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EMBO Reports Jan 2020Core facilities offer visiting scientists access to equipment and expertise to generate and analyze data. For some projects, it might however be more efficient to...
Core facilities offer visiting scientists access to equipment and expertise to generate and analyze data. For some projects, it might however be more efficient to collaborate remotely by sending in samples.
Topics: Postal Service
PubMed: 31840417
DOI: 10.15252/embr.201949755 -
Health Services Research Jun 2022To describe the design, implementation, and plans to evaluate the Veterans Crisis Line (VCL) Caring Letters intervention.
OBJECTIVE
To describe the design, implementation, and plans to evaluate the Veterans Crisis Line (VCL) Caring Letters intervention.
DATA SOURCES
Veterans with VCL contact and VHA service utilization.
STUDY DESIGN
Caring Letters is an evidence-based post-acute care suicide prevention intervention in which brief messages are mailed to individuals at high risk of suicide repeatedly over time to communicate that people care about them and are concerned for their well-being. An effectiveness-implementation hybrid type 1 trial using the RE-AIM evaluation framework is underway to examine the use of Caring Letters with veterans who contact the VCL. A team of suicide prevention subject matter experts, researchers, and operational partners from the VCL will evaluate the effects of Caring Letters on clinical outcomes and Department of Veterans Affairs - Veterans Health Administration (VHA) clinical utilization rates and examine facilitators and barriers to implementing the Caring Letters campaign.
DATA COLLECTION METHODS
Veterans who contact the VCL are linked with national administrative VHA data. Semi-structured interviews were conducted as part of a qualitative formative evaluation.
PRINCIPAL FINDINGS
In the first 12 months of the intervention, Caring Letters have been sent to over 100,000 veterans with VCL contact (over 500,000 letters mailed). A formative qualitative evaluation early in implementation revealed a variety of positive veteran perspectives on the intervention.
CONCLUSIONS
Partnered program design and evaluation with a high level of stakeholder engagement and participant feedback can result in a rigorous and feasible evaluation plan that improves implementation processes and produces actionable results. The initial results of this evaluation will be used to better inform care in the VHA and, specifically, the VCL.
Topics: Humans; Postal Service; United States; United States Department of Veterans Affairs; Veterans; Suicide Prevention
PubMed: 35403233
DOI: 10.1111/1475-6773.13985 -
Health Care Management Science Dec 2020The annual preventable cost from non-adherence in the US health care system amounts to $100 billion. While the relationship between adherence and the health system, the...
The annual preventable cost from non-adherence in the US health care system amounts to $100 billion. While the relationship between adherence and the health system, the condition, patient characteristics and socioeconomic factors are established, the role of the heterogeneous productivity of drug treatment remains ambiguous. In this study, we perform cross-sectional retrospective analyses to study whether patients who use newer drugs are more adherent to pharmacotherapy than patients using older drugs within the same therapeutic class, accounting for unobserved heterogeneity at the individual level (e.g. healthy adherer bias). We use US Marketscan commercial claims and encounters data for 2008-2013 on patients initiating therapy for five chronic conditions. Productivity is captured by a drug's earliest Food and Drug Administration (FDA) approval year ("drug vintage") and by FDA" therapeutic potential" designation. We control for situational factors as promotional activity, copayments and distribution channel. A 10-year increase in mean drug vintage is associated with a 2.5 percentage-point increase in adherence. FDA priority status, promotional activity and the share of mail-order prescription fills positively influenced adherence, while co-payments had a negative effect. Newer drugs not only may be more effective in terms of clinical benefits, on average. They provide means to ease drug therapy to increase adherence levels as one component of drug quality, a notion physicians and pharmacy benefit managers should be aware of.
Topics: Chronic Disease; Cross-Sectional Studies; Drug Prescriptions; Humans; Medication Adherence; Postal Service; Retrospective Studies; United States
PubMed: 32770286
DOI: 10.1007/s10729-020-09513-5 -
MBio 2011In the fall of 2001, Bacillus anthracis spores were spread through letters mailed in the United States. Twenty-two people are known to have been infected, and five of...
In the fall of 2001, Bacillus anthracis spores were spread through letters mailed in the United States. Twenty-two people are known to have been infected, and five of these individuals died. Together with the September 11 attacks, this resulted in a reevaluation of the risks and benefits of life science research with the potential for misuse. In this editorial, we review some of the results of these discussions and their implications for the future.
Topics: Anthrax; Bacillus anthracis; Biomedical Research; Bioterrorism; Humans; Postal Service; Security Measures; United States
PubMed: 22027008
DOI: 10.1128/mBio.00232-11 -
Scientific Reports Apr 2023The international postal network is one of the most widely used methods for correspondence throughout the world. Most postal traffic across the globe consists of...
The international postal network is one of the most widely used methods for correspondence throughout the world. Most postal traffic across the globe consists of legitimate interpersonal, business-consumer, and business-business communications. However, the global postal system is also utilized for criminal activity. In particular, it is often utilized to ship and distribute contraband, including illegal psychoactive drugs such as fentanyl and heroin, to consumers. Existing technological solutions are capable of identifying synthetic opioids and other illegal drugs within packages, but are accompanied by several disadvantages that make them unsuitable for large-scale authentication of international mail traffic. This paper presents a novel method for non-invasive authentication of mail packages that overcomes these challenges. The approach uses nuclear quadrupole resonance (NQR) spectroscopy to detect and quantify the presence of known active pharmaceutical ingredients (APIs) within the package. It has been experimentally demonstrated using a bench top prototype. Test results from a variety of package types demonstrate the effectiveness of the proposed authentication approach.
Topics: Postal Service; Magnetic Resonance Spectroscopy; Heroin; Analgesics, Opioid; Technology
PubMed: 37015953
DOI: 10.1038/s41598-023-31497-9 -
Journal of Medical Screening Dec 2021Digital health care offers an opportunity to scale and personalize cancer screening programs, such as mailed outreach for colorectal cancer (CRC) screening. However,... (Review)
Review
OBJECTIVE
Digital health care offers an opportunity to scale and personalize cancer screening programs, such as mailed outreach for colorectal cancer (CRC) screening. However, studies that describe the patient selection strategy and process for CRC screening are limited. Our objective was to evaluate implementation strategies for selecting patients for CRC screening programs in large health care systems.
METHODS
We conducted a systematic review of 30 studies along with key informant surveys and interviews to describe programmatic implementation strategies for selecting patients for CRC screening. PubMed and Embase were searched since inception through December 2018, and hand searches were performed of the retrieved reference lists but none were incorporated ( = 0). No language exclusions were applied.
RESULTS
Common criteria for outreach exclusion included: being up-to-date with routine CRC screening ( = 22), comorbidities ( = 20), and personal history ( = 22) or family history of cancer ( = 9). Key informant surveys and interviews were performed ( = 28) to understand data sources and practices for patient outreach selection, and found that 13 studies leveraged electronic medical care records, 10 studies leveraged a population registry (national, municipal, community, health), 4 studies required patient opt-in, and 1 study required primary care provider referral. Broad ranges in fecal immunochemical test completion were observed in community clinic ( = 8, 31.0-59.6%), integrated health system ( = 5, 21.2-82.7%), and national regional CRC screening programs ( = 17, 23.0-64.7%). Six studies used technical codes, and four studies required patient self-reporting from a questionnaire to participate.
CONCLUSION
This systematic review provides health systems with the diverse outreach practices and technical tools to support efforts to automate patient selection for CRC screening outreach.
Topics: Colorectal Neoplasms; Early Detection of Cancer; Humans; Mass Screening; Occult Blood; Patient Selection; Postal Service
PubMed: 33683155
DOI: 10.1177/0969141321997482 -
BMJ (Clinical Research Ed.) May 2002To identify methods to increase response to postal questionnaires. (Review)
Review
OBJECTIVE
To identify methods to increase response to postal questionnaires.
DESIGN
Systematic review of randomised controlled trials of any method to influence response to postal questionnaires.
STUDIES REVIEWED
292 randomised controlled trials including 258 315 participants INTERVENTION REVIEWED: 75 strategies for influencing response to postal questionnaires.
MAIN OUTCOME MEASURE
The proportion of completed or partially completed questionnaires returned.
RESULTS
The odds of response were more than doubled when a monetary incentive was used (odds ratio 2.02; 95% confidence interval 1.79 to 2.27) and almost doubled when incentives were not conditional on response (1.71; 1.29 to 2.26). Response was more likely when short questionnaires were used (1.86; 1.55 to 2.24). Personalised questionnaires and letters increased response (1.16; 1.06 to 1.28), as did the use of coloured ink (1.39; 1.16 to 1.67). The odds of response were more than doubled when the questionnaires were sent by recorded delivery (2.21; 1.51 to 3.25) and increased when stamped return envelopes were used (1.26; 1.13 to 1.41) and questionnaires were sent by first class post (1.12; 1.02 to 1.23). Contacting participants before sending questionnaires increased response (1.54; 1.24 to 1.92), as did follow up contact (1.44; 1.22 to 1.70) and providing non-respondents with a second copy of the questionnaire (1.41; 1.02 to 1.94). Questionnaires designed to be of more interest to participants were more likely to be returned (2.44; 1.99 to 3.01), but questionnaires containing questions of a sensitive nature were less likely to be returned (0.92; 0.87 to 0.98). Questionnaires originating from universities were more likely to be returned than were questionnaires from other sources, such as commercial organisations (1.31; 1.11 to 1.54).
CONCLUSIONS
Health researchers using postal questionnaires can improve the quality of their research by using the strategies shown to be effective in this systematic review.
Topics: Data Collection; Data Interpretation, Statistical; Humans; Motivation; Postal Service; Randomized Controlled Trials as Topic; Research Design; Surveys and Questionnaires
PubMed: 12016181
DOI: 10.1136/bmj.324.7347.1183 -
Ciencia & Saude Coletiva May 2013Dog bites are the third most common cause of absenteeism among postal workers of the Brazilian National Postal Service in Southern Brazil, with an average off-work time...
Dog bites are the third most common cause of absenteeism among postal workers of the Brazilian National Postal Service in Southern Brazil, with an average off-work time of approximately two days for each biting episode. The objective of this study was to evaluate the neighborhood characteristics involving dog bites that occurred during work time in postal workers, its impact on work and consequent preventive alternatives. A descriptive and analytical cross-sectional study was designed for all Curitiba postal workers. Data were descriptively analyzed and the hypothesis of correlation between median monthly income, population density and occurrence of dog bites was tested. A total of 34.9% of the postal workers answered the questionnaire and 64.6% of them had been bitten while working. The odds of bites occurring in a neighborhood increase by 1.035 times for every increase in one unit in the population density and decrease by 0.998 times for every increase of US$ 1.00 in the neighborhood median monthly income of the head of the family. The occurrence of dog bites among postal workers in Curitiba is related to income and population density and prevention strategies should address mailbox position and adequate fencing to provide protection for postal workers.
Topics: Animals; Bites and Stings; Brazil; Cross-Sectional Studies; Dogs; Humans; Occupational Injuries; Postal Service; Prevalence; Residence Characteristics
PubMed: 23670465
DOI: 10.1590/s1413-81232013000500022 -
Contraception Mar 2022To estimate the effectiveness, acceptability, and feasibility of medication abortion with mifepristone dispensed by a mail-order pharmacy after in-person clinical...
OBJECTIVE(S)
To estimate the effectiveness, acceptability, and feasibility of medication abortion with mifepristone dispensed by a mail-order pharmacy after in-person clinical assessment.
STUDY DESIGN
This is an interim analysis of an ongoing prospective cohort study conducted at five sites. Clinicians assessed patients in clinic and, if they were eligible for medication abortion and ≤ 63 days' gestation, electronically sent prescriptions for mifepristone 200 mg orally and misoprostol 800 mcg buccally to a mail-order pharmacy, which shipped medications for next-day delivery. Participants completed surveys three and 14 days after enrollment, and we abstracted medical chart data.
RESULTS
Between January 2020 and April 2021 we enrolled 240 participants and obtained clinical outcome information for 227 (94.6%); 3 reported not taking either medication. Of those with abortion outcome information (N = 224), 216 (96.4%) completed day-3 and 212 (94.6%) day-14 surveys. Of the 224 that took medications, none reported taking past 70 days' gestation, and complete medication abortion occurred for 217 participants (96.9%, 95% CI 93.7%-98.7%). Most received medications within three days (82.1%, 95% CI 76.5%-86.9%). In the day-3 survey, 95.4% (95% CI 91.7%-97.8%) reported being very (88.4%) or somewhat (6.9%) satisfied with receiving medications by mail. In the day-14 survey, 89.6% (95% CI 84.7%-93.4%) said they would use the mail-order service again if needed. Eleven (4.9%, 95% CI 2.5%-8.6%) experienced adverse events; two were serious (one blood transfusion, one hospitalization), and none were related to mail-order pharmacy dispensing.
CONCLUSIONS
Medication abortion with mail-order pharmacy dispensing of mifepristone appears effective, feasible, and acceptable to patients.
IMPLICATIONS
The in-person dispensing requirement for mifepristone, codified in the drug's Risk Evaluation and Mitigation Strategy, should be removed.
Topics: Abortion, Induced; Female; Humans; Mifepristone; Misoprostol; Pharmacy; Postal Service; Pregnancy; Prospective Studies
PubMed: 34555420
DOI: 10.1016/j.contraception.2021.09.008 -
Scientific Reports Aug 2022Serology provides tools for epidemiologic studies, and may have a role in vaccine prioritization and selection. Automated serologic testing of saliva, especially...
Serology provides tools for epidemiologic studies, and may have a role in vaccine prioritization and selection. Automated serologic testing of saliva, especially specimens that are self-collected at home and sent to a laboratory via the mail without refrigeration, could be a highly-scalable strategy for population-wide testing. In this prospective study, non-vaccinated patients were recruited after PCR testing to self-collect saliva and return their specimens via mail. Longitudinal specimens were analyzed in order to monitor seroconversion in the weeks after a diagnostic PCR test for SARS-CoV-2. Diverse users self-collected saliva and returned specimens via mail in compliance with shipping regulations. At our pre-established threshold (0.963 AU/mL), salivary IgG reactivity to full-length spike protein achieved 95.8% sensitivity and 92.4% specificity at 2-4 weeks after diagnostic testing, which is comparable to the typical sensitivity and specificity achieved for serum testing. Reactivity to N antigen also was detected with 92.6% sensitivity and 90.7% specificity at 4-8 weeks after diagnostic testing. Moreover, serologic testing for endemic coronaviruses performed in multiplex with SARS-CoV-2 antigens has the potential to identify samples that may require retesting due to effects of pre-analytical factors. The easy-to-use saliva collection kit, coupled with thresholds for positivity and methods of flagging samples for retest, provides a framework for large-scale serosurveillance of SARS-CoV-2.
Topics: COVID-19; Clinical Laboratory Techniques; Humans; Postal Service; Prospective Studies; SARS-CoV-2; Saliva; Sensitivity and Specificity
PubMed: 35982133
DOI: 10.1038/s41598-022-17057-7