Effect of Health Literacy on Decision Delay in Patients With Acute Myocardial Infarction

Background: Health literacy (HL) is a risk factor for adverse outcomes in patients with cardiovascular disease, and shorter pre-hospital delay time is crucial for successful treatment of acute myocardial infraction (AMI) patients. Most previous studies focused on the influencing factors of pre-hospital delay but ignore the essential contribution of decision delay.Aims: Therefore, the purpose of this study was to explore the effect of HL on decision delay.Methods: Continuously included AMI patients admitted to a grade A class three hospital in Chongqing. HL level was assessed using Brief Health Literacy Screen and categorized as adequate or inadequate. Mann-Whitney U-test and Chi-square test were used to compare the differences between groups, and binary logistic regression was used to analyze the association between HL and decision delay.Results: A total of 217 AMI patients were enrolled in this study, including 166 males (76.5%) and 51 females (23.5%), with the median age was 68 years old; 135 (62.2%) patients had delayed decision-making while 82 (37.8%) did not; 157 (72.7%) patients had inadequate HL and 59 (27.3%) had adequate HL. The total HL score of non-delayed group was higher than that in delayed group (9.22 vs. 7.02, P < 0.000).Conclusion: After adjusting for covariates, HL was significantly negatively associated with decision time. AMI patients with inadequate HL were more likely to delay seeking timely medical care.

Complexity Analysis and Control in Time-Delay Vaccine Supply Chain considering Cold Chain Transportation

Due to the important role of the vaccines in the prevention of global epidemics, this paper focuses on a vaccine transportation supply chain composed of one distributor and one retailer. Based on the assumption that the decision-maker does not make a decision instantaneously, we present a decision-making time-delay model. Firstly, we captured some sufficient conditions of delay-induced bifurcation for the model by regarding different combinations of the decision delay periods as the bifurcation parameters and analyzed how the speed of decision-making adjustment of distributor or retailer affects the critical point of system stability. Secondly, we made a numerical simulation on the model by using a two-dimensional bifurcation diagram, largest Lyapunov exponent, and entropy and chaotic attractor, respectively. Finally, we used two coordination methods to control chaos and compared them. The results show that when the decision delay exceeds a certain threshold, the system will lose stability or go into chaos. The precipitous speed of decision variable adjustment of the distributor or retailer will increase the entropy of the system and lead the system into a chaotic state. When the vaccine supply chain is in chaos, the effect of external control on chaos is better than that of internal control on chaos.

Investment Decisions And The Parallel Funding Routes: Informal savings as a new tool of funding decision in the Cameroonian SMEs

The criteria of the choice of investment elaborated by theoricians are based on rationality of deciders who after some work often consider two types of aids to investment decision: delay of getting back invested capital and net actualized value. Whereas other forms of aid to funding decision exist. We are proposing in the framework of this article, a new model of aid to funding decision corresponding to the new informal funding. We think that risk capital in the framework of informal funding (Ndjangi) can bring forth long-term funding as strategy, and solutions to questions of rationality of the heads of Small and Medium size Enterprise (SMEs) that prefers the delay of getting back invested capital, solutions to problems of decision of choice, and at last solutions to the quality of profitability of investments.