COVID-19. Methods: Qualitative study grounded in Alfred Schütz’s social phenomenology in which 20 nurses who work in intensive care units at public and private hospitals were interviewed between July and September 2020. Data were analyzed according to the adopted theoretical-methodological framework and the literature related to the subject. Results: The interviewed nurses mentioned demands about working conditions, professional recognition and training, and support to physical and mental health, which proved necessary considering the care intensity experienced by these professionals during the COVID-19 pandemic. Conclusion: Learning the nurses’ experiences evidenced the need to adjust to a new way of providing care that included the physical space, new institutional protocols, continuous use of protective equipment, and patients’ demand for special care. This originated the necessity to be around situations that interfered with their health and motivated them to carry out professional projects after the COVID-19 pandemic.

Estimation of Na\K - ATPase Enzyme Activity and Endogenous Digitalis in Patients with Diabetic Neuropathy

2021 ◽  
Vol 19 (5) ◽  
pp. 95-103
Author(s):  
Eman Hameed Al-Rikabi ◽  
Mazin J. Mousa ◽  
Oda M. Yasser
Keyword(s):  
Enzyme Activity ◽  
Diabetic Neuropathy ◽  
Inhibitory Activity ◽  
Strong Association ◽  
Clinical Manifestations ◽  
Gradual Loss ◽  
Study Results ◽  
Healthy Control ◽  
The Mean ◽  
Age Range

Background: Among the most common complications of diabetes is diabetic neuropathy (DN). Diabetic neuropathy is a heterogeneous group of disorders, which involves a different part of somatic and autonomic nervous systems, with a gradual loss of neural conductivity. Some studies have shown that they reduce the activity of the Na/K ATPase, however, elevated levels of endogenous sodium pump inhibitor in diabetic individuals, including those with neuropathy. Changes in this transfer enzyme are believed to be due to several diabetes complications. Objective: The study had designed to evaluate the Na/K ATPase enzymatic activity in the erythrocyte-membrane among three groups. The first group had represented the patients with type 2 diabetes mellitus (DM2) and neuropathy. The second group is diabetics without neuropathy. The third group was a healthy subject. As well, the study had estimated the inhibitory activity of endogenous digitalis among patient groups. Furthermore, the aim of this research was to see whether there was a connection between red blood cell membrane Na-K ATPase activity and the medical facts of the analysis subjects. Design and Methods: One-hundred fifty subjects had enrolled in this case-control study; 80 patients complained of diabetic neuropathy of both sexes, the mean age 59.3 years with an age range of 40-81, 40 DM2 without neuropathy (53.9 years), (35 – 70), and 30 healthy controls (30 years, 25 to 45). Patients in the first group were selected carefully according to their clinical manifestations and the nerve conduction study results. The evaluations of both inhibitory activities of endogenous digitalis and Na/K ATPase had completed using a spectrophotometer. Enzyme activity had expressed in micrograms of phosphate concentration per grams of red cell ghost total protein concentration. Results: The mean enzyme activity of Na/K ATPase was significantly lower (p<0.001) in patients with diabetic neuropathy (381±17.9) compared with the diabetic group without neuropathy (498±22.9) and the normal controls (837±61.43). There was a significant inhibitory activity of endogenous digitals (17.87±2.15) in patients with DNP, compared with the diabetics without neuropathy (8.78±0.89) and healthy control (5.3±1.33). There was a significant association of enzyme activity with the following parameters: duration of diabetes, age, level of glycated hemoglobin and endogenous digitalis with the respective p-values (0.000, 0.000, 0.000 and 0.021). Gender showed no significant relationship with enzyme activity (p 0.43). Conclusions: In DM2 with neuropathy, hyperglycemia can much reduce the activity of erythrocyte Na/K ATPase. In addition, it may enhance the inhibitory activity of endogenous digitals. The timedependent increase in diabetic complications can be due to a strong association between diabetes duration and erythrocyte Na/K-ATPase activities.

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