Buschhodges6762
0 (CI 1.2-7.8;
= 0.02)) were significantly associated with distress. Increasing age (45 years and above) appeared to be protective against distress (OR 0.2 (CI 0.02-0.69;
= 0.008)), as well anxiety and sleep pattern (OR 0.3
< 0.05).
Findings of the present study highlight that infected COVID-19 populations are at higher risk for acute and detrimental psychological well-being during quarantine and/or self-isolation. Identification of the coping mechanisms of older adults during periods of distress may prove beneficial in the pandemic preparedness of younger generations.
Findings of the present study highlight that infected COVID-19 populations are at higher risk for acute and detrimental psychological well-being during quarantine and/or self-isolation. Identification of the coping mechanisms of older adults during periods of distress may prove beneficial in the pandemic preparedness of younger generations.Many studies that assess efficiency in health systems are based on output mean values. That approach ignores the representativeness of the average statistic, which can become a serious problem in estimation. To solve this question, this research contributes in three different ways the first aim is to evaluate the technical efficiency in the management of European health systems considering a set of DEA (Data Envelopment Analysis) and FDEA (Fuzzy Data Envelopment Analysis) models. A second goal is to assess the bias in the estimation of efficiency when applying the conventional DEA. The third objective is the evaluation of the statistical relationship between the bias in the efficiency estimation and the macroeconomic variables (income inequality and economic freedom). The main results show positive correlations between DEA and FDEA scores. Notwithstanding traditional DEA models overestimate efficiency scores. Furthermore, the size of the bias is positively related to income inequality and negative with economic freedom in the countries evaluated.
Haemophilia is an inherited coagulopathy caused by the absence or dysfunction of clotting factor VIII or IX. Clinical manifestations are generally secondary to recurrent bleeding episodes mainly in the musculoskeletal system. Bleeding symptoms appear early in life and, when the disease is severe (when plasma factor VIII or IX activity is <1% of normal), joint and muscle bleeding may occur spontaneously. A pseudotumour is a recurrent, chronic, encapsulated, slowly expanding, muscle hematoma. Haemophilic pseudotumour is a rare complication of haemophilia which occurs, as a condition either from repeated spontaneous bleeding or coming from a traumatic origin, in 1-2% of haemophilic patients.
A 32-year-old man with severe haemophilia A referred to our Clinic with a massive right iliac wing pseudotumour complicated by Staphylococcus aureus superinfection and skin fistulisation. In this report we describe the medical management and surgical treatment by the adoption of a novel surgical technique which involves the use of a pedicle-screw and rod system (PSRS), a polyglycolic acid MESH and bone cement in order to build up an artificial ilium-like bony mass. buy Y-27632 This case report highlights the importance of interdisciplinary approach and the efficacy of eradicating surgery as treatment, especially in the case of large and long-lasting lesions.
A 32-year-old man with severe haemophilia A referred to our Clinic with a massive right iliac wing pseudotumour complicated by Staphylococcus aureus superinfection and skin fistulisation. In this report we describe the medical management and surgical treatment by the adoption of a novel surgical technique which involves the use of a pedicle-screw and rod system (PSRS), a polyglycolic acid MESH and bone cement in order to build up an artificial ilium-like bony mass. This case report highlights the importance of interdisciplinary approach and the efficacy of eradicating surgery as treatment, especially in the case of large and long-lasting lesions.
Patient's satisfaction is recognized as an indicator to monitor quality in healthcare services. Patient-reported experience measures (PREMs) may contribute to create a benchmark of hospital performance by assessing quality and safety in cancer care.
The areas of interest assessed were patient-centric welcome perception (PCWP), punctuality, professionalism and comfort using the Lean Six Sigma (LSS) methodology. The RAMSI (Radioterapia Amica Mia SmileIN
My Friend Radiotherapy
), project provided for the placement of SI totems with four push buttons using HappyOrNot technology in a high-volume radiation oncology (RO) department. The SI technology was implemented in the RO department of the Fondazione Policlinico Universitario A. Gemelli IRCCS. SI totems were installed in different areas of the department. The SI Experience Index was collected, analyzed and compared. Weekly and monthly reports were created showing hourly, daily and overall trends.
From October 2017 to November 2019, a total of 42,755 votork should be defined in order to set up a benchmark.Chronic obstructive pulmonary disease (COPD) remains a leading cause of morbidity and mortality. Much of the disease burden comes from exacerbations requiring hospitalization. Unwarranted care variation and divergence from evidence-based COPD management guidelines among hospitalists is a leading driver of the poor outcomes and excess costs associated with COPD-related hospitalizations. We engaged with Novant Health hospitalists to determine if measurement and feedback using fixed-choice simulated patients improves evidence-based care delivery and reduces costs. We created a series of gamified acute-care COPD case simulations with real-time feedback over 16 weeks then performed a year-over-year analytic comparison of the cost, length of stay (LOS), and revisits over the six months prior to the introduction of the simulated patients, the four months while caring for the simulated patients, and the six months after. In total, 245 hospitalists from 15 facilities at Novant Health participated. At baseline, the overall quality-of-care was measured as 58.4% + 12.3%, with providers correctly identifying COPD exacerbation in 92.4% of cases but only identifying the grade and group in 61.9% and 49.5% of cases, respectively. By the study end, the quality-of-care had improved 10.5% (p less then 0.001), including improvements in identifying the grade (+9.7%, p = 0.044) and group (+8.4%, p = 0.098). These improvements correlated with changes in real-world performance data, including a 19% reduction in COPD-related pharmacy costs. Overall, the annualized impact of COPD improvements led to 233 fewer inpatient days, 371 fewer revisit days, and inpatient savings totaling nearly $1 million. Engaging practicing providers with patient simulation-based serial measurements and gamified evidence-based feedback potentially reduces inpatient costs while simultaneously reducing patient LOS and revisit rates.The Cognitive Reserve hypothesis suggests that there are individual differences in the ability to cope with the pathologic changes in Alzheimer's Disease. The proportion of elderly individuals has increased in recent years; this increase emphasizes the importance of early detection of mild cognitive impairment and the promotion of healthy ageing. The purpose of our study is to characterize cognitive reserve and occupational performance implications in people with mild cognitive impairment. 125 patients with mild cognitive impairment were enrolled. The Montreal Cognitive Assessments (MoCA) was used to evaluate cognitive status and the Cognitive Reserve Index Questionnaire (CRIq) as an indicator of cognitive reserve. Higher level of education was associated with higher MoCA scores (r = 0.290, p = 0.001). Positive significant correlations were observed between MoCA and total CRIq (r = 0.385, p less then 0.001) as well as its three sub-domains, education (r = 0.231, p = 0.010), working activity (r = 0.237, p = 0.008) and leisure time (r = 0.319, p less then 0.001). This study findings provide the importance of considering socio-behavioral factors in cognitive status. This research helps to describe the importance of engaging occupationally along the whole life-course as a potential protective factor in ageing, and includes a perspective of occupational therapy regarding the hypothesis of cognitive reserve.Home care nurses assist older people in their daily living and well-being, including medication management. Medication management can be challenging for older people with functional constraints and several chronic conditions. This paper presents how home care nurses manage medications and their packaging for older people at their homes. This study followed an explorative qualitative research design, in which semi-structured interviews were conducted with home care nurses in Sweden (n = 14). The study revealed that home care nurses need to coordinate a multitude of interrelated tasks, with documentation being paramount. Regarding medication management, automated systems were preferred, as they reduce medication errors and facilitate dispensing of medications for each patient when compared with analogue systems still in use (i.e., dosing boxes), commonly used by older people. Importantly, the lack of a common journal system for updates on prescribed medication among health care providers and analogue communication still in place creates space for outdated prescription of medications for patients. There are opportunities for further investigation on how technology can help home care nurses in coordinating medication management tasks with other health care providers, and on receiving updates about medication intake by older patients when the nurse is not at their homes.This study aims to explore what medical associations in Israel do to promote public health, what values underpin their activities, and how their actions can be interpreted. For this purpose, an analysis of both individual and organizational levels was applied in an effort to yield a more nuanced understanding of the relationship between society and the medical profession. In-depth interviews with senior physicians were conducted, combined with a review of policy and public initiatives of medical associations between 2008 and 2018. The findings of this study reveal that medical associations engage in a range of social and policy initiatives designed to promote public health, but, at the same time, they tend to construct socially related health issues as medical problems in a manner that fits their sectorial agendas. This may reflect organized medicine's efforts to extend its dominance over society through the application of the biomedical model to social issues. It is necessary to integrate biosocial training with medical education to ensure that future physicians are equipped with the skills needed to implement social medicine.Parkinson's Disease (PD) is a neurodegenerative disease in which non-motor symptoms may appear before motor phenomena, which include Impulse Control Disorders (ICDs). The objective of this study is to identify factors associated with the development of ICDs in PD. An analytical, cross-sectional study was conducted using clinical records from patients diagnosed with PD, both genders, from 40 to 80 years old. Clinical and demographic data were collected 181 patients were recruited; 80 of them showed PD and ICDs, and they constituted the study group, whereas 101 patients with PD without ICDs constituted the control reference group. The duration of PD was longer in the group with ICDs (p less then 0.008), and all patients showed at least one ICD binge eating (61.29%), compulsive shopping (48.75%), hypersexuality (23.75%), gambling behavior (8.75%), and punding (3.75%). After logistic regression analysis, only the use of dopamine agonists remained associated with ICDs (p less then 0.001), and the tremorgenic form was suggested to be a protective factor (p less then 0.