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https://www.readbyqxmd.com/read/28546986/factors-affecting-the-overcrowding-in-outpatient-healthcare
#1
Mohammadkarim Bahadori, Ehsan Teymourzadeh, Ramin Ravangard, Mehdi Raadabadi
BACKGROUND: The expansion of outpatient services and the desire to provide more outpatient care than inpatient care create some problems such as the overcrowding in the outpatient clinics. Given the importance of overcrowding in the outpatient clinics, this qualitative study aimed to determine the factors influencing the overcrowding in the specialty and subspecialty clinic of a teaching hospital. MATERIALS AND METHODS: This was a qualitative study conducted in the specialty and subspecialty clinic of a hospital using content analysis method in the period of January to March 2014...
2017: Journal of Education and Health Promotion
https://www.readbyqxmd.com/read/28544700/income-inequality-and-traumatic-dental-injuries-in-12-years-old-children-a-multi-level-analysis
#2
Mario Vianna Vettore, Salma Efhima, Carolina Machuca, Gabriela de Almeida Lamarca
BACKGROUND/AIM: Contextual socioeconomic factors have been associated with traumatic dental injuries (TDIs). However, evidence concerning the role of income inequality on TDIs in children is scarce.The aim of this study was to investigate the association between contextual income inequality over a ten-year period and TDIs in Brazilian children. SUBJECTS AND METHODS: The study population comprised a representative sample of 5027 children aged 12 years who participated in the Brazilian oral health survey in 2010...
May 24, 2017: Dental Traumatology: Official Publication of International Association for Dental Traumatology
https://www.readbyqxmd.com/read/28544364/influenza-associated-delays-in-patient-throughput-and-premature-patient-departure-in-emergency-departments-in-new-south-wales-australia-a-time-series-analysis
#3
David J Muscatello, Kendall J Bein, Michael M Dinh
OBJECTIVES: Influenza outbreaks cause overcrowding in EDs. We aimed to quantify the impact of influenza on the National Emergency Access Targets and premature patient departure in New South Wales, Australia. METHODS: This was a retrospective observational study of 11 million presentations to 115 hospitals during 2010-2014, using routinely collected administrative records. A time series generalised additive regression model was used to assess the correlation between weekly influenza activity and the weekly proportion of patients leaving the ED in >4 h and the proportion that departed before commencing or completing treatment ('did not wait'), after controlling for background winter and holiday effects...
May 24, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28542225/the-impact-of-health-promotion-on-trachoma-knowledge-attitudes-and-practice-kap-of-staff-in-three-work-settings-in-remote-indigenous-communities-in-the-northern-territory
#4
Fiona D Lange, Kelly Jones, Rebecca Ritte, Haley E Brown, Hugh R Taylor
BACKGROUND: Globally, trachoma is the leading cause of infectious blindness and Australia is the only developed country with endemic trachoma. It is found in remote Indigenous communities burdened with poverty, overcrowding and poor hygiene. Lack of culturally appropriate health promotion, a small trachoma workforce and lack of awareness and support for trachoma elimination in general, were early barriers. METHODS: A cross-sectional pre-post study using a convenience sample, was conducted in clinics, schools and community work-settings from 63 of the 82 remote Aboriginal communities identified as being at risk of trachoma in the Northern Territory (NT)...
May 24, 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28534558/-proposing-a-physiological-model-for-emergency-department-operating-principles-classification-of-overcrowding-and-guidelines-for-redesign
#5
M Herrera Carranza, F Aguado Correa, N Padilla Garrido, F López Camacho
The operation of Emergency Departments (ED) is determined by demand, their own organizational structures and the connection to other medical care levels. When these elements are not simultaneous, it hinders patient flow and decreases capacity, making it necessary to employ a systemic approach to the chain of emergency care as a single operational entity. With this theoretical orientation, we suggest a conceptual model similar to the physiological cardiac output, in which the preload is the demand, the contractile or flow pump is the organizational structure, the afterload is the hospital, the pre-ED valve is primary care and outpatient emergencies, and the post-ED valve is the diagnostic support services and the specialist consultants...
April 30, 2017: Anales del Sistema Sanitario de Navarra
https://www.readbyqxmd.com/read/28530117/combined-impact-of-smoking-and-early-life-exposures-on-adult-lung-function-trajectories
#6
James P Allinson, Rebecca Hardy, Gavin C Donaldson, Seif O Shaheen, Diana Kuh, Jadwiga A Wedzicha
BACKGROUND: Both adverse early life exposures and adult smoking can negatively influence adult lung function trajectory but few studies consider how the impact of early life exposures may be modified by subsequent smoking. METHODS: The Medical Research Council National Survey of Health and Development is a nationally representative cohort, initially of 5362 individuals, followed since enrolment at birth in March 1946. Using data collected prospectively across life and multilevel modelling we investigated how the relationships between early life exposures (infant lower respiratory infection, manual social class, home overcrowding and pollution exposure) and FEV1 and FVC trajectories between ages 43 and 60-64 were influenced by smoking behaviour...
May 21, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28527642/depressive-symptoms-and-perceptions-of-ed-care-in-patients-evaluated-for-acute-coronary-syndrome
#7
Tara St Onge, Donald Edmondson, Emily Cea, Syed Husain, Bernard P Chang
INTRODUCTION: Posttraumatic stress disorder (PTSD) develops in 1 out of 8 survivors of acute coronary syndrome (ACS) events, and these persons have a doubling of risk for recurrent ACS and mortality. Overcrowding in the emergency department during ACS evaluation has been associated with increased risk for PTSD, and depressed patients have been found to be particularly vulnerable. Little is known about the mechanisms by which overcrowding increases PTSD risk in depressed patients. Our aim was to evaluate one possible mechanism, patient perception of crowding and care, in depressed and nondepressed ED patients evaluated for ACS...
May 17, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28527341/unravelling-respiratory-syncytial-virus-outbreaks-in-buenos-aires-argentina-molecular-basis-of-the-spatio-temporal-transmission
#8
Gabriel Lihue Rojo, Stephanie Goya, Mariana Orellana, Andrea Sancilio, Alberto Rodriguez Perez, César Montali, Carolina García, Lilian Sosa, Alejandra Musto, Daniela Alvarez, Alejandro Castello, Mariana Viegas
Respiratory syncytial virus (RSV) is the main viral cause of hospitalization due to acute lower respiratory tract infections in infants worldwide. Several vaccines against RSV are under research and development, which are about to be approved. We evaluated transmission patterns in different settings to determine age-specific vaccination targets from a viral perspective. We sequenced the G glycoprotein's ectodomain of a constant clinical sampling between two epidemic outbreaks in a limited geographical region and performed phylogeographic analyses...
May 17, 2017: Virology
https://www.readbyqxmd.com/read/28514641/mapping-workforce-configuration-and-operational-models-in-australian-emergency-departments-a-national-survey
#9
Glenn Gardner, Anne Gardner, Sandy Middleton, Julie Considine, Gerard Fitzgerald, Luke Christofis, Anna Doubrovsky, Margaret Adams, Jane O'Connell
Objective Hospital emergency departments (ED) in Australia and internationally have been experiencing increased demand, resulting in reduced hospital quality, impaired access and adverse health outcomes. Effective evaluation of new ED service models and their effect on outcomes is reliant on baseline measures of the staffing configuration and organisational characteristics of the EDs being studied. The aim of the present study was to comprehensively measure these variables in Australian EDs.Methods Australian hospital EDs with 24-h medical and nursing cover were identified and invited to participate in the study...
May 18, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28507994/a-step-by-step-framework-on-discrete-events-simulation-in-emergency-department-a-systematic-review
#10
REVIEW
Mahsa Dehghani, Nazila Moftian, Peyman Rezaei-Hachesu, Taha Samad-Soltani
OBJECTIVE: To systematically review the current literature of simulation in healthcare including the structured steps in the emergency healthcare sector by proposing a framework for simulation in the emergency department. METHODS: For the purpose of collecting the data, PubMed and ACM databases were used between the years 2003 and 2013. The inclusion criteria were to select English-written articles available in full text with the closest objectives from among a total of 54 articles retrieved from the databases...
April 2017: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/28487459/patient-flow-within-uk-emergency-departments-a-systematic-review-of-the-use-of-computer-simulation-modelling-methods
#11
Syed Mohiuddin, John Busby, Jelena Savović, Alison Richards, Kate Northstone, William Hollingworth, Jenny L Donovan, Christos Vasilakis
OBJECTIVES: Overcrowding in the emergency department (ED) is common in the UK as in other countries worldwide. Computer simulation is one approach used for understanding the causes of ED overcrowding and assessing the likely impact of changes to the delivery of emergency care. However, little is known about the usefulness of computer simulation for analysis of ED patient flow. We undertook a systematic review to investigate the different computer simulation methods and their contribution for analysis of patient flow within EDs in the UK...
May 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28485885/hospital-occupancy-and-discharge-strategies-a-simulation-based-study
#12
S Qin, C Thompson, T Bogomolov, D Ward, P Hakendorf
BACKGROUND: Increasing demand for hospital services has resulted in more arrivals to emergency department (ED), increased admissions, and, quite often, access block and ED congestion, along with patients' dissatisfaction. Cost constraints limit an increase in the number of hospital beds, so alternative solutions need to be explored. AIMS: The aims of this study were to propose and test different discharge strategies which, potentially, could reduce occupancy rates in the hospital, thereby improving patient flow and minimising frequency and duration of congestion episodes...
May 9, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28475787/zero-transmission-of-middle-east-respiratory-syndrome-lessons-learned-from-thailand
#13
Surasak Wiboonchutikul, Weerawat Manosuthi, Chariya Sangsajja
New emerging pathogens can quickly become a global health threat in this era. A number of Middle East respiratory syndrome (MERS) outbreaks have been linked to healthcare facilities. The healthcare-associated transmission of Middle East respiratory syndrome coronavirus (MERS-CoV) has been attributed to overcrowding, delayed diagnosis, and the breakdown of infection control systems. Strict infection control precautions and a well-prepared hospital system may have contributed to no nosocomial transmission occurring during the treatment of MERS-CoV infections imported to Thailand...
May 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28473351/sex-differences-in-the-association-between-area-deprivation-and-generalised-anxiety-disorder-british-population-study
#14
Olivia Remes, Nick Wainwright, Paul Surtees, Louise Lafortune, Kay-Tee Khaw, Carol Brayne
OBJECTIVE: Studies have shown that area-level deprivation measured by factors, such as non-home ownership, non-car ownership and household overcrowding, can increase the risk for mental disorders over and above individual-level circumstances, such as education and social class. Whether area-level deprivation is associated with generalised anxiety disorder (GAD) independent of personal circumstances, and whether this association is different between British women and men is unknown. DESIGN: Large, population study...
May 4, 2017: BMJ Open
https://www.readbyqxmd.com/read/28472348/rotavirus-infection-and-disease-in-a-multi-site-birth-cohort-results-from-the-mal-ed-study
#15
Venkata Raghava Mohan, Karthikeyan Ramanujam, Sudhir Babji, Monica McGrath, Sanjaya Shrestha, Jasmin Shrestha, Estomih Mdumah, Caroline Amour, Amidou Samie, Emanuel Nyathi, Rashidul Haque, Shahida Qureshi, Pablo Peñataro Yori, Aldo A M Lima, Ladaporn Bodhidatta, Erling Svensen, Pascal Bessong, Tahmeed Ahmed, Jessica C Seidman, Anita Km Zaidi, Margaret N Kosek, Richard L Guerrant, Jean Gratz, James A Platts-Mills, Dennis R Lang, Michael Gottlieb, Eric R Houpt, Gagandeep Kang
Background: In a multi-country birth cohort study, we describe rotavirus infection in the first two years of life in sites with and without rotavirus vaccination programs. Methods: Children were recruited by 17 days of age and followed to 24 months with collection of monthly surveillance and diarrheal stools. Data on socio-demographics, feeding and illness were collected at defined intervals. Stools were tested for rotavirus and sera for anti-rotavirus immunoglobulins by enzyme immunoassays...
May 3, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28468544/-shrouded-in-a-dark-fog-comparison-of-the-diagnosis-of-pellagra-in-venice-and-general-paralysis-of-the-insane-in-the-united-kingdom-1840-1900
#16
Egidio Priani
The debate on the causes and the nature of pellagra in Italy during the nineteenth century resembles and evokes the similar debate on General Paralysis of the Insane (GPI) that was growing at the same time in the United Kingdom. Pellagra and GPI had a massive and virulent impact on the populations of Italy and the UK, respectively, and contributed to a great extent to the increase and overcrowding of the asylum populations in these countries. This article compares the two illnesses by examining the features of their nosographic positioning, aetiology and pathogenesis...
June 2017: History of Psychiatry
https://www.readbyqxmd.com/read/28466256/the-effect-of-posterior-fossa-decompression-in-adult-chiari-malformation-and-basilar-invagination-a-systematic-review-and-meta-analysis
#17
Ulysses de Oliveira Sousa, Matheus Fernandes de Oliveira, Lindolfo Carlos Heringer, Alécio Cristino Evangelista Santos Barcelos, Ricardo Vieira Botelho
Chiari malformation (CM) and basilar invagination (BI) are mesodermal malformations with disproportion between the content and volume of posterior fossa capacity and overcrowding of neural structures at the level of foramen magnum. Several alternatives for posterior approaches are available, including extradural (ED), extra-arachnoidal, and intradural (ID) approaches. The objectives are to evaluate the effect of several surgical techniques for posterior fossa decompression (PFD) in the outcomes of patients with CCJM and to evaluate complications in the techniques reported...
May 2, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28459697/early-detection-of-peak-demand-days-of-chronic-respiratory-diseases-emergency-department-visits-using-artificial-neural-networks
#18
Krishan Lal Khatri, Lakshman Tamil
Chronic Respiratory diseases, mainly asthma and Chronic Obstructive Pulmonary Disease (COPD), affect the lives of people by limiting their activities in various aspects. Overcrowding of hospital emergency departments (EDs) due to respiratory diseases in certain weather and environmental pollution conditions results in the degradation of quality of medical care, and even limits its availability. A useful tool for ED managers would be to forecast peak demand days so that they can take steps to improve the availability of medical care...
April 26, 2017: IEEE Journal of Biomedical and Health Informatics
https://www.readbyqxmd.com/read/28459576/asymmetric-synthesis-of-second-generation-light-driven-molecular-motors
#19
Thomas van Leeuwen, Wojciech Danowski, Edwin Otten, Sander J Wezenberg, Ben L Feringa
The enantiomeric homogeneity of light-driven molecular motors based on overcrowded alkenes is crucial in their application as either unidirectional rotors or as chiral multistate switches. It was challenging to obtain these compounds as single enantiomers via the established synthetic procedures due to loss of optical purity in the key step, i.e., the Barton-Kellogg olefination reaction. Searching for strategies to avoid racemization, a new class of light-driven molecular motors was designed, synthesized, and studied...
May 19, 2017: Journal of Organic Chemistry
https://www.readbyqxmd.com/read/28458754/potential-impact-of-early-physiotherapy-in-the-emergency-department-for-non-traumatic-neck-and-back-pain
#20
Pothiawala Sohil, Pua Yong Hao, Leong Mark
BACKGROUND: Musculoskeletal complaints, especially non-traumatic neck and back pain, are routinely encountered in the emergency department (ED) and lead to ED overcrowding, a burgeoning wait time for physiotherapy and outpatient orthopedic reviews. The study aimed to evaluate the impact of early physiotherapy evaluation and treatment (EPET) vs. standard care (SC) on clinical outcomes for patients presenting to the ED with non-traumatic neck and back pain. METHODS: A retrospective observational study of 125 patients who presented to the ED with non-traumatic neck and back pain with/without peripheral symptoms from July 2010 to February 2011...
2017: World Journal of Emergency Medicine
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