scholarly journals Factors affecting complications according to the modified Clavien classification in complete supine percutaneous nephrolithotomy

2015 ◽  
Vol 9 (1-2) ◽  
pp. 83 ◽  
Author(s):  
Siavash Falahatkar ◽  
Keivan Gholamjani Moghaddam ◽  
Ehsan Kazemnezhad ◽  
Alireza Farzan ◽  
Hamidreza Baghani Aval ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Renal Dysfunction ◽  
Percutaneous Nephrolithotomy ◽  
Multivariate Logistic Regression Analysis ◽  
Urinary Tract Abnormality ◽  
Factors Affecting ◽  
Preoperative Hemoglobin ◽  
Clavien Classification ◽  
The Impact ◽  
Hemoglobin Drop

Introduction: An increase in percutaneous nephrolithotomy (PCNL) has been accompanied by an increase in complications. We identified the parameters affecting the severity of complications using the modified Clavien classification (MCC).Methods: From 2008 to 2013, 330 patients underwent complete supine PCNL using subcostal access, one-shot dilation, rigid nephroscopy, and pneumatic lithotripsy. We assessed the impact of the following factors on complication severity based on the MCC: age, gender, body mass index, hypertension, diabetes, previous stone surgery and extracorporeal shock wave lithotripsy, preoperative hemoglobin, renal dysfunction (creatinine >1.4 mg/dL), preoperative urinary tract infection, anatomic upper urinary tract abnormality (AUUTA), significant (moderate–severe) hydronephrosis, stonerelated parameters (opacity, number, burden, location, staghorn, complex stones), anesthesia type, kidney side, imaging and calyx for access, tract number, tubeless approach, operative time, postoperative hemoglobin, and hemoglobin drop and stone-free results.Results: The complication rate was 19.7% (MCC: 0=80.3%, I=6.4%, II=11.2%, ≥III=2.1%). On univariate analyses, only the following factors affected MCC: gender, preoperative hemoglobin, AUUTA, significant hydronephrosis, imaging for access, calyx for access, tract number, postoperative hemoglobin, hemoglobin drop and stone-free result. Renal dysfunction was accompanied by higher complications, yet the results were not statistically significant. Multivariate logistic regression analysis demonstrated renal dysfunction, absence of significant hydronephrosis, AUUTA, multiple tracts, lower postoperative hemoglobin, and higher postoperative hemoglobin drop as the significant parameters which affected MCC and predicted higher grades. The paper’s limitations include a low number of cases in the higher Clavien grades and some subgroups of variables, and not applying some techniques due to surgeon preference.Interpretation: Many of the complete supine PCNL complications were in the lower Clavien grades and major complications were uncommon. Renal dysfunction, AUUTA, significant hydronephrosis, tract number, postoperative hemoglobin, and hemoglobin drop were the only factors affecting MCC.

Factors affecting the administration of adjuvant therapy in patients with pancreatic adenocarcinoma.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e15087-e15087
Author(s):  
Pablo Emilio Serrano Aybar ◽  
Peter Tae Wan Kim ◽  
Kenneth Leung ◽  
Sean P. Cleary ◽  
Steven Gallinger ◽  
...  
Keyword(s):  
Adjuvant Therapy ◽  
Pancreatic Adenocarcinoma ◽  
Multivariate Logistic Regression Analysis ◽  
Major Complication ◽  
High Volume ◽  
Lower Probability ◽  
Node Negative ◽  
Factors Affecting ◽  
Major Complications ◽  
The Impact

e15087 Background: Adjuvant therapy for pancreatic adenocarcinoma is now considered standard of care. The proportion of patients receiving adjuvant therapy (ADT) following pancreatic resection is a good quality indicator of cancer care. The aim of this study was to evaluate factors associated with receiving ADT in patients with pancreatic cancer. Methods: Between years 2000-2010, all patients undergoing pancreaticoduodenectomy for pancreatic adenocarcinoma at a single high-volume hepatotopancreatobiliary center were evaluated. The impact of demographic, peri-operative and pathological risk factors affecting the administration of ADT were analyzed using univariate and multivariate logistic regression analysis. Results: There were 258 patients identified. Median age was 65 (37-84) years, 54% were females. There was a 15% margin positivity rate, 14% pancreatic leak rate, 14.7% major complication rate, and 1.2% 90 day/in-hospital mortality rate. Overall, 160/258 (70%) of patients received adjuvant therapy. On multivariate analysis; age, presence of major complications, node-negative disease and earlier era (2000-2004) were significantly associated with a lower probability of receiving ADT. Reasons for not receiving ADT were; patient preference: 20/67 (32%), not recommended: 14/67 (23%), disease recurrence: 12/67 (9.5%) and being medically unfit for ADT: 18/67 (11.5%). None of these reasons were different between time-periods except for fewer patients being offered ADT from 2000-2005 (15.4% vs. 2.5%, p <0.001). Conclusions: Thirty percent of patients do not receive ADT following pancreatectomy. Those with advanced age; node-negative disease and those who had major complications after pancreaticoduodenectomy were less likely to receive ADT. The impact of these factors should be taken into account when considering the administration of ADT.

scholarly journals Impact of Multidisciplinary Collaborative Intervention on Isolation Implementation in the Prevention and Control of Multidrug Resistance Infection—A Retrospective Study

2020 ◽  
Author(s):  
Ying Wang ◽  
Xinping Zhang ◽  
Xiaoquan Lai
Keyword(s):  
Prevention And Control ◽  
Univariate Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Multidrug Resistant ◽  
Central China ◽  
Factors Affecting ◽  
Collaborative Intervention ◽  
Collaborative Interventions ◽  
And Control ◽  
The Impact

Abstract Background: Isolation is important in the prevention and control of infection with multidrug-resistant organisms(MDROs) but implementation is weak. We aim to analyze the impact of multidisciplinary collaborative intervention on isolation in multidrug-resistant organism(MDRO) infection and determine the factors affecting the implementation of isolation measures.Methods: A retrospective analysis of the issuance of isolation orders for 1338 patients with MDRO infection and colonization in 10 months before and after multidisciplinary collaborative interventions carried out on November 1, 2018 at a teaching tertiary hospital in central China. Univariate analysis and multivariate logistic regression analysis were used to analyze factors affecting isolation implementation. Results: The overall issuance rate of isolation orders was 66.12%, which increased from 33.12% before the intervention to 75.88% after the intervention (P <0.000). The multidisciplinary collaborative intervention (OR = 0.154) is a promoting factor for the issuance of isolation orders, in addition to Length of stay(LOS)> 15d (OR = 0.459) and department (P <0.05). Conclusions: Multidisciplinary collaborative interventions related to isolation can promote doctors to issue isolation orders in accordance with regulations.

DAMPAK KEBIJAKAN FISKAL TERHADAP KINERJA SEKTOR PERTANIAN DI SULAWESI TENGGARA

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
La Ode Jabuddin ◽  
Ayub M Padangaran ◽  
Azhar Bafadal Bafadal
Keyword(s):  
Fiscal Policy ◽  
Interest Rates ◽  
Agricultural Sector ◽  
Simultaneous Equations ◽  
Poor People ◽  
Land Area ◽  
Factors Affecting ◽  
Historical Simulation ◽  
The Impact ◽  
Direct Expenditure

This study aims to: (1) Knowing the dynamics of fiscal policy and the performance of the agricultural sector, (2) Analyze the factors that influence fiscal policy and the performance                   of the agricultural sector, and (3) Analyzing the impact of fiscal policy on the performance of the agricultural sector. The data used in this study were pooled 2005-2013 data in the aggregate. Econometric model the impact of fiscal policy on the performance of the agricultural sector is built in the form of simultaneous equations, consisting of 7 equations with 25 total variables in the model, 7 endogenous variables, 12 exogenous variables, and 6 variables lag. The model is estimated by 2SLS method SYSLIN procedures and historical simulation with SIMNLIN procedure.The results showed that: (1) The development of fiscal policy in Southeast Sulawesi from year to year tends to increase, (2) The performance of the agricultural sector from the aspect of GDP has decreased, from the aspect of labor is still consistent, in terms of investment to grow positively, and assign roles which means to decrease the number of poor people, (3) factors affecting fiscal policy is local revenues, equalization funds, other revenues, as well as the lag fiscal policy, (4) the factors that affect the performance of the agricultural sector from the aspect GDP is labor, direct expenditure and GDP lag; from the aspect of labor is the total labor force, investment, land area, direct expenditure, as well as the lag of labor; from the aspect of investment is influenced by GDP per capita, land area, interest rates and investment lag; as well as from the aspect of poor people, are affected by population, investments, direct expenditure and poverty lag, (5). Fiscal policy impact on the agricultural sector GDP increase, a decrease in the number of poor, declining agricultural laborers, and a decrease in the amount of investment in the agricultural sector.Keywords: Fiscal policy, the performance of the agricultural sector, the simultaneous equations

Structural Model of Service Quality Factors Affecting Loyalty Sustainability

2020 ◽  
Vol 11 (2) ◽  
Author(s):  
Eman Al-erqi ◽  
◽  
Mohd Lizam Mohd Diah ◽  
Najmaddin Abo Mosali ◽  
◽  
...  
Keyword(s):  
International Students ◽  
Service Quality ◽  
Goodness Of Fit ◽  
Structural Model ◽  
Quality Factors ◽  
Factors Affecting ◽  
Measurement Models ◽  
Confirmatory Factor ◽  
The University ◽  
The Impact

This study seeks to address the impact of service quality affecting international student's satisfaction towards loyalty tothe Universiti Tun Hussein Onn Malaysia(UTHM). The aim of thestudy is to develop relationship between service quality factor and loyalty to the university from the international students’ perspectives. The study adopted quantitative approach where data was collected through questionnaire survey and analysed statistically. A total of 246 responses were received and found to be valid. The model was developed and analysed using AMOS-SEM software. Confirmatory factor analysis (CFA) function of the software was to assessed the measurement models and found that all the models achieved goodness of fit. Then path analysis function was used to assessed structural model and found that service qualityfactors have a significant effect on the students’ satisfaction and thus affecting the loyaltyto the university. Hopefully the outcome form this study will benefit the university in providing services especially to the international students.

Influence of the ICCPR in Asia

2018 ◽  
Author(s):  
Yogesh Tyagi
Keyword(s):  
Human Rights ◽  
Political Rights ◽  
International Human Rights ◽  
Factors Affecting ◽  
Judicial Discourse ◽  
International Human ◽  
Golden Jubilee ◽  
Civil And Political Rights ◽  
The Impact

The golden jubilee of the International Covenant on Civil and Political Rights (ICCPR) coincides with the emergence of Asia as a centre of global attention. However, greater attention to Asia has been accompanied by some scepticism over its attitude towards human rights. The chapter provides an overall assessment of the impact of the ICCPR on the major Asian States, with an analysis of the factors affecting such influence. The chapter considers the involvement in, observance of, and compliance with the provisions of the ICCPR by these States. It further delves into the academic and judicial discourse on the ICCPR within these States, recording the domestic disposition towards judgments of foreign courts, the output of the Human Rights Committee, and the work of other international human rights bodies. It makes suggestions for developing mechanisms to improve the effectiveness of the ICCPR and for creating databases to perform further research in the area.

scholarly journals Assessing the Impact of Bank Concentration and Liquidity of Refah Bank Branches on Profitability during the Period1383-190

2014 ◽  
Vol 4 (1) ◽  
pp. 248
Author(s):  
Hossin Ostadi ◽  
Nastran Monsef
Keyword(s):  
Commercial Banks ◽  
Bank Capital ◽  
Factors Affecting ◽  
Bank Branches ◽  
Independent Variables ◽  
Bank Deposits ◽  
The Impact ◽  
Bank Concentration ◽  
Research Period

Profitability is an important factor to show this articledoeswhat is the role of the intermediary bank to collect your savings and allocation of loans.  Given the importance of profitability indicators in this study, the factors affecting the profitability of commercial banks in Iranare analyzedwith emphasis on the degree of centralization and bank deposits. Dependent variable is indicators of profitability (ROE, ROA) and bank deposits, bank size, bank capital, focus on liquidity and banking requirements are independent variables. Correlation analysis and OLS regression are used and the research period is 1381 to 1390 that the country's territory where bank branches.Our results indicate that the effect of bank size on profitability is positive and the increase in bank size on profitability is increased. Impact on the profitability of bank deposits is positive, ie increasing the profitability of bank deposits increased. Finally, the impact of bank concentration on profitability is positive. Increasing the bank's focus profitability increases. Moreover, the results adversely affect the liquidity of the index is profit. 

scholarly journals THE FUTURE OF PASSENGER AIR TRANSPORT – VERY LARGE AIRCRAFT AND OUT KEY HUMAN FACTORS AFFECTING THE OPERATION AND SAFETY OF PASSENGER AIR TRANSPORT

2017 ◽  
Vol 12 ◽  
pp. 104
Author(s):  
Petra Skolilova
Keyword(s):  
Human Factors ◽  
Human Error ◽  
Operating Cost ◽  
Aircraft Design ◽  
Air Transport ◽  
Final Decision ◽  
Factors Affecting ◽  
Fuel Burn ◽  
The Future ◽  
The Impact

The article outlines some human factors affecting the operation and safety of passenger air transport given the massive increase in the use of the VLA. Decrease of the impact of the CO2 world emissions is one of the key goals for the new aircraft design. The main wave is going to reduce the burned fuel. Therefore, the eco-efficiency engines combined with reasonable economic operation of the aircraft are very important from an aviation perspective. The prediction for the year 2030 says that about 90% of people, which will use long-haul flights to fly between big cities. So, the A380 was designed exactly for this time period, with a focus on the right capacity, right operating cost and right fuel burn per seat. There is no aircraft today with better fuel burn combined with eco-efficiency per seat, than the A380. The very large aircrafts (VLAs) are the future of the commercial passenger aviation. Operating cost versus safety or CO2 emissions versus increasing automation inside the new generation aircraft. Almost 80% of the world aircraft accidents are caused by human error based on wrong action, reaction or final decision of pilots, the catastrophic failures of aircraft systems, or air traffic control errors are not so frequent. So, we are at the beginning of a new age in passenger aviation and the role of the human factor is more important than ever.

scholarly journals Public reporting of performance measures in long-term care in Canada: does it make a difference?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Poldrugovac ◽  
J E Amuah ◽  
H Wei-Randall ◽  
P Sidhom ◽  
K Morris ◽  
...  
Keyword(s):  
Performance Measures ◽  
Performance Indicators ◽  
Long Term Care ◽  
Public Reporting ◽  
Policy Implications ◽  
Term Care ◽  
Factors Affecting ◽  
Care Facilities ◽  
The Impact

Abstract Background Evidence of the impact of public reporting of healthcare performance on quality improvement is not yet sufficient to draw conclusions with certainty, despite the important policy implications. This study explored the impact of implementing public reporting of performance indicators of long-term care facilities in Canada. The objective was to analyse whether improvements can be observed in performance measures after publication. Methods We considered 16 performance indicators in long-term care in Canada, 8 of which are publicly reported at a facility level, while the other 8 are privately reported. We analysed data from the Continuing Care Reporting System managed by the Canadian Institute for Health Information and based on information collection with RAI-MDS 2.0 © between the fiscal years 2011 and 2018. A multilevel model was developed to analyse time trends, before and after publication, which started in 2015. The analysis was also stratified by key sample characteristics, such as the facilities' jurisdiction, size, urban or rural location and performance prior to publication. Results Data from 1087 long-term care facilities were included. Among the 8 publicly reported indicators, the trend in the period after publication did not change significantly in 5 cases, improved in 2 cases and worsened in 1 case. Among the 8 privately reported indicators, no change was observed in 7, and worsening in 1 indicator. The stratification of the data suggests that for those indicators that were already improving prior to public reporting, there was either no change in trend or there was a decrease in the rate of improvement after publication. For those indicators that showed a worsening trend prior to public reporting, the contrary was observed. Conclusions Our findings suggest public reporting of performance data can support change. The trends of performance indicators prior to publication appear to have an impact on whether further change will occur after publication. Key messages Public reporting is likely one of the factors affecting change in performance in long-term care facilities. Public reporting of performance measures in long-term care facilities may support improvements in particular in cases where improvement was not observed before publication.

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