scholarly journals Individual and Regional-level Factors Contributing to Variation in Length of Stay After Cerebral Infarction in Six European Countries

2015 ◽  
Vol 24 ◽  
pp. 38-52 ◽  
Author(s):  
Mikko Peltola ◽  
Timo T. Seppälä ◽  
Antti Malmivaara ◽  
Éva Belicza ◽  
Dino Numerato ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Cerebral Infarction ◽  
Regional Level ◽  
European Countries

Acute intracranial stenting with mechanical thrombectomy is safe and efficacious in patients diagnosed with underlying intracranial atherosclerotic disease

2021 ◽  
pp. 159101992110394
Author(s):  
Ameer E Hassan ◽  
Victor M Ringheanu ◽  
Laurie Preston ◽  
Wondwossen G Tekle ◽  
Adnan I Qureshi
Keyword(s):  
Ischemic Stroke ◽  
Length Of Stay ◽  
Intracerebral Hemorrhage ◽  
Cerebral Infarction ◽  
Acute Ischemic Stroke ◽  
Mechanical Thrombectomy ◽  
Modified Rankin Scale ◽  
Stroke Patients ◽  
Intracranial Stenting ◽  
Intracranial Atherosclerotic Disease

Objective To investigate whether significant differences exist in recanalization rates and primary outcomes between patients who undergo mechanical thrombectomy alone versus those who undergo mechanical thrombectomy with acute intracranial stenting. Methods Through the utilization of a prospectively collected endovascular database at a comprehensive stroke center between 2012 and 2020, variables such as demographics, co-morbid conditions, symptomatic intracerebral hemorrhage, mortality rate at discharge, and good/poor outcomes in regard to modified thrombolysis in cerebral infarction score and modified Rankin Scale were examined. The outcomes between patients receiving acute intracranial stenting + mechanical thrombectomy and patients that underwent mechanical thrombectomy alone were compared. Results There were a total of 420 acute ischemic stroke patients who met criteria for the study (average age 70.6 ± 13.01 years; 46.9% were women). Analysis of 46 patients from the acute stenting + mechanical thrombectomy group (average age 70.34 ± 13.75 years; 37.0% were women), and 374 patients from the mechanical thrombectomy alone group (average age 70.64 ± 12.92 years; 48.1% were women). Four patients (8.7%) in the acute stenting + mechanical thrombectomy group experienced intracerebral hemorrhage versus 45 patients (12.0%) in the mechanical thrombectomy alone group ( p = 0.506); no significant increases were noted in the median length of stay (7 vs 8 days; p = 0.208), rates of modified thrombolysis in cerebral infarction 2B-3 recanalization ( p = 0.758), or good modified Rankin Scale scores ( p = 0.806). Conclusion Acute intracranial stenting in addition to mechanical thrombectomy was not associated with an increase in overall length of stay, intracerebral hemorrhage rates, or any change in discharge modified Rankin Scale. Further research is required to determine whether mechanical thrombectomy and acute intracranial stenting in acute ischemic stroke patients is unsafe.

Insider or Outsider? Grand Corruption and Electoral Accountability

2017 ◽  
Vol 51 (4) ◽  
pp. 415-446 ◽  
Author(s):  
Monika Bauhr ◽  
Nicholas Charron
Keyword(s):  
Empirical Evidence ◽  
Political Corruption ◽  
Regional Level ◽  
European Countries ◽  
Democratic Accountability ◽  
Electoral Accountability ◽  
Level Data

While democratic accountability is widely expected to reduce corruption, citizens to a surprisingly large extent opt to forgo their right to protest and voice complaints, and refrain from using their electoral right to punish corrupt politicians. This article examines how grand corruption and elite collusion influence electoral accountability, in particular citizens’ willingness to punish corrupt incumbents. Using new regional-level data across 21 European countries, we provide clear empirical evidence that the level of societal grand corruption in which a voter finds herself systematically affects how she responds to a political corruption scandal. Grand corruption increases loyalty to corrupt politicians, demobilizes the citizenry, and crafts a deep divide between insiders, or potential beneficiaries of the system, and outsiders, left on the sidelines of the distribution of benefits. This explains why outsiders fail to channel their discontent into effective electoral punishment, and thereby how corruption undermines democratic accountability.

scholarly journals Romanian National Prevalence Study – problem and pathological gambling in children and adolescents

2018 ◽  
Vol 91 (4) ◽  
pp. 435-440 ◽  
Author(s):  
Viorel Lupu ◽  
Izabela Ramona Lupu
Keyword(s):  
At Risk ◽  
Problem Gambling ◽  
Pathological Gambling ◽  
Children And Adolescents ◽  
National Level ◽  
Regional Level ◽  
European Countries ◽  
South Oaks Gambling Screen ◽  
Gamblers Anonymous ◽  
National Prevalence

Background and Aims. The purpose of the present study was to measure the prevalence of problem and pathological gambling in children and adolescents at a national level, given that previous studies at regional level  had demonstrated high rates of prevalence.Methods. After designing the sample (2006 children and adolescents aged 11-19 years) we used two validated instruments for measuring the prevalence of problem and pathological gambling in children and adolescents – South Oaks Gambling Screen –Revised for Adolescents (SOGS-RA) and 20 Questions of Gamblers Anonymous Revised for Adolescents (20 GA-RA).Results. The following data have been found: gambling at risk is 7.1% and problem and pathological gambling is 4%, when results were analyzed by SOGS-RA; prevalence of problem gambling is 10.1% and pathological gambling is 2.6% when results were analyzed by 20 GA-RA.Conclusions. High rates of prevalence are noticed in Romania, similar to other European countries. This rates are based on self-reported questionnaires, meaning that real rates may be higher than reported, being known that children and adolescents tend to give socially expected response. An important issue is that we found pathological gambling at  the age of only 11 years. Our results compared to those of other studies from Romania are very similar to those from other European countries. 

scholarly journals Regional trends in births during the COVID-19 crisis in France, Germany, Italy, and Spain

2021 ◽  
Author(s):  
Bruno Arpino ◽  
FRANCESCA LUPPI ◽  
Alessandro Rosina
Keyword(s):  
At Risk ◽  
Labour Market ◽  
Excess Mortality ◽  
Market Performance ◽  
Mixed Effects ◽  
Regional Level ◽  
European Countries ◽  
Population At Risk ◽  
Early Evidence ◽  
Regional Trends

Early evidence shows mixed effects of the COVID-19 pandemic on births in Europe. This study examines changes in births at the regional level in the four European countries that have been affected by the pandemic earlier and to a larger extent. It is also investigated the association between birth changes and some labour market characteristics, the pandemic impact in terms of COVID-deaths, and the share of population at risk of poverty. Results show considerable within-country heterogeneity in birth changes after the pandemic and that higher share of poverty, worse labour market performance, and higher excess mortality are associated with births decline.

scholarly journals WHY DO PATIENTS HAVING CORONARY ARTERY BYPASS GRAFTS HAVE DIFFERENT COSTS OR LENGTH OF STAY? AN ANALYSIS ACROSS 10 EUROPEAN COUNTRIES

2012 ◽  
Vol 21 ◽  
pp. 77-88 ◽  
Author(s):  
James Gaughan ◽  
Conrad Kobel ◽  
Caroline Linhart ◽  
Anne Mason ◽  
Andrew Street ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Length Of Stay ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
European Countries ◽  
Coronary Artery Bypass Grafts ◽  
Bypass Grafts

scholarly journals An Analysis of Territorial Patterns in COVID-19 Mortality in France, Spain, Italy and the UK

2020 ◽  
Author(s):  
Roberto Zavatta
Keyword(s):  
European Union ◽  
United Kingdom ◽  
National Level ◽  
Mortality Rates ◽  
Regional Level ◽  
European Countries ◽  
The European Union ◽  
The United Kingdom ◽  
Territorial Disparities ◽  
The Uk

This paper provides an overview of territorial patterns of COVID-19 deaths in four European countries severely affected by the pandemic, Spain, France, Italy, and the United Kingdom. The analysis focuses on cumulated COVID-19 mortality at the sub-regional level, following the territorial subdivision of countries adopted by the European Union. The paper builds upon a dataset with highly granular information on COVID-19 deaths assembled from various sources. The analysis shows remarkable differences in territorial patterns of COVID-19 mortality, both within and across the four countries reviewed. Results somewhat differ depending on the aspect considered (concentration of deaths or mortality rates) but, in general, Italy, France and Spain display significant territorial disparities, with selected sub-regions being disproportionately affected by the pandemic. Instead, the picture is more uniform in the UK, with comparatively lower differences across the various sub-regions. These findings suggest that analyses of COVID-19 mortality at the national level (and, sometimes, even at the regional level) may conceal major differences and therefore be of limited use, both analytically and from an operational viewpoint.

scholarly journals Administrative-Territorial Reform: The Experience of the Countries of Western Europe

2020 ◽  
Vol 37 (65) ◽  
pp. 248-267
Author(s):  
Yuriy Harust ◽  
Yevhen Durnov ◽  
Andrii Boichuk ◽  
Olena Chernezhenko ◽  
Ivan Holosnichenko
Keyword(s):  
Research Methods ◽  
Western Europe ◽  
Political Power ◽  
Scientific Investigation ◽  
The State ◽  
Regional Level ◽  
European Countries ◽  
Main Research ◽  
State Administration ◽  
Western European

The relevance of this article is conditioned by the decentralization of the reform of political power in Ukraine, which presents the State with the permanent challenge of finding new ways to solve the problems of governance and governability at the district and regional level. The objective of the article was to carry out a scientific investigation on the mechanism of introduction of institutes of prefects in Ukraine, based on the experience of the main western European countries. The main research methods are general and specific, including the methods of logic, analysis and comparison of the sources consulted. The results of this study are to identify ways to introduce an institute of prefects in Ukraine. By way of conclusion, it highlights the importance of the results obtained, which is reflected in the fact that this study can serve as a basis to delineate future changes to the current legislation of Ukraine on issues of state administration, at the district and regional level, by introducing the institute of prefects.

scholarly journals Overcoming gaps: Regional collaborative to optimize capacity management and predict length of stay of patients admitted with COVID-19

JAMIA Open ◽  
2021 ◽  
Author(s):  
Michael G Usher ◽  
Roshan Tourani ◽  
Gyorgy Simon ◽  
Christopher Tignanelli ◽  
Bryan Jarabek ◽  
...  
Keyword(s):  
Weight Loss ◽  
Length Of Stay ◽  
Average Length ◽  
Capacity Management ◽  
Patient Data ◽  
Regional Level ◽  
System Level ◽  
Nursing Home Admission ◽  
Average Length Of Stay ◽  
Hospital Systems

Abstract Objective Ensuring an efficient response to COVID-19 requires a degree of inter-system coordination and capacity management coupled with an accurate assessment of hospital utilization including length of stay (LOS). We aimed to establish optimal practices in inter-system data sharing and LOS modeling to support patient care and regional hospital operations. Methods We completed a retrospective observational study of patients admitted with COVID-19 followed by 12-week prospective validation, involving 36 hospitals covering the upper Midwest. We developed a method for sharing de-identified patient data across systems for analysis. From this we compared three approaches, generalized linear model (GLM) and random forest (RF), and aggregated system level averages to identify features associated with LOS. We compared model performance by area under the ROC curve (AUROC). Results A total of 2068 patients were included and used for model derivation and 597 patients for validation. LOS overall had a median of 5.0 days and mean of 8.2 days. Consistent predictors of LOS included age, critical illness, oxygen requirement, weight loss, and nursing home admission. In the validation cohort, the RF model (AUROC-0.890) and GLM model (AUROC-0.864) achieved good to excellent prediction of LOS, but only marginally better than system averages in practice. Conclusion Regional sharing of patient data allowed for effective prediction of LOS across systems; however, this only provided marginal improvement over hospital averages at the aggregate level. A federated approach of sharing aggregated system capacity and average length of stay will likely allow for effective capacity management at the regional level. Lay Summary Regional planning for a surge in hospitalizations related to the COVID-19 pandemic requires three components: a prediction of new cases, prediction of how long COVID-19 patients will require hospitalization, and an ability to share that information across hospital systems that support that region. While prediction of new cases is well studied, hospital length of stay, and methods to share this information is less well established. In this study, we developed an approach to share information across hospital systems and explore approaches to predict length of stay. We find that length of stay can be accurately predicted using patient factors including age, low oxygen, and chronic conditions such as weight loss. However, in hospital planning at the regional level, the simplest solution: sharing raw case counts and average length of stay for each hospital is likely best.

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