scholarly journals P.216 Improving access to neurosurgeons through an electronic consultation service

Author(s):  
A Wang ◽  
S Guglani ◽  
T McCutcheon ◽  
E Keely ◽  
F Alkherayf

Background: Timely access to neurosurgeons for clinical advice is limited depending on region and other social factors. An eConsult service providing access to neurosurgeons in Ontario, Canada may influence primary care provider (PCP) course of action and referral behaviours. Methods: The Champlain BASE (Building Access to Specialist Care via eConsult) service allows PCPs to access specialist care in lieu of traditional face-to-face referrals. We conducted a cross-sectional study of eConsult cases submitted to neurosurgeons by PCPs between Jan 1, 2017 and Dec 31, 2018. Usage data and PCP responses to a mandatory closeout survey were analyzed. Results: A total of 432 eConsults were submitted. Specialist median response time was 2.29 days with 86.8% of responses occurring within 7 days. PCPs received a new or additional course of action in 53% of cases. An unnecessary face-to-face referral was avoided in 57% of all eConsults, and 50% of cases where the PCP initially contemplated requesting a referral. Over 86% of cases were rated at least 4 out of 5 in value for PCPs and their patients. Conclusions: The use of eConsult improves access to neurosurgeons by providing timely, highly-rated practice-changing clinical advice while reducing the need for patients to attend face-to-face office visits.

2017 ◽  
Vol 45 (1) ◽  
pp. 137-140 ◽  
Author(s):  
Krista Rostom ◽  
C. Douglas Smith ◽  
Clare Liddy ◽  
Amir Afkham ◽  
Erin Keely

Objective.To describe the use and benefits of an innovative eConsult service to improve access to rheumatologists.Methods.There were 225 eConsults directed to rheumatology that were categorized by type of question and effect on face-to-face referral rates.Results.The median response time by the rheumatologists was 1.9 days. Clinical questions included drug treatment (34%), diagnosis (26%), or management (14%). Osteoporosis was the most common diagnosis (22%), followed by pain in multiple joints (11%), and polyarthritis (10%). A face-to-face referral was avoided in 38% of cases.Conclusion.There are clinical questions that can be answered quickly by an eConsult, improving access to rheumatologists.


2020 ◽  
Author(s):  
Lim Jit Fan Christina ◽  
Goh Boon Kwang ◽  
Chee Wing Ling Vivian ◽  
Tang Woh Peng ◽  
Goh Qiuling Bandy

BACKGROUND Traditionally, patients wishing to obtain their prescription medications have had to present themselves physically at pharmacy counters and collect their medications via face-to-face interactions with pharmacy staff. Prescription in Locker Box (PILBOX) is a new innovation which allows patients and their caregivers to collect their medication asynchronously, 24/7 at their convenience, from medication lockers instead of from pharmacy staff and at any time convenient to them instead of being restricted to pharmacy operating hours. OBJECTIVE This study aimed to determine the willingness by patients/caregivers to use this new innovation and factors that affect their willingness. METHODS This prospective cross-sectional study was conducted over 2 months at 2 public primary healthcare centres in Singapore. Patients or caregivers who were at least 21 yo and turned up at the pharmacies to collect medications were administered a self-developed 3-part questionnaire face-to-face by trained study team members, if they gave their consent to participate in the study. RESULTS A total of 222 participants completed the study. About 40% of them participants were willing to use the PILBOX to collect their medications. Amongst the participants who were keen to use the PILBOX service, slightly more than half (i.e. 52.8%) of them were willing to pay for the PILBOX service. The participants felt that the ease of use (3.46±1.21 i.e. mean of ranking score ± standard deviation) of the PILBOX was the most important factor that would affect their willingness to use the medication pick up service. This was followed by “waiting time” (3.37±1.33), cost of using the medication pick up service (2.96±1.44) and 24/7 accessibility (2.62±1.35). This study also found that age (p=0.006), language literacy (p=0.000), education level (p=0.000), working status (p=0.011) and personal monthly income (p=0.009) were factors that affected the willingness of the patients or caregivers to use the PILBOX. CONCLUSIONS Patients and caregivers are keen to use PILBOX to collect their medications for its convenience and the opportunity to save time, if it is easy to use and not costly.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Omar A. Almohammed ◽  
Lama H. Alotaibi ◽  
Shatha A. Ibn Malik

Abstract Background The COVID-19 pandemic has required governments around the world to suspend face-to-face learning for school and university students. Colleges of pharmacy are faced with the challenge of training students in hospitals that are under considerable pressure at this time. The government of Saudi Arabia has moved all classes and training online to limit the spread of the virus. This study describes the experience of the Introductory and Advanced Pharmacy Practice Experience (IPPE and APPE) students and preceptors engaged in the virtual IPPE training. Methods A cross-sectional study was conducted to describe and appraise the implemented virtual IPPE training from the experiences of IPPE and APPE students, and their preceptor. The IPPE students described their experiences in close-ended questionnaires, while APPE students in open-ended questionnaires, and the preceptor described the experiences in narrative. The study focused on highlighting the advantages, opportunities, challenges, and shortcomings of the virtual training. Results Two preceptors and seven APPE students participated in the preparation and administration of the virtual training. The IPPE students’ experiences, based on 87 respondents, were mostly positive. Although IPPE students enjoyed the time flexibility that allowed the learning of new skills and reflection on previous experiences, 15% experienced difficulty finding quiet places with a reliable internet connection or had difficulty working on team-based activities. Moreover, some were anxious about the lack of adequate patient-care experience. On the other hand, the APPE students found the experience enriching as they gained experience and understanding of academic workflow, gained skills, and overcame the challenges they faced during this virtual training experience. Conclusions Future training programs should be organized to overcome the challenges and to maximize the benefits of training experiences. Schools of pharmacy may benefit from the training materials constructed, prepared, and administered by APPE students to improve IPPE students’ learning experiences and outcomes.


2021 ◽  
pp. 1-19
Author(s):  
Tao Han ◽  
Jingwen Dong ◽  
Jiangtao Zhang ◽  
Chenxiao Zhang ◽  
Yuxuan Wang ◽  
...  

Abstract Objective: To clarify nutrient supplementation usage and primary source of information among pregnant women in China. Design: This cross-sectional study used information on nutrient supplementation and primary source of information collected via face-to-face interviews. Data on the usage of folic acid, calcium/vitamin D, iron, vitamins, docosahexaenoic acid, and other dietary supplements were collected. Primary source of information were categorized as family/relatives, friends/co-workers, the Internet, books/magazines, television/radio, doctors, other people, and oneself. Setting: Maternal and Child Health Hospital in Chengdu, China. Participants: 1081 Chinese pregnant women aged ≥ 20 years with singleton pregnancies. Results: In all three trimesters of pregnancy, usage was highest and most stable for folic acid (81.7%), followed by vitamins (vitamin A, B-group vitamins, vitamin C, and multivitamins; 75.0%), whereas calcium/vitamin D (51.4%) and iron (18.1%) usage was low, potentially indicating a deficiency risk. All supplementation usage percentages increased with pregnancy duration (p < 0.05). Notably, approximately 10% of the pregnant women in our study did not use any nutrient supplementation, and this was especially common in early pregnancy. More than 50% of the women reported getting information on nutrient supplementation from family members, and about 30% reported getting this information from doctors. Conclusions: Among pregnant women in China, awareness about nutrient supplementation increases as the pregnancy progresses, but some types of nutrient supplementation (such as calcium/vitamin D and iron) remain at low levels. It is necessary to pay more attention to the health education of pregnant women in China, and the influence of family members should be emphasized.


2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Ali Mamane ◽  
Jean-François Tessier ◽  
Ghislaine Bouvier ◽  
Roger Salamon ◽  
Pierre Lebailly ◽  
...  

Background and Objective. Environmental factors are an increasing concern for respiratory health in developing countries. The objective of this study was to investigate whether Nigerien people living in cultivated areas have more respiratory symptoms than those living in pastoral areas. Method. A cross-sectional study was conducted in 2013 in two populations during the rainy season when land is cultivated. Environmental factors including pesticide use and respiratory symptoms were collected in adults and children during face-to-face interviews. Multivariate analysis between exposures and symptoms was performed in children and in adults separately. Results. The study included 471 adults and 229 children. Overall, none of the households reported the use of pesticides for agricultural purposes. However, 87.2% reported the use of insecticides at home. Multivariate analysis showed that people living in agricultural areas compared to those in pastoral areas had an increased risk of respiratory symptoms in adults (wheezing, dyspnea, sudden shortness of breath, and cough without fever) and in children (cough without fever). The use of insecticides showed no effect on respiratory symptoms after adjustment. Conclusion. This first epidemiological study on the environment and respiratory health conducted in Niger demonstrates a significant relationship between respiratory manifestations and the agricultural characteristics of the living area. However only the effect of insecticides in the home on respiratory health was observed.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mariam John Munyogwa ◽  
Kaloli Sayi Ntalima ◽  
Secilia Ng’weshemi Kapalata

Abstract Background Obesity at the workplace has been associated with symptoms of lower self-esteem, increased individual and employer healthcare costs, increased absenteeism and presenteeism and reduced productivity. Therefore, this study was designed to study the prevalence and correlates of central obesity among formal sector employees in Dodoma City. Methods Study design was a cross-sectional survey conducted from March to June, 2019. Participants were employees from formal sector employment defined as those paid regular monthly wage and with either a secured permanent or temporary contract. Simple random sampling was used to select four out of fifteen large buildings hosting various establishments. Respondents were obtained conveniently and interviewed face to face. Central obesity was defined as a waist circumference greater than 102 cm for males and greater than 88 cm for females. Chi-square test was conducted to assess the differences among the groups. Simple and multiple logistic regression models were fitted to identify the correlates of central obesity. Results A total of 392 respondents (98% response rate) agreed and participated in the study. The overall prevalence of central obesity was found to be 41.8% (164/392). The prevalence of central obesity was significantly higher among females (67.4% p < 0.001), respondents aged ≥51 years (60%, p = < 0.001), administrators (55.1% p = < 0.05), respondents with salary of > 1,000,000 Tanzanian Shilling (TSh.) per month (54.4%, p = < 0.05), respondents who eat homemade meals at the workplace (64.2%, p = < 0.05) and respondents with hypertension (62.5%, p = < 0.05). Correlates of central obesity were found to be female sex (AOR = 9.53; 95% CI: 5.49, 16.78), increased age, eating homemade meals at the workplace (AOR = 2.32; 95% CI: 1.04, 4.19) and hypertension (AOR = 3.15; 95% CI: 1.41, 6.91). Conclusions The present study revealed high prevalence of central obesity among formal sector employees in Dodoma City. Scholars and stakeholders are urged to generate more evidences and design appropriate interventions to curb the situation.


2021 ◽  
Author(s):  
Madiha M Abas ◽  
Shukir Saleem Hasan

Abstract Background and objectives: Colostrum is the first breastfeed which is a product by the mother. it has containing high amounts and concentrations of nutrients and antibodies. Methods: A comparative, cross-sectional study was conducted in different areas in Erbil Governorate. During the period started on 2nd Jan. to the end of May. 2019. Non- probability of 400 mothers who delivered their baby by normal vaginal delivery in the hospitals were recruited. A special tool was constructed by researchers, a direct face-to-face interview was adapted. Data were collected and interpreted to the computer. A special SPSS software version 23 was used for analyzing the data, frequency, chi-square, and two tailed t-test statistical analysis was applied for the study.Results: Incorrect knowledge among Erbil city and Koy-Sanjaq city was observed, with better information among Shaqlawa mothers. Poor practices of colostrum feeding among all mothers, and found a statistically significant association between mother’s knowledge, and relay to an association between mothers’ practices. Statistically significant differences were found between Erbil city and Koy-Sanjaq city; between Shaqlawa city and Koy-Sanjaq city concerning mothers’ practices respectively, with non-statistically differences between Erbil and Shaqlawa mothers, also non-statistically significant differences between mothers’ practices in Erbil and Shaqlawa city. There are statistically differences between mothers in Erbil, Koy-Sanjaq, and between Erbil and Shaqlawa with no statistical difference between Koy-Sanjaq and Shaqlawa mothers regarding knowledge. Conclusions: The mothers in Shaqlawa city had better knowledge and all three districts were having poor practices regarding colostrum feeding.


Curationis ◽  
2013 ◽  
Vol 36 (1) ◽  
Author(s):  
Tennyson Mgutshini

Educational discourse has long portrayed online, or e-based, learning and all non-campus-based learning options as second best to traditional face-to-face options. Critically much of the research and debate in this area of study has focused on evidence relating to student performance, attrition and retention with little consideration of the total learning experience, which values both the traditional learning outcome measures side-by-side with student-centered factors, such as students’ satisfaction with their learning experience. The objective of this study was to present a synchronous head-to-head comparison between online and campus-based students’ experiences of an undergraduate course. This paper reports on a qualitative comparative cross-sectional study, which used multiple data collection approaches to assess student learning and student satisfaction of 61 students who completed a semester of an undergraduate course. Of the 61 students, 34 were enrolled purely as online students, whilst the remaining 27 students studied the same material entirely through the traditional face-to-face medium. Methods included a standardised student satisfaction survey and an ‘achievement of learning outcomes’ measurement tool. Students on the online cohort performed better in areas where ‘self-direction’ in learning was indicated, for example self-directed problem-based tasks within the course. Online students gave less positive self-assessments of their perceived content mastery than their campus-based counterparts, despite performing just as well in both summative and formative assignments. A multi-factorial comparison shows online students to have comparable educational success and that, in terms of student satisfaction, online learners reported more satisfaction with their learning experience than their campus-based counterparts.


Author(s):  
Martin Mumuni Danaah Malick ◽  
Edem Yao Akpa ◽  
Peter Paul Bamaalabong

Background: Hospital Acquired Infections (HAIs) place a significant economic burden on the healthcare system. Infection control practices are important in minimizing healthcare associated infections. However, low compliance with Universal and Standard Precautions has been reported in a number of studies. The Centre for Disease Control and Prevention (CDC) developed baseline definitions for HAIs that were republished in 2004 and has defined HAIs as those that develop during hospitalization but are neither present nor incubating upon the patient’s admission to the hospital; generally, these infections occur between 48 to 72 hours after admission and within 10 days after hospital discharge. this study aimed at unveiling the level of knowledge, attitude and practices on infection prevention control in the operating theatres by anaesthesia practitioners at TTH. Materials and Methods: A cross-sectional study design was employed. A mixed-method approach was used for data collection which includes a structured questionnaire carried out via face to face interview and observation. Results: The study showed that 100% of the respondents have knowledge on hospital acquired infection control in the theatre in one way or the other whereas attitude and practices toward hospital infection control in the operating theatres are undesirable in some specific areas of infection control such as wearing of sterile gowns and goggle. As high as 80.6% and 69.4% do not wear goggle and gowns respectively whilst performing regional anaesthesia.  Conclusions:  This study demonstrated that anaesthetists at TTH have reported sub-optimal levels of compliance i.e. attitude and practices with selective infection control. The study further demonstrated that discrepancies exist between anaesthetists’ attitudes towards a guideline as well as their actual practice.


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