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https://www.readbyqxmd.com/read/28431545/optimising-spatial-accessibility-to-inform-rationalisation-of-specialist-health-services
#1
Catherine M Smith, Hannah Fry, Charlotte Anderson, Helen Maguire, Andrew C Hayward
BACKGROUND: In an era of budget constraints for healthcare services, strategies for provision of services that improve quality whilst saving costs are highly valued. A proposed means to achieve this is consolidation of services into fewer specialist centres, but this may lead to reduced spatial accessibility. We describe a methodology which includes implementing a combinatorial optimisation algorithm to derive combinations of services which optimise spatial accessibility in the context of service rationalisation, and demonstrate its use through the exemplar of tuberculosis clinics in London...
April 21, 2017: International Journal of Health Geographics
https://www.readbyqxmd.com/read/28422775/a-contemporary-assessment-of-acute-mechanical-ventilation-in-beijing-description-costs-and-outcomes
#2
Yanping Ye, Bo Zhu, Li Jiang, Qi Jiang, Meiping Wang, Lin Hua, Xiuming Xi
OBJECTIVE: To evaluate the contemporary practice, outcomes, and costs related to mechanical ventilation among ICUs in China. DESIGN: A prospective observational cohort study. SETTING: Fourteen ICUs among 13 hospitals in Beijing, China. PATIENTS: Seven hundred ninety-three patients who received at least 24 hours of mechanical ventilation within the first 48 hours of ICU stay. INTERVENTION: None...
April 18, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28422674/incorporation-of-efficient-second-order-solvers-into-latent-factor-models-for-accurate-prediction-of-missing-qos-data
#3
Xin Luo, MengChu Zhou, Shuai Li, YunNi Xia, Zhu-Hong You, QingSheng Zhu, Hareton Leung
Generating highly accurate predictions for missing quality-of-service (QoS) data is an important issue. Latent factor (LF)-based QoS-predictors have proven to be effective in dealing with it. However, they are based on first-order solvers that cannot well address their target problem that is inherently bilinear and nonconvex, thereby leaving a significant opportunity for accuracy improvement. This paper proposes to incorporate an efficient second-order solver into them to raise their accuracy. To do so, we adopt the principle of Hessian-free optimization and successfully avoid the direct manipulation of a Hessian matrix, by employing the efficiently obtainable product between its Gauss-Newton approximation and an arbitrary vector...
April 14, 2017: IEEE Transactions on Cybernetics
https://www.readbyqxmd.com/read/28420419/optimizing-veteran-centered-prostate-cancer-survivorship-care-study-protocol-for-a-randomized-controlled-trial
#4
Ted A Skolarus, Tabitha Metreger, Soohyun Hwang, Hyungjin Myra Kim, Robert L Grubb, Jeffrey R Gingrich, Sarah T Hawley
BACKGROUND: Although prostate cancer is the most common cancer among veterans receiving care in the Veterans Health Administration (VA), more needs to be done to understand and improve survivorship care for this large population. This study, funded by VA Health Services Research & Development (HSR&D), seeks to address the need to improve patient-centered survivorship care for veterans with prostate cancer. METHODS/DESIGN: This is a two-armed randomized controlled trial (RCT) with a target enrollment of up to 325 prostate cancer survivors per study arm (total anticipated n = 600)...
April 18, 2017: Trials
https://www.readbyqxmd.com/read/28420357/in-search-of-quality-indicators-for-down-syndrome-healthcare-a-scoping-review
#5
Francine A van den Driessen Mareeuw, Mirjam I Hollegien, Antonia M W Coppus, Diana M J Delnoij, Esther de Vries
BACKGROUND: The medical care chain around Down syndrome (DS) is complex, with many multidisciplinary challenges. The current quality of care is unknown. Outcome-oriented quality indicators have the potential to improve medical practice and evaluate whether innovations are successful. This is particularly interesting for the evolving care for people with DS and intellectual disabilities (ID). The aim of this study was to identify existing indicators for medical DS care, by reviewing the literature...
April 18, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28420102/efficient-actor-recovery-paradigm-for-wireless-sensor-and-actor-networks
#6
Reem K Mahjoub, Khaled Elleithy
The actor nodes are the spine of wireless sensor and actor networks (WSANs) that collaborate to perform a specific task in an unverified and uneven environment. Thus, there is a possibility of high failure rate in such unfriendly scenarios due to several factors such as power consumption of devices, electronic circuit failure, software errors in nodes or physical impairment of the actor nodes and inter-actor connectivity problem. Therefore, it is extremely important to discover the failure of a cut-vertex actor and network-disjoint in order to improve the Quality-of-Service (QoS)...
April 14, 2017: Sensors
https://www.readbyqxmd.com/read/28419264/evaluating-the-impact-of-contracting-out-basic-health-care-services-in-the-state-of-s%C3%A3-o-paulo-brazil
#7
Jane Greve, Vera Schattan Ruas Pereira Coelho
As a means of dealing with shortcomings in the coverage, quality and efficiency of the public health care sector, several municipalities in the state of São Paulo, Brazil, have started to contract pre-certified non-profit or non-governmental organizations to take part in the delivery of health care services.This paper explores the impact of introducing these contracts in the primary health care sector. Using data on the 645 municipalities in the state of São Paulo and difference-in-differences methods, we estimate the effect of contracting out in the primary health care sector on various dimensions of mortality and health care use...
April 16, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28417949/implementation-and-analysis-of-real-time-streaming-protocols
#8
Iván Santos-González, Alexandra Rivero-García, Jezabel Molina-Gil, Pino Caballero-Gil
Communication media have become the primary way of interaction thanks to the discovery and innovation of many new technologies. One of the most widely used communication systems today is video streaming, which is constantly evolving. Such communications are a good alternative to face-to-face meetings, and are therefore very useful for coping with many problems caused by distance. However, they suffer from different issues such as bandwidth limitation, network congestion, energy efficiency, cost, reliability and connectivity...
April 12, 2017: Sensors
https://www.readbyqxmd.com/read/28412463/frameworks-for-adaptation-of-health-guidelines-a-methodological-survey
#9
REVIEW
Andrea Darzi, Elias A Abou-Jaoude, Arnav Agarwal, Chantal Lakis, Wojtek Wiercioch, Nancy Santesso, Hneine Brax, Fadi El-Jardali, Holger J Schünemann, Elie A Akl
BACKGROUND: Our objective was to identify and describe published frameworks for adaptation of clinical, public health and health services guidelines. METHODS: We included reports describing methods of adaptation of guidelines in sufficient detail to allow its reproducibility. We searched Medline, and EMBASE databases. We also searched personal files, as well manuals and handbooks of organizations and professional societies that proposed methods of adaptation and adoption of guidelines...
April 12, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28411744/effects-of-transit-bus-interior-configuration-on-performance-of-wheeled-mobility-users-during-simulated-boarding-and-disembarking
#10
Clive D'Souza, Victor Paquet, James A Lenker, Edward Steinfeld
The emergence of low-floor bus designs and related regulatory standards in the U.S. have resulted in substantial improvements in public transit accessibility. However, passengers using wheeled mobility devices still experience safety concerns and inefficiencies in boarding, disembarking, and interior circulation on low-floor buses. This study investigates effects of low-floor bus interior configuration and passenger crowding on boarding and disembarking efficiency and safety. Users of manual wheelchairs (n = 18), powered wheelchairs (n = 21) and electric scooters (n = 9) simulated boarding and disembarking in three interior layout configurations at low and high passenger crowding conditions on a full-scale laboratory mock-up of a low-floor bus...
July 2017: Applied Ergonomics
https://www.readbyqxmd.com/read/28410384/relay-discovery-and-selection-for-large-scale-p2p-streaming
#11
Chengwei Zhang, Angela Yunxian Wang, Xiaojun Hei
In peer-to-peer networks, application relays have been commonly used to provide various networking services. The service performance often improves significantly if a relay is selected appropriately based on its network location. In this paper, we studied the location-aware relay discovery and selection problem for large-scale P2P streaming networks. In these large-scale and dynamic overlays, it incurs significant communication and computation cost to discover a sufficiently large relay candidate set and further to select one relay with good performance...
2017: PloS One
https://www.readbyqxmd.com/read/28410337/adaptation-of-lean-six-sigma-methodologies-for-the-evaluation-of-veterans-choice-program-at-3-urban-veterans-affairs-medical-centers
#12
Sherry L Ball, Lauren D Stevenson, Amy C Ladebue, Marina S McCreight, Emily C Lawrence, Taryn Oestreich, Anne C Lambert-Kerzner
OBJECTIVE: The Veterans Healthcare Administration (VHA) is adapting to meet the changing needs of our Veterans. VHA leaders are promoting quality improvement strategies including Lean Six Sigma (LSS). This study used LSS tools to evaluate the Veterans Choice Program (VCP), a program that aims to improve access to health care services for eligible Veterans by expanding health care options to non-VHA providers. RESEARCH DESIGN: LSS was utilized to assess the current process and efficiency patterns of the VCP at 3 VHA Medical Centers...
April 13, 2017: Medical Care
https://www.readbyqxmd.com/read/28410041/implementation-and-evaluation-of-a-pre-assessment-telephone-triage-system-in-an-outpatient-photopheresis-service
#13
Cherie Rushton, Leeah Robertson, Tracie Taylor, Peter Taylor, Arun Alfred
The prompt assessment of patients as fit for photopheresis is imperative to ensure delivery of a safe and efficient service. Before January 2015 the photopheresis unit was reliant on patients contacting the department directly to cancel their appointment if they were unwell or were suffering from any pre-defined exclusion criteria. Methods to reduce the number of cancellations and patients arriving unwell were therefore examined. The authors combined aspects of patient pre-assessment with telephone triage to develop a system that could provide better care and improve the use of resources within the department...
April 13, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28408014/cost-effectiveness-thresholds-in-global-health-taking-a-multisectoral-perspective
#14
Michelle Remme, Melisa Martinez-Alvarez, Anna Vassall
Good health is a function of a range of biological, environmental, behavioral, and social factors. The consumption of quality health care services is therefore only a part of how good health is produced. Although few would argue with this, the economic framework used to allocate resources to optimize population health is applied in a way that constrains the analyst and the decision maker to health care services. This approach risks missing two critical issues: 1) multiple sectors contribute to health gain and 2) the goods and services produced by the health sector can have multiple benefits besides health...
April 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28407857/a-review-of-the-ongoing-discussion-about-definition-diagnosis-and-pathomechanism-of-subclinical-endometritis-in-dairy-cows
#15
REVIEW
Karen Wagener, Christoph Gabler, Marc Drillich
In the last decade, several new aspects of the inflammation of the bovine endometrium have been investigated and described, including a new definition of subclinical endometritis. This review summarizes the recent discussion about the definition, diagnosis and pathomechanism of subclinical endometritis. Subclinical endometritis also referred to as cytological endometritis is defined by findings of endometrial cytology, which is usually performed with the cytobrush-technique or by low-volume flushing of the uterus...
May 2017: Theriogenology
https://www.readbyqxmd.com/read/28406340/team-functioning-in-hospice-interprofessional-meetings-an-exploratory-study-of-providers-perspectives
#16
Karla T Washington, Yuqi Guo, David L Albright, Alexandria Lewis, Debra Parker Oliver, George Demiris
Interprofessional collaboration is the foundation of hospice service delivery. In the United States, hospice agencies are required to regularly convene interprofessional meetings during which teams review plans of care for the patients and families they serve. A small body of research suggests that team functioning could be significantly enhanced in hospice interprofessional meetings; however, systematic investigation of this possibility has been limited to date. The purpose of this qualitative study was to better understand the experiences and perspectives of hospice providers who regularly participate in interprofessional meetings as a first step toward improving teamwork in this setting...
April 13, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28405807/management-and-outcomes-of-acute-surgical-patients-at-a-district-hospital-in-uganda-with-non-physician-emergency-clinicians
#17
Caleb Dresser, Usha Periyanayagam, Brad Dreifuss, Robert Wangoda, Julius Luyimbaazi, Mark Bisanzo
INTRODUCTION: Acute surgical care services in rural Sub-Saharan Africa suffer from human resource and systemic constraints. Developing emergency care systems and task sharing aspects of acute surgical care addresses many of these issues. This paper investigates the degree to which specialized non-physicians practicing in a dedicated Emergency Department contribute to the effective and efficient management of acute surgical patients. METHODS: This is a retrospective review of an electronic quality assurance database of patients presenting to an Emergency Department in rural Uganda staffed by non-physician clinicians trained in emergency care...
April 12, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28404531/an-integrated-method-of-therapeutic-lifestyle-change-for-older-adults-with-dyslipidaemia
#18
J-Y Zhao, H Li, S Jin, X-H Chen, L-L Chen
OBJECTIVES: To evaluate the effect of therapeutic lifestyle change with a non-pharmacological intervention method in older adults with dyslipidaemia. STUDY DESIGN: Stratified randomized trial. METHODS: Participants with dyslipidaemia (n = 214) aged ≥60 years were randomized to the conventional guide group, the educational course (EC) group, the telephone call (PC) group or the PC + EC group for 24 weeks. Total cholesterol, triglyceride, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and the knowledge, attitude and practice score for serum lipids were measured at baseline (T1), mid-intervention (week 12, T2) and post-intervention (week 24, T3)...
April 5, 2017: Public Health
https://www.readbyqxmd.com/read/28402750/an-efficient-nurse-practitioner-led-community-based-service-model-for-delivering-coordinated-care-to-persons-with-serious-mental-illness-at-risk-for-homelessness
#19
Jeannemarie Baker, Jasmine L Travers, Penelope Buschman, Jacqueline A Merrill
BACKGROUND: Access to mental health care is a struggle for those with serious mental illness (SMI). About 25% of homeless suffer from SMI, compared with 4.2% of the general population. OBJECTIVE: From 2003 to 2012, St. Paul's Center (SPC) operated a unique model to provide quality care to the homeless and those at risk for homelessness, incarceration, and unnecessary hospitalization because of SMI. Data were available for analysis for the years 2008 to 2010. DESIGN: The SPC was developed, managed, and staffed by board-certified psychiatric/mental health nurse practitioners, offering comprehensive mental health services and coordinated interventions...
April 1, 2017: Journal of the American Psychiatric Nurses Association
https://www.readbyqxmd.com/read/28402465/hospital-length-of-stay-and-readmission-rate-for-neurosurgical-patients
#20
Shaheryar F Ansari, Hong Yan, Jian Zou, Robert M Worth, Nicholas M Barbaro
BACKGROUND: Hospital readmission rate has become a major indicator of quality of care, with penalties given to hospitals with high rates of readmission. At the same time, insurers are increasing pressure for greater efficiency and reduced costs, including decreasing hospital lengths of stay (LOS). OBJECTIVE: To analyze the authors' service to determine if there is a relationship between LOS and readmission rates. METHODS: Records of patients admitted to the authors' institution from October 2007 through June 2014 were analyzed for several data points, including initial LOS, readmission occurrence, admitting and secondary diagnoses, and discharge disposition...
April 10, 2017: Neurosurgery
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