Total Attendance Research Articles

Proportion of Home and Leisure Accidents in mainland Portugal, in 2019

Abstract Unintentional injuries are recognized by the World Health Organization and the European Union as a preventable public health problem contributing to mortality and morbidity burden and expression in the emergency department (ED). According to EuroSafe injury is the fourth most common cause of death within the EU, being the leading cause of death in the youngest. Whereas injury related fatalities is only a part of the problem and more patients require hospital treatment it is essential measure the size of the injury problem and characteristics of these non-fatal injuries. Information from Injury Data-Base reveals that the majority of injury related ED attendances and hospital admissions result from accidents occur in home and during leisure times. So, the aim of this study it was to know the proportion of Home and Leisure Accidents (HLA) which needed attendance in the emergency rooms of the Hospitals National Health, in Portugal Mailand, in 2019. For the analysis were considered the total number of NHS health entities that have an ED, SONHO information system and National injury surveillance system - EVITA System. Based on hospital emergency records in 2019, was obtained the total number of victims by HLA who needed assistance in this health services. In 2019, there were 526 786 ED attendances due to HLA, so about 11,3% of hospital ED attendances in mainland Portugal were caused by HLA. Globally, it was observed a proportion of HLA with admission in ED higher in males (12,9%) than females (10,1%). Disaggregating the data by age group, it was possible to observe a preponderance of males in victims aged less than or equal to 54 years. On the other hand, females showed a higher proportion in individuals aged 55 and over. Additionally, victims aged 75 and over had the highest proportion of hospital admissions by HLA, both in females (15,5%) and males (13,1%). This study represented a relevant advance contributing to the revelation of the dimension of this problem in Portugal. Key messages The National Injury Surveillance System provides information that allows to know the dimension of this health problem in mainland Portugal. HLA represents 11,3 % of the total hospital ED attendances. HLA are the predominant cause of injury related ED attendances. Males and females have a different proportions of injury. Males aged 54 years and over have higher proportion of HLA than females.

SARS-CoV-2 pandemic and epilepsy: The impact on emergency department attendances for seizures

IntroductionThe risk of acquiring SARS-CoV-2 in a hospital setting and the need of reorganizing the Emergency Departments (EDs) to cope with infected patients have led to a reduction of ED attendances for non-infectious acute conditions and to a different management of chronic disorders. MethodsWe performed a retrospective study evaluating the frequency and features of ED attendances for seizures during the lockdown period (March 10th–April 30th 2020) in the University Hospital of Trieste, Italy. We studied the possible pandemic impact on the way patients with seizures sought for medical assistance by comparing the lockdown period to a matched period in 2019 and to a period of identical length preceding the lockdown (January 18th–March 9th 2020). ResultsA striking decrease in total ED attendances was observed during lockdown (4664) compared to the matched control (10424) and to the pre-lockdown (9522) periods. A similar reduction, although to a lesser extent, was detected for seizure attendances to the ED: there were 37 during lockdown and 63 and 44 respectively during the two other periods. Intriguingly, during the lockdown a higher number of patients attended the ED with first seizures (p = 0.013), and more EEGs (p = 0.008) and CT brain scans (p = 0.018) were performed; there was a trend towards more frequent transport to the ED by ambulance (p = 0.061) in the lockdown period. ConclusionsOur data suggest that the pandemic has affected the way patients with seizures access the Health Care System.

Strategy research and analysis on 10 590 cases of invalid ambulance attendance in prehospital emergency care in Nanshan District of Shenzhen from 2014 to 2018

To provide a scientific basis for reducing the rate of invalid ambulance attendance and the establishment of grades dispatch system through a retrospective analysis of the invalid ambulance attendance in prehospital emergency care. The data of the invalid ambulance attendance was collected in Huazhong University of Science and Technology Union Shenzhen Hospital (the only tertiary hospital of in Nanshan District) from 2014 to 2018, and the reasons of the invalid ambulance attendance, the time period during the invalid ambulance attendance occurred (every 3 hours was divided into one time period), and the reasons of ambulance calling were statistically analyzed. (1) The invalid ambulance attendance rates showed a fluctuating decrease trend year by year from 2014 to 2018, the rates were 31.22% (2 515/8 055), 26.94% (2 147/7 970), 29.80% (2 398/8 046), 25.69% (1 844/7 177) and 21.89% (1 686/7 703), respectively. The total invalid ambulance attendance rate was 27.19% (10 590/38 951) in the five years. (2) The top three reasons for the invalid ambulance attendance were cancelled calls, departure before the ambulance arrived, and going to hospital by themselves, accounting for 36.87%, 25.08%, and 17.03%, respectively. The constituent ratios of the causes of invalid ambulance attendance in each year were different with statistical significance (χ2 = 217.626, P < 0.001). (3) The top three time period of invalid ambulance attendance occurred at 21:00-23:59, 18:00-20:59 and 09:00-11:59, accounting for 16.86%, 14.95% and 13.54%, respectively. There was no statistical significance in the distribution of time period in each year (χ2 = 32.571, P = 0.252). (4) The top five reasons for ambulance calling of invalid ambulance attendance were fainting/syncope, trauma, alcoholism, traffic accident injuries, and brawls, accounting for 20.13%, 15.67%, 9.97%, 8.64%, and 6.45%, respectively, and there was statistically significant difference in the distribution of the reason for ambulance calls in each year (χ2 = 194.213, P < 0.001). The invalid ambulance attendance rate is high in Nanshan District of Shenzhen. Improving the professional level and triage ability of the dispatchers, improving the system construction of prehospital emergency care system and increasing social education are conducive to reduce invalid ambulance attendance rate.

Hyperbaric oxygen and focused rehabilitation program: a feasibility study in improving upper limb motor function after stroke.

Neuroplasticity and recovery after stroke can be enhanced by a rehabilitation program pertinent to upper limb motor function exercise and mental imagery (EMI) as well as hyperbaric oxygen therapy (HBOT). We assessed feasibility and safety of the combined approach utilizing both HBOT and EMI, and to derive preliminary estimates of its efficacy. In this randomized controlled trial, 27 patients with upper extremity hemiparesis at 3-48 months after stroke were randomized to receive either a complementary rehabilitation program of HBOT-EMI (intervention group), or EMI alone (control group). Feasibility and safety were assessed as total session attendance, duration of sessions, attrition rates, missing data, and intervention-related adverse events. Secondary clinical outcomes were assessed with both objective tools and self-reported measures at baseline, 8 weeks (end of treatment), and 12-weeks follow-up. Session attendance, duration, and attrition rate did not differ between the groups; there were no serious adverse events. Compared with baseline, there were significant sustained improvements of objective and subjective outcomes' measures in the intervention group, and a single improvement in an objective measure in the control group. Between-group outcome comparisons were not statistically significant. This study demonstrated that the combination HBOT-EMI was a safe and feasible approach in patients recovering from chronic stroke. There were also trends for improved motor function of the affected upper limb after the treatments. ClinicalTrials.gov registration no.: NCT02666469. Novelty HBOT combined with an upper limb exercise and mental imagery rehabilitation program is feasible and safe in chronic stroke patients. This combined approach showed trends for improved functional recovery.

Sales-based Brand Equity as a Performance Driver in ‘The Country of Soccer’

ABSTRACT Despite being the most popular sport in Brazil, soccer suffers from structural problems. Managers working in this reality know little about the factors that determine performance measures in stadiums. Existing research is undertaken according to an economic logic, which attributes importance to a dependent variable only, the total attendance of soccer matches. This article presents an approach that retrieves a sales-based brand equity (SBBE) measure responsible for performance (revenues and proportional demand) in Brazilian soccer stadiums. The methodology involved a process of a canonical regression model with two dependent variables using on-field performance and SBBE as the main drivers of marketing performance. The theoretical assumption underlying the models is the discussion about the multidimensionality of performance and the importance of testing the potential correlation amongst marketing performance variables. The model developed was estimated using all matches of the Premium Division of Brazilian Championship (Série A) held between 2012 and 2017. The main result highlights the power of SBBE as the primary driver of performance in Brazilian stadiums. Corinthians and Flamengo, the two most important Brazilian soccer club brands, exert a positive influence considerably higher than all other competitors.

Who Benefits Most from Adding Technology to Depression Treatment and How? An Analysis of Engagement with a Texting Adjunct for Psychotherapy.

Introduction: Cognitive behavioral therapy (CBT) is an established treatment for depression, but its success is often impeded by low attendance. Supportive text messages assessing participants' mood in between sessions might increase attendance to in-clinic CBT, although it is not fully understood who benefits most from these interventions and how. This study examined (1) user groups showing different profiles of study engagement and (2) associations between increased response rates to mood texts and psychotherapy attendance. Methods: We included 73 participants who attended Group CBT (GCBT) in a primary care clinic and participated in a supportive automated text-messaging intervention. Using unsupervised machine learning, we identified and characterized subgroups with similar combinations of total texting responsiveness and total GCBT attendance. We used mixed-effects models to explore the association between increased previous week response rate and subsequent week in-clinic GCBT attendance and, conversely, response rate following attendance. Results: Participants could be divided into four clusters of overall study engagement, showing distinct profiles in age and prior texting knowledge. The response rate to texts in the week before GCBT was not associated with GCBT attendance, although the relationship was moderated by age; there was a positive relationship for younger, but not older, participants. Attending GCBT was, however, associated with higher response rate the week after an attended session. Conclusion: User groups of study engagement differ in texting knowledge and age. Younger participants might benefit more from supportive texting interventions when their purpose is to increase psychotherapy attendance. Our results have implications for tailoring digital interventions to user groups and for understanding therapeutic effects of these interventions.

A national educational campaign to raise awareness of child physical abuse among health care professionals.

Education is necessary to improve child physical abuse detection and management. A few studies have described national child abuse training programs, but none has measured changes in knowledge among participants. A collaboration of child abuse experts from the USA, an academic pediatric department, and a non-governmental organization in child protection aimed at (a) training hospital physicians in a train-the-trainer course for the detection and management of child physical abuse and (b) conducting workshops and measuring attendance and gain of knowledge of participants. A train-the-trainer and a national curriculum were created. A 78-item and a 20-item knowledge questionnaire were used pre and post the train-the-trainer course and all workshops, respectively. Nineteen physicians from all pediatric departments of the seven medical schools in Greece attended the course. Eight workshops in seven cities took place with a total attendance of 1220 health care professionals. Gain of knowledge was demonstrated for participants in the train-the-trainer course (p = 0.0015) and local workshops (p < 0.001).Conclusion: We successfully engaged physicians from all medical schools in Greece and conducted a train-the-trainer module and eight workshops in major cities that improved the participants' knowledge in child physical abuse. This approach may help address physician deficiencies in emerging areas of child abuse clinical practice. What is Known: • Education is necessary to improve child physical abuse detection and management. • Although national training programs have been described, none has measured participants' changes in knowledge. What is New: • A collaboration of child abuse experts, all medical schools in Greece, and a non-governmental organization resulted in a national educational campaign in child physical abuse and gains in knowledge for participants. • This approach may help address deficiencies in emerging areas of clinical practice.

Abstract P1-15-03: Pilot training program of nurse navigators increases survivorship knowledge and support for young women diagnosed with breast cancer

Abstract Background: Women diagnosed with breast cancer before age 45 face unique survivorship challenges including early menopause, late effects of treatment, psychosocial distress, and sex and intimacy changes. Few cancer centers offer patient education programs that address these survivorship topics for young women, and some healthcare providers report feeling unprepared to address these patient needs. To address this gap in patient programming, Living Beyond Breast Cancer (LBBC), a national non-profit, developed the Survivorship Series for Young Women Affected By Breast Cancer and a curriculum to train nurse navigators to implement this four-part patient education program in their cancer centers. Objectives: Through this pilot program, LBBC first sought to increase the Program Leaders’ knowledge of the survivorship topics covered in the curriculum and their confidence to implement the program. Second, LBBC sought to increase the program participants’ knowledge of survivorship topics and confidence to make behavioral changes to increase their quality of life after breast cancer. Methods: To develop this pilot program, LBBC identified four survivorship topics and developed four corresponding sessions. LBBC staff collaborated with a nurse practitioner with expertise in breast cancer survivorship to develop the sessions. 11 selected nurse navigators agreed to be Program Leaders (PL), participate in an in-person training, implement the sessions at their cancer centers, and contribute to evaluation efforts. During the PL training, each survivorship topic was reviewed in-depth to increase the PL’s knowledge of the issue and management strategies. The PLs were trained on how to market and implement the series with their patients. Independent evaluators developed and implemented an evaluation plan. The PLs completed a pre and post training assessment. After each session held, the PLs completed session reports, summarizing the outcomes of the session. PLs provided evaluation forms to each participant after each session. Evaluators conducted one-hour interviews over the phone with all 11 PLs and interviewed 18 program participants from 9 of the 11 cancer centers. The evaluators analyzed numerical data and closed-ended responses using frequency distributions and the calculation of summary statistics. They used categorical content analysis as the primary strategy to summarize open-ended form responses and interview data. Results: The training evaluation showed that PLs increased their knowledge in all domains. Total participant attendance for each of the 4 sessions ranged from 68 to 111; individual group sizes across the 11 programs ranged from 1 to 21 participants. Most participants reported knowledge gain for all session topics. In addition, participants reported behavior changes or intentions of changing their behaviors. Through the program, participants made connections with other women and some reported connecting with participants outside of the sessions. Participants preferred a PL with strong facilitation skills that could guide group discussions, while providing credible information about the topics. Recommendations for improving the program included ways to strengthen the PLs facilitation skills. Most program participants knew little about LBBC prior to the series and by the end reported various levels of knowledge of LBBC programming. Conclusion: The pilot evaluation showed that the Survivorship Series successfully increased knowledge of survivorship topics for both PLs and program participants. Participants reported behavior changes and increased peer connections with other young women. The program engaged over 200 people and provided them with a supportive educational program tailored to the unique survivorship needs of young women affected by breast cancer. Citation Format: Arin Ahlum Hanson, Lori Ranallo, Karen Werner Carera, Betsy Smither, Jennifer Reynolds, Catherine Ormerod. Pilot training program of nurse navigators increases survivorship knowledge and support for young women diagnosed with breast cancer [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P1-15-03.

Epidemiological analysis of chemical burns: Does it reflect any change in trends?

Introduction: Chemical burns constitute small proportion of cases among the total admissions due to burn injuries. The spectrum of severity of illness can vary from mild injuries to life-threatening trauma. In the Indian scenario, the incidence of chemical burns has been reported to be 2.25%–2.4% of total burn admissions. We decided to analyze the epidemiological trends in a tertiary care center from 2013 to 2018 and observe if there has been any shift in the trends. Materials and Methods: A retrospective chart review of all burn victims who attended our burns casualty in V. M. M. C and Safdarjung Hospital, New Delhi, India, between January 2013 and December 2018, was carried out. Results: During the study period of 6 calendar years from 2013 to 2018, a total of 142 patients of chemical burns attended the hospital, with 47 of them requiring admission. The chemical burns accounted for 0.45% of the total burn patient's attendance. Male dominance was noted with 64% of patients being males. Nearly 59% of the chemical burn patients were from 21 to 40-year age group. Accidental chemical burns accounted for maximum cases. It was observed that acid burns have decreased in comparison to the initial 3 years. Conclusion: Downward trend in the incidence of overall chemical burns was noted. Acid burns decreased with simultaneous increase in alkali burns. The study period coincided with the Supreme Court's verdict with the formulation of guidelines on sale of acids in 2013 and this could be the major factor in declining trends of acid burns.

Does the IPS Have a Future?

Back to table of contents Previous article Next article From the PresidentFull AccessDoes the IPS Have a Future?Bruce Schwartz, M.D.Bruce SchwartzSearch for more papers by this author, M.D.Published Online:26 Nov 2019https://doi.org/10.1176/appi.pn.2019.12a17This year’s IPS: The Mental Health Services Conference (IPS) was held October 3 to 6 in New York City. The IPS has suffered from poor attendance for several years despite the high quality of the program and its focus on community psychiatry, which serves some of our most vulnerable patients. APA has had to heavily subsidize the meeting out of its reserves. Nonetheless, many of us are committed to this meeting and want to see it thrive once again. To accomplish that goal, since no meeting was scheduled for 2020, the Board of Trustees decided to use the time to study and implement a redesign that would make the IPS more successful.My objective for this year’s IPS was to open and advertise this meeting to the full range of mental health professionals who help care for patients in community settings, especially those with serious mental illness. Anyone who works at a community clinic or a major medical center knows that our day-to-day colleagues are psychologists, social workers, nurse practitioners, and, increasingly, peer counselors. Under the leadership of Drs. Eric Yarbrough and Robert Cotes, we may have found a potentially successful formula to help this meeting thrive.As a start, we added a nurse practitioner to the IPS Scientific Program Committee. I contacted universities in the New York City area with psychiatric nurse practitioner programs and invited them to submit an abstract for one of my Presidential Sessions. Staff in APA’s Department of Integrated Marketing reached out to the social work and psychology communities. Three directors of psychiatric nurse practitioner programs in the New York area responded to my invitation. Their session was titled “The Role of Interdisciplinary Collaboration in the Evolving Health Care System: Past, Present, and Future,” and I served as discussant. The three directors represented the programs at New York University, Columbia University, and the State University of New York at Stony Brook. I learned much from their presentations, including how their profession has evolved, the problems faced by their discipline, and the strengths and skills they bring to the care of their patients.It was clear from their complaints that they are trying to cope with many of the same issues as psychiatrists in our current system of care. Specifically, graduates of the programs represented at the IPS are expected to see very high volumes of patients. Clinic directors want them to be prescription writers only, despite their wanting to take a more psychologically holistic approach to patient care. Most of the graduates from these programs are trained in several psychotherapy modalities. They know as well as any psychiatrist that patients require psychological treatment, and just giving a pill does not constitute adequate care. Despite the graduates’ comprehensive training, they are usually given workloads that prevent them from providing these treatments. Sounds like conversations we all hear from just about every psychiatrist who works in these settings as well.These poor clinical practices are driven by inadequate and discriminatory compensation for psychiatric treatment. The pressure on treatment programs to remain solvent requires high volumes of visits, a problem compounded by the severe shortage of psychiatrists to meet the immense demand for mental health services. It is estimated that over 5,000 psychiatrists are required today to address just the needs of federally designated mental health care professional shortage areas.The program directors who presented at the IPS reported another major complaint from their graduates: There are usually no psychiatrists or senior nurse practitioners to supervise and to consult with them. They want access to skilled psychiatrists but are rarely afforded that opportunity.How did our strategy work to broaden the attendance at the New York meeting? There was a 33% increase in total professional attendance over the 2018 meeting in Chicago, evenly attributable to APA members and nonmembers. We also benefitted from the pre-meeting symposium on early psychosis, which attracted multidisciplinary attendees, and co-sponsorship by the World Psychiatric Association.My vision for the IPS is to become the forum for all who work in community psychiatry settings to learn together, share best practices, and foster collaboration and collegiality. As your president, I believe this is one of the best ways in which APA can demonstrate its leadership and make this vision a reality. ■ ISSUES NewArchived

Right-Site Care Programme with a community-based family medicine clinic in Singapore: secondary data analysis of its impact on mortality and healthcare utilisation

ObjectiveStable patients with chronic conditions could be appropriately cared for at family medicine clinics (FMC) and discharged from hospital specialist outpatient clinics (SOCs). The Right-Site Care Programme with Frontier FMC...

Journal club as a tool to facilitate evidence based practice in critical care

Background: A journal club is a forum to debate and review clinical practice using a number of models to gauge the strength of evidence associated with the clinical practice. A large body of evidence supports the importance of journal clubs as a method to improve patient outcome by enhancing the implementation of evidence-based practice and professional development in the clinical setting1–3. Journal club activities have been recommended by the Hamad Medical Corporation (HMC) Critical Care Nursing Network (CCNN), Qatar, and started in the critical care areas of Hamad General Hospital for different critical care specialties such as trauma, surgical, and medical ICUs since 2014. Methods: The journal club is a 1-hour monthly critical care educational activity for HMC critical care nurses. A flyer promoting the article to be discussed is shared with the critical care nurses one week prior to the scheduled date and each session is attended by 15–20 nurses. Participants gain continuing professional development (CPD) credits for each session they attend. The articles discussed cover patient safety and critical care clinical practices. A structured review of the selected articles is facilitated by an expert educator with a research background. The strength of the evidence to change current clinical practice will be evaluated in a group discussion format (Table 1). At the end of each journal club activity, the facilitator summarizes the learning points, recommendations, and the action plan if the group believes changes to current clinical practice are recommended3. Results: Around 50 journal clubs have been conducted in the critical care units of HMC with a total attendance of 1100 nurses. The journal club activity encouraged critical care nurses to establish the first nursing clinical research team in critical care areas of HMC (Table 2). Additionally, it had a positive impact on improving the professional development and competency level of the critical care nurses which were assessed and evaluated by HMC critical care competency assessors through applying the specialty critical care competency checklist. Finally, implementation of the journal club activity and reviewing best available evidence and research literature led to improvements in clinical practice (Table 3). Conclusion: Implementation of the journal club activity helped in developing critical care nurses’ awareness on current research studies and best available evidence, in addition to keeping them up-to-date with new findings, practices, and critical care trends. The journal club with its structured review questions has proven to be an effective way of evaluating the strengths of the evidence presented in the reviewed articles and sometimes led to changing our critical care clinical practice. It also contributes to improving nurses’ ability to critically appraise research articles. Furthermore, it promotes the implementation of new knowledge gained in clinical practice which is expected to improve patient safety and outcomes.

Alcohol-related attendances in French emergency departments in 2017

Abstract Background France is one of the leading countries in terms of daily alcohol consumption per inhabitant. Alcohol is a major concern for emergency department (ED) since it accounts for a large part of their resources and increases behavior problems resulting in violence against staff. Individual information of French ED attendances registered in OSCOUR network are daily collected by Santé publique France, the French Public Health Agency. This study aims at describing alcohol-related ED attendances (ARA) in 2017 in France. Methods The OSCOUR network included 677 ED in 2017 recording 92% of national attendances. ARA were identified through the main and associated medical diagnoses coded by physicians using ICD10. The study considered acute alcohol intoxication, dependence syndrome/withdrawal state, other mental disorders and intoxications due to alcohol, chronic complications and intentional self-poisoning by alcohol. The number of ARA was analyzed by age group, gender and region. Results 1.4% of total attendances were associated to alcohol consumption (202,184 attendances) in 2017. 68% of ARA were due to acute alcohol intoxication and 14% for dependence syndrome/withdrawal state. The highest proportions of ARA were observed for people aged 40-59 yo and 18-24 yo, particularly for women. Regions of North and West metropolitan France and La Réunion Island had the highest proportion of ARA among the total number of attendances. Conclusions The part of ARA in France is consistent with figures provided in international studies using similar data. This proportion is similar with proportion of major public health issues like influenza, that represented 1% of the total ED attendances from November 2016 to February 2017 and reached 1.8% in January (month of the epidemic peak). Consequences of alcohol use represent a heavy burden for ED and the health system in France. This is all the more true as ARA are underestimated due to the low coding rate of associated medical diagnosis in ED. Key messages 1.4% of total French ED attendances were associated to alcohol consumption in 2017. This proportion is close to the proportion of influenza attendances in ED.

Efficacy of intervention to relieve nest box competition for Orange‐bellied Parrot Neophema chrysogaster

SummaryWe use an experimental approach to evaluate the effectiveness of removing nests of a dominant competitor to create vacant nest boxes for a critically endangered parrot. We compared the number of times that Tree Martin (Petrochelidon nigricans – the dominant competitor at nest boxes) perched at or entered nest boxes intended for Orange‐bellied Parrot (Neophema chrysogaster – the subordinate nest competitor) over three time periods (before, immediately after and one week after experimental nest destruction). In the before period, rates of nest attendance by martins in treatment and control nests were not explained by treatment group. After experimental nest destruction, total attendance at boxes by martins rose to a mean of 6.1 visits over three five‐minute surveys in the treatment group, compared with 3.3 visits at control boxes. Within individual surveys, martins visited treatment boxes 4.4 times per survey one week after nest destruction, compared with only 1.6 visits in the control group. Martins in the treatment group rapidly rebuilt their nests and laid replacement clutches, and within a week, all boxes were reoccupied. Nest destruction did not increase nesting opportunities for the parrot, and increased vigilance of the dominant competitor may in fact reduce nesting opportunities in nearby boxes. Our study suggests that removing martin nests is an ineffective management action for alleviating nest competition for this parrot.

P6213The influence of working-age on attendance to cardiac rehabilitation: a gender comparison

Abstract Introduction Despite guidelines recommending referral to cardiac rehabilitation (CR), attendance remains poor. Literature cites a complexity of clinical, psychological and social factors as barriers to CR attendance and, females may attend less than males. Social factors including work commitments, may influence attendance, with many Australian CR programs offered during office hours, making access difficult. The Australian retirement age for females and males differs; (females &gt;60 years and males &gt;65 years). We hypothesised that working-age may influence attendance to CR. Purpose In a CR-referred population this study sought to compare working-age of males and females and the association with CR attendance. Methods Data from 24 country and metropolitan CR services between 2013 and 2015 were linked to 49,909 CR-eligible patients defined as, discharged alive with a primary cardiac-related diagnosis and/or interventional procedure, identified through public hospital administrative data (Figure). Only CR-referred patients were included, with males and females categorised by three age groups: &lt;60, 60–65 and &gt;65 years, comparing attendance in univariate analysis. Adjustment for clinical and psychological (International Classification of Disease-10 Australian Modification mental health diagnostic-related group diagnoses) factors were conducted using multi-logistic regression. Results Between 2013–2015, 15,089 patients were referred to CR with 4,819 &lt;60 years, 1,943 between 60–65 years and 8,327 &gt;65 years. Of referrals a total of 4,286 (28.4%) attended CR, 1134 (35%) of whom were female. Univariate analysis observed total attendance by age group ranged between 26–32%, with females less likely to attend than males (&lt;60 years; 25.3% v 32.2%, p&lt;0.001, 60–65 years; 29.5% v 33.2%, p=0.130 and &gt;65 years; 23.2% v 23.6%, p&lt;0.001). Multivariate analysis observed more attendance in the 60–65 years group compared to &lt;60 years (odds ratio (OR): 1.15 [95% confidence interval [CI]: 1.00–1.32], p=0.036) with females less likely to attend than males (OR: 0.81, [95% CI; 0.70–0.95], p=0.009). No interaction between the working age classification and gender were observed. Conclusion In an Australian cohort, working-age observed no influence on cardiac rehabilitation program attendance, with the period of female retirement age observing a 19% reduction in attendance. Further research on the complexity of factors that may be barriers to attendance is essential to evaluate how to improve cardiac rehabilitation programs to better suit the needs of our cardiac patients. Acknowledgement/Funding Flinders University partnership grant and South Australian Department of Health Local Health Networks

PENGARUH PENERAPAN ELINA MATA KULIAH BUSINESS ENGLISH UNTUK KELAS MAHASISWA PEKERJA DI UNIVERSITAS NAROTAMA

Narotama University has two classes for employee class. They are Class B and Class C. Class B get classic learning. On the other hand, Class C get classic learning and e-learning, it is called as Elina. This research is quasi experimental. The author tests the scores in the business English course on the midterm, final exam, assignments, attendance and total scores for the semester using the t-test method. The result is that there is no significant difference between mixed learning classes and classical learning classes for total scores and attendance. On the other hand, specifically there are two significant differences. First, in midterm grades, mixed learning classes have lower grades than classical learning classes. Second, in the final examination and assignment grades, mixed learning classes have higher grades than classical learning classes

Estimating the Crowd Size of a Rally by Crowdsourcing-Geocomputation

Estimating the Crowd Size of a Rally by Crowdsourcing-Geocomputation

Lessons learned from community-based tuberculosis case-finding in western Kenya.

Although Kenya has a high burden of tuberculosis (TB), only 46% of cases were diagnosed in 2016. To identify strategies for increasing attendance at community-based mobile screening units. We analysed operational data from a cluster-randomised trial, which included community-based mobile screening implemented during February 2015-April 2016. Community health volunteers (CHVs) recruited individuals with symptoms from the community, who were offered testing for human immunodeficiency virus (HIV) and sputum collection for Xpert® MTB/RIF testing. We compared attendance across different mobile unit sites using Wilcoxon rank-sum test. A total of 1424 adults with symptoms were screened at 25 mobile unit sites. The median total attendance among sites was 54 (range 6-134, interquartile range [IQR] 24-84). The median yields of TB diagnoses and new HIV diagnoses were respectively 2.4% (range 0.0-16.7, IQR 0.0-5.3) and 2.5% (range 0.0-33.3, IQR 1.2-4.2). Attendance at urban sites was variable; attendance at rural sites where CHVs were paid a daily minimum wage was significantly higher than at rural sites where CHVs were paid a nominal monthly stipend (P < 0.001). Mobile units were most effective and efficient when implemented as a single event with community health workers who are paid a daily wage.

Secondary prevention for non-communicable diseases at out-patient stage: schools of health for patients at municipal polyclinic

Background. Currently, chronic noncommunicable diseases (NCD) cause more than 2/3 of all deaths in the world. Despite the continuous improvement of approaches to drug therapy for chronic low risk infections, they can not be completely cured, and mortality tends to increase. In such conditions, the need for preventive measures comes to the fore. One of the approaches of secondary prevention is to educate patients in Health Schools, the goal of which is to reduce the incidence and progression of complications of NCD, reduce morbidity and mortality. Aim. The goal is to assess the attendance of Schools, the gender and sex composition of patients, the structure of educational activities. Methods. Аssessment of the work of the Health Schools through the analysis of patient case report stored in the clinic’s prevention department. The analysis of the cases was carried out taking into account the age, gender, and results of the patient survey. Results. The data obtained indicate a fairly uniform attendance at Health Schools. The School of Health in hypertension was the most visited (20% of the total attendance), the least - the School of Breast Health (less than 10% of the total attendance). Women visited Health Schools more often than men (71.2%). Men were more interested in the school on the general principles of healthy lifestyles and the School on quitting smoking. The main contingent of Health Schools is the elderly. The average age of the patients of the School for type 2 diabetes and healthy joints was about 65 years, and the School for hypertension - about 73 years. Conclusion. Due to patient education, it is possible to increase adherence to treatment prescribed by a doctor, reduce the effect of FR, help patients lead a healthier lifestyle.

907-P: Striking Improvements in HbA1c following Commencement of Flash Glucose Monitoring in Type 1 Diabetes

Little evidence currently supports the efficacy of Flash Monitoring (FM) in type 1 diabetes. We present the largest prospective study of clinical outcomes following FM. National Health Service (NHS) funding for FM was introduced in Feb 2018 in our center. We evaluated outcomes in 900 people with T1DM. Baseline HbA1c was the most recent value prior to commencing FM. Control HbA1c data were obtained from 518 people with no prior or current FM use. Pre- and post-FM hypoglycemia and Hospital Anxiety and Depression Scale (HADS) data were available in 57%. Hospital admission and test-strip prescription data were obtained for the 6 months following NHS-funding and the corresponding period the previous year. Median age was 42 years (IQR 30 - 55). Mean baseline HbA1c was 65±15 mmol/mol. Pre-FM, 34.2% had HbA1c &amp;lt;58 mmol/mol (7.5%) which rose to 50.9% at next follow-up (median 343 days from baseline HbA1c), P &amp;lt; 0.001. Those with HbA1c &amp;gt; 75 mmol/mol (9.0%) fell from 17.8% to 8.5%, P &amp;lt; 0.001. Mean reduction in HbA1c was 5.6±10.9 mmol/mol (P &amp;lt; 0.001) but was greater in those with baseline HbA1c above 75mmol/mol (-15.4±16.8 mmol/mol, P &amp;lt; 0.001). In the control group, HbA1c did not change across the corresponding period (+0.2 mmol/mol, P = 0.66). In multivariate analysis, less frequent SMBG pre-FM (P = 0.03), higher HbA1c (P &amp;lt;0.001) and higher socioeconomic status (P = 0.02) were all associated with greater likelihood of a ≥5 mmol/mol fall in HbA1c. Impaired awareness of hypoglycemia (IAH) improved, in those with a prior history of IAH, after FM use (P &amp;lt; 0.001). HADS depression (2 [1 - 5] vs. 1 [0 - 3], P &amp;lt; 0.0001) and anxiety scores (2 [1 - 5] vs. 1 [0 - 3], P = 0.03) were higher following FM use. DKA admissions fell significantly (2 vs. 8, P = 0.02) but no effect was observed on total admissions or emergency department attendance. Blood glucose test strip prescribing fell to 14.3% of pre-FM levels (P &amp;lt; 0.01). FM is associated with reduced DKA admissions and marked improvement in glycemic control across a wide range of people with T1DM. Disclosure F.W. Gibb: None. R.H. Stimson: None. J.A. McKnight: Other Relationship; Self; Boehringer Ingelheim International GmbH, Lilly Diabetes, MedImmune, Novo Nordisk Inc. V. Tyndall: None. S.A. Ritchie: Other Relationship; Self; MedImmune, Novo Nordisk Inc. N.N. Zammitt: None. A.R. Dover: Other Relationship; Self; Abbott.