Two-year Time Frame Research Articles

Enhancing Value-Based Care With a Walk-in Clinic: A Primary Care Provider Intervention to Decrease Low Acuity Emergency Department Overutilization.

BackgroundEmergency department overutilization is a known contributor to the high per-capita healthcare cost in the United States. There is a knowledge gap regarding the substitution effect of walk-in clinic availability in primary care provider (PCP) offices and emergency department utilization (EDU). This study evaluates associations between PCP availability and EDU and analyzes the potential cost savings for health systems.MethodsA retrospective cohort analysis compared low acuity EDU rates in established patients at a family medicine residency's PCP office before and after walk-in clinic implementation. The practice had 12 providers, 12 residents, and a patient panel of approximately 7,000-8,000. Inclusion criteria were met if patients were: (1) established with the PCP office, (2) had a low acuity emergency department (ED) visit (emergency index score level 4 or 5) OR had a walk-in clinic visit at the family practice. ED visits were tracked from January 2018 to January 2020 and encounters were compared numbers to pre and post-implementation of a walk-in clinic. Cost savings for comparable management was estimated with average price differences for low acuity encounters in the ED versus clinic.ResultsOver the two-year timeframe, there were 10,962 total visits to the ED by family practice patients, 4,250 of these visits were low acuity. Despite gross monthly increases of EDU from 2018-2020, after implementation of a walk-in clinic in 2019, rates of total EDU decreased by 1.5% and low acuity utilization rates also decreased. The average annual patient census nearly doubled from 5,763 to 8,042. T-tests confirmed statistical significance with p-values <0.05. Average low acuity ED visits ($437) cost 4.9 times more than comparable PCP office visits ($91). Managing 2,387 patients in the walk-in clinic resulted in an estimated annual cost savings of $825,902.ConclusionExtended walk-in availability in primary care offices provides non-ED capacity for low acuity management and might mitigate low acuity ED utilization while providing more cost-effective care. This study supports similarly described pre-hospital diversions in reducing ED over-utilization by increasing access to care. Higher levels of evidence are needed to establish causality.

Immigrant Entrepreneurship in Sweden: The Liability of Newness

Immigrant entrepreneurs face many challenges in the various early phases of their companies’ existence. These challenges are often referred to as “the liability of newness”. While some of these challenges are common to all entrepreneurs, the immigrant entrepreneur has an additional set of challenges. This article describes those challenges in the immigrant entrepreneurial experience in the Swedish agri-food industry. A qualitative research design is used. Interviews were conducted with 25 immigrant entrepreneurs who planned a business, had started a business, or had exited a business. Various websites and tax reports provided secondary data. The research, which covered a two-year time frame, identifies the strategies and actions the immigrant entrepreneurs adopted and used to try to overcome those challenges. The following strategies and actions were identified: use of business support, virtual embeddedness, family and ethnic groups, entrepreneurial experience, and niche markets. The companies in which the entrepreneurs recognized the gravity of those challenges early in their life cycle were more likely to survive beyond the start-up phase. The article, which also reviews much of the current literature on immigrant entrepreneurship, has implications for business support advisory services and policymakers who are involved in the effort to achieve economic (and social-cultural) integration of immigrants into their host countries.

Intensive Outpatient Treatment (IOP) of Behavioral Health (BH) Problems: Engagement Factors Predicting Subsequent Service Utilization.

The purpose of the study is to 1) better understand patterns of utilization of Intensive Outpatient Treatment (IOP) Programs and Services in the State of Connecticut by adult Medicaid recipients experiencing a serious mental illness, substance use disorder, or co-occurring disorders; and 2) to determine the relationship between the duration of an IOP episode and connection to care rates for higher (i.e., rehospitalization) or lower levels of care following discharge. We hypothesized that the duration of an IOP episode would impact positively in reducing the use of higher levels of care while increasing the use of lower levels of care. In order to examine the frequency and duration of use of Intensive Outpatient (IOP) services by the CT Medicaid population, a two-year timeframe was selected: July 1, 2012 to June 30, 2014. A survival analysis was conducted to assess the risk of readmission to an IOP within 180days based on demographic and utilization factors including, Age (in years on date of discharge), Race and Ethnicity, Gender, Homeless Status (at least one day in CY 2013), and Engagement Group (Intent to Treat, Early Termination, Minimally Adequate Dosage, & Target or More). To better understand the patterns of utilization associated with Adult IOP services, the average length of stay, number of treatment days, and average number of treatment days per week were explored. The number of unique individuals who were part of this analysis is 11,473, of which 2050 were mental health IOP utilizers (18%), 4598 were co-occurring IOP utilizers (40%), and 4825 (42%) were substance use IOP utilizers. For the total population, the average length of stay (ALOS) in days was 42 and the average number of treatment days attended per week was 2.5, for an average of 15 treatment days per episode of care. Among the IOP Cohorts, the Mental Health Cohort had the longest ALOS at 44.15days, an average of 2.34days of service per week, for an average of 14.76days of IOP service per episode of care. The Substance Use Cohort had the shortest ALOS at 41.33days, but had the highest intensity of services per week at 2.71 for an average of 16days of service per episode of care. The Co-Occurring Cohort presented an ALOS of 41.74days, an average of 2.32 services per week and an average of 13.83 sessions per episode. Overall there is evidence supporting an association between the number of days of care and protection from hospitalization, up to a certain number of days of care or number of days in IOP. Above the Minimally Adequate Dosage, the IOP protection factor seems to reach a plateau. This means that after 16days of care, the chances of hospitalization remain the same regardless of the additional days provided.

Efficacy of Active Charcoal and Mannitol in Patients with Haff Disease Caused by the Consumption of Crayfish (Procambarus clarkii): A Retrospective Cohort Study.

This study evaluates the clinical efficacy of activated charcoal combined with mannitol (ACM) for the treatment of Haff disease. This is a retrospective cohort study conducted at the Emergency Department of Affiliated Hospital of Integrated Traditional Chinese and Western Medicine. Consecutive patients who were hospitalized during a two-year time frame (from June 2016 to August 2017) and diagnosed with Haff disease were reviewed. Clinical symptoms, laboratory findings, pain/anxiety scores, and treatment-related adverse events were collected. Sixty-eight Haff disease patients after boiled crayfish consumption were enrolled in this study. Besides standard treatments for Haff disease, 22 patients had an oral administration of activated charcoal and mannitol within 12 hours of hospital admission (ACM group), while the other 46 patients did not receive such treatment (non-ACM group). Baseline characteristics including clinical symptoms, serum enzyme levels, and pain/anxiety scores were comparable between the two groups. Activated charcoal and mannitol treatment led to lower CK-MB and AST levels from 12 hours to 60 hours, lower ALT and LDH levels from 12 hours to 72 hours, and lower CK levels from 24 hours to 72 hours after hospitalization. Patients in the ACM group had significantly shortened duration of hospital stays (7.5 [6.0–8.0] days vs 8.0 [6.8–10.0] days, p = 0.032) and lower anxiety scores 24 hours after hospital admission (40.7 ± 4.9 vs 44.1 ± 6.3, p = 0.032) than in the non-ACM group. No patient experienced treatment-related adverse events. The overall prognosis of both groups is good. Among patients with Haff disease caused by boiled crayfish, activated charcoal combined with mannitol treatment resulted in shorter hospital stays, lower serum CK, CK-MB, AST, ALT, and LDH levels, and lower anxiety scores.

The SDSN Italia SDGs City Index Two Years Later: Update Report

After two years from the publication of the SDSN Italia SDGs City Index (FEEM, 2018), the following Report presents data updated to 2020 as the Italian capitals of provinces are concerned, proposing a comparison of them, where possible and subjected to appropriate methodological considerations, after two years. Through the collection of data for 103 Italian municipalities-capitals of provinces, and based on 46 elementary indicators about 16 out of 17 Sustainable Development Goals (SDGs), the following Report intends to be a tool to increase the awareness of civil societies on the sustainability level of their territories, and at the same time to support local administrators in their decision making, providing not only a screenshot of their cities’ distance to the targets of the 2030 Agenda, but also a comparison, if possible, among performances in a two-year timeframe.

Do Energy Burdens Contribute to Economic Poverty in the United States? A Panel Analysis

AbstractFor many households, energy consumption represents a non-discretionary portion of their budget and directly relates to quality of life. As researchers continue to study the environmental impacts of energy behavior, it is important to explore how energy consumption relates to socio-economic wellbeing. This paper examines the economic impacts of being energy-burdened in the United States, defined as spending at least 10% of household income on heating and electricity services; energy burdens are partially, but not entirely, driven by income, since energy needs and costs can vary substantially due to housing characteristics, utility rates, and other factors. Using panel data of US household income and energy expenditures during 1999–2017, this analysis demonstrates that energy-burdened households were at about 150%–200% greater risk of transitioning into or extending the duration of economic poverty over a two-year timeframe relative to non-burdened households. This analysis indicates that dedicating inordinate amounts of income to energy services can threaten a household’s economic well-being over time, possibly by preventing a household from engaging in other economic activities or compounding existing economic hardship. These results emphasize the importance of energy assistance and energy efficiency for low-income households, drawing attention to how structures of energy consumption, the welfare state, and social stratification intertwine.

An Efficacy Trial of the Ho'ouna Pono Drug Prevention Curriculum: An Evaluation of a Culturally Grounded Substance Abuse Prevention Program in Rural Hawai'i.

This study reports on the drug use outcomes in an efficacy trial of a culturally grounded, school-based, substance abuse prevention curriculum in rural Hawai'i. The curriculum (Ho'ouna Pono) was developed through a series of pre-prevention and pilot/feasibility studies funded by the National Institute on Drug Abuse, and focuses on culturally relevant drug resistance skills training. The present study used a dynamic wait-listed control group design (Brown, Wyman, Guo, & Pena, 2006), in which cohorts of middle/intermediate public schools on Hawai'i Island were exposed to the curriculum at different time periods over a two-year time frame. Four-hundred and eighty six youth participated in the study. Approximately 90% of these youth were 11 or 12 years of age at the start of the trial. Growth curve modeling over six waves of data was conducted for alcohol, marijuana, cigarettes/e-cigarettes, crystal methamphetamine, and other hard drugs. The findings for alcohol use were contrary to the hypothesized effects of the intervention, but may have been a reflection of a lack equivalence among the cohorts in risk factors that were unaccounted for in the study. Despite this issue, the findings also indicated small, statistically significant changes in the intended direction for cigarette/e-cigarette and hard drug use. The present study compliments prior pilot research on the curriculum, and has implications for addressing Native Hawaiian and Pacific Islander health disparities.

Linking partner violence survivors to supportive services: impact of the M Health Community Network project on healthcare utilization

BackgroundIntimate partner violence (IPV) is associated with adverse health effects and increased healthcare utilization. Systems-level interventions have been shown to be effective in identifying and referring survivors but little is known about how these strategies impact future utilization.The objective of this study is to examine the impact of a systems-level response on healthcare utilization among patients screening positive for IPV from November 2016 to February 2019 in a large multi-specialty outpatient health system in the Midwest.MethodsUsing electronic health record (EHR) data, we identified patients who screened positive for IPV (N = 756) and categorized their response as accepted printed material (N = 116), accepted direct referrals (N = 85), declined both (N = 271), or missing (N = 255). We used negative binomial models to model post-period utilization as a function of decision group, pre-period utilization, and clinical and demographic factors.ResultsAfter controlling for demographic characteristics and baseline utilization, the printed materials and direct referral groups had higher utilization rates than those who declined printed materials and direct referral during the post-period for every type of service. However, these differences were only statistically significant for outpatient, behavioral health, and social work services. Specifically, the visit rate for patients receiving printed materials was two times higher (rate ratio: 2.18; 95% CI: 1.21, 3.94) for behavioral health services and three times higher (rate ratio: 3.33; 95% CI: 1.3, 8.52) for social work services compared to those who refused printed material and direct referral. For those opting for a direct referral, the visit rate was two times higher for outpatient services (rate ratio: 1.97; 95% CI: 1.13, 3.42) compared to those who refused.ConclusionsPatients receiving printed materials or direct referrals had more social work and behavioral health visits, highlighting an important outcome of the protocol. However, higher utilization rates among outpatient services and a trend toward higher utilization of other services, including the emergency department, suggest greater health service utilization is not diminished by the systems level response—at least not within a two-year time frame.

In-kind contributions to Orange County marine protected area management

California's network of 124 marine protected areas (MPAs) is managed by state agencies with support from non-state partners. Partners include MPA Collaboratives, which were established through the California Collaborative Approach to provide a localized, comprehensive approach to ocean resource management by bringing together local experts and authorities in the areas of outreach and education, enforcement and compliance, and research and monitoring. Given their role in MPA management in California, there is a need to understand the contributions that MPA Collaboratives are making to MPA management activities. In this case study, Blue Earth Consultants, a Division of ERG, conducted a valuation of in-kind contributions made by non-state members of one Collaborative, the Orange County Marine Protected Area Council (OCMPAC), to MPA management activities in Orange County. We performed research and worked collaboratively with OCMPAC to develop a definition of in-kind contributions and a contribution reporting framework that asked respondents to report contributions by type (Labor Services; Goods, Equipment, and Supplies; Travel; Facilities; and Other) as well as by category (Outreach, Education, and Compliance Building; Research and Monitoring; Partnership Coordination and Fundraising Support; and Other). We distributed the reporting framework to each member organization of OCMPAC and performed data analysis to quantify the total values of the contributions they reported. We found that non-state members of OCMPAC contributed support worth over US $4 million to Orange County MPA management during a two-year time frame between 2013 and 2015. In both years, the contribution type with the greatest value was Labor Services, and the category with the greatest value was Outreach, Education, and Compliance Building. Member organizations also noted that their future contributions to OCMPAC, particularly volunteer hours and pro bono work, may be vulnerable to changes in funding, staff time, and organizational priorities. To help ensuring ongoing support for MPA management, OCMPAC and member organizations would benefit from dedicated staff time for MPA-related work, coordinating OCMPAC activities, and education and science programs, among other needs. The approach developed for this case study provides a replicable methodology for quantifying the value of in-kind contributions made through local partnerships to the management of natural resources in California and beyond.

UAVs for Structure-From-Motion Coastal Monitoring: A Case Study to Assess the Evolution of Embryo Dunes over a Two-Year Time Frame in the Po River Delta, Italy.

Coastal environments are usually characterized by a brittle balance, especially in terms of sediment transportation. The formation of dunes, as well as their sudden destruction as a result of violent storms, affects this balance in a significant way. Moreover, the growth of vegetation on the top of the dunes strongly influences the consequent growth of the dunes themselves. This work presents the results obtained through a long-term monitoring of a complex dune system by the use of Unmanned Aerial Vehicles (UAVs). Six different surveys were carried out between November 2015 and December 2017 in the littoral of Rosolina Mare (Italy). Aerial photogrammetric data were acquired during flight repetitions by using a DJI Phantom 3 Professional with the camera in a nadiral arrangement. The processing of the captured images consisted of the reconstruction of a three-dimensional model using the Structure-from-Motion (SfM). Each model was framed in the European Terrestrial Reference System (ETRS) using GNSS geodetic receivers in Network Real Time Kinematic (NRTK). Specific data management was necessary due to the vegetation by filtering the dense cloud. This task was performed by both performing a slope detection and a removal of the residual outliers. The final products of this approach were thus represented by Digital Elevation Models (DEMs) of the sandy coastal section. In addition, DEMs of Difference (DoD) were also computed for the purpose of monitoring over time and detecting variations. The accuracy assessment of the DEMs was carried out by an elevation comparison through especially GNSS-surveyed points. Relevant cross sections were also extracted and compared. The use of the Structure-from-Motion approach by UAVs finally proved to be both reliable and time-saving thanks to quicker in situ operations for the data acquisition and an accurate reconstruction of high-resolution elevation models. The low cost of the system and its flexibility represent additional strengths, making this technique highly competitive with traditional ones.

Making progress on identifying those who aren't making progress: Using situational judgment tests to predict those at risk for remediation and attrition.

This article was migrated. The article was marked as recommended. Introduction There is little evidence on tools that can be used to identify individuals most at risk for remediation and attrition in postgraduate surgical training. We explore the extent to which a situational judgment test (SJT) can predict which trainees are likely to require remediation or leave the program. Methods Postgraduate trainees in a single general surgery residency program in the United States completed a 50-item SJT. Data regarding remediation actions and attrition were retrieved from the program for the two years following completion of the assessment. United States Medical Licensing Examination (USMLE) scores were also included to examine their ability to predict remediation and attrition. Results Complete data was available from fifty-two of 56 (92%) residents in the program. Twenty-one percent (11/52) of residents required at least one remediation intervention within the one (for PGY5s) to two years after completing the SJT. Mann-Whitney U tests revealed a significant difference in SJT performance between those needing remediation versus those who did not require remediation, such that those requiring remediation performed worse on the assessment (p Conclusions These data demonstrate that SJTs can be created to effectively identify surgery residents most at risk for remediation across a two-year timeframe. These data provide an additional layer of validity evidence to support the role of SJTs in surgical education and align with other studies failing to find linkages between USMLE scores and residency performance criterion.

Ownership structure, board gender diversity and charitable donation

PurposeThis paper aims to examine the effect of ownership structure and board gender diversity on charitable donations for a group of listed electronics companies in Taiwan.Design/methodology/approachUsing linear regression analysis, this paper analyses the ownership structure, board gender diversity and charitable donations of 380 Taiwanese electronics companies (2011-2013).FindingsWhile domestic institutional investors, such as domestic mutual funds and corporate investors, take more of agency logic view, it negatively impacts on charitable donations. However, the empirical findings of this paper indicate that board gender diversity with the critical number of female directors was positively related to charitable donation. Thus, it is clear that female directors reaching critical numbers were taking more of a stakeholder view of institutional logic, emphasizing the balance of interests of internal and external stakeholders.Research limitations/implicationsThis paper is limited to selected Taiwanese electronics companies over a two-year time frame, and charitable donations are the only proxy of corporate social responsibility (CSR) activity. The paper suggests that, as predicted by stakeholder theory and critical mass theory, companies with boards composed of at least three female directors make higher charitable donations.Practical implicationsThis paper indicates that female directors on the board should have more voices on the board regarding the necessity and importance of CSR.Originality/valueThe paper contributes to existing literature by looking into the effects of ownership structure and board gender diversity on charitable donations.

Treasurer's Report November 2017

Treasurer's Report November 2017

Issue Attention and Group Mobilization for Caste Rights following the 2015 Gorkha, Nepal, Earthquake

People in Nepal labeled as low-caste carry the double burden of simultaneous denial of access to resources and to public space in which to discuss caste issues. Following the 2015 earthquake, issues regarding caste were pushed onto the national agenda through various groups seizing the window of opportunity to bring awareness to address issues related to caste rights and discrimination. Positioned in the Focusing Events Theory, we seek to understand how groups may have used the Nepal 2015 earthquake to mobilize to increase issue attention to caste and disaster vulnerability. To identify themes around these areas, we reviewed key news articles that were published in Nepalese and international media in the two-year time frame after the earthquake. We identified issue framing with several major themes: opportunities for lessons learned, outsiders and higher caste as “rescuing” lower caste, and disaster vulnerability linked to caste.

Healthcare quality and medicine reimbursement criteria in Iran

PurposeThis study aims to measure the quality of services provided to elderly people at the most crowded governmental ambulatory clinics of Tehran Province using the SERVQUAL scale (Study 1). Moreover, the research indicates the medicine reimbursement criteria to inform the decision-makers of public health insurance organizations using the Borda method (Study 2).Design/methodology/approachThis study was done as a cross-sectional research on 425 elderly patients who came to the clinics during 2014 and 2015. Finally, using the paired t-test, Friedman test, Borda method, SPSS, Matlab software and Delphi method, the collected data were analysed.FindingsRegarding the perceived quality, the services assurance dimension was ranked as having the highest quality (4.48) and the accessibility dimension as the lowest one (3.22). Based on the Borda method, the most important criterion for the Iranian health insurance companies to accept a medicine in their reimbursement list is the “life-threatening conditions” factor. On the other hand, “evidence quality” is accounted as the fifth important factor.Research limitations/implicationsThe main limitation was the senility of participants that makes it difficult for understanding and completing the questionnaires.Practical implicationsThe results can be useful for healthcare policy makers and related authorities. Besides, public health insurers can use the findings for decision-making about the elderly diseases and the problems such as the medical expenses.Originality/valueThe present research has been done in a two-year time frame, and it is more recent than other related studies. Thus, the results are far more authentic and applicable.

Restricting Russians: language and immigration laws in Soviet Latvia, 1956–1959

In 1956, a prominent faction within the leadership of Soviet Latvia, the Latvian national communists, launched two ambitious initiatives designed to redress perceived Stalinist Russification polices – a language law and residency restrictions. This article examines and evaluates these two policies and asks if they were part of a “Latvianization” program that deliberately targeted Russians for denial of residency permits and required Russians to gain Latvian-language competency within a two-year timeframe or face the threat of dismissal. In an effort to restore the primacy of the Latvian language, the national communists created a law enforcing knowledge of Latvian and Russian for Communist Party and government functionaries and service sector personnel. Using the Soviet legal system, the national communists also attempted to halt the influx of predominantly Slavic immigration to the Latvian capital, Riga. By instituting passport restrictions on settling in the city, the national communists sought to limit Slavic migration in order to maintain Riga's Latvian character and reduce pressure on the city's housing supply and municipal services. Existing studies deem passport restrictions in other Soviet cities a failure. The author argues, however, that the national communists’ scheme was generally successful, dramatically curbing migration to Riga during its operation.

How Does Sentiment Content of Product Reviews Make Diffusion Different?

ABSTRACTThe current study is focusing on diffusion and adoption of new digital artifacts. The goal is to explore the social role of user-generated content (UGC) during the diffusion process of digital products in the context of online social networks. Data collection is conducted on 154 new digital products during a two-year timeframe. Results of the study provide a deeper insight into the influence of sentiment content on new product diffusion and how such a web system (i.e., online social networks) can help to enable a process of value co-creation. The overall finding shows that sentiment content has a positive, but dynamic relationship with diffusion of digital products.The study sheds light on the crowding power and the long-tail effect in online social networks. Findings also offer valuable implications for organizations to set up their strategic vision in terms of information dissemination, digital marketing, and customer relationship management.

Lateral groundwater flow and pond interactions during dry and wet years

Groundwater and surface water are tightly coupled elements of the hydrologic cycle that have often been treated as separate entities. Future climate change modelling has predicted that hydrologic cycle changes, namely increasing drought frequency and flood-type events, are likely to occur. These events may directly impact the quality and quantity of both groundwater and surface water. Future water management policies must therefore be based on an understanding of how interactions between groundwater and surface water will change with a warming climate. The aim of this study was to model and analyze the lateral flow of groundwater and its interactions with a nearby pond in a shallow, unconsolidated, unconfined aquifer. Data were collected as part of a larger and ongoing study during the year 2012, a comparatively dry year, and 2013, a comparatively wet year. We first used ArcGIS and Visual MODFLOW Flex to create a conceptual model of the system, its soil layers, monitoring wells, and potential flow patterns. We then analyzed hydraulic head data, and calculated groundwater flow volumes using the Dupuit equation. We found that the groundwater flow direction reversed in the summer of 2012 and continued until the spring of 2013. Additonally, flow rate was greater in 2013 than 2012. The flow reversal was likely caused by higher evaporative demand during the summer months of 2012, drawing substantially more water from the pond than from the soil. The two-year timeframe was not long enough to determine whether this was a typical, yearly pattern, or was primarily due to the fact that 2012 was a particularly dry year.

Combining event- and variable-centred approaches to institution-facing learning analytics at the unit of study level

PurposeThe purpose of this paper is to demonstrate the utility of combining event-centred and variable-centred approaches when analysing big data for higher education institutions. It uses a large, university-wide data set to demonstrate the methodology for this analysis by using the case study method. It presents empirical findings about relationships between student behaviours in a learning management system (LMS) and the learning outcomes of students, and further explores these findings using process modelling techniques.Design/methodology/approachThe paper describes a two-year study in a Chilean university, using big data from a LMS and from the central university database of student results and demographics. Descriptive statistics of LMS use in different years presents an overall picture of student use of the system. Process mining is described as an event-centred approach to give a deeper level of understanding of these findings.FindingsThe study found evidence to support the idea that instructors do not strongly influence student use of an LMS. It replicates existing studies to show that higher-performing students use an LMS differently from the lower-performing students. It shows the value of combining variable- and event-centred approaches to learning analytics.Research limitations/implicationsThe study is limited by its institutional context, its two-year time frame and by its exploratory mode of investigation to create a case study.Practical implicationsThe paper is useful for institutions in developing a methodology for using big data from a LMS to make use of event-centred approaches.Originality/valueThe paper is valuable in replicating and extending recent studies using event-centred approaches to analysis of learning data. The study here is on a larger scale than the existing studies (using a university-wide data set), in a novel context (Latin America), that provides a clear description for how and why the methodology should inform institutional approaches.

EP 42. Bilateral subthalamic deep brain stimulation can help preserve working capabilities in Parkinson’s disease

Objectives There is a debate on the potential advantageous effects of bilateral subthalamic deep brain stimulation (DBS) in the treatment of Parkinson’s disease (PD) with early fluctuations. Our investigation aimed to evaluate if DBS therapy could preserve working capability. Materials & methods We reviewed the data of 40 young ( Results Although similar (approximately 50%) improvement was achieved in the severity of motor and major non-motor symptoms in both groups, the postoperative quality of life was significantly better in the ‘Active job’ group (0.687 vs. 0.587, medians, p Conclusions Although our study has several limitations, our results suggest that in patients with active job the appropriately ‘early’ usage of DBS might help preserve working capability in a two-year time-frame and gain higher improvement in quality of life.