Efficiency estimation on the use of elective surgical theaters in the Chilean public health system from 2018 to 2021

OBjECTivE The efficient use of wards intended for elective surgeries is essential to resolve cases on the surgical waiting list. This study aims to estimate the efficiency of ward use in the Chilean public health system between 2018 and 2021.METHoDS The design was an ecological study. Section A.21 of the database constructed by the monthly statistical summaries that each public health network facility reported to the Ministry of Health between 2018 and 2021 was analyzed. Data from subsections A, E, and F were extracted: ward staffing, total elective surgeries by specialty, number, and causes of cancelation of elective sur-geries. Then, the surgical performance during working hours and the percentage of hourly oc-cupancy for a working day was estimated. Additionally, an analysis was made by region with data from 2021.RESulTS The percentage of elective wards relative to staffed wards ranged from 81.1% to 94.1%, while those enabled in relation to staffed wards ranged from 70.5% to 90.4% during 2018 and 2021. The total number of surgeries was highest in 2019 (n = 416 339), but for 2018, 2020, and 2021 it ranged from 259 000 to 297 000. Cancelations ranged between 10.8% (2019) and 6.9% (2021), with the leading cause being patient-related. When analyzing the number of cases canceled monthly by facility, we saw that the leading cause was trade union-related. The maximum throughput of a ward intended for elective surgery was reached in 2019 with 2.5 surgeries;in 2018, 2020, and 2021, the throughput was around two surgeries per enabled ward for elective surgery. The percentage of ward time occupied during working hours as compared to a contract day ranged from 80.7% (2018) and 56.8% (2020). CoNCluSioNS All the parameters found and estimated in this study show an inefficient utilization of operating rooms in Chilean public healthcare facilities.

Sense of Community among Event Stakeholders during the COVID-19 Pandemic: The Case of the Illinois Marathon

This study investigated the ways in which event stakeholders perceived and actively secured their sense of community (SOC) in the wake of an event cancellation during the COVID-19 pandemic. We conducted document analysis and semi-structured interviews with 31 event stakeholders, including 14 runners, 9 volunteers, 4 business owners, and 4 charitable organization managers. Findings revealed that SOC among event stakeholders went through three key stages: leaving a hole in the community, getting a glimpse of normalcy, and living in a new normal. The findings extend the existing literature that has mainly focused on how hosting sport events contributes to SOC, rather than on SOC related to event cancellation, by highlighting how personal and contextual factors contribute to the unique trajectory of SOC among event stakeholders. This study also proposes strategies for keeping socially connected in the absence of in-person sport events, such as increasing media outlets and using interactive apps. © 2023 Global Alliance of Marketing & Management Associations (GAMMA).

Adaptive Noise Cancellation Using a Fully Connected Network: A Lesson Learned

Ambient noise causes annoying difficulty for listeners, especially in online learning and work-from-home environments such as during the COVID-19 pandemic. The aim of this work was to employ the neural network to mitigate such ambient noise in the online environment. The software was designed, implemented, and tested on 4 types of noise. The algorithm used was a fully connected network. The results indicated that the standard fully connected network might not be an effective solution for a specific situation. Nonetheless, the processing time was very low, making it possible for real-time application on standalone devices. The implementation using leaky ReLu, creating leaky networks, offered slightly better results in English speeches, i.e. an average of 1.382 and 0.4389 in the PESQ and STOI, respectively. The Thai leaky networks, on another hand, exhibited an average of 3.111 and 0.7096 in PESQ and STOI, respectively. © 2022 IEEE.

Fiscal Space Policies for Sustainable Development and Debt Relief: Empirical Analysis in West African Countries

The uncertainty that the COVID-19 pandemic has brought demonstrates that income redistribution and traditional debt relief mechanisms are insufficient to meet public spending needs, mitigate external debt, and comply with the UN's Sustainable Development Goals (SDGs), which aim to reduce multilateral debt to sustainable levels. Also, West African countries have focused their attention on the long-term fight against poverty and inequality and strengthening their social programs, especially in primary health care and macroeconomic stability. However, for more than a decade, the developing and least developed countries of West Africa have faced rapidly weakening macroeconomic conditions, combining several interrelated crises such as the sharp decline in oil prices, volatile financial markets and tourism disruptions, a global recession, the crisis of climate change, and shortages of food and energy, along with the economic contraction of COVID-19. Data from these countries show that health spending increases economic growth, minimizes infant mortality rates, and reduces debt. Furthermore, increasing government spending efficiency reduces the total debt and improves the health sector, in particular.

Retrospective analysis of the one-year surgical deferral of the COVID-19 pandemic.

Introduction: surgical deferral since the beginning of the COVID-19 pandemic represents a risk to the health of patients and a challenge for health institutions. The metric of productivity indicators in the operating room, such as the surgical deferral rate, will provide us with information to plan strategies based on scientific evidence that allow us to improve the quality of care. Objective: to determine the surgical deferral rate during the COVID-19 pandemic. Material and methods: a retrospective, descriptive and cross-sectional study was carried out in which 297 patients whose surgeries were deferred during the period from March 11, 2020 to March 10, 2021 were analyzed. Descriptive statistics were employed, using measures of central tendency and dispersion, simple frequencies and proportions. Additionally, a Pareto diagram was made. The information was processed with SPSS v-25.0. Results: the deferral rate was 7.34%. 20.92% of the causes were attributed to the patient, 31.65% to medical causes and 47.49% logistic-administrative. Conclusion: the established causes of surgical deferral are avoidable and reveal failures in the logistical-administrative processes that require continuous improvement plans. (English) [ FROM AUTHOR] Introducción: el diferimiento quirúrgico desde el inicio de la pandemia COVID-19 representa un riesgo para la salud de los pacientes y un reto para las instituciones sanitarias. La métrica de indicadores de productividad en quirófano, como la tasa de diferimiento quirúrgico, nos brindará información para planear estrategias basadas en evidencia científica que nos permitan mejorar la calidad de la atención. Objetivo: determinar la tasa de diferimiento quirúrgico durante la pandemia COVID-19. Material y métodos: se realizó un estudio, retrospectivo, descriptivo y transversal en el que se analizaron 297 pacientes cuyas cirugías fueron diferidas durante el período comprendido del 11 de marzo de 2020 al 10 de marzo de 2021. Para el análisis de variables se efectuó estadística descriptiva, utilizando medidas de tendencia central y dispersión, frecuencias simples y proporciones. Adicionalmente se realizó un diagrama de Pareto. La información fue procesada con SPSS v-25.0. Resultados: la proporción de diferimiento fue de 7.34%;20.92% de las causas fueron atribuidas al paciente, 31.65% a causas médicas y 47.49% fueron logísticoadministrativas. Conclusión: las causas de diferimiento quirúrgico establecidas son evitables y revelan fracasos en los procesos logístico-administrativos que requieren planes de mejora continua. (Spanish) [ FROM AUTHOR] Copyright of Revista Mexicana de Anestesiologia is the property of Colegio Mexicano de Anestesiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Participatory sport events in times of COVID-19: Analysing the (virtual) sport behaviour of event participants

Research question: Due to government restrictions because of COVID-19, all participatory sport events (PSEs) were cancelled. As a result, knowledge is needed as to how and to what extent participants of PSEs modified their sport behaviour to fill the void of event cancellation. Therefore, this study aimed to (1) investigate to what extent event participants have modified their sport behaviour as a result of the COVID-19 measures, and (2) analyse the factors that determine participation in virtual events (real activities using an online recording platform). Research methods: A total of 2869 respondents completed an online survey which was widely disseminated in Flanders (Belgium) six weeks after the announcement of the COVID-19 lockdown. The sample included both event and non-event participants. Descriptive and binary logistic regression analyses were used to investigate how event participants adapted their sport behaviour and which factors determined virtual event participation. Results and findings: Since the COVID-19 measures, event participants did not decrease the frequency but only the intensity of their sport behaviour. Based on social ecological theory, participation in virtual events could be explained by both individual determinants (e.g. motivation towards developing skills), and interpersonal determinants (e.g. previous participation in a virtual event). Implications: This study contributes to research on the impact of COVID-19 measures and consequently the cancellation of PSEs on sport behaviour of event participants. Confronted with an uncertain future, the findings provide insights for event organisers to develop and optimise virtual event experiences in order to reach non-event participants as well. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

A comparative analysis of outpatient nutrition clinic scheduling outcomes based on in-person and telehealth patient care delivery modalities.

During the start of the global COVID-19 pandemic in March 2020, patient care modalities changed from in-person to telehealth to comply with physical distancing guidelines. Our study uniquely examines operations data from three distinct periods: before the transition to telehealth, early transition from in-person care to telehealth, and the eventual adoption of telehealth. We present a comparative analysis of outpatient nutrition clinic scheduling outcomes based on care delivery modality. We used descriptive statistics to report means and variance and frequencies. We used inferential statistics to make comparisons: categorical data were compared using chi-square analysis with post-hoc comparisons using a z-test with alpha at 0.05. Means of continuous variables were compared using ANOVA with Tukey HSD post-hoc analysis. We found patient demographics remained widely unchanged across the three distinct periods as the demand for telehealth visits increased, with a notable rise in return patient visits, signaling both adaptability across the patient population and acceptance of the telehealth modality. These analyses along with evidence from the included literature review point to many the benefits of telehealth, thus telehealth as a healthcare delivery modality is here to stay. Our work serves as a foundation for future studies in this field, provides information for decision-makers in telehealth-related strategic planning, and can be utilized in advocacy for the extension of telehealth coverage.

In Times of Restricted Mobility: Cancel, Change Date, Or Change Format of Tourism Conferences

The aim of this article is to examine how tourism conference organizers react to the restricted mobility incurred by the spread of the COVID-19 virus. Do they cancel, change format, or change date for the event? This study contributes to an initial analysis of how organizers of international academic conferences in the tourism and hospitality industry deal with whole groups of participants who are no longer mobile and therefore cannot actively network personally. This uniquely compiled data covers a large representative number of conferences in this field. A Multinomial Logit model is used to estimate the options available. Data are based on unique information on almost 100 conferences, meetings, and congresses in the tourism and hospitality sector, including related fields such as leisure and recreation, planned to be held during the period of March to November 2020. Descriptive evidence shows that approximately one out of five conferences changes to a virtual format, somewhat more than half moves the date (mainly to the year 2021), and the remaining 25% cancel the event without alternative offers. Estimation results reveal that the decision to change to an online format increases nonlinearly over time in the form of an inverse U-shaped curve. This indicates a certain resistance to virtual conferences, although with more time for planning, a gradual adaptation to the actual situation appears to be possible. Longer conferences are less likely to change format. The probability of cancellations is lower for association conferences, which are held regularly.

The Impacts of the Cancellation of Historic Re-enactments in Portugal—The Case of Santa Maria da Feira

Re-enactment events are widely recognized to play an important role in individual, regional, or even national attractions, raising a community's cultural heritage identity and boosting local tourism development. The aim of this paper is to share the importance of experiences based on Historical Reconstruction and Recreation and analyze the consequences of cancellation of this type of events. The paper consists of six blocks to present a literature review, definitions of event tourism, medieval tourism events and analyses of the effects of cancellation of historical re-enactments and events in Portugal and in the world. We have selected the most important medieval re-enactment that takes place in Santa Maria da Feira, widely recognized by attendees and visitors, as well as by locals as the most significant of its kind in Portugal. The data is organized in the results of the survey conducted between June and September 2020, on the perceptions of residents, participants, and visitors to understand the various impacts of the cancellation of Historic Re-enactments in Portugal. Data analysis points out an unequal potential of these events. Conclusions seek to make suggestions for post-COVID-19 tourism recovery and define some future paths. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Evaluation of the Effect of Changing the Normalised Appointment Mode During the Coronavirus Disease 2019 Epidemic on the Development of Day Surgery.

Objective: To investigate the effect of changing the normal appointment mode on day surgery. Methods: From December 2020 to December 2021, 302 patients with day surgery admitted to the hospital by using the unified reservation mode of the intelligent bed system were selected as the experimental group, while 302 patients with day surgery admitted to the hospital by using the decentralised bed reservation mode were randomly selected as the control group. The same-day surgery cancellation rate, bed utilisation rate and patient satisfaction were analysed and compared between the two groups. Results: The treatment experience of the patients in the experimental group was higher than that in the control group. The same-day surgery cancellation rate was lower than that of the control group, with a statistically significant difference (P < 0.05). Conclusion: The unified computer reservation mode of the intelligent bed reservation system is superior to the decentralised reservation mode across departments. A daytime intelligent bed reservation mode was adopted for unifying bed appointments, which could effectively reduce the same-day cancellation rate of day surgery, improve bed utilisation and improve patient satisfaction.

When a pandemic cancels pride: An exploration of how stakeholders respond to the cancellation of a rural Australian pride event

Pride events challenge hegemonic notions of sexuality and gender within places they are held. This is particularly the case in rural communities that are perceived, rightly or wrongly, as prejudices towards individuals with a diverse sexuality or gender identity. However, although academic literature has extensively explored Pride events within an urban context, limited attention has been paid to the rural context, and still little to those in their infancy. This article examines how stakeholders responded to the cancellation of a Pride event in the Australian rural township of Wagga Wagga due to COVID19. The pandemic, in this context, provided an opportunity to understand attitudes towards the event and its cancellation. Through this process, eight topics were identified as: council funding, cancellation as homophobic, last-minute cancellation, cancellation regretted, cancellation supported, organizers acknowledged, LGBTIQI +, and Pride event. Based on these findings, implications for the cancellation of social contentious events in response to such circumstances are identified. These implications suggest the need for a more considered approach to communicating about the cancellation to prevent allegations of prejudice and demonstrate the value of such events. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

The effect of disruption due to COVID-19 on operating room utilization: Experience from a secondary care hospital in Riyadh, Saudi Arabia.

Introduction/Background: The disruption caused due to corona virus disease-2019 (Covid-19) has affected the overall health care delivery worldwide. The elective services were foremost to face the restrictions and closure, subsequently they were resumed only after adoption on newer protocols. Aims: We aimed to estimate the effect of COVID-19 restrictions on operative room utilization. Methodology: This is a retrospective descriptive study. The surgical volume indicators were calculated and a comparison was made between pre-COVID-19 (April-June 2019) and COVID-19 phase (April-June, 2020). Pre-operative covid assessment through the RT-PCR test among the cases waiting for elective surgeries. Results: Overall surgical volume decreased by 53%, which included 87% decrease in elective procedures and 8% decrease in emergency procedures. The overall OR utilization reduced by 63%. Highest reduction in the surgical volume was noted in bariatric surgery (no surgeries conducted in the COVID-19 phase), ophthalmology (99% reduction), and Ear, Nose and Throat surgery (ENT) surgery (92% reduction). Six patients tested positive for pre-operative RT-PCR from the sample of 261 cases posted for elective surgery during resumption phase of elective services, thereby giving the positivity rate of about 2.2%. Conclusion: We found a high level of reduction in the operating room utilization in a secondary care public sector hospital. The pre-operative assessment has enabled to find out the COVID-19 cases and hence preventing the unwanted spread of infection during the surgical procedures.

Strategies for Safely Maintaining Surgical Volume During the COVID-19 Pandemic: A Mixed-Methods Study.

Resuming elective surgeries that were canceled during the COVID-19 pandemic necessitated a change to preprocedure patient preparation at a pediatric tertiary care center in middle Tennessee. We conducted a prospective, observational, mixed-methods study to determine the effectiveness of a preprocedure COVID-19 testing team to prevent COVID-19-related cancellations among pediatric patients receiving planned anesthesia. The intervention involved family member and patient education and a change in health record reporting to include COVID-19 test results. A team tasked with follow-up reviewed test results, consulted with families, and coordinated the administration of rapid tests if necessary. We compared preimplementation and postimplementation cancellation rates in four procedural areas and found no significant difference in the cancellation or rescheduling rates (P = .89, 95% confidence interval = -4.29 to 3.09). The team-based intervention was associated with the preservation of low procedural cancellation rates by mitigating barriers to preprocedural testing.

One Year with COVID-19: The Impact on Air Transportation throughout 2020

Air transportation, in particular, has faced unprecedented effects by COVID-19 in terms of flight cancellations and airline bailouts;some argue that the air transportation sector is probably among the hardest hit. In this study, we explore the impact of COVID-19 on air transportation as a networked system throughout the year 2020, while taking the unaffected year 2019 as reference. Exploiting recently developed techniques in data science and network science, we analyzed the temporal evolution of air transportation networks at several scales of fractality, including airports, countries, and continents. Our study provides a comprehensive, data-driven analysis, enhanced with pointers into the recent literature, dissecting the impact of the COVID-19 on aviation as a networked system. It is hoped that this work not only improves understanding of COVID-19, but also gives anchor points on how to better handle future pandemics. © ASCE.

Manufacturing the Debt Republic of America: Mounting Student Loan Debt and Dismantling Its Neoliberal Political Ideology

This paper explores the political debate on student loan forgiveness from a religious (Christian) ethical perspective. In so doing, I answer the three specific questions. First, what are the prospects and limits of different political approaches to the issue? Second, what are the structural or ideological backgrounds that have given birth to the student loan crisis, but are not fully addressed by the president’s executive ordering? Last, what is the Christian ethical response to the issue, and how could it be theologically justified? Answering these questions, I argue that it is time now for American society to reckon with the neoliberal economy of debt that has relentlessly undertaken every aspect of our social and political lives. I also contend that student debt should be regarded as a form of social gift offered by society to the future generation.

COVID-19 effects on operating room cancellations at a pediatric tertiary care hospital: A retrospective cohort study.

Background: Same-day surgery cancellation results in decreased operating room (OR) utilization, reduced productivity, and inconvenience for patients. We aim to assess the cancellation rates of elective surgeries, identify common causes, and evaluate changes due to the COVID pandemic. Methods: A retrospective cohort study was conducted identifying all same-day surgery cancellations at a tertiary pediatric academic hospital from 1/1/2015 to 12/31/2017 (pre-COVID) and from 4/1/2020 to 3/31/2021 (post-COVID). Statistical analysis was performed using generalized regression with cancellation as the dependent variable. Period, age, ethnicity, gender, preferred language, and insurance were independent variables. Results: There were 55465 scheduled cases (41670 before and 13795 after COVID), with 1508 cancellations (2.7%). Of those, 1247 (3.0%) were before COVID and 261 (1.9%) after COVID (p < .001). Of all cases, 56.7% (31475) were male, 55.1% (30595) were non-Hispanic/Latinx whites, 82.3% (45638) spoke English, and 45.5% (25237) had public insurance. The mean age was 8.5 years (SD = 6.03).The decrease in the probability of cancellation was most significant in patients with public insurance, < 1 year-of-age, Hispanic/Latinx who spoke Spanish (pre-pandemic = 4.9% [CI = 4.2%-5.8%]; pandemic = 2.8% [95% CI = 1.9%-4.0%]. Regardless of the period, Hispanic/Latinx patients and those with public insurance had higher rates of surgery cancellations (p < .001). Conclusion: There was a significant decrease in same-day cancellations post-pandemic. We hypothesize that the required pre-operative COVID test helped to minimize same-day cancellations. Increased communication and education enhanced family engagement and was critical for improved OR metrics, including cancellation rates. Level of evidence: level IV.

The impact of COVID-19 on A fertility center in Indonesia: A brief report.

The coronavirus disease 2019 (COVID-19) affected the delivery of care in the fertility center. The higher transmissibility feature of omricon variant increase the transmission possibility between patients, healthcare professionals, and staff. Herein, we report the impact of the COVID-19 pandemic to the fertility center in Indonesia during the third wave period of the pandemic. Seven in vitro fertilization (IVF) cases were cancelled because the patients were tested positive for COVID-19 during their IVF program. Six of the total seventeen medical staff in our center were also tested positive for COVID-19 and stayed at home for self isolation. The cancellation of the IVF program was due to the lack of data regarding safety of IVF procedure in COVID-19 patients, shortage of medical staff, and the lack of negative pressure room in our fertility center. Our priority is to protect the remaining healthy patients in our center as well as the medical staff. The COVID-19 disadvantage both patients, care provider in reproductive healthcare. Regular screening of COVID-19 in fertility setting is highly recommended.