Sur les chemins de l'émancipation. Le pari de l'égalité

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Implementation of Oncology Standardized Scheduling Bundle Impacting Staff Productivity and Patient Satisfaction

BACKGROUND: Patients having timelyaccess to healthcare services is the entryway to quality of care and patient safety. Timely access is essential in cancer treatment and often requires complex scheduling requiring multiple, highly coordinated, time sensitive appointments. To facilitate optimal clinical care, timely appointment scheduling must be patient-centered. With the heavy scheduling workload growing at the the Cancer Network at Froedtert & the Medical College of Wisconsin and recognition of timely scheduling as a quality indicator, the need to examine the workflow and improve the process became apparent. METHODS: The goal of the quality improvement project was to provide patients with individualized and timely scheduling of appointments. The development and implementation of a standardized oncology scheduling bundle began with a SWOT analysis and the use of Donebedian Model to organize the improvement process. A scheduling bundle that included consistent scheduling practices and staff education to drive patient satisfaction scares and scheduling staff productivity metrics was developed. As well, a productivity dashboard was developed. RESULTS: The implementation of a standardized oncology scheduling bundle showed positive results with both quantative and qualitative metrics. There was positive shift in average scheduling staff productivity and staff turnover decreased pre and post implementation. Additionally, there was positive changes in feedback from patients, staff, and physicians. CONCLUSION: With the implementation of the standardized oncology scheduling bundle, patients are receiving timely, optimal, individualized clinical care. Additionally, there is now a standardized process for scheduling staff creating efficient and effective workflows

Treatment of Pectus Carinatum via Telemedicine

Pectus carinatum is a chest wall condition characterized by abnormal protrusion of the sternum and costal cartilages outward. Surgery had been the gold standard for treatment for a long time, but a non-operative approach to treatment with the use of a compression brace has proven to be highly successful and is now the treatment of choice for patients with pectus carinatum. The COVID-19 pandemic resulted in the cancellation of bracing clinics for pectus carinatum patients, resulting in delayed treatment. A review of literature demonstrated the importance of patient compliance and routine follow up as well as the benefits of telemedicine for both the patients and the providers, including convenience and decreased exposure to communicable diseases. The aim of this study is to develop an alternative to in person clinic visits that can be used especially during times of unexpected events or disasters that would prevent patients from being seen in the office. This pilot study focused on the development and implementation of a telemedicine program for pectus carinatum patients undergoing treatment with a compression brace. An educational handout, a script for a demonstration video, and a sample tool kit for patients were developed to help guide and launce a telemedicine program for pectus carinatum patients. Thirteen patients participated in telemedicine appointments and feedback from patients and providers was obtained through anonymous surveys. Overall, patients and providers reported that they were highly satisfied with the telemedicine program, especially as an alternative solution when they were unable to have an in person appointment. It was found that a telemedicine program would decrease interruptions and delay in care by offering patients an option to continue care virtually

The Effect of Yoga and Breathing Exercises on Children with Autism

The purpose of this case study was to determine the effects of yoga and breathing exercises on children with Autism Spectrum Disorder (ASD). Common characteristics of children with ASD were noted and observed throughout the study in order to determine effectiveness of the therapy at hand. Yoga therapy was implemented for nine (9) weeks through an at-home program. It was determined that, while long-term effects were not evident, there is reasonable evidence to implement yoga therapy to assist with focus and attention. This paper serves to review characteristics of children with ASD, typical therapies used to assist them and the effectiveness of yoga and breathing therapies. This research can assist professionals and parents of children with ASD to determine what non-traditional therapies may be useful for their child, as well as serve as a platform for further research into yoga and breathing therapies

Does Hydration Status Have An Effect on Wrestling Performance in High School Wrestlers?

Context. Hydration is important for all athletes not only for overall health, but for optimal performance during competition. Many studies have shown a relationship between a decrease in physiological function and performance as related to dehydration typically by measuring peak power output and aerobic capacity. But few studies have shown the relationship between hydration or dehydration and the performance of wrestlers throughout a competitive season. Objective. The purposes of this study were to determine: (1) if there is a difference between hydration levels over three time points between a high specific gravity group and a low specific gravity group; (2) if those who have the lower average specific gravity have a higher win percentage and; (3) if those who have a lower average specific gravity earn more team points throughout a competitive season. Design. This study was a longitudinal prospective comparative study. The independent variables for the first design were the three time points measured; baseline, 24-hours pre-competition (24PC), and pre-competition (PC), and a high average specific gravity group (HSG, \u3e1.02) and a low average specific gravity group (LSG, ≤1.02). The dependent variable was the specific gravity. The second design independent variable was based on two groups: HSG and LSG. The dependent variable was win percentage. The independent variable for the third purpose was based on two groups as well: HSG and LSG. The dependent variable was team points earned by the wrestler. Setting. The study took place at a Division AAA high school in Western Pennsylvania. Patients or other participants . Voluntary high school wrestlers between the ages of 14 and 18 (16.53+/-1.41 yrs) and grades 9--12 were used for the study. Subjects were excluded from the study if they did not participate in at least 75% of matches throughout the competitive season. Interventions. Specific gravity of urine and body weight was measured at baseline, 24 hours before a competition and then again the day of the competition, 2--3 hours before the start of the first match for home matches. For away competitions specific gravity was measured before the bus left for the match. Win percentages were calculated from dual meets as well as the first day of tournaments. Team points based on performance were measured on the outcome of each individuals match during dual meets as well as the first day of tournaments. Main outcome measures . The investigator believed that specific gravity would change over time with the LSG showing less variability than HSG. Those athletes in the LSG (i.e. more hydrated) will show a higher win percentage and earn more team points during those matches. Results. There was a significant time by group interaction (P=.005), for the HSG at baseline (P=.045) and HSG at 24PC (P=.004). A main effect for time (P\u3c.001) for all 3 time points: baseline to 24PC (P\u3c.001), baseline to PC (P\u3c.001), and 24PC to PC (P=.041). LSG had an average team point total of 14.33+/-7.74. HSG had an average team point total of 32+/-14.34. There was a significant difference between the two groups (P=.024) with HSG earning more team points. All other results showed no significance. Conclusions. The results of this study show a group by time interaction at baseline and 24PC with HSG being lower at baseline but higher at 24PC. A main effect for time showed specific gravity does change significantly from baseline to 24PC, baseline to PC, and 24PC to PC, and is significantly higher 24PC and PC than baseline. Also there was a significant difference between the groups for team points. However, HSG scored significantly more team points than LSG. There was no significant difference measured between groups when compared to win percentages

The Role of Mindfulness in Academic Stress, Self-Efficacy, and Achievement in College Students

This study was designed to assess the predictive quality of specific measures toward academic success in college students. In particular, high school grade point average, (GPA), American College Testing exam scores (ACT), academic stress, academic self-efficacy, and mindfulness measures were used as independent variables to determine their predictive significance toward undergraduate fall 2010 semester GPAs. Data from 268 undergraduate students at Midwestern university were collected and analyzed. Results revealed significant predictive quality of high school GPA and academic self-efficacy toward undergraduate performance. However, ACT scores, academic stress, and mindfulness measures were not found to be predictive of undergraduate semester GPAs. Further analysis showed significant positive correlations between: high school GPA and semester GPA; self-efficacy and semester GPA, ACT and semester GPA, ACT and high school GPA, self-efficacy and stress, and mindfulness and stress

The Role of Mindfulness in Academic Stress, Self-Efficacy, and Achievement in College Students

This study was designed to assess the predictive quality of specific measures toward academic success in college students. In particular, high school grade point average, (GPA), American College Testing exam scores (ACT), academic stress, academic self-efficacy, and mindfulness measures were used as independent variables to determine their predictive significance toward undergraduate fall 2010 semester GPAs. Data from 268 undergraduate students at Midwestern university were collected and analyzed. Results revealed significant predictive quality of high school GPA and academic self-efficacy toward undergraduate performance. However, ACT scores, academic stress, and mindfulness measures were not found to be predictive of undergraduate semester GPAs. Further analysis showed significant positive correlations between: high school GPA and semester GPA; self-efficacy and semester GPA, ACT and semester GPA, ACT and high school GPA, self-efficacy and stress, and mindfulness and stress

The Relationship between Financial Literacy, Financial Status, and Academic Success in College Students

As the cost of college continues to rise, an increasing number of students are relying on loans and credit cards to fund their postsecondary education. In an effort to curb student debt and increase retention and graduation rates, many universities have begun to offer financial literacy initiatives to stimulate financial knowledge and promote positive money management behaviors. This study examines the relationship between a for-credit personal financial literacy course and student academic success and economic status. Students who took a personal finance course during their first or second year of college are compared to a random sampling of students who did not take the course. Using archival data, this quantitative study measures retention and graduation rates, college GPA, and loan amounts for between and within group differences. Significant differences were found between the two groups on first- and second-year retention rates, four-year graduation rates, and final college GPA. Students who took the personal finance course were 11.7% more likely to return to the university after their first year of college as compared to those who did not take the course. Second-year retention rates also were higher for the finance course condition students (88%) as compared to non-finance course students (66%). Mean college GPA was significantly higher for finance course participants (3.24) at the end of their last semester of enrollmen

Free jet feasibility study of a thermal acoustic shield concept for AST/VCE application: Dual stream nozzles

The influence of selected geometric and aerodynamic flow variables of an unsuppressed coannular plug nozzle and a coannular plug nozzle with a 20-chute outer stream suppressor were experimentally determined. A total of 136 static and simulated flight acoustic test points were conducted with 9 scale model nozzles. Also, aerodynamic measurements of four selected plumes were made with a laser velocimeter. The presence of the 180 deg shield produced different mixing characteristics on the shield side compared to the unshield side because of the reduced mixing with ambient air on the shielded side. This resulted in a stretching of the jet, yielding a higher peak mean velocity up to a length of 10 equivalent diameters from the nozzle exit. The 180 deg shield in community orientation around the suppressed coannular plug nozzle yielded acoustic benefit at all observer angles for a simulated takeoff. While the effect of shield-to-outer stream velocity ratio was small at angles up to 120 deg, beyond this angle significant acoustic benefit was realized with a shield-to-outer stream velocity ratio of 0.64