Follow-Up Behavior of Patients Who Leave Without Being Seen from a Hybrid Point of Service Collection Emergency Department

Introduction: This study aims to assess follow-up behaviors of patients who leave without being seen (LWBS) from a hybrid point of service (POS) collection model Emergency Department (ED).Methods: A cross-sectional survey was administered to patients who LWBS from a hybrid POS collection model ED, one-week post-ED visit, at an academic tertiary care medical center in Lebanon, between June 2016 and May 2017.Results: LWBS patients were found to be young, males, and present with conditions of lower urgency and presenting mainly with a musculoskeletal chief complaint. Majority (66.8%) left because of third party payer denial of visit coverage followed by cost of visit (12.6%) and wait times (12.6%). A greater percentage of those who LWBS due to financial reasons were male (64.1% vs 33.3%, p <0.001) and waited less (23.4 min vs 30.8 min, p=0.08) compared to those who left for non-financial reasons. The majority of LWBS patients sought medical care within the week after leaving the ED (78.4%), primarily at ambulatory clinics (89.9%) with few at emergency departments (10.1%). Few required admission to hospital (4.2%) and no mortalities were reported. A greater percentage of those who left because of financial barriers, felt the same/better after leaving the ED (82.1% vs 66.7%, p=0.03), sought care at alternate sites (82.1% vs 66.7%, p=0.03), primarily ambulatory clinics (94.1%, p=0.003), with fewer requiring admission to the hospital within one well (1.4% vs 13.3%, p=003). Irrespective of the reason for LWBS, all patients who sought care at an ambulatory clinic, did so at a different institution (100.0%).Conclusion: While the majority of patients who left without being seen from a hybrid POS collection ED left for financial reasons, a high percentage sought care at ambulatory clinics after leaving the ED.  Larger-scale studies are needed to adequately assess the outcomes of those patients, especially in areas with limited access to primary care ambulatory services.&nbsp

The disease spectrum of adult patients at a tertiary care center emergency department in Lebanon.

OBJECTIVE:There is an increase in Emergency Department (ED) utilization globally. Understanding what patients present to EDs with is important for resource allocation, training and staffing purposes. There is paucity of data pertaining to ED visit presentations in Lebanon. This study aims at describing the spectrum of diseases among adult patients who present to a tertiary care center in Lebanon, an upper-middle income country (UMIC). METHODS:A retrospective chart review of adult patients (age ≥ 19) presenting to a tertiary care hospital ED during 2010-2011 was completed. Common diagnoses in three categories (all adult visits, treat and release, admitted visits) were assessed. Diagnoses were classified according to the Clinical Classifications Software. Descriptive statistics were presented in tables as frequencies and percentages. RESULTS:During the study period, 32787 adults presented to the ED with 18.7% resulting in hospital admission. The most common diagnoses in ED patients were injuries and conditions due to external causes, abdominal pain, non-specific chest pain and intestinal infections. In the treat and release group, intestinal infections emerged in the common list for ages 19-44. Coronary atherosclerosis was common in admitted patients aged ≥45 years. Summer was the busiest season, with abdominal pain and intestinal infection being prominent diagnoses during that season. CONCLUSIONS:This study is the first to assess adult ED visits in a Lebanese setting. Our study suggests that patients in our population suffer from the double burden of both communicable and non-communicable disease, with coronary atherosclerosis common in admitted patients (≥ 45 years) and intestinal infections common in treat and release adult patients (19-44years), the latter condition peaking in summer and driving seasonal surges in ED visits

Microcontroller Arduino untuk Pemula : Learning by Doing LED, Relay, LCD, Keypad, Ultrasonic, WI-FI, SMS, GSM, Audio Player, dll

x, 256 hl.; 21 c

Mitigating infodemics: The relationship between news exposure and trust and belief in COVID-19 fake news and social media spreading.

IntroductionMisinformation surrounding COVID-19 poses a global public health problem that adversely affects governments' abilities to mitigate the disease and causes accidental deaths and self-harm due to false beliefs about the virus, prevention measures, vaccines and cures. We aim to examine the relationship between exposure to and trust in COVID-19 news (from Television, social media, interpersonal communication) and information sources (healthcare experts, government, clerics) and belief in COVID-19 myths and false information, as well as critical verification practices before posting on social media.MethodsWe use a cross-sectional researcher-administered phone survey of adults living in Lebanon between March 27 and April 23, 2020.ResultsThe sample included 56.1% men and 43.9% women, 37.9% with a university degree, 63.0% older than 30, and 7% with media literacy training. Those who trust COVID-19 news from social media [95%CI:(1.05-1.52)] and interpersonal communication [95%CI:(1.25-1.82)], and those who trust information from clerics [95%CI:(1.25-1.82)] were more likely to believe in COVID-19 myths and false information. University graduates [95%CI:(0.25-0.51)] and those who trust information from government [95%CI:(0.65-0.89] were less likely to believe in myths and false information. Those who believe in COVID-19 myths and false information [95%CI:(0.25-0.70)] were less likely to engage in critical social media posting practices. Only those who underwent media literacy training [95%CI:(1.24-6.55)] were more likely to engage in critical social media posting practices.ConclusionHigher education and trust in information from government contributed to decreasing belief in COVID-19 myths and false information. Trust in news from social media, interpersonal communication and clerics contributed to increasing belief in COVID-19 myths and false information, which in turn contributed to less critical social media posting practices, thereby exacerbated the infodemic. Media literacy training contributed to increasing critical social media posting practices, thereby played a role in mitigating the infodemic