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Journal of the American Heart... Jul 2020
Topics: Diuretics; Heart Failure; Humans; Outpatients
PubMed: 32662304
DOI: 10.1161/JAHA.120.017485 -
The Yale Journal of Biology and Medicine Jun 2023Healthcare systems intend to address health needs of a community, but unfortunately may also inadvertently exacerbate the climate crisis through increased greenhouse gas... (Review)
Review
Healthcare systems intend to address health needs of a community, but unfortunately may also inadvertently exacerbate the climate crisis through increased greenhouse gas (GHG) emissions. Clinical medicine has not evolved to promote sustainability practices. New attention to the enormous impact of healthcare systems on GHG emissions and an escalating climate crisis has resulted in some institutions taking proactive measures to mitigate these negative effects. Some healthcare systems have made large-scale changes to conserve energy and materials, resulting in significant monetary savings. In this paper, we share our experience with developing an interdisciplinary work "green" team within our outpatient general pediatrics practice to implement changes, albeit small, to reduce our workplace carbon footprint. We share our experience with reducing paper usage by consolidating vaccine information sheets into a single use information sheet with quick response (QR) codes. We also share ideas for all workplaces to raise awareness of sustainability practices and to foster new ideas to address the climate crisis in both our professional and personal realms. These can help promote hope for the future and shift the collective mindset about climate action.
Topics: Humans; Child; Outpatients; Greenhouse Gases
PubMed: 37396977
DOI: 10.59249/VCAH6394 -
Clinical Journal of the American... Mar 2021
Topics: Deep Learning; Humans; Outpatients; Renal Dialysis
PubMed: 33574057
DOI: 10.2215/CJN.00450121 -
American Family Physician Feb 2022
Topics: Cervical Ripening; Female; Humans; Labor, Induced; Outpatients; Oxytocics; Pregnancy
PubMed: 35166490
DOI: No ID Found -
Journal of Healthcare Engineering 2021In order to study the construction method of long- and short-term memory neural network model, which is based on particle swarm optimization algorithm and its...
In order to study the construction method of long- and short-term memory neural network model, which is based on particle swarm optimization algorithm and its application in hospital outpatient management, we have selected historical data of outpatient volume of relevant departments in our hospital. Furthermore, we have designed and developed the outpatient volume prediction model, which is based on long- and short-term memory neural network. Additionally, we have used particle swarm optimization algorithm (PSO) to optimize various parameters of long- and short-term memory network and then utilized this optimized model to accurately predict the outpatient volume. Experimental observations, which are collected through the results of monthly outpatient volume prediction, show that Root Mean Square Error (RMSE) of the particle swarm optimized LTMN model on the test set is reduced by 48.5% compared with the unoptimized model. The particle swarm optimization algorithm has efficiently optimized the prediction model, which makes the model better predict the trend of outpatient volume and thus provide decision support for medical staff's outpatient management.
Topics: Algorithms; Humans; Neural Networks, Computer; Outpatients
PubMed: 34868529
DOI: 10.1155/2021/7246561 -
PloS One 2016Relatively few articles have focused on exploring factors influencing soldiers' overall satisfaction and differences between inpatients' and outpatients' satisfaction,...
BACKGROUND
Relatively few articles have focused on exploring factors influencing soldiers' overall satisfaction and differences between inpatients' and outpatients' satisfaction, particularly in the Chinese army. Elucidating factors influencing military inpatient and outpatient care separately and analyzing their differences may provide more information for the health system.
METHODS
The Revised China National Health Service Survey questionnaire was used in the survey. The questionnaire included 5 sections and 32 items concerning demographic, inpatient, and outpatient characteristics and perception variables for both inpatients and outpatients. Bivariate and multivariate techniques were used to reveal relationships between satisfaction and the variables assessed.
RESULTS
Outpatients' and inpatients' overall satisfaction rates were 19.0% and 18.5%, respectively. The strongest determinant of outpatients' satisfaction was satisfaction with doctor's communication regarding therapeutic regimen followed by length of military service, level of trust in medical staff, and disease severity. Determinants of inpatients' satisfaction included staff categories, satisfaction with environment, and satisfaction with medical quality.
CONCLUSION
The factors influencing military outpatients' satisfaction differed from those of inpatients. Exploring the causes of satisfaction and dissatisfaction with military health institutions is important in their fulfillment of their responsibility to maintain soldiers' health.
Topics: Adolescent; Adult; China; Humans; Inpatients; Military Medicine; Outpatients; Patient Satisfaction
PubMed: 27007805
DOI: 10.1371/journal.pone.0151234 -
JPMA. the Journal of the Pakistan... Sep 2021To identify the association among suicidal ideation, deliberate self-harm, and psychopathological distress in normal and deliberate self-harm adults.
OBJECTIVE
To identify the association among suicidal ideation, deliberate self-harm, and psychopathological distress in normal and deliberate self-harm adults.
METHODS
The cross-sectional study was conducted at the Department of Psychiatry, Military Hospital, Rawalpindi, Pakistan, from January to July 2017, and comprised deliberate self harm and normal adults aged 18-25 years. Psychiatric evaluation involved a semi-structured interview based on mental status examination. The self-harm tendency was assessed on the basis of self-harm inventory of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. Beck scale for suicide ideation and he depression anxiety and stress scale were also used for data collection. Data was analysed using SPSS 22.
RESULTS
There were 200 subjects with a mean age of 20.89±9.06 years; 100(50%) each in deliberate self-harm and normal groups. Deliberate self-harm was significantly positively associated with suicidal ideation and mental health problems, including depression, anxiety and stress (p<0.05). Deliberate self-harm tendency was also positively associated with mental health problems in normal adults (p<0.05). Normal adults had higher level of mental health problems, such as depression and stress, compared to deliberate self harm adults (p<0.05). Adults having self-harm behaviour were more inclined to have suicidal ideation compared to normal adults behaviour (p<0.05).
CONCLUSIONS
Deliberate self-harm was found to be strongly related to suicidal behaviour and mental health issues in both normal and deliberate self-harm adults.
Topics: Adolescent; Adult; Child; Cross-Sectional Studies; Humans; Male; Mental Disorders; Outpatients; Risk Factors; Self-Injurious Behavior; Suicidal Ideation; Young Adult
PubMed: 34580503
DOI: 10.47391/JPMA.03-379 -
Neuropsychiatrie : Klinik, Diagnostik,... Dec 2022The status of care in child and adoelscent psychiatry in Austria is still incomplete but increasing since the foundation of this medical specialty. Corona pandemia... (Review)
Review
The status of care in child and adoelscent psychiatry in Austria is still incomplete but increasing since the foundation of this medical specialty. Corona pandemia increases the pressure on the caring structures.In this paper the current state of publically paid outpatient care is reviewed and summarized. Differences between current state and the desired/planned state of care will document existing deficits and needed developments.The 9 federal states of Austria have made variable progress in developing the general child psychiatric care. We conclude with recommendations for further implementations.
Topics: Child; Adolescent; Humans; Austria; Outpatients; Psychiatry; Psychotherapy; Ambulatory Care
PubMed: 36315385
DOI: 10.1007/s40211-022-00437-w -
PloS One 2012Adverse drug reactions in children are an important public health problem. We have undertaken a systematic review of observational studies in children in three settings:... (Review)
Review
BACKGROUND
Adverse drug reactions in children are an important public health problem. We have undertaken a systematic review of observational studies in children in three settings: causing admission to hospital, occurring during hospital stay and occurring in the community. We were particularly interested in understanding how ADRs might be better detected, assessed and avoided.
METHODS AND FINDINGS
We searched nineteen electronic databases using a comprehensive search strategy. In total, 102 studies were included. The primary outcome was any clinical event described as an adverse drug reaction to one or more drugs. Additional information relating to the ADR was collected: associated drug classification; clinical presentation; associated risk factors; methods used for assessing causality, severity, and avoidability. Seventy one percent (72/102) of studies assessed causality, and thirty four percent (34/102) performed a severity assessment. Only nineteen studies (19%) assessed avoidability. Incidence rates for ADRs causing hospital admission ranged from 0.4% to 10.3% of all children (pooled estimate of 2.9% (2.6%, 3.1%)) and from 0.6% to 16.8% of all children exposed to a drug during hospital stay. Anti-infectives and anti-epileptics were the most frequently reported therapeutic class associated with ADRs in children admitted to hospital (17 studies; 12 studies respectively) and children in hospital (24 studies; 14 studies respectively), while anti-infectives and non-steroidal anti-inflammatory drugs (NSAIDs) were frequently reported as associated with ADRs in outpatient children (13 studies; 6 studies respectively). Fourteen studies reported rates ranging from 7%-98% of ADRs being either definitely/possibly avoidable.
CONCLUSIONS
There is extensive literature which investigates ADRs in children. Although these studies provide estimates of incidence in different settings and some indication of the therapeutic classes most frequently associated with ADRs, further work is needed to address how such ADRs may be prevented.
Topics: Child; Drug-Related Side Effects and Adverse Reactions; Hospitalization; Humans; Outpatients
PubMed: 22403604
DOI: 10.1371/journal.pone.0024061 -
Health Informatics Journal Dec 2020Scheduling of resources and patients are crucial in outpatient clinics, particularly when the patient demand is high and patient arrivals are random. Generally,...
Scheduling of resources and patients are crucial in outpatient clinics, particularly when the patient demand is high and patient arrivals are random. Generally, outpatient clinic systems are push systems where scheduling is based on average demand prediction and is considered for long term (monthly or bimonthly). Often, planning and actual scenario vary due to uncertainty and variability in demand and this mismatch results in prolonged waiting times and under-utilization of resources. In this article, we model an outpatient clinics as a multi-agent system and propose an intelligent real-time scheduler that schedules patients and resources based on the actual status of departments. Two algorithms are implemented: one for resource scheduling that is based on predictive demand and the other is patient scheduling which performs path optimization depending on the actual status of departments. In order to match resources with stochastic demand, a coordination mechanism is developed that reschedules the resources in the outpatient clinics in real time through auction-bidding procedures. First, a simulation study of intelligent real-time scheduler is carried out followed by implementation of the same in an outpatient clinic of Aravind Eye Hospital, Madurai, India. This hospital has huge patient demand and the patient arrivals are random. The results show that the intelligent real-time scheduler improved the performance measures like waiting time, cycle time, and utilization significantly compared to scheduling of resources and patients in isolation. By scheduling resources and patients, based on system status and demand, the outpatient clinic system becomes a pull system. This scheduler transforms outpatient clinics from open loop system to closed-loop system.
Topics: Ambulatory Care Facilities; Appointments and Schedules; Computer Simulation; Humans; India; Outpatients
PubMed: 32081068
DOI: 10.1177/1460458220905380