The Perceptions of Macao Undergraduates Regarding Help Websites for Problem Gambling

This study conducted a web-surfing exercise and a questionnaire survey among a group of Macao undergraduate students regarding the websites that offered help with problem gambling. The results of this study found that most help websites in Macao and Hong Kong provided basic information-sharing service. The students indicated that they would choose their preferred help organization based on factors such as trust, familiarity, and the characteristics of the websites. They also gave comments/suggestions related to the publicity, design, contents, and focus of the websites. This study discussed the results and their implications for future research and practice

Information systems development and the managment of organizational change: a study of interdependency

This research examines the relationship between organizational change and IS development. The purpose is to find out how IS development can cope with the changing organization and business attributes. Also, when preparing strategic planning and IS planning, managers and system designers often find it difficult to come up with an IS plan that can satisfy the changing organizational needs. Thus, this research proposes a simple framework that may enhance managers and system designers in determining the IS development for the organization. Theoretical hypotheses are set up by aligning different organizational change models and IS models and analyzing their relationships. These models include Mintzberg°s theory of organizational configurations, Greiner”s organizational life cycle, Nolan”s IS stage development, McFarlan and McKenny°s IT strategic grid, and Earl°s IT dependency model. The study then shows that there should exist a strong relationship between organizational change and IS development. In other words, each phase of the organizational growth process is shown to be associated with certain organizational configurations, which, in turn, requires a particular stage of IS development. From this association, a research framework is built, capable of illustrating the found relationship. Empirical validation of the proposed framework is carried out using 39 sampled organizations, each of which differs in business, size, IS development, and other organizational factors. After ruling out invalid cases, 21 organizations are left for the testing. Positive results show that IS development and organizational change are interrelated_ The research framework may also act as a simple tool to assist managers and system designers in determining the necessary IS development level in response to the changing organizational and business attributes.A tese estuda a relação entre Mudança Organizacional e o desenvolvimento de Sistemas de Informação (IS). O objectivo e compreender e forrnalizar a maneira como as importantes tarefas de desenvolvimento de IS em organizações conseguem lidar com a mudança em estruturas, atributos, métodos e objectivos dentro da organização. Como resultado da pesquisa efectuada, esta tese propõe também uma estrutura conceptual simples capaz de ajudar os gestores e os engenheiros de sistemas na hora de especificarem o tipo de desenvolvimento de IS adequado à organização. As hipóteses em que a tese se baseia são resultam do alinhamento de diferentes modelos de mudança organizacional e de desenvolvimento de IS. A tese mostra a forte relação que deverá existir entre estes dois tipos de modelos, com cada fase do processo de crescimento organizacional encontrando a sua correspondência numa configuração especifica da organização. Esta, por sua vez, requer uma fase determinada no processo de desenvolvimento de IS. A validação empírica da estrutura conceptual proposta e levada a cabo com o exame exaustivo de 39 organizações apresentadas, todas elas diferentes em tipo, dimensão, fase de desenvolvimento de IS e outros atributos. Depois de excluídos os casos não apropriados, restam 21 organizações para a validação. Os resultados desta validação sugerem o interesse da estrutura conceptual proposta

Association of Country Income Level With the Characteristics and Outcomes of Critically Ill Patients Hospitalized With Acute Kidney Injury and COVID-19

Introduction: Acute kidney injury (AKI) has been identified as one of the most common and significant problems in hospitalized patients with COVID-19. However, studies examining the relationship between COVID-19 and AKI in low- and low-middle income countries (LLMIC) are lacking. Given that AKI is known to carry a higher mortality rate in these countries, it is important to understand differences in this population. Methods: This prospective, observational study examines the AKI incidence and characteristics of 32,210 patients with COVID-19 from 49 countries across all income levels who were admitted to an intensive care unit during their hospital stay. Results: Among patients with COVID-19 admitted to the intensive care unit, AKI incidence was highest in patients in LLMIC, followed by patients in upper-middle income countries (UMIC) and high-income countries (HIC) (53%, 38%, and 30%, respectively), whereas dialysis rates were lowest among patients with AKI from LLMIC and highest among those from HIC (27% vs. 45%). Patients with AKI in LLMIC had the largest proportion of community-acquired AKI (CA-AKI) and highest rate of in-hospital death (79% vs. 54% in HIC and 66% in UMIC). The association between AKI, being from LLMIC and in-hospital death persisted even after adjusting for disease severity. Conclusions: AKI is a particularly devastating complication of COVID-19 among patients from poorer nations where the gaps in accessibility and quality of healthcare delivery have a major impact on patient outcomes

Thrombotic and hemorrhagic complications of COVID-19 in adults hospitalized in high-income countries compared with those in adults hospitalized in low- and middle-income countries in an international registry

Background: COVID-19 has been associated with a broad range of thromboembolic, ischemic, and hemorrhagic complications (coagulopathy complications). Most studies have focused on patients with severe disease from high-income countries (HICs). Objectives: The main aims were to compare the frequency of coagulopathy complications in developing countries (low- and middle-income countries [LMICs]) with those in HICs, delineate the frequency across a range of treatment levels, and determine associations with in-hospital mortality. Methods: Adult patients enrolled in an observational, multinational registry, the International Severe Acute Respiratory and Emerging Infections COVID-19 study, between January 1, 2020, and September 15, 2021, met inclusion criteria, including admission to a hospital for laboratory-confirmed, acute COVID-19 and data on complications and survival. The advanced-treatment cohort received care, such as admission to the intensive care unit, mechanical ventilation, or inotropes or vasopressors; the basic-treatment cohort did not receive any of these interventions. Results: The study population included 495,682 patients from 52 countries, with 63% from LMICs and 85% in the basic treatment cohort. The frequency of coagulopathy complications was higher in HICs (0.76%-3.4%) than in LMICs (0.09%-1.22%). Complications were more frequent in the advanced-treatment cohort than in the basic-treatment cohort. Coagulopathy complications were associated with increased in-hospital mortality (odds ratio, 1.58; 95% CI, 1.52-1.64). The increased mortality associated with these complications was higher in LMICs (58.5%) than in HICs (35.4%). After controlling for coagulopathy complications, treatment intensity, and multiple other factors, the mortality was higher among patients in LMICs than among patients in HICs (odds ratio, 1.45; 95% CI, 1.39-1.51). Conclusion: In a large, international registry of patients hospitalized for COVID-19, coagulopathy complications were more frequent in HICs than in LMICs (developing countries). Increased mortality associated with coagulopathy complications was of a greater magnitude among patients in LMICs. Additional research is needed regarding timely diagnosis of and intervention for coagulation derangements associated with COVID-19, particularly for limited-resource settings

Characteristics and outcomes of an international cohort of 600 000 hospitalized patients with COVID-19

Background: We describe demographic features, treatments and clinical outcomes in the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) COVID-19 cohort, one of the world's largest international, standardized data sets concerning hospitalized patients. Methods: The data set analysed includes COVID-19 patients hospitalized between January 2020 and January 2022 in 52 countries. We investigated how symptoms on admission, co-morbidities, risk factors and treatments varied by age, sex and other characteristics. We used Cox regression models to investigate associations between demographics, symptoms, co-morbidities and other factors with risk of death, admission to an intensive care unit (ICU) and invasive mechanical ventilation (IMV). Results: Data were available for 689 572 patients with laboratory-confirmed (91.1%) or clinically diagnosed (8.9%) SARS-CoV-2 infection from 52 countries. Age [adjusted hazard ratio per 10 years 1.49 (95% CI 1.48, 1.49)] and male sex [1.23 (1.21, 1.24)] were associated with a higher risk of death. Rates of admission to an ICU and use of IMV increased with age up to age 60 years then dropped. Symptoms, co-morbidities and treatments varied by age and had varied associations with clinical outcomes. The case-fatality ratio varied by country partly due to differences in the clinical characteristics of recruited patients and was on average 21.5%. Conclusions: Age was the strongest determinant of risk of death, with a ∼30-fold difference between the oldest and youngest groups; each of the co-morbidities included was associated with up to an almost 2-fold increase in risk. Smoking and obesity were also associated with a higher risk of death. The size of our international database and the standardized data collection method make this study a comprehensive international description of COVID-19 clinical features. Our findings may inform strategies that involve prioritization of patients hospitalized with COVID-19 who have a higher risk of death

The value of open-source clinical science in pandemic response: lessons from ISARIC

International audienc

ISARIC-COVID-19 dataset: A Prospective, Standardized, Global Dataset of Patients Hospitalized with COVID-19

The International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) COVID-19 dataset is one of the largest international databases of prospectively collected clinical data on people hospitalized with COVID-19. This dataset was compiled during the COVID-19 pandemic by a network of hospitals that collect data using the ISARIC-World Health Organization Clinical Characterization Protocol and data tools. The database includes data from more than 705,000 patients, collected in more than 60 countries and 1,500 centres worldwide. Patient data are available from acute hospital admissions with COVID-19 and outpatient follow-ups. The data include signs and symptoms, pre-existing comorbidities, vital signs, chronic and acute treatments, complications, dates of hospitalization and discharge, mortality, viral strains, vaccination status, and other data. Here, we present the dataset characteristics, explain its architecture and how to gain access, and provide tools to facilitate its use