Race and ethnicity: Not factors in the prescribing of hydrocodone- and codeine-containing products in two pediatric emergency departments

2019 ◽  
Vol 15 (3) ◽  
pp. 229-233
Author(s):  
Chris A. Rees, MD, MPH ◽  
Melanie Brooke Bernhardt, PharmD ◽  
Elizabeth A. Camp, PhD ◽  
Jessica S. Lin, BA ◽  
Corrie E. Chumpitazi, MD, MS
Keyword(s):  
Abdominal Pain ◽  
Race And Ethnicity ◽  
Emergency Departments ◽  
Secondary Analysis ◽  
Pediatric Emergency ◽  
P Value ◽  
Chi Square ◽  
Patient Race ◽  
Before And After ◽  
Caucasian Patients

Objective: To describe the prescription of hydrocodone-containing products (HCPs) and codeine-containing products (CCPs) by patient and provider race and ethnicity at two pediatric emergency departments (EDs) before and after the US Drug Enforcement Administration (DEA) rescheduling of HCPs in 2014.Design and setting: The authors performed a secondary analysis of data describing the prescription of HCPs and CCPs for 6 months before and after the DEA rescheduling of HCPs in two academic, urban pediatric EDs.Patients, participants: The authors included all children for whom race and ethnicity data were available and who were prescribed HCPs or CCPs at the time of discharge from the ED during a 12-month period (n = 1,246). The authors sent a three-question survey soliciting name, race, and ethnicity to all providers who prescribed an HCP or a CCP during the study period.Main outcome measures: Chi-square comparisons were made between the number of HCP and CCP prescriptions for primary ED diagnosis and patient ethnicity or race. The number of HCP and CCP prescriptions before and after the DEA rescheduling were compared to patient and provider race and ethnicity using the Breslow-Day test for homogeneity.Results: There were no significant differences in the number of HCP and CCP prescriptions between the pre- and post-DEA rescheduling periods across all racial and ethnic groups. When comparing the number of HCP and CCP prescriptions to patient race, Caucasian patients (84.4 percent) were prescribed more HCPs and CCPs than African Americans (15.6 percent) for abdominal pain (p value = 0.02). Non-Hispanic providers prescribed CCPs more often (n = 38, 55.2 percent) than Hispanic providers (n = 0, 0.0 percent) after DEA rescheduling (Breslow-Day p value = 0.01). Providers of all races wrote similar numbers of HCP and CCP prescriptions before and after the DEA rescheduling (Breslow-Day p value = 0.99).Conclusions: Pediatric patients of all races and ethnicities received fewer HCP prescriptions after the 2014 DEA rescheduling of HCPs. However, Caucasian patients were prescribed HCPs and CCPs for abdominal pain more frequently than African American patients. There were no significant differences in the number of prescriptions of HCPs and CCPs by provider race.

Abstract TP409: Reporting of Key Demographic Characteristics in Neurological Trials Registered on ClinicalTrials.gov

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Kush Fansiwala ◽  
Lauren Southwick ◽  
Emily Goldmann ◽  
Nina S Parikh ◽  
Joy Madubuonwu ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Race And Ethnicity ◽  
Neurological Diseases ◽  
Demographic Characteristics ◽  
Mandatory Reporting ◽  
Trial Participation ◽  
Limited Participation ◽  
Chi Square ◽  
Before And After ◽  
Race Ethnicity

Introduction: To increase the transparency of clinical trial information, U.S. Congress passed the Food and Drug Administration (FDA) Amendments Act of 2007, which expanded prior legislation to mandate inclusion of specific trial characteristics, such as funding source and gender demographics, in a new basic results section on ClinicalTrials.gov. Few studies have examined the extent to which key demographic characteristics such as sex and race/ethnicity are reported for neurological trials on ClinicalTrials.gov. Methods: As part of the National Initiative for Minority Involvement in Neurological Clinical Trials (NIMICT), we systematically identified neurological clinical trials on ClinicalTrials.gov (for stroke, epilepsy, Alzheimer’s Disease [AD]) and examined the proportion that reported sex, race, and ethnicity (Hispanic/Latino or not) of study participants. We used the website’s advanced search feature to evaluate demographic information reported from trials conducted between 1999 and 2015. We first calculated frequencies of trials reporting these characteristics, then assessed differences in reporting of each characteristic (yes/no) by condition (stroke, epilepsy, AD) and between trials conducted before and after the basic results section update (pre- and post-2008) using chi-square tests. Results: Our sample comprised 251,847 subjects across 393 trials (147 stroke, 127 epilepsy, 115 AD). Overall, sex was reported for nearly all trials (99.0%), while reporting of race and ethnicity was low (ethnicity: 14.0%, race: 19.8%). Reporting of these characteristics did not differ significantly across the three conditions or between periods preceding and following the FDA act. Conclusion: While ClinicalTrials.gov mandates reporting of sex, it does not require reporting of race/ethnicity, and few trials report these characteristics. This lack of information prevents understanding of neurological trial participation and how interventions might impact patients differently by race/ethnicity. Mandatory reporting of race/ethnicity would enhance transparency and increase awareness of the limited participation of racial/ethnic minorities-who suffer disproportionately from neurological diseases-in neurological trials.

scholarly journals The Effect of the Covid-19 Free Operation Path Protocol on the Incidence of Lung Complications in Postoperative Elective Patients at dr. Moewardi Hospital Surakarta

2021 ◽  
Vol 5 (11) ◽  
pp. 1030-1036
Author(s):  
Galih Aktama ◽  
Henky Agung Nugroho ◽  
Muhammad David Perdana Putra
Keyword(s):  
Cancer Patients ◽  
Elective Surgery ◽  
Pulmonary Complications ◽  
P Value ◽  
Chi Square ◽  
Elective Surgical Procedures ◽  
Significant Difference ◽  
Before And After ◽  
Chi Square Test ◽  
Elective Patients

The pandemic that began in late 2019, COVID-19, affects all patients, including cancer patients. Patients with cancer that continues to spread and  there is no other effective alternative treatment must undergo surgery so that cancer does not get worse. Given this problem, many health care centers have developed a protocol system in the form of a COVID-19-free surgical route. This study is a retrospective cohort study comparing the incidence of pulmonary complications in patients undergoing elective cancer surgery at dr. Moewardi Surakarta before and during the COVID-19 pandemic. The study sample was adult patients  aged ≥ 18 years which underwent elective surgical procedures with the aim of curative cancer starting before COVID-19 (March 2019-February 2020) until the time the COVID-19 pandemic emerged (March 2020 - February 2021). The data obtained were 768 patients. Of these patients, 384 were classified as having a COVID19-free operation route during the pandemic, and 384 others underwent elective surgery in the pre-pandemic period. Based on the Chi-Square test, a p-value of 0.850 was obtained (P>0.05) which shows that there is significant difference between cases of pulmonary complications in surgical patients before and after the pandemic who were carried out through the COVID-19-free protocol route. In conclusion, there is no significant change in effect of the covid-19 free operation path protocol on the incidence of lung complications in postoperative elective patients at dr. Moewardi Hospital Surakarta, although this patented and mandatory protocol can reduce cancer patients’ morbidity and mortality who undergoing elective surgery during a pandemic.

scholarly journals The Effect of the Covid-19 Free Operation Path Protocol on the Incidence of Lung Complications in Postoperative Elective Patients at dr. Moewardi Hospital Surakarta

2021 ◽  
Vol 5 (4) ◽  
pp. 940-946
Author(s):  
Galih Aktama ◽  
Hengky Agung Nugroho ◽  
Muhammad David Perdana Putra
Keyword(s):  
Cancer Patients ◽  
Elective Surgery ◽  
Pulmonary Complications ◽  
P Value ◽  
Chi Square ◽  
Elective Surgical Procedures ◽  
Significant Difference ◽  
Before And After ◽  
Chi Square Test ◽  
Elective Patients

The pandemic that began in late 2019, COVID-19, affects all patients, including cancer patients. Patients with cancer that continues to spread and  there is no other effective alternative treatment must undergo surgery so that cancer does not get worse. Given this problem, many health care centers have developed a protocol system in the form of a COVID-19-free surgical route. This study is a retrospective cohort study comparing the incidence of pulmonary complications in patients undergoing elective cancer surgery at dr. Moewardi Surakarta before and during the COVID-19 pandemic. The study sample was adult patients  aged ≥ 18 years which underwent elective surgical procedures with the aim of curative cancer starting before COVID-19 (March 2019-February 2020) until the time the COVID-19 pandemic emerged (March 2020 - February 2021). The data obtained were 768 patients. Of these patients, 384 were classified as having a COVID19-free operation route during the pandemic, and 384 others underwent elective surgery in the pre-pandemic period. Based on the Chi-Square test, a p-value of 0.850 was obtained (P>0.05) which shows that there is significant difference between cases of pulmonary complications in surgical patients before and after the pandemic who were carried out through the COVID-19-free protocol route. In conclusion, there is no significant change in effect of the covid-19 free operation path protocol on the incidence of lung complications in postoperative elective patients at dr. Moewardi Hospital Surakarta, although this patented and mandatory protocol can reduce cancer patients’ morbidity and mortality who undergoing elective surgery during a pandemic.

scholarly journals Pengaruh Aroma Terapi Lavender terhadap Nyeri Postpartum Sectio Caesarea di RSUD Panembahan Senopati Bantul

2020 ◽  
Vol 7 (2) ◽  
pp. 140
Author(s):  
Dinda Puspita ◽  
Dwi Yati
Keyword(s):  
General Hospital ◽  
Sectio Caesarea ◽  
Control Group ◽  
P Value ◽  
Chi Square ◽  
Control Group Design ◽  
Group Design ◽  
Before And After ◽  
Post Test ◽  
Equivalent Control

Nyeri yang disebabkan oleh sectio caesarea pada umumnya akan terasa hingga beberapa hari. Rasa nyeri tersebut biasanya dirasakan meningkat pada hari pertama post operasi sectio caesarea dan akan semakin terasa apabila pengaruh dari analgesik hilang. Manajemen untuk mengatasi nyeri dapat dilakukan dengan cara non-farmakologi menggunakan aromaterapi. Tujuan Penelitian  mengetahui pengaruh aromaterapi lavender terhadap nyeri post partum sectio caesarea. Metode penelitian merupakan kuantitatif menggunakan desain quasi experiment dengan pendekatan pre test and post test non equivalent control group design yang dilakukan dari bulan Agustus–September 2020. Teknik pengambilan sampel secara consecutive sampling dengan jumlah 22 ibu postpartum sectio caesarea di Ruang Alamanda 3 RSUD Panembahan Senopati Bantul. Uji statistik menggunakan Chi-Square. Hasil: Sebagian besar ibu postpartum sectio caesarea memiliki tingkat nyeri sebelum diberikan aromaterapi lavender pada kategori sedang (4-6) sebanyak 12 orang (54.5%). Setelah dilakukan pemberian aromaterapi lavender memiliki tingkat nyeri ringan (1-3) sebanyak 16 orang (72.7%). Terdapat perbedaan rerata tingkat nyeri ibu postpartum sectio caesarea sebelum dan setelah pemberian aromaterapi lavender dengan nilai mean 0.121, standar deviasi 0.568 dan nilai p-value sebesar 0,000 (p value<0,05).Kesimpulan: Ada pengaruh sebelum dan setelah pemberian aromaterapi lavender terhadap nyeri postpartum sectio caesareadi Ruang Alamanda 3 RSUD Panembahan Senopati Bantul. Kata Kunci: nyeri  postpartum; sectio caesarea; aromaterapi lavender.LAVENDER AROMATERAPY EFFECT ON POSTPARTUM SECTIO CAESAREA PAIN AT PANEMBAHAN SENOPATI HOSPITAL OF BANTUL   ABSTRACT Pain caused by section caesarea are generally felt for several days. The pain is usually felt on the first day of post caesarean section surgery and will be more painful when the effect of analgesic has gone. One of the ways in pain management is non-pharmacological therapy using lavender aromatherapy. This study aim was to determine the effectiveness of lavender aromatherapy on postpartum sectio caesarea mother at  Panembahan Senopati General Hospital of  Bantul. The study used a quasi experimental design with pre test and post test approach non equivalent control group design. This research was conducted from August until September 2020. The research sampling methods used consecutive sampling with a total of 22 postpartum sectio caesarea mothers in the Alamanda 3 room of Panembahan Senopati General Hospital of Bantul. Data analysis used chi square test. Most of the postpartum sectio Caesarea mothers had a level of pain before being given aromatherapy (pre test) in a moderate category (4-6) as much as 12 people (54.5%). After being given lavender aromatherapy had a mild category (1-3) as much as 16 people (72.7%). There is an influence between the level of pain in postpartum mother with section caesarea before and after giving lavender aromatherapy with a mean value of 0.121, standard deviation of 0.568 and a p-value of 0.000 (p value< 0,05). There is an effetiveness before and after being given lavender aromatherapy on postpartum sectio caesarea pain in the Alamanda 3 room at Panembahan Senopati General Hospital of Bantul. Keyword : Postpartum pain; sectio caesarea; lavender aromatherapy

scholarly journals OPTIMALISASI POSISI JANIN MELALUI PRENATAL YOGA TERHADAP OUTPUT PERSALINAN DI PUSKESMAS WILAYAH KOTA CIREBON

2020 ◽  
Vol 8 (3) ◽  
pp. 396
Author(s):  
Nurasih Nurasih ◽  
Endang Nurrochmi
Keyword(s):  
Intervention Group ◽  
T Test ◽  
Control Group ◽  
P Value ◽  
Test Results ◽  
Chi Square ◽  
Control Group Design ◽  
Before And After ◽  
Chi Square Test ◽  
And Control

In Indonesia, Yoga is currently one of the most popular sports, not only for the general public but also for pregnant women. Many benefits can be obtained from prenatal yoga including the mother feeling comfortable and relaxed throughout pregnancy and during childbirth, training the pelvic floor muscles and perineum, keeping the body's muscles relaxed, balanced during childbirth, reducing stress, increasing and improving oxygen circulation to the body and fetus. . This study aims to determine the effect of prenatal yoga on optimizing fetal position on third trimester Primigravida maternal delivery output at Puskesmas Cirebon City. This research is a quasi-experimental research pre post control group design and only post control group design with T test and Chi Square test. Paired T Test results of the intervention group (mean difference = 3.111, P value = 0.000, control group (mean difference = 0.833, P value = 0.318). Independent T Test results obtained (average difference = -1.944, P value = 0.024), Chi Square test obtained a value of P = 0.73. There is a difference in the average anxiety before and after the intervention in the intervention group, there is no difference in average anxiety before and after the intervention in the control group. There is a difference in the average anxiety between the intervention and control groups. There is a difference in mean Long I stage between the intervention and control groups There was no effect of prenatal yoga on the type of labor.

scholarly journals Relationship between Melanoma Stage at the Diagnosis and Survival During a period of 30 Years (1982-2011)

2018 ◽  
Vol 5 ◽  
Author(s):  
Talal M Alkhaldi ◽  
Sakhr A Dawari ◽  
Sami A Aldaham
Keyword(s):  
Cutaneous Melanoma ◽  
Proportional Hazards ◽  
Secondary Analysis ◽  
Cox Proportional Hazards ◽  
P Value ◽  
Chi Square ◽  
Primary Cutaneous Melanoma ◽  
Kaplan Meier ◽  
Hispanic Patients ◽  
The U.S

Melanoma is a malignant tumor of melanocytes, and is a potentially aggressive cancer. The incidence of melanoma is rising at a greater rate than any other cancer in the U.S. The aim of this study was to examine the association between melanoma stage at the time of diagnosis and survival among U.S. adult melanoma patients during 1982-2011. This was a secondary analysis of a non-concurrent cohort study conducted on 185219 U.S. adult patients who were diagnosed with primary cutaneous melanoma between 1982-2011. Chi-square, Kaplan-Meier, and Cox proportional hazards regression were used to analyze the data. Significance was assessed using p-value and 95% confidence interval. Men had more cutaneous melanoma. Black non-Hispanic patients were diagnosed less frequently. Patients who were married or in a domestic partnership were most likely to be diagnosed. The adjusted HR for distant melanoma was 141-fold that of in situ (95% CI 126.38-157.19). The adjusted HR was the highest in the first decade of diagnosis (1.7; 95% CI 1.6 1.75). In conclusion, survival is highly affected by melanoma stage at diagnosis. Black non-Hispanic patients had the lowest hazard ratio of all races. The sample size was large, which enhances the generalizability to the U.S. population.

Gender and University: Factors that Influence Peruvian Midwives’ Employment and Wages

2019 ◽  
Vol 21 (2) ◽  
Author(s):  
Olga Vicentina Pacovilca-Alejo ◽  
Cesar Cipriano Zea-Montesinos ◽  
Rafael Reginaldo-Huamaní ◽  
Gelber Sebasti Pacovilca-Alejo ◽  
Michael Cristian Villa-Jurado ◽  
...  
Keyword(s):  
Labour Market ◽  
Professional Training ◽  
Health Workers ◽  
Secondary Analysis ◽  
P Value ◽  
University Graduates ◽  
Structural Determinants ◽  
Wage Differences ◽  
Chi Square ◽  
Low Wages

Although a reduction in economic inequality has been reported in Peru, there are wage differences for professionals in the labour market mediated by structural determinants. Gender and university could be related to this problem. A secondary analysis of the “National Survey of University Graduates and Universities, 2014” was performed to analyse the influence of gender and university on employment and wages in the Peruvian midwifery labour market through a multivariate analysis. The chi square, p-value, odds ratio – crude and adjusted – and a 95 per cent confidence interval were calculated. The results allow concluding that gender and university determine unemployment and low wages in the Peruvian midwifery labour market. Female health workers experience a higher risk of unemployment, working in jobs that are not related to their professional training, and low payment. Midwives from public or upcountry universities experience a higher risk of unemployment and low wages. Working in jobs that are not related to the professional training was determined by coming from private and upcountry universities; it was a factor associated with low wages and the probability for having to do two jobs. It is necessary to improve governmental interventions to eliminate these barriers, of which the issue of remuneration is the most important.

scholarly journals Fatigue in Loading and Unloading Workers at the Port

2020 ◽  
Vol 16 (1) ◽  
pp. 93-100
Author(s):  
Viranda Nedine Putri Watulinggas ◽  
Mona Lestari ◽  
Novrikasari Novrikasari ◽  
Desheila Andarini ◽  
Anita Camelia
Keyword(s):  
Sun Exposure ◽  
Simple Random Sampling ◽  
Cross Sectional Study ◽  
Work Climate ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Before And After ◽  
Chi Square Test ◽  
The Right

The port has a fairly dense loading/unloading activity according to the total flow of goods it manages. In addition to high work activities, environment factors such as noise and work climate can also affect the occurrence of work fatigue.  Therefore, this study aims to determine factors associated with work fatigue in loading/unloading workers at the port.  This study uses cross sectional study design with simple random sampling.  Data analysis used the Paired Sample T-Test and Chi-Square test.  The results showed that there was a difference of fatigue before and after work and as many as 71.2% of workers experienced moderate fatigue.  It is known that age (p-value = 0,000), breakfast habits (p-value = 0,000), and years of service (p-value = 0,000) have a significant correlation with work fatigue, while nutritional status (p-value = 0.203), workload (p-value = 0.140), hot work climate (p-value = 0.362), and noise (p-value = 0.880) have no correlation with work fatigue.  It was concluded that age, breakfast habits and work duration were related to work fatigue in loading/unloading labor.  Therefore, workers are advised to be used to have breakfast with the right menu and time and workers should wear hats while working to reduce sun exposure.

scholarly journals ROLE OF OBSTETRIC TRIAGE IN IMPROVING PATIENT HEALTH CARE AT CMH KHARIAN-A COMPARITIVE STUDY

2020 ◽  
Vol 70 (6) ◽  
pp. 1792-98
Author(s):  
Asma Ansari ◽  
Umbreen Akram ◽  
Hafsa Khalil ◽  
Ayesha Imran
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Management Plan ◽  
Military Hospital ◽  
P Value ◽  
Chi Square ◽  
Triage System ◽  
Before And After ◽  
Patient Health ◽  
Chi Square Test

Objective: To evaluate the up gradation of obstetric patient care by using obstetrics-specific triage acuity tool. Study design: Comparative prospective study Place and duration of study: This study was conducted at obstetrics unit of combined military hospital Kharian from June 2018 to Dec 2018. Methodology: Pregnant patients were triaged and prioritized according to Maternal fetal triage index (MFTI) into five levels. Primary outcome was time to triage and management plan documentation. Patient and health care provider satisfaction was evaluated using Likert’s scale before and after implementation of MFTI. Data was collected and expressed in frequencies and percentage. Chi square test was applied for association between before and after triage intervention variables, and a P value of 0.05 was considered significant. Results: A total of 1000 pregnant patients referred to OPD were enrolled, 500 patients before and 500 after implementation of MFTI. Patients were prioritized using MFTI system,10(2%) patients category 1 while category 2,3,4,and 5 were 28(5.6%),68(13.6%),150(30%) and 244(48.8%) respectively. There was significant reduction in waiting time from 35.4±8.2 minutes to18.2±6.5 p=<0.002. Hospital complaints reduced significantly from 25(5%) in before group to 4(0.8%) P=<0.001 after application of obstetric triage. Conclusion: Obstetric triage by MFTI focuses on the urgency and symptoms at presentation to decide further disposal. The usage of a systematic and properly developed triage system produces improvement in patient care. The results of study not only highlight the importance of usage of a triage system but also explore its usefulness and improvement in outcomes in a developing country like Pakistan.

scholarly journals Effectiveness of Combination Irrigant Technique for Debris Removal in Simulated Canal Irregularities: An in vitro Study

2019 ◽  
Vol 4 (2) ◽  
pp. 79-84
Author(s):  
S Dhivyalakshmi ◽  
◽  
N Velmurugan ◽  
G Lakshmanan ◽  
L Karthik ◽  
...  
Keyword(s):  
Digital Camera ◽  
In Vitro Study ◽  
Combination Group ◽  
P Value ◽  
Chi Square ◽  
Group Iii ◽  
Group I ◽  
Intergroup Comparison ◽  
Before And After

Aim: To evaluate the debridement efficacy of different irrigation systems in simulated canal irregularities. Study Design and Setting: About sixty maxillary central incisors were selected and after chemomechanical preparation were split longitudinally into two halves. Each groove and depression were filled with dentine debris mixed with 2.5 % NaOCl to simulate a situation where dentine debris accumulates in the un-instrumented extensions of the root canal. Materials and Methods: The specimens were randomly divided into 4 experimental groups as follows: Group I - Conventional Needle Irrigation, Group II - Apical Negative Pressure Irrigation (EndoVac), Group III - Passive Ultrasonic Irrigation and Group IV - Combination Irrigation (EV+PUI). 9 ml of 2.5 % NaOCl, 9 ml of 17 % EDTA and 9 ml of saline was used for the final irrigation protocol. Images were taken before and after irrigation using PRIMA DNT surgical microscope with digital camera. Statistical Analysis: The intergroup and individual comparison of percentage reduction of debris in groove and depressions were carried out by using Kruskal-Wallis and Mann-Whitney U tests respectively. The intergroup comparison for different scoring criteria was compared using Pearson’s chi-square tests. Differences were considered statistically significant at P value < 0.05. Results: The combination group, EV group and PUI group showed better removal of debris in Groove and Depressions than Conventional needle irrigation group. The Combination group had significant reduction of debris at 2 mm level when compared to all the other groups. Conclusion: The effectiveness of this combination irrigant delivery system for smear layer removal and antibacterial efficacy have to be evaluated further in future clinical studies

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