scholarly journals Behavioural Health Screening and Service Use in a Statewide Sample of MedicaidEligible Pediatric Outpatients

2020 ◽  
pp. 1-6
Author(s):  
J. Michael Murphy ◽  
J. Michael Murphy ◽  
Alexa Riobueno-Naylor ◽  
Haregnesh Haile ◽  
Holcomb Juliana M ◽  
...  
Keyword(s):  
Service Use ◽  
Statistical Significance ◽  
Health Maintenance Organization ◽  
Screening Rate ◽  
Health Maintenance ◽  
Patients Âgés ◽  
Behavioural Health ◽  
Before And After ◽  
The Mean ◽  
High Level

Objective: This study explored site-level rates of behavioural health (BH) screening, positive screening, and BH service use in statewide data from the largest Medicaid Health Maintenance Organization in Massachusetts. Methods: Screening rates at annual well-child visits (WCVs) were assessed across 908 sites (practices) for patients ages 4-17 between 2014-2018. The primary analytic sample included WCVs in 2016 (N=76,752) and was restricted to sites with at least 30 WCVs (N=304 sites; N=72,842 patients). Use of BH services was assessed six months before and after the index WCV. Results: The mean WCV screening rate across the analytical sample was 71.2% (SD=31.3; range=0.0- 100.0%) and the mean positive screening rate was 7.2% (SD=12.7, range=0-100%). Using intra-class correlations, small, but meaningful differences, were found between sites in rates of overall (r=0.38; 95% CI=0.25-0.50) and positive (r=0.10; 95% CI=0.00-0.29) screening. Although the relationship between a site’s rate of screening and the rate of BH treatment failed to reach statistical significance, there was a nonsignificant correlation (r=0.08, p=0.17) in the predicted direction and sites that screened at or above the mean screening rate (71.9% of their WCVs) were significantly more likely to have 6.0% or more of their patients receive subsequent BH services than were sites with screening rates below 71.9% (67.2% vs. 51.2%, p<.05). Conclusion: The current study documented a high level of continued compliance with the statewide mandate for routine psychosocial screening after more than a decade, although there were some relatively small decreases in compliance in recent years. The study also found that there were significant differences between sites in rates of BH screening and positive screening and a relationship between site-level rates of screening and service use.

scholarly journals Accelerated Aging Effects on Surface Hardness and Roughness of Lingual Retainer Adhesives

2008 ◽  
Vol 78 (1) ◽  
pp. 140-144 ◽  
Author(s):  
Sabri Ilhan Ramoglu ◽  
Serdar Usumez ◽  
Tamer Buyukyilmaz
Keyword(s):  
Surface Roughness ◽  
Vickers Hardness ◽  
Statistical Significance ◽  
Accelerated Aging ◽  
Aging Effects ◽  
Surface Microhardness ◽  
Halogen Light ◽  
Before And After ◽  
The Mean ◽  
Lingual Retainer

Abstract Objective: To test the null hypothesis that accelerated aging has no effect on the surface microhardness and roughness of two light-cured lingual retainer adhesives. Materials and Methods: Ten samples of light-cured materials, Transbond Lingual Retainer (3M Unitek) and Light Cure Retainer (Reliance) were cured with a halogen light for 40 seconds. Vickers hardness and surface roughness were measured before and after accelerated aging of 300 hours in a weathering tester. Differences between mean values were analyzed for statistical significance using a t-test. The level of statistical significance was set at P &lt; .05. Results: The mean Vickers hardness of Transbond Lingual Retainer was 62.8 ± 3.5 and 79.6 ± 4.9 before and after aging, respectively. The mean Vickers hardness of Light Cure Retainer was 40.3 ± 2.6 and 58.3 ± 4.3 before and after aging, respectively. Differences in both groups were statistically significant (P &lt; .001). Following aging, mean surface roughness was changed from 0.039 μm to 0.121 μm and from 0.021 μm to 0.031 μm for Transbond Lingual Retainer and Light Cure Retainer, respectively. The roughening of Transbond Lingual Retainer with aging was statistically significant (P &lt; .05), while the change in the surface roughness of Light Cure Retainer was not (P &gt; .05). Conclusions: Accelerated aging significantly increased the surface microhardness of both light-cured retainer adhesives tested. It also significantly increased the surface roughness of the Transbond Lingual Retainer.

scholarly journals Prevalence and Predictors of Stress among Bankers in Enugu State South-East Nigeria

2020 ◽  
Vol 32 (2) ◽  
pp. 68-79
Author(s):  
T.J. Okwor ◽  
A.C. Ndu ◽  
S.U. Arinze-Onyia ◽  
I.J. Ogugua ◽  
I.M. Obionu ◽  
...  
Keyword(s):  
Sampling Method ◽  
Statistical Significance ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Eastern State ◽  
Management Standards ◽  
The Mean ◽  
Enugu State ◽  
Multistage Sampling ◽  
High Level

Background: The work environment is rapidly changing and in recent times, occupational stress poses a threat to the health, morale and productivity of workers and the organization. This study sought to determine the prevalence and predictors of stress among bankers in a south-eastern state of Nigeria. Methods: A descriptive cross-sectional study was carried out among 370 bankers in Enugu State, Nigeria using the Health, Safety, Executive (HSE) management standards indicator tool. Multistage sampling method was used to select participants. Statistical analysis was done using SPSS 22.0. Level of statistical significance was set at p< 0.05.Results: The mean age of the participants was 34.54±6.3 years while the mean years of work was 6.01±4.7years. One hundred and seventy-four (47%) reported high level of stress due to relationship at work while 318 (85.9%) reported low level of stress due to roles. Being 35 years or less was found to a predictor of high (AOR 0.55, CI 0.30-1.02) level of stress due to control.Work experience of 5 years or less was found to be a predictor of both high (AOR 0.74, CI 0.40--1.37) and low (AOR 0.99, CI 0.40-1.37) levels of stress due to control.Conclusion: This study has shown that the prevalence of stress was high among bankers in Enugu State, South-East Nigeria. There is, therefore, the need for routine stress assessment and interventions in the banking industry especially for those at high risk. Keywords: Bankers; HSE Stress Questionnaire; Stress; Workplace; Southeast Nigeria

scholarly journals Biochemical Markers of Renal Hypoperfusion, Hemoconcentration, and Proteinuria after Extreme Physical Exercise

Medicina ◽  
2019 ◽  
Vol 55 (5) ◽  
pp. 154 ◽  
Author(s):  
Wojciech Wołyniec ◽  
Katarzyna Kasprowicz ◽  
Patrycja Rita-Tkachenko ◽  
Marcin Renke ◽  
Wojciech Ratkowski
Keyword(s):  
Physical Exercise ◽  
Statistical Significance ◽  
Blood Perfusion ◽  
Fractional Excretion ◽  
Creatinine Ratio ◽  
Plasma Urea ◽  
Urinary Potassium ◽  
Before And After ◽  
The Mean ◽  
Renal Hypoperfusion

Background and Objectives: Physical exercise increases the blood perfusion of muscles, but decreases the renal blood flow. There are several markers of renal hypoperfusion which are used in the differential diagnosis of acute kidney failure. Albuminuria is observed after almost any exercise. The aim of this study was to assess changes in renal hypoperfusion and albuminuria after a 100-km race. Materials and Methods: A total of 27 males who finished a 100-km run were studied. The mean age of the runners was 38.04 ± 5.64 years. The exclusion criteria were a history of kidney disease, glomerular filtration rate (GFR) <60 ml/min, and proteinuria. Blood and urine were collected before and after the race. The urinary albumin/creatinine ratio (ACR), fractional excretion of urea (FeUrea) and sodium (FeNa), plasma urea/creatinine ratio (sUrea/Cr), urine/plasma creatinine ratio (u/pCr), urinary sodium to potassium ratio (uNa/K), and urinary potassium to urinary potassium plus sodium ratio (uK/(K+Na)) were calculated. Results: After the race, significant changes in albuminuria and markers of renal hypoperfusion (FeNa, FeUrea, sUrea/Cr, u/sCr, urinary Na, uNa/K, uK/(K+Na)) were found. Fifteen runners (55.56%) had severe renal hypoperfusion (FeUrea <35, uNa/K <1, and uK/(Na+K) >0.5) after the race. The mean ACR increased from 6.28 ± 3.84 mg/g to 48.43 ± 51.64 mg/g (p < 0.001). The ACR was higher in the group with severe renal hypoperfusion (59.42 ± 59.86 vs. 34.68 ± 37.04 mg/g), but without statistical significance. Conclusions: More than 50% of the runners had severe renal hypoperfusion after extreme exercise. Changes in renal hemodynamics are probably an important, but not the only, factor of post-exercise proteinuria.

scholarly journals Impacts of Distance Education System on Teacher Competency of Remote Schools in Lower Northern Thailand

2019 ◽  
Vol 10 (3) ◽  
pp. 41-47
Author(s):  
Sakchai Petsuwan ◽  
Paitoon Pimdee ◽  
Phadungchai Pupat
Keyword(s):  
Distance Education ◽  
Achievement Motivation ◽  
Education System ◽  
Statistical Significance ◽  
Northern Thailand ◽  
Teacher Competency ◽  
Before And After ◽  
High Level ◽  
Dependent Samples ◽  
Distance Education System

Abstract This research aimed to study the impacts of Distance Education System on teacher Competency and compare teacher Competency before and after Distance Education System is applied. The sample was 28 teachers from four Remote Schools in lower Northern Thailand. Questionnaire was used as a data collection tool with reliability 0.99. Mean, Standard deviation and t-test for dependent samples were applied in data analysis process. The results showed that the Competency of teacher before Distance Education System had four competencies in moderate level including Working Achievement Motivation, Self- Development, Curriculum and Learning Management and Analysis & Synthesis & Classroom Research while other competencies were in high level. Distance Education System has positive impacts on teacher Competency as the every competency reaches high level after the system is applied with statistical significance at the level of 0.01.

scholarly journals Efficacy and tolerability of combined medication of two different antimuscarinics for treatment of adults with idiopathic overactive bladder in whom a single agent antimuscarinic therapy failed

2013 ◽  
Vol 7 (1-2) ◽  
pp. 88 ◽  
Author(s):  
Junseok Yi ◽  
Seong Jin Jeong ◽  
Min Soo Chung ◽  
Hongzoo Park ◽  
Sang Wook Lee ◽  
...  
Keyword(s):  
Overactive Bladder ◽  
Statistical Significance ◽  
Single Agent ◽  
Clean Intermittent Catheterization ◽  
Dosage Escalation ◽  
Before And After ◽  
The Mean ◽  
Combined Medication ◽  
Voided Volume ◽  
Antimuscarinic Therapy

Objective: Recent studies have investigated a combination of two antimuscarinics for adult neurogenic bladder managed with clean intermittent catheterization or pediatric refractory overactive bladder (OAB). We assessed the efficacy and tolerability of this strategy in adults with idiopathic OAB.Methods: We reviewed 49 patients with idiopathic OAB whoreceived combined antimuscarinic medication. Patients had seriallyreceived different kinds of antimuscarinics as monotherapy, but wished to take combined medication due to a lack of sufficient subjective improvement in urgency, even with dosage escalation. Efficacy was measured by changes of episodes of urgency, daytime voiding, nocturia and mean voided volume before and after the addition of the second antimuscarinic.Results: The mean duration of combined medication was 9.3 months. After adding the second antimuscarinic, urgency per day decreased from 3.8 to 1.9 (p < 0.001) and daytime voiding decreased from 10.4 to 7.4 (p < 0.001). The number of nocturia episodes and the mean voided volume also improved, although therewas no statistical significance. Efficacy did not differ between the 29 cases, with non-selective and non-selective drugs and 20 cases with non-selective and M3 selective drugs. Thirty-three (67.3%) patients reported to have benefited from combined medication. Maximal flow rate and post-void residual volume did not change in either of the sexes. Eleven (22.4%) patients discontinued the combination due to continued ineffectiveness and dry mouth.Conclusion: This retrospective study suggests that combined medication can help adults with refractory idiopathic OAB. Combined medication was tolerated in most of our patients.

Antidepressant Pharmacotherapy: Economic Evaluation of Fluoxetine, Paroxetine and Sertraline in a Health Maintenance Organization

1995 ◽  
Vol 23 (6) ◽  
pp. 395-412 ◽  
Author(s):  
D A Sclar ◽  
L M Robison ◽  
T L Skaer ◽  
R S Galin ◽  
R F Legg ◽  
...  
Keyword(s):  
Health Service ◽  
Service Use ◽  
Health Maintenance Organization ◽  
Health Service Use ◽  
Health Maintenance ◽  
Physician Visits ◽  
Psychiatric Hospitalizations ◽  
Treatment Of Depression ◽  
Per Capita ◽  
Antidepressant Pharmacotherapy

The present study was designed to compare direct health service expenditures, for the treatment of depression, among patients enrolled in a health maintenance organization, and prescribed one of three selective serotonin reuptake inhibitors, fluoxetine, paroxetine or sertraline. Information regarding depression-related health service use was derived from the computer archive of a network-model health maintenance organization system serving 700 000 beneficiaries. A total of 744 health maintenance organization beneficiaries were found to satisfy the study selection criteria. Multivariate regression analysis was used to determine the incremental influence of selected demographic, clinical, financial and provider characteristics on health service expenditures related to the treatment of depression (ICD-9-CM, or DSM-IV code 296.2) 1 year after the start of antidepressant pharmacotherapy. Multivariate findings indicate that treatment with paroxetine increases average expenditures for physician visits ($31.93; P ≤ 0.05), psychiatric visits ($19.33; NS), laboratory tests ($2.35; P ≤ 0.05), hospitalizations ($85.33; P ≤ 0.05), psychiatric hospitalizations ($82.01; P ≤ 0.05), and antidepressant pharmacotherapy ($63.72; P ≤ 0.05), for a total per capita increase in health service use of $284.68 ( P ≤ 0.05), compared with treatment with fluoxetine. Sertraline treatment increases average expenditures for physician visits ($21.74; P ≤ 0.05), psychiatric visits ($56.79; P ≤ 0.05), laboratory tests ($1.21; P ≤ 0.05), hospitalizations ($70.59; P ≤ 0.05), psychiatric hospitalizations ($95.75; P ≤ 0.05), and antidepressant pharmacotherapy ($69.85; P ≤ 0.05), for a total per capita increase in health service use of $315.96 ( P ≤ 0.05), compared with treatment with fluoxetine. Economic comparisons between paroxetine and sertraline did not demonstrate any significant differences in expenditures for the health services examined.

scholarly journals Learning Achievement Improvement of 1st Grade Students by Using Problem-Based Learning (PBL) on TPACK MODEL

2022 ◽  
Vol 11 (2) ◽  
pp. 43
Author(s):  
Orathai Chaidam ◽  
Apantee Poonputta
Keyword(s):  
Problem Based Learning ◽  
Achievement Test ◽  
Lesson Plans ◽  
Learning Achievement ◽  
Average Efficiency ◽  
Class 1 ◽  
Before And After ◽  
The Mean ◽  
High Level ◽  
Academic Year

The objectives of the research were: 1) to develop the lesson plans for &ldquo;Weight and Measurement&rdquo; of Mathematics by using Problem-Based Learning on TPACK MODEL based on the efficiency of the process and the overall result (E1/E2) at the established criteria of 75/75; 2) to compare the students&rsquo; learning achievement in &ldquo;Weight and Measurement&rdquo; of the 1st grade students before and after by using Problem-Based Learning on TPACK MODEL; 3) to study the students&rsquo; satisfaction with Problem-Based Learning on TPACK MODEL. The research samples were thirty-five 1st grade students of class 1 in the 1st semester of the academic year 2020 at Sanambin School in Khon Kaen Province. They were selected by purposive sampling. The instruments used in this study were lesson plans, an achievement test, and a questionnaire on students&rsquo; satisfaction. The statistics used for analyzing the collected data were mean, standard deviation, percentage, and gain score. The research results showed that 1) the average efficiency of the lesson plans for &ldquo;Weight and Measurement&rdquo; by using Problem-Based Learning on TPACK MODEL with exercises was 85.54/78.71, which was higher than theestablished criteria. 2) The mean score of the 1st grade students for &ldquo;Weight and Measurement&rdquo; of Mathematics after using Problem-Based Learning on TPACK MODEL was significantly higher than that of before using the Problem-Based Learning Model. 3) The overall satisfaction of the students with the Problem-Based Learning on TPACK MODEL for &ldquo;Weight and Measurement was at a high level.

Autologous Adipose Tissue Injection of Vocal Cords in Presbyphonia

2021 ◽  
pp. 019459982110452
Author(s):  
Ramón González-Herranz ◽  
Andrés Navarro-Mediano ◽  
Estefanía Hernández-García ◽  
Guillermo Plaza
Keyword(s):  
Medical Center ◽  
Statistical Significance ◽  
Vocal Folds ◽  
Demographic Variables ◽  
Long Term Results ◽  
Maximum Phonation Time ◽  
Before And After ◽  
The Mean

Objective This series evaluates the long-term results of autologous adipose injection (AAI) in patients older than 65 years with presbyphonia. Study Design Retrospective cohort study. Setting Academic secondary medical center. Methods This was a retrospective study with a minimum follow-up of 12 months. All patients underwent AAI for atrophy of both vocal folds due to presbyphonia. We measured subjective parameters as Voice Handicap Index–10 (VHI-10) or GRBAS scale (grade, roughness, breathiness, asthenia, strain) and objective measures such as maximum phonation time (MPT) or square pixel closure defect. We reviewed the medical records of patients undergoing AAI during the 2011-2018 period. An analysis of the demographic variables of the group was performed, as well as the values of VHI-10, GRBAS, and MPT, and the minimum closure defect measured in square pixels and the number of closed frames in the glottal cycle before and after the intervention. Results At 12 months, 17 of 18 patients reported subjective and VHI-10 improvement. The mean preoperative VHI-10 (26.7) was significantly higher than the postoperative value (14.4), and the GRBAS scale had a preoperative mean of 8.7 and a postoperative mean of 4.3, both with statistical significance. MPT increased from 7.7 to 12.4 seconds ( P < .0001). The minimum closure defect measurements obtained in square pixels changed from 305 to 124, achieving complete closure in 3 patients. The closed phase of the glottal cycle change from 14.3% to 38.2% after the AAI. Conclusions AAI improves long-term vocal fold closure, demonstrating utility in patients with presbyphonia.

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