Background: Discharged against medical advice (DAMA) is defined as any instance when a patient wants to leave the hospital against the managing physician’s decision. This study aimed to identify factors that influenc...Background: Discharged against medical advice (DAMA) is defined as any instance when a patient wants to leave the hospital against the managing physician’s decision. This study aimed to identify factors that influence patients to decide to be DAMA. Methods: A descriptive, cross-sectional study. The study was conducted in the emergency department (ED) of King Fahad Medical City (KFMC)-Saudi Arabia-Riyadh city. A questionnaire in both Arabic and English was distributed to all participants to fill in either English or Arabic. Results: Between 1 March and 30 April 2021, 510 responses were collected. Most of the study participants (31.4%) were over the age of 54. Our findings showed that 12.5% of our participants had taken discharge against medical advice in the past. Results Regarding Factors That Influence Patients to Decide on DAMA Showed: Regarding Inappropriate behavior and disrespect of the physician or staff to the patient and his relatives, 262 (51.4%) participants, 85 (16.7%) participants, and 163 (32%) participants agreed, neutral, and disagreed, respectively. Regarding the Lack of physicians’ and nurses’ attention to the patient and his relatives (emotionally), our result showed that 278 (54.5%) participants, 95 (18.6%) participants, and 137 (26.9%) participants agreed, neutral, and disagree, respectively. Regarding failure to inform the patient or his relatives of his condition, it showed that 257 (50.4%) participants, 95 (18.6%) participants, and 158 (31%) participants agreed, neutral, and disagreed, respectively. Regarding feeling better from DAMA, our result showed 226 (44.3%) participants, 119 (23.3%) participants, and 165 (32.4%) participants agreed, neutral, and disagreed, respectively. Regarding patients’ or their relative’s tiredness of hospital stay, the result showed that 166 (32.5%) participants, 104 (20.4%) participants, and 240 (47.1%) participants agreed, neutral, and disagreed, respectively. Conclusion: The long wait time to be seen by a physician was the major factor that forced p展开更多
There is a growing interest on the potential interplay between weather,habitat,and interspecific competition on population dynamics of wild herbivores.Favorable environmental conditions may buffer the negative effects...There is a growing interest on the potential interplay between weather,habitat,and interspecific competition on population dynamics of wild herbivores.Favorable environmental conditions may buffer the negative effects of competition;conversely,competition may be expected to be stronger under harsh environmental conditions.We investigated relationships between competitor abundance,weather,and habitat cover on density and local distribution of a medium-sized herbivore,the roe deer Capreolus capreolus,as well as its spatial overlap with fallow deer Dama dama in a Mediterranean protected area.Over 11 years(2007–2017),roe deer density was not affected by spring–summer rainfall in the previous year and decreased with increasing density of fallow deer in the previous year.Hence,over the considered temporal scale,results supported a major role of competition over weather in influencing population trends of roe deer.At a finer spatial scale,roe deer occupancy was negatively affected by local abundance of fallow deer,especially in“poorer”habitats.We found a slight support for a positive effect of fallow deer density on interspecific spatial overlap.Moreover,fine-scale spatial overlap between deer species increased with decreasing rainfall in spring–summer.Fallow deer were introduced to our study area in historical times and their role as superior competitors over roe deer has been found also in other study areas.We suggest a potential role of harsh weather conditions during the growing season of vegetation(i.e.scarce rainfall)in triggering the potential for ecological overlap,emphasizing the negative effects of interspecific competition.展开更多
文摘Background: Discharged against medical advice (DAMA) is defined as any instance when a patient wants to leave the hospital against the managing physician’s decision. This study aimed to identify factors that influence patients to decide to be DAMA. Methods: A descriptive, cross-sectional study. The study was conducted in the emergency department (ED) of King Fahad Medical City (KFMC)-Saudi Arabia-Riyadh city. A questionnaire in both Arabic and English was distributed to all participants to fill in either English or Arabic. Results: Between 1 March and 30 April 2021, 510 responses were collected. Most of the study participants (31.4%) were over the age of 54. Our findings showed that 12.5% of our participants had taken discharge against medical advice in the past. Results Regarding Factors That Influence Patients to Decide on DAMA Showed: Regarding Inappropriate behavior and disrespect of the physician or staff to the patient and his relatives, 262 (51.4%) participants, 85 (16.7%) participants, and 163 (32%) participants agreed, neutral, and disagreed, respectively. Regarding the Lack of physicians’ and nurses’ attention to the patient and his relatives (emotionally), our result showed that 278 (54.5%) participants, 95 (18.6%) participants, and 137 (26.9%) participants agreed, neutral, and disagree, respectively. Regarding failure to inform the patient or his relatives of his condition, it showed that 257 (50.4%) participants, 95 (18.6%) participants, and 158 (31%) participants agreed, neutral, and disagreed, respectively. Regarding feeling better from DAMA, our result showed 226 (44.3%) participants, 119 (23.3%) participants, and 165 (32.4%) participants agreed, neutral, and disagreed, respectively. Regarding patients’ or their relative’s tiredness of hospital stay, the result showed that 166 (32.5%) participants, 104 (20.4%) participants, and 240 (47.1%) participants agreed, neutral, and disagreed, respectively. Conclusion: The long wait time to be seen by a physician was the major factor that forced p
文摘There is a growing interest on the potential interplay between weather,habitat,and interspecific competition on population dynamics of wild herbivores.Favorable environmental conditions may buffer the negative effects of competition;conversely,competition may be expected to be stronger under harsh environmental conditions.We investigated relationships between competitor abundance,weather,and habitat cover on density and local distribution of a medium-sized herbivore,the roe deer Capreolus capreolus,as well as its spatial overlap with fallow deer Dama dama in a Mediterranean protected area.Over 11 years(2007–2017),roe deer density was not affected by spring–summer rainfall in the previous year and decreased with increasing density of fallow deer in the previous year.Hence,over the considered temporal scale,results supported a major role of competition over weather in influencing population trends of roe deer.At a finer spatial scale,roe deer occupancy was negatively affected by local abundance of fallow deer,especially in“poorer”habitats.We found a slight support for a positive effect of fallow deer density on interspecific spatial overlap.Moreover,fine-scale spatial overlap between deer species increased with decreasing rainfall in spring–summer.Fallow deer were introduced to our study area in historical times and their role as superior competitors over roe deer has been found also in other study areas.We suggest a potential role of harsh weather conditions during the growing season of vegetation(i.e.scarce rainfall)in triggering the potential for ecological overlap,emphasizing the negative effects of interspecific competition.
