Hospital costs of out-of-hospital cardiac arrest patients treated in intensive care; a single centre evaluation using the national tariff-based system

OBJECTIVES: There is a scarcity of literature reporting hospital costs for treating out of hospital cardiac arrest (OOHCA) survivors, especially within the UK. This is essential for assessment of cost-effectiveness of interventions necessary to allow just allocation of resources within the National Health Service. We set out primarily to calculate costs stratified against hospital survival and neurological outcomes. Secondarily, we estimated cost effectiveness based on estimates of survival and utility from previous studies to calculate costs per quality adjusted life year (QALY). SETTING: We performed a single centre (London) retrospective review of in-hospital costs of patients admitted to the intensive care unit (ICU) following return of spontaneous circulation (ROSC) after OOHCA over 18 months from January 2011 (following widespread introduction of targeted temperature management and primary percutaneous intervention). PARTICIPANTS: Of 69 successive patients admitted over an 18-month period, survival and cerebral performance category (CPC) outcomes were obtained from review of databases and clinical notes. The Trust finance department supplied ICU and hospital costs using the Payment by Results UK system. RESULTS: Of those patients with ROSC admitted to ICU, survival to hospital discharge (any CPC) was 33/69 (48%) with 26/33 survivors in CPC 1–2 at hospital discharge. Cost per survivor to hospital discharge (including total cost of survivors and non-survivors) was £50 000, cost per CPC 1–2 survivor was £65 000. Cost and length of stay of CPC 1–2 patients was considerably lower than CPC 3–4 patients. The majority of the costs (69%) related to intensive care. Estimated cost per CPC 1–2 survivor per QALY was £16 000. CONCLUSIONS: The costs of in-hospital patient care for ICU admissions following ROSC after OOHCA are considerable but within a reasonable threshold when assessed from a QALY perspective

Effects of Preventative Ankle Taping on Planned Change-of-Direction and Reactive Agility Performance and Ankle Muscle Activity in Basketballers

This study investigated the effects of preventative ankle taping on planned change-of-direction and reactive agility performance and peak ankle muscle activity in basketballers. Twenty male basketballers (age = 22.30 ± 3.97 years; height = 1.84 ± 0.09 meters; body mass = 85.96 ± 11.88 kilograms) with no ankle pathologies attended two testing sessions. Within each session, subjects completed six planned and six reactive randomized trials (three to the left and three to the right for each condition) of the Y-shaped agility test, which was recorded by timing lights. In one session, subjects had both ankles un-taped. In the other, both ankles were taped using a modified subtalar sling. Peak tibialis anterior, peroneus longus (PL), peroneus brevis (PB), and soleus muscle activity was recorded for both the inside and outside legs across stance phase during the directional change, which was normalized against 10-meter sprint muscle activity (nEMG). Both the inside and outside cut legs during the change-of-direction step were investigated. Repeated measures ANOVA determined performance time and nEMG differences between un-taped and taped conditions. There were no differences in planned change-of-direction or reactive agility times between the conditions. Inside cut leg PL nEMG decreased when taped for the planned left, reactive left, and reactive right cuts (p = 0.01). Outside leg PB and soleus nEMG increased during the taped planned left cut (p = 0.02). There were no other nEMG changes during the cuts with taping. Taping did not affect change-of-direction or agility performance. Inside leg PL activity was decreased, possibly due to the tape following the line of muscle action. This may reduce the kinetic demand for the PL during cuts. In conclusion, ankle taping did not significantly affect planned change-of-direction or reactive agility performance, and did not demonstrate large changes in activity of the muscle complex in healthy basketballers

Pluralitas Agama dalam Keluarga Jawa

Dalam masyarakat Jawa terdapat pemahaman dan pemaknaan sendiri terhadap agama yaitu â€agami ageming ajiâ€. Artinya apa pun agama yang dipeluk sama saja karena semua agama mengajarkan keselamatan. Oleh sebab itu menjadi sebuah fenomena menarik di kalangan masyarakat Jawa karena mereka cenderung lebih toleran dalam menyikapi perbedaaan dan keragaman beragama. Salah satu contoh masyarakat yang menghargai pluralitas agama adalah masyarakat Desa Getas Kaloran Temanggung. Tujuan penelitian ini adalah untuk menjelaskan tentang sejumlah keluarga yang dapat menerima pluralitas agama dan toleransi terhadap pluralitas agama dalam keluarga Jawa. Tulisan ini merupakan hasil penelitian yang menggunakan pendekatan deskriptif kualitatif. Subyek penelitian adalah masyarakat Desa Getas yang memiliki keragaman agama dalam keluarganya. Berdasarkan hasil penelitian dapat disimpulkan bahwa masyarakat Desa Getas dapat menerima pluralitas agama karena menurut mereka agama adalah urusan pribadi seseorang jadi tidak ada pihak yang dapat memaksakan suatu keyakinan kepada individu lain. Pluralitas agama tersebut tidak menimbulkan masalah berarti karena masyarakat memiliki derajat toleransi yang tinggi antar anggota keluarga, yang ditunjukkan melalui saling menghargai dan mengormati dan tidak mencampuri urusan keagamaan orang lain, serta saling membantu antar anggota keluarga untuk memperlancar kegiatan ibadah masing – masing. In Javanese community there is a specific principle on the meaning of religion, namely â€agami ageming ajiâ€. This pilosophy means whatever religion people believe, it doesn’t matter because they all teach salvation. This is an interesting phenomenon among the Javanese community because they tend to be tolerant in dealing with differences and diversity of religion that happen in one household. The objective of this article is to discuss the practices of religious tolerance found in a rural community of Getas, Kaloran, Temanggung Central Java. Techniques of data collection is done by interviews and observation. The study subjects were villagers of Getas, which has a diversity of religion in families. Based on the research results, it can be concluded that the villagers embrace a tradition of religious pluralism because they think religion is one’s personal affairs so that no party can impose a conviction for another individual. The plurality of religion does not cause significant problems because the public has a high degree of tolerance among family members, which is demonstrated through mutual respect and attitude not to interfere in religious affairs of others, and mutual help among family members to facilitate the worship activities of their relatives

Analysis of Total and Segmental Body Composition Relative to Fitness Performance Measures in Law Enforcement Recruits

International Journal of Exercise Science 15(4): 245-260, 2022. Law enforcement agencies often test the fitness performance and body composition of incoming recruits. This study investigated the relationships between whole and segmental body composition, and fitness tests in law enforcement recruits. A retrospective analysis of 72 male and 11 female recruits was performed. Bioelectrical impedance analysis (BIA) variables were: lean mass (LM), upper-extremity lean mass (UELM), trunk LM, lower-extremity lean mass (LELM), fat mass (FM), upper-extremity fat mass (UEFM), trunk FM, and lower-extremity fat mass (LEFM). Fitness tests included: vertical jump (VJ), peak anaerobic power (PAPw), 75-yard pursuit run (75PR), push-ups, sit-ups, 2-kg medicine ball throw (MBT), and the multi-stage fitness test (MSFT). Partial correlations and ANCOVAs between quartiles assessed relationships between body composition and performance. Significant moderate-to-large relationships were found; LM, UELM, trunk LM, LELM all related to PAPw (r = 0.500-0.558) and MBT (r = 0.494-0.526). FM, UEFM, trunk FM, LEFM all related to VJ (r = -0.481 to -0.493), 75PR (r = 0.533-0.557), push-ups (r = -0.484 to -0.503), sit-ups (r = -0.435 to -0.449), and MSFT (r = -0.371 to -0.423). The highest LM quartile (4) had superior PAPw and MBT than LM quartiles 1-3. Higher FM quartiles performed poorer in VJ, push-ups, and sit-ups. The 75PR quartiles 2, 3, and 4 were slower than quartile 1, and MSFT quartile 4 completed less shuttles. Total and segmental measures of LM and FM shared the same relationships; lower FM and higher LM related to better performance. Monitoring body composition could help guide training to optimize performance

Hungry for change: the Sydney Food Fairness Alliance

The Sydney Food Fairness Alliance is one of a growing number of nascent food movements in Australia to have emerged out of concern for the country’s food future, as well as the deleterious effect the present food system is having on its citizens’ health and the continent’s fragile environment. The Alliance’s structure and activities clearly position it as a new social movement (NSM) engaged in collective action on a specific issue, in this instance, food security/justice, and operating outside the political sphere while aiming to influence and affect societal change. Food security as a human right lies at the heart of the Alliance’s philosophy, and equitable, sustainable food policies for New South Wales are a core focus of its advocacy work. The authors argue that the Alliance is a distinctive food movement in that it positions itself as an \u27umbrella\u27 organization representing a wide range of stakeholders in the food system. This chapter reflects on the values, achievements, issues of concern, strengths and weaknesses, and future of the Sydney Food Fairness Alliance. This resource is Chapter 8 in \u27Food Security in Australia: Challenges and Prospects for the Future\u27 published by Springer in 2013

Reducing green tape or rolling back IA in Australia: What are found jurisdictions up to?

EIA has been practiced in Australia and the rest of the world for over 40 years, but despite its successes, EIA may now be facing its biggest challenge since it came into being in 1970 with the US National Environmental Policy Act. As Morgan (2012, 11) notes: “As governments look to stimulate economic growth and create employment in response to the current financial crisis, many are promoting a major expansion of physical infrastructure, encouraging resource development projects, and generally seeking to speed decision-making about development projects. Both EIA and SEA should be even more important in such circumstances, yet the moves taken in some countries to speed up decision-making may weaken the provisions for environmental protection, including impact assessment.” In this political and economic environment, EIA is under scrutiny. Proposed changes to the EU directive on EIA released in October 2012 contain ten changes to the Articles of the Directive, with six of these referring to either ‘streamlining’ EIA or introducing specific timeframes for parts of the EIA process (European Commission 2012). This scrutiny has not been restricted to economies in recession, but includes those that have avoided recession because of strong resources sectors. The same appears to be happening in Australia, and this paper reports on these and other possible ‘efficiency’ changes to EIA in Australia at both national and sub-national levels. We attempt to critically examine the nature of such changes and the risks that may be associated with their implementation. Changes to three of the sub-national EIA processes are reviewed in detail, as well as the proposed changes to the national EIA process. There is always room for more timely assessments, but a critical examination of the potential consequences of these “reforms” on the conduct of EIAs is needed, including whether these efficiency changes will deliver sound environmental management and sustainability-oriented decision-making