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Suzanne Grant, Bruce Guthrie
Patient safety is an increasing concern for health systems internationally. The majority of administrative work in UK general practice takes place in the context of organisational routines such as repeat prescribing and test results handling, where high workloads and increased clinician dependency on administrative staff have been identified as an emerging safety issue. Despite this trend, most research to date has focused on the redistribution of the clinical workload between doctors, nurses and allied health professionals within individual care settings...
March 2, 2018: Social Science & Medicine
Faye M Evans, Juan C Duarte, Carolina Haylock Loor, Wayne Morriss
There is an urgent need to train more anesthesia providers in low- and middle-income countries (LMICs). There is also a need to provide more educational opportunities in subspecialty areas of anesthetic practice such as trauma management, pain management, obstetric anesthesia, and pediatric anesthesia. Together, these subspecialty areas make up a large proportion of the clinical workload in LMICs. In these countries, the quality of education may be variable, there may be few teachers, and opportunities for continued learning and mentorship are rare...
April 2018: Anesthesia and Analgesia
Emmett Harrison, Paul B A Dhillon
INTRODUCTION: Rural family physicians are often required to meet a wide variety of medical service demands that are otherwise the responsibility of specialty physicians in urban centres. However, many rural physicians enjoy the practice variety and ability to meet patients' medical needs through this wider spectrum of care. We aimed to quantify and summarize the workload and clinical disorders seen by rural family physicians in Saskatchewan relative to urban family physicians. METHODS: We used Saskatchewan Ministry of Health billing data for 2015/16 to compare rural and urban care provision...
2018: Canadian Journal of Rural Medicine
Bernardo Costa-Pinel, Santiago Mestre-Miravet, Francisco Barrio-Torrell, Joan-Josep Cabré-Vila, Xavier Cos-Claramunt, Sofía Aguilar-Sanz, Claustre Solé-Brichs, Conxa Castell-Abat, Victoria Arija-Val, Jaana Lindström
BACKGROUND: The DE-PLAN-CAT project (Diabetes in Europe-Prevention using lifestyle, physical activity and nutritional intervention-Catalonia) has shown that an intensive lifestyle intervention is feasible in the primary care setting and substantially reduces the incidence of diabetes among high-risk Mediterranean participants. The DP-TRANSFERS project (Diabetes Prevention-Transferring findings from European research to society) is a large-scale national programme aimed at implementing this intervention in primary care centres whenever feasible...
2018: PloS One
Harsh H Buddhadev, Daniel L Crisafulli, David N Suprak, Jun G San Juan
Cycling is commonly prescribed for physical rehabilitation of individuals with knee osteoarthritis (OA). Despite the known therapeutic benefits, no research has examined interlimb symmetry of power output during cycling in these individuals. We investigated the effects of external workload and cadence on interlimb symmetry of crank power output in individuals with knee OA versus healthy controls. Twelve older participants with knee OA and 12 healthy sex- and age-matched controls were recruited. Participants performed 2-minute bouts of stationary cycling at four workload-cadence conditions (75 W-60 rpm, 75 W-90 rpm, 100 W-60 rpm, and 100 W-90 rpm)...
March 15, 2018: Journal of Applied Biomechanics
Marcus J Colby, Brian Dawson, Peter Peeling, Jarryd Heasman, Brent Rogalski, Michael K Drew, Jordan Stares
OBJECTIVES: To assess the effect of multiple high risk scenario (HRS) exposures on non-contact injury prediction in elite Australian footballers. DESIGN: Retrospective cohort study. METHODS: Sessional workload data (session-rating of perceived exertion; GPS-derived distance, sprint distance, maximum velocity) from one club (n= 60 players) over 3 seasons were collated; several established HRS were also defined. Accumulated HRS sessional exposures were calculated retrospectively (previous 1-8 weeks)...
March 15, 2018: International Journal of Sports Physiology and Performance
Billy T Hulin, Tim J Gabbett, Rich D Johnston, David G Jenkins
PURPOSE: Determine: 1) how change of direction (COD) workloads influence PlayerLoad variables when controlling total distance covered, and 2) relationships among collision workloads and PlayerLoad variables during rugby league match-play. METHODS: Participants completed 3 protocols (crossover design) consisting of 10 repetitions of a 60 m effort in 15 s. The difference between each protocol was the COD demands required to complete 1 repetition; no COD (SL), 1 x 180º COD (1COD), or 3 x 180º COD (3COD)...
March 15, 2018: International Journal of Sports Physiology and Performance
Conor Raleigh, Bernard Donne, Neil Fleming
We compared lactate threshold (TLac ) with non-invasive markers of an aerobic-anaerobic transition; namely, ventilatory (VT) and tissue saturation index (TSIT ) thresholds. While identification of a breakpoint in blood lactate concentration ([BLa]) is common for determination of an aerobic-anaerobic transition, non-invasive measures, VT and NIRS, have also received attention as a means of determining this critical exercise intensity. We hypothesised that one or other of these non-invasive measures would have a strong association with TLac ...
2018: International Journal of Exercise Science
Sarah Sims, Mary Leamy, Nigel Davies, Katy Schnitzler, Ros Levenson, Felicity Mayer, Robert Grant, Sally Brearley, Stephen Gourlay, Fiona Ross, Ruth Harris
BACKGROUND: Intentional rounding (IR) is a structured process whereby nurses conduct one to two hourly checks with every patient using a standardised protocol. OBJECTIVE: A realist synthesis of the evidence on IR was undertaken to develop IR programme theories of what works, for whom, in what circumstances and why. METHODS: A three-stage literature search and a stakeholder consultation event was completed. A variety of sources were searched, including AMED, CINAHL, MEDLINE, PsycINFO, HMIC, Google and Google Scholar, for published and unpublished literature...
March 14, 2018: BMJ Quality & Safety
Sana B Ali, Juana Romero, Kevin Morrison, Baria Hafeez, Jessica S Ancker
OBJECTIVES:  Although electronic patient portals are offered by most health care organizations, poor usability and poor fit to patient needs may pose barriers to adoption. We collaborated with an academic hospital to conduct iterative user evaluation of a newly deployed portal designed to deliver inpatient data upon hospital discharge. METHODS:  Three evaluators applied heuristic usability evaluation and conducted 23 individual user testing sessions with patients with chronic disease or managing the care of family members with chronic disease...
January 2018: Applied Clinical Informatics
Rangarirai Matima, Katherine Murphy, Naomi S Levitt, Rhonda BeLue, Tolu Oni
BACKGROUND: Current South African health policy for chronic disease management proposes integration of chronic services for better outcomes for chronic conditions; that is based on the Integrated Chronic Disease Model (ICDM). However, scant data exist on how patients with chronic multimorbidities currently experience the (re)-organisation of health services and what their perceived needs are in order to enhance the management of their conditions. METHODS: A qualitative study was conducted in a community health centre treating both HIV and diabetes patients in Cape Town...
2018: PloS One
Bridget M Smith, Rachael N Martinez, Charlesnika T Evans, Karen L Saban, Salva Balbale, Eric J Proescher, Kevin Stroupe, Timothy P Hogan
BACKGROUND: Veterans who experience traumatic brain injury (TBI) may have long-term needs placing a premium on well-coordinated care. This study aimed to (1) identify barriers to care coordination for Veterans with TBI; and (2) describe strategies used by VA polytrauma care team members to coordinate care for Veterans with TBI. METHODS: We utilised a mixed method design, including an online survey of VA polytrauma care team members (N = 236) and subsequent semi-structured interviews (N = 25)...
March 14, 2018: Brain Injury: [BI]
Sarah K Mesrobian, Alessandro E P Villa, Michel Bader, Lorenz Götte, Alessandra Lintas
Attention-deficit hyperactivity disorder (ADHD) is characterized by deficits in executive functions and decision making during childhood and adolescence. Contradictory results exist whether altered event-related potentials (ERPs) in adults are associated with the tendency of ADHD patients toward risky behavior. Clinically diagnosed ADHD patients ( n = 18) and healthy controls ( n = 18), aged between 18 and 29 (median 22 Yo), were screened with the Conners' Adult ADHD Rating Scales and assessed by the Mini-International Neuropsychiatric Interview, adult ADHD Self-Report Scale, and by the 60-item HEXACO Personality Inventory...
2018: Frontiers in Human Neuroscience
Jeanne M Ferrante, Eric K Shaw, Jennifer E Bayly, Jenna Howard, M Nell Quest, Elizabeth C Clark, Connie Pascal
BACKGROUND: Many primary care practices participating in patient-centered medical home (PCMH) transformation initiatives are expanding the work roles of their medical assistants (MAs). Little is known about attitudes of MAs or barriers and facilitators to these role changes. METHODS: Secondary data analysis of qualitative cross-case comparison study of 15 New Jersey primary care practices participating in a PCMH project during 2012 to 2013. Observation field notes and in-depth and key informant interviews (with physicians, office managers, staff and care coordinators) were iteratively analyzed using grounded theory...
March 2018: Journal of the American Board of Family Medicine: JABFM
Ray O'Connor, Jane O'Doherty, Andrew O'Regan, Colum Dunne
BACKGROUND: Antimicrobial resistance is an emerging global threat to health and is associated with increased consumption of antibiotics. Seventy-four per cent of antibiotic prescribing takes place in primary care. Much of this is for inappropriate treatment of acute respiratory tract infections. AIMS: To review the published literature pertaining to antibiotic prescribing in order to identify and understand the factors that affect primary care providers' prescribing decisions...
March 12, 2018: Irish Journal of Medical Science
Nirmala Saravanan Narayanasamy, Subitha Lakshminarayanan, S Ganesh Kumar, Sitanshu Sekar Kar, Kalaiselvi Selvaraj
Background: A multipurpose health worker (MPHW) is the key functionary and the first contact person in a subcenter. This study explores the workload of MPHWs in the multifarious domains of their activities and also assesses their time utilization pattern. Methods: A time and motion study was conducted among 19 auxiliary nurse midwives (ANMs) and 10 HWs male (M) from six selected primary health centers of Puducherry. Participants self-reported their daily activities on a time measurement sheet for 6 days in a week...
January 2018: Indian Journal of Community Medicine
Rena Hirani, James Peberdy, Phillip Mondy
BACKGROUND: For Australian apheresis platelet donations, in-centre haematology analysers provided the platelet count used to program the platelet collection machines. When the haematology analysers were not functional, historical platelet counts from previous donations were used. This study aimed to confirm that the routine use of historical platelet counts for programming apheresis collection machines would maintain platelet yields within the donated units and that haematology analysers could be removed...
March 6, 2018: Transfusion and Apheresis Science
Allison Gates, Cydney Johnson, Lisa Hartling
BACKGROUND: Machine learning tools can expedite systematic review (SR) processes by semi-automating citation screening. Abstrackr semi-automates citation screening by predicting relevant records. We evaluated its performance for four screening projects. METHODS: We used a convenience sample of screening projects completed at the Alberta Research Centre for Health Evidence, Edmonton, Canada: three SRs and one descriptive analysis for which we had used SR screening methods...
March 12, 2018: Systematic Reviews
Katherine E Gallagher, Tusajigwe Erio, Kathy Baisley, Shelley Lees, Deborah Watson-Jones
BACKGROUND: The burden of cervical cancer and shortage of screening services in Tanzania confers an urgent need for human papillomavirus (HPV) vaccination. However, the sustainability and impact of another new vaccine campaign in an under-resourced health system requires consideration. We aimed to determine the impact of the government's school-based HPV vaccine campaign in Kilimanjaro region on the provision of routine primary health services and staff workload. METHODS: Data on daily numbers of consultations were collected from health facility register books in 63 dispensaries and health centres in North-West Tanzania for 20 weeks in 2014...
March 12, 2018: BMC Health Services Research
Jenna Dran
In 2015, Zika virus rapidly emerged as a concern for obstetric patients and health care providers as the disease spread geographically and it was discovered that Zika virus infection had the potential to cause devastating birth defects. Essentially overnight, obstetric care providers were faced with an influx of rapidly evolving information and an increased workload. New systems, workflows, and personnel were needed to effectively address the new patient care needs fueled by the burgeoning Zika virus epidemic...
March 8, 2018: Obstetrics and Gynecology
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