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resource optimisation

Simon R Knight, Leanne Metcalfe, Katriona O'Donoghue, Simon T Ball, Angela Beale, William Beale, Rachel Hilton, Keith Hodkinson, Graham W Lipkin, Fiona Loud, Lorna P Marson, Peter J Morris
BACKGROUND: It has been suggested that the research priorities of those funding and performing research in transplantation may differ from those of end service users such as patients, carers and healthcare professionals involved in day-to-day care. The Kidney Transplant Priority Setting Partnership (PSP) was established with the aim of involving all stakeholders in prioritising future research in the field. METHODS: The PSP methodology is as outlined by the James Lind Alliance...
2016: PloS One
Jeremy Brown, Jason Patterson, Briony Hazelton, Mitchell Brown, Peter Jelfs, Vitali Sintchenko, Sharon C-A Chen
No abstract text is available yet for this article.
February 2016: Pathology
Theresa Rosenkranz, Johannes Kisser, Walter W Wenzel, Markus Puschenreiter
Phytomining could represent an innovative low-cost technology for the selective recovery of valuable trace elements from secondary resources. In this context the potential of phytomining from waste incineration bottom ash was tested in a pot experiment. Fresh bottom ash was acidified, leached to reduce salinity and amended with organic material to obtain a suitable substrate for plant growth. Two hyperaccumulator species, Alyssum serpyllifolium subsp. lusitanicum and Sedum plumbizincicola as well as three metal tolerant species, Brassica napus, B...
October 7, 2016: Science of the Total Environment
R P Abratt
The drug cost of adjuvant trastuzumab to benefit one patient with localised human epidermal growth factor receptor 2 (HER2)-positive breast cancer depends on the baseline survival rate (BLSR) of the prognostic group of the patient. This varies from ZAR13 752 900 (BLSR 90%) to ZAR4 006 100 (BLSR 60%). All treated patients are exposed to potential toxicity. The value and affordability of treatments need to be considered, as there are finite resources available in our healthcare system. All patients must have access to cost-effective treatments...
September 23, 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
A Brink, D Van den Bergh, M Mendelson, G A Richards
The optimisation of antibiotic use to maximise patient care and safety through antibiotic stewardship forms one of the cornerstones of the global response to antibiotic resistance. Stewardship efforts in low- and middle-income countries are challenged by lack of healthcare professionals trained in infection. Therefore, in resource-poor settings, the traditional model of infection specialist-led stewardship may be impractical, requiring new models to be developed. A recent South African study across 47 Netcare hospitals nationally highlighted the role of pharmacists in this regard, proving that non-specialised pharmacists can drive a prospective audit, feedback collaborative strategy and a range of improvement science principles to reduce antibiotic consumption by the same levels as that documented in high-resource, infection specialist-led stewardship programmes...
September 6, 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
G C Maitland
This paper aims to pull together the main points, messages and underlying themes to emerge from the Discussion. It sets these remarks in the context of where Carbon Capture and Storage (CCS) fits into the spectrum of carbon mitigation solutions required to meet the challenging greenhouse gas (GHG) emissions reduction targets set by the COP21 climate change conference. The Discussion focused almost entirely on carbon capture (21 out of 23 papers) and covered all the main technology contenders for this except biological processes...
October 20, 2016: Faraday Discussions
Geraldine M Leydon, Beth Stuart, Lisa Danquah, Katie Ekberg, Lucy Brindle, Sue Latter, Clare Moynihan, Peter Salmon, Sonia Howe, Elizabeth Stokoe, Paul Little
BACKGROUND: There are over 1500 UK health helplines in operation, yet we have scant knowledge about the resources in place to support the seeking and delivering of cancer-related telephone help and support. This research aimed to identify and describe cancer and cancer-related helpline service provision: the number of helplines available, the variety of services provided and accessibility of those services. METHOD: Online national questionnaire survey sent to 95 cancer and cancer-related helplines in the UK RESULTS: 69 (73%) of 95 surveyed cancer and cancer-related helplines completed the survey...
October 8, 2016: Psycho-oncology
Carsten Murawski, Peter Bossaerts
Life presents us with problems of varying complexity. Yet, complexity is not accounted for in theories of human decision-making. Here we study instances of the knapsack problem, a discrete optimisation problem commonly encountered at all levels of cognition, from attention gating to intellectual discovery. Complexity of this problem is well understood from the perspective of a mechanical device like a computer. We show experimentally that human performance too decreased with complexity as defined in computer science...
October 7, 2016: Scientific Reports
Cristina Meléndez Frigola, Elena Arroyo Borrell, Marc Saez
OBJECTIVE: It is necessary to deepen in the knowledge of the Basic Minimum Set of Data (CMBD-RSS) of patients with chronic pathology associated and frequent hospitalisations (the subacute care). The aim of this study was to analyse the sanitary information of these patients, once initiated the subacute program. METHODS: We used data of 660 patients hospitalised in the subacute care unit at the Santa Caterina Hospital, sanitary region of Girona, from October 2013 to December 2014...
October 3, 2016: Revista Española de Salud Pública
Padraig Dixon, Sandra Hollinghurst, Louisa Edwards, Clare Thomas, Alexis Foster, Ben Davies, Daisy Gaunt, Alan A Montgomery, Chris Salisbury
BACKGROUND: Depression is a prevalent long-term condition that is associated with substantial resource use. Telehealth may offer a cost-effective means of supporting the management of people with depression. AIMS: To investigate the cost-effectiveness of a telehealth intervention ('Healthlines') for patients with depression. METHOD: A prospective patient-level economic evaluation conducted alongside a randomised controlled trial. Patients were recruited through primary care, and the intervention was delivered via a telehealth service...
July 2016: BJPsych Open
Andrew W Cairns, Raymond R Bond, Dewar D Finlay, Cathal Breen, Daniel Guldenring, Robert Gaffney, Anthony G Gallagher, Aaron J Peace, Pat Henn
INTRODUCTION: The 12-lead Electrocardiogram (ECG) presents a plethora of information and demands extensive knowledge and a high cognitive workload to interpret. Whilst the ECG is an important clinical tool, it is frequently incorrectly interpreted. Even expert clinicians are known to impulsively provide a diagnosis based on their first impression and often miss co-abnormalities. Given it is widely reported that there is a lack of competency in ECG interpretation, it is imperative to optimise the interpretation process...
September 26, 2016: Journal of Biomedical Informatics
Tchern Kuang Lambert Low, Kai Hong Tay, Tina Fang, Daniel Shuen Sheng Fung
OBJECTIVE: Patients admitted to a psychiatric hospital commonly suffer from comorbid medical problems which sometimes require urgent medical attention. Twenty-two percent of emergency medical transfers from the Institute of Mental Health (IMH) to the emergency rooms of general hospitals were preventable and could be managed at IMH itself. We undertook a quality improvement project to understand the reasons behind such preventable referrals and implemented changes to address this. METHODS: Using the model for improvement, we deconstructed our processes and analysed root causes for such preventable referrals...
September 30, 2016: International Journal of Psychiatry in Clinical Practice
Claire Croteau
People with aphasia (PWA) and their loved ones claim that one of their biggest needs is to develop efficient means to communicate better "together". Researchers suggest that conversation partner training (CPT), a training for a PWA and a loved one aiming to use communication strategies in conversations, would be most promising regarding this need (e.g. Simmons-Mackie et al., 2010). The purpose of this presentation is to report the development and the home services organisation of the social speech-language pathology part of the "service aux proches d'une personne aphasique" (SAPPA; services to caregivers of a person with aphasia)...
September 2016: Annals of Physical and Rehabilitation Medicine
Jan Breckwoldt, Jan R Ludwig, Joachim Plener, Torsten Schröder, Hans Gruber, Harm Peters
BACKGROUND: Distributing a fixed amount of teaching hours over a longer time period (spaced approach) may result in better learning than delivering the same amount of teaching within a shorter time (massed approach). While a spaced approach may provide more opportunities to elaborate the learning content, a massed approach allows for more economical utilisation of teaching facilities and to optimise time resources of faculty. Favourable effects of spacing have been demonstrated for postgraduate surgery training and for spacing intervals of weeks to months...
September 26, 2016: BMC Medical Education
Dianne Goeman, Sue Conway, Ralph Norman, Jo Morley, Rona Weerasuriya, Richard H Osborne, Alison Beauchamp
Background. Health literacy is the ability to access, understand, and use information and services for good health. Among people with chronic conditions, health literacy requirements for effective self-management are high. The Optimising Health Literacy and Access (Ophelia) study engaged diverse organisations in the codesign of interventions involving the Health Literacy Questionnaire (HLQ) needs assessment, followed by development and evaluation of interventions addressing identified needs. This study reports the process and outcomes of one of the nine organisations, the Royal District Nursing Service (RDNS)...
2016: Journal of Diabetes Research
Hilary Piercy, Gill Bell, Charlie Hughes, Simone Naylor, Christine A Bowman
This study aimed to examine what specialist nursing contributes to HIV service delivery across England and how it could be optimised. A three part multi-method qualitative study was undertaken, involving (1) interviews with 19 stakeholders representing professional or service user groups; (2) interviews with nurse/physician pairs from 21 HIV services; and (3) case studies involving site visits to five services. A framework analysis approach was used to manage and analyse the data. There was substantial variability in specialist nursing roles and the extent of role development...
September 22, 2016: International Journal of STD & AIDS
Marjorie Koblinsky, Cheryl A Moyer, Clara Calvert, James Campbell, Oona M R Campbell, Andrea B Feigl, Wendy J Graham, Laurel Hatt, Steve Hodgins, Zoe Matthews, Lori McDougall, Allisyn C Moran, Allyala K Nandakumar, Ana Langer
To improve maternal health requires action to ensure quality maternal health care for all women and girls, and to guarantee access to care for those outside the system. In this paper, we highlight some of the most pressing issues in maternal health and ask: what steps can be taken in the next 5 years to catalyse action toward achieving the Sustainable Development Goal target of less than 70 maternal deaths per 100 000 livebirths by 2030, with no single country exceeding 140? What steps can be taken to ensure that high-quality maternal health care is prioritised for every woman and girl everywhere? We call on all stakeholders to work together in securing a healthy, prosperous future for all women...
September 14, 2016: Lancet
Ciara McGlade, Edel Daly, Joan McCarthy, Nicola Cornally, Elizabeth Weathers, Rónán O'Caoimh, D William Molloy
BACKGROUND: A high prevalence of cognitive impairment and frailty complicates the feasibility of advance care planning in the long-term-care population. RESEARCH AIM: To identify challenges in implementing the 'Let Me Decide' advance care planning programme in long-term-care. RESEARCH DESIGN: This feasibility study had two phases: (1) staff education on advance care planning and (2) structured advance care planning by staff with residents and families...
September 16, 2016: Nursing Ethics
I F Richens, P Hobson-West, M L Brennan, Z Hood, J Kaler, M Green, N Wright, W Wapenaar
The use of vaccines in the cattle industry is widespread; however, there is limited published guidance for use by decision-makers such as farmers and vets. To best support vets in advising dairy farmers on the optimisation of vaccination strategies, it is important to understand how and why vets make decisions about recommending the vaccination of cattle. The objective of this study was to explore in-depth farm animal vets' motivators and barriers to the implementation of vaccination strategies on British dairy farms...
September 14, 2016: Veterinary Record
Silvia Bermedo-Carrasco, Cheryl L Waldner
BACKGROUND: While cervical cancer (CC) is an important cause of premature mortality in Colombia, the impact of socio-demographic factors on CC mortality in young women is not well understood. The primary objective of this study was to identify differences in CC mortality among Colombian women aged 20-49 years associated with education, type of health insurance, urban or rural and region of residence, and to determine whether differences in mortality associated with education or insurance varied by age...
2016: BMC Public Health
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