scholarly journals Timely delivery of laboratory efficiency information, Part II: Assessing the impact of a turn-around time dashboard at a high-volume laboratory

2020 ◽  
Vol 9 (2) ◽  
Author(s):  
Naseem Cassim ◽  
Lindi M. Coetzee ◽  
Manfred E. Tepper ◽  
Louella Perelson ◽  
Deborah K. Glencross
Keyword(s):  
Ad Hoc ◽  
High Volume ◽  
Descriptive Study ◽  
Microsoft Excel ◽  
Important Indicator ◽  
Laboratory Service ◽  
Turn Around Time ◽  
The Impact ◽  
Short Times ◽  
Timely Delivery

Background: In South Africa’s National Health Laboratory Service, ad hoc mean turn-around time (TAT) reporting is an important indicator of performance. However, historic static TAT reporting did not assess very long or very short times. An interactive TAT dashboard was developed using the following TAT measures; (1) median, (2) 75th percentile and (3) percentage of within cut-off TAT to allow for improved differentiation of TAT performance.Objectives: The objective of our study was to demonstrate increased efficiency achieved by using an interactive TAT dashboard.Methods: A retrospective descriptive study design was used. Creatinine TAT outcomes were reported over 122 weeks from a high-volume laboratory in Gauteng, South Africa. The percentage of within cut-off and 75th percentile TAT were analysed and reported using Microsoft Excel. A focus group session was used to populate a cause and effect diagram.Results: The percentage of within cut-off TAT increased from 10% in week 4 to 90% and higher from week 81. The 75th percentile decreased from 10 hours in week 4 to under 5 h from week 71. Component TAT analysis revealed that the 75th percentile testing was 5 h or longer for weeks 4, 5 and 48. The 75th percentile review TAT ranged from 1 h to 15 h. From week 41, the review TAT was under 1 h.Conclusion: Our study demonstrated that the use of an interactive TAT dashboard coupled with good management can dramatically improve TAT and efficiency in a high-volume laboratory.

Report of the Ad Hoc Subgroup on the Impact of Competition in Contracting on Research and Development

1988 ◽  
Author(s):  
Laurence Storch ◽  
Donald Fraser ◽  
Robert Lunn ◽  
Barbara Glacel ◽  
Naomi J. McAfee
Keyword(s):  
Research And Development ◽  
Ad Hoc ◽  
The Impact

PP469 From Theory To Practice: Which Value Framework Is Applied For Onco-Hematology Therapies In Italy? A 5-year Retrospective Analysis

2020 ◽  
Vol 36 (S1) ◽  
pp. 37-37
Author(s):  
Americo Cicchetti ◽  
Rossella Di Bidino ◽  
Entela Xoxi ◽  
Irene Luccarini ◽  
Alessia Brigido
Keyword(s):  
Real World ◽  
Ad Hoc ◽  
Grey Literature ◽  
National Level ◽  
Pharmaceutical Products ◽  
European Medicines Agency ◽  
The Real ◽  
R Process ◽  
The One ◽  
The Impact

IntroductionDifferent value frameworks (VFs) have been proposed in order to translate available evidence on risk-benefit profiles of new treatments into Pricing & Reimbursement (P&R) decisions. However limited evidence is available on the impact of their implementation. It's relevant to distinguish among VFs proposed by scientific societies and providers, which usually are applicable to all treatments, and VFs elaborated by regulatory agencies and health technology assessment (HTA), which focused on specific therapeutic areas. Such heterogeneity in VFs has significant implications in terms of value dimension considered and criteria adopted to define or support a price decision.MethodsA literature research was conducted to identify already proposed or adopted VF for onco-hematology treatments. Both scientific and grey literature were investigated. Then, an ad hoc data collection was conducted for multiple myeloma; breast, prostate and urothelial cancer; and Non Small Cell Lung Cancer (NSCLC) therapies. Pharmaceutical products authorized by European Medicines Agency from January 2014 till December 2019 were identified. Primary sources of data were European Public Assessment Reports and P&R decision taken by the Italian Medicines Agency (AIFA) till September 2019.ResultsThe analysis allowed to define a taxonomy to distinguish categories of VF relevant to onco-hematological treatments. We identified the “real-world” VF that emerged given past P&R decisions taken at the Italian level. Data was collected both for clinical and economical outcomes/indicators, as well as decisions taken on innovativeness of therapies. Relevant differences emerge between the real world value framework and the one that should be applied given the normative framework of the Italian Health System.ConclusionsThe value framework that emerged from the analysis addressed issues of specific aspects of onco-hematological treatments which emerged during an ad hoc analysis conducted on treatment authorized in the last 5 years. The perspective adopted to elaborate the VF was the one of an HTA agency responsible for P&R decisions at a national level. Furthermore, comparing a real-world value framework with the one based on the general criteria defined by the national legislation, our analysis allowed identification of the most critical point of the current national P&R process in terms ofsustainability of current and future therapies as advance therapies and agnostic-tumor therapies.

scholarly journals The malaria burden of Amerindian groups of three Venezuelan states: a descriptive study based on programmatic data

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Juan C. Gabaldón-Figueira ◽  
Carlos Chaccour ◽  
Jorge Moreno ◽  
Maria Villegas ◽  
Leopoldo Villegas
Keyword(s):  
Risk Factors ◽  
Plasmodium Falciparum ◽  
Malaria Incidence ◽  
Hot Spot ◽  
Public Health Problem ◽  
Epidemiological Data ◽  
Descriptive Study ◽  
Malaria Burden ◽  
Indigenous Groups ◽  
The Impact

Abstract Background Fifty-three percent of all cases of malaria in the Americas in 2019 came from Venezuela, where the epidemic is heavily focused south of the Orinoco river, and where most of the country’s Amerindian groups live. Although the disease is known to represent a significant public health problem among these populations, little epidemiological data exists on the subject. This study aims to provide information on malaria incidence, geospatial clustering, and risk factors associated to Plasmodium falciparum infection among these groups. Methods This is a descriptive study based on the analysis of published and unpublished programmatic data collected by Venezuelan health authorities and non-government organizations between 2014 and 2018. The Annual Parasite Index among indigenous groups (API-i) in municipalities of three states (Amazonas, Bolivar, and Sucre) were calculated and compared using the Kruskal Wallis test, risk factors for Plasmodium falciparum infection were identified via binomial logistic regression and maps were constructed to identify clusters of malaria cases among indigenous patients via Moran’s I and Getis-Ord’s hot spot analysis. Results 116,097 cases of malaria in Amerindian groups were registered during the study period. An increasing trend was observed between 2014 and 2016 but reverted in 2018. Malaria incidence remains higher than in 2014 and hot spots were identified in the three states, although more importantly in the south of Bolivar. Most cases (73.3%) were caused by Plasmodium vivax, but the Hoti, Yanomami, and Eñepa indigenous groups presented higher odds for infection with Plasmodium falciparum. Conclusion Malaria cases among Amerindian populations increased between 2014 and 2018 and seem to have a different geographic distribution than those among the general population. These findings suggest that tailored interventions will be necessary to curb the impact of malaria transmission in these groups.

scholarly journals IMPACT OF LAPAROSCOPIC COLORECTAL SURGERY ON BODY IMAGE

2021 ◽  
Vol 108 (Supplement_3) ◽  
Author(s):  
A Fernández Candela ◽  
L Sánchez-Guillén ◽  
L García Catalá ◽  
C Curtis Martínez ◽  
M Bosch Ramírez ◽  
...  
Keyword(s):  
Body Image ◽  
Colorectal Surgery ◽  
Laparoscopic Colorectal Surgery ◽  
Wound Complication ◽  
Descriptive Study ◽  
Surgical Quality ◽  
Body Image Scale ◽  
Study Results ◽  
The Impact ◽  
Observational Descriptive Study

Abstract INTRODUCTION The aim of this study is to evaluate the impact of laparoscopic colorectal surgery (LCS) on body image using the validated Body Image Scale (BIS) as a parameter of surgical quality. MATERIAL AND METHODS We conducted an observational descriptive study. Patients who underwent scheduled LCS between June 2015 and December 2019 by a General Hospital Coloproctology Unit were included. RESULTS The sample included 180 patients, 115 men (63.9%) and 65 women (36.1%) with a median age of 67 years. Right hemicolectomies (31.7%) and sigmoidectomies (28.3%) were the main procedures performed. In most patients, a suprapubic (69.4%) or transverse (19.4%) incision was made. 21.9% suffered some type of postoperative complication (13.9% wound complication, 10.6% incisional hernia). The general result of the BIS questionnaire was satisfactory, with a median of 0 in the responses (no alteration of body image). We found that 46.2% of the women had some alteration in body image, compared to 28.7% of the men (p = 0.018) and low and ultra-low anterior resection were the surgeries that obtained worst scores, with 13,5% and 12,5% respectively of patients with a BIS score above 5 (p = 0.044). Patients with a stoma also obtained worst punctuation (25% above 5 vs 6,1%, p = 0.001). No statistically significant differences were found regarding type of incision, presence of complications and anxiety or depression. CONCLUSION Study results show, in general, good post-surgical body image after LCS. However, patients with stoma and women were more dissatisfied. Interestingly, there is no worse body image due to type of incision, so we recommend the least iatrogenic one.

scholarly journals Prevalence of SARS-CoV-2 Infection at the University of Barcelona during the Third COVID-19 Pandemic Wave in Spain

2021 ◽  
Vol 18 (12) ◽  
pp. 6526
Author(s):  
Sebastián Videla ◽  
Aurema Otero ◽  
Sara Martí ◽  
M. Ángeles Domínguez ◽  
Nuria Fabrellas ◽  
...  
Keyword(s):  
Ad Hoc ◽  
Venous Blood ◽  
Herd Immunity ◽  
Cross Sectional Study ◽  
Rt Pcr ◽  
Igg Antibody ◽  
Cross Sectional ◽  
Total Prevalence ◽  
The University ◽  
The Impact

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic started in December 2019 and still is a major global health challenge. Lockdown measures and social distancing sparked a global shift towards online learning, which deeply impacted universities’ daily life, and the University of Barcelona (UB) was not an exception. Accordingly, we aimed to determine the impact of the SARS-CoV-2 pandemic at the UB. To that end, we performed a cross-sectional study on a sample of 2784 UB members (n = 52,529). Participants answered a brief, ad hoc, online epidemiological questionnaire and provided a nasal swab for reverse transcription polymerase chain reaction (RT-PCR) SARS-CoV-2 analysis and a venous blood sample for SARS-CoV-2 IgG antibody assay. Total prevalence of SARS-CoV-2 infection (positive RT-PCR or positive IgG) was 14.9% (95%CI 13.3 to 17.0%). Forty-four participants (1.6%, 95%CI: 1.2–2.1%) were positive for SARS-CoV-2 RT-PCR. IgG against SARS-CoV-2 was observed in 12.8% (95%CI: 11.6–14.1%) of participants. Overall, while waiting for population vaccination and/or increased herd immunity, we should concentrate on identifying and isolating new cases and their contacts.

scholarly journals Relationship between Changes over Time in Factors, Including the Impact of Meteorology on Photochemical Oxidant Concentration and Causative Atmospheric Pollutants in Kawasaki

Atmosphere ◽  
2021 ◽  
Vol 12 (4) ◽  
pp. 446
Author(s):  
Akinori Fukunaga ◽  
Takaharu Sato ◽  
Kazuki Fujita ◽  
Daisuke Yamada ◽  
Shinya Ishida ◽  
...  
Keyword(s):  
Moving Average ◽  
Atmospheric Pollutants ◽  
Important Indicator ◽  
Photochemical Oxidant ◽  
Oxidant Concentration ◽  
Using Data ◽  
Changes Over Time ◽  
The Impact ◽  
The Relationship ◽  
The City

To clarify the relationship between changes in photochemical oxidants’ (Ox) concentrations and their precursors in Kawasaki, a series of analyses were conducted using data on Ox, their precursors, nitrogen oxides (NOx) and volatile organic compounds (VOCs), and meteorology that had been monitored throughout the city of Kawasaki for 30 years from 1990 to 2019. The trend in air temperature was upward, wind speed was downward, and solar radiation was upward, indicating an increasing trend in meteorological factors in which Ox concentrations tend to be higher. Between 1990 and 2013, the annual average Ox increased throughout Kawasaki and remained flat after that. The three-year moving average of the daily peak increased until 2015, and after that, it exhibited a slight decline. The amount of generated Ox is another important indicator. To evaluate this, a new indicator, the daytime production of photochemical oxidant (DPOx), was proposed. DPOx is defined by daytime averaged Ox concentrations less the previous day’s nighttime averaged Ox concentrations. The trend in DPOx from April to October has been decreasing since around 2006, and it was found that this indicator reflects the impact of reducing emissions of NOx and VOCs in Kawasaki.

The underrepresentation of female participants in studies assessing the impact of high-dose exercise on cardiovascular outcomes: a scoping review

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
S Pallikadavath ◽  
R Patel ◽  
CL Kemp ◽  
M Hafejee ◽  
N Peckham ◽  
...  
Keyword(s):  
Scoping Review ◽  
High Volume ◽  
Cardiovascular Outcomes ◽  
High Dose ◽  
Funding Sources ◽  
Review Protocol ◽  
The Mean ◽  
The Impact ◽  
Over Time ◽  
Funding Acknowledgements

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Cardiovascular adaptations as a result of exercise conducted at high-intensity and high-volume are often termed the ‘Athlete’s heart’. Studies have shown that these cardiovascular adaptations vary between sexes. It is important that both sexes are well represented in this literature. However, many studies assessing the impact of high-dose exercise on cardiovascular outcomes under-recruit female participants. Purpose This scoping review aimed to evaluate the representation of females in studies assessing the impact of high-dose exercise on cardiovascular outcomes and demonstrate how this has changed over time. Methods The scoping review protocol as outlined by Arksey and O’Malley was used. OVID and EMBASE databases were searched and studies independently reviewed by two reviewers. Studies must have investigated the effects of high-dose exercise on cardiovascular outcomes. To assess how the recruitment of females has changed over time, two methods were used. One, the median study date was used to categorise studies into two groups. Two, studies were divided into deciles to form ten equal groups over the study period. Mean percentage of female recruitment and percentage of studies that failed to include females were calculated. Results Overall, 250 studies were included. Over half the studies (50.8%, n = 127) did not include female participants. Only 3.2% (n = 8) did not include male participants. Overall, mean percentage recruitment was 18.2%. The mean percentage of recruitment was 14.5% before 2011 and 21.8% after 2011. The most recent decile of studies demonstrated the highest mean percentage of female recruitment (29.3%) and lowest number of studies that did not include female participants (26.9%). Conclusion Female participants are significantly underrepresented in studies assessing cardiovascular outcomes caused by high-dose exercise. The most recent studies show that female recruitment may be improving, however, this still falls significantly short for equal representation. Risk factors, progression and management of cardiovascular diseases vary between sexes, hence, translating findings from male dominated data is not appropriate. Future investigators should aim to establish barriers and strategies to optimise fair recruitment. Mean percentage females recruited per study (%) Percentage studies that do not include women (%) Overall (n = 250) 18.2 50.8 (n = 127) Studies before 2011 (n = 121) 14.5 59.5 (n = 72) Studies after 2011 (n = 129) 21.8 42.6 (n = 55) Table 1: Female recruitment characteristics. The year 2011 (median study year) was chosen as this divides all included studies into two equal groups.

scholarly journals A Comparative UAV Forensic Analysis: Static and Live Digital Evidence Traceability Challenges

Drones ◽  
2021 ◽  
Vol 5 (2) ◽  
pp. 42
Author(s):  
Fahad E. Salamh ◽  
Umit Karabiyik ◽  
Marcus K. Rogers ◽  
Eric T. Matson
Keyword(s):  
High Volume ◽  
Forensic Analysis ◽  
Digital Evidence ◽  
Incident Response ◽  
Scientific Contribution ◽  
Response Plan ◽  
Technical Challenges ◽  
And Control ◽  
The Impact ◽  
Categorization Model

The raising accessibility of Unmanned Aerial Vehicles (UAVs), colloquially known as drones, is rapidly increasing. Recent studies have discussed challenges that may come in tow with the growing use of this technology. These studies note that in-depth examination is required, especially when addressing challenges that carry a high volume of software data between sensors, actuators, and control commands. This work underlines static and live digital evidence traceability challenges to further enhance the UAV incident response plan. To study the live UAV forensic traceability issues, we apply the `purple-teaming’ exercise on small UAVs while conducting UAV forensic examination to determine technical challenges related to data integrity and repeatability. In addition, this research highlights current static technical challenges that could pose more challenges in justifying the discovered digital evidence. Additionally, this study discusses potential drone anti-forensic techniques and their association with the type of use, environment, attack vector, and level of expertise. To this end, we propose the UAV Kill Chain and categorize the impact and complexity of all highlighted challenges based on the conducted examination and the presented scientific contribution in this work. To the best of our knowledge, there has not been any contribution that incorporates `Purple-Teaming’ tactics to evaluate UAV-related research in cybersecurity and digital forensics. This work also proposes a categorization model that classifies the discovered UAV static and live digital evidence challenges based on their complexity and impact levels

scholarly journals The Clean pilot study: evaluation of an environmental hygiene intervention bundle in three Tanzanian hospitals

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Giorgia Gon ◽  
Abdunoor M. Kabanywanyi ◽  
Petri Blinkhoff ◽  
Simon Cousens ◽  
Stephanie J. Dancer ◽  
...  
Keyword(s):  
Pilot Study ◽  
Study Design ◽  
Low Income ◽  
High Volume ◽  
Surface Cleaning ◽  
Low Income Countries ◽  
Training Period ◽  
Future Research ◽  
Environmental Hygiene ◽  
The Impact

Abstract Background Healthcare associated infections (HAI) are estimated to affect up to 15% of hospital inpatients in low-income countries (LICs). A critical but often neglected aspect of HAI prevention is basic environmental hygiene, particularly surface cleaning and linen management. TEACH CLEAN is an educational intervention aimed at improving environmental hygiene. We evaluated the effectiveness of this intervention in a pilot study in three high-volume maternity and newborn units in Dar es Salaam, Tanzania. Methods This study design prospectively evaluated the intervention as a whole, and offered a before-and-after comparison of the impact of the main training. We measured changes in microbiological cleanliness [Aerobic Colony Counts (ACC) and presence of Staphylococcus aureus] using dipslides, and physical cleaning action using gel dots. These were analysed with descriptive statistics and logistic regression models. We used qualitative (focus group discussions, in-depth interviews, and semi-structured observation) and quantitative (observation checklist) tools to measure why and how the intervention worked. We describe these findings across the themes of adaptation, fidelity, dose, reach and context. Results Microbiological cleanliness improved during the study period (ACC pre-training: 19%; post-training: 41%). The odds of cleanliness increased on average by 1.33 weekly during the pre-training period (CI = 1.11–1.60), and by 1.08 (CI = 1.03–1.13) during the post-training period. Cleaning action improved only in the pre-training period. Detection of S. aureus on hospital surfaces did not change substantially. The intervention was well received and considered feasible in this context. The major pitfalls in the implementation were the limited number of training sessions at the hospital level and the lack of supportive supervision. A systems barrier to implementation was lack of regular cleaning supplies. Conclusions The evaluation suggests that improvements in microbiological cleanliness are possible using this intervention and can be sustained. Improved microbiological cleanliness is a key step on the pathway to infection prevention in hospitals. Future research should assess whether this bundle is cost-effective in reducing bacterial and viral transmission and infection using a rigorous study design.

scholarly journals Adherence to French and ESGO Quality Indicators in Ovarian Cancer Surgery: An Ad-Hoc Analysis from the Prospective Multicentric CURSOC Study

Cancers ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1593
Author(s):  
Alejandra Martinez ◽  
Witold Gertych ◽  
Christophe Pomel ◽  
Gwenael Ferron ◽  
Amelie Lusque ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Quality Indicators ◽  
Ad Hoc ◽  
Randomized Study ◽  
Institutional Quality ◽  
High Volume ◽  
Cost Utility ◽  
Case Volume ◽  
Tertiary Institutions ◽  
The Cost

Background: Quality Indicators for ovarian cancer (OC) have been developed by the European Society of Gynaecological Oncology (ESGO) and by the French National Cancer Institute (Institut National du Cancer, INCa). The aim of the study was to characterize OC care distribution in France by case-volume and to prospectively evaluate the adherence of high-volume institutions to INCa/ESGO quality indicators. Methods: The cost-utility of radical surgery in ovarian cancer (CURSOC) trial is a prospective, multicenter, comparative and non-randomized study that includes patients with stage IIIC-IV epithelial OC treated in nine French health care tertiary institutions. Adherence to institutional quality indicators were anonymously assessed by an independent committee. OC care distribution in France were provided by the nationwide database of hospital procedures. Results: More than half of patients are treated in low-volume institutions. Among the nine high-volume centers participating in the study, four (44.4%) met all institutional INCa/ESGO quality indicators. The other five (55.6%) did not fulfil one of the quality indicator criteria. Conclusions: Access to high-volume OC providers in France is restricted to a minority of patients, and yet half of the referral institutions included in this study failed to meet all recommended institutional quality indicators. It is mandatory that national authorities work both to improve OC centralization and to incorporate quality assurance programs into certified centers.

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