scholarly journals A modified walk-in clinic for shoe insoles: Follow-up of non-attendants

2019 ◽  
Vol 43 (6) ◽  
pp. 597-600
Author(s):  
Gustav Jarl ◽  
Liselotte M Norling Hermansson
Keyword(s):  
Clinical Relevance ◽  
Waiting Times ◽  
Attendance Rate ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Medical Interventions ◽  
Number Of Patients ◽  
Shoe Insoles ◽  
Clear Information

Background: In a previous study ( n = 1286), we found that a modified walk-in system reduced waiting times for prescription of shoe insoles by 40 days compared to scheduled appointments but resulted in a non-attendance rate of 17% compared to 6% for scheduled appointments. Objectives: To investigate the reasons for non-attendance at the modified walk-in clinic. Study design: This is a cross-sectional survey. Methods: Unlike traditional walk-in clinics, a limited number of patients were invited each week from the waiting list to attend the modified walk-in clinic on pre-specified days during the following 5 weeks. A questionnaire was sent to 137 patients who did not attend the modified walk-in clinic, of whom 50 (36%) responded. Results: The most frequently reported reasons for not attending were the following: could not attend on the suggested days and times (30%), had already received help (18%) and illness or other medical interventions (16%). The majority of these issues could have been overcome by rescheduling to a scheduled appointment. Conclusion: The main reason for not attending a modified walk-in clinic was that suggested days and times did not suit the patients. The option to reschedule the appointment needs to be clearly emphasized in the information provided to the patient. Clinical relevance With clear information about rescheduling options, a modified walk-in clinic could be used to reduce waiting times for certain groups of patients.

scholarly journals Evaluation of the Initial 12 Months of a Routine Cryptococcal Antigen Screening Program in Reduction of HIV-Associated Cryptococcal Meningitis in Uganda

2021 ◽  
Author(s):  
Kagimu Enock ◽  
Kiwanuka Julius ◽  
Bridget C Griffith ◽  
Derrick Bary Abila ◽  
Morris K Rutakingirwa ◽  
...  
Keyword(s):  
Antifungal Therapy ◽  
Cryptococcal Meningitis ◽  
Screening Program ◽  
Health Facilities ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Number Of Patients ◽  
Fluconazole Therapy ◽  
Screening Cascade

Abstract Background: Asymptomatic Cryptococcal Antigenemia (CrAg) patients develop meningitis within a month of testing positive. Pre-emptive antifungal therapy can prevent progression to Cryptococcal meningitis(CM). In April 2016, a national CrAg screening program was initiated in 206 high-volume health facilities that provide antiretroviral therapy in Uganda. We report the evaluation of the CrAg screening cascade focusing on linkage to care, fluconazole therapy for 10 weeks, and ART initiation in a subset of facilities.Methods: We conducted a retrospective, cross-sectional survey of patients with CD4<100 at seven urban and seven rural facilities after one year of program implementation. We quantified the number of patients who transitioned through the steps of the CrAg screening cascade over six-months follow-up. We defined cascade completion as a prophylactic fluconazole prescription. We conducted semi-structured interviews with lab personnel and clinic staff to assess functionality of the CrAg screening program. Data was collected using REDCap.Results:We evaluated 359 patient records; the majority (358/359, 99.7%) were from government owned health facilities and just over half (193/359, 53.8%) had a median baseline CD4 cell count of <50 cell/µL. Overall, CrAg screening had been performed in 255/359 (71.0%, 95% CI, 66.0-75.7) of patients’ records reviewed, with a higher proportion among urban facilities (170/209 (81.3%, 95% CI, 75.4-86.4)) than rural facilities (85/150 (56.7%, 95% CI, 48.3-64.7)). Among those who were CrAg screened, 56/255 (22.0%, 95% CI, 17.0-27.5%) had cryptococcal antigenemia, of whom 47/56 (83.9%, 95% CI, 71.7-92.4%) were initiated on pre-emptive therapy with fluconazole and 8/47 (17.0%, 95% CI, 7.6-30.8%) of these were still receiving antifungal therapy at 6 months follow up. Atleast one CNS symptom was present in 70% (39/56) of those with antigenemia. In patients who had started ART, almost 40% initiated ART prior to CrAg screening. Inadequacy of equipment/supplies was reported by 15/26 (58%) of personnel as a program barrier, while 13/26 (50%) reported a need for training about CM and CrAg screening.Conclusion:There was a critical gap in the follow-up of patients after initiation on fluconazole therapy. ART had been initiated in almost 40% of patients prior to CrAg screening, which predisposes them to unmasking Cryptococcal IRIS. Higher antigenemia patients presenting with CNS symptoms could be related to late presentation. There is need to address these gaps after a more thorough evaluation.

Prevalence and determinant factors of exclusive breastfeeding practices among mothers in Marrakesh province, Morocco: A cross- sectional survey

2021 ◽  
pp. 1-11
Author(s):  
Soufiane El Moussaoui ◽  
Kamal Kaoutar ◽  
Ahmed Chetoui ◽  
Abdeslam El Kardoudi ◽  
Fatiha Chigr ◽  
...  
Keyword(s):  
Exclusive Breastfeeding ◽  
Multivariate Logistic Regression ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Factors Associated ◽  
Breastfeeding Practices ◽  
Survey Report ◽  
Duration Of Breastfeeding ◽  
Breastfeeding Practice

BACKGROUND: Exclusive breastfeeding is the best form of nutrition for infants during the first 6 months of life. Nevertheless, the practice of breastfeeding is currently declining throughout the world. OBJECTIVE: The objective of this study was to assess the prevalence of exclusive breastfeeding (EBF) practice and its associated factors among mothers living in Marrakesh province, Morocco. METHODS: The data were collected using an interviewer administered questionnaire. Both bivariate and multivariate logistic regression analyses were used to identify factors associated with exclusive breastfeeding practice. RESULTS: Prevalence of exclusive breastfeeding was 50.2%. Mothers with age more than 30 years, residing in rural area, receiving counseling related breastfeeding during antenatal follow up and having knowledge about duration of breastfeeding were more likely to practice exclusive breastfeeding than their counterparts. CONCLUSION: Although the prevalence of breastfeeding in Marrakesh was higher than the last national survey report but it is still insufficient. These findings have to stress authorities and deciders to sensitize mothers and future mothers to increase exclusive breastfeeding practice notably through the involvement of health professionals.

scholarly journals Support received by family members before, at and after an ill person’s death

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Anna O’Sullivan ◽  
Anette Alvariza ◽  
Joakim Öhlén ◽  
Cecilia Larsdotter
Keyword(s):  
Survey Design ◽  
Family Members ◽  
Time Of Death ◽  
Healthcare Staff ◽  
Care Needs ◽  
Advanced Illness ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Bereaved Family

Abstract Background It is widely recognised, that family members are central to care of people with advanced illness, and that support should be provided to all family members in need thereof. The aim of this study was to investigate family members’ experiences of support received during the last three months of life, at the time of death and after the death of a person with advanced illness. Methods A retrospective cross-sectional survey design was employed, using the VOICES(SF) questionnaire and multiple methods for data analyses. The sample consisted of 485 bereaved family members (aged: 20–90 years old, 70% women) of people who died in hospital between August 2016-April 2017. Results Of the family members, 58,8% reported they had received enough help and support during the illness, whereas 30,2% had not. Family members’ comments about support during the illness were mainly related to care the ill person had or had not received, rather than about support they themselves received. Of all family members, 52,8% reported having had enough support at the time of the ill person’s death. Related to support at death, 14,6% reported that the imminence of death was not clear, which was described as having affected their opportunity to be with the dying person at the time of death. Of all, 25,2% had a follow-up conversation after the death, 48% did not and did not want to, and 21% had no follow-up conversation, but would have liked one. A follow-up conversation was described as helpful for the bereavement process, and disappointment was expressed when not receiving support after the death. Conclusions Family members’ experiences of support were partly related to whether the ill person’s care needs were fulfilled. Healthcare staff expressing empathy and respect in the care of dying people and their family members were important for family members’ experiences of support. Family members’ difficulty recognising that death was imminent and the importance of healthcare staff providing them with clear information were expressed in connection with support at death. Follow-up conversations were valued by family members, especially if with a healthcare professional who was present at the time of death.

scholarly journals A Cross-sectional Survey of the North American Skull Base Society: Current Practice Patterns of Vestibular Schwannoma Evaluation and Management in North America

2017 ◽  
Vol 79 (03) ◽  
pp. 289-296 ◽  
Author(s):  
Jamie Van Gompel ◽  
R. Wiet ◽  
Nicole Tombers ◽  
Anand Devaiah ◽  
Devyani Lal ◽  
...  
Keyword(s):  
North America ◽  
Skull Base ◽  
Vestibular Schwannoma ◽  
North American ◽  
Management Practices ◽  
Current Practice ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Number Of Patients ◽  
Wide Range

Background Very few studies have examined vestibular schwannoma (VS) management trends across centers and between providers. The objective of this study is to examine current practice trends, variance in treatment philosophies, and nuanced or controversial aspects of VS care across North America. Methods This is a cross-sectional survey of North American Skull Base Society (NASBS) members who report regular involvement in VS care. Results A total of 57 completed surveys were returned. Most respondents claimed to have over 20 years of experience and the majority reported working in an academic practice with an affiliated otolaryngology and/or neurosurgery residency program. Sixty-three percent of respondents claimed to evaluate VS patients in clinic with both an otolaryngologist and neurosurgeon involved. Eighty-six percent of respondents claimed to operate on VS with both an otolaryngologist and neurosurgeon involved, while only 18% of neurosurgeons and 9% of otolaryngologists performed surgery alone. There was a wide range in the number of cases evaluated at each center annually. Similarly, there was wide variation in the number of patients treated with microsurgery and radiation at each center. Additional details regarding management preferences for microsurgery, stereotactic radiosurgery, stereotactic radiotherapy, and conservative observation are presented. Conclusion VS management practices vary between providers and centers. Overall, most centers employ a multidisciplinary approach to management with collaboration between otolaryngology and neurosurgery. Overall, survey responses concur with previous studies suggesting a shift toward conservatism in management.

scholarly journals Determinants of Method Switching among Social Franchise Clients Who Discontinued the Use of Intrauterine Contraceptive Device

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Waqas Hameed ◽  
Syed Khurram Azmat ◽  
Moazzam Ali ◽  
Wajahat Hussain ◽  
Ghulam Mustafa ◽  
...  
Keyword(s):  
User Satisfaction ◽  
Intrauterine Contraceptive Device ◽  
Contraceptive Device ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Contraceptive Usage ◽  
Social Franchise ◽  
Intrauterine Contraceptive ◽  
Contraceptive Discontinuation

Introduction. Women who do not switch to alternate methods after contraceptive discontinuation, for reasons other than the desire to get pregnant or not needing it, are at obvious risk for unplanned pregnancies or unwanted births. This paper examines the factors that influence women to switch from Intrauterine Contraceptive Device (IUCD) to other methods instead of terminating contraceptive usage altogether.Methods. The data used for this study comes from a larger cross-sectional survey conducted in nine (9) randomly selected districts of Sindh and Punjab provinces of Pakistan, during January 2011. Using Stata 11.2, we analyzed data on 333 women, who reported the removal of IUCDs due to reasons other than the desire to get pregnant.Results. We found that 39.9% of the women do not switch to another method of contraception within one month after IUCD discontinuation. Use of contraception before IUCD insertion increases the odds for method switching by 2.26 times after removal. Similarly, postremoval follow-up by community health worker doubles (OR = 2.0) the chances of method switching. Compared with women who received free IUCD service (via voucher scheme), the method switching is 2.01 times higher among women who had paid for IUCD insertion.Conclusion. To increase the likelihood of method switching among IUCD discontinuers this study emphasizes the need for postremoval client counseling, follow-up by healthcare provider, improved choices to a wider range of contraceptives for poor clients, and user satisfaction.

scholarly journals Reasons patients leave their nearest healthcare service to attend Karen Park Clinic, Pretoria North

2013 ◽  
Vol 5 (1) ◽  
Author(s):  
Agnes T. Masango- Makgobela ◽  
Indiran Govender ◽  
John V. Ndimande
Keyword(s):  
Healthcare Provider ◽  
Waiting Time ◽  
Healthcare Service ◽  
Waiting Times ◽  
Healthcare Providers ◽  
Descriptive Study ◽  
Staff Attitudes ◽  
Quality Service ◽  
Cross Sectional

Background: Many patients move from one healthcare provider or facility to another, disturbing the continuity that enhances holistic patient care.Objectives: To investigate the reasons given by patients for attending Karen Park Clinic rather than the clinic nearest to their homes.Methods: A cross-sectional descriptive study was conducted during 2010. Three hundred and fifty patients attending Karen Park Clinic were given questionnaires to complete, with the following variables: place of residence; previous attendance at the clinic nearest their home; services available at their nearest clinic; and their willingness to attend their nearest clinic in future.Results: Respondents were from Soshanguve (153; 43.7%), Mabopane (92; 26.3%), Garankuwa (29; 8.3%) and Hebron (20; 5.7%) and most were women (271; 77.4%) aged 26–45 (177; 50.6%). Eighty per cent (281) of the patients had visited their nearest clinic previously and 54 of these (19.2%) said they would not return. The reasons for this were: long waiting time (88; 25.1%); long queues (84; 24%); rude staff (60; 17%); and no medication (39; 11.1%).Conclusion: The majority of patients who had attended their nearest clinic were adamant that they would not return. It is necessary to reduce waiting times, thus reducing long queues. This can be achieved by having adequate, satisfied healthcare providers to render a quality service and by organising training for management. Patients can thus be redirected to their nearest clinic and the health centre’s capacity can be increased by procuring adequate drugs. There is a need to follow up on patients’ complaints about staff attitudes.

scholarly journals THE ATTITUDES OF MEDICAL STUDENTS TOWARDS CLINICAL RELEVANCE OF HISTOLOGY

2021 ◽  
Vol 71 (1) ◽  
pp. 351-56
Author(s):  
Naureen Waseem ◽  
Aaqiba Rasheed ◽  
Maria Gill ◽  
Ayesha Asad ◽  
Muhammad Omar Shamim ◽  
...  
Keyword(s):  
Medical Students ◽  
Private Sector ◽  
Clinical Relevance ◽  
Clinical Importance ◽  
Attitude Score ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Public And Private ◽  
Medical College ◽  
Public And Private Sector

Objective of Study: The objective of this study is to have an insight on student’s attitudes regarding histology’s clinical relevance in public and private sector medical college. Methodology: A cross sectional survey for attitude analysis towards histology’s clinical importance was carried out among 200 third year medical students from private and public sector medical college. Thurdstone and Chave attitude analysis questionnaire was employed to find the attitude score. Results: Students of both public and private sector medical college show scepticism towards the clinical importance of histology. There was no marked difference in the attitudes of students of public and private sector medical college. Most data remained on the borderline of the attitude scale employed. Conclusion: This study provided useful information for the teachers that students do not appreciate the clinical importance of histology much. Teachers need to devise strategies and to work on the students helping them comprehend the importance of histology.

scholarly journals SEPTICEMIA;

2012 ◽  
Vol 19 (06) ◽  
pp. 808-811
Author(s):  
SAEMA TEHSEEN ◽  
AFIFA WAHEED ◽  
NABEELA SHAMI
Keyword(s):  
Study Design ◽  
Teaching Hospital ◽  
Public Awareness ◽  
Developed Countries ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Number Of Patients ◽  
Elective Termination ◽  
Complete History ◽  
Definite Role

Induced Miscarriage is defined as the elective termination of pregnancy before 24 weeks of gestation. Objectives: To determinethe frequency of sepsis associated with induced Miscarriage. Study Design: Cross-sectional survey. Setting: Department of Obstetrics andGynaecology, Unit-II, Ghurki Trust Teaching Hospital, Lahore. Duration of Study: Six months from 25-12-08 to 24-06-09. Materials andMethods: Total 110 cases were taken. Complete history including parity and mode of admission was taken. All information was recorded onspecially designed proforma. Results: A large number of patients turned out to be para 3-4 i.e. 87 (79%), 15 cases (13.7%) had the paritybetween 5-7 and only 8 cases (7.3%) were para 1-2 (Table-I).On analyzing the mode of admission it was found that 50 (45.4%) patients wereadmitted through out-patient department. 60 cases (54.6%) were admitted through emergency (Table-II). Finally the frequency of sepsisamongst women presenting with Miscarriage was calculated and it was found to be 25 (22.7%). 85 (77.3%) cases did not show any evidence ofsepsis (Table-III). Conclusions: Illegal Miscarriages are a major contribution to septic morbidity leading to a large number of maternal deathswhich is a dilemma in under developed countries like ours. Better public awareness and access to contraceptive measures has a definite role toplay in improving the outcome.

scholarly journals Knowledge, Attitude & Practice Among Psoriasis Patients in India Towards Teledermatology During COVID-19 Pandemic

2021 ◽  
Vol 6 (4) ◽  
pp. 01-13
Author(s):  
Archana Mavoori ◽  
Sudha Bala ◽  
Rajiv Kumar Bandaru ◽  
Aruna Kumari Yerra
Keyword(s):  
Teaching Hospital ◽  
Tertiary Care ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Tertiary Care Teaching Hospital ◽  
Care Teaching ◽  
Attitude And Practice ◽  
Knowledge And Attitude ◽  
Knowledge Attitude And Practice

Background: The current COVID-19 pandemic has imposed upon the entire community norms of social distancing and home quarantine. Follow up consultations in these times can be made through teledermatology through smart phones. Success of this technology in these hours of crisis depends upon the knowledge, attitude and behaviour of patients towards teledermatology. Follow up consultations done through teleconsultations will decrease risk of exposure to COVID-19 among psoriasis patients who need frequent follow ups. Aim: The main objective of this study is to assess the awareness, knowledge, attitude and practice of teledermatology through teledermatology among psoriasis patients at a tertiary care teaching hospital. Materials and Methods: A cross-sectional survey, from Psoriasis Clinic registry maintained in the outpatient department of DVL of a tertiary care teaching hospital in India is conducted. A pre-validated self-administered questionnaire is used for the survey to assess knowledge, attitude and practice of teledermatology. Analysis will be done as per study objectives using descriptive statistics for quantitative data and content analysis for qualitative data. Results: Out of 150 patients, 87(58%) were males and females were 63(42%). Most common age group to participate in the study was 36-45 years- 43(28.7%). Majority of participants were educated up to –graduate 53(35.3%). Males had higher knowledge and attitude scores compared to females. Most of the patients found using teleconsutations easy and convenient. Conclusion: Teledermatology is the need of the hour to be implemented in these hours of COVID-19 pandemic.

scholarly journals Methods of conduct and reporting of living systematic reviews: a protocol for a living methodological survey

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 221 ◽  
Author(s):  
Assem M. Khamis ◽  
Lara A. Kahale ◽  
Hector Pardo-Hernandez ◽  
Holger J. Schünemann ◽  
Elie A. Akl
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Evidence Synthesis ◽  
Cochrane Library ◽  
Cross Sectional Survey ◽  
Systematic Review Methodology ◽  
Cross Sectional ◽  
Prospective Longitudinal ◽  
Over Time

Background: The living systematic review (LSR) is an emerging approach for improved evidence synthesis that uses continual updating to include relevant new evidence as soon as it is published. The objectives of this study are to: 1) assess the methods of conduct and reporting of living systematic reviews using a living study approach; and 2) describe the life cycle of living systematic reviews, i.e., describe the changes over time to their methods and findings. Methods: For objective 1, we will begin by conducting a cross-sectional survey and then update its findings every 6 months by including newly published LSRs. For objective 2, we will conduct a prospective longitudinal follow-up of the cohort of included LSRs. To identify LSRs, we will continually search the following electronic databases: Medline, EMBASE and the Cochrane library. We will also contact groups conducting LSRs to identify eligible studies that we might have missed. We will follow the standard systematic review methodology for study selection and data abstraction. For each LSR update, we will abstract information on the following: 1) general characteristics, 2) systematic review methodology, 3) living approach methodology, 4) results, and 5) editorial and publication processes. We will update the findings of both the surveys and the longitudinal follow-up of included LSRs every 6 months. In addition, we will identify articles addressing LSR methods to be included in an ‘LSR methods repository’. Conclusion: The proposed living methodological survey will allow us to monitor how the methods of conduct, and reporting as well as the findings of LSRs change over time. Ultimately this should help with ensuring the quality and transparency of LSRs.

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