Levels In Patients Research Articles

Investigating Body Mass Index and Body Composition in Patients with Schizophrenia: A Case-Control Study.

Background Antipsychotics exert metabolic side effects, and prolonged treatment with antipsychotics causes changes in body weight and muscle composition. Nevertheless, reports on the changes in body composition of patients with schizophrenia have been limited. This study is aimed at comparing the body mass index and body composition of patients with schizophrenia with healthy individuals in Indonesia. Methods A total of 195 patients with schizophrenia (148 males and 47 females) and 195 healthy individuals matched by gender were recruited. Using the Bioelectrical Impedance Analysis method, the participants' body compositions were measured. Results Compared to healthy individuals, the patient group exhibited a higher rate of underweight as well as a lower rate of overweight and obesity. Multiple regression analysis confirmed the associations between the body mass index and all measured body compositions. Furthermore, the diagnosis of schizophrenia is significantly associated with lower muscle mass, lower bone mass, higher basal metabolic rate, older metabolic age, and higher total body water. Conclusions The results showed that patients with schizophrenia are at a greater risk of a lower quality of certain components of body composition. Priority should be given to research that addresses increasing the patient's level of physical activity.

OPRA-RS: A Hearing-Aid Fitting Method Based on Automatic Speech Recognition and Random Search.

Hearing-aid (HA) prescription rules (such as NAL-NL2, DSL-v5, and CAM2) are used by HA audiologists to define initial HA settings (e.g., insertion gains, IGs) for patients. This initial fitting is later individually adjusted for each patient to improve clinical outcomes in terms of speech intelligibility and listening comfort. During this fine-tuning stage, speech-intelligibility tests are often carried out with the patient to assess the benefits associated with different HA settings. As these tests tend to be time-consuming and performance on them depends on the patient's level of fatigue and familiarity with the test material, only a limited number of HA settings can be explored. Consequently, it is likely that a suboptimal fitting is used for the patient. Recent studies have shown that automatic speech recognition (ASR) can be used to predict the effects of IGs on speech intelligibility for patients with age-related hearing loss (ARHL). The aim of the present study was to extend this approach by optimizing, in addition to IGs, compression thresholds (CTs). However, increasing the number of parameters to be fitted increases exponentially the number of configurations to be assessed. To limit the number of HA settings to be tested, three random-search (RS) genetic algorithms were used. The resulting new HA fitting method, combining ASR and RS, is referred to as “objective prescription rule based on ASR and random search" (OPRA-RS). Optimal HA settings were computed for 12 audiograms, representing average and individual audiometric profiles typical for various levels of ARHL severity, and associated ASR performances were compared to those obtained with the settings recommended by CAM2. Each RS algorithm was run twice to assess its reliability. For all RS algorithms, ASR scores obtained with OPRA-RS were significantly higher than those associated with CAM2. Each RS algorithm converged on similar optimal HA settings across repetitions. However, significant differences were observed between RS algorithms in terms of maximum ASR performance and processing costs. These promising results open the way to the use of ASR and RS algorithms for the fine-tuning of HAs with potential speech-intelligibility benefits for the patient.

Comparative Study between Pregnant and Non-Pregnant Women Regarding Variation of Liver Function Tests: Assessment of Health Literacy


 
 
 Context: Pregnancy is associated with normal physiological adaptive changes. Biochemical parameters reflect these changes and are distinct from the non-pregnant state. Low levels of health literacy have been shown to result in less healthy choices, riskier behavior, poorer health, less self-management, and more hospitalization among that category of adult patients. Aim: The study aimed to examine the effect of pregnancy on liver function tests among pregnant women during various trimesters of pregnancy and compare with non-pregnant and determine the patients' level of health literacy regarding the variation of liver function tests among those patients.
 Methods: A descriptive cross-sectional design was used to achieve the study aim. A random sample of 65 women was selected from an outpatient clinic in the maternity hospital; 54 out of them were pregnant women. Three tools were used to collect data, socio-demographic and clinical data assessment sheet; assessment of liver function tests by Cobas c 311; and health literacy management scale. Results: The sample's age range was between 20-40 years. This study revealed that; serum albumin levels decreased from the first trimester (3.7-4.7), and this decrease became progressively more accentuated as the pregnancy advanced (3.35-4.36 decreased significantly to 3.19-3.81). There was no significant decrease in serum AST between pregnant and non-pregnant women, but there was a significant decrease in ALT in pregnant women compared with non-pregnant women (11.90 Vs. 8.60 at p 0.017). In the current study, Serum alkaline phosphatase (ALP) was significantly higher (P˂0.0001) during the third trimester (63-171) compared with the second trimester (33-137), and the first trimester (36-129), and with the control group (48-122). Finally, it was found that a significant decrease in total serum bilirubin concentrations during the second (0.11-0.38) and third trimesters (0.12-0.42) compared to control (0.11-1.57) and the first trimester (0.12-0.85). Moreover, most of the studied sample has a low level of health literacy for all subscales and the total scores.
 Conclusion: During normal pregnancy, most values of liver function tests remain below the normal upper limits compared to non-pregnant women. Any increase in serum ALT and AST activity levels and serum bilirubin should be considered pathologic and prompt for further evaluation. Moreover, most of the studied sample has a low level of health literacy for all subscales and the total scores. The study recommended that the liver function tests should be routinely investigated during pregnancy to outline any pathologic changes. Focusing on the nurse's role, she should emphasize increasing the patient's level of health literacy regarding the variation of liver function tests. So, it is a must for nurses to develop many skills to enable them to function for this category of patients with low health literacy levels. Also, those patients should be equipped with information-seeking behavior, decision-making abilities, and problem-solving approaches along their health and illness continuum.
 
 

TINGKAT KEPERCAYAAN PASIEN TERHADAP KEAMANAN UNIT PENDAFTARAN RAWAT JALAN DI MASA PANDEMI COVID-19 DI RUMAH SAKIT IMC BINTARO

This study was conducted to obtain an overview of the patient's level of trust in safety in the outpatient registration unit of IMC Bintaro hospital during the COVID-19 pandemic. The number of patients visiting IMC Bintaro Hospital decreased at the beginning of the pandemic, there where 55,101 people who registered outpatients in January-July 2019 while in January-July 2020 only 37,121 people (decreased 32%). This condition is thought to be due to the patient's concern about the transmission of COVID-19.
 The level of confidence research was carried out using a descriptive method in the outpatient registration unit of the IMC Bintaro Hospital, in February-April 2021. A randomly selected sample of 100 patients where registered in December 2020-February 2021. The technique of collecting data was by interviewing the head of the registration unit, observation, and an electronic questionnaire containing 10 questions related to the patient's level of confidence.
 The results showed that IMC Bintaro Hospital does not yet have an SOP for outpatient registration adapted to the pandemic conditions. However, health workers and registration areas have implemented health protection based on the Director's memo. While data from questionnaires to patients showed a high level of patient knowledge about COVID-19 (an average of 94.8% answered agree), accompanied by a high level of patient confidence in safety in the outpatient registration unit (an average of 88% answered agree).
 Most of the samples gave a positive response, they have received services in line with expectations. Patients feel safe for treatment at the IMC Bintaro Hospital during the COVID-19 pandemic. However, it should be understood that the sample was taken from patients who came to the hospital after the pandemic lasted for about 1 year, while number of patients who visited the hospital during the study was not carried out.
 Keywords: Level of trust, security. COVID-19 pandemic, registration unit

Creating a standard inpatient opioid withdrawal protocol.

Background: Despite safety and efficacy of medications for opioid use disorder, United States (US) hospitals face high health care costs when hospitalized patients with opioid use disorder (OUD) leave due to untreated opioid withdrawal. Recent studies have concluded that evidence-based interventions for OUD like buprenorphine are underutilized by hospital services. Objective: We developed a practical opioid withdrawal protocol utilizing buprenorphine and the Clinical Opiate Withdrawal Scale to address opioid withdrawal during inpatient treatment of a primary medical condition. We are currently implementing this protocol at the UCLA hospital in Santa Monica. Design: The protocol includes order sets with appropriate and modifiable orders that can be submitted in the electronic medical record in order to deliver seamless care for opioid withdrawal. After the physician assesses the patient and initiates the protocol, nursing provides an essential role in continuing to monitor the patient's level of withdrawal and administering the appropriate medications in response. Inpatient pharmacy is instrumental in monitoring medication administration, as well as calculating and providing dosages for orders on Day 2 and 3 of the protocol. Collaboration with case managers is essential for providing appropriate resources and ensuring a safe discharge. Conclusion: Current challenges to widespread implementation of a standardized withdrawal protocol are discrepancies in addiction education across medical disciplines and inadequate outpatient access to buprenorphine providers and pharmacies that carry buprenorphine supplies.

Patient-centred care in thoracic surgery: a holistic approach-A review of the subjects of enhanced recovery after surgery, rehabilitation, pain management and patient-reported outcome measures in thoracic surgery.

The symposium Patient-centered care in thoracic care: a holistic approach was held on June 22, 2021, as a virtual event in the context of the European conference on general thoracic surgery. Its aim was to explore how to improve patient outcomes in thoracic surgery by using enhanced recovery after surgery (ERAS®) frameworks and collaboration within healthcare. During the four presentations, topics on patient mobilization and physical rehabilitation, pain management, and the role of chest drainage in facilitating perioperative care were discussed. Strategies to minimize opioid consumption and incorporate patients’ experiences as quality indicators were described. There were two main ideas that were considered pivotal to achieve optimal care: (I) the use of simple, easily implementable perioperative protocols and practices to improve compliance from both patients and the healthcare team, and (II) promote a better recovery with early mobilization and reducing the patient’s levels of pain. Among the key learnings that emerged from the presentations are the importance of taking the patient’s experiences into account, including what they value the most after surgery, and how technology can enable better care. The use of digital chest drainage systems emerged as a way for improving patient outcomes and experiences across several key indicators.

Social Equity in the Efficacy of Computer-Based and In-Person Brief Alcohol Interventions Among General Hospital Patients With At-Risk Alcohol Use: A Randomized Controlled Trial

BackgroundSocial equity in the efficacy of behavior change intervention is much needed. While the efficacy of brief alcohol interventions (BAIs), including digital interventions, is well established, particularly in health care, the social equity of interventions has been sparsely investigated.ObjectiveWe aim to investigate whether the efficacy of computer-based versus in-person delivered BAIs is moderated by the participants’ socioeconomic status (ie, to identify whether general hospital patients with low-level education and unemployed patients may benefit more or less from one or the other way of delivery compared to patients with higher levels of education and those that are employed).MethodsPatients with nondependent at-risk alcohol use were identified through systematic offline screening conducted on 13 general hospital wards. Patients were approached face-to-face and asked to respond to an app for self-assessment provided by a mobile device. In total, 961 (81% of eligible participants) were randomized and received their allocated intervention: computer-generated and individually tailored feedback letters (CO), in-person counseling by research staff trained in motivational interviewing (PE), or assessment only (AO). CO and PE were delivered on the ward and 1 and 3 months later, were based on the transtheoretical model of intentional behavior change and required the assessment of intervention data prior to each intervention. In CO, the generation of computer-based feedback was created automatically. The assessment of data and sending out feedback letters were assisted by the research staff. Of the CO and PE participants, 89% (345/387) and 83% (292/354) received at least two doses of intervention, and 72% (280/387) and 54% (191/354) received all three doses of intervention, respectively. The outcome was change in grams of pure alcohol per day after 6, 12, 18, and 24 months, with the latter being the primary time-point of interest. Follow-up interviewers were blinded. Study group interactions with education and employment status were tested as predictors of change in alcohol use using latent growth modeling.ResultsThe efficacy of CO and PE did not differ by level of education (P=.98). Employment status did not moderate CO efficacy (Ps≥.66). Up to month 12 and compared to employed participants, unemployed participants reported significantly greater drinking reductions following PE versus AO (incidence rate ratio 0.44, 95% CI 0.21-0.94; P=.03) and following PE versus CO (incidence rate ratio 0.48, 95% CI 0.24–0.96; P=.04). After 24 months, these differences were statistically nonsignificant (Ps≥.31).ConclusionsComputer-based and in-person BAI worked equally well independent of the patient’s level of education. Although findings indicate that in the short-term, unemployed persons may benefit more from BAI when delivered in-person rather than computer-based, the findings suggest that both BAIs have the potential to work well among participants with low socioeconomic status.Trial RegistrationClinicalTrials.gov NCT01291693; https://clinicaltrials.gov/ct2/show/NCT01291693

Effect of eplerenone on aldosterone and von Willebrand factor levelsin patients with myocardial infarction and chronic kidney disease

Aim: to study the levels of aldosterone and von Willebrand factor (VWF) in patients with Q-wave acute myocardial infarction (Q-AMI) and underling chronic kidney disease (CKD) using aldosterone antagonists. Materials and methods. The study group consisted of 106 patients with renal dysfunction who were hospitalized for acute Q-AMI. Serum levels of neurohumoral parameters (aldosterone and VWF) were determined in all the patients by enzyme-linked immunosorbent assay kits. Results. Reduction in the aldosterone levels was found in patients with Q-AMI and stage 2 CKD from 245.08 ± 17.38 pmol/l to 195.15 ± 13.82 pmol/l (P < 0.05;) who received spironolactone and from 275.59 ± 23.43 to 169.37 ± 24.46 pmol/l (P < 0.001) with eplerenone usage. Patients with stage 1 CKD showed a decreasing trend in aldosterone levels when using spironolactone (from 238.04 ± 20.37 pmol/l to 200.78 ± 9.15 pmol/l), and significantly decreased aldosterone levels when receiving eplerenone (from 229.77 ± 13.76 pmol/l to 156.76 ± 5.76 pmol/l; P < 0.05). The serum concentration of VWF in stage 2 CKD patients was changed insignificantly on spironolactone therapy (from 0.99 ± 0.13 mg/l to 1.13 ± 0.06 mg/l) and it was significantly decreased in the eplerenone group – from 1.29 ± 0.19 mg/l to 0.71 ± 0.14 mg/l (P < 0.05). In stage 1 CKD patients, the concentration of VWF was not decreased significantly with the use of spironolactone (from 1.22 ± 0.13 mg/l to 1.03 ± 0.06 mg/l), but it was decreased significantly when receiving eplerenone (from 1.14 ± 0.09 mg/l to 0.79 ± 0.08 mg/l; P < 0.05). The data obtained indicate the significantly higher probability of declining both aldosterone (t = 2.91; P < 0.01) and VWF (t = 2.59; P < 0.01) with the use of eplerenone in the complex treatment as compared to the spironolactone administration. Conclusions. The effect of eplerenone to decrease the concentration of aldosterone and VWF is significantly greater than that of spironolactone, especially in AMI patients with stage 2 CKD.

MINERAL BONE DENSITY AND VITAMIN D LEVELS IN PATIENTS WITH PSORIATIC ARTHRITIS.

The objective of this study was to explore the possible differences in bone mass density (BMD) and markers of bone metabolism between patients with psoriasis with concomitant psoriatic arthritis (PsA) and patients with psoriasis only (PV). A comparable sample of both types of patients were included in analysis. In all patients, vitamin D serum levels along with inflammatory markers and parathyroid hormone (PTH) were measured. BMD was assessed with dual-energy x-ray absorptiometry scan in axial and appendicular skeleton. Patients with PsA tended to have decreased BMD in axial skeleton, while BMD in appendicular skeleton was comparable between the groups. No statistically significant correlation was found of inflammatory markers, vitamin D and PTH levels with BMD in either patient group. A negative correlation was recorded between vitamin D serum concentration and PTH levels.

CHANGES IN PHYSICAL ACTIVITY LEVELS IN PATIENTS WITH ACUTE CORONARY SYNDROME BETWEEN THE FIRST AND THIRD DECADES OF THE 21st CENTURY.

Sedentary lifestyle and obesity increase the risk of coronary disease (CAD). The aims of this prospective study were to estimate the trends in physical activity (PA) level, accuracy of the Baecke's/LRC-PA questionnaires, and trends in obesity parameters (body mass index-BMI/waist-to-hip ratio-WHR) in patients with acute coronary syndrome (ACS) in the last two decades. We grouped 209 patients with ACS (UAP-unstable angina, STEMI-ST-elevation myocardial infarction, NSTEMI-non STEMI) by year of admission (Group 2002-05/Group 2017) and compared them by the levels of PA (Baecke's/LRC-PA questionnaires) and obesity parameters (BMI, WHR). Group 2017 had higher WHR (1.02 vs. 0.97) and leisure PA index (LI) (3.00 vs. 2.50), as well as less high and very low activity patients (P<0.05). Patients with UAP/STEMI had higher WHR in 2017 (1.02 vs. 0.96, 1.02 vs. 0.99, respectively) (P<0.05) and had lower LI in 2002-05 (2.50 vs. 3.25, 2.75 vs. 3.50, respectively) (P<0.05). In conclusion, leisure PA and WHR was increased in the study period both in patients with ACS and in the general population. We emphasize the usage of more precise methods for evaluation of PA and obesity (Baecke's/Four-point LRC-PA questionnaires, WHR), and that only increased PA with dietary changes leads to reduction of central obesity and risk of ACS.

Self-efficiency of patients with diabetes on self-care at Al- Najaf Center for Diabetes and Endocrine disorders, Babylon, Iraq

Objective: To evaluate a patient's level of self-efficiency in regards to self-care tasks by diabetic patients. Methodology: This descriptive correlational study was carried out from December 2020 to July 2021. A non-probability purposive sampling technic was used. Diabetes Mellitus patients who visited the Al-Sadder Medical City/Al-Najaf Center for Diabetes and Endocrine disorders were included. Demographic and clinical data, self-efficiency and self-care were recorded. Results: Patients' self-care was given a moderate rating, and their replies to the self-efficiency domain questions were given a moderate rating. Furthermore, with a p-value of 0.005, patients' self-care, there was a very strong association with self-efficiency. Conclusion: Patients' self-care had a direct impact on their self-efficiency. Because of this, patients' self-care grows as well as their self-efficiency, and vice versa.

Letter to the Editor: Rethinking The Cost Of Antipsychotic Treatment: The Average Cost Of The Drugs Used In Turkey In 2020.

Letter to the Editor: Rethinking The Cost Of Antipsychotic Treatment: The Average Cost Of The Drugs Used In Turkey In 2020.

Effect of oxygen-helium mixture inhalation on blood saturation levelsin patients with COVID-19

Effect of oxygen-helium mixture inhalation on blood saturation levelsin patients with COVID-19

Patient Factors That Influence Reliable Delirium Assessments in a Medical Intensive Care Unit During the Routine Clinical Practice.

This study aimed to determine patient and therapeutic characteristics of patients in the medical intensive care unit (MICU) that contribute to inconsistent results of delirium assessments performed during routine clinical practice. Therefore, electronic health records were reviewed and compared with secondary data collected from the same medical ICU patients who were assessed using the Confusion Assessment Method in the ICU (CAM-ICU). Of 5,241 cases involving 762 patients, 827 (15.78%) cases showed disagreement between assessments. Continuous renal replacement therapy, physical restraint use, and altered mental status were factors that increased the likelihood of inconsistencies between assessments. A significant positive correlation was found between the CAM-ICU disagreement rate and the total number of assessments per month. To maximize the reliability of delirium assessments, individual-targeted approaches considering the patient's level of consciousness and type of treatment implemented are required, along with ensuring a stable, and regulated working environment and customized educational programs.

A novel approach for detection of consciousness level in comatose patients from EEG signals with 1-D convolutional neural network

Coma is an unresponsive state of unconsciousness from which a person cannot be awakened. Glasgow Coma Score (GCS) is a clinical scale for determining the depth and length of a coma. GCS plays an important role in effective and accurate patient evaluation and is critical in planning the right treatment modalities and patient care because it shows patient outcomes and is a measurement performed several times a day. The GCS is universally accepted as a gold standard and validated scale for assessing a patient's level of consciousness. However, the scale's success has been questioned due to variations in interobserver reliability performance. In this study, the data set generated from Electroencephalography (EEG) signals obtained from 39 comatose patients was used in the training of deep neural networks for the classification of consciousness level. The EEG signals were recorded during nurse and family interaction with comatose patients. The level of consciousness was classified with the proposed 1D-CNN model. Consequently, the two classes that we label as low and high consciousness are classified with 83.3% accuracy. To our best knowledge, no prior studies are using 1D-CNN for the classification of EEG-based level of consciousness using the proposed recording process. Our study is unique from other studies in terms of recording procedure and methods.

Continuous action deep reinforcement learning for propofol dosing during general anesthesia

PurposeAnesthesiologists simultaneously manage several aspects of patient care during general anesthesia. Automating administration of hypnotic agents could enable more precise control of a patient's level of unconsciousness and enable anesthesiologists to focus on the most critical aspects of patient care. Reinforcement learning (RL) algorithms can be used to fit a mapping from patient state to a medication regimen. These algorithms can learn complex control policies that, when paired with modern techniques for promoting model interpretability, offer a promising approach for developing a clinically viable system for automated anesthestic drug delivery. MethodsWe expand on our prior work applying deep RL to automated anesthetic dosing by now using a continuous-action model based on the actor-critic RL paradigm. The proposed RL agent is composed of a policy network that maps observed anesthetic states to a continuous probability density over propofol-infusion rates and a value network that estimates the favorability of observed states. We train and test three versions of the RL agent using varied reward functions. The agent is trained using simulated pharmacokinetic/pharmacodynamic models with randomized parameters to ensure robustness to patient variability. The model is tested on simulations and retrospectively on nine general anesthesia cases collected in the operating room. We utilize Shapley additive explanations to gain an understanding of the factors with the greatest influence over the agent's decision-making. ResultsThe deep RL agent significantly outperformed a proportional-integral-derivative controller (median episode median absolute performance error 1.9% ± 1.8 and 3.1% ± 1.1). The model that was rewarded for minimizing total doses performed the best across simulated patient demographics (median episode median performance error 1.1% ± 0.5). When run on real-world clinical datasets, the agent recommended doses that were consistent with those administered by the anesthesiologist. ConclusionsThe proposed approach marks the first fully continuous deep RL algorithm for automating anesthestic drug dosing. The reward function used by the RL training algorithm can be flexibly designed for desirable practices (e.g. use less anesthetic) and bolstered performances. Through careful analysis of the learned policies, techniques for interpreting dosing decisions, and testing on clinical data, we confirm that the agent's anesthetic dosing is consistent with our understanding of best-practices in anesthesia care.

P016 Impact of Non-Remission on Health-Related Quality of Life and Patient Reported Outcomes in Patients With Crohn's Disease: Targeted Literature Review.

Crohn's disease (CD) leads to chronic inflammation of the gastrointestinal tract that significantly impacts patients over an entire lifetime. The decrease in health-related quality of life (HRQoL) may have an impact on patient's level of functioning, work productivity, and other activities. The goal of treatment for CD is clinical remission based on clinical, endoscopic, and biological parameters. There has been introduction of new treatments in recent years. A review was conducted to assess the impact of non-remission on HRQoL and patient reported outcomes (PROs) in patients with CD. Literature search of English language publications from 2015-2021 was conducted in Embase® and MEDLINE®. Real world studies meeting predefined criteria (adult CD patients in non-remission presenting data for HRQoL or PROs) were included in the review. Data on study characteristics, disease characteristics, HRQoL and PROs were extracted from the included studies. The review retrieved 1384 records from which only 10 studies presented data for HRQoL and/or PROs. The definition of remission varied across the included studies. In most studies (90%), remission was defined using Harvey-Bradshaw Index and/or Crohn's disease activity index. Different tools were used to assess HRQoL and sleep quality. In a study, no normalization of long-term HRQoL was observed in patients who did not achieve clinical remission. A negative correlation was found between utility indexes & disease activity in a study (ρ = -0.586, p < 0.001). A significant correlation was also observed in a study between HRQoL and disease activity where HRQoL in patients with active disease was poor compared to patients in remission. The HRQoL domains of anxiety, depression and pain were impacted in non-remitters. The mean IBDQ score was 189 ± 16.1 in remitters and 145 ± 15.9 in non-remitters (p < 0.001). A strong negative correlation between IBDQ and disease activity was reported by a study. In a study, work productivity was moderately but significantly correlated with disease activity indicating reduction in work productivity of patients with active disease (mild, moderate, and severe) compared to remitters. In another study, severe disease activity was significantly associated with an increased amount of fragmented sleep. Patients with moderate to severe disease had a significantly longer time awake after falling asleep compared to patients in remission or with mild disease activity (65.8 minutes, 44.3 minutes, 49.1 minutes, respectively). Patients with active disease also reported poor sleep quality and suffered from excessive daytime sleepiness. There was a significant difference in the median sleep efficiency for patients with moderate to severe disease compared to patients with remission. This targeted review found in general that not being able to achieve/maintain remission had an impact on the HRQoL of patients with CD. Patients not achieving remission were associated with decreased work productivity, poor sleep quality, lower sleep efficiency, daytime sleepiness and poor HRQoL. However, studies assessing HRQoL and PROs in the real-world are scarce, with discrepancies based on remission status. Further research is warranted, and health care providers and payers should consider the impact of therapies on the improvement in HRQoL of patients with CD.

Awareness and utilization of urgent care services among patients attending Al-Wazarat PHCC in Riyadh, Saudi Arabia 2020.

Background:Urgent Care Clinics (UCCs) offer unscheduled appointments with a “treat and release” length of visits not exceeding 60 min. The growth of clinics is dictated by patients’ demand for quality care that is unscheduled, expedited, and ubiquitous, making them accessible and available.Objectives:This study aimed to assess the patient's level of awareness and utilization pattern of UCCs in Wazarat Health Care Center (WHCC) and assess factors associated with them.Aim:This study aims to provide information contributing to the support of decision-makers about the level of awareness among patients on urgent care services and their pattern of use within primary health care.Methods:This cross-sectional study included 288 patients visiting PHC clinics to measure their level of awareness and pattern of utilization using a self-administered questionnaire.Results:A total of 288 patients participated, 55.99% were females, and the highest percentage was in the age group of 18-38 years at 60.07%. Only one quarter, 73 (25.35%) of the patients were aware of the term urgent clinics, from them, more than a half (53.42%) visited such clinics 1–3 times in the three months before the time of study conduction, and the main cause of the visits was the common cold (25.76%). Less than half of the participants reported visiting the primary clinics without booking an appointment in advance at 44.79%. The reason for this was mainly because of having difficulty booking appointments at 54.55%. Awareness level was the highest (28.32%) among the lowest age group (18-38 years) and decreased gradually by increasing the age. A significantly higher percentage of low educational level participants reported visiting primary clinics without booking an appointment in advance at 51.33% vs. 37.68% of the university and above participants. According to patients ‘ income, there was a significant (0.023) difference in the awareness level; the highest was among participants with an income of 6000-12000 SAR at 32.86%.Conclusion:Only one-quarter of the studied patients know about the UCCs. More than half of the patients reported visiting these clinics because of difficulties in booking an appointment at the primary healthcare centers and convenience with the services provided at the UCCs. The common cold was the main reason for visiting the UCCs.

Tingkat Kecemasan dengan Lama Rawat Inap Covid 19

Introduction: The patient's level of anxiety while undergoing treatment at the hospital greatly affects the length of stay in the hospital. Purpose: The purpose of this study was to determine the relationship between the anxiety level of COVID-19 patients and the length of patient care in the COVID-19 inpatient room at the Kalideres Hospital, Jakarta in 2021. Methods: This type of quantitative research is correlative with a cross-sectional approach. The population in this study were covid 19 patients in the inpatient room for covid 19 patients at Kalideres Hospital, Jakarta in 2021 and the sample needed in this study was 54 respondents with the accidental sampling method. The researcher's data analysis used the Spearman-Ro Rank test. Results: Based on the results of the study, the description of the level of anxiety of most of the patients' anxiety was severe anxiety, as many as 26 respondents (48.1%). The description of the length of treatment partly is long, as many as 38 respondents (70.4%). The results of statistical tests are known with the value of P = 0.000 &lt;0.05. Conclusion: There is a relationship between the anxiety level of COVID-19 patients and the length of patient care in the inpatient room at the Kalideres Hospital in 2021.

Analysis of Patient Operation Interest in Sumber Glagah Hospital, Mojokerto Regency

A person's interest in services is related to the ability of the service provider to provide services. The purpose of this research is to analyze the influence of perception, service quality, anxiety and type of surgery on patient interest in performing surgery at Sumber Glagah Hospital, Mojokerto Regency. The design of this study is a quantitative analytic study with a cross sectional approach with the focus of the research being aimed at analyzingthe influence of perception, service quality, anxiety and type of surgery on patient interest in performing surgery at Sumber Glagah Hospital, Mojokerto Regency with a population of a number 143 respondents and a sample of 105 respondents who were taken using purposive sampling technique. Data analysis using Linear Regression test.The findings found that Most of the respondents had the perception of a sufficient category as many as 65 respondents (61.9%). Most of the respondents had a sufficient service quality category as many as 66 respondents (62.9%). Most of the respondents had moderate anxiety as many as 61 respondents (58.1%). Most of the respondents had a selective category of operation as many as 92 respondents (87.6%). Most of the respondents have a moderate interest category as many as 69 respondents (65.7%). Based on the results of the Multiple Linear Regression analysis, it shows that with a p-value of 0.000 &lt;0.05, H1 is accepted so it can be concluded that simultaneously there isinfluence perception, quality of service, anxiety and type of surgery on patient interest in performing surgery at Sumber Glagah Hospital, Mojokerto Regency with a magnitude of influence 70.4%. Basically, a person's interest can be influenced by various factors ranging from the patient's point of view, the quality of existing services and even the patient's level of anxiety.