Telephone Follow-Up to Reduce the Readmission Rate in Gynecologic Oncology Surgery Patients

Unplanned hospital readmissions are commonly viewed as a marker of poor quality care and result in increased costs for both healthcare institutions and patients. Factors associated with readmission for gynecological oncology patients can be related to the radical surgical interventions required for the management of their disease, as well as complex comorbidity profiles, surgical complexity, cancer stage, and perioperative complications. The purpose of this study was to explore and examine the impact of nursing-led telephone follow up on the reduction of the readmission rate in gynecologic oncology abdominal surgery patients following initial discharge post-operatively. A cross-sectional research study was used to examine the relationship between the use of post discharge follow-up calls (intervention group versus control group) and 30-day readmission (yes/no) using chi-squared test for all categorical variables, and two sample t-tests for continuous variables. Variables were compared between the experimental and control groups given the potential association with the outcome of interest (readmission), including age, body mass index (BMI), comorbidities, tobacco use, performance status using the Eastern Cooperative Oncology Group (ECOG) status, length of surgery, estimated blood loss, perioperative blood transfusion, formation of ostomy, and length of hospital stay of one day or greater than one day duration. There were no significant differences found between the control group and experimental groups and each variable. There are future implications of this study surrounding the profound importance of the involvement of nursing staff in improvement in discharge teaching, transitions of care, and the patient experience. Evidenced-based practices are needed to improve the health and safety of the patients we care for

Tangible Needs Assessment for Teenage Cancer Patients and Their Siblings

Jacob’s Heart Children’s Cancer Support Services works to improve the quality of life for children with cancer and support their families in the challenges they face. Jacob’s Heart serves families in Santa Cruz, Monterey, San Benito, and South Santa Clara Counties who have a child diagnosed with cancer under the age of 18. Unfortunately, too many teens with cancer and their families experience emotional instability and lack of self awareness. To address the social problem, a tangible needs assessment was created with the support of the department of Family Support Specialist. The assessment will help Jacob’s Heart teens achieve tangible needs and post-traumatic growth. By asking questions that push teens to be as specific as possible in their likes and dislikes, teens will obtain a sense of control resulting in self awareness. It is recommended that the agency begins implementing the assessment

Investigation on the Damage Localization in a Pipe Using Torsional Guided Waves and Sensor Array Reconstruction Techniques

Continuous monitoring for damage detection and localization on large fluid filled pipe-like structures is needed. To address this problem we propose the use of a Macro Fiber Composite (MFC) sensor to generate the first order torsional mode and to detect scatter signals from the discontinuities by an EMAT sensor positioned in various locations on the surface of the structure to simulate an array of sensors. Signals are post-processed with a developed algorithm based on entropy and arrival time. Numerical results were obtained for simulated signals and experimentally tested on a stainless steel pipe A-36 (43.6 and 48.2 mm in inner and outer diameter respectively). It was found that it is possible to locate an artificial defect by identifying the torsional modes and incorporating this information in the developed entropy algorithm of the simulated sensor array

A Study of Sensor Array Aperture for Damage Localization in a Plate-Like Structure Using Ultrasonic Guided Waves

An array of sensors for source localization has been used in various areas of engineering such as seismology, oceanography and radar operations. However, there are limited studies for applications using guided waves. The aperture function which characterizes the sensors topology is fundamental for the performance of the array. In this work we study the array aperture function in the context of dispersive attenuated multimode Lamb waves. Time-frequency beamforming analysis was used to study the effect of the aperture function characteristics. The methodology was implemented on various symmetric and non-symmetric modes generated on an aluminum thin plate. The results show that it is possible to locate the wave source by optimizing the aperture of the array for the dispersive modes generated

Síndrome de Burnout en docentes de una universidad particular de Piura según género - 2020

El presente estudio de tipo sustantivo y diseño descriptivo - comparativo tiene como objetivo establecer las diferencias en las dimensiones del Síndrome de Burnout en docentes de una universidad particular de Piura, según género. La muestra estuvo conformada por 136 docentes, varones y mujeres, de una universidad particular de Piura, quienes fueron evaluados mediante el instrumento “Inventario de Burnout de Maslach”, el mismo que ha sido adaptado en Perú por Fernández (2002); el cual fue desarrollado originalmente por Maslach, Jackson y Schwab en 1986 denominado “Maslach Burnout Inventory - Educare Survey MBI-ES’. El instrumento consta de 22 ítems valorados en una escala tipo Likert en un rango de 7 adjetivos que van de “Nunca” (0) a “Todos los días” (6). Además, evalúa mediante tres dimensiones las cuales están orientadas a medir la presencia del estrés laboral o síndrome de quemado, que son denominados Agotamiento Emocional, Despersonalización y Realización Personal. Por último, en cuanto a los resultados obtenidos se evidencian que no se encontraron diferencias en las dimensiones del Síndrome de Burnout entre los docentes de una universidad particular de Piura, según género, sin embargo, en la dimensión de realización personal, el p valor hallado es 0,029 y dado a que es menor a 0.05, indica estadísticamente una diferencia entre los estratos evaluados.The present study of substantive type and descriptive-comparative design aims to establish the differences in the dimensions of Burnout Syndrome in teachers of a private university in Piura, according to gender. The sample consisted of 136 male and female teachers from a private university in Piura, who were evaluated using the "Maslach Burnout Inventory" instrument, which has been adapted in Peru by Fernandez (2002); it was originally developed by Maslach, Jackson and Schwab in 1986 called "Maslach Burnout Inventory - Educare Survey MBI-ES'. The instrument consists of 22 items rated on a Likert-type scale in a range of 7 adjectives ranging from "Never" (0) to "Every day" (6). In addition, it evaluates by means of three dimensions which are oriented to measure the presence of work stress or burnout syndrome, which are called Emotional Exhaustion, Depersonalization and Personal Accomplishment. Finally, as for the results obtained, it is evident that no differences were found in the dimensions of Burnout Syndrome among teachers of a particular university in Piura, according to gender, however, in the dimension of personal fulfillment, the p value found is 0.029 and given that it is less than 0.05, it statistically indicates a difference between the strata evaluated.Tesi

Uso de las TIC y desempeño docente en un hospital nacional de salud, Lima 2023

La presente investigación sobre el Uso de las TIC y el desempeño docente en un Hospital Nacional de Salud, 2023, tuvo como objetivo de determinar la relación que existe entre ambas variables. El estudio fue de tipo básica, de diseño no experimental, con enfoque cuantitativo, y de nivel correlacional. Se trabajó con una muestra de 100 docente de los cuales se les aplico el cuestionario basado en el formato Likert y los análisis fueron realizados usando el programa Excel, mediante el método de tabulación para organizar la información y se usó el software estadístico SPSS 25.0. En el análisis se evidencio que al relacionar la dimensión dominio tecnológico en el desempeño docente, obtuvimos un coeficiente de correlación o Rho de Spearman de 0,358 y un grado significancia bilateral < 0,001. Con lo que se concluye que el dominio tecnológico afecta significativamente, de manera directa y positiva al desempeño docente. El estudio concluyo que existe una correlación baja entre ambas variables, donde se realizó el análisis mediante el Rho de Sperman de 0,387 y una significancia < 0,001

Propuesta de un Manual de Procedimientos para Optimizar la Eficiencia de los Monitoreos de Cumplimiento de las Reglas Estándar del método Especial de Contratación a través de los Catálogos Electrónicos de Acuerdo Marco

La presente investigación tiene como objetivo determinar el nivel de influencia en la optimización de la eficiencia de los monitoreos de cumplimiento de las Reglas Estándar del Métodos Especial de Contratación a través de los Catálogos Electrónicos de Acuerdo Marco, a partir de la aplicación de un manual de procedimientos. La investigación cuenta con un diseño no experimental transversal, descriptivo con un alcance correlacional. La muestra es no probabilística e intencional, la población considerada en el estudio es de 50 trabajadores y la muestra está conformada por 32 trabajadores, a quien se aplicó el cuestionario. Como resultado se determinó de forma general el valor chi-cuadrado es de 28,474, con 4 grados de libertad y un valor de significancia de 0,000, como este valor de significancia es menor a 0,05 se afirma que, la aplicación de un manual de procedimientos influirá positivamente en la optimización de la eficiencia de los monitoreos de cumplimiento de las Reglas Estándar del Métodos Especial de Contratación a través de los Catálogos Electrónicos de Acuerdo Marco. Finalmente, se concluye que la aplicación de un Manual de Procedimientos para el cumplimiento de las Reglas Estándar del Método Especial de Contratación a través de los Catálogos Electrónicos de Acuerdos Marco, optimizan la eficiencia de los monitoreo

Comparative Sorption of Methylene Blue onto Hydrophobic Clays

Chemical modifications of clay to remove methylene blue (MB) from aqueous solutions at room temperature were compared. Natural bentonite (NC) was modified by cation exchange with hexadecyltrimethylammonium chloride (HC), bencyltriethylammonium chloride (BC), and tetramethylammonium chloride (TC) to reverse the surface polarity of the hydrophilic bentonite. The adsorption of MB was studied and fitted by the adsorption theories of Langmuir, Freundlich, Dubinin-Radushkevich, and Temkin. Equilibrium parameters were calculated, indicating that chemical modification did not improve the adsorption, due to the electrostatic adsorption mechanism. Specific surface area was determined, reporting the following trend: NC \u3e TC \u3e BC \u3e HC. Isotherms show that TC is the best modified clay for the adsorption of MB with a capacity of 217 mg/g. Adsorbents were characterized by SEM and the determination of their point zero charge, indicating a charge reversal at pH 9.5 and a heterogeneous surface that is optimum for the adsorption of molecules and ions onto their surfaces

Prognostic and Predictive Value of Immune-Related Gene Expression Signatures vs Tumor-Infiltrating Lymphocytes in Early-Stage ERBB2/HER2-Positive Breast Cancer: A Correlative Analysis of the CALGB 40601 and PAMELA Trials

Càncer de mama; Expressió gènicaCáncer de mama; Expresión génicaBreast cancer; Gene ExpressionImportance Both tumor-infiltrating lymphocytes (TILs) assessment and immune-related gene expression signatures by RNA profiling predict higher pathologic complete response (pCR) and improved event-free survival (EFS) in patients with early-stage ERBB2/HER2-positive breast cancer. However, whether these 2 measures of immune activation provide similar or additive prognostic value is not known. Objective To examine the prognostic ability of TILs and immune-related gene expression signatures, alone and in combination, to predict pCR and EFS in patients with early-stage ERBB2/HER2-positive breast cancer treated in 2 clinical trials. Design, Setting, and Participants In this prognostic study, a correlative analysis was performed on the Cancer and Leukemia Group B (CALGB) 40601 trial and the PAMELA trial. In the CALGB 40601 trial, 305 patients were randomly assigned to weekly paclitaxel with trastuzumab, lapatinib, or both for 16 weeks. The primary end point was pCR, with a secondary end point of EFS. In the PAMELA trial, 151 patients received neoadjuvant treatment with trastuzumab and lapatinib for 18 weeks. The primary end point was the ability of the HER2-enriched subtype to predict pCR. The studies were conducted from October 2013 to November 2015 (PAMELA) and from December 2008 to February 2012 (CALGB 40601). Data analyses were performed from June 1, 2020, to January 1, 2022. Main Outcomes and Measures Immune-related gene expression profiling by RNA sequencing and TILs were assessed on 230 CALGB 40601 trial pretreatment tumors and 138 PAMELA trial pretreatment tumors. The association of these biomarkers with pCR (CALGB 40601 and PAMELA) and EFS (CALGB 40601) was studied by logistic regression and Cox analyses. Results The median age of the patients was 50 years (IQR, 42-50 years), and 305 (100%) were women. Of 202 immune signatures tested, 166 (82.2%) were significantly correlated with TILs. In both trials combined, TILs were significantly associated with pCR (odds ratio, 1.01; 95% CI, 1.01-1.02; P = .02). In addition to TILs, 36 immune signatures were significantly associated with higher pCR rates. Seven of these signatures outperformed TILs for predicting pCR, 6 of which were B-cell related. In a multivariable Cox model adjusted for clinicopathologic factors, including PAM50 intrinsic tumor subtype, the immunoglobulin G signature, but not TILs, was independently associated with EFS (immunoglobulin G signature–adjusted hazard ratio, 0.63; 95% CI, 0.42-0.93; P = .02; TIL-adjusted hazard ratio, 1.00; 95% CI, 0.98-1.02; P = .99). Conclusions and Relevance Results of this study suggest that multiple B-cell–related signatures were more strongly associated with pCR and EFS than TILs, which largely represent T cells. When both TILs and gene expression are available, the prognostic value of immune-related signatures appears to be superior