Private Health Institutions Research Articles

PRINCIPAIS CAUSAS PARA O CANCELAMENTO DE CIRURGIAS ELETIVAS EM UMA INSTITUIÇÃO DE REDE PRIVADA.

The objective of this study was to identify the main causes for the cancellation of elective surgeries in a private institution in a municipality in the Northern region of Brazil, from August 2021 to August 2022. This is a cross-sectional, retrospective, quantitative study carried out in a private health institution, located in the municipality of Belém, capital of the State of Pará, in the Northern region of Brazil. Considering a universe of 110 physical medical records according to the period established from August 2021 to August 2022, a sampling error margin of no more than 5% and a confidence level of 95% were used. Therefore, the sample of this study is composed of 86 medical records of patients who had their elective surgical procedure canceled. The following were excluded: medical records of urgent and emergency surgeries; medical records with inadequately filled out or incomplete information; duplicate medical records. The demographic profile of the patients analyzed, the majority are female (61.63%). The age group 60 to 69 years had the highest prevalence, with a total of 25.58% of surgical cancellations. The majority of patients were brown, with 76.74% of the patients analyzed. (53.49%) patients denied any type of comorbidity, either concomitantly or in isolation. Regarding the surgical specialties with the highest cancellations, orthopedics (52.33%) and otorhinolaryngology (24.42%) were found. Among the main causes of surgical cancellation with the highest rate is related to the unfavorable clinical conditions of the patients (30.23%). Regarding organizational issues, surgeries canceled at the request of the surgeon stand out, with 26.74%.

Spatial distribution and associated factors of cesarean section in Ethiopia using mini EDHS 2019 data: a community based cross-sectional study

Maternal health is a major public health tricky globally. Cesarean section delivery reduces morbidity and mortality when certain complications occur throughout pregnancy and labor. Cesarean section subjected to the availability and use of essential obstetric services in regional factors in Ethiopia. There was a scarcity of studies that assess the spatial distribution and associated factors of cesarean section. Consequently, this study aimed to assess the spatial variation of cesarean section and associated factors using mini EDHS 2019 national representative data. A community based cross-sectional study was conducted in Ethiopia from March to June 2019. A two-stage stratified sampling design was used to select participants. A Global Moran’s I and Getis-Ord Gi* statistic hotspot analysis was used to assess the spatial distribution. Kuldorff’s SaTScan was employed to determine the purely statistically significant spatial clusters. A multilevel binary logistic regression model fitted to identify factors. A total of 5753 mothers were included. More than one-fourth of mothers delivered through cesarean section at private health institutions and 54.74% were not educated. The proportion of cesarean section clustered geographically in Ethiopia and hotspot areas were observed in Addis Ababa, Oromia, Tigray, Derie Dewa, Amhara, and SNNR regions. Mothers’ age (AOR = 1.07, 95% CI 1.02–1.12), mother’s had secondary education (AOR = 2.113, 95% CI 1.414, 3.157), mother’s higher education (2.646, 95% CI 1.724, 4.063), Muslim religion followers (AOR = 0.632, 95% CI 0.469, 0.852), poorer (AOR = 1.719, 95% CI 1.057, 2.795), middle wealth index (AOR = 1.769, 95% CI 1.073, 2.918), richer (AOR = 2.041, 95% CI 1.246, 3.344), richest (AOR = 3.510, 95% CI 2.197, 5.607), parity (AOR = 0.825, 95% CI 0.739, 0.921), and multiple pregnancies (AOR = 4.032, 95% CI 2.418, 6.723) were significant factors. Therefore, geographically targeted interventions are essential to reduce maternal and infant mortality with WHO recommendations for those Muslim, poorest and not educated mothers.

Quality of work life and associated factors among health professionals working at private and government health institutions in Awi zone, Amhara regional state, Ethiopia, 2022: a comparative cross-sectional study.

Quality of work-life issues significantly impact the economic, physical, and psychological well-being of health professionals and their families. Enhancing QWL aims to foster a conducive environment and improve work performance. This study evaluated the quality of work life of health professionals in government and private health institutions in the Awi zone, Ethiopia. A comparative cross-sectional approach was employed, with study participants selected via the lottery method in 2022. Socio-demographic and organizational-related data were collected, coded, cleaned, and entered into Epi-Data version 3.1, then analyzed using SPSS version 27. Candidate variables were selected using bivariable logistic regression (p < 0.20). We used multivariable logistic regression to identify factors associated with quality of work life, presenting AOR with a 95% CI at a 5% significance level. The study included 385 private health professionals and 395 government health professionals, with response rates of 90.38 and 92.72%, respectively. Overall quality of work-life satisfaction was 53.08% (95% CI: 49.2-57.0), with private health institution workers reporting satisfaction at 42.3% (95% CI: 37.4-47.30) and government health professionals at 63.54% (95% CI: 58.78-68.31). The difference between the two groups was 21.2% (95% CI: 14.3, 27.9). Factors significantly associated with quality of work life included type of health institutions (AOR = 2.272; 1.684, 3.065), family size (AOR = 1.536; 1.122, 2.103), personnel protective equipment (AOR = 1.369; 1.006, 1.863), eye protection (AOR = 2.090; 1.514, 2.885), engineering control (AOR = 1.563; 1.140, 2.143), and accessibility of alcohol (AOR = 1.714; 1.219, 2.410). Health professionals in private health institutions exhibited lower quality of work-life satisfaction than government health institutions. Quality of work life was significantly associated with the type of health institutions, family size, availability of personal protective equipment, eye protection, engineering control, and accessibility of alcohol. Regular monitoring and evaluation of the quality of work life, ensuring the availability of appropriate personal protective equipment, and providing sufficient materials and equipment for both groups were recommended based on the findings.

ETHICS COMMITTEES AND THEIR SOCIAL PROJECTION

Clinical ethics committees (CEC) fulfill three relevant functions: training in bioethics for mem­bers of the hospital community, participation in the institution’s ethical policies and guidelines, and advising clinical teams in resolving ethical problems. Both in Chile and in other countries, the function that demands the greatest dedication and that has been most evaluated in its impact is the consultative function. Thus, less time and effort are allocated to the educational task. In July 2023, a consultation was carried out to the CEC of public and private health institutions in Chile to find out the educational or training activities performed in the last 5 years. Of 83 queries sent, the response rate was 25%. A high percentage of those who responded (76%) had carried out at least one activity in the period, courses and conferences being the most frequent. There was a wide variety in the topics addressed, such as the adequacy of the therapeutic effort, exercise of autonomy, confidentiality, and end-of-life dilemmas, among others. Red de Salud UC CHRISTUS CEC stands out, because since 2016 has developed an annual conference with the objective of training and sharing experiences with members of other committees at the national level. It is concluded that it is necessary to continue promoting and evaluating the educational task of the CEC.

Abstract PO3-07-11: Concordance between abbreviated and complete magnetic resonance protocols for screening woman at moderate and high risk for breast cancer

Abstract Introduction: Patients at high risk for developing breast cancer are potential beneficiaries of personalized screening strategies. Breast magnetic resonance imaging (MRI) has shown high sensitivity, but its broader use remains constrained by issues such as high cost and long examination time. The abbreviated magnetic resonance protocol is presented as an alternative to overcome these challenges. Our primary outcome was to evaluate the concordance of the final report between full and abbreviated protocols. Secondary outcomes included the acquisition and reading time of images from the abbreviated protocol. Methods: A cross-sectional study was conducted on asymptomatic women at moderate and high risk for breast cancer who underwent the full MRI screening protocol in private health institutions in the city of Belo Horizonte, Brazil. The abbreviated protocol was derived from the full protocol by the computer through selection of specific sequences. Each image was independently blind read, and assigned a category from the Breast Imaging - Reporting and Data System (BI-RADS) by at least two examiners. The results were then compared using the Cohen's kappa and Intraclass Correlation Coefficients. Results: The study included 170 women, and a concordance rate of 96,9% was found for the reported BI-RADS category between protocols in this population. A 21-minute reduction was observed in examination time for the abbreviated protocol. Conclusion: The significant concordance between protocols indicates that despite the reduction in acquisition time, number of acquired images, and method's complexity, the abbreviated MRI protocol meets most screening demands. It is, therefore, a viable alternative for cost reduction and improving patients tolerability for the studied population. Table 1. Clinical characteristics of the study population Absolute and percentage data about age, personal risk for breast cancer, family history, and previous genetic testing in the study population. Table 2. Concordance analysis between abbreviated and complete MRI protocols based on the ACR-BIRADS classification - Coen Kappa and Intraclass Correlation Coefficient The Kappa value of 0.9687 (95% CI 0.9426 - 0.9949, p &amp;lt; 0.01) indicates almost perfect concordance between the two protocols. The intraclass correlation coefficient of 0.982 (95% CI 0.97 - 0.987, p &amp;lt; 0.01), also indicates excellent concordance using the two-way random effect models criteria. Citation Format: Mariana Mitraud Ottoni Guedes, Agnaldo Lopes da Silva Filho, Thais Paiva Moraes, Adriene Moraes Campos, Ivie Braga de Paula, Felipe Marcondes de Oliveira Coelho, Barbara Silveira Santana, Bertha Andrade Coelho, Maria Fernanda Sperotto Valadares Gontijo, Leticia Martins De Araujo Campos Linhares, Anna Dias Salvador, Waldeir José de Almeida Junior, José Tadeu Campos de Avelar. Concordance between abbreviated and complete magnetic resonance protocols for screening woman at moderate and high risk for breast cancer [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO3-07-11.

Determinants of public institutional births in India: An analysis using the National Family Health Survey (NFHS-5) factsheet data.

Institutional births ensure deliveries happen under the supervision of skilled healthcare personnel in an enabling environment. For countries like India, with high neonatal and maternal mortalities, achieving 100% coverage of institutional births is a top policy priority. In this respect, public health institutions have a key role, given that they remain the preferred choice by most of the population, owing to the existing barriers to healthcare access. While research in this domain has focused on private health institutions, there are limited studies, especially in the Indian context, that look at the enablers of institutional births in public health facilities. In this study, we look to identify the significant predictors of institutional birth in public health facilities in India. We rely on the National Family Health Survey (NFHS-5) factsheet data for analysis. Our dependent variable (DV) in this study is the % of institutional births in public health facilities. We first use Welch's t-test to determine if there is any significant difference between urban and rural areas in terms of the DV. We then use multiple linear regression and partial F-test to identify the best-fit model that predicts the variation in the DV. We generate two models in this study and use Akaike's Information Criterion (AIC) and adjusted R2 values to identify the best-fit model. We find no significant difference between urban and rural areas (P = 0.02, α =0.05) regarding the mean % of institutional births in public health facilities. The best-fit model is an interaction model with a moderate effect size (Adjusted2 = 0.35) and an AIC of 179.93, lower than the competitive model (AIC = 183.56). We find household health insurance (β = -0.29) and homebirth conducted under the supervision of skilled healthcare personnel (β = -0.56) to be significant predictors of institutional births in public facilities in India. Additionally, we observe low body mass index (BMI) and obesity to have a synergistic impact on the DV. Our findings show that the interaction between low BMI and obesity has a strong negative influence (β = -0.61) on institutional births in public health facilities in India. Providing households with health insurance coverage may not improve the utilisation of public health facilities for deliveries in India, where other barriers to public healthcare access exist. Therefore, it is important to look at interventions that minimise the existing barriers to access. While the ultimate objective from a policy perspective should be achieving 100% coverage of institutional births in the long run, a short-term strategy makes sense in the Indian context, especially to manage the complications arising during births outside an institutional setting.

The role of Satisfaction predictors in determining Revisit Intentions of patients in Private Health Institutions of Pakistan

This study is conducted to investigate the relationship of patient satisfaction with service quality and revisit intention of patients in private hospitals of Pakistan. The research was conducted by quantitative and cross-sectional survey-based method, where 334 responses were collected through convenience sampling technique from patients and attendants visiting the private hospitals in Pakistan. The data was analysed using SEM-PLS. Results revealed that patient satisfaction levels mediate the relationship between service quality parameters and revisit intentions of patients in private healthcare sector of Pakistan. This study contributes in helping the healthcare policy makers in adopting patient-centric structures for betterment of their service quality and enhancing patient satisfaction, eventually increasing the revisit intentions.

‘Beware of dalals’: a moral world of health market brokerage in Bangladesh

AbstractAnthropological enquiry into brokers and brokerage practice provides a prime entry point for making sense of social change. This article tends to the ways in which the trope of the broker and the everyday practice of those identified as enacting brokerage act as linchpins in broader moral grappling during a period of rapid social change. It draws from the ethnographic context of brokerage discursively constituted and enacted within maternal health markets in Bangladesh, focusing on the trope and actual practice of those identified as morally compromised dalals: brokers bringing women and families from public to private health institutions. It argues that the trope of the dalal operates as a metaphor for immorality ascribed to morally ambiguous spaces of the private health sector, a way for people to contend with a moral discomfort integral to applying market logics to health services enacted largely outside the jurisdiction of formal regulatory mechanisms. The practice of those identified as embodying dalals, in contrast, while flourishing in these conditions, is rooted in economic precarity, primarily of young men with limited power waiting for better opportunities, who negotiate and balance moral and economic imperatives in their line of work.

Are institutional deliveries equitable in the southern states of India? A benefit incidence analysis

BackgroundDespite a commendable rise in the number of women seeking delivery care at public health institutions in South India, it is unclear if the benefit accrues to wealthier or poorer socio-economic groups. The study’s aim was to investigate at how the public subsidy is distributed among Indian women who give birth in public hospitals in the southern regions.MethodsData from the Indian Demographic Health Survey’s fifth wave (NFHS-5, 2019–21) was used in this study. A total of 22, 403 were institutional deliveries across all the southern states of India were included. Out-of-pocket expenditure (OOPE) on childbirth in health institutions was the outcome variable. We used summary statistics, Benefits Incidence Analysis (BIA), concentration index (CI), and concentration curve (CC) were used.ResultsMost women in the lowest, poorest, and medium quintiles of wealth opted to give birth in public facilities. In contrast, about 69% of mothers belonging to highest quintile gave birth in private health institutions. The magnitude of CI and CC of institutional delivery indicates that public sector usage was concentrated among poorer quintiles [CIX: − 0.178; SE: 0.005; p < 0.001] and private sector usage was concentrated among wealthier quintiles [CIX: 0.239; SE: 0.006; p < 0.001]. Benefit incidence analyses suggest that middle quintile of women received the maximum public subsidy in primary health centres (33.23%), followed by richer quintile (25.62%), and poorer wealth quintiles (24.84%). These pattern in the secondary health centres was similar.ConclusionPoorer groups utilize the public sector for institutional delivery in greater proportions than the private sector. Middle quintiles seem to benefit the most from public subsidy in terms of the median cost of service and non-payment. Greater efforts must be made to understand how and why these groups are being left behind and what policy measures can enhance their inclusion and financial risk protection.

Institutional Deliveries at Public and Private Health Institutions in Punjab: A Comparative Study of Pre-Lockdown, Lockdown and Post-Lockdown Periods in Selected Districts

From 25 March 2020, there was a complete lockdown in Punjab till 31 May 2020 in four different phases affecting almost all types of services except delivery of essential services. Further, lockdown restrictions continued for night movement in the State in various phases. Out-patient (OPD) services were closed and entry to medical institutions was restricted to emergency services. Since institutional deliveries constitute an important ingredient of maternal and child health care facilities, it is important to study and examine the impact on institutional births in Punjab in the context of lockdown. The main objectives of the research paper are to find out the patterns of actual institutional deliveries in the selected districts of Punjab; to study the variations in three-distinct phases such as pre-lockdown (before March 2020), lockdown (March-July 2020) and the post-lockdown (after July 2020). Further, all deliveries have been classified in different categories-normal, caesarean, public, private, core and periphery, etc. Among various things, paper finds there was an edge of government sector in both the selected districts during pre-lockdown period which started intermingling during the lockdown period and completely reversed in favour of private sector during the post- lockdown period.

Instrumento brasileiro para investigação de eventos adversos na saúde: estudo de validação

Abstract Objective To build the Brazilian instrument for investigating adverse health events and evaluate the evidence of content validity and the response process. Methods This psychometric study was conducted according to the Standards for Education and Psychological Testing in the following stages: search for evidence of content validity and response process. In the content evidence, 46 experts from all regions of Brazil participated. In the response process, 76 professionals from 31 health institutions participated. The Statistical Package for the Social Sciences program was used for the distribution of quantitative variables and synthesis, via the calculation of descriptive statistics. In the content evidence stage, the acceptable Content Validity Ratio (CVR) greater than the expected critical CVR for N judges was used; the critical CVR of 0.35 was used in this study. The focus group has been performed for the response process. Results In total, 46 experts participated in the content validation stage, predominantly training nurses (84.8%), and nurses who graduated 11 years ago (60.7%) or more. The results obtained for each level in content validation were as follows: levels I, II, and III respectively presented the following CVR values: 0.88, 0.76, and 0.97. In the response process stage, adjustments to the nomenclature and sequence of steps were performed. Conclusion Building and validating the first Brazilian Instrument for Investigating Adverse Events in Health was possible with the necessary sources to ensure the content and response process. The best evidence articulated with national and international references was considered, making it possible to improve investigation systems in private and public health institutions.

Prevalencia y gravedad de síntomas de menopausia en mujeres de mediana edad residentes de Lima-Perú

Objective: To determine the prevalence and severity of menopausal symptoms in women attended in a private health institution in the city of Lima. Method: A non-experimental, descriptive, cross-sectional designed quantitative research approach was used. Participating women were between 40 and 70 years of age and were attended in a private health institution. The Menopause Symptoms Severity Inventory instrument was used to collect the information. It contains 38 symptoms, organized in 12 dimensions, and internal consistency with values between 0.61 and 0.89. The Wilcoxon-Mann-Whitney test and the Chi-Square test were applied. Results: The final sample consisted of 775 women with an average age of 52.1 years ± 5.7. 77.2% did not seek medical help and 91.4% did not use hormone therapy. The comparative analysis of frequency and intensity by symptoms showed differences (p≤0.05). Symptoms such as muscle, joint pain, headache, tiredness, and loss of sexual interest presented severely. These correspond to the anxiety, aches and pains, cognitive impairment, and sexual symptoms dimensions. The anxiety and body shape dimensions did not present with significant differences, symptom severity in premenopause was 22.5%, in perimenopause 34% and 41.5% in postmenopause (p=0.003). The total prevalence was 34.8%, being higher in postmenopausal women. Conclusions: Sexual symptoms, cognitive impairment, pain and discomfort presented severely, with a total prevalence of 34.8% and especially affected postmenopausal women.

Investigation of the Relationship Between Serum Low-Density Lipoprotein Cholesterol Levels with Genetic Polymorphisms, Gut Microbiota, and Nutrition.

Background: To prevent cardiovascular disease (CVD), it is important to determine the factors that are associated with its development. High serum low-density lipoprotein (LDL) cholesterol (LDL-C) levels are a modifiable prevention and treatment target known to contribute to the development of CVD, but the factors affecting blood cholesterol levels, including LDL-C, remain controversial. Objective: In this study, the factors (genetic, nutritional, and gut microbiota) thought to be effective on serum LDL-C levels were discussed from a holistic perspective, and the effects of the relationship between these factors on LDL-C levels were examined. Methods: The study was carried out with 609 adults (48% male) who applied to a private health institution between 2016 and 2022. Results: It was observed that serum LDL-C levels were positively correlated with body mass index (BMI) (P = 0.000) and different ApoE alleles had significant effects on LDL-C levels. It was observed that the highest LDL-C levels were in the ɛ4+ group, followed by ɛ3+ and ɛ2+ groups, respectively (P = 0.000). Results showed that dietary cholesterol and fiber consumption did not significantly affect serum LDL-C levels (P = 0.705 and P = 0.722, respectively). It was also observed that enterotypes and the butyrate synthesis potential of intestinal microbiota did not cause significant changes in serum LDL-C levels (P = 0.369 and P = 975, respectively). Conclusion: Serum LDL-C levels are affected by modifiable factors such as BMI and nonmodifiable factors such as APOE genotype. By identifying these factors and conducting further studies on them, new ways to improve serum LDL-C levels, which is an important factor in the development of CVD, can be identified. In addition, no significant effect of gene-nutrient or microbiota-nutrient interactions on serum LDL-C levels was detected. Further research is needed, especially on the relationship between intestinal microbiota and serum LDL levels.

Knowledge, attitude, and perception of Nigerian-based physiotherapists on the utilization of musculoskeletal ultrasound imaging in the clinical management of musculoskeletal conditions

BackgroundMusculoskeletal ultrasound imaging (MSUI) is an efficient monitoring and re-evaluation tool used for the management of musculoskeletal conditions in several clinical domains. Its utilization among physiotherapists, particularly in African countries, is yet to be explored.ObjectiveThis study investigated the knowledge, attitude, and perception of physiotherapists on the utilization of MSUI in the clinical management of musculoskeletal conditions.MethodsOne hundred and ninety-two consenting Nigerian-based physiotherapists practicing in public and private health institutions participated in this cross-sectional survey. They responded to a three-sectioned structured questionnaire, investigating socio-demographic and occupational characteristics, knowledge, attitude, and utilization of MSUI for the management of musculoskeletal conditions. Data were analyzed with descriptive statistics and Pearson’s chi-square test at a significant level of 0.05.ResultsThe majority (79.2%) of the respondents had positive knowledge of MSUI and its benefits as a clinical modality for managing MSCs. However, only 4.2% had utilized MSUI in clinical practice. Non-utilization of MSUI was commonly attributed to a lack of access to MSUI (60.3%) and its unavailability in most diagnostic centers (42.9%). Almost all (99.0%) of them agreed to the necessity for increased availability of MSUI to physiotherapists for enhancement of physiotherapy interventions in the management of MSCs.ConclusionKnowledge of MSUI among Nigerian-based physiotherapists is adequate, but its utilization as a clinical tool is poor. Improved availability of MSUI to physiotherapists is necessary as well as specialty training on the utilization and interpretation of MSUI.

Recherche clinique au sein des centres hospitaliers généraux en France, forces et faiblesses

Clinical research is an essential activity in cancer care. Both for patients, who can gain access to innovative therapies, and for practitioners, who can maintain their skills and stay at the forefront of new treatment approaches. First developed in university hospitals, clinical research is now established in general hospitals and private health institutions. The number of patient inclusions in clinical trials has doubled over the last ten years, thus reflecting the dynamism of it. Strengths and weaknesses, opportunities and threats concerning clinical research, and more specifically clinical research in general hospitals, are exposed in this article.

Economic crisis and its impact on the mental health of nursing and medical personnel

Obgective: The sample constituted by 112 employees of nursing and medical personnel of public alongside private health institutions in the prefecture of Imathia. The survey was conducted by using the General Health Questionnaire (GHQ-30). The first part of the questionnaire comprised of demographic and questions regarding theis profession. Statistical analysis was performed with SPSS v23. Method: The sample constituted by 112 employees of nursing and medical personnel of public alongside private health institutions in the prefecture of Imathia. The survey was conducted by using the General Health Questionnaire (GHQ-30). The first part of the questionnaire comprised of demographic and questions regarding theis profession. Statistical analysis was performed with SPSS v23. Results: The 25% of the research personnel appear to be anxious and 16% appear to be depressed although no one experience depression. The variables that show strong correlations seem to affect employees in relation with their decisions, the way they work/ live, and their psychopathology are distinguished by their age, the working sector, the years of work, marital status, the salary reduction and finally the insecurity. Conclusions: Governments in periods of economic crisis should invest in health sector, as through this kind of investment, they will have a reinforcement of human development and social well-being.

Health Information Management and Patient Profile Estimation Using Data Mining Classification Techniques

Nowadays, the rapid advancement of technological developments consists of complex and large databases. Software programmes are needed because it can be very difficult to process the complex data. The aim of the study is to reveal the patient profile by data mining of the hospital information system and to help make strategic decisions according to patient profile analysis in the establishment of a new hospital or additional hospital departments in the future. The application of data mining in the health sector provides the sector with a faster, reliable and different perspective on decision-making by reaching the desired data. For this purpose, data mining decision tree algorithms were applied, and patient profile estimations were found by using the data of patients receiving service from a private health institution with hospitals in different settlements. By categorising the characteristics of the individuals receiving service and the branches from which they receive service, it was revealed with which variables the patient profile is related. It is thought that determining patient profile will help to follow a more accurate path in the stage of meeting their demands.

Readability Analysis of Turkish Patient Informing Texts about Teeth Whitening on the Internet: Cross-Sectional Study

Objective: Considering that the texts presented on the internet will be read by people of very different education levels, it is important to examine the readability of these texts. The aim of this study was to evaluate the readability analysis of Turkish patient information texts about teeth whitening on the internet. Method: A Google search using the term “Teeth Whitening” revealed the top 100 websites. Turkish patient information texts on the 86 websites included in this study were evaluated according to the Atesman Readability Index. The information texts originated from dentists, specialist dentists, private health institutions, university hospitals, and newspapers. The Kolmogorov–Smirnov test and descriptive statistics were used for statistical evaluation. Statistical significance level was accepted as P &lt; .05. Results: Atesman Readability Index score was 59.08 ± 8.14. According to the findings obtained in the research, 0% of the websites examined were rated as very easy, 7% as easy, 86% as moderately difficult, 5.8% as difficult, and 1.2% as very difficult. When the readability levels of the texts were examined according to grade levels, the following was found: 43% were grades 11th–12th , 43% grades 9th–10th, 7% grades 7th–8th, and 5.8% grade associate degree. Conclusion: The readability of Turkish texts on teeth whitening on the internet was found to be of medium difficulty. When creating texts for the internet about teeth whitening, it would be beneficial to make them easier to read by using readability programs before they are published. Keywords: Access to information, dentists, internet, teeth whitening

INCIDENCE OF PULMONARY THROMBOEMBOLISM IN PATIENTS WITH COVID-19 ADMITTED TO THE INTENSIVE CARE CENTER

Introduction: Sars-CoV-2 imposed complex challenges on the global community, on March 11, 2020, when the World Health Organization (WHO) declared COVID-19 as a pandemic, it aroused concern from public and private health institutions internationally, due to to the high proportions of dissemination and risk to global health. Objective: to investigate the incidence of pulmonary thromboembolism (PT) in patients hospitalized for COVID-19 in an Intensive Care Unit (ICU) in southern Brazil. Method: documentary and descriptive research, quantitative approach, through a retrospective analysis of the medical records of patients treated at the ICU. Results: data collection resulted in 306 medical records of patients admitted to the ICU, 64.7% were positive for COVID-19, comprising the sample of interest for the present study, 59% men and 41% women, mean age 53, 8 ± 13.3 years, the constantly cited comorbidities were hypertension, diabetes mellitus and obesity. The sample showed an incidence of PT of 11% in the ICU, the PT+ group had a longer hospital stay compared to the COVID-19 group, angiotomography was performed 7.3 ± 6.3 days after the presence of symptoms compatible with PT, the morbidity and mortality was similar between groups. In the PT+ group, the length of stay and the presence of hypertension were greater than in the COVID-19 group. Conclusion: the understanding that COVID-19 is a respiratory disease, but that through its aggravation, it can evolve into a complication in the coagulative system, predisposing to thrombotic events, is essential, especially to recognize PT early, thus allowing greater chance in the treatment and early diagnosis of this disease.

Paying attention to cyber-attacks: A multi-layer perceptron with self-attention mechanism

Cyber-attacks cause huge monetary losses to the institutions that are victims of them. Cyber-attack is becoming increasingly sophisticated. Therefore, the protection system against cyber-attacks has become a highly requested resource by any type of state or private institution. During the pandemic caused by COVID-19, the number of cyber-attacks against both public and private health institutions has increased. Cybersecurity systems have become a necessity. Various protection systems have been proposed using different machine learning algorithms, but deep learning consistently provides the best results. In this work we develop a deep learning model for the detection of different kinds of cyber-attacks, a study is carried out on the relevance of the selection of features in this type of algorithm and the importance of attention mechanisms is analyzed to improve the assessment of features within the same model. We have carried out the experiments using two datasets that are benchmarks in the field of cybersecurity and we have carried out a comparative study with both.