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Access schedule

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
Sonya Nicholl, Holly Seale, Vicky Sheppeard, Sue Campbell-Lloyd
INTRODUCTION: In response to a significant increase of measles cases and a high percentage of unvaccinated adolescents in New South Wales, Australia, a measles high school catch-up vaccination programme was implemented between August and December 2014. This study aimed to explore the factors affecting school-based supplementary immunization activities (SIAs) and to inform future SIA and routine school-based vaccination programme implementation and service provision. METHODS: Focus group analysis was conducted among public health unit (PHU) staff responsible for implementing the SIA catch-up programme...
July 2016: Western Pacific Surveillance and Response Journal: WPSAR
Zaheed Damani, Gail MacKean, Eric Bohm, Brie DeMone, Brock Wright, Tom Noseworthy, Jayna Holroyd-Leduc, Deborah A Marshall
BACKGROUND: Policy dialogues are critical for developing responsive, effective, sustainable, evidence-informed policy. Our multidisciplinary team, including researchers, physicians and senior decision-makers, comprehensively evaluated The Winnipeg Central Intake Service, a single-entry model in Winnipeg, Manitoba, to improve patient access to hip/knee replacement surgery. We used the evaluation findings to develop five evidence-informed policy directions to help improve access to scheduled clinical services across Manitoba...
October 18, 2016: Health Research Policy and Systems
M E Cazzaniga, L Cortesi, A Ferzi, L Scaltriti, F Cicchiello, M Ciccarese, S Della Torre, F Villa, M Giordano, C Verusio, M Nicolini, A R Gambaro, L Zanlorenzi, E Biraghi, L Legramandi, E Rulli
PURPOSE: The VICTOR-1 study demonstrated that the all-oral metronomic combination of vinorelbine and capecitabine is highly active and well tolerated in hormone receptor-positive/HER2-negative patients. The VICTOR-2 study was designed to confirm these results. METHODS: Patients received mVNR 40 mg three times a week and mCAPE 500 mg three times a day, continuously. The primary endpoint was the clinical benefit rate (CBR); secondary endpoints were toxicity, objective response rate (ORR), and progression-free survival (PFS)...
October 17, 2016: Breast Cancer Research and Treatment
Michael S Businelle, Ping Ma, Darla E Kendzor, Summer G Frank, David W Wetter, Damon J Vidrine
BACKGROUND: Mobile phone‒based real-time ecological momentary assessments (EMAs) have been used to record health risk behaviors, and antecedents to those behaviors, as they occur in near real time. OBJECTIVE: The objective of this study was to determine if intensive longitudinal data, collected via mobile phone, could be used to identify imminent risk for smoking lapse among socioeconomically disadvantaged smokers seeking smoking cessation treatment. METHODS: Participants were recruited into a randomized controlled smoking cessation trial at an urban safety-net hospital tobacco cessation clinic...
October 17, 2016: Journal of Medical Internet Research
Roque da Silva Araújo, Edna Apparecida Moura Arcuri, Victor Cauê Lopes
Objective: to verify causes of inactivity in the Home Delivery Medicament Program, as referred by users from a Primary Health Care Service in São Paulo, comparing them to the causes registered in the program and analyzing them in the theoretical model Concept of Access to Health. Methods: cross-sectional study, interviewing 111 inactive users; and documentary study in the program records. Results: half of the users did not know the condition of inactivity...
October 10, 2016: Revista Latino-americana de Enfermagem
Craig D Newgard, Rongwei Fu, Eileen Bulger, Jerris R Hedges, N Clay Mann, Dagan A Wright, David P Lehrfeld, Carol Shields, Gregory Hoskins, Craig Warden, Lynn Wittwer, Jennifer N B Cook, Michael Verkest, William Conway, Stephanie Somerville, Matthew Hansen
Importance: Despite a large rural US population, there are potential differences between rural and urban regions in the processes and outcomes following trauma. Objectives: To describe and evaluate rural vs urban processes of care, injury severity, and mortality among injured patients served by 9-1-1 emergency medical services (EMS). Design, Setting, and Participants: This was a preplanned secondary analysis of a prospective cohort enrolled from January 1 through December 31, 2011, and followed up through hospitalization...
October 12, 2016: JAMA Surgery
Nadine E Palermo, Katherine L Modzelewski, Alan P Farwell, Jennifer Fosbroke, Kalpana N Shankar, Sara M Alexanian, William E Baker, Donald C Simonson, Marie E McDonnell
OBJECTIVE: Patients who present to the emergency department (ED) for diabetes without hyperglycemic crisis are at risk of unnecessary hospitalizations and poor outcomes. To address this, the ED Diabetes Rapid-referral Program (EDRP) was designed to provide ED staff with direct booking into the diabetes center. The objective of this study was to determine the effects of the EDRP on hospitalization rate, ED utilization rate, glycemic control, and expenditures. METHODS: We conducted a single-center analysis of the EDRP cohort (n = 420) and compared 1-year outcomes to historic controls (n = 791)...
October 2016: Endocrine Practice
Holly Blake, Natalia Stanulewicz, Francesca McGill
AIMS: To investigate physical activity levels of nursing and medicine students; examine predictors of physical activity level; and examine the most influential benefits and barriers to exercise. BACKGROUND: Healthcare professionals have low levels of physical activity, which increases their health risk and may influence their health promotion practices with patients. DESIGN: We surveyed 361 nursing (n=193) and medicine (n=168) students studying at a UK medical school...
October 12, 2016: Journal of Advanced Nursing
J Painter, L Trevithick, R P Hastings, B Ingham, A Roy
BACKGROUND: In meeting the needs of individuals with intellectual disabilities (ID) who access health services, a brief, holistic assessment of need is useful. This study outlines the development and testing of the Learning Disabilities Needs Assessment Tool (LDNAT), a tool intended for this purpose. METHOD: An existing mental health (MH) tool was extended by a multidisciplinary group of ID practitioners. Additional scales were drafted to capture needs across six ID treatment domains that the group identified...
October 11, 2016: Journal of Intellectual Disability Research: JIDR
Michelle White, Dennis Alcorn, Kirsten Randall, Stephanie Duncan, Heather Klassen, Mark Shrime
BACKGROUND: Billions of people worldwide lack access to safe affordable surgery. Surgical missions and non-governmental organisations (NGO) are vital in meeting this need, but long-term outcomes are rarely reported. Mercy Ships is a surgical NGO, and we aimed to measure disability-free survival, impact and patient satisfaction in Madagascar after a 7-month mission. METHOD: We aimed to evaluate 346 patients. Primary outcome measure was the World Health Organisation Disability Assessment Schedule 2...
October 11, 2016: World Journal of Surgery
Paul Sebo, François R Herrmann, Dagmar M Haller
BACKGROUND: No study has assessed the association between patients' and doctors' gender and patient satisfaction with organizational aspects of health care in primary care. However, just like satisfaction regarding communication styles or technical skills, satisfaction towards organization of the general practitioner (GP) practice could also depend on doctors' and/or patients' gender. Different expectations between female and male patients regarding the organization of the practice or different ways of organizing care delivery between female and male GPs could act on this satisfaction...
August 27, 2016: BMC Family Practice
Craig Evan Pollack, Michelle E Ross, Katrina Armstrong, Charles C Branas, Karin V Rhodes, Justin E Bekelman, Alicia Wentz, Christian Stillson, Archana Radhakrishnan, Enny Oyeniran, David Grande
PURPOSE: Prior work suggests that access to health care may influence the diagnosis and treatment of prostate cancer. Mystery-caller methods have been used previously to measure access to care for health services such as primary care, where patients' self-initiate requests for care. We used a mystery-caller survey for specialized prostate cancer care to assess dimensions of access to prostate cancer care. MATERIALS AND METHODS: We created an inventory of urology and radiation oncology practices in southeastern Pennsylvania...
2016: PloS One
Edward Watkins, Alexandra Newbold, Michelle Tester-Jones, Mahmood Javaid, Jennifer Cadman, Linda M Collins, John Graham, Mohammod Mostazir
BACKGROUND: Depression is a global health challenge. Although there are effective psychological and pharmaceutical interventions, our best treatments achieve remission rates less than 1/3 and limited sustained recovery. Underpinning this efficacy gap is limited understanding of how complex psychological interventions for depression work. Recent reviews have argued that the active ingredients of therapy need to be identified so that therapy can be made briefer, more potent, and to improve scalability...
October 6, 2016: BMC Psychiatry
Jennifer A Price, Ana I F Sousa Soares, Augustine D Asante, Joao S Martins, Kate Williams, Virginia L Wiseman
BACKGROUND: Despite public health care being free at the point of delivery in Timor-Leste, wealthier patients access hospital care at nearly twice the rate of poorer patients. This study seeks to understand the barriers driving inequitable utilisation of hospital services in Timor-Leste from the perspective of community members and health care managers. METHODS: This multisite qualitative study in Timor-Leste conducted gender segregated focus groups (n = 8) in eight districts, with 59 adults in urban and rural settings, and in-depth interviews (n = 8) with the Director of community health centres...
September 30, 2016: BMC Health Services Research
Carlos H Barrios, Daniel Herchenhorn, Matías Chacón, Paula Cabrera-Galeana, Peter Sajben, Ke Zhang
BACKGROUND: Sunitinib is an approved treatment for metastatic renal cell carcinoma (mRCC). The safety profile and efficacy of sunitinib were confirmed in a global expanded access trial ( identifier: NCT00130897). This report presents a subanalysis of the final trial data from patients in Latin America. METHODS: Treatment-naïve or previously treated mRCC patients aged ≥18 years received oral sunitinib at a starting dose of 50 mg/day on a 4-weeks-on/2-weeks-off schedule...
2016: OncoTargets and Therapy
Antonio Ferragud, Adam D Howell, Catherine F Moore, Tina L Ta, Marius C Hoener, Valentina Sabino, Pietro Cottone
Compulsive, binge eating of highly palatable food constitutes a core feature of some forms of obesity and eating disorders, as well as of the recently proposed disorder of food addiction. Trace Amine-Associated Receptor 1 (TAAR1) is a highly conserved G-protein-coupled receptor bound by endogenous trace amines. TAAR1 agonists have been shown to reduce multiple behavioral effects of drugs of abuse through their actions on the mesocorticolimbic system. In this study, we hypothesized that TAAR1 may play a role in compulsive, binge-like eating; we tested this hypothesis by assessing the effects of a TAAR1 agonist, RO5256390, in multiple excessive feeding-related behaviors induced by limiting access to a highly palatable diet in rats...
October 6, 2016: Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology
Balwinder-Singh, E Humphreys, D S Gaydon, P L Eberbach
Machinery for sowing wheat directly into rice residues has become more common in the rice-wheat systems of the north-west Indo-Gangetic Plains of South Asia, with increasing numbers of farmers now potentially able to access the benefits of residue retention. However, surface residue retention affects soil water and temperature dynamics, thus the optimum sowing date and irrigation management for a mulched crop may vary from those of a traditional non-mulched crop. Furthermore, the effects of sowing date and irrigation management are likely to vary with soil type and seasonal conditions...
October 2016: Field Crops Research
Emely Ek Blæhr, Rikke Søgaard, Thomas Kristensen, Ulla Væggemose
INTRODUCTION: Non-attended hospital appointments are receiving increasing attention in times when rapid access and efficient service delivery at public hospitals are on the agenda. The aim of this study was to investigate the extent of non-attendance in a Danish outpatient setting and its association with user-level and provider-level characteristics. METHODS: The study was based on appointments scheduled from June 2013 to March 2015 at an orthopaedic and a radiologic outpatient clinic...
October 2016: Danish Medical Journal
Teri M Furlong, Jhodie R Duncan, Laura H Corbit, Caroline D Rae, Benjamin D Rowlands, Anthony D Maher, Fatima A Nasrallah, Carol J Milligan, Steven Petrou, Andrew J Lawrence, Bernard W Balleine
Toluene is a commonly abused inhalant that is easily accessible to adolescents. Despite the increasing incidence of use, our understanding of its long-term impact remains limited. Here we used a range of techniques to examine the acute and chronic effects of toluene exposure on glutameteric and GABAergic function, and on indices of psychological function in adult rats after adolescent exposure. Metabolomics conducted on cortical tissue established that acute exposure to toluene produces alterations in cellular metabolism indicative of a glutamatergic and GABAergic profile...
October 1, 2016: Journal of Neurochemistry
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