Reducing Early Hospital Readmission Rates After Bariatric Surgery

The prevalence of 30-day readmission after bariatric surgery is 0.6% to 11.3%, with a single hospital readmission nearly tripling the average 180-day cost of the surgery. Given that nearly 50% of early readmissions are preventable, close postoperative follow-up may allow for early identification of high-risk patients and preventative interventions. This 7-month quality improvement project augmented clinical follow up post-bariatric surgery by incorporating a 7-10 day post-discharge call by an RD following a routine 1-3 day post-discharge call by an APP. Impact on readmission rate was examined. 166 participants included men and women ≥18 years of age, status post primary bariatric surgery only. The proportion of patients experiencing a post-surgery hospital readmission or ED visit was evaluated across the sample, and stratified by procedure type and number of calls answered. Post-project readmission and ED visits were compared to those from the NYP Semi-Annual Report (SAR) using 2-sample tests of proportions. A clear downward trend was noted in the overall readmission rate for project participants (6.5% (SAR) vs. 4.8% (Project)). Readmission rate was related to procedure type: 9.2% (SAR) vs. 7.1% (Project) for post Roux-en-Y gastric bypass, and 5.4% (SAR) vs. 4% (Project), for sleeve gastrectomy. Patients who only connected on the 7-10 day post-discharge call had 0 readmission and post-operation ED visits. Findings here are promising. Additional projects should be conducted on a larger scale and include factors that may place patients in a ‘higher risk’ category for readmission e.g., obstructive sleep apnea, diabetes, depression/anxiety, and history of DVT/PE. Keywords: bariatric surgery, readmission, hospital readmission, sleeve gastrectomy, Roux-en-Y gastric bypass, readmission rates, readmissions, abdominal pain, nausea, vomiting, dehydration, complication

A Study on the Effect of Fabric Structure and Finishing on Perceived Image Quality

Valued at nearly US 7.5 billion, the global textile industry continues on a growth trajectory. Printed textiles represent a major segment of the market, and are making significant contributions to the overall expansion of the industry. Historically, screen printing has dominated the printed textile market, but digital technologies continue to make inroads (Hayward, 2016). One of the problems encountered in the textile industry is obtaining the desired color. Studies have shown that the texture and finishing of a fabric can have an impact on the way the ink sets on the fabric and in turn effect the quality of image. Valentini (2012) concluded in her study that the quality of the image is an important consideration for buyers. However, defining image quality attributes that correlate with the human perception of overall quality can be difficult. Hence, the present study is rooted in the early works of Engeldrum (2004) who stated that image quality depends on the “nesses“ (e.g. colorfulness, lightness, sharpness) rather than on physical image parameters. According to him these “nesses” relate to human perception of quality. Building on Engeldrum’s work, Pederson et al. (2010) formulated a more practical approach by distilling image quality attributes into the five most meaningful (i.e., colorfulness, lightness, contrast, sharpness and artifacts). In addition, Pederson et al. (2010) recommend researchers operationalize overall image quality as a separate construct, recognizing that it encompasses the other five attributes. These have been deployed in the present study. A Likert scale was developed and thirty participants were recruited for a psychophysical experiment. A test form was printed on four fabrics of different texture and sheen combination and the participants were asked to rate these fabrics based on the six image quality attributes. The data obtained was statistically analyzed and the results indicate that a Low Texture and Low Sheen fabric was preferred the most and Image Sharpness is the most effective image attribute for consumers. The study also led to the conclusion that image quality is subjective and observer dependent and also implies that the structural properties of fabrics or substrates can have an impact on the perceived image quality

Passing It Forward: Intervening and Moderating Mechanisms in the Supportive Leadership Cascading Process

Using survey data collected from enlisted soldiers and non-commissioned officers (NCOs) nested in platoons in the U.S. Army, my dissertation examines intervening and moderating mechanisms in the cascading process of supportive leadership. Typically cascading studies focus on influence processes occurring in dyadic settings, neglect to consider boundary conditions, and utilize a group mean approach to analyzing the phenomenon. In my study, however, I find support for a conditional indirect effect of cascading supportive leadership at the group level, such that supportive leadership by groups of upper-level leaders (officers) promotes social cohesion for groups of lower-level leaders (NCOs) under high levels of combat exposure. In turn, lower-level social cohesion is positively linked with supportive leadership by groups of leaders at lower organizational levels. In addition, analyses using within-unit standard deviations of the substantive measures (i.e., strength) indicate that combat exposure strength moderates the relationship between upper-level supportive leadership strength and lower-level social cohesion strength, such that the positive relationship is stronger when combat exposure strength is higher (i.e., when within-unit standard deviation in combat exposure is lower)

DISADVANTAGES OF ANABOLIC STEROID: A CASE STUDY

The word steroid - we all know these are life saving drugs. Steroids have different meanings. Steroids are chemicals, often hormones that your body makes naturally. They help your organs, tissues, and cells do their jobs. Steroids can also refer to man-made medicines. We all know misuse of anything could be fatal. Nowadays anabolic steroids are very common especially in young adults going to gym for making muscles. Gym trainers are giving them steroids by saying and assuring that it will help them to build their muscle and body mass index. In some cases it can become life threatening too. Here in this article I’m going to present such case in which a young boy of just 25 years of age has taken such steroids and lands himself in deep trouble. He was healthy but the moment he joined gym, everything was ruined. He was diagnosed with AVN (Avascular Necrosis) of hip joint. AVN is a deadly pathology in which death of bone tissue occur due to lack of blood supply. Now he is not able to walk on his own and using wheel chair. So this article is basically awareness to young generation who are running behind this stuff and making their life hell

Social Justice as a Prominent Theme in the Novels of Bhabani Bhattacharya

In present scenario, peace is usually taken for granted by many people without going into the details of what made it (Peace) the most cherished ideal of almost all the societies. Its importance has only been realized by the humanity after going through a dreadful phase of history, full of violence, wars, massacres, genocide and so on. Moreover, the meaning of peace is misunderstood by many as mere absence of war; rather it has a wider connotation. Peace is an absence of violent conflicts of all kinds including war, riot, massacre, or simply physical attack. Sometimes, violence is rooted in the very structure of society, which is termed as "Structural Violence". This structural violence can take many shapes such as caste- based violence, class- based violence, ethnic violence, racism, communalism, colonialism etc. The elimination of structural violence necessitates the creation of a just and democratic society. Structural violence emerges out of the unequal and unjust structure of the society. So to eradicate structural violence, a society needs to employ the tool of social justice. This paper is an attempt to understand this structural violence ingrained in Indian social fabric during the independence and the post independence period and to hear its resonance in the novels of Bhabani Bhattacharya. She is an outstanding Indian English writer, globally known brilliant scholar was a socialist and reformist to the core. Almost all his novels are remarkably known as social fables, as contemporary Indian society is very authentically and sensitively represented in his fiction. Bhattacharya was having a profound knowledge of contemporary (from 1945 to 1975) social crisis, as the topic of his research thesis was also related to Indian socio-political perspectives of the time period. Through his novels he proclaims, when justice is denied to any particular person or community or sections of society, the reverse circumstances leads to anarchic situations and the society directly or indirectly becomes responsible for converting its people to social rebels, a threat to national peace and security. Therefore, through his novels, he motivates the countrymen to establish equality and maintain social justice to promote the feelings of love and harmony in different sections of society. To inspire the countrymen for setting up an equal and just social order, he frequently emphasise them to follow the teachings of great ancient minds. He quotes Gandhiji's socialism, marxism, Tagore’s humanism, Nehru’s rationalism, liberalism and practical approach, to create peace and harmony in the society and ensure social justice