scholarly journals Assessment of costs and insurance policies for referral treatment of equine colic

2019 ◽  
Vol 185 (16) ◽  
pp. 508-508 ◽  
Author(s):  
Isobel Barker ◽  
Sarah L Freeman
Keyword(s):  
Surgical Treatment ◽  
Insurance Companies ◽  
Insurance Policies ◽  
Insurance Cover ◽  
Survey Costs ◽  
The Mean ◽  
High Degree ◽  
Mean Cost ◽  
Monthly Premium ◽  
Equine Colic

Colic is the most common emergency problem in horses. The aims of this study were to survey costs of different referral treatments and to review insurance policies relevant to horses with colic. Data were collected retrospectively from nine equine hospitals for case costs, categorised into four different outcomes: admitted and euthanased; euthanased during or immediately after surgery; medical treatment and survived more than 24 hours; and surgical treatment and survived more than 24 hours. Data from five UK equine insurance companies were extracted and analysed using a standardised case example. Costs were obtained for 108 cases. The mean cost for horses admitted and euthanased was £873.89 (range £459.72–£1471.51), and for surgical treatment and survival more than 24 hours was £6437.80 (range £3178.87–£9100.00). Insurance cover for veterinary fees ranged from £5000 to £7500, and monthly premium rates for a standardised case ranged from £27.06 to £47.06. The terms and conditions for the insurance policies ranged in length from 2098 to 17,701 words; Flesch Kincaid Reading Ease scores ranged from 21.6 to 57.7, indicating a high degree of complexity and low readability. This study highlights the complexity and challenges for decision-making in critical cases of colic.

scholarly journals Perception of the Online Learning Environment of Nursing Students in Slovenia: Validation of the DREEM Questionnaire

Healthcare ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 998
Author(s):  
Lucija Gosak ◽  
Nino Fijačko ◽  
Carolina Chabrera ◽  
Esther Cabrera ◽  
Gregor Štiglic
Keyword(s):  
Nursing Students ◽  
Nursing Student ◽  
Student Perception ◽  
Psychometric Testing ◽  
Educational Environment ◽  
Educational Process ◽  
Survey Questionnaire ◽  
Self Perception ◽  
The Mean ◽  
High Degree

At the time of the outbreak of the coronavirus pandemic, several measures were in place to limit the spread of the virus, such as lockdown and restriction of social contacts. Many colleges thus had to shift their education from personal to online form overnight. The educational environment itself has a significant influence on students’ learning outcomes, knowledge, and satisfaction. This study aims to validate the tool for assessing the educational environment in the Slovenian nursing student population. To assess the educational environment, we used the DREEM tool distributed among nursing students using an online platform. First, we translated the survey questionnaire from English into Slovenian using the reverse translation technique. We also validated the DREEM survey questionnaire. We performed psychometric testing and content validation. I-CVI and S-CVI are at an acceptable level. A high degree of internal consistency was present, as Cronbach’s alpha was 0.951. The questionnaire was completed by 174 participants, of whom 30 were men and 143 were women. One person did not define gender. The mean age of students was 21.1 years (SD = 3.96). The mean DREEM score was 122.2. The mean grade of student perception of learning was 58.54%, student perception of teachers was 65.68%, student academic self-perception was 61.88%, student perception of the atmosphere was 60.63%, and social self-perception of students was 58.93%. Although coronavirus has affected the educational process, students still perceive the educational environment as positive. Nevertheless, there is still room for improvement in all assessed areas.

The cost of a general stochastic epidemic

1972 ◽  
Vol 9 (02) ◽  
pp. 257-269 ◽  
Author(s):  
J. Gani ◽  
D. Jerwood
Keyword(s):  
Recursive Equation ◽  
Stieltjes Transform ◽  
Stochastic Epidemic ◽  
The Mean ◽  
The Cost ◽  
Mean Cost ◽  
General Stochastic

This paper is concerned with the cost Cis = aWis + bTis (a, b > 0) of a general stochastic epidemic starting with i infectives and s susceptibles; Tis denotes the duration of the epidemic, and Wis the area under the infective curve. The joint Laplace-Stieltjes transform of (Wis, Tis ) is studied, and a recursive equation derived for it. The duration Tis and its mean Nis are considered in some detail, as are also Wis and its mean Mis . Using the results obtained, bounds are found for the mean cost of the epidemic.

scholarly journals Comparison of the costs of HPV testing through community health campaigns versus home-based testing in rural Western Kenya: a microcosting study

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e033979
Author(s):  
Easter Elizabeth Olwanda ◽  
James G Kahn ◽  
Yujung Choi ◽  
Jessica Yasmine Islam ◽  
Megan Huchko
Keyword(s):  
Community Health ◽  
Outcome Measures ◽  
Health Campaigns ◽  
Capital Goods ◽  
Western Kenya ◽  
Home Based ◽  
Registration Number ◽  
The Mean ◽  
The Cost ◽  
Mean Cost

ObjectivesTo estimate the cost of human papillomavirus (HPV)-based screening through community health campaigns (CHCs) and home-based testing.SettingCHCs and home-based testing in six communities in rural Western Kenya.ParticipantsCHCs and home-based screening reached 2297 and 1002 women aged 25–65 years, respectively.Outcome measuresOutcome measures were overall cost per woman screened achieved through the CHCs and home-based testing and the cost per woman for each activity comprising the screening intervention.ResultsThe mean cost per woman screened through CHCs and home-based testing were similar, at $37.7 (range $26.4–$52.0) and $37.1 (range $27.6–$54.0), respectively. For CHCs, personnel represented 49% of overall cost, supplies 25%, services 5% and capital goods 23%. For home-based testing, these were: personnel 73%, supplies 25%, services 1% and capital goods 2%. A greater number of participants was associated with a lower cost per participant.ConclusionsThe mean cost per woman screened is comparable for CHC and home-based testing, with differences in type of input. The CHCs generally reached more eligible women in the six communities, whereas home-based strategies more efficiently reached populations with low screening rates.Trial registration numberNCT02124252.

Responses of the bovine teat to machine milking: measurement of changes in thickness of the teat apex

1988 ◽  
Vol 55 (3) ◽  
pp. 331-338 ◽  
Author(s):  
Jörn Hamann ◽  
Graeme A. Mein
Keyword(s):  
Positive Pressure ◽  
Vacuum Level ◽  
Machine Milking ◽  
Before And After ◽  
The Mean ◽  
High Degree

SummaryChanges in the teat apex before and after different milking treatments were measured with a spring-loaded caliper device known as a cutimeter which could detect changes in thickness of the tissues of the teat end, presumably due to congestion and/or oedema, with a high degree of accuracy (± 2%) and repeatability (r = 0·99). Teat end thickness increased with increasing vacuum level. The mean increase immediately after milking with a conventional cluster was 2% for 24 teats milked at 30 kPa, 8% at 50 kPa and 21% at 70 kPa. At these vacuum levels, the mean increases for the same teats milked with an unconventional (PKME) teatcup were 10, 18 and 25% respectively. Cyclic application of 35 kPa positive pressure to the pulsation chamber of a conventional teatcup operating at 50 kPa reduced teat end thickness by 8% compared with the mean premilking value. Although most teats returned to within ± 2% of their premilking thickness values by 1 h after milking, differences were apparent between different milking systems for up to 4 h postmilking.

scholarly journals Scrotal reconstruction with superomedial fasciocutaneous thigh flap

2018 ◽  
Vol 45 (1) ◽  
Author(s):  
DANIEL FRANCISCO MELLO ◽  
AMERICO HELENE JÚNIOR
Keyword(s):  
Surgical Treatment ◽  
Complication Rate ◽  
Longitudinal Direction ◽  
Functional Results ◽  
Fasciocutaneous Flap ◽  
Surgical Time ◽  
Cross Sectional ◽  
Skin Loss ◽  
Scrotal Reconstruction ◽  
The Mean

ABSTRACT Objective: to describe the use of a superomedial fasciocutaneous thigh flap for scrotal reconstruction in open areas secondary to the surgical treatment of perineal necrotizing fasciitis (Fournier’s gangrene). Methods: retrospective analysis of cases treated at the Plastic Surgery Service of Santa Casa de Misericórdia, São Paulo, from 2009 to 2015. Results: fifteen patients underwent scrotal reconstruction using the proposed flap. The mean age was 48.9 years (28 to 66). Skin loss estimates in the scrotal region ranged from 60 to 100%. Definitive reconstruction was performed on average 30.6 days (22 to 44) after the initial surgical treatment. The mean surgical time was 76 minutes (65 to 90) to obtain the flaps, bilateral in all cases. Flap size ranged from 10cm to 13cm in the longitudinal direction and 8cm to 10cm in the cross-sectional direction. The complication rate was 26.6% (four cases), related to the occurrence of segmental and partial dehiscence. Conclusion: the superomedial fasciocutaneous flap of thigh is a reliable and versatile option for the reconstruction of open areas in the scrotal region, showing adequate esthetic and functional results.

Outcomes and Cost of Outpatient or Inpatient Management of 712 Patients With Febrile Neutropenia

2008 ◽  
Vol 26 (4) ◽  
pp. 606-611 ◽  
Author(s):  
Linda S. Elting ◽  
Charles Lu ◽  
Carmelita P. Escalante ◽  
Sharon H. Giordano ◽  
Jonathan C. Trent ◽  
...  
Keyword(s):  
Febrile Neutropenia ◽  
Statistical Tests ◽  
Signs And Symptoms ◽  
Low Risk ◽  
Outpatient Management ◽  
Single Episode ◽  
Risk Patients ◽  
Inpatient Management ◽  
The Mean ◽  
Mean Cost

Purpose We retrospectively compared the outcomes and costs of outpatient and inpatient management of low-risk outpatients who presented to an emergency department with febrile neutropenia (FN). Patients and Methods A single episode of FN was randomly chosen from each of 712 consecutive, low-risk solid tumor outpatients who had been treated prospectively on a clinical pathway (1997-2003). Their medical records were reviewed retrospectively for overall success (resolution of all signs and symptoms of infection without modification of antibiotics, major medical complications, or intensive care unit admission) and nine secondary outcomes. Outcomes were assessed by physician investigators who were blinded to management strategy. Outcomes and costs (payer's perspective) in 529 low-risk outpatients were compared with 123 low-risk patients who were psychosocially ineligible for outpatient management (no access to caregiver, telephone, or transportation; residence > 30 minutes from treating center; poor compliance with previous outpatient therapy) using univariate statistical tests. Results Overall success was 80% among low-risk outpatients and 79% among low-risk inpatients. Response to initial antibiotics was 81% among outpatients and 80% among inpatients (P = .94); 21% of those initially treated as outpatients subsequently required hospitalization. All patients ultimately responded to antibiotics; there were no deaths. Serious complications were rare (1%) and equally frequent between the groups. The mean cost of therapy among inpatients was double that of outpatients ($15,231 v $7,772; P < .001). Conclusion Outpatient management of low-risk patients with FN is as safe and effective as inpatient management of low-risk patients and is significantly less costly.

Poor Claims Settlement And Demand For Insurance Policies In Nigeria

2021 ◽  
Vol 8 (4) ◽  
pp. 53-64
Author(s):  
Omowumi Ayoni Momoh ◽  
Oyefemi Ismail O. Oyetunji
Keyword(s):  
Insurance Industry ◽  
Insurance Companies ◽  
Primary Data ◽  
Demand For Insurance ◽  
Insurance Policies ◽  
Chi Squared ◽  
Insurance Firms ◽  
And Control ◽  
Structured Questionnaire

This study investigates the poor claims settlement and demand for insurance policies in Nigeria to provide empirical evidence which would assist not only the insurance companies but also the policymakers by using these findings to design future insurance services and policies that can be geared towards promoting insurance market development. The population focused in the study included few licensed insurance firms in Nigeria. This is due to the fact that they dominate and control the larger interest in the market share. Primary data was used for this study through well-structured questionnaire. Chi- squared statistics and correlation with the tabulated contingency table on the basis of an assumptions were employed. The results show that poor claim settlement has significant effect on demand for Insurance policies in Nigeria and that there is long term and significant relationship between poor claim settlement and demand for insurance policies in Nigeria. The study therefore, recommends that insurance industry should be redefined through appropriate Acts, introducing competitions and innovations in the services so as to compete effectively and meet consumer needs by dealing with changing expectations of policyholders so as to ensure that satisfaction of all the parties are guaranteed.

Predictors of Surgical Intervention in Patients with Inflammatory Bowel Disease

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Khaled Hamdy Abd El Megeed ◽  
Shereen Abou Bakr Saleh ◽  
Christina Alphonse Anwar ◽  
Ahmed Elkattary Mohamed Elkattary
Keyword(s):  
Inflammatory Bowel Disease ◽  
Surgical Treatment ◽  
Bowel Disease ◽  
Surgical Intervention ◽  
High Sensitivity ◽  
Medical Patients ◽  
Mayo Score ◽  
Calprotectin Level ◽  
Inflammatory Bowel ◽  
The Mean

Abstract Background Inflammatory bowel disease (IBD) is comprised of two major disorders: Ulcerative Colitis and Crohn’s disease. Ulcerative Colitis affects the colon, where as Crohn’s disease can involve any component of the gastrointestinal tract from the mouth to the perianal area. These disorders have somewhat different pathologic and clinical characteristics, but with substantial overlap; their pathogenesis remains poorly understood. Objective To determine & detect different predictors that help us to characterize patients with high probability of undergoing surgical intervention for inflammatory bowel diseases. Patients and Methods The present study was designed to detect & identify possible factors that can be used to predict surgical intervention in patients with IBD. The present study was a case control study that was conducted on 80 patients with inflammatory bowel disease (either controlled by medical treatment or needed surgical intervention as a part of disease control) who were recruited form Ain-Shams university hospitals and El Quabbary general hospital in Alexandria. In the present study, the mean age of the included patients was 36.67 ±8.5 years old and 50% of the patients were males. The mean age at the onset of the disease was 25.81 ±6.8 years old. Results In the present study, there were statistically significant differences between surgical and medical patients in terms of CDAI for CD (p &lt; 0.001) and Mayo score for UC (p &lt; 0.001). Surgical patients were more likely to have higher scores. CDAI and Mayo score were negative predictors of surgical treatment. CDAI score &gt; 287 and Mayo score &gt; 8.5 achieved high sensitivity and specificity for the detection of surgical treatment. In the present study, we found that there was statistically significant differences between surgical and medical patients in terms of Stool Calprotectin level. Surgical patients were more likely to have higher Stool Calprotectin level. Stool Calprotectin level was negative predictor of surgical treatment at a level of &gt; 341.5 microgm/gm with high sensitivity and specificity. Conclusion Surgical treatment is a common outcome in IBD. Certain clinical features and the extent of disease are risk factors for surgical intervention. Our study indicates that smoking, Chron’s disease, perianal disease, granulomas, higher severity scores, higher stool Calprotectin level, CRP, and ESR were associated with higher risks of surgical intervention. In addition, smoking, peri-anal disease, CDAI, Mayo score, Stool Calprotectin level, and CRP level were predictors of surgical treatment. The findings of our analysis have implications for practice, particularly in the promotion of preoperative individualized risk prediction. The ability to predict which patients will need surgery and target more intensive, early treatment to that group would be invaluable. Further research through large prospective cohort studies is needed to confirm our findings and conclusions.

scholarly journals Potato Late Blight in the Columbia Basin: An Economic Analysis of the 1995 Epidemic

Plant Disease ◽  
1997 ◽  
Vol 81 (1) ◽  
pp. 103-106 ◽  
Author(s):  
D. A. Johnson ◽  
T. F. Cummings ◽  
P. B. Hamm ◽  
R. C. Rowe ◽  
J. S. Miller ◽  
...  
Keyword(s):  
Late Blight ◽  
Management Practice ◽  
Columbia Basin ◽  
Copper Hydroxide ◽  
Total Cost ◽  
Late Season ◽  
The Mean ◽  
The Cost ◽  
Mean Cost ◽  
First Time

The cost of managing late blight in potatoes during a severe epidemic caused by new, aggressive strains of Phytophthora infestans in the Columbia Basin of Washington and Oregon in 1995 was documented. The mean number of fungicide applications per field varied from 5.1 to 6.3 for early- and midseason potatoes, and from 8.2 to 12.3 for late-season potatoes in the northern and southern Columbia Basin, respectively. In 1994, a year when late blight was not severe, the mean number of fungicide applications per field made to early- and midseason potatoes was 2.0; whereas late-season potatoes received a mean of 2.5 applications. The mean per acre cost of individual fungicides applied varied from $4.90 for copper hydroxide to $36.00 for propamocarb + chlorothalonil. Total per acre expenses (application costs plus fungicide material) for protecting the crop from late blight during 1995 ranged from $106.77 to $110.08 for early and midseason potatoes in different regions of the Columbia Basin and from $149.30 to $226.75 for lateseason potatoes in the northern and southern Columbia Basin, respectively. Approximately 28% of the crop was chemically desiccated before harvest as a disease management practice for the first time in 1995, resulting in an additional mean cost of $34.48/acre or $1.3 million for the region. Harvested yields were 4 to 6% less than in 1994. The total cost of managing late blight in the Columbia Basin in 1995 is estimated to have approached $30 million.

scholarly journals Resource Utilization and Costs of Care prior to ART Initiation for Pediatric Patients in Zambia

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Hari S. Iyer ◽  
Callie A. Scott ◽  
Deophine Lembela Bwalya ◽  
Gesine Meyer-Rath ◽  
Crispin Moyo ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Blood Chemistry ◽  
Full Blood Count ◽  
National Guidelines ◽  
Art Initiation ◽  
Time To Initiation ◽  
The Mean ◽  
Study Sites ◽  
Cd4 Percentage ◽  
Mean Cost

Objective. We estimated time to initiation, outpatient resource use, and costs of outpatient care during the 6 months prior to ART initiation for HIV-infected pediatric patients in Zambia.Methods. We enrolled 1,102 children who initiated ART at <15 years of age between 2006 and 2011 at 5 study sites. Of these, 832 initiated ART ≤6 months after first presenting to care at the study sites. Data on time in care and resources utilized during the 6 months prior to ART initiation were extracted from patient medical records. Costs were estimated from the provider’s perspective and are reported in 2011 USD.Results. For the patients who initiated ART ≤6 months after presenting to care, median age at presentation to care was 3.9 years; median CD4 percentage was 13%. Median time to ART initiation was 26 days. Patients made, on average, 2.38 clinic visits prior to ART initiation and received 0.81 CD4 tests, 0.74 full blood count tests, and 0.49 blood chemistry tests. The mean cost of pre-ART care was $20 per patient.Conclusions. Zambian pediatric patients initiating ART ≤6 months after presenting to care do so quickly, utilize fewer resources than mandated by national guidelines, and accrue low costs.

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