scholarly journals Improving the attendance for new psychiatric out-patient referrals

1993 ◽  
Vol 17 (6) ◽  
pp. 347-348 ◽  
Author(s):  
Martin Baggaley
Keyword(s):  
Health Centre ◽  
Significant Proportion ◽  
Psychiatric History ◽  
Attendance Rate ◽  
Personal Letter ◽  
Standard Card ◽  
Family Setting ◽  
Short Time ◽  
Patient Referrals ◽  
Referral Letters

A significant proportion of patients referred to psychiatric out-patient clinics fail to attend the first appointment. Previous work suggested that typically 30% do not attend (Burgess & Harrington, 1964; Skuse, 1975) and this results in an inefficient utilisation of psychiatrists' time. One solution would be to overbook new patients by 30%. Unfortunately the proportion of non-attendance at each clinic is variable and difficult to estimate in advance. Psychiatrists have been shown to be poor predictors of non-attendance from examining referral letters (Woods, 1992). Overbooking might result in a long waiting time and short time for assessment. Previous research has suggested patients are more likely to attend if they received a personal letter rather than a standard card, had a previous psychiatric history, and if they were seen in a health centre rather than a hospital (Hillis, 1990). Allaying the patient's fears and misconceptions about psychiatry also improved attendance (Skuse, 1975). Work in a child and family setting suggested that sending a family questionnaire prior to the appointment reduced the non-attendance rate (Mathai & Markantonakis, 1990).

scholarly journals Pre-diagnostic drop out of presumptive TB patients and its associated factors at Bugembe Health Centre IV in Jinja, Uganda

2020 ◽  
Vol 20 (2) ◽  
pp. 633-640
Author(s):  
Godfrey Ekuka ◽  
Ismael Kawooya ◽  
Edward Kayongo ◽  
Ronald Ssenyonga ◽  
Frank Mugabe ◽  
...  
Keyword(s):  
Associated Factors ◽  
Health Centre ◽  
Significant Proportion ◽  
Final Diagnosis ◽  
Drop Out ◽  
Population Characteristics ◽  
Dropping Out ◽  
Keywords Tuberculosis ◽  
Male Patients ◽  
The Individual

Background: Drop out of presumptive TB individuals before making a final diagnosis poses a danger to the individual and their community. We aimed to determine the proportion of these presumptive TB drop outs and their associated factors in Bugembe Health Centre, Jinja, Uganda. Methods: We used data from the DHIS2, presumptive and laboratory registers of Bugembe Health Centre IV for 2017. Descriptive statistics were used to summarize the population characteristics. A modified Poisson regression model via the generalized linear model (GLM) with log link and robust standard errors was used for bivariate and multivariate analysis. Results: Among the 216 registered presumptive TB patients who were less than 1% of patients visiting the outpatients’ department, 40.7% dropped out before final diagnosis was made. Age and HIV status were significantly associated with pre-diagnostic drop out while gender and distance from the health center were not. Conclusion: A high risk to individuals and the community is posed by the significant proportion of presumptive TB pa- tients dropping out before final diagnosis. Health systems managers need to consider interventions targeting young persons, male patients, HIV positive persons. Keywords: Tuberculosis (TB); Pre-diagnostic drop out; Presumptive TB; SORT IT.

scholarly journals Assessing Facilitators and Barriers to Referral of Children Under the Age of Five Years at Ndirande Health Centre in Blantyre, Malawi

2021 ◽  
Vol 8 ◽  
pp. 2333794X2110518
Author(s):  
Wezzie Kaunda ◽  
Thokozani Umali ◽  
Marumbo Eve Chirwa ◽  
Alinane Linda Nyondo-Mipando
Keyword(s):  
Quality Care ◽  
Group Discussion ◽  
Health Centre ◽  
Community Support ◽  
Care Workers ◽  
Facilitators And Barriers ◽  
Patient Referrals ◽  
Depth Interviews ◽  
Purposive Sample ◽  
Queen Elizabeth Central Hospital

Patient referrals among health facilities are initiated to maximize receipt of quality care at a proper level within the health system. This study explored the processes, factors that influence, and strategies for referral of children from Ndirande Health Centre to Queen Elizabeth Central Hospital in Blantyre, Malawi. We drew a purposive sample comprising health care workers, mothers, fathers, ambulance drivers, and Health Center Advisory Committee (HCAC) members and held 19 in-depth interviews and 1 focus group discussion in August 2020. The referral process is influenced by the availability of motor and bicycle ambulances that are well equipped with medical equipment, delay in seeking health services, uptake of referral, and community support. Education and communication with the community and parents respectively optimize the process of referral. There is a need to improve the referral system of under-five children by instituting a policy that is functional while addressing the main barriers.

scholarly journals Aquatic Mosses as Adaptable Bio-Filters for Heavy Metal Removal from Contaminated Water

2020 ◽  
Vol 21 (13) ◽  
pp. 4769
Author(s):  
Paride Papadia ◽  
Fabrizio Barozzi ◽  
Danilo Migoni ◽  
Makarena Rojas ◽  
Francesco P. Fanizzi ◽  
...  
Keyword(s):  
Heavy Metal ◽  
Metal Removal ◽  
Heavy Metal Removal ◽  
Significant Proportion ◽  
Pollutant Removal ◽  
Polluted Water ◽  
Aquatic Moss ◽  
Aquatic Mosses ◽  
High Concentrations ◽  
Short Time

Heavy metals (HMs) are released into the environment by many human activities and persist in water even after remediation. The efficient filtration of solubilized HMs is extremely difficult. Phytoremediation appears a convenient tool to remove HMs from polluted water, but it is limited by the choice of plants able to adapt to filtration of polluted water in terms of space and physiological needs. Biomasses are often preferred. Aquatic moss biomasses, thanks to gametophyte characteristics, can act as live filtering material. The potential for phytoremediation of Hypnales aquatic mosses has been poorly investigated compared to aquatic macrophytes. Their potential is usually indicated as a tool for bioindication and environmental monitoring more than for pollutant removal. When phytoremediation has been considered, insufficient attention has been paid to the adaptability of biomasses to different needs. In this study the heavy metal uptake of moss Taxiphyllum barbieri grown in two different light conditions, was tested with high concentrations of elements such as Pb, Cd, Zn, Cu, As, and Cr. This moss produces dense mats with few culture needs. The experimental design confirmed the capacity of the moss to accumulate HMs accordingly to their physiology and then demonstrated that a significant proportion of HMs was accumulated within a few hours. In addition to the biosorption effect, an evident contribution of the active simplistic mass can be evidenced. These reports of HM accumulation within short time intervals, show how this moss is particularly suitable as an adaptable bio-filter, representing a new opportunity for water eco-sustainable remediation.

Neurodevelopmental Outcomes of Very Low Birth Weight Infants at 18–24 Months, Corrected Gestational Age in a Tertiary Health Centre: A Prospective Cohort Study

2019 ◽  
Vol 65 (6) ◽  
pp. 552-560
Author(s):  
Samuel P Oommen ◽  
Sridhar Santhanam ◽  
Hima John ◽  
Reeba Roshan ◽  
T O Swathi ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Health Centre ◽  
Significant Proportion ◽  
Neurodevelopmental Outcome ◽  
Developmental Outcome ◽  
Neurodevelopmental Outcomes ◽  
Vlbw Infants ◽  
Neonatal Complications

Abstract Objective To determine the prevalence and risk factors for poor neurodevelopmental outcome in a cohort of very low birth weight (VLBW) infants. Subjects and methods Four hundred and twenty-two infants of a total of 643 VLBW survivors from a teaching hospital in South India were followed up to assess their neurodevelopmental outcomes. Results Among the 422 children who completed the assessment, results of 359 children whose assessments were done between 18 and 24 months were analysed. Thirty-seven children (10.31%) had poor neurodevelopmental outcome, six children [1.67%] had cerebral palsy, one child had visual impairment and another had hearing impairment. Poor post-natal growth was independently associated with poor neurodevelopmental outcomes in the multivariate analysis (p = 0.045). Neonatal complications were not associated with the developmental outcome. Conclusion Despite lower rates of neonatal complications compared with Western cohorts, significant proportion of VLBW infants had poor neurodevelopmental outcomes. Poor post-natal growth was an important determinant of the developmental outcome

scholarly journals Kissing may be an important and neglected risk factor for oropharyngeal gonorrhoea: a cross-sectional study in men who have sex with men

2019 ◽  
Vol 95 (7) ◽  
pp. 516-521 ◽  
Author(s):  
Eric P F Chow ◽  
Vincent J Cornelisse ◽  
Deborah A Williamson ◽  
David Priest ◽  
Jane S Hocking ◽  
...  
Keyword(s):  
Health Centre ◽  
Significant Proportion ◽  
Gay And Bisexual Men ◽  
Cross Sectional Study ◽  
Nucleic Acid Amplification ◽  
Bisexual Men ◽  
Sex Partners ◽  
Cross Sectional ◽  
And Bisexual ◽  
Sex With Men

ObjectivesA mathematical model suggested that a significant proportion of oropharyngeal gonorrhoea cases are acquired via oropharynx-to-oropharynx transmission (ie, tongue-kissing), but to date, no empirical study has investigated this. This study aimed to examine the association between kissing and oropharyngeal gonorrhoea among gay and bisexual men who have sex with men (MSM).MethodsMSM attending a public sexual health centre in Melbourne, Australia, between March 2016 and February 2017 were invited to participate in a brief survey that collected data on their number of male partners in the last 3 months, in three distinct categories: kissing-only (ie, no sex including no oral and/or anal sex), sex-only (ie, any sex without kissing), and kissing-with-sex (ie, kissing with any sex). Univariable and multivariable logistic regression analyses were performed to examine associations between oropharyngeal gonorrhoea positivity by nucleic acid amplification tests and the three distinct partner categories.ResultsA total of 3677 men completed the survey and were tested for oropharyngeal gonorrhoea. Their median age was 30 (IQR 25–37) and 6.2% (n=229) had oropharyngeal gonorrhoea. Men had a mean number of 4.3 kissing-only, 1.4 sex-only, and 5.0 kissing-with-sex partners in the last 3 months. Kissing-only and kissing-with-sex were associated with oropharyngeal gonorrhoea, but sex-only was not. The adjusted odds for having oropharyngeal gonorrhoea were 1.46-fold (95% CI 1.04 to 2.06) for men with ≥4 kissing-only partners and 1.81-fold (95% CI 1.17 to 2.79) for men with ≥4 kissing-with-sex partners.ConclusionsThese data suggest that kissing may be associated with transmission of oropharyngeal gonorrhoea in MSM, irrespective of whether sex also occurs.

scholarly journals Do clinicians in areas of declining malaria transmission adhere to malaria diagnosis guidelines? A cross-sectional study from Kampala, Uganda

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Angella Atukunda ◽  
Mwaka Amos Deogratius ◽  
Emmanuel Arinaitwe ◽  
Philip Orishaba ◽  
Moses R. Kamya ◽  
...  
Keyword(s):  
Malaria Transmission ◽  
Diagnostic Test ◽  
Clinical Management ◽  
Tertiary Education ◽  
Health Centre ◽  
Significant Proportion ◽  
Management Guidelines ◽  
Factors Associated ◽  
Diagnostic Practices ◽  
History Of

Abstract Background Uganda's clinical management guidelines recommend a malaria laboratory test in all patients presenting with fever (history of fever or an axillary temperature ≥ 37.5 °C), and only those with a positive test receive anti-malarial treatment. However, the current practice in areas with declining malaria transmission remains unknown. This study assessed the clinicians’ diagnostic practices, the factors associated with recommending a test, and the risk of missing a malaria case when a test is not recommended in patients presenting with fever in Kampala, an area of declining malaria transmission in Uganda. Methods Between January and March 2020, 383 participants aged ≥ 12 years and presenting to Kisenyi Health Centre IV in Kampala district with fever were enrolled in the study. A questionnaire was administered during exit interviews, routine diagnostic practices were recorded from participant clinical notes, and a research blood slide was obtained for later reading. Results Of the enrolled participants, 356 (93%) had a malaria diagnostic test recommended by the clinician. Factors associated with increasing prevalence of having a test recommended included; history of overnight travel (adjusted prevalence ratio [aPR] 1.07, 95% confidence interval [CI] 1.02–1.13, p = 0.011), being married (aPR = 1.07, 95% CI 1.01–1.13, p = 0.022), and having tertiary education (aPR = 1.09 95% CI 1.01–1.17, p = 0.031). Among the 27 participants where a malaria diagnostic test was not recommended, 4 (14.8%) had a positive study smear. Conclusion Despite having significant declines in malaria transmission in Kampala in the last decade, clinicians at the study health facility highly adhered to the clinical management guidelines, recommending a malaria test in almost all patients presenting with fever. However, a significant proportion of malaria cases was missed when a test was not recommended. These results highlight the importance of laboratory testing for malaria in all patients who present with fevers and live in endemic settings even when the transmission has significantly declined.

scholarly journals A cross sectional study to assess the diagnostic and management practices of general practitioners regarding tuberculosis in an urban slum of Mumbai, Maharashtra

2017 ◽  
Vol 4 (7) ◽  
pp. 2548
Author(s):  
G. B. Sawase ◽  
S. M. Achrya ◽  
R. R. Shinde
Keyword(s):  
Management Practices ◽  
Health Centre ◽  
Significant Proportion ◽  
Urban Slum ◽  
Drug Regimen ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Private Practitioners ◽  
Field Practice

Background: India has large and growing private medical sector and it is observed that Private Practitioners are generally the first point of contact for significant proportion of patients with tuberculosis. Hence the present study was carried out to assess the diagnostic and management practices for tuberculosis among the private practitioners in an urban slum area. Methods: A cross sectional study was conducted in the field practice area of Urban Health Centre attached to the teaching hospital and medical college. A total of 76 Private Practitioners practising in the field practice area were contacted, explained the purpose and benefits of the study, 67 private practitioners gave consent for involvement in the study. A semi structured and pretested questionnaire was used to interview the private practitioners. Data was analyzed by using SPSS software version 17.0. Results: Among 67 Private Practitioners in the area only 19 (28.4%) doctors mentioned that they diagnose TB patients in their clinic and start the diagnosed TB patients on treatment. Persistent cough (97%), fever (86.5%), weight loss (58.2%) were the most common symptoms of TB identified by these doctors. The mean duration for suspecting TB mentioned was 3.79 weeks. Chest x-ray was the most common (85.1%) investigation advised. HRZE was the drug regimen of choice whereas few doctors gave various anti-TB drugs including 2nd line drugs like kanamycin, PAS, cycloserine to their patients. Conclusions: In present study showed majority of the private practitioners are neither updated nor very particular about the diagnosis and correct regimen of anti TB therapy. A few doctors also used 2nd line anti-TB drugs drugs like kanamycin, PAS, cycloserine to their patients which shows the likely irrational use of the few available anti-tuberculosis drugs, which may favour the emergence and spread of drug resistance.  

Do Clinicians in Areas of Declining Malaria Transmission Adhere to Malaria Diagnosis Guidelines? A Cross-sectional Study From Kampala, Uganda.

2020 ◽  
Author(s):  
Atukunda Angella ◽  
Mwaka Amos Deogratius ◽  
Emmanuel Arinaitwe ◽  
Phillip Orishaba ◽  
Moses R. Kamya ◽  
...  
Keyword(s):  
Malaria Transmission ◽  
Diagnostic Test ◽  
Clinical Management ◽  
Tertiary Education ◽  
Health Centre ◽  
Significant Proportion ◽  
Cross Sectional ◽  
Management Guidelines ◽  
Factors Associated ◽  
Diagnostic Practices

Abstract Background: Uganda clinical management guidelines recommend a malaria laboratory test in all patients presenting with fever, and only those with a positive test receive antimalarial treatment. However, the current practice in areas with declining malaria transmission remains unknown. We assessed the clinicians’ diagnostic practices, the factors associated with recommending a test, and the risk of missing a malaria case when a test is not recommended in patients presenting with fever in Kampala, an area of declining malaria transmission in Uganda. Methods: Between January and March 2020, 383 participants aged > 12 years and presenting to Kisenyi Health Centre IV with fever were enrolled in the study. A questionnaire was administered during exit interviews, routine diagnostic practices were recorded from participant clinical notes, and a research blood slide was obtained for later reading. Results: Of the enrolled participants, 356 (93%) had a malaria diagnostic test recommended by the managing clinician. Factors associated with increasing prevalence of having a test recommended included; history of overnight travel (adjusted prevalence ratio [aPR] 1.07, 95% confidence interval [CI] 1.02 – 1.13, p=0.011), being married (aPR=1.07, 95% CI 1.01 – 1.13, p=0.022), and having tertiary education (aPR=1.09 95% CI 1.01 – 1.17, p=0.031). Among the 27 participants where a malaria diagnostic test was not recommended, 4 (14.8%) had a positive study smear. Conclusion: Despite having significant declines in malaria transmission in Kampala in the last decade, clinicians at the study health facility highly adhered to the clinical management guidelines, recommending a malaria test in almost all patients presenting with fever. However, a significant proportion of malaria cases was missed when a test was not recommended. These results highlight the importance of laboratory testing for malaria in all patients who present with fevers and live in endemic setting even when transmission has significantly declined.

Non-attendance at new appointments at St James's Child Guidance Clinic

2009 ◽  
Vol 26 (1) ◽  
pp. 20-22 ◽  
Author(s):  
Norbert Skokauskas ◽  
Tom Moran ◽  
Sarah Buckley
Keyword(s):  
Information System ◽  
Patient Information ◽  
Evidence Based ◽  
Child Guidance Clinic ◽  
Attendance Rates ◽  
Attendance Rate ◽  
Guidance Clinic ◽  
Child Guidance ◽  
Clinical Records ◽  
Referral Letters

AbstractObjective: This study aimed to examine non-attendance rates at new appointments at St James's Child Guidance Clinic.Method: The sample consisted of all new referrals to St. James's Child Guidance Clinic in one calendar year (2004). Data was collected retrospectively from an electronic patient information system (Pinpoint), the new patient-referral logbook, referral letters, the appointment diary, and from clinical records.Results: There were 260 new referrals to St James's Child Guidance Clinic in 2004. Out of the 260 children and adolescents granted a new appointment, 34 (13.07%) who failed to keep their appointment were identified. All patients granted an urgent appointment did attend.Conclusions: Non-attendance rates at new assessment in St James's Child Guidance Clinic were slightly lower than those reported in other studies. The implemented evidence-based strategies to reduce non-attendance rates could explain the relatively low non-attendance rate at new assessment.

Herring submesoscale dynamics through a major spawning wave: duration, abundance fluctuation, distribution, and schooling

2016 ◽  
Vol 74 (3) ◽  
pp. 717-727
Author(s):  
Georg Skaret ◽  
Aril Slotte
Keyword(s):  
Significant Proportion ◽  
Clupea Harengus ◽  
Night Time ◽  
State Dependent ◽  
Swimming Depth ◽  
Spawning Stock ◽  
Schooling Behaviour ◽  
Bottom Depth ◽  
Short Time ◽  
Observation Period

In this study, a series of 17 repeated acoustic trawl surveys within a ca. 1500 km2 area covering the major spawning location for Norwegian spring-spawning herring (Clupea harengus) was conducted over a period of about 1 month. Local herring abundance increased from ca. 25 000 to 237 000 t, a significant proportion of the total spawning stock, in just 3 d and subsequently decreased to <30 000 t over the next 7 d. The abundance change was due to a single major spawning wave developing over the observation period, and an estimated 46 000 t of eggs and milt were deposited during the short time spent at the spawning ground. There was no difference in spawning activity between day and night, but herring were more associated with deep trenches and also generally stayed deeper in more dense schools during daylight than night-time. Schooling behaviour and distribution were also strongly state-dependent, and both school swimming depth and school height decreased as spawning progressed, as did the bottom depth where the schools were located. The massive herring spawning events seem to be low-risk adaptations to an environment where predators are abundant, with rapid spawning in huge aggregations as a strategy for predator swamping.

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