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Urgent care access

Patrizia Carrieri, Antoine Vilotitch, Sandra Nordmann, Caroline Lions, Laurent Michel, Marion Mora, Alain Morel, Gwenaelle Maradan, Bruno Spire, Perrine Roux
BACKGROUND: Patients receiving buprenorphine who are poor responders can continue to commit drug-related offences. Switching them from buprenorphine to methadone may result in reduced criminal behaviour. We compared self-reported offences and incarceration before and after starting methadone treatment of patients switching from buprenorphine (PSB) and maintenance treatment incident users (MIU). METHODS: Data on offences, incarceration and other information, were obtained via a telephone interview...
October 19, 2016: International Journal on Drug Policy
Diane Gu, Yurong Mao, Zhenzhu Tang, Julio Montaner, Zhiyong Shen, Qiuying Zhu, Roger Detels, Xia Jin, Ran Xiong, Juan Xu, Walter Ling, Lynda Erinoff, Robert Lindblad, David Liu, Paul Van Veldhuisen, Albert Hasson, Zunyou Wu
BACKGROUND: Patients who are newly screened HIV positive by EIA are lost to follow-up due to complicated HIV testing procedures. Because this is the first step in care, it affects the entire continuum of care. This is a particular concern in rural China. OBJECTIVE(S): To assess the routine HIV testing completeness and treatment initiation rates at 18 county-level general hospitals in rural Guangxi. METHODS: We reviewed original hospital HIV screening records...
2016: PloS One
Helen J Sims-Williams, Hugh P Sims-Williams, Edith Mbabazi Kabachelor, James Fotheringham, Benjamin C Warf
OBJECTIVE Myelomeningocele (MM) is a neural tube defect complicated by neurological deficits below the level of the spinal lesion and, in many cases, hydrocephalus. Long-term survival of infants treated for MM in a low- and middle-income country has never been reported. This retrospective cohort study reports 10-year outcomes and factors affecting survival for infants undergoing MM repair at CURE Children's Hospital of Uganda. METHODS Patients were traced by telephone or home visit. Survival was estimated using the Kaplan-Meier method...
October 21, 2016: Journal of Neurosurgery. Pediatrics
Maarten Milders, Stephen Bell, Angus Lorimer, Heather Jackson, Paul McNamee
Due to the increasing social and economic costs of dementia, there are urgent calls to develop accessible and sustainable care for people with dementia and their caregivers. Multi-component non-pharmacological interventions (NPIs) appear effective in improving or maintaining daily functioning and well-being, but are typically labour-intensive for health care professionals, thus hindering access. The current study aimed to explore the feasibility and acceptability of a novel approach to widen access to NPI by involving caregivers to present part of the intervention and with staff from local support organizations instructed to train the caregivers...
October 6, 2016: Dementia
Karidia Diallo, Surbhi Modi, Mackenzie Hurlston, Rachel Suzanne Beard, John N Nkengasong
Early diagnosis of HIV infection in infants and children remains a challenge in resource-limited settings, with approximately half of all HIV-exposed infants receiving virological testing for HIV by the recommended age of two months in 2015. In order to reduce morbidity and mortality among HIV-infected children and to close the treatment gap for HIV-infected children, there is an urgent need to evaluate existing programmatic and laboratory practices for early infant diagnosis and introduce strategies to improve identification of HIV-exposed infants and ensure access to systematic, early HIV testing with early linkage to treatment for HIV-infected infants...
October 19, 2016: AIDS Research and Human Retroviruses
Yu-Li Huang, Sarah M Bach
BACKGROUND: Patient access to care has been a known and continuing struggle for many health care providers. In spite of appointment lead time policies set by government or clinics, the problem persists. Justification for how lead time policies are determined is lacking. OBJECTIVES: This paper proposed a data-driven approach for how to best set feasible appointment target lead times given a clinic's capacity and appointment requests. METHODS: The proposed approach reallocates patient visits to minimize the deviation between actual appointment lead time and a feasible target lead time...
October 19, 2016: Applied Clinical Informatics
Nicola Mackintosh, Marius Terblanche, Ritesh Maharaj, Andreas Xyrichis, Karen Franklin, Jamie Keddie, Emily Larkins, Anna Maslen, James Skinner, Samuel Newman, Joana Hiew De Sousa Magalhaes, Jane Sandall
BACKGROUND: Telemedicine applications aim to address variance in clinical outcomes and increase access to specialist expertise. Despite widespread implementation, there is little robust evidence about cost-effectiveness, clinical benefits, and impact on quality and safety of critical care telemedicine. The primary objective was to determine the impact of critical care telemedicine (with clinical decision support available 24/7) on intensive care unit (ICU) and hospital mortality and length of stay in adults and children...
October 18, 2016: Systematic Reviews
Gang-Xi Lin, Yin-Ling Yang, Denise Kudirka, Colleen Church, Collin K K Yong, Fiona Reilly, Qi-Yi Zeng
BACKGROUND: Pediatric emergency rooms (PERs) in Chinese hospitals are perpetually full of sick and injured children because of the lack of sufficiently developed community hospitals and low access to family physicians. The aim of this study was to evaluate the clinical value of a new five-level Chinese pediatric emergency triage system (CPETS), modeled after the Canadian Triage System and Acuity Scale. METHODS: In this study, we compared CPETS outcomes in our PER relative to those of the prior two-level system...
2016: Chinese Medical Journal
Chinelo C Okigbo, Korede K Adegoke, Comfort Z Olorunsaiye
There is an urgent need to improve reproductive health (RH) in Nigeria - the most populous country in Africa. In 2015, Nigeria had the highest number of maternal deaths in the world. This study assessed the trends in select RH indicators in Nigeria over two decades. Data used were from Nigeria Demographic and Health Surveys (NDHS) conducted between 1990 and 2013. The NDHS uses a two-stage cluster sampling design to select nationally representative samples of reproductive-age women. The study sample ranged from 7620 to 38,948 women aged 15-49 across the five surveys...
October 16, 2016: Global Public Health
E Knowles, A O'Cathain, J Turner, J Nicholl
OBJECTIVE: To measure the effect of an urgent care telephone service NHS 111 on population perceptions of urgent care. DESIGN: Controlled before and after population survey, using quota sampling to identify 2000 respondents reflective of the age/sex profile of the general population. SETTING: England. 4 areas where NHS 111 was introduced, and 3 control areas where NHS 111 had yet to be introduced. PARTICIPANTS: 28 071 members of the general population, including 2237 recent users of urgent care...
October 14, 2016: BMJ Open
Alissa Davis, Beth E Meyerson, Blessing Aghaulor, Katherine Brown, Adisyn Watson, Kathryn E Muessig, Ligang Yang, Joseph D Tucker
BACKGROUND: Increased trade between China and Uganda has fueled trafficking of female Ugandans into China. These women may face challenges accessing health services. This study focused on examining barriers to health care access among female Ugandan sex workers in China. METHODS: In 2014, we undertook in-depth interviews with 19 female Ugandan sex workers in Guangzhou, China. Interviews focused on barriers to health service access and were analyzed using an a priori coding framework followed by open-coding to capture emergent themes...
October 14, 2016: International Journal for Equity in Health
Joia S Mukherjee, Danika Barry, Robert D Weatherford, Ishaan K Desai, Paul E Farmer
The advent of antiretroviral therapy (ART) in 1996 brought with it an urgent need to develop models of health care delivery that could enable its effective and equitable delivery, especially to patients living in poverty. Community-based care, which stretches from patient homes and communities-where chronic infectious diseases are often best managed-to modern health centers and hospitals, offers such a model, providing access to proximate HIV care and minimizing structural barriers to retention. We first review the recent literature on community-based ART programs in low- and low-to-middle-income country settings and document two key principles that guide effective programs: decentralization of ART services and long-term retention of patients in care...
October 13, 2016: Current HIV/AIDS Reports
Sandi Rowland, Jonathon P Leider, Clare Davidson, Joanne Brady, Alana Knudson
OBJECTIVES: To characterize the expansion of a community dental access program (CDP) in rural Maryland providing urgent dental care to low-income individuals, as well as the CDP's impact on dental-related visits to a regional emergency department (ED). METHODS: We used de-identified CDP and ED claims data to construct a data set of weekly counts of CDP visits and dental-related ED visits among Maryland adults. A time series model examined the association over time between visits to the CDP and ED visits for fiscal years (FYs) 2011 through 2015...
October 13, 2016: American Journal of Public Health
Andrea Driscoll, Sharon Meagher, Rhoda Kennedy, Melanie Hay, Jayant Banerji, Donald Campbell, Nicholas Cox, Debra Gascard, David Hare, Karen Page, Voltaire Nadurata, Rhonda Sanders, Harry Patsamanis
BACKGROUND: Hospital admissions for heart failure are predicted to rise substantially over the next decade placing increasing pressure on the health care system. There is an urgent need to redesign systems of care for heart failure to improve evidence-based practice and create seamless transitions through the continuum of care. The aim of the review was to examine systems of care for heart failure that reduce hospital readmissions and/or mortality. METHOD: Electronic databases searched were: Ovid MEDLINE, EMBASE, CINAHL, grey literature, reviewed bibliographies and Cochrane Central Register of Controlled Trials for randomised controlled trials, non-randomised trials and cohort studies from 1(st) January 2008 to 4(th) August 2015...
October 11, 2016: BMC Cardiovascular Disorders
Jennifer Manne-Goehler, Rifat Atun, Andrew Stokes, Alexander Goehler, Dismand Houinato, Corine Houehanou, Mohamed Msaidie Salimani Hambou, Benjamin Longo Mbenza, Eugène Sobngwi, Naby Balde, Joseph Kibachio Mwangi, Gladwell Gathecha, Paul Waweru Ngugi, C Stanford Wesseh, Albertino Damasceno, Nuno Lunet, Pascal Bovet, Demetre Labadarios, Khangelani Zuma, Mary Mayige, Gibson Kagaruki, Kaushik Ramaiya, Kokou Agoudavi, David Guwatudde, Silver K Bahendeka, Gerald Mutungi, Pascal Geldsetzer, Naomi S Levitt, Joshua A Salomon, John S Yudkin, Sebastian Vollmer, Till Bärnighausen
BACKGROUND: Despite widespread recognition that the burden of diabetes is rapidly growing in many countries in sub-Saharan Africa, nationally representative estimates of unmet need for diabetes diagnosis and care are in short supply for the region. We use national population-based survey data to quantify diabetes prevalence and met and unmet need for diabetes diagnosis and care in 12 countries in sub-Saharan Africa. We further estimate demographic and economic gradients of met need for diabetes diagnosis and care...
October 7, 2016: Lancet Diabetes & Endocrinology
Maureen M Black, Susan P Walker, Lia C H Fernald, Christopher T Andersen, Ann M DiGirolamo, Chunling Lu, Dana C McCoy, Günther Fink, Yusra R Shawar, Jeremy Shiffman, Amanda E Devercelli, Quentin T Wodon, Emily Vargas-Barón, Sally Grantham-McGregor
Early childhood development programmes vary in coordination and quality, with inadequate and inequitable access, especially for children younger than 3 years. New estimates, based on proxy measures of stunting and poverty, indicate that 250 million children (43%) younger than 5 years in low-income and middle-income countries are at risk of not reaching their developmental potential. There is therefore an urgent need to increase multisectoral coverage of quality programming that incorporates health, nutrition, security and safety, responsive caregiving, and early learning...
October 3, 2016: Lancet
Sara Modig, Cecilia Lenander, Nina Viberg, Patrik Midlöv
BACKGROUND: There is an urgent need to improve patient safety in the area of medication treatment among the elderly. The aim of this study was to explore which improvement needs and strengths, relating to medication safety, arise from a multi-professional intervention in primary care and further to describe and follow up on the agreements for change that were established within the intervention. METHODS: The SÄKLÄK project was a multi-professional intervention in primary care consisting of self-assessment, peer-review, feedback and written agreements for change...
October 4, 2016: BMC Family Practice
Taopheeq Bamidele Rabiu, Edward Oluwole Komolafe
BACKGROUND: Africa has very few neurosurgeons. These are almost exclusively in urban centers. Consequently, people in rural areas, most of the African population, have poor or no access to neurosurgical care. We have recently pioneered rural neurosurgery in Nigeria. OBJECTIVES: This report details our initial experiences and the profile of neurosurgical admissions in our center. METHODS: A prospective observational study of all neurosurgical patients managed at a rural tertiary health institution in Nigeria from December 2010 to May 2012 was done...
October 2016: Journal of Neurosciences in Rural Practice
Joanna M Ledingham, Neil Snowden, Ali Rivett, James Galloway, Zoe Ide, Jill Firth, Elizabeth MacPhie, Ngianga Kandala, Elaine M Dennison, Ian Rowe
OBJECTIVES: A national audit was performed assessing the early management of suspected inflammatory arthritis by English and Welsh rheumatology units. The aim of this audit was to measure the performance of rheumatology services against National Institute for Health and Care Excellence (NICE) quality standards (QSs) for the management of early inflammatory arthritis benchmarked to regional and national comparators for the first time in the UK. METHODS: All individuals >16 years of age presenting to rheumatology services in England and Wales with suspected new-onset inflammatory arthritis were included in the audit...
October 1, 2016: Rheumatology
Vijay Danivas, Muffadal Bharmal, Paul Keenan, Steven Jones, Samuel Christaprasad Karat, Kumaran Kalyanaraman, Martin Prince, Caroline H D Fall, Murali Krishna
PURPOSE: Limited availability of specialist services places a considerable burden on caregivers of Persons with Dementia (PwD) in Low- and Middle-Income Countries (LMICs). There are limited qualitative data on coercive behavior towards PwD in an LMIC setting. AIM: The aim of this study was to find relevant themes of the lived experience of relatives as caregivers for PwD in view of their use of coercive measures in community setting in South India. METHOD: Primary caregivers (n = 13) of PwDs from the Mysore study of Natal effects on Ageing and Health (MYNAH) in South India were interviewed to explore the nature and impact of coercion towards community dwelling older adults with dementia...
September 29, 2016: Social Psychiatry and Psychiatric Epidemiology
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