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Illness And Wait Time

Pallavi Dham, Neeraj Gupta, Jacob Alexander, Warwick Black, Tarek Rajji, Elaine Skinner
BACKGROUND: Evaluation of telepsychiatry (via videoconference) for older adults is mostly focussed on nursing homes or inpatients. We evaluated the role of a community based program for older adults in rural and remote regions of South Australia. METHOD: The utilization pattern was studied using retrospective chart review of telepsychiatry assessments over 24 months (2010-2011). Satisfaction was evaluated through prospective post-consultation feedback (using a 5-point Likert scale), from patients, community based clinicians and psychiatrist participating in consecutive assessments from April-November 2012...
September 27, 2018: BMC Psychiatry
Laura Lai, Robert G Bota
Objective: Older adults with complicated illnesses such as Alzheimer's disease often require specialized treatment in geriatric facilities when inpatient psychiatric hospitalization is needed. However, there is a shortage of these inpatient facilities. Thus, patients could wait in the emergency department (ED) for days pending availability of a bed at an appropriate facility. The objective of this study was to quantify that wait time. Methods: Records for patients aged 60-89 years who were seen in the ED and had a psychiatric consultation over a 2-year period (July 2014 to June 2016) were reviewed...
September 20, 2018: Primary Care Companion to CNS Disorders
Salome C Erekaha, Llewellyn J Cornelius, Melissa L Bessaha, Abdulmumin Ibrahim, Gabriel D Adeyemo, Mofoluwake Fadare, Manhattan Charurat, Echezona E Ezeanolue, Nadia A Sam-Agudu
The acceptability of lifelong antiretroviral therapy (ART) among HIV-positive women in high-burden Nigeria, is not well-known. We explored readiness of users and providers of prevention of mother-to-child transmission of HIV (PMTCT) services to accept lifelong ART -before Option B plus was implemented in Nigeria. We conducted 142 key informant interviews among 100 PMTCT users (25 pregnant-newly-diagnosed, 26 pregnant-in-care, 28 lost-to-follow-up (LTFU) and 21 postpartum women living with HIV) and 42 PMTCT providers in rural North-Central Nigeria...
December 2018: SAHARA J: Journal of Social Aspects of HIV/AIDS Research Alliance
Henrik Auråen, Hans Henrik L Schultz, Pekka Hämmäinen, Gerdt C Riise, Hillevi Larsson, Lennart Hansson, Göran Dellgren, Michael Perch, Odd Geiran, Arnt E Fiane, Martin Iversen, Are Martin Holm
BACKGROUND: Throughout the world, the scarcity of donor organs makes optimal allocation systems necessary. In the Scandiatransplant countries, organs for lung transplantation are allocated nationally. To ensure shorter wait time for critically ill patients, the Scandiatransplant urgent lung allocation system (ScULAS) was introduced in 2009, giving supranational priority to patients considered urgent. There were no pre-defined criteria for listing a patient as urgent, but each center was granted only 3 urgent calls per year...
August 8, 2018: Journal of Heart and Lung Transplantation
Ryan W Haines, Christopher J Kirwan, John R Prowle
PURPOSE OF REVIEW: Continuous renal replacement therapy (CRRT) is now the mainstay of renal organ support in the critically ill. As our understanding of CRRT delivery and its impact on patient outcomes improves there is a focus on researching the potential benefits of tailored, patient-specific treatments to meet dynamic needs. RECENT FINDINGS: The most up-to-date studies investigating aspects of CRRT prescription that can be individualized: CRRT dose, timing, fluid management, membrane selection, anticoagulation and vascular access are reviewed...
September 18, 2018: Current Opinion in Critical Care
Frédéric Ehrler, Christian Lovis, Jessica Rochat, Franck Schneider, Alain Gervaix, Annick Galetto-Lacour, Johan N Siebert
Nowadays, citizens are little supported to decide whether they should consult the Emergency Departments (ED) in case of illness or trauma. Moreover, once in the ED, they often must deal with overcrowding, long waiting times, the acute nature of the visits, administrative data management, and a lack of follow-up after the visit. To improve this situation, we have developed an e-health solution delivering a more patient-centered experience by connecting patients, caregivers, and administrative clerks through a web and mobile applications...
September 5, 2018: Revue Médicale Suisse
Taurayi A Tafuma, Nyikadzino Mahachi, Chengetai Dziwa, Tafara Moga, Paul Baloyi, Gladys Muyambo, Auxilia Muchedzi, Tinashe Chimbidzikai, Getrude Ncube, Joseph Murungu, Tendai Nyagura, Katherine Lew
Background: The emergence of antiretroviral therapy (ART) transformed HIV from a terminal illness to a chronic disease. However, limited access to health services remains one of many barriers to HIV service utilisation by people living with HIV (PLHIV) in low-resource settings. The goal of this study was to describe the barriers to HIV service utilisation in two provinces of Zimbabwe. Methods: A qualitative descriptive study was conducted with PLHIV and village health workers (VHW) in eight districts within the two provinces...
2018: Southern African Journal of HIV Medicine
Apichai Wattanapisit, Udomsak Saengow
Background: A universal health coverage policy was implemented in Thailand in 2002 and led to an increase in accessibility to, and equity of, healthcare services. The Thai government and academics have focused on the large-scale aspects, including effectiveness and impacts, of universal health coverage over one decade. Here, we aimed to identify patients' perspectives on hospital visits under universal health coverage. Methods: A qualitative study was carried out in four public hospitals in rural Thailand...
2018: Asia Pacific Family Medicine
Ugenthiri Naiker, Gerry FitzGerald, Joel M Dulhunty, Michael Rosemann
Objective. The delivery of public out-patient services is an essential part of complex healthcare systems, but the contribution of public out-patient services is often ill defined and poorly evaluated. The aim of this study was to identify and better understand those factors that may affect the performance of out-patient services to provide health service managers, clinicians and executives with a conceptual framework for future decision-making processes. Methods. The present qualitative research involved five exploratory case studies...
August 20, 2018: Australian Health Review: a Publication of the Australian Hospital Association
Melissa Henry, Yu Chang, Saul Frenkiel, Gabrielle Chartier, Richard Payne, Christina MacDonald, Carmen Loiselle, Martin J Black, Alex M Mlynarek, Antoinette Ehrler, Zeev Rosberger, Michael Tamilia, Michael P Hier
PURPOSE: To offer a better understanding of the experiences, preferences, and needs of patients with thyroid cancer. PARTICIPANTS & SETTING: 17 patients with thyroid cancer receiving treatment at a university-affiliated hospital in Montreal, Québec, Canada. METHODOLOGIC APPROACH: Interviews were conducted with patients, and descriptive phenomenology was used to explore patients' lived experience. FINDINGS: Coping with uncertainty was a major theme that emerged from interviews, with some of the main concerns being difficult treatment decisions, long surgery wait times, and fears about surgical complications, potential metastases, and death...
September 1, 2018: Oncology Nursing Forum
Hiran Thabrew, Karolina Stasiak, Sarah E Hetrick, Stephen Wong, Jessica H Huss, Sally N Merry
BACKGROUND: Long-term physical conditions affect 10% to 12% of children and adolescents worldwide; these individuals are at greater risk of developing psychological problems, particularly anxiety and depression. Access to face-to-face treatment for such problems is often limited, and available interventions usually have not been tested with this population. As technology improves, e-health interventions (delivered via digital means, such as computers and smart phones and ranging from simple text-based programmes through to multimedia and interactive programmes, serious games, virtual reality and biofeedback programmes) offer a potential solution to address the psychological needs of this group of young people...
August 16, 2018: Cochrane Database of Systematic Reviews
Y Amare, S Paul, L M Sibley
BACKGROUND: Ethiopia has made significant progress in reducing child mortality but newborn mortality has stagnated at around 29 deaths per 1000 births. The Maternal Health in Ethiopia Partnership (MaNHEP) was a 3.5-year implementation project aimed at developing a community-oriented model of maternal and newborn health in rural Ethiopia and to position it for scale up. In 2014, we conducted a case study of the project focusing on recognition of and timely biomedical care seeking for maternal and newborn complications...
August 6, 2018: BMC Pediatrics
Raheel Rizwan, Farhan Zafar, Clifford Chin, James Tweddell, Roosevelt Bryant, David Morales
BACKGROUND: Infants awaiting heart transplantation (HTx) have the highest waitlist mortality than other HTx patients. This study analyzed the impact of weight and other factors on waitlist and post-HTx outcomes in infants. METHODS: All infants on the HTx waitlist in the United Network for Organ Sharing database from October 1987 to June 2016 were divided into the following weight groups: less than 2.5 kg, 2.5 to 3.9 kg, and more than 4 kg. Survival from listing regardless of transplantation was compared by using Kaplan-Meier analysis...
October 2018: Annals of Thoracic Surgery
K Cohen, S Bruijns
BACKGROUND: Data measured as key performance indicators (KPIs) are used internationally in emergency medicine to measure and monitor quality of care. The Department of Health in the Western Cape Province, South Africa, introduced time-based KPIs for emergency centres (ECs) in 2012. OBJECTIVES: To describe the most recently processed results of the audits conducted in Western Cape ECs between 2013 and 2014. METHODS: A retrospective, descriptive study was conducted on data collected in the 6-monthly Western Cape EC triage and waiting time audits for 2013 - 2014...
June 26, 2018: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Ella Baruch, Nancy Pistrang, Chris Barker
PURPOSE: Clinical guidelines emphasise the central role of family members in supporting people with bipolar disorder. However, there has been little focus on the challenges family members face in supporting their relative. This qualitative study explored the challenges of providing support to a relative with bipolar disorder, and how family members attempted to meet these challenges. Factors that helped or hindered their efforts were also explored, including experiences of professional support...
July 9, 2018: Social Psychiatry and Psychiatric Epidemiology
Javier D Garzon-Rodriguez, Carlos Obando-Lopez, Manuel Giraldo-Grueso, Nestor Sandoval-Reyes, Jaime Camacho, Juan P Umaña
BACKGROUND: Mechanical circulatory support (MCS) represents an effective urgent therapy for patients with cardiac arrest or end-stage cardiac failure. However, its use in developing countries as a bridge therapy remains controversial due to costs and limited duration. This study presents five patients who underwent MSC as bridge therapy for heart transplantation in a developing country. CASE PRESENTATION: We present five patients who underwent MCS as bridge therapy for heart transplant between 2010 and 2015 at Fundación Cardioinfantil-Instituto de Cardiología...
July 3, 2018: BMC Research Notes
Karen Walseth Hara, Petter Borchgrevink
Background All nations are posed with the challenge of deciding how to allocate limited health care resources. A Patients' Rights Law from 1999 gives patients in Norway with a serious health condition, for which there is efficacious and cost-effective treatment, a legal right to receive health care from the National Health Care system. Methods Recently national guidelines have been produced for implementing these legal rights within 32 fields of specialist health care. One of these fields deals with serious chronic pain conditions...
January 1, 2010: Scandinavian Journal of Pain
S Buchholz, S P W Guenther, S Michel, R Schramm, C Hagl
End-stage heart failure is associated with significant morbidity and mortality. Heart transplantation has the potential to offer a return to daily activities for critically ill patients and is the gold standard therapy. However, heart transplantations are decreasing yearly with a historic low in Germany in 2017. By striking contrast, both waiting list numbers and waiting time have increased owing to a lack of acceptable donor organs. Ventricular assist devices (VAD) represent a reasonable therapeutic alternative for patients on heart transplantation waiting lists...
August 2018: Herz
Yasuko Igai
AIM: This study aimed to extract patient narratives regarding the end-of-life trajectory of their self-care and coping experiences as patients with idiopathic pulmonary fibrosis and to use meta-ethnography to discover common metaphors of their experience in order to inform the development of nursing interventions. METHODS: A comprehensive search of qualitative research using electronic databases, in English and Japanese, regarding patients with IPF, identified four articles...
May 17, 2018: Japan Journal of Nursing Science: JJNS
Jonathan S Schultz, Adam J Atherly, Andrés F Henao-Martínez
Uninsured and unprepared travelers to countries with endemic tropical diseases pose great health-care burdens and financial risks on returning to the United States. We discuss the delayed presentation of an uninsured U.S. traveler returning from West Africa with severe malaria who required intensive care measures to save his life. Despite being critically ill on his return, he sat rigoring on his couch taking antipyretics for 3 days, while he applied for insurance on the Affordable Care Act website and waited for approval because he was fearful of the costs of seeking care...
July 2018: American Journal of Tropical Medicine and Hygiene
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