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resource optimisation

Michael Schriver, Vincent Kalumire Cubaka, Peter Vedsted, Innocent Besigye, Per Kallestrup
BACKGROUND: External supervision of primary health care facilities to monitor and improve services is common in low-income countries. Currently there are no tools to measure the quality of support in external supervision in these countries. AIM: To develop a provider-reported instrument to assess the support delivered through external supervision in Rwanda and other countries. METHODS: "External supervision: Provider Evaluation of Supervisor Support" (ExPRESS) was developed in 18 steps, primarily in Rwanda...
2018: Global Health Action
Sherrie L Kelly, Rowan Martin-Hughes, Robyn M Stuart, Xiao F Yap, David J Kedziora, Kelsey L Grantham, S Azfar Hussain, Iyanoosh Reporter, Andrew J Shattock, Laura Grobicki, Hassan Haghparast-Bidgoli, Jolene Skordis-Worrall, Zofia Baranczuk, Olivia Keiser, Janne Estill, Janka Petravic, Richard T Gray, Clemens J Benedikt, Nicole Fraser, Marelize Gorgens, David Wilson, Cliff C Kerr, David P Wilson
BACKGROUND: To move towards ending AIDS by 2030, HIV resources should be allocated cost-effectively. We used the Optima HIV model to estimate how global HIV resources could be retargeted for greatest epidemiological effect and how many additional new infections could be averted by 2030. METHODS: We collated standard data used in country modelling exercises (including demographic, epidemiological, behavioural, programmatic, and expenditure data) from Jan 1, 2000, to Dec 31, 2015 for 44 countries, capturing 80% of people living with HIV worldwide...
March 9, 2018: Lancet HIV
Khansoudaphone Phakhounthong, Pimwadee Chaovalit, Podjanee Jittamala, Stuart D Blacksell, Michael J Carter, Paul Turner, Kheng Chheng, Soeung Sona, Varun Kumar, Nicholas P J Day, Lisa J White, Wirichada Pan-Ngum
BACKGROUND: Dengue fever is a re-emerging viral disease commonly occurring in tropical and subtropical areas. The clinical features and abnormal laboratory test results of dengue infection are similar to those of other febrile illnesses; hence, its accurate and timely diagnosis for providing appropriate treatment is difficult. Delayed diagnosis may be associated with inappropriate treatment and higher risk of death. Early and correct diagnosis can help improve case management and optimise the use of resources such as hospital staff, beds, and intensive care equipment...
March 13, 2018: BMC Pediatrics
Kate Suzanne Hutson, Alexander Karlis Brazenor, David Brendan Vaughan, Alejandro Trujillo-González
Global expansion in fish production and trade of aquatic ornamental species requires advances in aquatic animal health management. Aquatic parasite cultures permit diverse research opportunities to understand parasite-host dynamics and are essential to validate the efficacy of treatments that could reduce infections in captive populations. Monogeneans are important pathogenic parasites of captured captive fishes and exhibit a single-host life cycle, which makes them amenable to in vivo culture. Continuous cultures of oviparous monogenean parasites provide a valuable resource of eggs, oncomiracidia (larvae) and adult parasites for use in varied ecological and applied scientific research...
2018: Advances in Parasitology
Håkan Uvhagen, Mia von Knorring, Henna Hasson, John Øvretveit, Johan Hansson
Purpose The purpose of this paper is to explore factors influencing early implementation and intermediate outcomes of a healthcare-academia partnership in a primary healthcare setting. Design/methodology/approach The Academic Primary Healthcare Network (APHN) initiative was launched in 2011 in Stockholm County, Sweden and included 201 primary healthcare centres. Semi-structured interviews were conducted in 2013-2014 with all coordinating managers ( n=8) and coordinators ( n=4). A strategic change model framework was used to collect and analyse data...
February 12, 2018: International Journal of Health Care Quality Assurance
Sayed Mustafa Mahmood Shah, Mahnoor Sohail, Khwaja Mubeen Ahmad, Fouzia Imtiaz, Sundus Iftikhar
PURPOSE: To evaluate the research trends and underlying motivations that shape intentions for the future uptake of an academic career among medical students. Further, to investigate the barriers and sought-after interventions which may optimise research outcomes in a resource-limited setting. METHODS: A cross-sectional study was conducted among 294 undergraduate (UG) medical students in Karachi, Pakistan. A self-administered questionnaire was employed to assess current research practices and future intentions, and to evaluate related motivations, barriers, and sought-after interventions...
December 27, 2017: Curēus
Gillian Harper
OBJECTIVES: To quality assure a Trusted Third Party linked data set to prepare it for analysis. SETTING: Birth registration and notification records from the Office for National Statistics for all births in England 2005-2014 linked to Maternity Hospital Episode Statistics (HES) delivery records by NHS Digital using mothers' identifiers. PARTICIPANTS: All 6 676 912 births that occurred in England from 1 January 2005 to 31 December 2014. PRIMARY AND SECONDARY OUTCOME MEASURES: Every link between a registered birth and an HES delivery record for the study period was categorised as either the same baby or a different baby to the same mother, or as a wrong link, by comparing common baby data items and valid values in key fields with stepwise deterministic rules...
March 1, 2018: BMJ Open
Khalide Azam, Nureisha Cadir, Carla Madeira, Stephen H Gillespie, Wilber Sabiiti
Tuberculosis (TB) diagnostics are centralised, requiring long-distance transportation of specimens in most resource-limited settings. We evaluated the ability of OMNIgene.SPUTUM (OM-S) to obviate cold-chain transport of TB specimens. A two-arm (same-day and after 5 days sample processing) study was conducted to assess contamination rates and Mycobacterium tuberculosis viability in OM-S-treated samples against the standard decontamination procedure (SDP) in Mozambique, using Lowenstein Jensen (LJ) and mycobacterial growth indicator tube (MGIT) culture and molecular bacterial load assay...
January 2018: ERJ Open Research
Victor Ng, Allyn Walsh, Nandani de Silva, Eleni Politi, Heather Grusauskas
While all physicians must continue to learn new knowledge through their careers, their post-training continuing professional development (CPD) has received less attention. Problems include lack of support for physicians, frequent deviations from best practices such as mandatory participation, focus on community need, and clear conflicts of interest amongst providers. Additionally, specialists from other disciplines catering to different patient populations often provide CPD for family doctors. The Working Party on Education of the World Organisation of Family Doctors (WONCA) sought to develop global standards in CPD for family doctors...
February 23, 2018: Education for Primary Care
Vikki Wylde, Wendy Bertram, Andrew D Beswick, Ashley W Blom, Julie Bruce, Amanda Burston, Jane Dennis, Kirsty Garfield, Nicholas Howells, Athene Lane, Candy McCabe, Andrew J Moore, Sian Noble, Tim J Peters, Andrew Price, Emily Sanderson, Andrew D Toms, David A Walsh, Simon White, Rachael Gooberman-Hill
BACKGROUND: Approximately 20% of patients experience chronic pain after total knee replacement. There is little evidence for effective interventions for the management of this pain, and current healthcare provision is patchy and inconsistent. Given the complexity of this condition, multimodal and individualised interventions matched to pain characteristics are needed. We have undertaken a comprehensive programme of work to develop a care pathway for patients with chronic pain after total knee replacement...
February 21, 2018: Trials
Diana Oelofse, Ilse Truter
BACKGROUND: The incidence of haematological malignancies in Africa's rapidly urbanising populations is insufficiently explored. Reliable population-based cancer statistics, however, continues to be a scarce resource in Africa and tends to be urban biased with limited rural coverage. In addition, many haematological malignancies are regarded as rare cancers, a sub-group that often affects the young disproportionately and require advanced diagnostic services and facilities able to deliver costly sophisticated treatments...
February 17, 2018: Cancer Epidemiology
Emily L Clarke, Jennifer R Evans, Liam Smeeth
BACKGROUND: Visual problems in older people are common and frequently under-reported. The effects of poor vision in older people are wide reaching and include falls, confusion and reduced quality of life. Much of the visual impairment in older ages can be treated (e.g. cataract surgery, correction of refractive error). Vision screening may therefore reduce the number of older people living with sight loss. OBJECTIVES: The objective of this review was to assess the effects on vision of community vision screening of older people for visual impairment...
February 20, 2018: Cochrane Database of Systematic Reviews
V Damuzzo, A Russi, M Chiumente, C Masini, B Rebesco, F Gregis, S Nozza, J Pigozzo, V Chiarion-Sileni, A C Palozzo
Objective In a scenario of new expensive cancer therapies entering the market, strategies of optimisation and cost containment are crucial in oncology care. Better management of drug waste and centralization of drug preparation can be effective strategies to achieve these goals. The aim of this work is to describe the economic management of a high cost anticancer drug (ipilimumab) in some Italian reference centres. Methods This was an observational, multicentred study in which economical and clinical data of 21 cancer centres (418 patients) were collected during the enrollment period from February 2013 to August 2014...
January 1, 2018: Journal of Oncology Pharmacy Practice
Sharon Goldfeld, Elise D'Abaco, Hannah Bryson, Fiona Mensah, Anna Mh Price
AIM: Many, varied, antenatal risk factors can adversely impact children's health, behaviour and cognition. Understanding the antenatal risk factors experienced by women can help identify which families are most likely to benefit from additional early supports; however, there is a dearth of published Australian antenatal risk data. This study aimed to determine the prevalence and co-occurrence of a broad range of risk factors in a community-based sample of pregnant Australian women. METHODS: A brief risk factor survey (10 items, including age, social support, health, smoking, stress or anxious mood, education, household income, employment) completed by pregnant women attending the antenatal clinic waiting rooms of 10 public maternity hospitals, which were selected for their provision of care to areas with fewer socio-economic resources in the states of Victoria and Tasmania, between May 2013 and August 2014...
February 14, 2018: Journal of Paediatrics and Child Health
Bozena Poller, Samantha Hall, Claire Bailey, Samantha Gregory, Richard Clark, Paul Roberts, Anne Tunbridge, Vin Poran, Brian Crook, Cariad Evans
BACKGROUND: Healthcare workers caring for patients with high consequence infectious diseases (HCID) require protection from pathogen exposure, for example by wearing personal protective equipment (PPE). Protection is acquired through the inherent safety of the PPE components, but also their safe and correct use, supported by adequate training and user familiarity. However, the evidence base for HCID PPE ensembles and any associated training is lacking, with subsequent variation between healthcare providers...
February 5, 2018: Journal of Hospital Infection
Ceri Rowlands, Leila Rooshenas, Katherine Fairhurst, Jonathan Rees, Carrol Gamble, Jane M Blazeby
OBJECTIVES: To examine the design and findings of recruitment studies in randomised controlled trials (RCTs) involving patients with an unscheduled hospital admission (UHA), to consider how to optimise recruitment in future RCTs of this nature. DESIGN: Studies within the ORRCA database (Online Resource for Recruitment Research in Clinical TriAls; that reported on recruitment to RCTs involving UHAs in patients >18 years were included. Extracted data included trial clinical details, and the rationale and main findings of the recruitment study...
February 2, 2018: BMJ Open
Lyndal Hickey, Vicki Anderson, Stephen Hearps, Brigid Jordan
OBJECTIVE: To compare the efficacy of a new intervention 'Family Forward' with 'Usual Care' social work practice in optimising family appraisal of a child's acquired brain injury to ensure better adaptation during the inpatient rehabilitation phase of care and early transition home. RESEARCH DESIGN: Single site, prospective, sequential comparison group design. METHODS AND PROCEDURES: Families were recruited on admission to an inpatient rehabilitation service based at a tertiary paediatric hospital...
February 8, 2018: Developmental Neurorehabilitation
Nicholas John Tierney, H Jost Reinhold, Antonietta Mira, Martin Weiser, Roman Burkart, Claudio Benvenuti, Angelo Auricchio
BACKGROUND: Mathematical optimisation models have recently been applied to identify ideal Automatic External Defibrillator (AED) locations that maximise coverage of Out of Hospital Cardiac Arrest (OHCA). However, these fixed location models cannot relocate existing AEDs in a flexible way, and have nearly exclusively been applied to urban regions. We developed a flexible location model for AEDs, compared its performance to existing fixed location and population models, and explored how these perform across urban and rural regions...
February 4, 2018: Resuscitation
Anant Jani, Sven Jungmann, Muir Gray
Increasing need and demand because of growing and aging populations combined with stagnant or decreasing resources being invested into healthcare globally mean that a radical shift is needed to ensure that healthcare systems can meet current and future challenges. Quality-, safety- and efficiency-improvement approaches have been used as means to address many problems in healthcare and while they are essential and necessary, they are not sufficient to meet our current challenges. To build resilient and sustainable healthcare systems, we need a shift to focus on triple value healthcare, which will help healthcare professionals improve outcomes at the process, patient and population levels while also optimising resource utilisation...
February 2, 2018: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
Anna Rosala-Hallas, Aneel Bhangu, Jane Blazeby, Louise Bowman, Mike Clarke, Trudie Lang, Mona Nasser, Nandi Siegfried, Karla Soares-Weiser, Matt R Sydes, Duolao Wang, Junhua Zhang, Paula R Williamson
BACKGROUND: Methodological research into the design, conduct, analysis and reporting of trials is essential to optimise the process. UK specialists in the field have established a set of top priorities in aid of this research. These priorities, however, may not be reflected in the needs of similar research in low- to middle-income countries (LMICs) with different healthcare provision, resources and research infrastructure. The aim of the study was to identify the top priorities for methodological research in LMICs to inform further research and ultimately to improve clinical trials in these regions...
February 5, 2018: Trials
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