Number Of Visits Research Articles

Valuing the nature-based recreational benefits of Iloilo river esplanade using the travel cost method

This paper presents the assessment of the economic value of the Iloilo river esplanade, a recreational site in Iloilo City. The objective of the study is to evaluate the demand for the site or recreation therein using the travel cost method. Data was gathered through online surveys of 385 college students from five universities in Iloilo City who had visited the place. By employing a negative binomial model, the analysis resulted in an estimated economic value of Php 5,120.33 (US$ 93.9) per person per trip. Variables such as travel costs, age, distance, group size, sex, and the visitor’s civil status are significant factors on the number of trips to esplanade. Travel cost has a negative relationship with the trip’s frequency and distance is a factor affecting the number of visits undertaken, indicating that as the as the trip distance increases, the total number of trips decreases. The results presented in this study can improve the quality of the recreational and environmental services of the Iloilo river esplanade, as the findings can assist in identifying the variety of services that the place could offer based on the visitors’ demand. Further, the study can provide valuable inputs in resource and policy planning, as well as assist resource managers and the local government of Iloilo City in making crucial decisions to improve the overall experience for visitors to the Esplanade and ensure the continued preservation of the recreational site to maximize its nature- based and recreational benefits.

Differing clinical characteristics among individuals with concussions sustained at work, in motor vehicle collisions, and sport

ABSTRACT Purpose To compare clinical characteristics in patients with concussions sustained by prevalent, but understudied, mechanisms (work-related concussion [WRC] and motor vehicle collision [MVC]-related concussion) to sport-related concussion (SRC). Methods Retrospective review of 281 electronic medical records from an outpatient concussion clinic. Time since injury (days), duration of care (days), amount of care (number of visits), and perceived health (Short-Form 12) were collected. Results The time between injury and clinic presentation was significantly greater in WRC and MVC-related concussion compared to SRC. These groups were also older, had a longer duration of care, required more referrals for outside clinical services, and reported worse perceived mental and physical health versus SRC. Conclusion These results suggest that clinical courses may be significantly different for individuals with SRC, WRC and MVC-related concussion, and that different management approaches and expectations may be necessary for these groups. Further research is indicated.

Pengaruh Diskon Dan Cashback Terhadap Frekuensi Pembelian Pada Aplikasi Shopeefood Di Wilayah Kabupaten Jember

This study aims to examine the effect of discount and cashback programs on the frequency of purchases on the Shopeefood application. The background of this research is the rapid development of e-commerce in Indonesia, where Shopee remains the leader with the highest number of monthly visits by 2023. Shopeefood, as one of the main services on this platform, uses various promotional strategies to attract more users, one of which is the discount and cashback program. This study highlights that Shopeefood's strategies, especially the use of discounts and cashback, contribute to an increase in transactions. Discounts provide an immediate price cut that appeals to consumers while cashback offers a financial incentive in the form of a refund that encourages consumers to shop more frequently in the future. However, there are some complaints from consumers regarding the relatively long period of receiving cashback and the less transparent application process, which may affect their level of satisfaction. Through a quantitative approach with multiple linear regression analysis and hypothesis testing, this study found that discount and cashback programs have a significant influence on the frequency of purchases at Shopeefood. The results of this study are expected to provide valuable insights for companies to develop more effective marketing strategies, not only in increasing purchase frequency, but also in building consumer loyalty amid increasingly fierce competition in the food delivery service industry.

Evaluation of the effect of DRG payment policy based on interrupted time series modeling: evidence from a tertiary hospital in Anhui Province

BackgroundThe payment methodology for diagnosis-related groups (DRG) has implications for both society and medical institutions. Our study aims to analyse the impact of the reform of the payment policy according to the DRG on the operation of a tertiary hospital in Anhui Province.MethodsMonthly data were collected from April 2020 to September 2023 during the reform period for a tertiary hospital on nine types of operational indicators, including average length of stay (ALOS), number of discharges, number of outpatient visits, percentage of discharged patients undergoing level III or IV surgery, bed turnover rate, inpatient essential drug utilization rate, low-risk group mortality, outpatient subaverage cost and inpatient subaverage cost. The data were divided into two phases according to the time of DRG implementation: pre-reform (April 2020–December 2021) and post-reform (January 2022–September 2023), and the segmented regression model with interrupted time series data was used to analyse the changes in the trend of each type of indicator before and after the reform. Statistical analysis was performed using R software (4.3.1).ResultsAfter the implementation of the DRG, the number of discharges increased by 112 800 patients (95% confidence interval [CI] 31.125–194.484, P = 0.008), the bed turnover rate rose by 1.403% (95% CI 1.028–1.778, P = 0.022) and the percentage of discharged patients undergoing level III or IV surgery decreased by 0.098% (95% CI −0.181 to −0.015, P = 0.022). The low-risk group mortality decreased by 0.016% (95% CI −0.027 to −0.005, P = 0.007), and the inpatient subaverage cost decreased by 81.514 CNY (95% CI −121.782 to −41.245, P < 0.001). However, there were no significant differences in the trends of average length of stay, outpatient visits, inpatient essential drug utilization rate and outpatient subaverage cost after the DRG implementation.ConclusionsThe findings show that the DRG reform has positively impacted hospital functioning, including quality, safety, efficiency and costs. Although the average length of stay remained unchanged, there was an increase in discharged patients and outpatient visits, indicating hospitals adapted to the new payment model. The reduction in low-risk group mortality suggests improvements in patient safety and care quality. However, challenges remain, as evidenced by decreased surgical complexity and initial drops in bed turnover rates. While the DRG reform holds promise for enhancing healthcare efficiency and controlling costs, potential negative effects such as patient selection bias and coding changes need to be monitored. Future research should focus on the long-term effects of the DRG policy across different healthcare institutions.

The acceptability of intimate partner violence screening and response among refugee women accessing Australian resettlement services.

Screening and response for intimate partner violence (IPV) is recommended for women in priority populations and is implemented in health services across diverse jurisdictions. Most women experiencing IPV strongly support screening, however this is untested with refugee women in resettlement contexts. Around one third of refugee women in Australia experience IPV and face multiple post-migration challenges. SAHAR (Safety and Health after Arrival) tested IPV screening using the ACTS tool, brief intervention, and referral with women accessing four settlement support services. Women attending sites during the study period were invited to participate in a three month follow up survey with participation by 321/375 women recruited (86%). Acceptability of IPV screening was assessed against (i) levels of comfort with the IPV screening questions and (ii) strength of agreement/disagreement with settlement services asking women about being frightened, controlled or hurt by their partners. Of participants who recalled the screening, 93% reported being very or moderately comfortable with being asked the questions (89% who had experienced IPV; 94% of those with no IPV identified). For all participants, 84% strongly or somewhat agreed with services asking the questions, with no significant difference in agreement between disclosing and non-disclosing groups. Those with no recall of the questions had lower overall agreement and higher disagreement than those who recalled the questions (88% and 10%). Acceptability was not associated with age, country of origin, household composition, time since arrival or number of prior service visits. Participants identified 'care shown by the worker', 'talking to someone in my own language', 'trust in the privacy of the service', and 'talking to a female worker' as the factors most important for encouraging discussion of IPV. High acceptance of IPV screening by refugee women supports consideration of implementation across settlement services, a key access point for refugee women with diverse needs.

Do Different Queue Formations Influence the Overestimation of Tourism Carrying Capacity?

Tourism carrying capacity in scenic areas refers to the maximum number of visitors a site can accommodate while maintaining safety and ensuring a satisfactory visitor experience. Effective management of carrying capacity is crucial for ecological preservation, operational efficiency, and visitor safety. This study focuses on the Maiji Mountain Grottoes in China, employing both simulation and field experiments to examine how varying walking speeds and queue formations affect the site’s carrying capacity. Simulation results reveal that, compared to lateral queue formations, linear queue formations exert a more pronounced negative impact on carrying capacity, with an impact coefficient of 0.56. Field observations further demonstrate that carrying capacity is closely tied to visitor activity patterns. This study introduces more innovative ideas: one is the strategy of zoning analysis within the same scenic spot, and the other is a more careful consideration of tourist queue formation. The findings provide valuable methodological insights for future research on tourism carrying capacity and for developing strategies to enhance tourist management in scenic areas.

Public Valuations of Managing Compromised Molars: A Discrete Choice Experiment.

There is limited evidence to support optimal patient-centered management for compromised first permanent molars (cFPM) in children. Based on an online discrete choice experiment (DCE), this study elicits UK adult general population preferences and calculates willingness to pay (WTP) for pathways to manage cFPM. The DCE was designed with information from semistructured interviews and literature reviews, as well as focus groups with an expert panel of dentists, citizens, and policy makers. A statistically optimal D-efficient design generated 18 choice tasks, split across 2 blocks. Each respondent answered one block of 9 tasks to reduce survey fatigue. Choice tasks varied across 5 attributes: type of treatment, provider of care, who makes the management decision, number of future visits avoided, and cost. An opt-out was included (no treatment). Conditional logit models (fixed effects) were used for data analysis, and marginal WTP for each attribute level was calculated. An overall 430 respondents completed the DCE. Respondents valued children receiving care as compared with not. Restoring a cFPM was valued equally to spontaneous or orthodontic gap closure. In contrast, having a partial gap, prosthetic replacement with a bridge, or a full unit gap was valued less than restoration or full gap closure. General dentists were preferred to dentists with enhanced skills, but there was no evidence of a preference for general dentists over specialists in pediatric dentistry. Respondents preferred to be wholly or partly involved in the decision-making process as opposed to the dentist making the decision alone. Respondents preferred less costly treatments and the avoidance of future dental work. Dental care service providers must consider service user preferences for health and nonhealth outcomes in any service redesign. Furthermore, the results provide marginal WTP estimates that can be used to value dental care services.

A Study on the Prevalence of Inguinal Hernia at Keluarga Sehat Hospital Pati, Indonesia

Background and Objective: Inguinal hernia is a common medical condition, with potential serious complications such as incarcerated or strangulated hernias. Keluarga Sehat Hospital Pati, a Type C hospital, reports a significant number of patient visits. This study aims to determine the prevalence of inguinal hernia at Keluarga Sehat Hospital Pati in 2023 and to describe the demographic characteristics of the affected patients. Methods: This descriptive observational study analyzed the medical records of inguinal hernia patients treated at Keluarga Sehat Hospital Pati in 2023. Data were analyzed using SPSS for univariate analysis of categorical (gender, occupation) and numerical (age) variables. Results: Among 164 inguinal hernia patients, the majority were male (157 patients; 95.7%) with a mean age of 52.19 years (SD = 19.94 years). The most common age groups were 52-61 years (29.9%) and 62-71 years (29.3%). The most frequent occupations were farmers (18.9%) and self-employed individuals (10.4%). Conclusion: The prevalence of inguinal hernia at Keluarga Sehat Hospital Pati was predominantly found in males, particularly within the 52-71 years age group. These findings highlight the need for better healthcare planning and public awareness, especially for individuals in physical labor occupations and those in middle to older age groups.

State of the pediatric ophthalmology service of the Russian Federation in 2014–2022

The article presents the results of the analysis of the dynamics of the main performance indicators of the pediatric ophthalmology service from 2014 to 2022. The number of ophthalmology offices (from 6.262 in 2014 to 6.037 in 2022) and children’s ophthalmology beds (from 2.,558 to 2.094) decreased, and the number of ophthalmologists decreased by 681 individuals, 7.3% of the total, in the Russian Federation. The provision of ophthalmologists and ophthalmology beds per 10,000 individuals in 2022 is presented for individual federal districts (FDs) of the Russian Federation. To date, North Caucasus FD and Southern FD received the lowest provision with ophthalmologists per 10,000 individuals (0.69 and 0.68, respectively), whereas Northwestern FD and Far Eastern FD received the highest provision (1.03 and 0.89, respectively). The number of visits to ophthalmologists by children, including for preventive purposes, decreased, and the efficiency of preventive examinations increased, which led to an increase in the proportion of diseases detected during routine examinations by nearly three times. The paper presents the detection rate of ophthalmological diseases during preventive examinations in children by FDs in 2022. On average, the coverage of regular medical check-ups of children with ophthalmological diseases in the Russian Federation has increased (from 25.5% in 2014 to 42% in 2023), and the values of this indicator in individual FDs in 2022 are indicated. The highest and lowest coverage of regular medical check-ups were noted in the Siberian FD (54.0%) and Far Eastern FD (33%), respectively. The indicators of overall and primary morbidity of ophthalmological diseases in general and individual nosological forms, blindness, low vision, and disability were analyzed. The dynamics of surgical activity indicators in the FDs of the Russian Federation are presented.

Impacts of Air Pollution on Community Well-Being in the Tourism Sector: A Comprehensive Literature Review

This critical review examines the interplay between air pollution and community well-being within the tourism industry. Utilizing a systematic literature review methodology, the study focuses on three domains: air quality, tourism, and sustainability. Employing VOSviewer for bibliometric analysis, the research identifies key themes and trends. The findings reveal that air pollution, particularly in urban tourist destinations, negatively impacts tourist behavior, reduces visitor numbers, and threatens the economic sustainability of tourism. Additionally, it highlights health risks to both tourists and local communities, underscoring the need for adaptive strategies and sustainable practices. The study prioritizes articles employing statistical methods and incorporates geographic visualizations using GeoPandas and Matplotlib to illustrate research distribution. By synthesizing the existing literature, this review emphasizes the importance of effective policies that balance tourism growth with environmental protection amidst escalating ecological challenges.

Evaluating Tourism Performance through Tourist Perceptions: A Case Study of Petengoran Mangrove Tourism in Lampung, Indonesia

The existence of components that did not represent the concept of ecotourism and the decline in the number of visits was very significant. This research evaluated tourism performance based on tourists’ perspectives to determine the components that need improvement. The respondents in this study were 100 tourists, who were obtained by applying the Slovin formula. This study used primary data collected through research questionnaires distributed to respondents. The research instrument was tested to ensure its validity and reliability. The collected data were analyzed using the Customer Satisfaction Index (CSI), Gap Analysis, and Importance-Performance Analysis (IPA). Petengoran Mangrove Tourism does not match tourists’ expectations. The attributes that become the main priority because their performance is considered not to have met tourists’ expectations are the availability and diversity of tourist activities, accessibility conditions, implementation of educational activities, and several facilities that do not meet tourist satisfaction, even though these components are what tourists highly expected. Keywords: customer satisfaction index, mangrove tourism, Petengoran, tourism performance, tourist perception

Health System Expansion and Changes in Medicare Beneficiary Utilization of Safety Net Providers.

Evidence is limited on insured patients' use of safety net providers as vertically integrated health systems spread throughout the United States. To examine whether market-level health system penetration is associated with: (1) switches in Medicare beneficiaries' usual source of primary care from federally qualified health centers (FQHCs) to health systems; and (2) FQHCs' overall Medicare patient and visit volume. Beneficiary-level discrete-time survival analysis and market-level linear regression analysis using Medicare fee-for-service claims data from 2013 to 2018. A total of 659,652 Medicare fee-for-service beneficiaries aged 65 and older lived in one of 27,386 empirically derived primary care markets whose usual source of care in 2013 was an FQHC or a non-FQHC-independent physician organization that predominantly served low-income patients. Beneficiary-year measure of the probability of switching to health system-affiliated physician organizations and market-year measures of the number of FQHC visits by Medicare beneficiaries, number of beneficiaries attributed to FQHCs, and FQHC Medicare market shares. During 2013-2018, 16.5% of beneficiaries who sought care from FQHCs switched to health systems. When health system penetration increases from the 25th to 75th percentile, the probability of Medicare FQHC patient switching increases by 4.6 percentage points, with 22 fewer Medicare FQHC visits and 4 fewer beneficiaries attributed to FQHCs per market year. Complex patients and patients who sought care from non-FQHC, independent physician organizations exhibited higher rates of switching to health systems. Health system expansion was associated with the loss of Medicare patients by FQHCs, suggesting potential negative spillovers of vertical integration on independent safety net providers.

Trends and determinants of caesarean section in South Asian countries: Bangladesh, Nepal, and Pakistan.

The prevalence of caesarean sections (C-sections) has remarkably increased in the past few decades worldwide, especially in the lower and middle-income countries (LMICs). To our best knowledge, no studies focused on and compared the C-section scenarios of Bangladesh, Nepal, and Pakistan based on the latest demographic and health survey (DHS) data. To assess the trends and factors associated with C-sections in the three South Asian countries. Mothers aged 15-49 years participated in DHS 1990 to 2017-2018 and gave birth within three years of each of the surveys in Bangladesh, Nepal, and Pakistan. This study analyzed data from five recent DHS rounds in Bangladesh and four in Nepal and Pakistan. Multivariable logistic regression was used to assess the association between C-sections and sociodemographic characteristics. The results show that institutional delivery and C-sections have increased throughout the period in all three countries. In Bangladesh, the hospital birth rate increased from 10.0% in 2004 to 49.9% in 2017, and the corresponding figures [S1 Appendix: Figure A1 and Figure A2] for C-sections increased from 3.5% to 32.8%. In Nepal, the hospital birth rate increased from 11.0% in 2001 to 58.6% in 2016, and the C-sections from 0.8% to 11.0%. Pakistan observed a sharp increase from 13.7% to 66.3% and 2.7% to 22.3% in the respective cases from 1990 to 2017. Results from regression reveal that the mother's age, place of residence, education, partner's education, wealth status, birth order, number of antenatal care visits, and body mass index are associated with C-section deliveries in all three countries. Our findings regarding the association of sociodemographic factors with increased C-sections may help identify subgroups of women susceptible to C-sections and offer better support regarding C-sections plans. However, the substantial increase in C-sections across the three countries warrants further investigation to identify the reasons.

Pengelolahan Sampah Di Kawasan Wisata Bukit Kebo Balikpapan Melalui Konsep Bank Sampah

The ecotourism environment must be kept clean and sustainable for the sake of sustainability and comfort of visitors. Bukit Kebo Tourism Area is one of the many ecotourism and edutourism destinations in Balikpapan City. With the increasing number of visitors (tourists) to Bukit Kebo, it has an impact on the increase in the volume of waste produced. The increase in the volume of waste has not been managed properly, because the waste is only piled up and burned. Where the impact of hoarding can provide the potential for environmental pollution and the results of burning waste also cause pollution. In overcoming these problems, a solution is offered by using the concept of a waste bank to manage waste, as well as providing assistance to partners about the importance of recycling waste. In addition, education is also carried out for visitors to increase awareness and attention about the importance of maintaining environmental cleanliness through the installation of appeal plaques and campaigns through the distribution of brochures. The results of the responses given by management partners and visitors show quite positive results regarding the impacts given from the results of activities to always maintain environmental sustainability and cleanliness, especially in tourist areas.

Pricing of display advertising as indication of the roots of market power of the digital platforms

Multi-sided digital platforms such as GAFAM (Google, Apple, Facebook, Amazon, Microsoft) provide services at zero cost by monetizing user attention and data through advertising. Testing the hypotheses on the determinants of display advertising price set by three largest digital platforms — Google, YouTube and Facebook, — contributes to the explanations of the roots of platforms market power. During the period from January 2018 to March 2024 cost per mile (CPM) increases with the number of unique visitors and traffic (total visits), as well as with the time that the user spends on the platform. However, the second effect is more pronounced. We interpret this result as an evidence that the market power in digital advertising depends more on the data of particular user’s preferences (digital footprint) and therefore on the ability to personalize advertising messages than on the number of users and data traffic on the platforms. The results high-light the economic value of personal data under monetization of cross-platform externalities through digital advertising.

Impact of COVID-19 pandemic on sex-disparities in asthma healthcare utilization and outcomes: a population study

BackgroundSex-disparities in healthcare access were exacerbated during the COVID-19 pandemic. For respiratory conditions like asthma where females have poorer disease outcomes, it is unclear if the pandemic further worsened this sex-disparity. Thus, theobjectiveof this study is to compare the impact of the pandemic on healthcare utilization, exacerbations, and mortality rates in males and females with asthma.MethodsA retrospective population-based provincial-level analysis was conducted using linked administrative datasets from Alberta, Canada. We measured hospitalization, emergency department and outpatient visits, and asthma outpatient exacerbations in female and males with asthma 18 months before and after March 12, 2020. Mortality data were compared pre-versuspost-pandemic, taking into account confirmed COVID-19 infection within 30 days. Subgroup analysis was undertaken to determine if healthcare utilization differed in those with severe asthma.ResultsAcute care and outpatient encounters for patients with asthma declined for both females and males. Those with severe asthma of either sex experienced a reduction in hospitalizations during the pandemic. Total number of outpatient asthma visits, including both virtual and in-person, increased during the pandemic for both sexes but significantly more in females. Mortality rate was unchanged after adjusting for COVID-19-associated deaths pre-versuspost-pandemic.ConclusionAll patients with asthma accessed acute care resources less but outpatient visits increased during the pandemic. There was no increase in non-COVID-related mortality, regardless of sex, suggesting that the previously established sex-disparity in asthma outcomes was not seen during the pandemic.

Antidepressant therapeutic strategies and health care utilization in patients with depression.

Individuals with depression who do not respond to initial antidepressant may switch to a different antidepressant, add a second antidepressant, or add an atypical antipsychotic. Previous studies comparing these strategies' efficacy and safety reported conflicting results, and the impact of these strategies on subsequent health care utilization is unknown. To compare health care utilization between individuals with depression who switched antidepressants, added a second antidepressant (ie, combination), or added an atypical antipsychotic (ie, augmentation) following their initial antidepressant. This retrospective cohort study used a 25% random sample of the IQVIA PharMetrics Plus for Academics health plan claims database. The study cohort included individuals aged 10-64 years who newly initiated an antidepressant at any point from January 2016 to December 2020. New use was defined as no evidence of an antidepressant in the 180 days preceding the antidepressant dispensing. Individuals had to have a depression diagnosis and a treatment change in the 180 days following the initial antidepressant. The index date was the date of the first observed antidepressant change, which was defined as a switch, combination, or augmentation. Health care utilization, measured as the number of outpatient visits, any all-cause hospitalization, and any emergency department (ED) visit, was assessed in the 180 days after the index date. Negative binomial regression models evaluated the rate ratio of the number of outpatient visits. Logistic regression models estimated the odds ratio of a hospitalization, and modified Poisson regression estimated the relative risk of an ED visit. Models were adjusted for demographics, clinical characteristics, and previous health care utilization. Among 3,847 individuals with depression who had the first treatment change following the initial antidepressant, we identified 2,418 (62.9%) who switched, 1,268 (33.0%) who combined, and 161 (4.2%) who augmented their antidepressant. The augmentation group had a significantly higher rate of outpatient visits than the combination group (adjusted rate ratio = 1.14, 95% CI = 1.04-1.25). There was no statistically significant difference in hospitalizations or ED visits between the switch and augmentation vs combination groups. Augmentation comprised 4% of our antidepressant cohort but had higher outpatient health care utilization than those who combined treatment.

Changes in the Utilization of Korean Medicine Clinical Services on Clinic Level Before and After COVID-19

Objectives: The coronavirus disease 2019(COVID-19) impacted the utilization of medical services in Republic of Korea, leading to decreased utilization due to social distancing and diverted healthcare priorities. Post-pandemic, anxiety about infection remained high, further affecting medical service utilization, however, there was no study between infection disease and the utilization of Korean Medicine clinical services. Therefore, this aimed to find the changes in the utilization of Korean Medicine clinical services on the level of clinics by reflecting the environmental factors of the COVID-19.Methods: This study examined data from 2016 to 2022, focusing on clinic-level statistics derived from census, national health insurance(NHI), and the data of medical care assistance. It described changes in the number of clinics and doctors, patient’s visits, and medical expense and compared pre- and post-COVID-19 especially.Results: In the utilization of Korean Medicine clinical services before and after COVID-19, the number of Korean Medicine clinics and doctors per 10,000 people nationwide increased, but in Gwangju, Jeonnam, and Chungnam, both decreased. The number of visits in Korean Medicine clinics for NHI and medical care assistance decreased, but that of visits in Western Medicine clinics recovered. The medical expense increased in both Western Medicine clinics and Korean Medicine clinics, and the rate of increase in Western Medicine clinics was higher than that of Korean Medicine clinics.Conclusion: These changes were the result of COVID-19 affecting medical services including Korean Medicine, and further research is needed on Korean Medicine clinical services due to external effects including infectious diseases.

Diabetes specialist nurse support, training and 'virtual' advice reduces district nurse visits and improves outcomes for people with diabetes requiring visits for insulin administration.

We evaluated the effectiveness of a community diabetes specialist nurse (cDSN) working with district nurses (DNs) to optimise insulin therapy on DN workload and patient outcomes. This was an observational clinical improvement study of outcomes pre- and post-introduction of an intervention within a community diabetes service in an areas of England. Patients were followed up for 6 months. The intervention was a cDSN providing advice and support to DNs in safe diabetes management, with a particular focus on insulin use. in total, 148 of 224 patients were reviewed; 130 (87.8 %) were available for follow up 6 months after their first review. Comparing pre- to post-intervention outcomes, number of patients with a hypoglycaemic event reduced from 21/129 to 1/128 (X2 = 19.71, p < 0.001) as did the number with a hyperglycaemic event; 53/129 to 23/128 (X2 = 16.48, p < 0.001). Number of DN visits and use of acute hospital services also improved significantly. Estimated cost savings through reduced DN visits, insulin usage, and hospital service use totalled £1.9 million. Significant financial savings and reduced patient harms were identified following our intervention in this cohort. Roll-out to other sites in England is a next step.

Pemanfaatan Media Promosi sebagai Sarana Pemasaran Pariwisata Festival Budaya Peh Cun di Kota Tangerang Tahun 2024

The Peh Cun Festival is one of the cultural traditions brought by ethnic Chinese who came to Indonesia, the Cisadane River Peh Cun Festival itself is one of the oldest festivals in Indonesia. This festival is one of the big and lively cultural tourism agendas because there are various interesting event activities presented, the Peh Cun media can be said to be lacking in terms of promotion, especially in promotion using existing digital media. So, promotions need to be carried out to increase the number of tourist visits. This study aims to determine how to utilize effective Promotional Media in Marketing the Peh Cun Cultural Festival in Tangerang City. This study uses a qualitative descriptive method, with data collection techniques using interviews, observations and documentation. The results of the study show that the Tourism Communication used by the Boen Tek Bio Association in promoting the 2024 Peh Cun Festival includes Integrated Marketing Communication (IMC). This implementation can be seen from the use of Print Media, Outdoor Media, Electronic Media and Content on Social Media. Inhibiting factors in the 2024 Peh Cun Festival activities are time constraints and natural factors, while supporting factors include full support from the City Government, local television and radio stations, surrounding communities, and the local community.