Data Mining and Associated Analytical Tools as Decision Aids for Healthcare practitioners in Vascular Surgery

Vascular surgery is an increasingly data rich speciality. Planning treatment and assessing outcomes are highly dependent on objective assessment of number of imaging modalities including duplex ultrasound, CT scans and angiograms which are almost exclusively digitally created stored and accessed. Developments such as the national vascular registry mean that treatment outcomes are recorded scrutinised electronically. The widespread availability of data which is collected electronically and stored for future clinical use has created the opportunity to examine the efficacy of investigations and treatments in a way which has hitherto not been possible. In addition, new computational methods for data analysis have provided the opportunity for the clinicians and researchers to utilise this data to address pertinent clinical questions

The effects of the NHS reforms on quality of care

The Health and Social Care Act 2012 (HSCA2012) has altered the operational and business environment in which NHS trusts in England operate. The Shelford group is one of the leading multi-specialty NHS trusts in England. The aim of this study was to assess the impact of HSCA2012 on the quality of care provided by the group. Annual quality of accounts produced by each of the Shelford group trusts for financial years (FYs) 2012–13, 2013–14 and FY 2014-15 were reviewed. The key performance indicators (KPIs) for each organisation were collected and classified in line with NHS Quality and Outcomes Framework (QOF). KPIs for the period just prior to enactment of HSCA2012 (FY2012–13) were compared with the corresponding values for the period after the enactment of HSCA2012. The benchmarking model used in the study was validated against the Hospital Intelligent Monitoring Report used by the Care Quality Commission. The clinical services provided by the group increased year on year by 7.5%, 6.4% and 4% respectively. In the FY2014–15, the group collectively provided 14 735 000 patient care episodes There was no significant difference in the value of the KPIs before and after enactment of HSCA2012 along the six domains defined by the QOF. Good correlation was observed between the benchmarking method used in the study compared with the HIMR (r2 = 0.86). The quality of care provided by the group did not change following enactment of HSCA2012

Identificando os componentes da gestão de talentos na organização aduaneira do Irã pelo método delphi-fuzzy (estudo de caso)

Talent management is a system for identifying, upbringing, promoting, and preserving talented persons to optimize the capability of an organization to come up with optimal business results. Nowadays, the developing talent management is one of the most important business factors, which is considered as one of the key components to maintain a sustainable competitive advantage in organizations. the purpose of this study was to identify the components of talent management in the custom organization so that its implementation will be expedited. Considering various advantages of Fuzzy Delphi, we opted this method in conducting the study (The most important advantage is its greater accuracy than classical Delphi). Twenty persons were chosen as experts through a snowball sampling method. At the first step, 139 components were proposed based on previously reported through interviews, suggested to experts that, after four phases of deactivation, 54 indicators and components that were more relevant to the experts remained. In this study, we used a modified Three-branch model of Dr Mirzai Ahranjani (2005) (Of course, we also added a perceptual/cognitive branch that our model has a circular layer of four) to present a talent management model. The results of the research show that the behavioral/functional components in the final analytical model have the largest share.La gestión del talento es un sistema para identificar, educar, promover y preservar a las personas con talento para optimizar la capacidad de una organización y obtener resultados empresariales óptimos. Hoy en día, el desarrollo de la gestión del talento es uno de los factores empresariales más importantes, que se considera como un componente clave para mantener una ventaja competitiva sostenible en las organizaciones. El propósito de este estudio fue identificar los componentes de la gestión del talento en la organización personalizada para que su implementación se agilice. Teniendo en cuenta las diversas ventajas de Fuzzy Delphi, optamos por este método para realizar el estudio (la ventaja más importante es su mayor precisión que la clásica Delphi). Veinte personas fueron elegidas como expertos a través de un método de muestreo de bola de nieve. En el primer paso, se propusieron 139 componentes basados en entrevistas anteriores, y se sugirió a los expertos que, después de cuatro fases de desactivación, quedaban 54 indicadores y componentes que eran más relevantes para los expertos. En este estudio, utilizamos un modelo modificado de tres ramas del Dr. Mirzai Ahranjani (2005) (Por supuesto, también agregamos una rama perceptiva / cognitiva que nuestro modelo tiene una capa circular de cuatro) para presentar un modelo de gestión del talento. Los resultados de la investigación muestran que los componentes de comportamiento / funcionales en el modelo analítico final tienen la mayor participación.O gerenciamento de talentos é um sistema para identificar, criar, promover e preservar pessoas talentosas para otimizar a capacidade de uma organização de obter resultados comerciais ideais. Hoje em dia, o desenvolvimento de gestão de talentos é um dos fatores de negócios mais importantes, considerado um dos principais componentes para manter uma vantagem competitiva sustentável nas organizações. O objetivo deste estudo foi identificar os componentes do gerenciamento de talentos na organização personalizada para que sua implementação seja acelerada. Considerando várias vantagens do Fuzzy Delphi, optamos por este método na condução do estudo (a vantagem mais importante é a sua maior precisão do que o Delphi clássico). Vinte pessoas foram escolhidas como especialistas por meio de um método de amostragem de bolas de neve. Na primeira etapa, 139 componentes foram propostos com base em entrevistas previamente reportadas, sugeridas a especialistas que, após quatro fases de desativação, restavam 54 indicadores e componentes mais relevantes para os especialistas. Neste estudo, usamos um modelo de três ramos modificado do Dr. Mirzai Ahranjani (2005) (claro, também adicionamos um ramo perceptivo / cognitivo que nosso modelo tem uma camada circular de quatro) para apresentar um modelo de gestão de talentos. Os resultados da pesquisa mostram que os componentes comportamentais / funcionais no modelo analítico final têm a maior participação

Demographics of Scorpion Sting in Iran; a Cross Sectional Study

Introduction: Scorpion sting is an important public health problem in some countries, including Iran. This study aimed to describe the demographics of a large number of these victims in some endemic areas of Iran.Methods: This cross-sectional study evaluated baseline characteristics, clinical findings, management, and disposition of scorpion stung cases in 26 cities of 4 provinces in the southwest quarter of Iran, during one year. Results: 3008 cases of scorpion sting with mean age of 27.07 ± 16.58 years were studied (51.3% female). The mean time from sting to hospital was 1.89 ± 1.04 hours. No first aid measures had been taken in 96.6% of cases. Lower (39.5%) and upper (35.7%) extremities were stung most frequently. Midnight to 6:00 am was the period of time most of stings occurred (34.2%). Local pain (77.2%) and erythema (63.5) were among the most common signs and symptoms. 2026 (67.3%) victims had been discharged; 326 (10.8%) were admitted or referred to other hospitals and 5 (0.2%) cases died.Conclusion: It seems that demographic characteristics of scorpion sting in Iran are not so different from those reported from other sites of the world, as signs and symptoms of local and systemic envenomations. Victims, companions, and healthcare providers perform many futile and maybe harmful measures and there is a need to educate all about all of these details

Evaluation of the concavity depth and inclination in jaws using CBCT

Introduction: Nowadays, using implants as a choice in patient's treatment plans has become popular. The aim of this study was to determine the prevalence of mandibular lingual and maxillary buccal concavity, mean concavity depth and angle and its relation to age and gender. Materials &Methods: In 200 CBCT, concavity depth and angle were measured in 2 mm superior to the inferior alveolar canal in the mandibular first molar area and in 1 mm distance from nasal floor in the midpoint region of maxillary lateral incisor and canine. Concavity depth and angle relationships with age and gender have been evaluated using Spearman Correlation and a t-test. Results: Mean and standard deviation of lingual concavity, concavity angle and ridge angle in mandible were 1.3±1.54 mm, 15.45±16.19 and 10.13±6.1. Mean and standard deviation of buccal concavity and concavity angle in maxilla were 5.35±1.03 mm and 30.6±5.75. Mandibular concavity depth was zero in 44% of subjects and more than zero in 56%. Results were more than 3 mm in maxillary samples. There was a linear relationship between mandibular concavity depth and age equaled to -0.27, p=0.007 and for mandibular concavity angle and age equaled to -0.25, p=0.01. There was no significant relationship between mandibular ridge angle and age. In maxilla, there was no linear relationship between age and gender with any other variables. Conclusion: It is necessary to provide more information on these regions' anatomy using CBCT cross sections before implant placement

Use of a Javid™ shunt in the management of axillary artery injury as a complication of fracture of the surgical neck of the humerus: a case report

<p>Abstract</p> <p>Introduction</p> <p>Axillary artery injury is a rare but severe complication of fractures of the surgical neck of the humerus.</p> <p>Case presentation</p> <p>We present a case of axillary artery pseudoaneurysm secondary to such a fracture, in a 82-year-old white woman, presenting 10 weeks after the initial injury, successfully treated with subclavian to brachial reversed vein bypass together with simultaneous open reduction and internal fixation of the fracture. We discuss the use of a Javid™ shunt during combined upper limb revascularisation and open reduction and internal fixation of the fractured humerus.</p> <p>Conclusion</p> <p>This case highlights the usefulness of a Javid™ shunt, over other forms of vascular shunts, in prompt restoration of blood flow to effect limb salvage. It can be considered as a temporary measure whilst awaiting definitive revascularisation which can be performed following fracture fixation.</p

Evaluation of overall survival and disease-free survival of adjuvant chemotherapy and hormone therapy in patients with breast cancer

Abstract : Background: This study evaluated the effect of adjuvant chemotherapy and hormone therapy on overall survival and disease-free survival in patients with breast cancer with hormone receptor-positive, HER2-negative tumor without lymph node involvement. Methods: Breast cancer patients with hormone receptor-positive, HER2-negative, and no lymph node involvement were included in this retrospective cohort study. Patient records were used to collect data on sex, age, time of disease onset, tumor subtype, tumor size, grade, lymphovascular and perineural involvement, ki67, and treatment protocols. Patients were divided into 2 groups: Patients who received both adjuvant chemotherapy and hormonal therapy and patients who received hormonal therapy only. Disease-free survival index (DFS) and overall survival index (OS) were evaluated. Results: Sixty-seven female patients were enrolled in this study. Of them, 68.2% received both adjuvant chemotherapy and hormonal therapy and 31.6% received hormonal therapy only. During follow-up, recurrences occurred in 8 patients. The 3-year and 5-year DFS were 93.4% and 90%, respectively. The 3-year and 5-year DFS were 94% and 92%, respectively, in patients who received both adjuvant chemotherapy and hormonal therapy, and 91% and 85%, respectively, in patients who received hormonal therapy. None of the factors studied affected the 3-year and 5-year DFS. The 3-year and 5-year DFS OS were 98.6% and 96.9%, respectively CONCLUSION: Adjuvant chemotherapy in patients with breast cancer with hormone receptor-positive, HER2-negative, and no lymph node involvement compared with similar patients receiving hormone therapy alone had no significant difference in disease-free survival index and overall survival index. Keywords: breast cancer; disease-free survival index; overall survival inde

Effects of the NHS reforms on financial sustainability

The Health and Social Care Act of 2012 (HSCA2012) has transformed the operational and business environment within which NHS trusts in England operate. The Shelford Group is the leading multi-specialty NHS trusts in England. The aim of this study was to assess the impact of HSCA2012 on the financial position of the Shelford Group of NHS trusts. The annual account statements produced by each of the trusts for financial years (FY) 2011–12; 2012–13; 2013–14 and 2014–15 were reviewed and the key financial indicators (KFIs) for each organisation were collected. KFIs for the period just prior to enactment of HSCA2012 (FY2011–12, FY2012–13) were compared with the corresponding values for the period after the enactment of HSCA2012. The clinical services provided by the Shelford Group increased year on year by 10.6%, 7.5% and 4% respectively as did their combined annual income. In FY2014–15, the Shelford Group collectively provided 14 735 000 patient care episodes and reported a combined annual income of £9 672 066 000. There was no significant difference in the median operating surplus returned by the Shelford Group before and after HSCA2012; despite this, 5 of the 10 Shelford Group members delivered an operational deficit in FY 2014–15. The level of financial liabilities and total capital employed remained stable. There were significant improvements in total assets employed in the Shelford Group in the 2 years after the enactment of HSCA2012 compared to before. The financial standing of Shelford Group trusts has not been adversely affected by the enactment of HSCA2012, although there was some evidence that the operational finances of these NHS trusts were less robust in FY 2014–15 than previous years