Cost per case or total cost? The potential of prevention of hand injuries in young children – Retrospective and prospective studies

<p>Abstract</p> <p>Background</p> <p>Health-care costs for hand and forearm injuries in young children are poorly documented. We examined costs in 533 children injured years 1996–2003.</p> <p>Methods</p> <p>Health-care costs and costs for lost productivity were retrospectively calculated in children from three catchment areas in Sweden. Seven case categories corresponding to alternative prevention strategies were constructed.</p> <p>Results</p> <p>Over time, diminishing number of ward days reduced the health-care cost per case. Among children, the cost of lost productivity due to parental leave was 14 percent of total cost. Fingertip injuries had low median costs but high total costs due to their frequency. Complex injuries by machine or rifle had high costs per case, and despite a low number of cases, total cost was high. Type of injury, surgery and physiotherapy sessions were associated with variations in health-care cost. Low age and ethnic background had a significant effect on number of ward days.</p> <p>Conclusion</p> <p>The costs per hand injury for children were lower compared to adults due to both lower health-care costs and to the fact that parents had comparatively short periods of absence from work. Frequent simple fingertip injuries and rare complex injuries induce high costs for society. Such costs should be related to costs for prevention of these injuries.</p

Multilayered Analyses of the Experiences of Undocumented Latinx College Students

Being the target of constant discrimination and marginalization can often cause intense negative psychological reactions and shame for undocumented students. The following qualitative study describes past and current undocumented Latinx students’ experiences of educational inequality in higher education influenced by labels associated with “being undocumented.” In this study we used a constructivist theoretical perspective which enabled us to focus on undocumented participants’ perspectives, experiences, meaning-making processes, values, and beliefs. Data was collected through hour-long, semi-structured interviews with five undocumented students. Student narratives were analyzed using a multi-layered analysis approach: (1) narrative, (2) thematic, and (3) critical incident analysis. Findings for this study provided insight on the narratives of carrying labels, themes associated with various labels, and critical incidents in the narratives and lives of undocumented students. Through our findings, we are able to contribute to existing literature and provide directions for future research

Academic Problem-Solving and Students’ identities as engineers

Socially constructed identities and language practices influence the ways students perceive themselves as learners, problem solvers, and future professionals. While research has been conducted on individuals’ identity as engineers, less has been written about how the language used during engineering problem solving influences students’ perceptions and their construction of identities as learners and future engineers. This study investigated engineering students’ identities as reflected in their use of language and discourses while engaged in an engineering problem solving activity. We conducted interviews with eight engineering students at a large southeastern university about their approaches to open and closed-ended materials engineering problems. A modification of Gee’s analysis of language-in-use was used to analyze the interviews. We found that pedagogical and engineering problem solving uses of language were the most common. Participants were more likely to perceive themselves as students highlighting the practices, expectations, and language associated with being a student rather than as emerging engineers whose practices are affected by conditions of professional practice. We suggest that problem solving in an academic setting may not encourage students to consider alternative discourses related to industry, professionalism, or creativity; and, consequently, fail to promote connections to social worlds beyond the classroom. By learning about the ways in which language in particular settings produces identities and shapes problem solving practices, educators and engineering professionals can gain deeper understanding of how language shapes the ways students describe themselves as problem-solvers and make decisions about procedures and techniques to solve engineering problems

Why Do Patients Opt for the Emergency Department over Other Care Choices? A Multi-Hospital Analysis

Introduction: There are several options for receiving acute care besides emergency departments (ED), such as primary care physician (PCP) offices, urgent care centers (UCC), and telehealth services. It is unknown whether these alternative modes of care have decreased the number of ED visits for patients or whether they are considered before visiting the ED. A comprehensive study considering all potential methods of care is needed to address the evolving landscape of healthcare. Our goal was to identify any factors or barriers that may have influenced a patient’s choice to visit the ED as opposed to a UCC, PCP, another local ED, or use telehealth services. Methods: We surveyed ED patients between three hospital sites in the greater Buffalo, NY, area. The survey consisted of questions regarding the patients’ reasons and rationale for choosing the ED over the alternative care options. The study also involved a health record review of the patients’ diagnoses, tests/procedures, consults, and final disposition after completion of the survey. Results: Of the 590 patients consented and surveyed, 152 (25.7%) considered seeking care at a UCC, 18 (3.1%) considered telehealth services, and 146 (24.7%) attempted to contact their PCP. On the recommendation of their PCP, patients presented to the ED 110 (20.7%) times and on the recommendation of the clinician at the UCC 54 (9.2%) times. Patients’ perceived seriousness of their condition was the most common reason for their selected mode of transport to the ED and reason for choosing the ED as opposed to alternative care sites (PCP, UCC, telehealth). Based on criteria for an avoidable ED visit, 83 (14.1%) ED patients met these criteria. Conclusion: Individuals prioritize the perceived severity of their condition when deciding where to seek emergency care. While some considered alternatives (PCP, UCC, telehealth services), uncertainties about their condition and recommendations from other clinicians led many to opt for ED care. Our findings suggest a potential gap in understanding the severity of symptoms and determining the most suitable place to seek medical care for these particular conditions

Secondary user relations in emerging mobile computing environments

Mobile technologies are enabling access to information in diverse environ.ments, and are exposing a wider group of individuals to said technology. Therefore, this paper proposes that a wider view of user relations than is usually considered in information systems research is required. Specifically, we examine the potential effects of emerging mobile technologies on end-­‐user relations with a focus on the ‘secondary user’, those who are not intended to interact directly with the technology but are intended consumers of the technology’s output. For illustration, we draw on a study of a U.K. regional Fire and Rescue Service and deconstruct mobile technology use at Fire Service incidents. Our findings provide insights, which suggest that, because of the nature of mobile technologies and their context of use, secondary user relations in such emerging mobile environments are important and need further exploration

Multi-performance optimisation framework for the selection of structural alternatives based on sustainable qualities

In recent years, the increasing demand for innovative sustainable policies in building engineering has shifted the decision rationale from traditional performance-based systems towards systems augmented by life-cycle sustainability notions. This paper investigates a novel optimisation framework, which supports the selection of buildings’ structural alternatives at concept stage by applying multiple performance, sustainable requirements. The established model explores ways to effectively compute and process expert knowledge across different stakeholders groups into a consolidated decision-making platform supported by Lean Theory. A systematic procedure based on the Quality Function Deployment is utilised to successfully translate 16 sustainability requirements into 27 corresponding engineering design requirements. The theoretical and mathematical principles of Analytic Network Process are applied on a pilot study to build general decision clusters, identify feedback links amongst the various engineering criteria and determine their inner dependences