This paper is to analyze the impact of ambulatory care pharmacists on reduction of 30-day readmission rates of HDF （hospital discharge follow-up） patients and to assess a link between readmission rates and medicatio...This paper is to analyze the impact of ambulatory care pharmacists on reduction of 30-day readmission rates of HDF （hospital discharge follow-up） patients and to assess a link between readmission rates and medication appointment compliance as well as medication discrepancies. This was a retrospective, single-center study that included all adult patients scheduled for HDF appointments at the UIM （university internal medicine） clinic of the MUSC （Medical University of South Carolina） from May 1, 2013 through December 31, 2013. A total of 470 patients were included with 190 patients attended their scheduled HDF appointments with their PCPs （primary care providers） and the ambulatory care pharmacists, and 280 patients attended their scheduled HDF appointments only with their PCPs. The 30-day readmission rate was 22% in patients who attended HDF appointments with both of the healthcare providers versus 41% in patients who attended HDF appointments only with their PCPs （P 〈 0.05）. Medication errors and discrepancies are common during transitions of care. However, ambulatory care pharmacists play a crucial role in significantly reducing 30-day readmission rates after hospital discharge by providing thorough and complete medication reconciliation services.展开更多
Background:Current practice in the Western Cape region of South Africa is to discharge newborns born in-hospital within 24 h following uncomplicated vaginal delivery and two days after caesarean section.Mothers are in...Background:Current practice in the Western Cape region of South Africa is to discharge newborns born in-hospital within 24 h following uncomplicated vaginal delivery and two days after caesarean section.Mothers are instructed to bring their newborn to a clinic after discharge for a health assessment.We sought to determine the rate of newborn follow-up visits and the potential barriers to timely follow-up.Methods:Mother-newborn dyads at Tygerberg Hospital in Cape Town,South Africa were enrolled from November 2014 to April 2015.Demographic data were obtained via questionnaire and medical records.Mothers were contacted one week after discharge to determine if they had brought their newborns for a follow-up visit,and if not,the barriers to follow-up.Factors associated with follow-up were analyzed using logistic regression.Results:Of 972 newborns,794(82%)were seen at a clinic for a follow-up visit within one week of discharge.Mothers with a higher education level or whose newborns were less than 37 weeks were more likely to follow up.The follow-up rate did not differ based on hospital length of stay.Main reported barriers to follow-up included maternal illness,lack of money for transportation,and mother felt follow-up was unnecessary because newborn was healthy.Conclusions:Nearly 4 in 5 newborns were seen at a clinic within one week after hospital discharge,in keeping with local practice guidelines.Further research on the outcomes of this population and those who fail to follow up is needed to determine the impact of postnatal healthcare policy.展开更多
Objective To investigate the human body’s complex system,and classify and characterize the human body’s health states with“a comprehensive integrated method from qualitative to quantitative”.Methods This paper int...Objective To investigate the human body’s complex system,and classify and characterize the human body’s health states with“a comprehensive integrated method from qualitative to quantitative”.Methods This paper introduces the concept of“order parameters”and proposes a method for establishing an order parameter model of gas discharge visualization(GDV)based on the principle of“mastering both permanence and change(MBPC)”.The method involved the fol-lowing three steps.First,average luminous intensity(I)and average area(S)of the GDV im-ages were calculated to construct the phase space,and the score of the health questionnaire was calculated as the health deviation index(H).Second,the k-means++clustering method was employed to identify subclasses with the same health characteristics based on the data samples,and to statistically determine the symptom-specific frequencies of the subclasses.Third,the distance(d)between each sample and the“ideal health state”,which determined in the phase space of each subclass,was calculated as an order parameter describing the health imbalance,and a linear mapping was established between the d and the H.Further,the health implications of GDV signals were explored by analyzing subclass symptom profiles.We also compare the mean square error(MSE)with classification methods based on age,gen-der,and body mass index(BMI)indices to verify that the phase space possesses the ability to portray the health status of the human body.Results This study preliminarily tested the reliability of the order parameter model on data samples provided by 20 participants.Based on the discovered linear law,the current model can use d calculated by measuring the GDV signal to predict H(R^(2)>0.77).Combined with the symptom profiles of the subclasses,we explain the classification basis of the phase space based on the pattern identification.Compared with common classification methods based on age,gender,BMI,etc.,the MSE of phase space-based classification was reduced by an order of magnitude.Conclusion In this study,the GDV order parameter model based on MBPC can identify sub-classes and characterize individual health levels,and explore the TCM health meanings of the GDV signals by using subjective-objective methods,which holds significance for establishing mathematical models from TCM diagnosis principles to interpret human body signals.展开更多
<strong>Objectives:</strong> To control the Corona Virus Disease (COVID-19) epidemic, it is meaningful to improve the home quarantine ability and home-quarantine compliancy of patients released from medica...<strong>Objectives:</strong> To control the Corona Virus Disease (COVID-19) epidemic, it is meaningful to improve the home quarantine ability and home-quarantine compliancy of patients released from medical isolation, and to prevent cross-contamination. This study aimed to up protocols for COVID-19 patients released from medical isolation. <strong>Methods:</strong> A total of 35 patients discharged from the isolation ward of the Third Affiliated Hospital of Guangzhou Sun Yat-sen University from January 22, 2020 to February 18, 2020 were included. The patients received health education through discharge preparation, education leaflets and videos. The patients were followed up on the 2nd, 7th and 14th day after discharge through WeChat and phone call. On the 2nd and 14th day after discharge, the patients completed the knowledge assessment, self-perceived burden survey and satisfaction survey using a self-made home quarantine knowledge paper. <strong>Results:</strong> There were statistical differences in the knowledge and understanding of home quarantine and self-perceived burden between the 2nd day and 14th day after home quarantine (P < 0.05). The completion rate of home quarantine was 94.3%, and the satisfaction rate was 96.7%. <strong>Conclusion:</strong> By improving the discharge preparation, conducting in-time follow-up after discharge via WeChat and phone call, and performing multi-channel health education, the follow-up researchers could help the patients perform a more effective home quarantine, which could effectively prevent the spread of COVID-19 epidemic.展开更多
BACKGROUND Treatment for offenders with mental disorders is a key concern in public mental health.Provision of adequate psychiatric treatment is important for the offender and their community.An approach used in Japan...BACKGROUND Treatment for offenders with mental disorders is a key concern in public mental health.Provision of adequate psychiatric treatment is important for the offender and their community.An approach used in Japan to address this issue is administrative involuntary hospitalization.Under this scheme,a person at risk for harming themselves or others because of a mental disorder can be involuntarily hospitalized in a designated psychiatric hospital.However,this scheme does not include tracking of these patients after discharge.Although some data for administrative involuntary hospitalizations are available,it remains unclear what happens to these patients after discharge.AIM To evaluate follow-up of patients under administrative involuntary hospitalization after discharge and obtain data for later comparisons with outcomes.METHODS We used a retrospective design and conducted a national survey of administrative involuntary hospitalizations.Questionnaires were distributed to 939 facilities across Japan.The questionnaire collected data for selected involuntary hospitalization cases in the hospital on June 30,2010(census date),and the prognoses of each patient on a specified date in 2011 and 2012.We also asked about the treatment provided to each patient.We stratified patients by prognosis(good or poor),and used logistic regression analysis to examine the relationship between treatment and prognosis.RESULTS We received completed questionnaires from 292 facilities(response rate 31.1%);105 facilities had no relevant patients.Our analysis included data for 394 patients with valid data.Official statistics indicated 1503 patients were under administrative involuntary hospitalization as at June 30,2012,meaning the capture rate was 27.2%.Approximately a fourth(104/394)at 1 year,and a third(137/294)at 2 years after the census had unknown prognosis.Treatment content included multi-disciplinary team meetings(78.2%of patients),counseling by public workers(59.9%),and discussion with external specialists(32.5%).Overall,116 patients were categorized as having a good prognosis at 1 year,and 168 had a poor prognosis.At the 2-year point,102 patients had a good prognosis and 150 had a poor prognosis.“Discussion with external specialists”was positively associated with a good prognosis at both 1 year(P=0.016)and 2 years(P=0.036).CONCLUSION We found that facilities in Japan currently have limited ability to track the prognoses of patients who were hospitalized involuntarily.Discussion with external specialists is associated with a good prognosis.展开更多
In this paper,we introduce a long-term follow-up specific individual searching(SIS)model.This model introduces the concept of node search contributions by considering the characteristics of the network structure.A nod...In this paper,we introduce a long-term follow-up specific individual searching(SIS)model.This model introduces the concept of node search contributions by considering the characteristics of the network structure.A node search contribution indicates the ability of a certain node to correctly guide the search path and successfully complete an SIS.The influencing factors of node search contributions have three components:the individual influence index,attribute similarity,and node search willingness.On the basis of node search contributions and the PeopleRank idea,this paper proposes an SIS model based on node search contribution values and conducts comparison experiments with several mainstream SIS algorithms in three aspects:the search failure rate,the minimum number of search hops,and the search size.The experimental results verify the advanced nature and operability of the model proposed in this paper,which presents theoretical and practical significance to the quantitative study of the SIS process.展开更多
文摘This paper is to analyze the impact of ambulatory care pharmacists on reduction of 30-day readmission rates of HDF （hospital discharge follow-up） patients and to assess a link between readmission rates and medication appointment compliance as well as medication discrepancies. This was a retrospective, single-center study that included all adult patients scheduled for HDF appointments at the UIM （university internal medicine） clinic of the MUSC （Medical University of South Carolina） from May 1, 2013 through December 31, 2013. A total of 470 patients were included with 190 patients attended their scheduled HDF appointments with their PCPs （primary care providers） and the ambulatory care pharmacists, and 280 patients attended their scheduled HDF appointments only with their PCPs. The 30-day readmission rate was 22% in patients who attended HDF appointments with both of the healthcare providers versus 41% in patients who attended HDF appointments only with their PCPs （P 〈 0.05）. Medication errors and discrepancies are common during transitions of care. However, ambulatory care pharmacists play a crucial role in significantly reducing 30-day readmission rates after hospital discharge by providing thorough and complete medication reconciliation services.
基金Support has been provided by Stellenbosch University Rural Medical Education Partnership Initiative(SURMEPI).
文摘Background:Current practice in the Western Cape region of South Africa is to discharge newborns born in-hospital within 24 h following uncomplicated vaginal delivery and two days after caesarean section.Mothers are instructed to bring their newborn to a clinic after discharge for a health assessment.We sought to determine the rate of newborn follow-up visits and the potential barriers to timely follow-up.Methods:Mother-newborn dyads at Tygerberg Hospital in Cape Town,South Africa were enrolled from November 2014 to April 2015.Demographic data were obtained via questionnaire and medical records.Mothers were contacted one week after discharge to determine if they had brought their newborns for a follow-up visit,and if not,the barriers to follow-up.Factors associated with follow-up were analyzed using logistic regression.Results:Of 972 newborns,794(82%)were seen at a clinic for a follow-up visit within one week of discharge.Mothers with a higher education level or whose newborns were less than 37 weeks were more likely to follow up.The follow-up rate did not differ based on hospital length of stay.Main reported barriers to follow-up included maternal illness,lack of money for transportation,and mother felt follow-up was unnecessary because newborn was healthy.Conclusions:Nearly 4 in 5 newborns were seen at a clinic within one week after hospital discharge,in keeping with local practice guidelines.Further research on the outcomes of this population and those who fail to follow up is needed to determine the impact of postnatal healthcare policy.
基金Program of Office of Science and Technology Development,Peking University(3124-2021|-L-w6).
文摘Objective To investigate the human body’s complex system,and classify and characterize the human body’s health states with“a comprehensive integrated method from qualitative to quantitative”.Methods This paper introduces the concept of“order parameters”and proposes a method for establishing an order parameter model of gas discharge visualization(GDV)based on the principle of“mastering both permanence and change(MBPC)”.The method involved the fol-lowing three steps.First,average luminous intensity(I)and average area(S)of the GDV im-ages were calculated to construct the phase space,and the score of the health questionnaire was calculated as the health deviation index(H).Second,the k-means++clustering method was employed to identify subclasses with the same health characteristics based on the data samples,and to statistically determine the symptom-specific frequencies of the subclasses.Third,the distance(d)between each sample and the“ideal health state”,which determined in the phase space of each subclass,was calculated as an order parameter describing the health imbalance,and a linear mapping was established between the d and the H.Further,the health implications of GDV signals were explored by analyzing subclass symptom profiles.We also compare the mean square error(MSE)with classification methods based on age,gen-der,and body mass index(BMI)indices to verify that the phase space possesses the ability to portray the health status of the human body.Results This study preliminarily tested the reliability of the order parameter model on data samples provided by 20 participants.Based on the discovered linear law,the current model can use d calculated by measuring the GDV signal to predict H(R^(2)>0.77).Combined with the symptom profiles of the subclasses,we explain the classification basis of the phase space based on the pattern identification.Compared with common classification methods based on age,gender,BMI,etc.,the MSE of phase space-based classification was reduced by an order of magnitude.Conclusion In this study,the GDV order parameter model based on MBPC can identify sub-classes and characterize individual health levels,and explore the TCM health meanings of the GDV signals by using subjective-objective methods,which holds significance for establishing mathematical models from TCM diagnosis principles to interpret human body signals.
文摘<strong>Objectives:</strong> To control the Corona Virus Disease (COVID-19) epidemic, it is meaningful to improve the home quarantine ability and home-quarantine compliancy of patients released from medical isolation, and to prevent cross-contamination. This study aimed to up protocols for COVID-19 patients released from medical isolation. <strong>Methods:</strong> A total of 35 patients discharged from the isolation ward of the Third Affiliated Hospital of Guangzhou Sun Yat-sen University from January 22, 2020 to February 18, 2020 were included. The patients received health education through discharge preparation, education leaflets and videos. The patients were followed up on the 2nd, 7th and 14th day after discharge through WeChat and phone call. On the 2nd and 14th day after discharge, the patients completed the knowledge assessment, self-perceived burden survey and satisfaction survey using a self-made home quarantine knowledge paper. <strong>Results:</strong> There were statistical differences in the knowledge and understanding of home quarantine and self-perceived burden between the 2nd day and 14th day after home quarantine (P < 0.05). The completion rate of home quarantine was 94.3%, and the satisfaction rate was 96.7%. <strong>Conclusion:</strong> By improving the discharge preparation, conducting in-time follow-up after discharge via WeChat and phone call, and performing multi-channel health education, the follow-up researchers could help the patients perform a more effective home quarantine, which could effectively prevent the spread of COVID-19 epidemic.
基金Supported by a grant awarded to the corresponding author from the Japanese Ministry of Health,Labour and Welfare as part of a research project entitled “Research of the inclusive care for the psychiatric patients discharged from involuntary admission by the prefectural governor’s order”
文摘BACKGROUND Treatment for offenders with mental disorders is a key concern in public mental health.Provision of adequate psychiatric treatment is important for the offender and their community.An approach used in Japan to address this issue is administrative involuntary hospitalization.Under this scheme,a person at risk for harming themselves or others because of a mental disorder can be involuntarily hospitalized in a designated psychiatric hospital.However,this scheme does not include tracking of these patients after discharge.Although some data for administrative involuntary hospitalizations are available,it remains unclear what happens to these patients after discharge.AIM To evaluate follow-up of patients under administrative involuntary hospitalization after discharge and obtain data for later comparisons with outcomes.METHODS We used a retrospective design and conducted a national survey of administrative involuntary hospitalizations.Questionnaires were distributed to 939 facilities across Japan.The questionnaire collected data for selected involuntary hospitalization cases in the hospital on June 30,2010(census date),and the prognoses of each patient on a specified date in 2011 and 2012.We also asked about the treatment provided to each patient.We stratified patients by prognosis(good or poor),and used logistic regression analysis to examine the relationship between treatment and prognosis.RESULTS We received completed questionnaires from 292 facilities(response rate 31.1%);105 facilities had no relevant patients.Our analysis included data for 394 patients with valid data.Official statistics indicated 1503 patients were under administrative involuntary hospitalization as at June 30,2012,meaning the capture rate was 27.2%.Approximately a fourth(104/394)at 1 year,and a third(137/294)at 2 years after the census had unknown prognosis.Treatment content included multi-disciplinary team meetings(78.2%of patients),counseling by public workers(59.9%),and discussion with external specialists(32.5%).Overall,116 patients were categorized as having a good prognosis at 1 year,and 168 had a poor prognosis.At the 2-year point,102 patients had a good prognosis and 150 had a poor prognosis.“Discussion with external specialists”was positively associated with a good prognosis at both 1 year(P=0.016)and 2 years(P=0.036).CONCLUSION We found that facilities in Japan currently have limited ability to track the prognoses of patients who were hospitalized involuntarily.Discussion with external specialists is associated with a good prognosis.
基金This work was supported by the National Key Research and Development Program of China(No.2016YFC0901303)the National Natural Science Foundation of China(Nos.72004147 and 62173158).
文摘In this paper,we introduce a long-term follow-up specific individual searching(SIS)model.This model introduces the concept of node search contributions by considering the characteristics of the network structure.A node search contribution indicates the ability of a certain node to correctly guide the search path and successfully complete an SIS.The influencing factors of node search contributions have three components:the individual influence index,attribute similarity,and node search willingness.On the basis of node search contributions and the PeopleRank idea,this paper proposes an SIS model based on node search contribution values and conducts comparison experiments with several mainstream SIS algorithms in three aspects:the search failure rate,the minimum number of search hops,and the search size.The experimental results verify the advanced nature and operability of the model proposed in this paper,which presents theoretical and practical significance to the quantitative study of the SIS process.
