AIM:To assess glaucoma patient satisfaction and follow-up adherence in case management and identify associated predictors to improve healthcare quality and patient outcomes.METHODS:In this cross-sectional study,a tota...AIM:To assess glaucoma patient satisfaction and follow-up adherence in case management and identify associated predictors to improve healthcare quality and patient outcomes.METHODS:In this cross-sectional study,a total of 119 patients completed a Patient Satisfaction Questionnaire-18 and a sociodemographic questionnaire.Clinical data was obtained from the case management system.Follow-up adherence was defined as completing each follow-up within±30d of the scheduled time set by ophthalmologists during the study period.RESULTS:Average satisfaction scored 78.65±7,with an average of 4.39±0.58 across the seven dimensions.Age negatively correlated with satisfaction(P=0.008),whilst patients with follow-up duration of 2 or more years reported higher satisfaction(P=0.045).Multivariate logistics regression analysis revealed that longer follow-up durations were associated with lower follow-up adherence(OR=0.97,95%CI,0.95-1.00,P=0.044).Additionally,patients with suspected glaucoma(OR=2.72,95%CI,1.03-7.20,P=0.044)and those with an annual income over 100000 Chinese yuan demonstrated higher adherence(OR=5.57,95%CI,1.00-30.89,P=0.049).CONCLUSION:The case management model proves effective for glaucoma patients,with positive adherence rates.The implementation of this model can be optimized in the future based on the identified factors and extended to glaucoma patients in more hospitals.展开更多
Background:Much has been written about the loss to follow-up in the transition between pediatric and adult Congenital Heart Disease(CHD)care centers.Much less is understood about the loss to follow-up(LTF)after a succ...Background:Much has been written about the loss to follow-up in the transition between pediatric and adult Congenital Heart Disease(CHD)care centers.Much less is understood about the loss to follow-up(LTF)after a successful transition.This is critical too,as patients lost to specialised care are more likely to experience mor-bidity and premature mortality.Aims:To understand the prevalence and reasons for loss to follow-up(LTF)at a large Australian Adult Congenital Heart Disease(ACHD)centre.Methods:Patients with moderate or highly complex CHD and gaps in care of>3 years(defined as LTF)were identified from a comprehensive ACHD data-base.Structured telephone interviews examined current care and barriers to clinic attendance.Results:Overall,407(22%)of ACHD patients(n=1842)were LTF.The mean age at LTF was 31(SD 11.5)years and 54%were male;311(76%)were uncontactable.Compared to adults seen regularly,lost patients were younger,with a greater socio-economic disadvantage,and had less complex CHD(p<0.05 for all).We interviewed 59 patients(14%).The top 3 responses for care absences were“feeling well”(61%),losing track of time(36%),and not needing fol-low-up care(25%).Conclusions:A large proportion of the ACHD population becomes lost to specialised cardiac care,even after a successful transition.This Australian study reports younger age,moderate complexity defects,and socio-economic disadvantage as predictive of loss to follow-up.This study highlights the need for novel approaches to patient-centered service delivery even beyond the age of transition and resources to maintain patient engagement within the ACHD service.展开更多
Clear cell sarcoma(CCS)is a rare melanocytic soft tissue sarcoma known for itspropensity to metastasize to the lymph nodes and typically has an unfavorableprognosis.Currently,surgical resection is the primary treatmen...Clear cell sarcoma(CCS)is a rare melanocytic soft tissue sarcoma known for itspropensity to metastasize to the lymph nodes and typically has an unfavorableprognosis.Currently,surgical resection is the primary treatment for localizedCCS,while radiotherapy and chemotherapy are preferred for metastatic cases.The roles of adjuvant chemotherapy,radiotherapy,and lymph node dissection arecontroversial.Although immunotherapy has emerged as a promising avenue inCCS treatment research,there are no established clinical standards for postoperativefollow-up.This editorial discusses a recent article by Liu et al,with afocus on current diagnostic modalities,treatment approaches,and the challengingprognosis associated with CCS.Our aim is to underscore the importance of longtermpatient follow-up in CCS management.展开更多
BACKGROUND Enzymatic fasciotomy with collagenase clostridium histolyticum(CCH)has revolutionized the treatment for Dupuytren’s contracture(DC).Despite its benefits,the long-term outcomes remain unclear.This study pre...BACKGROUND Enzymatic fasciotomy with collagenase clostridium histolyticum(CCH)has revolutionized the treatment for Dupuytren’s contracture(DC).Despite its benefits,the long-term outcomes remain unclear.This study presented a comprehensive 10-year follow-up assessment of the enduring effects of CCH on patients with DC.AIM To compare the short-term(12 wk)and long-term(10 years)outcomes on CCH treatment in patients with DC.METHODS A cohort of 45 patients was treated with CCH at the metacarpophalangeal(MCP)joint and the proximal interphalangeal(PIP)joint and underwent systematic reevaluation.The study adhered to multicenter trial protocols,and assessments were conducted at 12 wk,7 years,and 10 years post-surgery.RESULTS Thirty-seven patients completed the 10-year follow-up.At 10 years,patients treated at the PIP joint exhibited a 100%recurrence.However,patients treated at the MCP joint only showed a 50%recurrence.Patient satisfaction varied,with a lower satisfaction reported in PIP joint cases.Recurrence exceeding 20 degrees on the total passive extension deficit was observed,indicating a challenge for sustained efficacy.Significant differences were noted between outcomes at the 7-year and 10-year intervals.CONCLUSION CCH demonstrated sustained efficacy when applied to the MCP joint.However,caution is warranted for CCH treatment at the PIP joint due to a high level of recurrence and low patient satisfaction.Re-intervention is needed within a decade of treatment.展开更多
Follow-up of environmental impacts is an integral part of the Environmental Impact Assessment (EIA) process, closely related to the effectiveness of the instrument. EIA follow-up has been receiving a lot of interest f...Follow-up of environmental impacts is an integral part of the Environmental Impact Assessment (EIA) process, closely related to the effectiveness of the instrument. EIA follow-up has been receiving a lot of interest from scientists and practitioners, though it is recognized as one of the weakest points of EIA systems globally. Also, EIA follow-up is influenced by the context, mainly in terms of the types of projects or activities and their related impacts on the environment. Therefore, the present paper is focused on the investigation of the follow-up stage applied to the activity of seismic survey coupled with offshore oil & gas exploitation in Brazil. Research was based on a qualitative approach that included document analysis and semi-structured interviews with analysts involved in EIA processes, and sought to generate evidence of effectiveness of the EIA follow-up as conducted by the Federal Environment Agency (Ibama) in order to situate the practice of follow-up in the broader context of international best practice principles. Based on the findings, it was concluded that, due to the peculiarities of offshore seismic survey, it is necessary to promote adaptations in the procedures for monitoring impacts in order to ensure proper alignment with the principles and conceptual foundations that guide EIA practice. Specifically, the timing of the execution of the activity imposes challenges for its integration into the “conventional” cycle that has guided the monitoring of the impacts in the EIA of projects.展开更多
AIM: To investigate the effects of daily telephonebased re-education(TRE) before taking medicine for the eradication of Helicobacter pylori(H. pylori) on the compliance and the eradication rate in a Chinese patient po...AIM: To investigate the effects of daily telephonebased re-education(TRE) before taking medicine for the eradication of Helicobacter pylori(H. pylori) on the compliance and the eradication rate in a Chinese patient population.METHODS : Aprospective, physician-blind e d, randomized, controlled clinical study was conducted. The patients were randomly assigned to receive TRE every day before taking medicine(TRE group) or no TRE(control group). The patients in the TRE group received regular instructions before taking medicine for the eradication of H. pylori during the entire courseof treatment through telephone calls. The patients in the control group received detailed instructions at the time of seeing a doctor for the guidance. The primary outcome was the H. pylori eradication rate after treatment. The secondary outcomes included the clinical remissions after treatment, adverse events, compliance, and patients' satisfaction.RESULTS: A total of 140 patients were randomized, 70 to the TRE group and 70 to the control group. As the primary outcome, the H. pylori eradication rates in the TRE and control groups were 62.7% and 71.2% in per protocol analysis(P = 0.230), and 52.9% and 52.9% in intention-to-treat analysis(P = 0.567), respectively. As the secondary outcomes, there were no significant differences in the patients' satisfaction between the two groups(good, 79.7% vs 76.9%; fair, 13.6% vs 19.2%; poor, 6.7% vs 3.9%, for the TRE group and control group, respectively; P > 0.05 for all); the rates of adverse effects were 15.2% and 63.5% in the TRE and control groups, respectively(P < 0.001); the compliance rates in the TRE and control groups were 85.7% and 74.3%, respectively(P = 0.069).CONCLUSION: Daily TRE before taking medicine had no significant impact on the patients' compliance, satisfaction, or H. pylori eradication, but reduced the rate of adverse events.展开更多
BACKGROUND:To assess the effectiveness of the telephone chest-compression-only cardiopulmonary resuscitation(CPR)guided by a pre-recorded instructional audio when compared with dispatcher-assisted resuscitation.METHOD...BACKGROUND:To assess the effectiveness of the telephone chest-compression-only cardiopulmonary resuscitation(CPR)guided by a pre-recorded instructional audio when compared with dispatcher-assisted resuscitation.METHODS:It was a prospective,blind,randomised controlled study involving 109 medical students without previous CPR training.In a standardized mannequin scenario,after the step of dispatcher-assisted cardiac arrest recognition,the participants performed compression-only resuscitation guided over the telephone by either:(1)the pre-recorded instructional audio(n=57);or(2)verbal dispatcher assistance(n=52).The simulation video records were reviewed to assess the CPR performance using a 13-item checklist.The interval from call reception to the first compression,total number and rate of compressions,total number and duration of pauses after the first compression were also recorded.RESULTS:There were no significant differences between the recording-assisted and dispatcher-assisted groups based on the overall performance score(5.6±2.2 vs.5.1±1.9,P>0.05)or individual criteria of the CPR performance checklist.The recording-assisted group demonstrated provided(170.2±48.0 vs.156.2±60.7).CONCLUSION:When provided by untrained persons in the simulated settings,the compression-only resuscitation guided by the pre-recorded instructional audio is no less efficient than dispatcher-assisted CPR.Future studies are warranted to further assess feasibility of using instructional audio aid as a potential alternative to dispatcher assistance.展开更多
We read the article "Effects of daily telephone-based re-education before taking medicine on Helicobacter pylori(H. pylori) eradication: A prospective singlecenter study from China" written by Wang et al wit...We read the article "Effects of daily telephone-based re-education before taking medicine on Helicobacter pylori(H. pylori) eradication: A prospective singlecenter study from China" written by Wang et al with great interest. It is reported in American and European guidelines that there is no sufficient test for the diagnosis of H. pylori except culture and that using at least two different tests for diagnosis of H. pylori is recommended. Patients who used antibiotics or bismuth salts in the previous 2 wk were excluded from study. But patients who used probiotics and antioxidant vitamins such as vitamins C and E were not excluded.展开更多
Telephone conversation,one of the most common uses of human communication,has been a hot topic in linguistic field in modern times. This essay aims at reviewing the main theories and findings in telephone conversation...Telephone conversation,one of the most common uses of human communication,has been a hot topic in linguistic field in modern times. This essay aims at reviewing the main theories and findings in telephone conversation analysis and providing some insights of this aspect which can often be overlooked in our daily life. It is also hoped that this essay can help to pave a foundation for further in-depth study in telephone conversations.展开更多
Telephone interviewing is a crucial but not well-documented qualitative research method in sociology.Such aspects as how to conduct a telephone interview and by whom such a method is best used,are illustrated specific...Telephone interviewing is a crucial but not well-documented qualitative research method in sociology.Such aspects as how to conduct a telephone interview and by whom such a method is best used,are illustrated specifically.More importantly,the advantages and disadvantages of telephone interviews are critically exploited.As a relatively cheap,flexible and reliable means of gathering data,telephone interview deserves more attention.Moreover,due to such obstacles as sampling,establishing rapport and recognizing the limitations of data generated,it is best to use telephone interviewing for educational research in conjunction with other data collection methods.展开更多
This paper focuses on parents’ use and experiences of general practitioner (GP) out-of-hours (OOHs) services in Ireland. The progress in the establishment of GP OOHs services is considered by the Health Service Execu...This paper focuses on parents’ use and experiences of general practitioner (GP) out-of-hours (OOHs) services in Ireland. The progress in the establishment of GP OOHs services is considered by the Health Service Executive (HSE) to be a highly significant quality initiative for patient care, and the health service as a whole. Outside of normal GP surgery hours, parents of children can call a dedicated telephone number, to have their urgent health concerns assessed and to be advised about the appropriate level of care. Experienced nurses, who are often based in a GP OOHs centre, assess the call over the telephone and provide advice to the callers. The spur for conducting this study arose from my personal and professional experience which, I believe, underscores the need for exploring and understanding parents’ views of GP OOHs services, in order to bring about change in nurses’ practice of delivering advice over the telephone. The overall aim of the study is to explore and understand the views of parents of children, aged two years and under, following telephone advice received from nurses in the context of a GP out-of-hours service. A qualitative, exploratory, and descriptive design was used to examine the views and experiences of parents of children aged two years and under, who used a GP out-of-hours service provider in Ireland. Nine parents who had received phone advice from a nurse were purposively sampled to take part in the study. Data were collected using semi-structured interviews by telephone. Data were transcribed and analysed thematically. Themes included parents’ perceptions of illness in children with the need to be heard, parents’ views about accessibility to GP OOHs, parents’ expectations that the service would offer guidance and reassurance, parents’ satisfaction with the nurse’s advice, and parents’ experiences of hospital emergency departments (EDs). Suggestions for improving the GP OOHs service were made across these themes. The suggestions include: higher staffing levels, wanting a quicker call back, preference for face-to-face assessment over telephone advice and a preference for a children’s area in the GP OOHs. The study revealed that parents are satisfied with the GP OOHs service and the parental decision-making model has the potential to provide an opportunity to continue the progress of the establishment of GP OOHs services in Ireland.展开更多
Background: Survey quality, in particular sampling, coverage, and issues of representativity, are important for valid and reliable conclusions from epidemiological data. Dental anxiety (DA) still challenges dental cli...Background: Survey quality, in particular sampling, coverage, and issues of representativity, are important for valid and reliable conclusions from epidemiological data. Dental anxiety (DA) still challenges dental clinicians since it is synonymous with care avoidance. Accurate estimates of DA are important for public health. Aims were to 1) assess demographic representativity (age/ gender) of a 2013-14 web survey and a 1992-93 telephone survey about DA in Danish adults aged 16 - 80 yr using government statistics;2) assess DA frequency and characteristics from web survey data (N = 701);and 3) compare web results with 1993 results. Method: Dental Anxiety Scale (DAS) measured DA, while other items revealed gender, age, education, dentist avoidance, and three types of negative dentist behaviors. Analyses used frequencies, Chi- square, odds ratios (OR) and ANOVAs. Results: Samples from 1992-3 and 2013-14 were not significantly different by demographics or government statistics, with the exception of low numbers in ages 16 - 19 yr for both surveys. Ages 20 - 29 yr and 30 - 39 yr were slightly overrepresented in telephone data, while ages 50 - 59 yo were in web data. Mean DAS scores were 7.5 for both 1992-3 and 2013-14. Extreme DA (DAS 20-15) increased from 4.2% to 5.3%, while high DA (DAS ≥ 13) increased from 6% to 9.5%. Main 2013-14 associations with DAS ≥ 15 were women (OR = 4.7), avoiding dentists (OR = 11.4) and negative dentist behaviors (OR = 4.2 - 6.7) similar to 1992-3 data. Conclusion: Web survey results from this convenience sample were demographically representative for adults 20 - 80 yo and showed small changes in DA after 20 years. Future strategies regarding survey of teenagers require special attention.展开更多
BACKGROUND Colonoscopy attendance is a key quality parameter in colorectal cancer population screening programmes.Within these programmes,educative interventions with bidirectional contact carried out by trained perso...BACKGROUND Colonoscopy attendance is a key quality parameter in colorectal cancer population screening programmes.Within these programmes,educative interventions with bidirectional contact carried out by trained personnel have been proved to be an important tool for colonoscopy attendance improvement,and because of its huge clinical and economic impact,they have been widely implemented.However,outside of this population programmes,educative measures to improve colonoscopy attendance have been poorly studied and no navigation interventions are usually performed.AIM To investigate the clinical and economic impacts of an educational telephone intervention on colonoscopy attendance outside colorectal cancer screening programmes.METHODS This randomized controlled trial included consecutive patients referred to colonoscopy from primary care centres from November 2017 to May 2018.The intervention group(IG)received a telephone intervention,while the control group(CG)did not.Patients assigned to the IG received an educational telephone call 7 d before the colonoscopy appointment.The intervention was carried out by two nurses with deep endoscopic knowledge who were previously trained for a telephone educational intervention for colonoscopy.The impact on patient compliance with preparedness protocols related to bowel cleansing,antithrombotic management,and sedation scheduling was also evaluated.A second call was conducted to assess patient satisfaction.Intention-to-treat(ITT)and perprotocol(PP)analyses were performed.RESULTS A total of 738 and 746 patients were finally included in the IG and CG respectively.Six hundred thirteen(83%)patients were contacted in the IG.The non-attendance rate was lower in the IG,both in the ITT analysis(IG 8.4%vs CG 14.3%,P<0.001)and in the PP analysis(4.4%vs 14.3%,P<0.001).In a multivariable analysis,belonging to the control group increased the risk of nonattendance in both,the ITT analysis(OR 1.81,95%CI:1.27 to 2.58,P=0.001)and the PP analysis(OR 3.56,95%CI:2.25 to 5.64,P<0.001).There was also a significant difference in compliance with preparedness protocols[bowel cleansing:IG 61.7%vs CG 52.6%(P=0.001),antithrombotic management:IG 92.5%vs CG 62.8%(P=0.001),and sedation scheduling:IG 78.8%vs CG 0%(P≤0.001)].We observed a net benefit of €55600/year after the intervention.The information given before the procedure was rated as excellent by 26%(CG)and 51%(IG)of patients,P≤0.001.CONCLUSION Educational telephone nurse intervention improves attendance,protocol compliance and patient satisfaction in the non-screening colonoscopy setting and has a large economic impact,which supports its imple-mentation and maintenance over time.展开更多
BACKGROUND The coronavirus disease 2019(COVID-19)pandemic has resulted in seismic changes in healthcare delivery.As a result of this,hospital footfall required to be reduced due to increased risk of transmission of in...BACKGROUND The coronavirus disease 2019(COVID-19)pandemic has resulted in seismic changes in healthcare delivery.As a result of this,hospital footfall required to be reduced due to increased risk of transmission of infection.To ensure patients can safely access healthcare,we introduced orthopaedic clinic telephone consultations in our busy district general hospital.AIM To investigate patients’and clinicians’perspective of telephone consultations during COVID-19,and whether this method of consultation could be a viable option in the post-pandemic future.METHODS This is a single centre,prospective study conducted in a busy National Health Service district general hospital.In May 2020,100 non-consecutive adult patients were contacted by independent investigators within 48 h of their orthopaedic clinic telephone consultation to complete a telephone satisfaction questionnaire.The questions assessed satisfaction regarding various aspects of the consultation including overall satisfaction and willingness to use this approach long term.Satisfaction and perspective of 25 clinicians conducting these telephone consultations was also assessed via an online survey tool.RESULTS 93%of patients were overall satisfied with telephone consultations and 79%were willing to continue this method of consultation post-pandemic.Patients found telephone consultations to reduce personal cost and inconvenience associated with attending a hospital appointment.72%of clinicians reported overall satisfaction with this service and 80%agreed that telephone consultations should be used in the future.The majority found it less laborious in time and administration in comparison to face to face consultations.Patients and clinicians expressed their desire for video consultations as a method of further improving their experience with remote consultations.CONCLUSION Our study has shown that telephone consultations are a safe and rapid method of adaptation to the COVID-19 pandemic,achieving the aim of reducing hospital footfall.This method of consultation has resulted in immense clinician and patient satisfaction.Our findings suggest that this tool has benefits in post pandemic healthcare delivery.It has also highlighted that telephone consultations can act as a steppingstone to the introduction of the more complex platform of video consulting.展开更多
The Chinese intelligence input technology, its applications, and a customer service call center system are developed. This technology can be used both in standard English telephone number input keyboard and in Chinese...The Chinese intelligence input technology, its applications, and a customer service call center system are developed. This technology can be used both in standard English telephone number input keyboard and in Chinese telephone number input keyboard .And authors develop sophisticated technologies including "Pinyin" (the Chinese phonetic alphabet ) encoding technology of phonetic symbol code and formal symbol code of Chinese character structure, phrase encoding technology, input technology of whole sentence intelligence encoding and input technology of Chinese telephone number encoding.展开更多
A new effective technique, useful in telecommunications industry for passing an optical telephone cord attached to a connector through pipeline,has been developed using the spiral flow. Using this technique, the cord ...A new effective technique, useful in telecommunications industry for passing an optical telephone cord attached to a connector through pipeline,has been developed using the spiral flow. Using this technique, the cord could be passed through a straight pipeline 150 meters long and a roll of vinyl tube 50 meters long. However, under the same condition, the cord could not pass through when using the turbulent flow. To obtain a high speed stable spiral flow, a nozzle with an annular slit connected to a conical cylinder was used. A pressurized fluid with no tangential flow was supplied through this slit and the fluid, passing through the conical cylinder, was deformed into spiral flow with the steeper axial velocity distribution compared to that of turbulence pipe flow due to Coanda effect and instability. As a result, the cord was attracted to the axis area of the pipe, which effectively increased the ability for the work of cord passing. This high ability for cord passing is attributed mainly to the reduction of the friction made between the cord and the pipe wall, caused by the deformation to spiral flow.展开更多
Advanced PC digital telephone exchanger have been popularized in China since 1982, becoming the main telecommunication exchange in China. By the end of 1993, there were 1,978 urban PC exchangers in operation nationwid...Advanced PC digital telephone exchanger have been popularized in China since 1982, becoming the main telecommunication exchange in China. By the end of 1993, there were 1,978 urban PC exchangers in operation nationwide, accounting for 89.5 percent of the urban automatic exchange network. There are 1.19 million PC exchange terminals out of 120 longdistance automatic exchanges, accounting for 99.7 percent. This shows that China’s telecommunication technology is reaching world level.展开更多
基金Supported by the Key Innovation and Guidance Program of the Eye Hospital,School of Ophthalmology&Optometry,Wenzhou Medical University(No.YNZD2201903)the Scientific Research Foundation of the Eye Hospital,School of Ophthalmology&Optometry,Wenzhou Medical University(No.KYQD20180306)the Nursing Project of the Eye Hospital of Wenzhou Medical University(No.YNHL2201908).
文摘AIM:To assess glaucoma patient satisfaction and follow-up adherence in case management and identify associated predictors to improve healthcare quality and patient outcomes.METHODS:In this cross-sectional study,a total of 119 patients completed a Patient Satisfaction Questionnaire-18 and a sociodemographic questionnaire.Clinical data was obtained from the case management system.Follow-up adherence was defined as completing each follow-up within±30d of the scheduled time set by ophthalmologists during the study period.RESULTS:Average satisfaction scored 78.65±7,with an average of 4.39±0.58 across the seven dimensions.Age negatively correlated with satisfaction(P=0.008),whilst patients with follow-up duration of 2 or more years reported higher satisfaction(P=0.045).Multivariate logistics regression analysis revealed that longer follow-up durations were associated with lower follow-up adherence(OR=0.97,95%CI,0.95-1.00,P=0.044).Additionally,patients with suspected glaucoma(OR=2.72,95%CI,1.03-7.20,P=0.044)and those with an annual income over 100000 Chinese yuan demonstrated higher adherence(OR=5.57,95%CI,1.00-30.89,P=0.049).CONCLUSION:The case management model proves effective for glaucoma patients,with positive adherence rates.The implementation of this model can be optimized in the future based on the identified factors and extended to glaucoma patients in more hospitals.
文摘Background:Much has been written about the loss to follow-up in the transition between pediatric and adult Congenital Heart Disease(CHD)care centers.Much less is understood about the loss to follow-up(LTF)after a successful transition.This is critical too,as patients lost to specialised care are more likely to experience mor-bidity and premature mortality.Aims:To understand the prevalence and reasons for loss to follow-up(LTF)at a large Australian Adult Congenital Heart Disease(ACHD)centre.Methods:Patients with moderate or highly complex CHD and gaps in care of>3 years(defined as LTF)were identified from a comprehensive ACHD data-base.Structured telephone interviews examined current care and barriers to clinic attendance.Results:Overall,407(22%)of ACHD patients(n=1842)were LTF.The mean age at LTF was 31(SD 11.5)years and 54%were male;311(76%)were uncontactable.Compared to adults seen regularly,lost patients were younger,with a greater socio-economic disadvantage,and had less complex CHD(p<0.05 for all).We interviewed 59 patients(14%).The top 3 responses for care absences were“feeling well”(61%),losing track of time(36%),and not needing fol-low-up care(25%).Conclusions:A large proportion of the ACHD population becomes lost to specialised cardiac care,even after a successful transition.This Australian study reports younger age,moderate complexity defects,and socio-economic disadvantage as predictive of loss to follow-up.This study highlights the need for novel approaches to patient-centered service delivery even beyond the age of transition and resources to maintain patient engagement within the ACHD service.
基金Liaoning Province Applied Basic Research Program Joint Program Project,No.2022JH2/101500076Shenyang Young and Middle-aged Science and Technology Innovation Talent Support Program,No.RC200438+1 种基金Tree Planting Program of Shengjing Hospital,No.M1595the Doctoral Start-up Foundation of Liaoning Province,No.2022-BS-127.
文摘Clear cell sarcoma(CCS)is a rare melanocytic soft tissue sarcoma known for itspropensity to metastasize to the lymph nodes and typically has an unfavorableprognosis.Currently,surgical resection is the primary treatment for localizedCCS,while radiotherapy and chemotherapy are preferred for metastatic cases.The roles of adjuvant chemotherapy,radiotherapy,and lymph node dissection arecontroversial.Although immunotherapy has emerged as a promising avenue inCCS treatment research,there are no established clinical standards for postoperativefollow-up.This editorial discusses a recent article by Liu et al,with afocus on current diagnostic modalities,treatment approaches,and the challengingprognosis associated with CCS.Our aim is to underscore the importance of longtermpatient follow-up in CCS management.
文摘BACKGROUND Enzymatic fasciotomy with collagenase clostridium histolyticum(CCH)has revolutionized the treatment for Dupuytren’s contracture(DC).Despite its benefits,the long-term outcomes remain unclear.This study presented a comprehensive 10-year follow-up assessment of the enduring effects of CCH on patients with DC.AIM To compare the short-term(12 wk)and long-term(10 years)outcomes on CCH treatment in patients with DC.METHODS A cohort of 45 patients was treated with CCH at the metacarpophalangeal(MCP)joint and the proximal interphalangeal(PIP)joint and underwent systematic reevaluation.The study adhered to multicenter trial protocols,and assessments were conducted at 12 wk,7 years,and 10 years post-surgery.RESULTS Thirty-seven patients completed the 10-year follow-up.At 10 years,patients treated at the PIP joint exhibited a 100%recurrence.However,patients treated at the MCP joint only showed a 50%recurrence.Patient satisfaction varied,with a lower satisfaction reported in PIP joint cases.Recurrence exceeding 20 degrees on the total passive extension deficit was observed,indicating a challenge for sustained efficacy.Significant differences were noted between outcomes at the 7-year and 10-year intervals.CONCLUSION CCH demonstrated sustained efficacy when applied to the MCP joint.However,caution is warranted for CCH treatment at the PIP joint due to a high level of recurrence and low patient satisfaction.Re-intervention is needed within a decade of treatment.
文摘Follow-up of environmental impacts is an integral part of the Environmental Impact Assessment (EIA) process, closely related to the effectiveness of the instrument. EIA follow-up has been receiving a lot of interest from scientists and practitioners, though it is recognized as one of the weakest points of EIA systems globally. Also, EIA follow-up is influenced by the context, mainly in terms of the types of projects or activities and their related impacts on the environment. Therefore, the present paper is focused on the investigation of the follow-up stage applied to the activity of seismic survey coupled with offshore oil & gas exploitation in Brazil. Research was based on a qualitative approach that included document analysis and semi-structured interviews with analysts involved in EIA processes, and sought to generate evidence of effectiveness of the EIA follow-up as conducted by the Federal Environment Agency (Ibama) in order to situate the practice of follow-up in the broader context of international best practice principles. Based on the findings, it was concluded that, due to the peculiarities of offshore seismic survey, it is necessary to promote adaptations in the procedures for monitoring impacts in order to ensure proper alignment with the principles and conceptual foundations that guide EIA practice. Specifically, the timing of the execution of the activity imposes challenges for its integration into the “conventional” cycle that has guided the monitoring of the impacts in the EIA of projects.
基金National Natural Science Foundation of China,No.81171526 and No.81472006
文摘AIM: To investigate the effects of daily telephonebased re-education(TRE) before taking medicine for the eradication of Helicobacter pylori(H. pylori) on the compliance and the eradication rate in a Chinese patient population.METHODS : Aprospective, physician-blind e d, randomized, controlled clinical study was conducted. The patients were randomly assigned to receive TRE every day before taking medicine(TRE group) or no TRE(control group). The patients in the TRE group received regular instructions before taking medicine for the eradication of H. pylori during the entire courseof treatment through telephone calls. The patients in the control group received detailed instructions at the time of seeing a doctor for the guidance. The primary outcome was the H. pylori eradication rate after treatment. The secondary outcomes included the clinical remissions after treatment, adverse events, compliance, and patients' satisfaction.RESULTS: A total of 140 patients were randomized, 70 to the TRE group and 70 to the control group. As the primary outcome, the H. pylori eradication rates in the TRE and control groups were 62.7% and 71.2% in per protocol analysis(P = 0.230), and 52.9% and 52.9% in intention-to-treat analysis(P = 0.567), respectively. As the secondary outcomes, there were no significant differences in the patients' satisfaction between the two groups(good, 79.7% vs 76.9%; fair, 13.6% vs 19.2%; poor, 6.7% vs 3.9%, for the TRE group and control group, respectively; P > 0.05 for all); the rates of adverse effects were 15.2% and 63.5% in the TRE and control groups, respectively(P < 0.001); the compliance rates in the TRE and control groups were 85.7% and 74.3%, respectively(P = 0.069).CONCLUSION: Daily TRE before taking medicine had no significant impact on the patients' compliance, satisfaction, or H. pylori eradication, but reduced the rate of adverse events.
文摘BACKGROUND:To assess the effectiveness of the telephone chest-compression-only cardiopulmonary resuscitation(CPR)guided by a pre-recorded instructional audio when compared with dispatcher-assisted resuscitation.METHODS:It was a prospective,blind,randomised controlled study involving 109 medical students without previous CPR training.In a standardized mannequin scenario,after the step of dispatcher-assisted cardiac arrest recognition,the participants performed compression-only resuscitation guided over the telephone by either:(1)the pre-recorded instructional audio(n=57);or(2)verbal dispatcher assistance(n=52).The simulation video records were reviewed to assess the CPR performance using a 13-item checklist.The interval from call reception to the first compression,total number and rate of compressions,total number and duration of pauses after the first compression were also recorded.RESULTS:There were no significant differences between the recording-assisted and dispatcher-assisted groups based on the overall performance score(5.6±2.2 vs.5.1±1.9,P>0.05)or individual criteria of the CPR performance checklist.The recording-assisted group demonstrated provided(170.2±48.0 vs.156.2±60.7).CONCLUSION:When provided by untrained persons in the simulated settings,the compression-only resuscitation guided by the pre-recorded instructional audio is no less efficient than dispatcher-assisted CPR.Future studies are warranted to further assess feasibility of using instructional audio aid as a potential alternative to dispatcher assistance.
文摘We read the article "Effects of daily telephone-based re-education before taking medicine on Helicobacter pylori(H. pylori) eradication: A prospective singlecenter study from China" written by Wang et al with great interest. It is reported in American and European guidelines that there is no sufficient test for the diagnosis of H. pylori except culture and that using at least two different tests for diagnosis of H. pylori is recommended. Patients who used antibiotics or bismuth salts in the previous 2 wk were excluded from study. But patients who used probiotics and antioxidant vitamins such as vitamins C and E were not excluded.
文摘Telephone conversation,one of the most common uses of human communication,has been a hot topic in linguistic field in modern times. This essay aims at reviewing the main theories and findings in telephone conversation analysis and providing some insights of this aspect which can often be overlooked in our daily life. It is also hoped that this essay can help to pave a foundation for further in-depth study in telephone conversations.
文摘Telephone interviewing is a crucial but not well-documented qualitative research method in sociology.Such aspects as how to conduct a telephone interview and by whom such a method is best used,are illustrated specifically.More importantly,the advantages and disadvantages of telephone interviews are critically exploited.As a relatively cheap,flexible and reliable means of gathering data,telephone interview deserves more attention.Moreover,due to such obstacles as sampling,establishing rapport and recognizing the limitations of data generated,it is best to use telephone interviewing for educational research in conjunction with other data collection methods.
文摘This paper focuses on parents’ use and experiences of general practitioner (GP) out-of-hours (OOHs) services in Ireland. The progress in the establishment of GP OOHs services is considered by the Health Service Executive (HSE) to be a highly significant quality initiative for patient care, and the health service as a whole. Outside of normal GP surgery hours, parents of children can call a dedicated telephone number, to have their urgent health concerns assessed and to be advised about the appropriate level of care. Experienced nurses, who are often based in a GP OOHs centre, assess the call over the telephone and provide advice to the callers. The spur for conducting this study arose from my personal and professional experience which, I believe, underscores the need for exploring and understanding parents’ views of GP OOHs services, in order to bring about change in nurses’ practice of delivering advice over the telephone. The overall aim of the study is to explore and understand the views of parents of children, aged two years and under, following telephone advice received from nurses in the context of a GP out-of-hours service. A qualitative, exploratory, and descriptive design was used to examine the views and experiences of parents of children aged two years and under, who used a GP out-of-hours service provider in Ireland. Nine parents who had received phone advice from a nurse were purposively sampled to take part in the study. Data were collected using semi-structured interviews by telephone. Data were transcribed and analysed thematically. Themes included parents’ perceptions of illness in children with the need to be heard, parents’ views about accessibility to GP OOHs, parents’ expectations that the service would offer guidance and reassurance, parents’ satisfaction with the nurse’s advice, and parents’ experiences of hospital emergency departments (EDs). Suggestions for improving the GP OOHs service were made across these themes. The suggestions include: higher staffing levels, wanting a quicker call back, preference for face-to-face assessment over telephone advice and a preference for a children’s area in the GP OOHs. The study revealed that parents are satisfied with the GP OOHs service and the parental decision-making model has the potential to provide an opportunity to continue the progress of the establishment of GP OOHs services in Ireland.
文摘Background: Survey quality, in particular sampling, coverage, and issues of representativity, are important for valid and reliable conclusions from epidemiological data. Dental anxiety (DA) still challenges dental clinicians since it is synonymous with care avoidance. Accurate estimates of DA are important for public health. Aims were to 1) assess demographic representativity (age/ gender) of a 2013-14 web survey and a 1992-93 telephone survey about DA in Danish adults aged 16 - 80 yr using government statistics;2) assess DA frequency and characteristics from web survey data (N = 701);and 3) compare web results with 1993 results. Method: Dental Anxiety Scale (DAS) measured DA, while other items revealed gender, age, education, dentist avoidance, and three types of negative dentist behaviors. Analyses used frequencies, Chi- square, odds ratios (OR) and ANOVAs. Results: Samples from 1992-3 and 2013-14 were not significantly different by demographics or government statistics, with the exception of low numbers in ages 16 - 19 yr for both surveys. Ages 20 - 29 yr and 30 - 39 yr were slightly overrepresented in telephone data, while ages 50 - 59 yo were in web data. Mean DAS scores were 7.5 for both 1992-3 and 2013-14. Extreme DA (DAS 20-15) increased from 4.2% to 5.3%, while high DA (DAS ≥ 13) increased from 6% to 9.5%. Main 2013-14 associations with DAS ≥ 15 were women (OR = 4.7), avoiding dentists (OR = 11.4) and negative dentist behaviors (OR = 4.2 - 6.7) similar to 1992-3 data. Conclusion: Web survey results from this convenience sample were demographically representative for adults 20 - 80 yo and showed small changes in DA after 20 years. Future strategies regarding survey of teenagers require special attention.
基金Supported by Hospital del Mar,Parc de Salut Mar.
文摘BACKGROUND Colonoscopy attendance is a key quality parameter in colorectal cancer population screening programmes.Within these programmes,educative interventions with bidirectional contact carried out by trained personnel have been proved to be an important tool for colonoscopy attendance improvement,and because of its huge clinical and economic impact,they have been widely implemented.However,outside of this population programmes,educative measures to improve colonoscopy attendance have been poorly studied and no navigation interventions are usually performed.AIM To investigate the clinical and economic impacts of an educational telephone intervention on colonoscopy attendance outside colorectal cancer screening programmes.METHODS This randomized controlled trial included consecutive patients referred to colonoscopy from primary care centres from November 2017 to May 2018.The intervention group(IG)received a telephone intervention,while the control group(CG)did not.Patients assigned to the IG received an educational telephone call 7 d before the colonoscopy appointment.The intervention was carried out by two nurses with deep endoscopic knowledge who were previously trained for a telephone educational intervention for colonoscopy.The impact on patient compliance with preparedness protocols related to bowel cleansing,antithrombotic management,and sedation scheduling was also evaluated.A second call was conducted to assess patient satisfaction.Intention-to-treat(ITT)and perprotocol(PP)analyses were performed.RESULTS A total of 738 and 746 patients were finally included in the IG and CG respectively.Six hundred thirteen(83%)patients were contacted in the IG.The non-attendance rate was lower in the IG,both in the ITT analysis(IG 8.4%vs CG 14.3%,P<0.001)and in the PP analysis(4.4%vs 14.3%,P<0.001).In a multivariable analysis,belonging to the control group increased the risk of nonattendance in both,the ITT analysis(OR 1.81,95%CI:1.27 to 2.58,P=0.001)and the PP analysis(OR 3.56,95%CI:2.25 to 5.64,P<0.001).There was also a significant difference in compliance with preparedness protocols[bowel cleansing:IG 61.7%vs CG 52.6%(P=0.001),antithrombotic management:IG 92.5%vs CG 62.8%(P=0.001),and sedation scheduling:IG 78.8%vs CG 0%(P≤0.001)].We observed a net benefit of €55600/year after the intervention.The information given before the procedure was rated as excellent by 26%(CG)and 51%(IG)of patients,P≤0.001.CONCLUSION Educational telephone nurse intervention improves attendance,protocol compliance and patient satisfaction in the non-screening colonoscopy setting and has a large economic impact,which supports its imple-mentation and maintenance over time.
文摘BACKGROUND The coronavirus disease 2019(COVID-19)pandemic has resulted in seismic changes in healthcare delivery.As a result of this,hospital footfall required to be reduced due to increased risk of transmission of infection.To ensure patients can safely access healthcare,we introduced orthopaedic clinic telephone consultations in our busy district general hospital.AIM To investigate patients’and clinicians’perspective of telephone consultations during COVID-19,and whether this method of consultation could be a viable option in the post-pandemic future.METHODS This is a single centre,prospective study conducted in a busy National Health Service district general hospital.In May 2020,100 non-consecutive adult patients were contacted by independent investigators within 48 h of their orthopaedic clinic telephone consultation to complete a telephone satisfaction questionnaire.The questions assessed satisfaction regarding various aspects of the consultation including overall satisfaction and willingness to use this approach long term.Satisfaction and perspective of 25 clinicians conducting these telephone consultations was also assessed via an online survey tool.RESULTS 93%of patients were overall satisfied with telephone consultations and 79%were willing to continue this method of consultation post-pandemic.Patients found telephone consultations to reduce personal cost and inconvenience associated with attending a hospital appointment.72%of clinicians reported overall satisfaction with this service and 80%agreed that telephone consultations should be used in the future.The majority found it less laborious in time and administration in comparison to face to face consultations.Patients and clinicians expressed their desire for video consultations as a method of further improving their experience with remote consultations.CONCLUSION Our study has shown that telephone consultations are a safe and rapid method of adaptation to the COVID-19 pandemic,achieving the aim of reducing hospital footfall.This method of consultation has resulted in immense clinician and patient satisfaction.Our findings suggest that this tool has benefits in post pandemic healthcare delivery.It has also highlighted that telephone consultations can act as a steppingstone to the introduction of the more complex platform of video consulting.
文摘The Chinese intelligence input technology, its applications, and a customer service call center system are developed. This technology can be used both in standard English telephone number input keyboard and in Chinese telephone number input keyboard .And authors develop sophisticated technologies including "Pinyin" (the Chinese phonetic alphabet ) encoding technology of phonetic symbol code and formal symbol code of Chinese character structure, phrase encoding technology, input technology of whole sentence intelligence encoding and input technology of Chinese telephone number encoding.
文摘A new effective technique, useful in telecommunications industry for passing an optical telephone cord attached to a connector through pipeline,has been developed using the spiral flow. Using this technique, the cord could be passed through a straight pipeline 150 meters long and a roll of vinyl tube 50 meters long. However, under the same condition, the cord could not pass through when using the turbulent flow. To obtain a high speed stable spiral flow, a nozzle with an annular slit connected to a conical cylinder was used. A pressurized fluid with no tangential flow was supplied through this slit and the fluid, passing through the conical cylinder, was deformed into spiral flow with the steeper axial velocity distribution compared to that of turbulence pipe flow due to Coanda effect and instability. As a result, the cord was attracted to the axis area of the pipe, which effectively increased the ability for the work of cord passing. This high ability for cord passing is attributed mainly to the reduction of the friction made between the cord and the pipe wall, caused by the deformation to spiral flow.
文摘Advanced PC digital telephone exchanger have been popularized in China since 1982, becoming the main telecommunication exchange in China. By the end of 1993, there were 1,978 urban PC exchangers in operation nationwide, accounting for 89.5 percent of the urban automatic exchange network. There are 1.19 million PC exchange terminals out of 120 longdistance automatic exchanges, accounting for 99.7 percent. This shows that China’s telecommunication technology is reaching world level.