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Sample records for waiting lists

  1. VHA Support Service Center Electronic Wait List (EWL)

    Data.gov (United States)

    Department of Veterans Affairs — The goal of the Electronic Wait List (EWL) is to provide care to the patient as quickly as possible. To facilitate this goal, patients may be placed on a Wait List...

  2. 8 CFR 207.5 - Waiting lists and priority handling.

    Science.gov (United States)

    2010-01-01

    ... REFUGEES § 207.5 Waiting lists and priority handling. Waiting lists are maintained for each designated refugee group of special humanitarian concern. Each applicant whose application is accepted for filing by... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Waiting lists and priority handling....

  3. Waiting list in a public health facility in Santiago, Chile

    Directory of Open Access Journals (Sweden)

    Alejandro Letelier

    2014-07-01

    Full Text Available Introduction Waiting lists are a well-known problem in public healthcare systems worldwide. For instance, England had over one million people in waiting lists for elective surgical procedures in 2000. Spain had over 360 000 patients in surgical waiting lists in 2007. Chile has been trying to manage waiting times through the GES (Explicit Guarantees in Healthcare plan, which was established by the Chilean government in 2005. Waiting lists for the guaranteed-care diseases in the GES plan had 380 000 patients at the beginning of 2010, and that number was reduced to zero in 2011. Internationally, there are some descriptive studies about waiting lists that focus on variables such as waiting times and number of patients in the list. In Chile, however, this type of study is lacking. Purpose This study aims to describe the characteristics of waiting lists for medical specialties between April and October 2011. It also aims to identify the components of management models in public healthcare centers, and to identify and analyze waiting-time frames of patients referred to a secondary or tertiary healthcare public center from a public primary healthcare center. Methods A descriptive cross-sectional study of the waiting list for first-time consultations for medical specialties was carried out. Referred patients were described and grouped using indicators of access to healthcare and waiting time between April and October 2011. Each consultation request or referral of a new patient was included in the waiting list and analyzed. Results There were 15 935 requests for consultations; 5 717 requests were resolved, and 8 544 were not (54% of the total requests for consultation. There was a mean waiting time of 498 days for non-resolved requests for consultation, and a mean of 141 days for resolved requests. The specialties in highest demand were orthopedic surgery and ophthalmology. The main waiting-list management processes were referral and reception of requests

  4. Ethics in radiology: wait lists queue jumping.

    Science.gov (United States)

    Cunningham, Natalie; Reid, Lynette; MacSwain, Sarah; Clarke, James R

    2013-08-01

    Education in ethics is a requirement for all Royal College residency training programs as laid out in the General Standards of Accreditation for residency programs in Canada. The ethical challenges that face radiologists in clinical practice are often different from those that face other physicians, because the nature of the physician-patient interaction is unlike that of many other specialties. Ethics education for radiologists and radiology residents will benefit from the development of teaching materials and resources that focus on the issues that are specific to the specialty. This article is intended to serve as an educational resource for radiology training programs to facilitate teaching ethics to residents and also as a continuing medical education resource for practicing radiologists. In an environment of limited health care resources, radiologists are frequently asked to expedite imaging studies for patients and, in some respects, act as gatekeepers for specialty care. The issues of wait lists, queue jumping, and balancing the needs of individuals and society are explored from the perspective of a radiologist.

  5. Ultrasound waiting lists: rational queue or extended capacity?

    Science.gov (United States)

    Brasted, Christopher

    2008-06-01

    The features and issues regarding clinical waiting lists in general and general ultrasound waiting lists in particular are reviewed, and operational aspects of providing a general ultrasound service are also discussed. A case study is presented describing a service improvement intervention in a UK NHS hospital's ultrasound department, from which arises requirements for a predictive planning model for an ultrasound waiting list. In the course of this, it becomes apparent that a booking system is a more appropriate way of describing the waiting list than a conventional queue. Distinctive features are identified from the literature and the case study as the basis for a predictive model, and a discrete event simulation model is presented which incorporates the distinctive features.

  6. Who gets a family physician through centralized waiting lists?

    OpenAIRE

    Breton, Mylaine; Brousselle, Astrid; Boivin, Antoine; Roberge, Dani?le; Pineault, Raynald; Berbiche, Djamal

    2015-01-01

    Background North American patients are experiencing difficulties in securing affiliations with family physicians. Centralized waiting lists are increasingly being used in Organisation for Economic Co-operation and Development countries to improve access. In 2011, the Canadian province of Quebec introduced new financial incentives for family physicians? enrolment of orphan patients through centralized waiting lists, the Guichet d?acc?s aux client?les orphelines, with higher payments for vulner...

  7. Bed capacity and surgical waiting lists: a simulation analysis

    Directory of Open Access Journals (Sweden)

    Manel Antelo

    2015-12-01

    Full Text Available Waiting time for elective surgery is a key problem in the current medical world. This paper aims to reproduce, by a Monte Carlo simulation model, the relationship between hospital capacity, inpatient activity, and surgery waiting list size in teaching hospitals. Inpatient activity is simulated by fitting a Normal distribution to real inpatient activity data, and the effect of the number of beds on inpatient activity is modelled with a linear regression model. Analysis is performed with data of the University Multi-Hospital Complex of Santiago de Compostela (Santiago de Compostela, Spain, by considering two scenarios regarding the elastiticity of demand with bed increase. If demand does not grow with an increase on bed capacity, small changes lead to drastic reductions in the waiting lists. However, if demand grows as bed capacity does, adding additional capacity merely makes waiting lists worse.

  8. 24 CFR 982.205 - Waiting list: Different programs.

    Science.gov (United States)

    2010-04-01

    ... program, project-based voucher program or moderate rehabilitation program: (i) If the PHA's waiting list... public housing program, project-based voucher program or moderate rehabilitation program, the PHA must... list for its public housing program, project-based voucher program or moderate rehabilitation......

  9. Waiting Lists for Radiation Therapy: A Case Study

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    Singer Peter A

    2001-04-01

    Full Text Available Abstract Background Why waiting lists arise and how to address them remains unclear, and an improved understanding of these waiting list "dynamics" could lead to better management. The purpose of this study is to understand how the current shortage in radiation therapy in Ontario developed; the implications of prolonged waits; who is held accountable for managing such delays; and short, intermediate, and long-term solutions. Methods A case study of the radiation therapy shortage in 1998-99 at Princess Margaret Hospital, Toronto, Ontario, Canada. Relevant documents were collected; semi-structured, face-to-face interviews with ten administrators, health care workers, and patients were conducted, audio-taped and transcribed; and relevant meetings were observed. Results The radiation therapy shortage arose from a complex interplay of factors including: rising cancer incidence rates; broadening indications for radiation therapy; human resources management issues; government funding decisions; and responsiveness to previous planning recommendations. Implications of delays include poorer cancer control rates; patient suffering; and strained doctor-patient relationships. An incompatible relationship exists between moral responsibility, borne by government, and legal liability, borne by physicians. Short-term solutions include re-referral to centers with available resources; long-term solutions include training and recruiting health care workers, improving workload standards, increasing compensation, and making changes to the funding formula. Conclusion Human resource planning plays a critical role in the causes and solutions of waiting lists. Waiting lists have harsh implications for patients. Accountability relationships require realignment.

  10. Who gets a family physician through centralized waiting lists?

    Science.gov (United States)

    Breton, Mylaine; Brousselle, Astrid; Boivin, Antoine; Roberge, Danièle; Pineault, Raynald; Berbiche, Djamal

    2015-02-05

    North American patients are experiencing difficulties in securing affiliations with family physicians. Centralized waiting lists are increasingly being used in Organisation for Economic Co-operation and Development countries to improve access. In 2011, the Canadian province of Quebec introduced new financial incentives for family physicians' enrolment of orphan patients through centralized waiting lists, the Guichet d'accès aux clientèles orphelines, with higher payments for vulnerable patients. This study analyzed whether any significant changes were observed in the numbers of patient enrolments with family physicians' after the introduction of the new financial incentives. Prior to then, financial incentives had been offered for enrolment of vulnerable patients only and there were no incentives for enrolling non-vulnerable patients. After 2011, financial incentives were also offered for enrolment of non-vulnerable patients, while those for enrolment of vulnerable patients were doubled. A longitudinal quantitative analysis spanning a five-year period (2008-2013) was performed using administrative databases covering all patients enrolled with family physicians through centralized waiting lists in the province of Quebec (n = 494,697 patients). Mixed regression models for repeated-measures were used. The number of patients enrolled with a family physician through centralized waiting lists more than quadrupled after the changes in financial incentives. Most of this increase involved non-vulnerable patients. After the changes, 70% of patients enrolled with a family physician through centralized waiting lists were non-vulnerable patients, most of whom had been referred to the centralized waiting lists by the physician who enrolled them, without first being registered in those lists or having to wait because of their priority level. Centralized waiting lists linked to financial incentives increased the number of family physicians' patient enrolments. However, although

  11. [Waiting list for nursing home admission gives limited insight of the problems. Study in handling of the waiting list and the consequences for the patients].

    Science.gov (United States)

    Meiland, Franka

    2002-04-01

    The waiting list for nursing home admission is expected to remain unacceptably long. A study of the use and of possibly problematic consequences of the waiting list was described in a thesis. Despite long mean waiting periods and many problems (depressive symptoms, experiences of burden) already at the start of the waiting period, the majority of the informal caregivers were satisfied with the waiting times. This may be explained by a reticence to nursing home admission and by enlistment to the waiting list "out of precaution". Both a long and a short waiting period could be experienced as too long. Waiting list figures give insufficient insight in the "real" demand for nursing home care and in problematic waiting periods.

  12. [Access to the waiting list and renal transplantation].

    Science.gov (United States)

    Hourmant, M; de Cornelissen, F; Brunet, P; Pavaday, K; Assogba, F; Couchoud, C; Jacquelinet, C

    2013-09-01

    This chapter provides a set of indicators related to Renal Transplantation access in France. It describes patient outcomes and reports on cumulative incidence rates of wait-listing and renal transplantation according to main patient of characteristics and regions. The REIN registry integrates kidney transplant and dialysis data. It provides a comprehensive view on waiting list and renal transplantation access to the patients, nephrologists, and national or regional health authorities. Access to the waiting list is evaluated on a cohort of 51,845 new patients who started dialysis between 2002 and 2011 in 25 regions. The probability of first wait-listing was of 3.7% at the start of dialysis (pre-emptive registrations), 15% at 12, 22% at 36 and 24% to 60 months. The probability of being registered was strongly related to age, diabetes and region. Patient older than 60 had a very poor access to the waiting list, whatever their diabetes status was. Probability of first wait-listing was much lower (36.5% at 60 months) in type 2 diabetic-40 to 59 years old patients. Among 13,653 patients less than 60 years old, the probability of being registered was 11% at the start of dialysis, 43% to 12 months, 62% to 36 months and 66% to 60 months (median dialysis duration: 16 months). Seventeen regions with up to 5 years follow-up show an increase of 8 to 15% in pre-emptive registrations between 2007 and 2001, without change at 1 year. Access to kidney transplant is evaluated on a cohort of 53,301 new patients who started a renal replacement therapy (dialysis or pre-emptive renal transplant) between 2002 and 2011 in 25 regions. The probability of first kidney transplant was of 7% at 12, 17% at 36 and 21% at 60 months. 8,633 patients (16,2%) had received a first renal transplant within 14.7 month median time; 1,455 (2.7%) had received a pre-emptive graft [male: 58%, median age: 48.7y]. Among the 14,770 new patients less than 60 years old, the probability of being transplanted was of

  13. HYPOXIA AMONG PATIENTS ON THE LIVER-TRANSPLANT WAITING LIST

    Science.gov (United States)

    NACIF, Lucas Souto; ANDRAUS, Wellington; SARTORI, Kathryn; BENITES, Carlos Marlon; SANTOS, Vinicius Rocha; ROCHA-FILHO, Joel Avancini; D'ALBUQUERQUE, Luiz Carneiro

    2014-01-01

    Background Hepatopulmonary syndrome is formed by a triad of liver disease, intrapulmonary vascular dilatation and changes in blood gases. This condition is present in 4-32% of patients with cirrhosis. Aim To analyze the blood gas changes data of patients in liver-transplant waiting list. Method Clinical data of 279 patients in liver transplantation waiting list in May 2013 were studied. Overall patient was analyzed by the demographic aspects, laboratorial and image findings on exams that determine lung disease (hypoxemia) in these cirrhotic patients. The mean values and standard deviations were used to examine normally distributed variables. Results There was a high prevalence of male patients (68%); the mean age was 51(±5,89) years, and the predominant reason for listing was hepatitis C cirrhosis. The MELD score mean was 16±5,89, without prioritization or special situation. The most common blood type was O in 129 cases (46%) and the mean of body max index was 25,94±4,58. Regarding arterial blood gas tests was observed 214 patients with PaO2 transplant. Due to the high severity and morbidity, is suggested better monitoring and therapeutic support to hypoxemic patients on liver transplant waiting list. PMID:24676301

  14. Trading with the waiting-list: the justice of Living Donor List Exchange

    NARCIS (Netherlands)

    den Hartogh, G.

    2010-01-01

    In a Living Donor List Exchange program, the donor makes his kidney available for allocation to patients on the postmortal waiting-list and receives in exchange a postmortal kidney, usually an O-kidney, to be given to the recipient he favours. The program can be a solution for a candidate donor who

  15. Trading with the waiting-list: the justice of Living Donor List Exchange

    NARCIS (Netherlands)

    den Hartogh, G.

    2010-01-01

    In a Living Donor List Exchange program, the donor makes his kidney available for allocation to patients on the postmortal waiting-list and receives in exchange a postmortal kidney, usually an O-kidney, to be given to the recipient he favours. The program can be a solution for a candidate donor who

  16. [Waiting lists guarantee in health care. Some theoretical reflections].

    Science.gov (United States)

    Piene, H; Hauge, H K; Nyen, P A

    1997-01-30

    In 1990 a "waiting list guarantee" was introduced in the Norwegian health care system to secure treatment within six months for patients belonging to priority group II. (Priority group II are patients in need of treatment to avoid health hazards or serious long-term effects.) This guarantee has been difficult to honour and has caused considerable political unrest in the recent years. In an attempt to reform the guarantee, an analysis of our hospitals' capacity problems has been carried out, based on the general theory of queues. One result was that in order to fulfill the guarantee it is necessary to drastically reduce the queues and increase the capacity to deliver health services. This article presents the reasoning behind the analysis, in order to demonstrate the necessary foundation for a health policy that aims to reduce the time Norwegian patients have to wait for treatment in hospital.

  17. A Triage Approach to Managing a Two Year Wait-List in a Chronic Pain Program

    Directory of Open Access Journals (Sweden)

    Alexander J Clark

    2005-01-01

    Full Text Available OBJECTIVE: Individuals with chronic pain referred to specialist chronic pain management programs frequently wait months to years for assessment and care. In the authors' pain management program, approximately 600 patients are on the waiting list. An innovative recommendation program to encourage and educate referring physicians to continue active care of pain during this waiting period was developed.

  18. Influence of Waiting List in Recurrence Disease of Hepatocellular Carcinoma.

    Science.gov (United States)

    San Miguel, C; Vílchez, A; Villegas, T; Granero, K M; Becerra, A; López, M Á; Expósito, M; Fundora, Y

    2015-11-01

    We describe the results of our liver transplantation (LT) patients for hepatocellular carcinoma (HCC) in 2004 to 2012 to determine the differences on the basis of time on the waiting list to establish the risk of recurrence of liver disease. Clinical variables were recorded for both donors and recipients as well as variables of diagnosis, the use of transarterial chemoembolization during the waiting list time (WLT), complications, re-transplantation, and exitus. Fifty-eight patients were analyzed. Mean age was 57 ± 8 years (men, 83%; 48 patients). Viral etiology of HCC was 50% (n = 29); alcoholic, 26% (n = 15); and others, 24% (n = 14). Exitus was established in 24 patients (41%); only 5 patients (7%) were attributable to HCC. In the cohort of patients with less than 6 months of WLT, we registered both higher rates of downstaging protocols (10.7% vs 7.5%) and tumor size (3 cm vs 2 cm) compared with the other group. Bivariate studies were conducted according to the WLT (WLT <6 months, WLT ≥6 months), finding differences in recurrence of liver disease (P < .05). This fact was confirmed after a binary logistic regression. Our results in a subgroup of less than 6 months of WLT included patients with increased tumor size or presentation of multiple nodes, with a worse prognosis and therefore to be prioritized in the treatment of LT. Therefore, in our population there is a significant risk of tumor recurrence in patients with less WLT for LT, but it cannot be overestimated to all type of patients with HCC. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Reasons for dropping out from a waiting list for in vitro fertilization

    NARCIS (Netherlands)

    van Dongen, Angelique J. C. M.; Verhagen, Tamara E. M.; Dumoulin, John C. M.; Land, Jolande A.; Evers, Johannes L. H.

    2010-01-01

    Objective: To determine the incidence of couples dropping out of the in vitro fertilization (IVF) waiting list and to describe the couples' reasons. Design: Prospective cohort study. Setting: Fertility center in an academic hospital. Patient(s): 674 women placed consecutively on the IVF waiting list

  20. Trading with the waiting-list: the justice of living donor list exchange.

    Science.gov (United States)

    den Hartogh, Govert

    2010-05-01

    In a Living Donor List Exchange program, the donor makes his kidney available for allocation to patients on the postmortal waiting-list and receives in exchange a postmortal kidney, usually an O-kidney, to be given to the recipient he favours. The program can be a solution for a candidate donor who is unable to donate directly or to participate in a paired kidney exchange because of blood group incompatibility or a positive cross-match. Each donation within an LDLE program makes an additional organ available for transplantation. But because most of the pairs making use of the program will be A/O incompatible, it will also tend to increase the waiting time for patients with blood group O, who already have the longest waiting time. It has therefore been objected that the program is materially unjust, because it further disadvantages the least advantaged. This objection appeals to John Rawls' difference principle. However, the context for which Rawls proposed that difference principle, is significantly different from the present one. Applying the principle here amounts to a lop-sided trade-off between considerations of need and considerations of overall utility. Considerations of formal justice, however, may lead to a stronger objection to LDLE programs. Such a program means that one O-patient on the waiting list is exempted from the application of the general criteria used in constructing the list because he has a special bargaining advantage. This objection is spelled out and weighed against the obvious attraction of LDLE in a situation of (extreme) organ scarcity.

  1. Cholelithiasis in patients on the kidney transplant waiting list

    Directory of Open Access Journals (Sweden)

    André Thiago Scandiuzzi Brito

    2010-01-01

    Full Text Available OBJECTIVES: To evaluate the prevalence of cholecystopathy in chronic renal patients awaiting kidney transplants. INTRODUCTION: The prevalence and management of cholelithiasis in renal transplant patients is not well established. METHODS: A total of 342 chronic renal failure patients on the waiting list for a kidney transplant were studied. Patients were evaluated for the presence of cholelithiasis and related symptoms, previous cholecystectomies and other abdominal surgeries, time on dialysis, and general data (gender, age, number of pregnancies, and body mass index. RESULTS: Cholelithiasis was found in 41 out of 342 patients (12%. Twelve of these patients, all symptomatic, had previously undergone cholecystectomies. Five out of 29 patients who had not undergone surgery were symptomatic. Overall, 17 patients (41.5% were symptomatic. Their mean age was 54 (range 32-74 years old; 61% were female, and their mean body mass index was 25.4. Nineteen (76% out of 25 women had previously been pregnant, with an average of 3.6 pregnancies per woman. CONCLUSIONS: The frequency of cholelithiasis was similar to that reported in the literature for the general population. However, the high frequency of symptomatic patients points toward an indication of routine pre-transplant cholecystectomy to avoid serious post-transplant complications.

  2. Cholelithiasis in patients on the kidney transplant waiting list

    Science.gov (United States)

    Brito, André Thiago Scandiuzzi; Azevedo, Luiz Sergio; Nahas, Willian Carlos; Matheus, André Siqueira; Jukemura, José

    2010-01-01

    OBJECTIVES To evaluate the prevalence of cholecystopathy in chronic renal patients awaiting kidney transplants. INTRODUCTION The prevalence and management of cholelithiasis in renal transplant patients is not well established. METHODS A total of 342 chronic renal failure patients on the waiting list for a kidney transplant were studied. Patients were evaluated for the presence of cholelithiasis and related symptoms, previous cholecystectomies and other abdominal surgeries, time on dialysis, and general data (gender, age, number of pregnancies, and body mass index). RESULTS Cholelithiasis was found in 41 out of 342 patients (12%). Twelve of these patients, all symptomatic, had previously undergone cholecystectomies. Five out of 29 patients who had not undergone surgery were symptomatic. Overall, 17 patients (41.5%) were symptomatic. Their mean age was 54 (range 32–74) years old; 61% were female, and their mean body mass index was 25.4. Nineteen (76%) out of 25 women had previously been pregnant, with an average of 3.6 pregnancies per woman. CONCLUSIONS The frequency of cholelithiasis was similar to that reported in the literature for the general population. However, the high frequency of symptomatic patients points toward an indication of routine pre-transplant cholecystectomy to avoid serious post-transplant complications. PMID:20454496

  3. Simulated waiting list prioritization for equitable allocation of donor lungs

    NARCIS (Netherlands)

    Ouwens, JP; Groen, H; TenVergert, EM; Koeter, GH; van der Bij, W

    Background: In lung transplantation (LTx), allocation of donor lungs is usually based on blood group, height and waiting time. Long waiting times favor patients with a slowly progressive end-stage lung disease and make the current allocation system the subject of discussion. In an attempt to

  4. Don't stop the clock: manipulating hospital waiting lists.

    Science.gov (United States)

    Buchanan, David A; Storey, John

    2010-01-01

    This paper aims to explore the theoretical and practical management implications of a case involving the falsification of hospital patient waiting lists for elective orthopaedic surgery. This case study is based on qualitative schedule-structured interviews with 20 senior hospital staff (managerial and clinical), including the head of the investigation team, downloads from the hospital website, and internal hospital documentation. Those data were used to construct an event narrative exploring the underlying causes and implications of the incident. The blame for misconduct pointed at three surgeons, a senior manager, a general manager, an assistant general manager, one administrative staff member, and several organizational factors. In addition to censuring some of those involved, an investigation recommended changes to training and working practices, policies and procedures, governance arrangements, and organization culture, and led to an external evaluation of the hospital board. However, one year later, another similar incident occurred. This is a single case, and events are viewed through a management lens, the individuals concerned being protected by research ethics considerations. By detailing the sequence of events, surrounding conditions, and the reactions of multiple players, this analysis reveals typified responses to incidents of this kind, and the limitations inherent in post-event investigations. If the benefits derived from national targets are to be realized in a manner which commands support from staff at all levels, then greater attention should be paid by managers and regulators to issues of transparency, responsiveness, and honesty. As core dimensions of good governance, managers must be accountable for helping to meet targets, and also for tracking how targets are met, ensuring that resources are made available, and that problematic issues raised are promptly and effectively addressed. Studies of organizational misbehaviour are rare in healthcare

  5. Waiting list management practices for home-care occupational therapy in the province of Quebec, Canada.

    Science.gov (United States)

    Raymond, Marie-Hélène; Demers, Louise; Feldman, Debbie E

    2016-03-01

    Referral prioritisation is commonly used in home-based occupational therapy to minimise the negative impacts of waiting, but this practice is not standardised. This may lead to inequities in access to care, especially for clients considered as low priority, who tend to bear the brunt of lengthy waiting lists. This cross-sectional study aimed to describe waiting list management practices targeting low-priority clients in home-based occupational therapy in the province of Quebec, Canada, and to investigate the association between these practices and the length of the waiting list. A structured telephone interview was conducted in 2012-2013 with the person who manages the occupational therapy waiting list in 55 home care programmes across Quebec. Questions pertained to strategies aimed at servicing low-priority clients, the date of the oldest referral and the number of clients waiting. Results were analysed using descriptive statistics and non-parametric tests. The median wait time for the oldest referral was 18 months (range: 2-108 months). A variety of strategies were used to service low-priority clients. Programmes that used no strategies to service low-priority clients (n = 16) had longer wait times (P occupational therapy programmes. However, in programmes where none of these strategies are used, low-priority clients may be denied access to services indefinitely.

  6. THE EXPERIENCE OF WAITING LIST MANAGEMENT FOR LIVER TRANSPLANTATION IN EKATERINBURG

    Directory of Open Access Journals (Sweden)

    E. N. Bessonova

    2011-01-01

    Full Text Available Gaining the experience of liver transplantation waiting list formation is the important condition of transplant cen- ter successful work. In the era of transplant organ shortage careful medical examination of the patient before the operation and detection of unfavorable facts and transplantation contraindications are of paramount importance. At the same time evaluation of the structure of potential liver transplant recipients category allows to develop maximal effective management of waiting list patients and prevention of fatal complications before operation. 

  7. Chances of late surgery in relation to length of wait lists

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    Levy Adrian R

    2005-09-01

    Full Text Available Abstract Background The proportion of patients who undergo surgery within a clinically safe time is an important performance indicator in health systems that use wait lists to manage access to care. However, little is known about chances of on-time surgery according to variations in existing demand. We sought to determine what proportion of patients have had late coronary bypass surgery after registration on wait lists of different size in a network of hospitals with uniform standards for timing of surgery. Methods Using records from a population-based registry, we studied wait-list times prospectively collected in a cohort of patients registered on wait lists for coronary artery bypass grafting procedures. We compared the number of weeks from registration to surgery against target access times established for three urgency groups. The chances of undergoing surgery within target time have been evaluated in relation to wait-list size at registration and the number of surgeries performed without registration on a wait list. Results In 1991–2001, two in three patients were at risk of late surgery when registered on wait lists for isolated coronary bypass procedures in British Columbia, Canada. Although urgent patients had never seen a wait list with clearance time exceeding one week, the odds of on-time surgery were reduced by 25%, odds ratio [OR] = 0.75 (95% confidence interval [CI] 0.65–0.87 for every additional operation performed without registration on a list. When the wait list at registration required a clearance time of over one month, semi-urgent patients had 51% lower odds of on-time surgery as compared to lists with clearance time less than one week, OR = 0.49 (95%CI 0.41–0.60, after adjustment for age, sex, comorbidity, calendar period, hospital and week on the list. In the non-urgent group, the odds were 69% lower, OR = 0.31 (95%CI 0.20–0.47. Every time an operation in the same hospital was performed without registration on a

  8. Improving the waiting list by using 75-year-old donors for recipients with hepatocellular carcinoma.

    Science.gov (United States)

    Cascales Campos, P A; Romero, P R; Gonzalez, R; Zambudio, A R; Martinez Frutos, I M; de la Peña, J; Bueno, F S; Robles Campos, R; Miras, M; Pons Miñano, J A; Sanmartin Monzo, A; Domingo, J; Bixquert Montagud, V; Parrilla Paricio, P

    2010-03-01

    The best treatment for hepatocellular carcinoma (HCC) associated with liver cirrhosis is liver transplantation and the best results are obtained when the tumors fulfill the Milan criteria. However, although the number of transplants is increasing, the organ deficit is growing, which lengthens time on the waiting list, increasing the risk of tumor progression of and exclusion from the list. The use of elderly donors is a valid option for patients on the transplant waiting list with HCC, reducing time on the waiting list. We report our experience with patients transplanted for HCC associated with hepatic cirrhosis using livers from donors >75 years of age. Our preliminary results supported the use of elderly suboptimal donors making it possible to give priority to these patients. All patients in the series achieved good graft function after a follow-up of 2 years with a 100% disease-free survival rate. More extensive long-term studies are needed to confirm these findings.

  9. Addition of long-distance heart procurement promotes changes in heart transplant waiting list status

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    Fernando Antibas Atik

    2014-09-01

    Full Text Available Objective: Evaluate the addition of long-distance heart procurement on a heart transplant program and the status of heart transplant recipients waiting list. Methods: Between September 2006 and October 2012, 72 patients were listed as heart transplant recipients. Heart transplant was performed in 41 (57%, death on the waiting list occurred in 26 (36% and heart recovery occurred in 5 (7%. Initially, all transplants were performed with local donors. Long-distance, interstate heart procurement initiated in February 2011. Thirty (73% transplants were performed with local donors and 11 (27% with long-distance donors (mean distance=792 km±397. Results: Patients submitted to interstate heart procurement had greater ischemic times (212 min ± 32 versus 90 min±18; P<0.0001. Primary graft dysfunction (distance 9.1% versus local 26.7%; P=0.23 and 1 month and 12 months actuarial survival (distance 90.1% and 90.1% versus local 90% and 86.2%; P=0.65 log rank were similar among groups. There were marked incremental transplant center volume (64.4% versus 40.7%, P=0.05 with a tendency on less waiting list times (median 1.5 month versus 2.4 months, P=0.18. There was a tendency on reduced waiting list mortality (28.9% versus 48.2%, P=0.09. Conclusion: Incorporation of long-distance heart procurement, despite being associated with longer ischemic times, does not increase morbidity and mortality rates after heart transplant. It enhances viable donor pool, and it may reduce waiting list recipient mortality as well as waiting time.

  10. 24 CFR 882.513 - Public notice to low-income families; waiting list.

    Science.gov (United States)

    2010-04-01

    ... HOUSING FOR PERSONS WITH DISABILITIES PROGRAM) SECTION 8 MODERATE REHABILITATION PROGRAMS Special Procedures for Moderate Rehabilitation-Program Development and Operation § 882.513 Public notice to low... must maintain a waiting list for applicants for the Moderate Rehabilitation Program. This...

  11. Transplants in Foreign Countries Among Patients Removed from the US Transplant Waiting List.

    Science.gov (United States)

    Merion, R M; Barnes, A D; Lin, M; Ashby, V B; McBride, V; Ortiz-Rios, E; Welch, J C; Levine, G N; Port, F K; Burdick, J

    2008-04-01

    Transplant tourism, where patients travel to foreign countries specifically to receive a transplant, is poorly characterized. This study examined national data to determine the minimum scope of this practice. US national waiting list removal data were analyzed. Waiting list removals for transplant without a corresponding US transplant in the database were reviewed via a data validation query to transplant centers to identify foreign transplants. Additionally, waiting list removal records with text field entries indicating a transplant abroad were identified. We identified 373 foreign transplants (173 directly noted; 200 from data validation); most (89.3%) were kidney transplants. Between 2001 and 2006, the annual number of waiting list removals for transplant abroad increased. Male sex, Asian race, resident and nonresident alien status and college education were significantly and independently associated with foreign transplant. Recipients from 34 states, plus the District of Columbia, received foreign transplants in 35 countries, led by China, the Philippines and India. Transplants in foreign countries among waitlisted candidates in the US are increasingly performed. The data reported here represent the minimum number of cases and the full extent of this practice cannot be determined using existing data. Additional reporting requirements are needed.

  12. Continuity of care for patients on a waiting list for institutional long-term care.

    NARCIS (Netherlands)

    Caris-Verhallen, W.M.C.M.; Kerkstra, A.

    2001-01-01

    The aim of this study was to examine patients' satisfaction with continuity of care while on a waiting list for residential care or nursing home care. Two hundred and seventy-eight patients participated in the study, all living in the community setting of two cities in the Netherlands. These patient

  13. Guided online or face-to-face cognitive behavioral treatment for insomnia: A randomized wait-list controlled trial

    NARCIS (Netherlands)

    Lancee, J.; van Straten, A.; Morina, N.; Kaldo, V.; Kamphuis, J.H.

    2016-01-01

    Study Objectives: To compare the efficacy of guided online and individual face-to-face cognitive behavioral treatment for insomnia (CBT-I) to a wait-list condition. Methods: A randomized controlled trial comparing three conditions: guided online; face-to-face; wait-list. Posttest measurements were a

  14. Time on wait lists for coronary bypass surgery in British Columbia, Canada, 1991 – 2000

    Directory of Open Access Journals (Sweden)

    Hayden Robert

    2005-03-01

    Full Text Available Abstract Background In British Columbia, Canada, all necessary medical services are funded publicly. Concerned with growing wait lists in the mid-1990s, the provincial government started providing extra funding for coronary artery bypass grafting (CABG operations annually. Although aimed at improving access, it is not known whether supplementary funding changed the time that patients spent on wait lists for CABG. We sought to determine whether the period of registration on wait lists had an effect on time to isolated CABG and whether the period effect was similar across priority groups. Methods Using records from a population-based registry, we studied the wait-list time before and after supplementary funding became available. We compared the number of weeks from registration to surgery for equal proportions of patients in synthetic cohorts defined by five registration periods in the 1990s. Results Overall, 9,231 patients spent a total of 137,126 person-weeks on the wait lists. The time to surgery increased by the middle of the decade, and decreased toward the end of the decade. Relative to the 1991–92 registration period, the conditional weekly probabilities of undergoing surgery were 30% lower among patients registered on the wait lists in 1995–96, hazard ratio (HR = 0.70 (0.65–0.76, and 23% lower in 1997–98 patients, HR = 0.77 (0.71–0.83, while there were no differences with 1999–2000 patients, HR = 0.94 (0.88–1.02, after adjusting for priority group at registration, comorbidity, age and sex. We found that the effect of registration period was different across priority groups. Conclusion Our results provide evidence that time to CABG shortened after supplementary funding was provided on an annual basis to tertiary care hospitals within a single publicly funded health system. One plausible explanation is that these hospitals had capacity to increase the number of operations. At the same time, the effect was not uniform across

  15. Predictors of mortality in patients on the waiting list for liver transplantation

    Directory of Open Access Journals (Sweden)

    Lívia Garcia Ferreira

    2013-06-01

    Full Text Available Background and aim: The demand for liver transplantation (LTx increases every year, which is in contrast to the stagnation in the number of donors. This phenomenon has given rise to longer waiting times, which results in higher pre-transplantation mortality. Thus, our aim for this study was to identify risk factors, including nutritional variables, for mortality for patients who are on the waiting list for LTx. Methods: Patients on the waiting list were assessed to identify risk factors for mortality. Data related to demographic, socioeconomic, and etiologic factors, liver disease severity, complications, medications, and biochemical tests related to disease, nutritional status, diet intake, and physical activity were collected. Results: There were 159 patients followed, and 47.8% (76 were transplanted. The mortality rate while on the waiting list was 25.7% patient-years, and 40 patients died (28.0%. Variables associated with mortality during this period (p < 0.05 were the following: severe malnutrition (OR 2.5/CI: 1.2-5.3, low serum sodium values (OR: 1.1/CI: 1.01-1.2, and cryptogenic cirrhosis (OR: 2.2/CI: 1.1-4.6. Conclusions: Special attention should be given to patients with low serum sodium, those who are diagnosed with cryptogenic cirrhosis and the severely malnourished. An early diagnosis of malnutrition and an appropriate nutritional intervention is mandatory in such patients.

  16. Diabetes Mellitus and Prediabetes on Kidney Transplant Waiting List- Prevalence, Metabolic Phenotyping and Risk Stratification Approach.

    Directory of Open Access Journals (Sweden)

    Martina Guthoff

    Full Text Available Despite a significant prognostic impact, little is known about disturbances in glucose metabolism among kidney transplant candidates. We assess the prevalence of diabetes mellitus (DM and prediabetes on kidney transplant waiting list, its underlying pathophysiology and propose an approach for individual risk stratification.All patients on active kidney transplant waiting list of a large European university hospital transplant center were metabolically phenotyped.Of 138 patients, 76 (55% had disturbances in glucose metabolism. 22% of patients had known DM, 3% were newly diagnosed. 30% were detected to have prediabetes. Insulin sensitivity and-secretion indices allowed for identification of underlying pathophysiology and risk factors. Age independently affected insulin secretion, resulting in a relative risk for prediabetes of 2.95 (95%CI 1.38-4.83 with a cut-off at 48 years. Body mass index independently affected insulin sensitivity as a continuous variable.The prevalence of DM or prediabetes on kidney transplant waiting list is as high as 55%, with more than one third of patients previously undiagnosed. Oral glucose tolerance test is mandatory to detect all patients at risk. Metabolic phenotyping allows for differentiation of underlying pathophysiology and provides a basis for early individual risk stratification and specific intervention to improve patient and allograft outcome.

  17. The attitude toward xenocorneal transplantation in wait-listed subjects for corneal transplantation in Korea.

    Science.gov (United States)

    Lee, Jong Joo; Kim, Dong Hyun; Jang, Young Eun; Choi, Hyuk Jin; Kim, Mee Kum; Wee, Won Ryang

    2014-01-01

    Shortage of donor cornea is a significant problem in Asia, and xenocorneal transplantation is being actively studied to alleviate this problem. However, the attitudes of subjects who await corneal transplants toward xenocorneal transplantation are not known at all. Thus, this study aimed to investigate the attitudes of subjects on the waiting lists for corneal transplants, toward corneal xenotransplantation. A telephone questionnaire survey comprising six items was conducted in 132 subjects among the wait-listed individuals (n = 590) who were awaiting corneal transplantation or had undergone corneal transplantation at Seoul National University Hospital from July, 2003 to August, 2012. Among six inquiries, four questions were used to analyze attitudes toward corneal xenotransplantation. Each question pertained to (1) the acceptance of xenocorneal transplantation, (2) willingness to participate in clinical trials, (3) worries in xenocorneal transplantation, and (4) the concern of self-identity or social life after xenocorneal transplantation. To analyze demographic factors influencing the question, the subjects were arbitrarily divided into two groups: the young (age xenotransplantation. Younger subjects expressed more worry about xenotransplantation than elderly subjects. The well-educated expressed less concern over self-identity and social life than the less-educated. This survey among subjects who are wait-listed for corneal transplant or who have received a corneal transplant demonstrates that there is an interest in xenocorneal transplantation as an alternate procedure, although there are worries about the procedure that should be further explored in educational campaigns and future studies of the general population.

  18. [A higher place on the waiting list for kidney transplantation after earlier donation: a matter of give and take].

    Science.gov (United States)

    Hoitsma, Andries J

    2011-01-01

    In May 2011 the Dutch Health Council released an advice regarding living kidney donors who developed end-stage renal disease (ESRD) after donation. These donors with ESRD will have a high priority when they are on the waiting list for kidney transplantation. With this new rule the former donors will be transplanted within 6 weeks and transplantation can preferably be performed preemptively. It is expected that this measure shall prolong the waiting list for a donor kidney for the remaining patients with end stage renal disease by 6 days at most, on a total average waiting period of 4 years.

  19. The Frequency of Familial Mediterranean Fever Related Amyloidosis in Renal Waiting List for Transplantation

    Science.gov (United States)

    Keles, Mustafa; Eyerci, Nilnur; Uyanik, Abdullah; Aydinli, Bulent; Sahin, Gonul Zisan; Cetinkaya, Ramazan; Pirim, Ibrahim; Polat, Kamil Yalcin

    2010-01-01

    Objective: Our goal is to investigate the distribution of MEFV mutations in patients with renal amyloidosis who are in renal transplant waiting list which is prepared for transplantation. Materials and Methods: FMF was diagnosed in 25 of the 297 patients between the years 2004 and 2008, who were involved in the study (15 male, 10 female; age 34±7.8). 5 out of 25 patients were transplanted, remaining were waiting for Tx. Biopsy results were amyloidosis and taken from renal (n:16), rectal (n:8) and duodenal (1).All of them were carrier of mutations in both pyrin alleles.The primer cause of chronic renal failure in our group was secondary AA amyloidosis. DNA was isolated from 25 whole blood samples. The NanoChip Molecular Biology Workstation (Nanogen) uses electronic microarrays for mutation detection. Exon 2,3,5 and 10 of pyrin gene genotypes were identified in the NanoChip. Results: Genetic analysis of the patients demonstrated that each subject carries either homozygote or compound heterozygote mutations of the gene. The most common mutations were M694V, V726A, E148Q and M680I. Conclusions: The clinic manifestation and complain of our patients were febrile and painful attacks such as in the abdomen, chest and joints due to inflammation of the peritoneum, pleura and synovial membrane. The major problem in FMF is the occurrence of amyloidosis that primarily affects the kidneys causing proteinuria and renal failure. Dialysis and renal transplantation can be treatment, but it is important to diagnose FMF at earliest stages. The percentage of FMF patients in our waiting list was 8.4%. Moreover, in our region FMF incidence is highly frequent, so FMF should be chased by genetically so as to prevent chronic renal failure due to amyloidosis. PMID:25610112

  20. Modelling access to renal transplantation waiting list in a French healthcare network using a Bayesian method.

    Science.gov (United States)

    Bayat, Sahar; Cuggia, Marc; Kessler, Michel; Briançon, Serge; Le Beux, Pierre; Frimat, Luc

    2008-01-01

    Evaluation of adult candidates for kidney transplantation diverges from one centre to another. Our purpose was to assess the suitability of Bayesian method for describing the factors associated to registration on the waiting list in a French healthcare network. We have found no published paper using Bayesian method in this domain. Eight hundred and nine patients starting renal replacement therapy were included in the analysis. The data were extracted from the information system of the healthcare network. We performed conventional statistical analysis and data mining analysis using mainly Bayesian networks. The Bayesian model showed that the probability of registration on the waiting list is associated to age, cardiovascular disease, diabetes, serum albumin level, respiratory disease, physical impairment, follow-up in the department performing transplantation and past history of malignancy. These results are similar to conventional statistical method. The comparison between conventional analysis and data mining analysis showed us the contribution of the data mining method for sorting variables and having a global view of the variables' associations. Moreover theses approaches constitute an essential step toward a decisional information system for healthcare networks.

  1. Limitations of the MELD score in predicting mortality or need for removal from waiting list in patients awaiting liver transplantation

    Directory of Open Access Journals (Sweden)

    Schmidt Jan

    2009-09-01

    Full Text Available Abstract Background Decompensated cirrhosis is associated with a poor prognosis and liver transplantation provides the only curative treatment option with excellent long-term results. The relative shortage of organ donors renders the allocation algorithms of organs essential. The optimal strategy based on scoring systems and/or waiting time is still under debate. Methods Data sets of 268 consecutive patients listed for single-organ liver transplantation for nonfulminant liver disease between 2003 and 2005 were included into the study. The Model for End-Stage Liver Disease (MELD and Child-Turcotte-Pugh (CTP scores of all patients at the time of listing were used for calculation. The predictive ability not only for mortality on the waiting list but also for the need for withdrawal from the waiting list was calculated for both scores. The Mann-Whitney-U Test was used for the univariate analysis and the AUC-Model for discrimination of the scores. Results In the univariate analysis comparing patients who are still on the waiting list and patients who died or were removed from the waiting list due to poor conditions, the serum albumin, bilirubin INR, and CTP and MELD scores as well as the presence of ascites and encephalopathy were significantly different between the groups (p Comparing the predictive abilities of CTP and MELD scores, the best discrimination between patients still alive on the waiting list and patients who died on or were removed from the waiting list was achieved at a CTP score of ≥9 and a MELD score of ≥14.4. The sensitivity and specificity to identify mortality or severe deterioration for CTP was 69.0% and 70.5%, respectively; for MELD, it was 62.1% and 72.7%, respectively. This result was supported by the AUC analysis showing a strong trend for superiority of CTP over MELD scores (AUROC 0.73 and 0.68, resp.; p = 0.091. Conclusion The long term prediction of mortality or removal from waiting list in patients awaiting liver

  2. Assessing the performance of centralized waiting lists for patients without a regular family physician using clinical-administrative data.

    Science.gov (United States)

    Breton, Mylaine; Smithman, Mélanie Ann; Brousselle, Astrid; Loignon, Christine; Touati, Nassera; Dubois, Carl-Ardy; Nour, Kareen; Boivin, Antoine; Berbiche, Djamal; Roberge, Danièle

    2017-01-05

    With 4.6 million patients who do not have a regular family physician, Canada performs poorly compared to other OECD countries in terms of attachment to a family physician. To address this issue, several provinces have implemented centralized waiting lists to coordinate supply and demand for attachment to a family physician. Although significant resources are invested in these centralized waiting lists, no studies have measured their performance. In this article, we present a performance assessment of centralized waiting lists for unattached patients implemented in Quebec, Canada. We based our approach on the Balanced Scorecard method. A committee of decision-makers, managers, healthcare professionals, and researchers selected five indicators for the performance assessment of centralized waiting lists, including both process and outcome indicators. We analyzed and compared clinical-administrative data from 86 centralized waiting lists (GACOs) located in 14 regions in Quebec, from April 1, 2013, to March 31, 2014. During the study period, although over 150,000 patients were attached to a family physician, new requests resulted in a 30% median increase in patients on waiting lists. An inverse correlation of average strength was found between the rates of patients attached to a family physician and the proportion of vulnerable patients attached to a family physician meaning that as more patients became attached to an FP through GACOs, the proportion of vulnerable patients became smaller (r = -0.31, p < 0.005). The results showed very large performance variations both among GACOs of different regions and among those of a same region for all performance indicators. Centralized waiting lists for unattached patients in Quebec seem to be achieving their twofold objective of attaching patients to a family physician and giving priority to vulnerable patients. However, the demand for attachment seems to exceed the supply and there appears to be a tension between giving

  3. Rationing scarce organs for transplantation: healthcare provider perspectives on wait-listing and organ allocation.

    Science.gov (United States)

    Tong, Allison; Jan, Stephen; Wong, Germaine; Craig, Jonathan C; Irving, Michelle; Chadban, Steven; Cass, Alan; Howard, Kirsten

    2013-01-01

    Ongoing debate about how to maximize the benefit of scarce organs while maintaining equity of access to transplantation exists. This study aims to synthesize healthcare provider perspectives on wait-listing and organ allocation. MEDLINE, Embase, and PsycINFO were searched till February 21, 2011. Quantitative data were extracted, and a qualitative synthesis of the studies was conducted. Twenty studies involving 4254 respondents were included. We identified two goals underpinning healthcare provider preferences for organ allocation: (i) maximize clinical benefit (quality of life gains, patient survival, treatment adherence, and graft survival) and social outcomes (social support, productivity, and valuation); (ii) achieve equity (waiting time, patient preferences, access to live donation, and medical urgency). Maximizing clinical or social outcomes meant organs would be preferentially given to patients expected to achieve good transplant outcomes or wider social gain. Achieving equity meant all patients should have an equal chance of transplant, or patients deemed more urgent receive higher priority. A tension between equity and efficiency is apparent. Balanced against dimensions of efficiency were considerations to instill a degree of perceived fairness in organ allocation. Ongoing engagement with stakeholders is needed to enhance transparency, a reasonable balance between efficiency and equity, and avoid discrimination against specific populations.

  4. Six-Minute-Walk Distance Predicts Waiting List Survival in Idiopathic Pulmonary Fibrosis

    Science.gov (United States)

    Lederer, David J.; Arcasoy, Selim M.; Wilt, Jessie S.; D'Ovidio, Frank; Sonett, Joshua R.; Kawut, Steven M.

    2006-01-01

    Rationale: Functional studies may be useful to predict survival in idiopathic pulmonary fibrosis (IPF). Various cutoffs of 6-min-walk distance (6MWD) have been suggested to identify patients at a high risk of death. Objectives: To examine the association between 6MWD and survival in patients with IPF listed for lung transplantation, and to identify sensitive and specific cutoffs for predicting death at 6 mo. Methods: We performed a retrospective cohort study of 454 patients classified as having IPF listed for lung transplantation with the United Network for Organ Sharing between June 30, 2004 and July 22, 2005. Measurements and Main Results: Lower 6MWD was associated with an increased mortality rate (p value for linear trend < 0.0001). Patients with a walk distance less than 207 m had a more than fourfold greater mortality rate than those with a walk distance of 207 m or more, despite adjustment for demographics, anthropomorphics, FVC % predicted, pulmonary hypertension, and medical comorbidities (adjusted rate ratio, 4.7; 95% confidence interval, 2.5–8.9; p < 0.0001). 6MWD was a significantly better predictor of 6-mo mortality than was FVC % predicted (c-statistic = 0.73 vs. 0.59, respectively; p = 0.02). Conclusions: Lower 6MWD was strongly and independently associated with an increased mortality rate for wait-listed patients classified as having IPF. 6MWD was a better predictor of death at 6 mo than was FVC % predicted. PMID:16778159

  5. Waiting list paradox: Danish cancer patients diagnosed fast have higher mortality after diagnosis

    DEFF Research Database (Denmark)

    Tørring, Marie Louise; Frydenberg, Morten; Hansen, Rikke Pilegaard

    on hospital discharge diagnoses for the 2004-2005 period, extracted from population-based healthcare databases in the former County of Aarhus, Denmark, and subsequently validated in the National Danish Cancer Registry. All patients with a first-time diagnosis of colon, rectal, lung, skin, breast, or prostate...... after diagnosis, and we used Cox regression to estimate mortality rate ratios as a function of diagnostic delay using restricted cubic splines, and adjusting for gender, age, and co-morbidity. We identified 1080 cancer patients. For all cancers, except breast cancer, mortality after diagnosis decreased...... with longer diagnostic interval until the reference point of 30 days. For colon, rectal, skin, and breast cancer mortality seemed to increase with diagnostic interval longer than 30 days. The waiting list paradox is manifest in Denmark. We speculate that medical professionals organise the diagnostic pathway...

  6. Prioritisation of patients on waiting lists for hip and knee arthroplasties and cataract surgery: Instruments validation

    Directory of Open Access Journals (Sweden)

    Moharra Montse

    2008-04-01

    Full Text Available Abstract Background Prioritisation instruments were developed for patients on waiting list for hip and knee arthroplasties (AI and cataract surgery (CI. The aim of the study was to assess their convergent and discriminant validity and inter-observer reliability. Methods Multicentre validation study which included orthopaedic surgeons and ophthalmologists from 10 hospitals. Participating doctors were asked to include all eligible patients placed in the waiting list for the procedures under study during the medical visit. Doctors assessed patients' priority through a visual analogue scale (VAS and administered the prioritisation instrument. Information on socio-demographic data and health-related quality of life (HRQOL (HUI3, EQ-5D, WOMAC and VF-14 was obtained through a telephone interview with patients. The correlation coefficients between the prioritisation instrument score and VAS and HRQOL were calculated. For the reliability study a self-administered questionnaire, which included hypothetic patients' scenarios, was sent via postal mail to the doctors. The priority of these scenarios was assessed through the prioritisation instrument. The intraclass correlation coefficient (ICC between doctors was calculated. Results Correlations with VAS were strong for the AI (0.64, CI95%: 0.59–0.68 and for the CI (0.65, CI95%: 0.62–0.69, and moderate between the WOMAC and the AI (0.39, CI95%: 0.33–0.45 and the VF-14 and the CI (0.38, IC95%: 0.33–0.43. The results of the discriminant analysis were in general as expected. Inter-observer reliability was 0.79 (CI95%: 0.64–0.94 for the AI, and 0.79 (CI95%: 0.63–0.95 for the CI. Conclusion The results show acceptable validity and reliability of the prioritisation instruments in establishing priority for surgery.

  7. The effects of brief cognitive-behaviour therapy for pathological skin picking: A randomized comparison to wait-list control

    NARCIS (Netherlands)

    Schuck, K.; Keijsers, G.P.J.; Rinck, M.

    2011-01-01

    Thirty-four college students suffering from pathological skin picking were randomly assigned to a four-session cognitive-behavioural treatment (n = 17) or a waiting-list condition (n = 17). Severity of skin picking, psycho-social impact of skin picking, strength of skin-picking-related dysfunctional

  8. [A higher place on the waiting list for kidney transplantation after earlier donation: a matter of give and take

    NARCIS (Netherlands)

    Hoitsma, A.J.

    2011-01-01

    In May 2011 the Dutch Health Council released an advice regarding living kidney donors who developed end-stage renal disease (ESRD) after donation. These donors with ESRD will have a high priority when they are on the waiting list for kidney transplantation. With this new rule the former donors will

  9. A Randomized Wait-List Controlled Analysis of the Implementation Integrity of Team-Initiated Problem Solving Processes

    Science.gov (United States)

    Newton, J. Stephen; Horner, Robert H.; Algozzine, Bob; Todd, Anne W.; Algozzine, Kate

    2012-01-01

    Members of Positive Behavior Interventions and Supports (PBIS) teams from 34 elementary schools participated in a Team-Initiated Problem Solving (TIPS) Workshop and follow-up technical assistance. Within the context of a randomized wait-list controlled trial, team members who were the first recipients of the TIPS intervention demonstrated greater…

  10. Increased wait-list time predicts dropout from outpatient enhanced cognitive behaviour therapy (CBT-E) for eating disorders.

    Science.gov (United States)

    Carter, Olivia; Pannekoek, Louise; Fursland, Anthea; Allen, Karina L; Lampard, Amy M; Byrne, Susan M

    2012-08-01

    Between 30 and 70% of patients with eating disorders drop out from outpatient treatment. However, research has been unable to identify factors that consistently predict dropout from eating disorder treatment. Most studies have exclusively investigated the role that individual patient characteristics play in dropout and have ignored more process-based factors such as expectations about treatment, the therapeutic alliance, or time spent on a treatment waiting list. This study aimed to investigate the roles of both individual patient characteristics and process-based factors in dropout from outpatient treatment for eating disorders. The study involved data collected from consecutive eating disorder referrals to the only public specialist eating disorder service for youth and adults in Perth, Western Australia. The standard treatment provided at this service is Enhanced Cognitive Behaviour Therapy on an individual basis. The study involved 189 patients referred to the service between 2005 and 2010. Forty five percent of this sample dropped out of treatment. Results showed that, in this sample, two individual factors, lowest reported weight and the tendency to avoid affect, and one process-based factor, time spent on the wait list for treatment, were significant predictors of dropout. These findings are valuable because a process-based factor, such as wait-list time, may be easier to address and modify than a patient's weight history or the trait of mood intolerance. Increased resources for eating disorder services may reduce waiting list times which would help to reduce dropout and maximize treatment outcomes.

  11. Cumulative incidence for wait-list death in relation to length of queue for coronary-artery bypass grafting: a cohort study

    Directory of Open Access Journals (Sweden)

    Levy Adrian R

    2006-08-01

    Full Text Available Abstract Background In deciding where to undergo coronary-artery bypass grafting, the length of surgical wait lists is often the only information available to cardiologists and their patients. Our objective was to compare the cumulative incidence for death on the wait list according to the length of wait lists at the time of registration for the operation. Methods The study cohort included 8966 patients who registered to undergo isolated coronary-artery bypass grafting (82.4% men; 71.9% semi-urgent; 22.4% non-urgent. The patients were categorized according to wait-list clearance time at registration: either "1 month or less" or "more than 1 month". Cumulative incidence for wait-list death was compared between the groups, and the significance of difference was tested by means of regression models. Results Urgent patients never registered on a wait list with a clearance time of more than 1 month. Semi-urgent patients registered on shorter wait lists more often than non-urgent patients (79.1% vs. 44.7%. In semi-urgent and non-urgent patients, the observed proportion of wait-list deaths by 52 weeks was lower in category "1 month or less" than in category "more than 1 month" (0.8% [49 deaths] vs. 1.6% [39 deaths], P P Conclusion Long wait lists for coronary-artery bypass grafting are associated with increased probability that a patient dies before surgery. Physicians who advise patients where to undergo cardiac revascularization should consider the risk of pre-surgical death that is associated with the length of a surgical wait list.

  12. Metacognitive Therapy for Depression in Adults: A Waiting List Randomized Controlled Trial with Six Months Follow-Up

    Science.gov (United States)

    Hagen, Roger; Hjemdal, Odin; Solem, Stian; Kennair, Leif Edward Ottesen; Nordahl, Hans M.; Fisher, Peter; Wells, Adrian

    2017-01-01

    This randomized controlled trial examines the efficacy of metacognitive therapy (MCT) for depression. Thirty-nine patients with depression were randomly assigned to immediate MCT (10 sessions) or a 10-week wait list period (WL). The WL-group received 10 sessions of MCT after the waiting period. Two participants dropped out from WL and none dropped out of immediate MCT treatment. Participants receiving MCT improved significantly more than the WL group. Large controlled effect sizes were observed for both depressive (d = 2.51) and anxious symptoms (d = 1.92). Approximately 70–80% could be classified as recovered at post-treatment and 6 months follow-up following immediate MCT, whilst 5% of the WL patients recovered during the waiting period. The results suggest that MCT is a promising treatment for depression. Future controlled studies should compare MCT with other active treatments. PMID:28174547

  13. Acceptability of an open-label wait-listed trial design: Experiences from the PROUD PrEP study

    Science.gov (United States)

    Brodnicki, Elizabeth; Desai, Monica; McCormack, Sheena; Nutland, Will; Wayal, Sonali; White, Ellen; Wood, Gemma; Barber, Tristan; Bell, Gill; Clarke, Amanda; Dolling, David; Dunn, David; Fox, Julie; Haddow, Lewis; Lacey, Charles; Nardone, Anthony; Quinn, Killian; Rae, Caroline; Reeves, Iain; Rayment, Michael; White, David; Apea, Vanessa; Ayap, Wilbert; Dewsnap, Claire; Collaco-Moraes, Yolanda; Schembri, Gabriel; Sowunmi, Yinka; Horne, Rob

    2017-01-01

    Background PROUD participants were randomly assigned to receive pre-exposure prophylaxis (PrEP) immediately or after a deferred period of one-year. We report on the acceptability of this open-label wait-listed trial design. Methods Participants completed an acceptability questionnaire, which included categorical study acceptability data and free-text data on most and least liked aspects of the study. We also conducted in-depth interviews (IDI) with a purposely selected sub-sample of participants. Results Acceptability questionnaires were completed by 76% (415/544) of participants. After controlling for age, immediate-group participants were almost twice as likely as deferred-group participants to complete the questionnaire (AOR:1.86;95%CI:1.24,2.81). In quantitative data, the majority of participants in both groups found the wait-listed design acceptable when measured by satisfaction of joining the study, intention to remain in the study, and interest in joining a subsequent study. However, three-quarters thought that the chance of being in the deferred-group might put other volunteers off joining the study. In free-text responses, data collection tools were the most frequently reported least liked aspect of the study. A fifth of deferred participants reported ‘being deferred’ as the thing they least liked about the study. However, more deferred participants disliked the data collection tools than the fact that they had to wait a year to access PrEP. Participants in the IDIs had a good understanding of the rationale for the open-label wait-listed study design. Most accepted the design but acknowledged they were, or would have been, disappointed to be randomised to the deferred group. Five of the 25 participants interviewed reported some objection to the wait-listed design. Conclusion The quantitative and qualitative findings suggest that in an environment where PrEP was not available, the rationale for the wait-listed trial design was well understood and

  14. The effects of brief cognitive-behaviour therapy for pathological skin picking: A randomized comparison to wait-list control.

    Science.gov (United States)

    Schuck, Kathrin; Keijsers, Ger P J; Rinck, Mike

    2011-01-01

    Thirty-four college students suffering from pathological skin picking were randomly assigned to a four-session cognitive-behavioural treatment (n=17) or a waiting-list condition (n=17). Severity of skin picking, psycho-social impact of skin picking, strength of skin-picking-related dysfunctional cognitions, and severity of skin injury were measured at pre-, post-, and two-months follow-up assessment. Participants in the treatment condition showed a significantly larger reduction on all measured variables in comparison to the waiting-list condition. The obtained effect sizes for the outcome measures were large, ranging from .90 to 1.89. Treatment effects were maintained at follow-up. In conclusion, cognitive-behavioural therapy, even in brief form, constitutes an adequate treatment option for pathological skin-picking behaviour.

  15. Guided Online or Face-to-Face Cognitive Behavioral Treatment for Insomnia: A Randomized Wait-List Controlled Trial.

    Science.gov (United States)

    Lancee, Jaap; van Straten, Annemieke; Morina, Nexhmedin; Kaldo, Viktor; Kamphuis, Jan H

    2016-01-01

    To compare the efficacy of guided online and individual face-to-face cognitive behavioral treatment for insomnia (CBT-I) to a wait-list condition. A randomized controlled trial comparing three conditions: guided online; face-to-face; wait-list. Posttest measurements were administered to all conditions, along with 3- and 6-mo follow-up assessments to the online and face-to-face conditions. Ninety media-recruited participants meeting the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for insomnia were randomly allocated to either guided online CBT-I (n = 30), individual face-to-face CBT-I (n = 30), or wait-list (n = 30). At post-assessment, the online (Cohen d = 1.2) and face-to-face (Cohen d = 2.3) intervention groups showed significantly larger treatment effects than the wait-list group on insomnia severity (insomnia severity index). Large treatment effects were also found for the sleep diary estimates (except for total sleep time), and anxiety and depression measures (for depression only in the face-to-face condition). Face-to-face treatment yielded a statistically larger treatment effect (Cohen d = 0.9) on insomnia severity than the online condition at all time points. In addition, a moderate differential effect size favoring face-to-face treatment emerged at the 3- and 6-mo follow-up on all sleep diary estimates. Face-to-face treatment further outperformed online treatment on depression and anxiety outcomes. These data show superior performance of face-to-face treatment relative to online treatment. Yet, our results also suggest that online treatment may offer a potentially cost-effective alternative to and complement face-to-face treatment. Clinicaltrials.gov, NCT01955850. A commentary on this article appears in this issue on page 13. © 2016 Associated Professional Sleep Societies, LLC.

  16. Differences in waiting list prioritization preferences of occupational therapists, elderly people and persons with disabilities: a discrete choice experiment.

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    Raymond, Marie-Hélène; Demers, Louise; Feldman, Debbie E

    2017-08-07

    To compare the preferences of occupational therapists, elderly people and adults with disabilities regarding prioritization criteria for occupational therapy waiting lists in home care. Discrete choice experiment survey. Respondents completed eight choice tasks where they were asked to choose which of two referral scenarios should be prioritized for services. Scenarios varied in terms of four attributes reflecting competing issues that come into play in waiting list prioritization: the person's ability to shower, ability to enter and exit the home, history of falls and time already spent on the waiting list. The survey was mailed to occupational therapists working in home care and community-dwelling elderly or disabled persons. Not applicable. 241 home-based occupational therapists, 226 elderly persons from a bank of research participants and 247 adults with physical disabilities recruited through community organizations. The dependent variable was whether the referral scenario was prioritized or not in each question. Results were analyzed through logistic regression using conditional logit models. Prioritization preferences differed between groups (p Occupational therapists most strongly prioritized people who had had a few falls (OR vs. no falls = 48.9) whereas elderly people and adults with disabilities most strongly prioritized people who were unable to enter and exit the home (OR vs. no difficulty entering and exiting the home = 30.8 for elderly people and 16.9 for persons with disabilities.) CONCLUSIONS: Our results highlight the gap between the priorities of home-based occupational therapists and their target clientele. Although further inquiry is needed to inform priority-setting, the findings emphasize the importance of public or patient involvement in decisions on waiting list prioritization. Copyright © 2017. Published by Elsevier Inc.

  17. Impact of MELD Allocation System on Waiting List and Early Post-Liver Transplant Mortality.

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    Juan Jurado-García

    Full Text Available MELD allocation system has changed the clinical consequences on waiting list (WL for LT, but its impact on mortality has been seldom studied. We aimed to assess the ability of MELD and other prognostic scores to predict mortality after LT.301 consecutive patients enlisted for LT were included, and prioritized within WL by using the MELD-score according to: hepatic insufficiency (HI, refractory ascites (RA and hepatocellular carcinoma (HCC. The analysis was performed to predict early mortality after LT (8 weeks.Patients were enlisted as HI (44.9%, RA (19.3% and HCC (35.9%. The major aetiologies of liver disease were HCV (45.5%. Ninety-four patients (31.3% were excluded from WL, with no differences among the three groups (p = 0.23. The remaining 207 patients (68.7% underwent LT, being HI the most frequent indication (42.5%. HI patients had the shortest length within WL (113.6 days vs 215.8 and 308.9 respectively; p<0.001, but the highest early post-LT mortality rates (18.2% vs 6.8% and 6.7% respectively; p<0.001. The independent predictors of early post-LT mortality in the HI group were higher bilirubin (OR = 1.08; p = 0.038, increased iMELD (OR = 1.06; p = 0.046 and non-alcoholic cirrhosis (OR = 4.13; p = 0.017. Among the prognostic scores the iMELD had the best predictive accuracy (AUC = 0.66, which was strengthened in non-alcoholic cirrhosis (AUC = 0.77.Patients enlisted due to HI had the highest early post-LT mortality rates despite of the shortest length within WL. The iMELD had the best accuracy to predict early post-LT mortality in patients with HI, and thus it may benefit the WL management.

  18. Impact of MELD Allocation System on Waiting List and Early Post-Liver Transplant Mortality

    Science.gov (United States)

    Jurado-García, Juan; Muñoz García-Borruel, María; Rodríguez-Perálvarez, Manuel Luis; Ruíz-Cuesta, Patricia; Poyato-González, Antonio; Barrera-Baena, Pilar; Fraga-Rivas, Enrique; Costán-Rodero, Guadalupe; Briceño-Delgado, Javier; Montero-Álvarez, José Luis; de la Mata-García, Manuel

    2016-01-01

    Background and aims MELD allocation system has changed the clinical consequences on waiting list (WL) for LT, but its impact on mortality has been seldom studied. We aimed to assess the ability of MELD and other prognostic scores to predict mortality after LT. Methods 301 consecutive patients enlisted for LT were included, and prioritized within WL by using the MELD-score according to: hepatic insufficiency (HI), refractory ascites (RA) and hepatocellular carcinoma (HCC). The analysis was performed to predict early mortality after LT (8 weeks). Results Patients were enlisted as HI (44.9%), RA (19.3%) and HCC (35.9%). The major aetiologies of liver disease were HCV (45.5%). Ninety-four patients (31.3%) were excluded from WL, with no differences among the three groups (p = 0.23). The remaining 207 patients (68.7%) underwent LT, being HI the most frequent indication (42.5%). HI patients had the shortest length within WL (113.6 days vs 215.8 and 308.9 respectively; p<0.001), but the highest early post-LT mortality rates (18.2% vs 6.8% and 6.7% respectively; p<0.001). The independent predictors of early post-LT mortality in the HI group were higher bilirubin (OR = 1.08; p = 0.038), increased iMELD (OR = 1.06; p = 0.046) and non-alcoholic cirrhosis (OR = 4.13; p = 0.017). Among the prognostic scores the iMELD had the best predictive accuracy (AUC = 0.66), which was strengthened in non-alcoholic cirrhosis (AUC = 0.77). Conclusion Patients enlisted due to HI had the highest early post-LT mortality rates despite of the shortest length within WL. The iMELD had the best accuracy to predict early post-LT mortality in patients with HI, and thus it may benefit the WL management. PMID:27299728

  19. Prognostic Abilities and Quality Assessment of Models for the Prediction of 90-Day Mortality in Liver Transplant Waiting List Patients

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    Barthold, Marc; Kaltenborn, Alexander

    2017-01-01

    Background Model of end-stage liver disease (MELD)-score and diverse variants are widely used for prognosis on liver transplant waiting-lists. Methods 818 consecutive patients on the liver transplant waiting-list included to calculate the MELD, MESO Index, MELD-Na, UKELD, iMELD, refitMELD, refitMELD-Na, upMELD and PELD-scores. Prognostic abilities for 90-day mortality were investigated applying Receiver-operating-characteristic-curve analysis. Independent risk factors for 90-day mortality were identified with multivariable binary logistic regression modelling. Methodological quality of the underlying development studies was assessed with a systematic assessment tool. Results 74 patients (9%) died on the liver transplant waiting list within 90 days after listing. All but one scores, refitMELD-Na, had acceptable prognostic performance with areas under the ROC-curves (AUROCs)>0.700. The iMELD performed best (AUROC = 0.798). In pediatric cases, the PELD-score just failed to reach the acceptable threshold with an AUROC = 0.699. All scores reached a mean quality score of 72.3%. Highest quality scores could be achieved by the UKELD and PELD-scores. Studies specifically lack statistical validity and model evaluation. Conclusions Inferior quality assessment of prognostic models does not necessarily imply inferior prognostic abilities. The iMELD might be a more reliable tool representing urgency of transplantation than the MELD-score. PELD-score is assumedly not accurate enough to allow graft allocation decision in pediatric liver transplantation. PMID:28129338

  20. Impact of pulmonary rehabilitation on quality of life and functional capacity in patients on waiting lists for lung transplantation

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    Juliessa Florian

    2013-06-01

    Full Text Available OBJECTIVE: To investigate the impact of a pulmonary rehabilitation program on the functional capacity and on the quality of life of patients on waiting lists for lung transplantation. METHODS: Patients on lung transplant waiting lists were referred to a pulmonary rehabilitation program consisting of 36 sessions. Before and after the program, participating patients were evaluated with the six-minute walk test and the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36. The pulmonary rehabilitation program involved muscle strengthening exercises, aerobic training, clinical evaluation, psychiatric evaluation, nutritional counseling, social assistance, and educational lectures. RESULTS: Of the 112 patients initially referred to the program, 58 completed it. The mean age of the participants was 46 ± 14 years, and females accounted for 52%. Of those 58 patients, 37 (47% had pulmonary fibrosis, 13 (22% had pulmonary emphysema, and 18 (31% had other types of advanced lung disease. The six-minute walk distance was significantly greater after the program than before (439 ± 114 m vs. 367 ± 136 m, p = 0.001, the mean increase being 72 m. There were significant point increases in the scores on the following SF-36 domains: physical functioning, up 22 (p = 0.001, role-physical, up 10 (p = 0.045; vitality, up 10 (p < 0.001; social functioning, up 15 (p = 0.001; and mental health, up 8 (p = 0.001. CONCLUSIONS: Pulmonary rehabilitation had a positive impact on exercise capacity and quality of life in patients on lung transplant waiting lists.

  1. Retrospective review of bone mineral metabolism management in end-stage renal disease patients wait-listed for renal transplant

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    Chavlovski A

    2012-09-01

    Full Text Available Anna Chavlovski,1 Greg A Knoll,1–3 Timothy Ramsay,4 Swapnil Hiremath,1–3 Deborah L Zimmerman1–31University of Ottawa, 2Ottawa Hospital, 3Kidney Research Centre, Ottawa Hospital Research Institute, 4Ottawa Methods Centre, Ottawa, ON, CanadaBackground: In patients with end-stage renal disease, use of vitamin D and calcium-based phosphate binders have been associated with progression of vascular calcification that might have an impact on renal transplant candidacy. Our objective was to examine management of mineral metabolism in patients wait-listed for renal transplant and to determine the impact on cardiac perfusion imaging.Methods: Data was collected retrospectively on patients wait-listed for a renal transplant (n = 105, being either active (n = 73 and on hold (n = 32. Demographic data, medications, serum concentrations of calcium, phosphate, parathyroid hormone, and cardiac perfusion imaging studies were collected from the electronic health record. Chi-square and Student’s t-tests were used to compare active and on-hold patients as appropriate. Logistic regression was used to examine variables associated with worsening cardiac imaging studies.Results: The wait-listed patients were of mean age 56 ± 14 years and had been on dialysis for 1329 ± 867 days. On-hold patients had received a significantly greater total dose of calcium (2.35 ± .94 kg versus 1.49 ± 1.52 kg; P = 0.02 and were more likely to have developed worsening cardiovascular imaging studies (P = 0.03. Total doses of calcium and calcitriol were associated with worsening cardiovascular imaging studies (P = 0.05.Conclusion: Patients on hold on the renal transplant waiting list received higher total doses of calcium. A higher total dose of calcium and calcitriol was also associated with worsening cardiovascular imaging. Time on dialysis before transplant has been associated with worse post-transplant outcomes, and it is possible that the total calcium and calcitriol dose

  2. Pregnancy chances on an IVF/ICSI waiting list: a national prospective cohort study.

    NARCIS (Netherlands)

    Eijkemans, M.J.; Lintsen, A.M.E.; Hunault, C.C.; Bouwmans, C.A.; Hakkaart, L.; Braat, D.D.M.; Habbema, J.D.

    2008-01-01

    BACKGROUND: The effectiveness of IVF over expectant management has been proven only for bilateral tubal occlusion. We aimed to estimate the chance of pregnancy without treatment for IVF patients, using data on the waiting period before the start of IVF. METHODS: A prospective cohort study included

  3. Competitive Market Analysis of Transplant Centers and Discrepancy of Wait-Listing of Recipients for Kidney Transplantation.

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    Cho, P S; Saidi, R F; Cutie, C J; Ko, D S C

    2015-01-01

    There are over 250 kidney transplant programs in the USA. To determine if highly competitive regions, defined as regions with a higher number of transplant centers, will approve and wait-list more end-stage renal disease (ESRD) candidates for transplant despite consistent incidence and prevalence of ESRD nationwide. ESRD Network and OPTN data completed in 2011 were obtained from all transplant centers including listing data, market saturation, market share, organs transplanted, and ESRD prevalence. Herfindahl-Hirschman Index (HHI) was used to measure the size of firms in relation to the industry to determine the amount of competition. States were separated into 3 groups (HHI1800 considered highly concentrated). The percentage of ESRD patients listed in competitive, moderate, and highly concentrated regions were 19.73%, 17.02%, and 13.75%, respectively. The ESRD listing difference between competitive versus highly concentrated was significant (pmarket share. Our analysis of the available national data suggests a discrepancy in access for ESRD patient to transplantation due to transplant center competition.

  4. DVD training for depression identification and treatment in older adults: a two-group, randomized, wait-list control study.

    Science.gov (United States)

    Lysack, Cathy; Leach, Carrie; Russo, Theresa; Paulson, Daniel; Lichtenberg, Peter A

    2013-01-01

    OBJECTIVE. To test the effectiveness of an educational intervention aimed at improving mental health knowledge and skills in occupational therapists working with older rehabilitation patients. METHOD. The DVD-format educational intervention was evaluated using a two-group randomized wait-list control design. Occupational therapists (n = 75) completed a 32-item knowledge questionnaire at three time points. Patient charts were reviewed (n = 960) at 3 months before and 3 and 6 months after DVD training to evaluate clinical practice change. RESULTS. A two-way analysis of variance showed knowledge scores increased significantly for both groups after DVD training. A significant Group × Time interaction and significant main effects for time and group were found. Chart review data also showed significant increases in desired clinical behaviors in both groups after training. The greatest single item of clinical practice change was use of a standardized depression screen. CONCLUSION. DVD-based training can significantly improve mental health practice.

  5. Argentine tango dance compared to mindfulness meditation and a waiting-list control: a randomised trial for treating depression.

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    Pinniger, Rosa; Brown, Rhonda F; Thorsteinsson, Einar B; McKinley, Patricia

    2012-12-01

    To determine whether tango dancing is as effective as mindfulness meditation in reducing symptoms of psychological stress, anxiety and depression, and in promoting well-being. This study employed analysis of covariance (ANCOVA) and multiple regression analysis. Ninety-seven people with self-declared depression were randomised into tango dance or mindfulness meditation classes, or to control/waiting-list. classes were conducted in a venue suitable for both activities in the metropolitan area of Sydney, Australia. Participants completed six-week programmes (1½h/week of tango or meditation). The outcome measures were assessed at pre-test and post-test. Depression, Anxiety and Stress Scale; The Self Esteem Scale; Satisfaction with Life Scale, and Mindful Attention Awareness Scale. Sixty-six participants completed the program and were included in the statistical analysis. Depression levels were significantly reduced in the tango (effect size d=0.50, p=.010), and meditation groups (effect size d=0.54, p=.025), relative to waiting-list controls. Stress levels were significantly reduced only in the tango group (effect size d=0.45, p=.022). Attending tango classes was a significant predictor for the increased levels of mindfulness R(2)=.10, adjusted R(2)=.07, F (2,59)=3.42, p=.039. Mindfulness-meditation and tango dance could be effective complementary adjuncts for the treatment of depression and/or inclusion in stress management programmes. Subsequent trials are called to explore the therapeutic mechanisms involved. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

  6. Cognitive behavioral therapy of socially phobic children focusing on cognition: a randomised wait-list control study

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    Stadler Christina

    2011-02-01

    Full Text Available Abstract Background Although literature provides support for cognitive behavioral therapy (CBT as an efficacious intervention for social phobia, more research is needed to improve treatments for children. Methods Forty four Caucasian children (ages 8-14 meeting diagnostic criteria of social phobia according to the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; APA, 1994 were randomly allocated to either a newly developed CBT program focusing on cognition according to the model of Clark and Wells (n = 21 or a wait-list control group (n = 23. The primary outcome measure was clinical improvement. Secondary outcomes included improvements in anxiety coping, dysfunctional cognitions, interaction frequency and comorbid symptoms. Outcome measures included child report and clinican completed measures as well as a diagnostic interview. Results Significant differences between treatment participants (4 dropouts and controls (2 dropouts were observed at post test on the German version of the Social Phobia and Anxiety Inventory for Children. Furthermore, in the treatment group, significantly more children were free of diagnosis than in wait-list group at post-test. Additional child completed and clinician completed measures support the results. Discussion The study is a first step towards investigating whether CBT focusing on cognition is efficacious in treating children with social phobia. Future research will need to compare this treatment to an active treatment group. There remain the questions of whether the effect of the treatment is specific to the disorder and whether the underlying theoretical model is adequate. Conclusion Preliminary support is provided for the efficacy of the cognitive behavioral treatment focusing on cognition in socially phobic children. Active comparators should be established with other evidence-based CBT programs for anxiety disorders, which differ significantly in their dosage and type of cognitive

  7. A single German center experience with intermittent inotropes for patients on the high-urgent heart transplant waiting list.

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    Hübner, T; Nickel, T; Steinbeck, G; Massberg, S; Schramm, R; Reichart, B; Hagl, C; Kiwi, A; Weis, Michael

    2015-11-01

    Currently, more than 900 patients with end-stage heart failure are listed for heart transplantation in Germany. All patients on the Eurotransplant high-urgent status (HU) have to be treated in intensive care units and have to be relisted every 8 weeks. Long-term continuous inotropes are associated with tachyphylaxia, arrhythmias and even increased mortality. In this retrospective analysis, we report our single center experience with HU patients treated with intermittent inotropes as a bridging therapy. 117 consecutive adult HU candidates were treated at our intensive care heart failure unit between 2008 and 2013, of whom 14 patients (12 %) were stabilized and delisted during follow-up. In the remaining 103 patients (age 42 ± 15 years), different inotropes (dobutamine, milrinone, adrenaline, noradrenaline, levosimendan) were administered based on the patient's specific characteristics. After initial recompensation, patients were weaned from inotropes as soon as possible. Thereafter, intermittent inotropes (over 3-4 days) were given as a predefined weekly (until 2011) or 8 weekly regimen (from 2011 to 2013). In 57 % of these patients, additional regimen-independent inotropic support was necessary due to hemodynamic instabilities. Fourteen patients (14 %) needed a left- or biventricular assist device; 14 patients (14 %) died while waiting and 87 (84 %) received heart transplants after 87 ± 91 days. Cumulative 3 and 12 months survival of all 103 patients was 75 and 67 %, respectively. Intermittent inotropes in HU patients are an adequate strategy as a bridge to transplant; the necessity for assist devices was low. These data provide the basis for a prospective multicenter trial of intermittent inotropes in patients on the HU waiting list.

  8. Trends and Milestones: Leveraging Federal Funding in the States To Address Olmstead [and] Growing Waiting Lists.

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    Hemp, Richard; Parish, Susan; Braddock, David, Ed.; Smith, Gary, Ed.

    2001-01-01

    This article discusses using existing state resources not currently used for matching purposes to leverage additional federal Medicaid funding for community services and supports for persons with mental retardation. A table is provided that lists state funds potentially available to match additional federal Medicaid funding. (Contains six…

  9. Transient probabilities for queues with applications to hospital waiting list management.

    Science.gov (United States)

    Joy, Mark; Jones, Simon

    2005-08-01

    In this paper we study queuing systems within the NHS. Recently imposed government performance targets lead NHS executives to investigate and instigate alternative management strategies, thereby imposing structural changes on the queues. Under such circumstances, it is most unlikely that such systems are in equilibrium. It is crucial, in our opinion, to recognise this state of affairs in order to make a balanced assessment of the role of queue management in the modern NHS. From a mathematical perspective it should be emphasised that measures of the state of a queue based upon the assumption of statistical equilibrium (a pervasive methodology in the study of queues) are simply wrong in the above scenario. To base strategic decisions around such ideas is therefore highly questionable and it is one of the purposes of this paper to offer alternatives: we present some (recent) research whose results generate performance measures and measures of risk, for example, of waiting-times growing unacceptably large; we emphasise that these results concern the transient behaviour of the queueing model-there is no asssumption of statistical equilibrium. We also demonstrate that our results are computationally tractable.

  10. Efficacy of Cognitive Behavioral Therapy for insomnia in adolescents: A randomized controlled trial with internet therapy, group therapy and a waiting list condition

    NARCIS (Netherlands)

    de Bruin, E.J.; Bögels, S.M.; Oort, F.J.; Meijer, A.M.

    2015-01-01

    Study Objectives: To investigate the efficacy of cognitive behavioral therapy for insomnia (CBTI) in adolescents. Design: A randomized controlled trial of CBTI in group therapy (GT), guided internet therapy (IT), and a waiting list (WL), with assessments at baseline, directly after treatment (post-t

  11. A wait-list randomized controlled trial of loving-kindness meditation programme for self-criticism.

    Science.gov (United States)

    Shahar, Ben; Szsepsenwol, Ohad; Zilcha-Mano, Sigal; Haim, Netalee; Zamir, Orly; Levi-Yeshuvi, Simi; Levit-Binnun, Nava

    2015-01-01

    Self-criticism is a vulnerability risk factor for a number of psychological disorders, and it predicts poor response to psychological and pharmacological treatments. In the current study, we evaluated the efficacy of a loving-kindness meditation (LKM) programme designed to increase self-compassion in a sample of self-critical individuals. Thirty-eight individuals with high scores on the self-critical perfectionism subscale of the Dysfunctional Attitude Scale were randomized to an LKM condition (n = 19) or a wait-list (WL) condition (n = 19). Measures of self-criticism, self-compassion and psychological distress were administered before and immediately following the intervention (LKM or WL). WL participants received the intervention immediately after the waiting period. Both groups were assessed 3 months post-intervention. Intent-to-treat (n = 38) and per-protocol analyses (n = 32) showed significant reductions in self-criticism and depressive symptoms as well as significant increases in self-compassion and positive emotions in the LKM condition compared with the WL condition. A follow-up per-protocol analysis in both groups together (n = 20) showed that these gains were maintained 3 months after the intervention. These preliminary results suggest that LKM may be efficacious in alleviating self-criticism, increasing self-compassion and improving depressive symptoms among self-critical individuals. Self-criticism plays a major role in many psychological disorders and predicts poor response to brief psychological and pharmacological treatments for depression. The current study shows that loving-kindness meditation, designed to foster self-compassion, is efficacious in helping self-critical individuals become less self-critical and more self-compassionate. The study also suggests that practising loving-kindness may reduce depressive symptoms and increase positive emotions. Copyright © 2014 John Wiley & Sons, Ltd.

  12. Clinical characteristics of Japanese candidates for lung transplant for interstitial lung disease and risk factors for early death while on the waiting list.

    Science.gov (United States)

    Higo, Hisao; Kurosaki, Takeshi; Ichihara, Eiki; Kubo, Toshio; Miyoshi, Kentaroh; Otani, Shinji; Sugimoto, Seiichiro; Yamane, Masaomi; Miyahara, Nobuaki; Kiura, Katsuyuki; Miyoshi, Shinichiro; Oto, Takahiro

    2017-07-01

    Lung transplants have produced very favorable outcomes for patients with interstitial lung disease (ILD) in Japan. However, because of the severe donor lung shortage, patients must wait approximately 2.5 years before they can undergo transplantation and many candidates die before allocation. We reveal the clinical characteristics of Japanese patients with ILD who are candidates for lung transplants and the risk factors for early death while on the waiting list. We retrospectively reviewed the clinical data of patients registered in the Japan Organ Transplant Network from Okayama University Hospital who are candidates for cadaveric lung transplants for ILD between 1999 and 2015. Fifty-three patients with ILD were included (24 patients with idiopathic pulmonary fibrosis and 29 others). They had severe pulmonary dysfunction and low exercise tolerability. The median waiting time for transplantation was 462 days, and 22 patients died before allocation. Patients who died before 462 days without undergoing transplantation had more severe dyspnea, shorter 6-minute walk distance (6MWD), and lower performance status than those who waited ≥462 days. Japanese candidates for cadaveric lung transplants for ILD have severe pulmonary dysfunction. Severe dyspnea, short 6MWD, and low performance status are risk factors for early death while on the waiting list. Copyright © 2017 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.

  13. Do women spend longer on wait lists for coronary bypass surgery? Analysis of a population-based registry in British Columbia, Canada

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    Kuramoto Lisa

    2007-08-01

    Full Text Available Abstract Background Studies have shown patients who are delayed for surgical cardiac revascularization are faced with increased risks of symptom deterioration and death. This could explain the observation that operative mortality among persons undergoing coronary artery bypass surgery (CABG is higher among women than men. However, in jurisdictions that employ priority wait lists to manage access to elective cardiac surgery, there is little information on whether women wait longer than men for CABG. It is therefore difficult to ascertain whether higher operative mortality among women is due to biological differences or to delayed access to elective CABG. Methods Using records from a population-based registry, we compared the wait-list time between women and men in British Columbia (BC between 1990 and 2000. We compared the number of weeks from registration to surgery for equal proportions of women and men, after adjusting for priority, comorbidity and age. Results In BC in the 1990s, 9,167 patients aged 40 years and over were registered on wait lists for CABG and spent a total of 136,071 person-weeks waiting. At the time of registration for CABG, women were more likely to have a comorbid condition than men. We found little evidence to suggest that women waited longer than men for CABG after registration, after adjusting for comorbidity and age, either overall or within three priority groups. Conclusion Our findings support the hypothesis that higher operative mortality during elective CABG operations observed among women is not due to longer delays for the procedure.

  14. Web-based stress management for newly diagnosed cancer patients (STREAM-1): a randomized, wait-list controlled intervention study.

    Science.gov (United States)

    Grossert, Astrid; Urech, Corinne; Alder, Judith; Gaab, Jens; Berger, Thomas; Hess, Viviane

    2016-11-03

    Being diagnosed with cancer causes major psychological distress, yet the majority of newly diagnosed cancer patients lack psychological support. Internet interventions overcome many barriers for seeking face-to-face support and allow for independence in time and place. We assess efficacy and feasibility of the first web-based stress management intervention (STREAM: STREss-Aktiv-Mindern) for newly diagnosed, German-speaking cancer patients. In a prospective, wait-list controlled trial 120 newly diagnosed cancer patients will be included within 12 weeks of starting anti-cancer treatment and randomized between an immediate (intervention group) or delayed (control group) 8-week, web-based intervention. The intervention consists of eight modules with weekly written feedback by a psychologist ("minimal-contact") based on well-established stress management manuals including downloadable audio-files and exercises. The aim of this study is to evaluate efficacy in terms of improvement in quality of life (FACT-F), as well as decrease in anxiety and depression (HADS), as compared to patients in the wait-list control group. A sample size of 120 patients allows demonstrating a clinically relevant difference of nine points in the FACT score after the intervention (T2) with a two-sided alpha of 0.05 and 80 % power. As this is the first online stress management intervention for German-speaking cancer patients, more descriptive outcomes are equally important to further refine the group of patients with the largest potential for benefit who then will be targeted more specifically in future trials. These descriptive endpoints include: patients' characteristics (type of cancer, type of treatment, socio-demographic factors), dropout rate and dropout reasons, adherence and satisfaction with the program. New technologies open new opportunities: minimal-contact psychological interventions are becoming standard of care in several psychological disorders, where their efficacy is often

  15. Effectiveness and cost-effectiveness of web-based treatment for phobic outpatients on a waiting list for psychotherapy: protocol of a randomised controlled trial

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    Kok Robin N

    2012-08-01

    Full Text Available Abstract Background Phobic disorders are highly prevalent and constitute a considerable burden for patients and society. As patients wait for face-to-face psychotherapy for phobic disorders in outpatient clinics, this time can be used for guided self-help interventions. The aim of this study is to investigate a five week internet-based guided self-help programme of exposure therapy in terms of clinical effectiveness and impact on speed of recovery in psychiatric outpatients, as well as the cost-effectiveness of this pre-treatment waiting list intervention. Methods/design A randomised controlled trial will be conducted among 244 Dutch adult patients recruited from waiting lists of outpatient clinics for face-to-face psychotherapy for phobic disorders. Patients suffering from at least one DSM-IV classified phobic disorder (social phobia, agoraphobia or specific phobia are randomly allocated (at a 1:1 ratio to either a five-week internet-based guided self-help program followed by face-to-face psychotherapy, or a control group followed by face-to-face psychotherapy. Waiting list status and duration are unchanged and actual need for further treatment is evaluated prior to face-to-face psychotherapy. Clinical and economic self-assessment measurements take place at baseline, post-test (five weeks after baseline and at 3, 6, 9 and 12 months after baseline. Discussion Offering pre-treatment internet-based guided self-help efficiently uses time otherwise lost on a waiting list and may increase patient satisfaction. Patients are expected to need fewer face-to-face sessions, reducing total treatment cost and increasing speed of recovery. Internet-delivered treatment for phobias may be a valuable addition to psychotherapy as demand for outpatient treatment increases while budgets decrease. Trial registration Netherlands Trial Register NTR2233

  16. Long waiting lists and health care spending The example of cholecystectomy.

    Science.gov (United States)

    Palmisano, Silvia; Benvenuto, Chiara; Casagranda, Biagio; Dobrinja, Chiara; Piccinni, Giuseppe; de Manzini, Nicolò

    2015-01-01

    Lo scopo dello studio è stato valutare l’incidenza di complicanze correlate alla calcolosi della colecisti in pazienti in lista d’attesa per l’intervento di colecistectomia e quantificare le implicazioni economiche di quest’attesa in termini di costi sanitari relativi agli esami ematochimici, strumentali, alla degenza, all’intervento chirurgico e alle terapie somministrate. La popolazione oggetto dello studio è stata di 86 pazienti, 39 uomini e 47 donne, inseriti in lista d’attesa per intervento chirurgico di colecistectomia in un periodo compreso fra aprile 2007 e aprile 2010. Di tali pazienti sono stati raccolti dati anagrafici, la durata del tempo d’attesa, dettagli sugli accessi in PS ed eventuali ricoveri durante l’attesa, esami e terapie eseguite, il tipo di intervento chirurgico effettuato e i giorni di degenza. È stato fatto uno studio comparativo di natura economica tra tre gruppi di pazienti: A: asintomatici durante l’attesa, B: complicati ma non operati in urgenza, C: complicati e operati in regime d’urgenza. Utilizzando il tariffario regionale delle prestazioni di assistenza specialistica ambulatoriale e quello delle prestazioni di assistenza ospedaliera per acuti erogate in regime di ricovero diurno abbiamo stimato che un singolo paziente complicato ma non operato in regime d’urgenza abbia determinato un ingente spesa per il sistema sanitario ( gruppo B: circa 3513,2 €) circa 1.9 volte in più se paragonata a un paziente che durante l’attesa non abbia sviluppato complicanze ( gruppo A: circa 1.849,4 €) o 1.36 volte in più di un paziente precocemente operato in regime d’urgenza (gruppo c: circa 2.584,6 €). Nel nostro limitato, ma a nostro parere esplicativo, campione abbiamo stimato i costi specifici legati alla lunghezza delle liste d’attesa pari a circa 26.112 €. In questo periodo di crisi economica, che ha portato numerosi tagli anche al sistema sanitario, questo significativo ammontare di denaro, a nostro

  17. Long waiting lists and health care spending: the example of cholecystectomy.

    Science.gov (United States)

    Palmisano, Silvia; Benvenuto, Chiara; Casagranda, Biagio; Dobrinja, Chiara; Piccinni, Giuseppe; de Manzini, Nicolò

    2014-03-28

    Lo scopo dello studio è stato valutare l’incidenza di complicanze correlate alla calcolosi della colecisti in pazienti in lista d’attesa per l’intervento di colecistectomia e quantificare le implicazioni economiche di quest’attesa in termini di costi sanitari relativi agli esami ematochimici, strumentali, alla degenza, all’intervento chirurgico e alle terapie somministrate. La popolazione oggetto dello studio è stata di 86 pazienti, 39 uomini e 47 donne, inseriti in lista d’attesa per intervento chirurgico di colecistectomia in un periodo compreso fra aprile 2007 e aprile 2010. Di tali pazienti sono stati raccolti dati anagrafici, la durata del tempo d’attesa, dettagli sugli accessi in PS ed eventuali ricoveri durante l’attesa, esami e terapie eseguite, il tipo di intervento chirurgico effettuato e i giorni di degenza. È stato fatto uno studio comparativo di natura economica tra tre gruppi di pazienti: A: asintomatici durante l’attesa, B: complicati ma non operati in urgenza, C: complicati e operati in regime d’urgenza. Utilizzando il tariffario regionale delle prestazioni di assistenza specialistica ambulatoriale e quello delle prestazioni di assistenza ospedaliera per acuti erogate in regime di ricovero diurno abbiamo stimato che un singolo paziente complicato ma non operato in regime d’urgenza abbia determinato un ingente spesa per il sistema sanitario ( gruppo B: circa 3513,2 €) circa 1.9 volte in più se paragonata a un paziente che durante l’attesa non abbia sviluppato complicanze ( gruppo A: circa 1.849,4 €) o 1.36 volte in più di un paziente precocemente operato in regime d’urgenza (gruppo c: circa 2.584,6 €). Nel nostro limitato, ma a nostro parere esplicativo, campione abbiamo stimato i costi specifici legati alla lunghezza delle liste d’attesa pari a circa 26.112 €. In questo periodo di crisi economica, che ha portato numerosi tagli anche al sistema sanitario, questo significativo ammontare di denaro, a nostro

  18. ¿Ha llegado la hora de la gestión de las listas de espera? Has the time arrived for the management of waiting lists?

    Directory of Open Access Journals (Sweden)

    E. Bernal

    2002-10-01

    Full Text Available Las personas que ocupan una lista de espera sufren a menudo un riesgo adicional derivado del tiempo que pasa hasta que obtienen tratamiento; sin embargo, en otras ocasiones, las personas en lista no tienen necesidad del tratamiento por el que esperan. Ambos argumentos, contrastables con evidencias empíricas, serían suficientes para afirmar que debe llegar la gestión a las listas de espera dejando a un lado políticas más o menos oportunistas. Por políticas oportunistas se entiende mantener la mala información sobre listas o su "maquillaje", utilizar programas de autoconcertación sin más horizonte que llegar a final de año sin lista de más de seis meses, etcétera. El panorama no es del todo oscuro. Algunas iniciativas de gestión (incluso de Política con mayúscula se van abriendo paso y pueden entrar en la agenda de los próximos años. Así, cabe destacar la aplicación de tiempos de atención garantizada o la priorización de las listas en función de criterios explícitos. En todo caso, conviene recordar que, con la excepción de las colas producidas en las salas de espera de los centros de salud y aquéllas que se producen en las puertas de urgencias, el resto de colas del sistema están mediadas por la decisión de un médico. Así que una estrategia ineludible para gestionar las listas de espera consiste en atenuar los problemas derivados de la incertidumbre (o ignorancia con respecto al diagnóstico o al pronóstico de los pacientes.Individuals on the waiting list frequently suffer an additional risk caused by the mean time until they receive treatment; however, other individuals do not need the treatment for which they are waiting. Both arguments, which can be contrasted with empirical evidence, would be sufficient to affirm that waiting list management should be implemented, leaving aside policies that are more of less opportunistic. Opportunistic policies are understood as those providing misinformation on waiting lists or

  19. Stress, psychological distress, and coping in patients on the waiting list for lung transplantation : an exploratory study

    NARCIS (Netherlands)

    Vermeulen, KM; Bosma, OH; van der Bij, W; Koeter, GH; TenVergert, EM

    2005-01-01

    Little information is available in literature on quality of life, stress and coping during the period patients are waiting for lung transplantation. This study explored potential stressful events that patients experience during the waiting period assessed the level of anxiety and depression and expl

  20. A Support Group for Parents of Children on a Waiting List for an Assessment for Autism Spectrum Disorder

    Science.gov (United States)

    Connolly, Micaela; Gersch, Irvine

    2013-01-01

    Parents of children waiting for a diagnostic assessment for autism spectrum disorder (ASD) experience distress and anxiety while they wait. The present small-scale study took place in a multi-disciplinary therapeutic service in Ireland for children with ASD and was run between April and September 2011. The first author, an educational psychologist…

  1. Oncological Evaluation by Positron-emission Tomography, Circulating Tumor Cells and Alpha Fetoprotein in Patients With Hepatocellular Carcinoma on the Waiting List for Liver Transplantation.

    Science.gov (United States)

    Ramirez, P; Sáenz, L; Cascales-Campos, P A; González Sánchez, M R; Llàcer-Millán, E; Sánchez-Lorencio, M I; Díaz-Rubio, E; De La Orden, V; Mediero-Valeros, B; Navarro, J L; Revilla Nuin, B; Baroja-Mazo, A; Noguera-Velasco, J A; Sánchez, B F; de la Peña, J; Pons-Miñano, J A; Sánchez-Bueno, F; Robles-Campos, R; Parrilla, P

    2016-11-01

    The objectives of this study are the determination of the number of circulating tumor cells (CTCs), by means of the IsoFlux enrichment system (Fluxion Biosciences Inc, San Francisco, California, United States) in patients with hepatocellular carcinoma (HCC) in compliance with the Milan criteria and on the waiting list for hepatic transplantation, as well as the study of its relation with the of α-fetoprotein levels (AFP) and positron-emission tomography-computed tomography (PET-CT) findings. An oncologycal evaluation with PET-CT, CTCs, and AFP was conducted in 24 consecutive patients with HCC eligible for orthotopic liver transplantation according to the Milan criteria. The diagnosis of HCC was made according to clinical, biological, and radiological findings. We detected CTCs in peripheral blood in 21 of 24 patients (87.5%) before liver transplantation, with a mean number CTCs of 156 ± 370 (range, 2 to 1768) with statistically significant association between number of CTCs detected in peripheral blood and the time within the waiting list (P  .05). PET-TC, CTCs, and AFP levels could be an essential key for the correct management of the patients with HCC on the waiting list for liver transplantation. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. The Impact of the Introduction of MELD on the Dynamics of the Liver Transplantation Waiting List in São Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Eleazar Chaib

    2014-01-01

    Full Text Available Until July 15, 2006, the time on the waiting list was the main criterion for allocating deceased donor livers in the state of São Paulo, Brazil. After this date, MELD has been the basis for the allocation of deceased donor livers for adult transplantation. Our aim was to compare the waitlist dynamics before MELD (1997–2005 and after MELD (2006–2012 in our state. A retrospective study was conducted including the data from all the liver transplant candidate waiting lists from July 1997 to December 2012. The data were related to the actual number of liver transplantations (Tr, the incidence of new patients on the list (I, and the number of patients who died while being on the waitlist (D from 1997 to 2005 (the pre-MELD era and from 2006 to 2012 (the post-MELD era. The number of transplantations from 1997 to 2005 and from 2006 to 2012 increased nonlinearly, with a clear trend to levelling to equilibrium at approximately 350 and 500 cases per year, respectively. The implementation of the MELD score resulted in a shorter waiting time until liver transplantation. Additionally, there was a significant effect on the waitlist dynamics in the first 4 years; however, the curves diverge from there, implying a null long-range effect on the waitlist by the MELD scores.

  3. Queuing for coronary angiography during severe supply-demand mismatch in a US public hospital: analysis of a waiting list registry.

    Science.gov (United States)

    Rosanio, S; Tocchi, M; Cutler, D; Uretsky, B F; Stouffer, G A; deFilippi, C R; MacInerney, E J; Runge, S R; Aaron, J; Otero, J; Garg, S; Runge, M S

    1999-07-14

    Adverse cardiac events have been reported in patients waiting for either coronary surgery or angioplasty. However, data on the risk of adverse events while awaiting coronary angiography are limited, and none are available from a US population. To quantify cardiac outcomes in patients waiting for elective coronary angiography. Observational cohort study of 381 adult outpatients (mean [SD] age, 55 [12] years; 64% male; 61% white) on a waiting list for coronary angiography at a US tertiary care public teaching hospital during 1993-1994. Rates of cardiac death, nonfatal myocardial infarction, and hospitalizations for unstable angina or heart failure as a function of amount of time spent on a waiting list. Sixty-six patients were dropped from the waiting list but were included in the study analysis. During a mean (SD) follow-up of 8.4 (6.5) months, cardiac death, myocardial infarction, and hospitalization occurred in 6 (1.6%), 4 (1.0%), and 26 (6.8%) patients, respectively. The probability of events was minimal in the first 2 weeks and increased steadily between 3 and 13 weeks. By Cox multivariate analysis, 2 variables independently identified an increased risk of adverse events: a strongly positive treadmill exercise electrocardiogram or positive stress imaging result at referral (odds ratio [OR], 2.32; 95% confidence interval [CI], 1.22-4.16; P=.01) and the use of 2 to 3 anti-ischemic medications (OR, 1.98; 95% CI, 1.19-3.96; P=.04). Among 311 patients who ultimately underwent angiography, those with adverse events had a higher prevalence of coronary disease (96% vs 60%; P<.001), more frequently required revascularization (93% vs 53%; P<.001), and had longer hospital stays (mean [SD], 6.2 [4.3] vs 1.3 [0.7] days; P=.001). Our data suggest that in a cohort referred for coronary angiography, delaying the procedure places some patients at risk for death, myocardial infarction, unplanned hospitalization, a longer hospital stay, and, potentially, a poorer prognosis. Waits

  4. Predicting Outcomes on the Liver Transplant Waiting List in the United States: Accounting for Large Regional Variation in Organ Availability and Priority Allocation Points.

    Science.gov (United States)

    Hart, Allyson; Schladt, David P; Zeglin, Jessica; Pyke, Joshua; Kim, W Ray; Lake, John R; Roberts, John P; Hirose, Ryutaro; Mulligan, David C; Kasiske, Bertram L; Snyder, Jon J; Israni, Ajay K

    2016-10-01

    The probability of liver transplant and death on the waiting list in the United States varies greatly by donation service area (DSA) due to geographic differences in availability of organs and allocation of priority points, making it difficult for providers to predict likely outcomes after listing. We aimed to develop an online calculator to report outcomes by region and patient characteristics. Using the Scientific Registry of Transplant Recipients database, we included all prevalent US adults aged 18 years or older waitlisted for liver transplant, examined on 24 days at least 30 days apart over a 2-year period. Outcomes were determined at intervals of 30 to 365 days. Outcomes are reported by transplant program, DSA, region, and the nation for comparison, and can be shown by allocation or by laboratory model for end-stage liver disease (MELD) score (6-14, 15-24, 25-29, 30-34, 35-40), age, and blood type. Outcomes varied greatly by DSA; for candidates with allocation MELD 25-29, the 25th and 75th percentiles of liver transplant probability were 30% and 67%, respectively, at 90 days. Corresponding percentiles for death or becoming too sick to undergo transplant were 5% and 9%. Outcomes also varied greatly for candidates with and without MELD exception points. The waitlist outcome calculator highlights ongoing disparities in access to liver transplant and may assist providers in understanding and counseling their patients about likely outcomes on the waiting list.

  5. The effects of a group based stress treatment program (the Kalmia concept) targeting stress reduction and return to work. A randomized, wait-list controlled trial

    DEFF Research Database (Denmark)

    Netterstrøm, Bo; Friebel, Lene; Ladegaard, Yun Katrine

    2012-01-01

    of an integrative approach of group psychotherapy for 2.5 hours per week and Basic Body Awareness Therapy (BBAT) with mindfulness meditation for 1.5 hours per week, which runs in a parallel process supplemented with workplace dialogue; the treatment-as-usual control group (TAUCG, 71 participants), who received 12...... consultations with a psychologist; and the wait-listed control group (WLCG, 58 participants). Treatment in the IG and the TAUCG lasted 10 and 12 weeks, respectively. Results Reductions in symptom levels (as measured by scores on the SCL92) were significantly larger in the IG (Cohen�s d= 0.73) and TAUCG compared...

  6. Evaluation of wet-cupping therapy for persistent non-specific low back pain: a randomised, waiting-list controlled, open-label, parallel-group pilot trial

    Directory of Open Access Journals (Sweden)

    Kim Kun

    2011-06-01

    Full Text Available Abstract Background Persistent non-specific low back pain (PNSLBP is one of the most frequently experienced types of back pain around the world. Wet-cupping is a common intervention for various pain conditions, especially in Korea. In this context, we conducted a pilot study to determine the effectiveness and safety of wet-cupping treatment for PNSLBP. Methods We recruited 32 participants (21 in the wet-cupping group and 11 in the waiting-list group who had been having PNSLBP for at least 3 months. The participants were recruited at the clinical research centre of the Korea Institute of Oriental Medicine, Korea. Eligible participants were randomly allocated to wet-cupping and waiting-list groups. Following the practice of traditional Korean medicine, the treatment group was provided with wet-cupping treatment at two acupuncture points among the BL23, BL24 and BL25 6 times within 2 weeks. Usual care, including providing brochures for exercise, general advice for PNSLBP and acetaminophen, was allowed in both groups. Separate assessors participated in the outcome assessment. We used the 0 to100 numerical rating scale (NRS for pain, the McGill Pain Questionnaire for pain intensity (PPI and the Oswestry Disability Questionnaire (ODQ, and we assessed acetaminophen use and safety issues. Results The results showed that the NRS score for pain decreased (-16.0 [95% CI: -24.4 to -7.7] in the wet-cupping group and -9.1 [-18.1 to -0.1] in the waiting-list group, but there was no statistical difference between the groups (p = 0.52. However, the PPI scores showed significant differences between the two groups (-1.2 [-1.6 to -0.8] for the wet-cupping group and -0.2 [-0.8 to 0.4] for the waiting-list group, p Conclusion This pilot study may provide preliminary data on the effectiveness and safety of wet-cupping treatments for PNSLBP. Future full-scale randomised controlled trials will be needed to provide firm evidence of the effectiveness of this intervention

  7. Comparison of psychological placebo and waiting list control conditions in the assessment of cognitive behavioral therapy for the treatment of generalized anxiety disorder: a meta-analysis.

    Science.gov (United States)

    Zhu, Zhipei; Zhang, Li; Jiang, Jiangling; Li, Wei; Cao, Xinyi; Zhou, Zhirui; Zhang, Tiansong; Li, Chunbo

    2014-12-01

    There is ongoing debate about the efficacy of placebos in the treatment of mental disorders. In randomized control trials (RCTs) about the treatment of generalized anxiety disorder, the administration of a psychological placebo or placement on a waiting list are the two most common control conditions. But there has never been a systematic comparison of the clinical effect of these different strategies. Compare the change in symptom severity among individuals treated with cognitive behavioral therapy, provided a psychological placebo, or placed on a waiting list using data from RCTs on generalized anxiety disorder. The following databases were searched for RCTs on generalized anxiety disorder: PubMed, PsycInfo, EMBASE, The Cochrane Library, CNKI, Chongqing VIP, Wanfang, Chinese Biological Medical Literature Database, and Taiwan Electronic Periodical Services. Studies were selected based on pre-defined inclusion and exclusion criteria and the quality of each included study - based on the risk of bias and the level of evidence - was formally assessed. Meta-analysis was conducted using RevMan5.3 and network meta-analyses comparing the three groups were conducted using R. Twelve studies with a combined sample size of 531 were included in the analysis. Compared to either control method (placebo or waiting list), cognitive behavioral therapy was more effective for generalized anxiety disorder. Provision of a psychological placebo was associated with a significantly greater reduction of symptoms than placement on a waiting list. Eight of the studies were classified as 'high risk of bias', and the overall level of evidence was classified as 'moderate', indicating that further research could change the overall results of the meta-analysis. RCTs about the treatment of generalized anxiety disorders are generally of moderate quality; they indicate the superiority of CBT but the results cannot, as yet, be considered robust. There is evidence of a non-negligible treatment effect

  8. Impact of diagnostic interval on mortality after diagnosis of colorectal cancer: A new perspective on the waiting list paradox

    DEFF Research Database (Denmark)

    Tørring, Marie Louise; Frydenberg, Morten; Hansen, Rikke Pilegaard

    INTRODUCTION: The impact of diagnostic delay on colorectal cancer mortality has never been conclusively evaluated. Most studies show either no association or find that rapidly diagnosed patients have higher mortality rates than patients with longer waits in the primary and secondary health care...

  9. A wait-list controlled pilot study of eye movement desensitization and reprocessing (EMDR) for children with post-traumatic stress disorder (PTSD) symptoms from motor vehicle accidents.

    Science.gov (United States)

    Kemp, Michael; Drummond, Peter; McDermott, Brett

    2010-01-01

    The present study investigated the efficacy of four EMDR sessions in comparison to a six-week wait-list control condition in the treatment of 27 children (aged 6 to 12 years) suffering from persistent PTSD symptoms after a motor vehicle accident. An effect for EMDR was identified on primary outcome and process measures including the Child Post-Traumatic Stress-Reaction Index, clinician rated diagnostic criteria for PTSD, Subjective Units of Disturbance and Validity of Cognition scales. All participants initially met two or more PTSD criteria. After EMDR treatment, this decreased to 25% in the EMDR group but remained at 100% in the wait-list group. Parent ratings of their child's PTSD symptoms showed no improvement, nor did a range of non-trauma child self-report and parent-reported symptoms. Treatment gains were maintained at three and 12 month follow-up. These findings support the use of EMDR for treating symptoms of PTSD in children, although further replication and comparison studies are required.

  10. A 13-Weeks Mindfulness Based Pain Management Program Improves Psychological Distress in Patients with Chronic Pain Compared with Waiting List Controls

    DEFF Research Database (Denmark)

    Andersen, Tonny Elmose; Vægter, Henrik Bjarke

    2016-01-01

    ) in patients with chronic non-malignant pain with a control condition. It was hypothesised that the CBTm program would reduce pain intensity and psychological distress compared to the control condition and that level of mindfulness and acceptance both would be associated with the reduction in pain intensity...... and psychological distress. METHODS: A case-control design was used and data were collected from a convenience sample of 70 patients with chronic non-malignant pain. Fifty patients were consecutively recruited to the CBTm intervention and 20 patients matched waiting list controls. Assessments of clinical pain...... and psychological distress were performed in both groups at baseline and after 13 weeks. RESULTS: The CBTm program reduced depression, anxiety and pain-catastrophizing compared with the control group. Increased level of mindfulness and acceptance were associated with change in psychological distress...

  11. The effects of a group based stress treatment program (the Kalmia concept) targeting stress reduction and return to work. A randomized, wait-list controlled trial

    DEFF Research Database (Denmark)

    Netterstrøm, Bo; Friebel, Lene; Ladegaard, Yun Katrine

    2012-01-01

    Abstract Objective The aim of this study was to evaluate the effects of a group based multidisciplinary stress treatment program on reductions in symptom levels and the return to work (RTW) rate. Methods General practitioners referred 199 patients with persistent work related stress symptoms......%) and the WLCG (24%). Conclusion The stress treatment program significantly reduced symptom levels and increased the RTW rate in the IG compared to the TAUCG and the WLCG. ISRCTN52839015...... to the project. The inclusion criteria included being employed and being on sick leave. Using a randomized wait- list control design, the participants were randomized into three groups: the intervention group (IG, 70 participants) was treated using the Stress Therapy Concept of Kalmia, which consists...

  12. DUNDRUM-2: Prospective validation of a structured professional judgment instrument assessing priority for admission from the waiting list for a Forensic Mental Health Hospital.

    LENUS (Irish Health Repository)

    Flynn, Grainne

    2011-07-03

    Abstract Background The criteria for deciding who should be admitted first from a waiting list to a forensic secure hospital are not necessarily the same as those for assessing need. Criteria were drafted qualitatively and tested in a prospective \\'real life\\' observational study over a 6-month period. Methods A researcher rated all those presented at the weekly referrals meeting using the DUNDRUM-1 triage security scale and the DUNDRUM-2 triage urgency scale. The key outcome measure was whether or not the individual was admitted. Results Inter-rater reliability and internal consistency for the DUNDRUM-2 were acceptable. The DUNDRUM-1 triage security score and the DUNDRUM-2 triage urgency score correlated r = 0.663. At the time of admission, after a mean of 23.9 (SD35.9) days on the waiting list, those admitted had higher scores on the DUNDRUM-2 triage urgency scale than those not admitted, with no significant difference between locations (remand or sentenced prisoners, less secure hospitals) at the time of admission. Those admitted also had higher DUNDRUM-1 triage security scores. At baseline the receiver operating characteristic area under the curve for a combined score was the best predictor of admission while at the time of admission the DUNDRUM-2 triage urgency score had the largest AUC (0.912, 95% CI 0.838 to 0.986). Conclusions The triage urgency items and scale add predictive power to the decision to admit. This is particularly true in maintaining equitability between those referred from different locations.

  13. Brain training improves recovery after stroke but waiting list improves equally: A multicenter randomized controlled trial of a computer-based cognitive flexibility training

    Science.gov (United States)

    Buitenweg, Jessika I. V.; Schmand, Ben; Veltman, Dick J.; Aaronson, Justine A.; Nijboer, Tanja C. W.; Kruiper-Doesborgh, Suzanne J. C.; van Bennekom, Coen A. M.; Rasquin, Sascha M. C.; Ridderinkhof, K. Richard; Murre, Jaap M. J.

    2017-01-01

    Background Brain training is currently widely used in an attempt to improve cognitive functioning. Computer-based training can be performed at home and could therefore be an effective add-on to available rehabilitation programs aimed at improving cognitive functioning. Several studies have reported cognitive improvements after computer training, but most lacked proper active and passive control conditions. Objective Our aim was to investigate whether computer-based cognitive flexibility training improves executive functioning after stroke. We also conducted within-group analyses similar to those used in previous studies, to assess inferences about transfer effects when comparisons to proper control groups are missing. Methods We conducted a randomized controlled, double blind trial. Adults (30–80 years old) who had suffered a stroke within the last 5 years were assigned to either an intervention group (n = 38), active control group (i.e., mock training; n = 35), or waiting list control group (n = 24). The intervention and mock training consisted of 58 half-hour sessions within a 12-week period. Cognitive functioning was assessed using several paper-and-pencil and computerized neuropsychological tasks before the training, immediately after training, and 4 weeks after training completion. Results and conclusions Both training groups improved on training tasks, and all groups improved on several transfer tasks (three executive functioning tasks, attention, reasoning, and psychomotor speed). Improvements remained 4 weeks after training completion. However, the amount of improvement in executive and general cognitive functioning in the intervention group was similar to that of both control groups (active control and waiting list). Therefore, this improvement was likely due to training-unspecific effects. Our results stress the importance to include both active and passive control conditions in the study design and analyses. Results from studies without proper control

  14. A national analysis of dental waiting lists and point-in-time geographic access to subsidised dental care: can geographic access be improved by offering public dental care through private dental clinics?

    Science.gov (United States)

    Dudko, Yevgeni; Kruger, Estie; Tennant, Marc

    2017-01-01

    Australia is one of the least densely populated countries in the world, with a population concentrated on or around coastal areas. Up to 33% of the Australian population are likely to have untreated dental decay, while people with inadequate dentition (fewer than 21 teeth) account for up to 34% of Australian adults. Historically, inadequate access to public dental care has resulted in long waiting lists, received much media coverage and been the subject of a new federal and state initiative. The objective of this research was to gauge the potential for reducing the national dental waiting list through geographical advantage, which could arise from subcontracting the delivery of subsidised dental care to the existing network of private dental clinics across Australia. Eligible population data were collected from the Australian Bureau of Statistics website. Waiting list data from across Australia were collected from publicly available sources and confirmed through direct communication with each individual state or territory dental health body. Quantum geographic information system software was used to map distribution of the eligible population across Australia by statistical area, and to plot locations of government and private dental clinics. Catchment areas of 5 km for metropolitan clinics and 5 km and 50 km for rural clinics were defined. The number of people on the waiting list and those eligible for subsidised dental care covered by each of the catchment areas was calculated. Percentage of the eligible population and those on the waiting list that could benefit from the potential improvement in geographic access was ascertained for metropolitan and rural residents. Fifty three percent of people on the waiting list resided within metropolitan areas. Rural and remote residents made up 47% of the population waiting to receive care. The utilisation of both government and private dental clinics for the delivery of subsidised dental care to the eligible population

  15. A randomised wait-list controlled clinical trial of the effects of acceptance and commitment therapy in patients with type 1 diabetes: a study protocol.

    Science.gov (United States)

    Lindholm-Olinder, Anna; Fischier, Johan; Fries, Jenny; Alfonsson, Sven; Elvingson, Veronika; Eriksson, Jan W; Leksell, Janeth

    2015-01-01

    In order to manage the acute and long-term effects of living with a chronic disease such as diabetes, both medical treatment and good psychosocial support are needed. In this study, we wish to examine whether a psychological group intervention targeting people with poorly controlled type 1 diabetes can be helpful in augmenting quality of life while also lowering participants' HbA1c level. The group intervention will consist of a brief treatment developed from a branch of cognitive behavioural therapy called acceptance and commitment therapy, which is part of the so-called third wave of cognitive behavioural therapy. Common for these third-wave therapies, the focus is less on the content and restructuring of thoughts and more on the function of behaviour. Here, we describe the protocol and plans for study enrolment. This on-going study is designed as a randomised wait-list controlled trial. Eighty patients aged 26-55 years and with an HbA1c level >70 mmol/mol at the time of enrolment will be included. In this study, we will assess the effect of starting acceptance and commitment therapy group treatment for patients with type 1 diabetes and its effect on glycaemic control and well-being. Current controlled trials: ISRCTN17006837, registered 12(th) January 2015.

  16. Cognitive behavioural therapy and mindfulness for stress and burnout: a waiting list controlled pilot study comparing treatments for parents of children with chronic conditions.

    Science.gov (United States)

    Anclair, Malin; Lappalainen, Raimo; Muotka, Joona; Hiltunen, Arto J

    2017-08-29

    Parents of children with chronic conditions often experience a crisis with serious mental health problems for themselves as a consequence. The healthcare focus is on the children; however, the parents often worry about their children's health and future but are seldom offered any counselling or guidance. The aim of this study was to investigate the effectiveness of two group-based behavioural interventions on stress and burnout among parents of children with chronic conditions. After a waiting list control period (n = 28), parents were offered either a cognitive behavioural (CBT, n = 10) or a mindfulness program (MF, n = 9). Both interventions decreased significantly stress and burnout. The within-group effect sizes were large in both interventions (CBT, g = 1.28-1.64; MF, g = 1.25-2.20). Hence, the results of this pilot study show that treating a group using either CBT or mindfulness can be an efficient intervention for reducing stress levels and burnout in parents of children with chronic conditions. © 2017 Nordic College of Caring Science.

  17. Effects of group metacognitive training (MCT) on mental capacity and functioning in patients with psychosis in a secure forensic psychiatric hospital: a prospective-cohort waiting list controlled study.

    LENUS (Irish Health Repository)

    Naughton, Marie

    2012-06-01

    Metacognitive Training (MCT) is a manualised cognitive intervention for psychosis aimed at transferring knowledge of cognitive biases and providing corrective experiences. The aim of MCT is to facilitate symptom reduction and protect against relapse. In a naturalistic audit of clinical effectiveness we examined what effect group MCT has on mental capacity, symptoms of psychosis and global function in patients with a psychotic illness, when compared with a waiting list comparison group.

  18. Self-help interventions for adjustment disorder problems: a randomized waiting-list controlled study in a sample of burglary victims.

    Science.gov (United States)

    Bachem, Rahel; Maercker, Andreas

    2016-09-01

    Adjustment disorders (AjD) are among the most frequent mental disorders yet often remain untreated. The high prevalence, comparatively mild symptom impairment, and transient nature make AjD a promising target for low-threshold self-help interventions. Bibliotherapy represents a potential treatment for AjD problems. This study investigates the effectiveness of a cognitive behavioral self-help manual specifically directed at alleviating AjD symptoms in a homogenous sample of burglary victims. Participants with clinical or subclinical AjD symptoms following experience of burglary were randomized to an intervention group (n = 30) or waiting-list control group (n = 24). The new explicit stress response syndrome model for diagnosing AjD was applied. Participants received no therapist support and assessments took place at baseline, after the one-month intervention, and at three-month follow-up. Based on completer analyses, group by time interactions indicated that the intervention group showed more improvement in AjD symptoms of preoccupation and in post-traumatic stress symptoms. Post-intervention between-group effect sizes ranged from Cohen's d = .17 to .67 and the proportion of participants showing reliable change was consistently higher in the intervention group than in the control group. Engagement with the self-help manual was high: 87% of participants had worked through at least half the manual. This is the first published RCT of a bibliotherapeutic self-help intervention for AjD problems. The findings provide evidence that a low-threshold self-help intervention without therapist contact is a feasible and effective treatment for symptoms of AjD.

  19. What Kind of Information About Marginal Donors Is Available Through Sources Other Than Health Care Professionals for Patients on the Waiting List for Organ Transplantation?

    Science.gov (United States)

    Kamran, Sara; Calmus, Yvon; Pomey, Marie Pascale; Vidal-Trécan, Gwenaëlle

    2015-07-14

    The current organ shortage has necessitated expanding the criteria for potential donations to marginal donors (older or sick donors whose organs would have been considered unsuitable before). In France, physicians are not required to provide information to recipients about marginal donors except for hepatitis C or hepatitis B infection and non-heart-beating donations. We hypothesized that patients can be informed about these risks by other information sources than health care professionals, such as websites and patient associations. The objectives of the study were to identify the main health information sources of transplant patients other than health professionals and to evaluate the information provided by websites and associations to patients about the risks of transplantation from marginal donors. In this study, the information sources for kidney, liver, heart, and lung patients that had already received transplants or registered on waiting lists were identified by a survey in four transplant centers. Further, the information proposed by French and English language websites and patient associations were evaluated, respectively, by a systematic review of websites and a survey among the presidents of kidney, liver, heart, and lung patient associations. For the first survey, (367/402) 91.3% responses were registered. Apart from health professionals identified as the principal information source (363/367) 98.9%, 19 liver and 28 heart patients searched for information on the websites, while 37 kidney and 42 lung patients were more informed by patients' associations. Our two last surveys showed that information about marginal donors is accessible by websites and (10/34) 30% of associations. All of the 60 Internet documents evaluated on French language and English language websites proposed information about marginal donors. Otherwise, (52/65) 80% of these documents were dedicated to health professionals and contained specialized information, difficult to understand

  20. Consumer behaviour in the waiting area.

    Science.gov (United States)

    Mobach, Mark P

    2007-02-01

    To determine consumer behaviour in the pharmacy waiting area. The applied methods for data-collection were direct observations. Three Dutch community pharmacies were selected for the study. The topics in the observation list were based on available services at each waiting area (brochures, books, illuminated new trailer, children's play area, etc.). Per patient each activity was registered, and at each pharmacy the behaviour was studied for 2 weeks. Most patients only waited during the waiting time at the studied pharmacies. Few consumers obtained written information during their wait. The waiting area may have latent possibilities to expand the information function of the pharmacy and combine this with other activities that distract the consumer from the wait. Transdisciplinary research, combining knowledge from pharmacy practice research with consumer research, has been a useful approach to add information on queueing behaviour of consumers.

  1. Improving Patient Satisfaction with Waiting Time

    Science.gov (United States)

    Eilers, Gayleen M.

    2004-01-01

    Waiting times are a significant component of patient satisfaction. A patient satisfaction survey performed in the author's health center showed that students rated waiting time lowest of the listed categories--A ratings of 58% overall, 63% for scheduled appointments, and 41% for the walk-in clinic. The center used a quality improvement process and…

  2. Weighing waiting

    Directory of Open Access Journals (Sweden)

    Samuel M. Duncan

    2007-12-01

    Full Text Available People have been shown to delay decision making to wait for missing noninstrumental attribute information --- information that would not have altered their decision if known at the outset --- with this delay originally attributed to uncertainty obscuring one's true preference (Bastardi and Shafir, 1998. To test this account, relative to an alternative that delay arises from low confidence in one's preference (Tykocinski and Ruffle, 2003, we manipulated information certainty and the magnitude of a penalty for delay, the latter intended to reduce the influence of easily resolved sources of delay and to magnify any influence of uncertainty. Contrary to expectations, the results were largely inconsistent with the uncertainty account in that, under a low penalty, delay did not depend on information certainty; and, under a high penalty, delay rate was actually much lower when information was uncertain. To explain the latter, we propose that people use a strategy for resolving choice under uncertainty that does not require establishing a confident preference for each value of the missing information. These findings are related to others in which choice difficulty has been found to be a major source of delay.

  3. The Effects of Twelve Weeks of Tai Chi Practice on Anxiety in Stressed But Healthy People Compared to Exercise and Wait-List Groups-A Randomized Controlled Trial.

    Science.gov (United States)

    Zheng, Shuai; Kim, Christine; Lal, Sara; Meier, Peter; Sibbritt, David; Zaslawski, Chris

    2017-06-13

    This randomized controlled trial was undertaken to determine whether 12 weeks of Tai Chi (TC) practice can reduce anxiety in healthy but stressed people. Fifty participants were randomized into TC (n=17), exercise (n=17), and wait-list (WL) groups (n=16). Outcome measures used were State Trait Anxiety Inventory, Perceived Stress Scale 14 (PSS14), blood pressure and heart rate variability, visual analogue scale (VAS), and Short Form 36. Significant improvements were observed from baseline for both TC and exercise groups for both state (p stress levels in healthy individuals and provides a safer, cost effective, and less physically vigorous alternative to exercise. © 2017 Wiley Periodicals, Inc.

  4. Perfil epidemiológico dos pacientes na lista de espera para transplante de córnea no Estado de Sergipe Epidemiological profile of the patients on the waiting list for cornea transplantation in the State of Sergipe , Brazil

    Directory of Open Access Journals (Sweden)

    Ângelo Augusto Araújo

    2004-08-01

    Full Text Available OBJETIVO: Avaliar o perfil epidemiológico dos pacientes em lista de espera e submetidos a transplante de córnea no estado de Sergipe e as principais indicações para este procedimento. MÉTODOS: Na Central de Transplantes de Sergipe, foram colhidos os dados de 320 pacientes que entraram em lista de espera e daqueles que tiveram a córnea transplantada entre maio de 2000 e novembro de 2002. Os dados registrados foram: doença corneana, a idade, o sexo, a acuidade visual e o tempo de espera na lista até a realização do transplante. RESULTADOS: A ceratopatia bolhosa do afácico e do pseudofácico foi a doença mais freqüente (39,1%, seguida por leucoma (22,5%, ceratocone (14,1%, "outras doenças" (10,6%, retransplante (7,8% e úlcera (5,6%. A idade média foi de 52,16 anos e não houve diferença significante entre os sexos. A acuidade visual mais freqüente foi visão de vultos e "percebe luz". Os 110 pacientes que tiveram a córnea transplantada esperaram, em média, seis meses. Os indicados por úlcera e por retransplante tiveram prioridade, aguardando menos tempo. Os portadores de ceratopatia bolhosa encontravam-se na faixa etária média de 68,5 anos e os com ceratocone, na de 23,6 anos. CONCLUSÕES: Pode-se concluir que a ceratopatia bolhosa é a principal indicação para transplante de córnea em nosso estado. Não há diferença entre a freqüência dos sexos; a idade média da doença mais freqüente está de acordo com seu aparecimento. A acuidade visual está dentro do esperado e o tempo em lista de espera é longo e inadequado.PURPOSE: To define the epidemiological aspects of the patients on the waiting list and those submitted to corneal transplantation in the state of Sergipe, Brazil and the main indications for this procedure. METHODS: The data of 320 patients who were on the waiting list and those who had their corneas transplanted from May 2000 to November 2002 were collected at the Transplantation Center of Sergipe. The

  5. Protocol: the effect of 12 weeks of Tai Chi practice on anxiety in healthy but stressed people compared to exercise and wait-list comparison groups: a randomized controlled trial.

    Science.gov (United States)

    Zheng, Shuai; Lal, Sara; Meier, Peter; Sibbritt, David; Zaslawski, Chris

    2014-06-01

    Stress is a major problem in today's fast-paced society and can lead to serious psychosomatic complications. The ancient Chinese mind-body exercise of Tai Chi may provide an alternative and self-sustaining option to pharmaceutical medication for stressed individuals to improve their coping mechanisms. The protocol of this study is designed to evaluate whether Tai Chi practice is equivalent to standard exercise and whether the Tai Chi group is superior to a wait-list control group in improving stress coping levels. This study is a 6-week, three-arm, parallel, randomized, clinical trial designed to evaluate Tai Chi practice against standard exercise and a Tai Chi group against a nonactive control group over a period of 6 weeks with a 6-week follow-up. A total of 72 healthy adult participants (aged 18-60 years) who are either Tai Chi naïve or have not practiced Tai Chi in the past 12 months will be randomized into a Tai Chi group (n = 24), an exercise group (n = 24) or a wait-list group (n = 24). The primary outcome measure will be the State Trait Anxiety Inventory with secondary outcome measures being the Perceived Stress Scale 14, heart rate variability, blood pressure, Short Form 36 and a visual analog scale. The protocol is reported using the appropriate Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) items.

  6. Can We Predict Patient Wait Time?

    Science.gov (United States)

    Pianykh, Oleg S; Rosenthal, Daniel I

    2015-10-01

    The importance of patient wait-time management and predictability can hardly be overestimated: For most hospitals, it is the patient queues that drive and define every bit of clinical workflow. The objective of this work was to study the predictability of patient wait time and identify its most influential predictors. To solve this problem, we developed a comprehensive list of 25 wait-related parameters, suggested in earlier work and observed in our own experiments. All parameters were chosen as derivable from a typical Hospital Information System dataset. The parameters were fed into several time-predicting models, and the best parameter subsets, discovered through exhaustive model search, were applied to a large sample of actual patient wait data. We were able to discover the most efficient wait-time prediction factors and models, such as the line-size models introduced in this work. Moreover, these models proved to be equally accurate and computationally efficient. Finally, the selected models were implemented in our patient waiting areas, displaying predicted wait times on the monitors located at the front desks. The limitations of these models are also discussed. Optimal regression models based on wait-line sizes can provide accurate and efficient predictions for patient wait time. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  7. Resultados de un plan de gestión de listas de espera quirúrgica de prótesis articulares Results of a management plan for surgical waiting lists for hip and knee replacements

    Directory of Open Access Journals (Sweden)

    Josep Martí-Valls

    2006-06-01

    Full Text Available Se describe un plan de gestión de las listas de espera quirúrgicas de prótesis articulares de cadera y rodilla y sus resultados a los 3 años. El plan de gestión se basó en la unificación de la información y programación, depuración periódica, guía clínica, gestión de la demanda, priorización por necesidad e incremento de la oferta. Durante el primer año se consiguió aflorar la lista de espera real, con un 23% más de pacientes de los contabilizados hasta entonces. A los 3 años, se depuró la lista en un 16% de los pacientes, se disminuyó la estancia media de estos procedimientos en 4 días, se evaluó el 59,5% de los pacientes con un instrumento de priorización y se incrementó la actividad de artroplastias en un 16%. Se redujo en un 14,7% los pacientes en espera de prótesis articulares y el tiempo de resolución de estos procedimientos disminuyó en 3 meses para las artroplastias de rodilla y en un mes para las de cadera.This study describes the implementation of a management plan for surgical joint replacement waiting lists and its results after 3 years. The plan was based on the following: unification of information and scheduling, periodic review, clinical guidelines, management of demand, prioritization according to need, and increasing the services provided. During the first year, the plan succeeded in revealing the real waiting list, with 23% more patients than previously included. Three years later, 16% of the patients had not turned up for surgery after being scheduled; the mean length of hospital stay for joint replacements had been reduced by 4 days; 59.5% of the patients joining the list had been assessed with a prioritization instrument, and the number of joint replacements had increased by 16% with a reduction of 14.7% in patients waiting for joint replacements. The resolution time for these procedures had also deceased by 3 months for knee arthroplasty and by 1 month for hip arthroplasty.

  8. Percepções do paciente em lista de espera para o transplante renal Percepciones del paciente en lista de espera para el transplante renal Feelings of patients on the waiting list for a kidney transplant

    Directory of Open Access Journals (Sweden)

    Rosiele Vemdrame Flores

    2004-12-01

    Full Text Available Estudo exploratório descritivo, com abordagem qualitativa cujo objetivo foi: conhecer as percepções dos pacientes em lista de espera para transplante renal. O local da pesquisa foi a Unidade de Hemodiálise de um hospital universitário de Porto Alegre. Os participantes foram os pacientes ativos na lista de espera para fazer o transplante renal, sendo a amostra constituída de 09 portadores de IRC, que realizam hemodiálise. Como resultados identificou-se as seguintes percepções: esperança, ansiedade, liberdade, ambivalência, medo, culpa e fé. A dependência da diálise para sobreviver remete o paciente ao confronto com a morte e a descrença, ao mesmo tempo em que busca força e fé para lutar e manter-se na espera por um doador.Estudio exploratorio descriptivo, con abordaje cualitativo cuyo objetivo fue: conocer las percepciones de los pacientes en lista de espera para transplante renal. El local de la encuesta fue la Unidad de Hemodiálisis de un hospital universitario de Porto Alegre. Los participantes fueron los pacientes activos en la lista de espera para hacer el transplante renal, siendo la muestra constituida de 09 portadores de IRC (Insuficiencia Renal Crónica, que realizan hemodiálisis. Como resultados se identificaron las siguientes percepciones: esperanza, ansiedad, libertad, ambivalencia, miedo, culpa y fe. La dependencia de la diálisis para supervivir remete al paciente al enfrentamiento con la muerte y la descreencia, al mismo tiempo en que busca fuerza y fe para luchar y mantenerse en la espera por un donador.A descriptive and exploratory study with a qualitative approach whose aim was to get to know the feelings of patients on the waiting list for a kidney transplant. The research was conducted at the Hemodialysis Unit of a university hospital of Porto Alegre. The participants were the active patients on the waiting list for a kidney transplant. The sample comprised 9 patients affected with chronic renal

  9. Low-intensity cognitive-behaviour therapy interventions for obsessive-compulsive disorder compared to waiting list for therapist-led cognitive-behaviour therapy: 3-arm randomised controlled trial of clinical effectiveness.

    Science.gov (United States)

    Lovell, Karina; Bower, Peter; Gellatly, Judith; Byford, Sarah; Bee, Penny; McMillan, Dean; Arundel, Catherine; Gilbody, Simon; Gega, Lina; Hardy, Gillian; Reynolds, Shirley; Barkham, Michael; Mottram, Patricia; Lidbetter, Nicola; Pedley, Rebecca; Molle, Jo; Peckham, Emily; Knopp-Hoffer, Jasmin; Price, Owen; Connell, Janice; Heslin, Margaret; Foley, Christopher; Plummer, Faye; Roberts, Christopher

    2017-06-01

    Obsessive-compulsive disorder (OCD) is prevalent and without adequate treatment usually follows a chronic course. "High-intensity" cognitive-behaviour therapy (CBT) from a specialist therapist is current "best practice." However, access is difficult because of limited numbers of therapists and because of the disabling effects of OCD symptoms. There is a potential role for "low-intensity" interventions as part of a stepped care model. Low-intensity interventions (written or web-based materials with limited therapist support) can be provided remotely, which has the potential to increase access. However, current evidence concerning low-intensity interventions is insufficient. We aimed to determine the clinical effectiveness of 2 forms of low-intensity CBT prior to high-intensity CBT, in adults meeting the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for OCD. This study was approved by the National Research Ethics Service Committee North West-Lancaster (reference number 11/NW/0276). All participants provided informed consent to take part in the trial. We conducted a 3-arm, multicentre randomised controlled trial in primary- and secondary-care United Kingdom mental health services. All patients were on a waiting list for therapist-led CBT (treatment as usual). Four hundred and seventy-three eligible patients were recruited and randomised. Patients had a median age of 33 years, and 60% were female. The majority were experiencing severe OCD. Patients received 1 of 2 low-intensity interventions: computerised CBT (cCBT; web-based CBT materials and limited telephone support) through "OCFighter" or guided self-help (written CBT materials with limited telephone or face-to-face support). Primary comparisons concerned OCD symptoms, measured using the Yale-Brown Obsessive Compulsive Scale-Observer-Rated (Y-BOCS-OR) at 3, 6, and 12 months. Secondary outcomes included health-related quality of life, depression, anxiety, and functioning. At

  10. Attitude towards related living donation among candidates on the liver transplant waiting list Actitud hacia la donación de vivo relacionada entre los candidatos a trasplante hepático en lista de espera

    Directory of Open Access Journals (Sweden)

    Laura Martínez-Alarcón

    2011-03-01

    Full Text Available Objective: to analyze attitude of patients on the liver transplant waiting list toward living donation (LD. Design and patients: patients on the transplant waiting list -2003-2005 (n = 164- were selected. Attitude was evaluated using a validated questionnaire, completed by an independent healthcare professional. Results: the questionnaire completion rate was 97% (n = 159. A total of 87% (n = 138 of patients stated that they would donate an organ while alive if a family member needed one. However, only 39% (n = 61 would be prepared to receive a liver donation from a living relative and 50% would prefer to wait on the list (n = 80. 90% accepted that living liver donation involves a certain amount of risk. This assumption was not associated with a willingness to accept related LD (p = 0.170. A willingness to accept LD was related to patient's knowledge of his or her family's attitude toward donating an organ to the patient (p = 0.027. Conclusions: patients had a favorable attitude toward living liver donation. When there was a family base that is in favor of LD then this encouraged acceptance, and therefore, it is essential to carry out family screening of patients to detect those cases in which this type of LD can be successfully requested.Objetivo: analizar la actitud hacia la donación de vivo de los pacientes en lista de espera para trasplante hepático. Diseño y pacientes: seleccionados los pacientes incluidos en lista de espera para trasplante hepático (2003-2005 (n = 164. La actitud hacia la donación de vivo se valora mediante un cuestionario validado. La cumplimentación fue mediante entrevista por un profesional sanitario independiente de la Unidad de Trasplantes. Resultados: el grado de cumplimentación: 97% (n = 159. El 87% (n =138 de los pacientes indican que donarían en vida un órgano si un familiar o amigo íntimo lo necesitase. Sin embargo, solo el 39% (n = 61 aceptaría una donación hepática de vivo relacionada, prefiriendo

  11. Low-intensity cognitive-behaviour therapy interventions for obsessive-compulsive disorder compared to waiting list for therapist-led cognitive-behaviour therapy: 3-arm randomised controlled trial of clinical effectiveness.

    Directory of Open Access Journals (Sweden)

    Karina Lovell

    2017-06-01

    Full Text Available Obsessive-compulsive disorder (OCD is prevalent and without adequate treatment usually follows a chronic course. "High-intensity" cognitive-behaviour therapy (CBT from a specialist therapist is current "best practice." However, access is difficult because of limited numbers of therapists and because of the disabling effects of OCD symptoms. There is a potential role for "low-intensity" interventions as part of a stepped care model. Low-intensity interventions (written or web-based materials with limited therapist support can be provided remotely, which has the potential to increase access. However, current evidence concerning low-intensity interventions is insufficient. We aimed to determine the clinical effectiveness of 2 forms of low-intensity CBT prior to high-intensity CBT, in adults meeting the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV criteria for OCD.This study was approved by the National Research Ethics Service Committee North West-Lancaster (reference number 11/NW/0276. All participants provided informed consent to take part in the trial. We conducted a 3-arm, multicentre randomised controlled trial in primary- and secondary-care United Kingdom mental health services. All patients were on a waiting list for therapist-led CBT (treatment as usual. Four hundred and seventy-three eligible patients were recruited and randomised. Patients had a median age of 33 years, and 60% were female. The majority were experiencing severe OCD. Patients received 1 of 2 low-intensity interventions: computerised CBT (cCBT; web-based CBT materials and limited telephone support through "OCFighter" or guided self-help (written CBT materials with limited telephone or face-to-face support. Primary comparisons concerned OCD symptoms, measured using the Yale-Brown Obsessive Compulsive Scale-Observer-Rated (Y-BOCS-OR at 3, 6, and 12 months. Secondary outcomes included health-related quality of life, depression, anxiety, and

  12. Waiting for coronary angiography: is there a clinically ordered queue?

    Science.gov (United States)

    Hemingway, H; Crook, A M; Feder, G; Dawson, J R; Timmis, A

    2000-03-18

    Among over 3000 patients undergoing coronary angiography in the absence of a formal queue-management system, we found that a-priori urgency scores were strongly associated with waiting times, prevalence of coronary-artery disease, rate of revascularisation, and mortality. These data challenge the widely held assumption that such waiting lists are not clinically ordered; however, the wide variation in waiting times within urgency categories suggests the need for further improvements in clinical queueing.

  13. Effects of a multidisciplinary stress treatment programme on patient return to work rate and symptom reduction: results from a randomised, wait-list controlled trial.

    Science.gov (United States)

    Netterstrøm, Bo; Friebel, Lene; Ladegaard, Yun

    2013-01-01

    To evaluate the efficacy of a multidisciplinary stress treatment programme. General practitioners referred 198 employed patients on sick leave with symptoms of persistent work-related stress. Using a waitlisted randomised controlled trial design, the participants were randomly divided into the following three groups: the intervention group (IG, 69 participants); treatment-as-usual control group (TAUCG, 71 participants), which received 12 consultations with a psychologist, and the waitlisted control group (WLCG, 58 participants). The stress treatment intervention consisted of nine 1-hour sessions conducted over 3 months. The goals of the sessions were the following: (1) identifying relevant stressors; (2) changing the participant's coping strategies; (3) adjusting the participant's workload and tasks, and (4) improving workplace dialogue. Each participant also attended a mindfulness-based stress reduction (MBSR) course for 2 h a week over 8 weeks. The IG and TAUCG showed significantly greater symptom level (Symptom Check List 92) reductions compared to the WLCG. Regarding the return to work (RTW) rate, 67% of participants in the IG returned to full-time work after treatment, which was a significantly higher rate than in the TAUCG (36%) and WLCG (24%). Significantly more participants in the IG (97%) increased their working hours during treatment compared with the participants in the control groups, TAUCG (71%) and WLCG (64%). The stress treatment programme--a combination of work place-focused psychotherapy and MBSR--significantly reduced stress symptom levels and increased RTW rates compared with the WLCG and TAUCG. Copyright © 2013 S. Karger AG, Basel.

  14. Consumer behaviour in the waiting area

    NARCIS (Netherlands)

    Mobach, M.P.

    Objective of the study: To determine consumer behaviour in the pharmacy waiting area. Method: The applied methods for data-collection were direct observations. Three Dutch community pharmacies were selected for the study. The topics in the observation list were based on available services at each

  15. Organ Type and Waiting Time

    Science.gov (United States)

    ... Kidney/Pancreas Liver Intestine Organ Type and Waiting Time Most candidates, except those with living donors, wait ... organ needed How does organ type affect waiting times? Heart Allocation Physicians assign a status code to ...

  16. Reducing client waiting time.

    Science.gov (United States)

    1992-01-01

    This first issues of Family Planning (FP) Manager focuses on how to analyze client waiting time and reduce long waits easily and inexpensively. Client flow analysis can be used by managers and staff to identify organizational factors affecting waiting time. Symptoms of long waiting times are overcrowded waiting rooms, clients not returning for services, staff complaints about rushing and waiting, and hurried counseling sessions. Client satisfaction is very important in order to retain FP users. Simple procedures such as routing return visits differently can make a difference in program effectiveness. Assessment of the number of first visits, the number of revisits, and types of methods and services that the clinic provides is a first step. Client flow analysis involves assigning a number to each client on registration, attaching the client flow form to the medical chart, entering the FP method and type of visit, asking staff to note the time at each station, and summarizing data in a master chart. The staff should be involved in plotting data for each client to show waiting versus staff contact time through the use of color coding for each type of staff contact. Bottlenecks become very visible when charted. The amount of time spent at each station can be measured, and gaps in client's contact with staff can be identified. An accurate measure of total waiting time can be obtained. A quick assessment can be made by recording arrival and departure times for each client in one morning or afternoon of a peak day. The procedure is to count the number of clients waiting at 15-minute intervals. The process should be repeated every 3-6 months to observe changes. If waiting times appear long, a more thorough assessment is needed on both a peak and a typical day. An example is given of a completed chart and graph of results with sample data. Managers need to set goals for client flow, streamline client routes, and utilize waiting time wisely by providing educational talks

  17. Priorización de pacientes en lista de espera para cirugía de cataratas: diferencias en las preferencias entre ciudadanos Prioritizing patients on waiting list for cataract surgery: preference differences among citizens

    Directory of Open Access Journals (Sweden)

    Laura Sampietro-Colom

    2006-10-01

    application. Differences were assessed by group analysis and their comparison. Results: The criteria selected and their relative importance were: visual impairment (45%, difficulty in performing activities of daily living (ADL (15%, limitation of ability to work (14%, being looked after by someone (11%, being a caregiver (8%, and recovery probability (7%. Differences in scores were observed among groups. Visual impairment was scored more highly by the general public and patients/relatives than by other groups (p 0.9. However, the final order of patients on the waiting list could differ by up to 27 positions when different group scores were applied. Conclusions: Social and clinical criteria were considered important. The observed differences among citizens regarding how to prioritize patients on the waiting lists indicates the need to take into account the preferences of all groups of citizens.

  18. Comparing the clinical-effectiveness and cost-effectiveness of an internet-delivered Acceptance and Commitment Therapy (ACT) intervention with a waiting list control among adults with chronic pain: study protocol for a randomised controlled trial

    Science.gov (United States)

    Hayes, Sara; Hogan, Michael; Dowd, Haulie; Doherty, Edel; O'Higgins, Siobhan; Nic Gabhainn, Saoirse; MacNeela, Padraig; Murphy, Andrew W; Kropmans, Thomas; O'Neill, Ciaran; Newell, John; McGuire, Brian E

    2014-01-01

    Introduction Internet-delivered psychological interventions among people with chronic pain have the potential to overcome environmental and economic barriers to the provision of evidence-based psychological treatment in the Irish health service context. While the use of internet-delivered cognitive–behavioural therapy programmes has been consistently shown to have small-to-moderate effects in the management of chronic pain, there is a paucity in the research regarding the effectiveness of an internet-delivered Acceptance and Commitment Therapy (ACT) programme among people with chronic pain. The current study will compare the clinical-effectiveness and cost-effectiveness of an online ACT intervention with a waitlist control condition in terms of the management of pain-related functional interference among people with chronic pain. Methods and analysis Participants with non-malignant pain that persists for at least 3 months will be randomised to one of two study conditions. The experimental group will undergo an eight-session internet-delivered ACT programme over an 8-week period. The control group will be a waiting list group and will be offered the ACT intervention after the 3-month follow-up period. Participants will be assessed preintervention, postintervention and at a 3-month follow-up. The primary outcome will be pain-related functional interference. Secondary outcomes will include: pain intensity, depression, global impression of change, acceptance of chronic pain and quality of life. A qualitative evaluation of the perspectives of the participants regarding the ACT intervention will be completed after the trial. Ethics and dissemination The study will be performed in agreement with the Declaration of Helsinki and is approved by the National University of Ireland Galway Research Ethics Committee (12/05/05). The results of the trial will be published according to the CONSORT statement and will be presented at conferences and reported in peer

  19. Comparing the effectiveness of an internet-delivered Acceptance and Commitment Therapy (ACT intervention with a wait list control on health related quality of life among adults with multimorbidity: Study protocol for a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Brian Slattery

    2015-10-01

    Full Text Available Multimorbidity is defined as the coexistence of two or more conditions within one person, where no one condition is primary. Chronic Pain (CP is found to be one of the most frequent conditions represented amongst multimorbidities. CP and in particular MM, can have significant debilitating effects on a persons’ Health Related Quality of Life (HRQoL. There is a dearth of research however, targeting and improving HRQoL for people living with MM, were CP is a feature. Aim of Investigation: This study will compare the clinical- effectiveness of an online ACT intervention with a waitlist control condition in terms of increasing health related quality of life among people with multimorbidities, were chronic pain is a feature. Methods: Adult participants with non-malignant pain that persists for at least three months and at least one other condition as diagnosed by a doctor will be randomised to one of two study conditions. The experimental group will undergo an 8-session internet-delivered ACT-programme over an 8-week period. A wait-list group will be offered the ACT intervention after the 3-month follow-up period. Results: Participants will be assessed pre-intervention, post-intervention and at a 3-month follow-up. HRQoL will be the primary outcome. Secondary outcomes will include: pain intensity; depression; acceptance of chronic pain and symptoms of other morbidities. Conclusions: At present, we are in the early stages of participant recruitment. As a result, the focus of this poster will be on describing the methodological and recruitment processes for the current study.

  20. Comparing the clinical-effectiveness and cost-effectiveness of an internet-delivered Acceptance and Commitment Therapy (ACT) intervention with a waiting list control among adults with chronic pain: study protocol for a randomised controlled trial.

    Science.gov (United States)

    Hayes, Sara; Hogan, Michael; Dowd, Haulie; Doherty, Edel; O'Higgins, Siobhan; Nic Gabhainn, Saoirse; MacNeela, Padraig; Murphy, Andrew W; Kropmans, Thomas; O'Neill, Ciaran; Newell, John; McGuire, Brian E

    2014-07-02

    Internet-delivered psychological interventions among people with chronic pain have the potential to overcome environmental and economic barriers to the provision of evidence-based psychological treatment in the Irish health service context. While the use of internet-delivered cognitive-behavioural therapy programmes has been consistently shown to have small-to-moderate effects in the management of chronic pain, there is a paucity in the research regarding the effectiveness of an internet-delivered Acceptance and Commitment Therapy (ACT) programme among people with chronic pain. The current study will compare the clinical-effectiveness and cost-effectiveness of an online ACT intervention with a waitlist control condition in terms of the management of pain-related functional interference among people with chronic pain. Participants with non-malignant pain that persists for at least 3 months will be randomised to one of two study conditions. The experimental group will undergo an eight-session internet-delivered ACT programme over an 8-week period. The control group will be a waiting list group and will be offered the ACT intervention after the 3-month follow-up period. Participants will be assessed preintervention, postintervention and at a 3-month follow-up. The primary outcome will be pain-related functional interference. Secondary outcomes will include: pain intensity, depression, global impression of change, acceptance of chronic pain and quality of life. A qualitative evaluation of the perspectives of the participants regarding the ACT intervention will be completed after the trial. The study will be performed in agreement with the Declaration of Helsinki and is approved by the National University of Ireland Galway Research Ethics Committee (12/05/05). The results of the trial will be published according to the CONSORT statement and will be presented at conferences and reported in peer-reviewed journals. ISRCTN18166896. Published by the BMJ Publishing Group

  1. Testing the impact of a social skill training versus waiting list control group for the reduction of disruptive behaviors and stress among preschool children in child care: the study protocol for a cluster randomized trial.

    Science.gov (United States)

    Côté, Sylvana M; Larose, Marie-Pier; Geoffroy, Marie Claude; Laurin, Julie; Vitaro, Frank; Tremblay, Richard E; Ouellet-Morin, Isabelle

    2017-08-07

    Most preschoolers growing up in western industrialized countries receive child care services (CCS) during the day, while their parents are at work. Meta-analytic data suggest that CCS represent a stressful experience for preschoolers. This may be because preschoolers have not yet developed the social skills necessary to cope with the new and rapidly fluctuating social contexts of CCS. We tested the effectiveness of a child care-based social skill training program aiming to improve children's social behaviors and reduce the stress they experience. We used a cluster randomized control trial (cRCT) to compare children's social behaviors and stress levels in pre- and post-intervention according to whether they received a social skill training intervention or not. Nineteen (n = 19) public CCS (n = 362, 3-years-old preschoolers) of underprivileged neighborhoods (Montreal, Canada) were randomized to one of two conditions: 1) social skills training (n = 10 CCS); or 2) waiting list control group (n = 9 CCS). Educators in the intervention group conducted bi-weekly social skills training sessions over a period of 8 months. The intervention covered four topics: making social contacts, problem solving, emotional self-regulation, as well as emotional expression and recognition. Main outcome measures included preschoolers' disruptive (e.g. aggression, opposition, conflicts) and prosocial behaviors (e.g. sharing toys, helping another child), and stress levels assessed by salivary cortisol sampling at pre and post intervention assessments. Educators' practices will be tested as potential mediators of the expected changes in behaviors and neuroendocrine stress. To our knowledge, this is the first cRCT to test the effectiveness of a child care based social skill training program on the reduction of disruptive behaviors and levels of stress. Significant challenges include the degree of adherence to the intervention protocol as well educators and preschoolers' turnover

  2. Challenging "Waiting for Superman"

    Science.gov (United States)

    Bruhn, Molle

    2014-01-01

    A group of New York City public school teachers, angry about the depiction of public schools in 'Waiting for Superman," decide to make their own film about the realities of the current education reform movement. They persevered even though they had no budget when they started and lacked a background in filmmaking. "The Inconvenient Truth…

  3. Intervención para reducir la variabilidad de las indicaciones quirúrgicas y la lista de espera de pacientes con prioridad 1: Una experiencia en Galicia Intervention to reduce variability in surgical indications and the waiting list of priority 1 patients: An experience in Galicia (Spain

    Directory of Open Access Journals (Sweden)

    M.ª Nieves Domínguez González

    2011-12-01

    Full Text Available Los objetivos de este trabajo fueron homogeneizar las indicaciones quirúrgicas de prioridad 1 en los hospitales gallegos y proponer una metodología orientada a conseguir que las esperas de los pacientes en prioridad 1 no superen los 30 días. Se recopilaron y revisaron todas las indicaciones quirúrgicas de prioridad 1 de los diferentes servicios quirúrgicos de Galicia y se enviaron a las sociedades científicas para validar. Para reducir la espera a menos de 30 días se implantó un procedimiento de monitorización periódica de pacientes, con asignación de tareas a todos los implicados. Para medir el cambio se compararon los tiempos medios de espera previos con los de después de la implantación, y se habían reducido en un 55,7% respecto a la situación previa a la intervención. Todas las especialidades quirúrgicas redujeron sus tiempos medios de espera, excepto una. El procedimiento instaurado ha permitido disminuir el número de pacientes en espera y reducir ésta a menos de 30 días en casi todas las especialidades quirúrgicas.The aims of this study were to homogenize priority 1 surgical indications in Galician hospitals and propose a methodology designed to ensure that that the waiting times of priority 1 patients do not exceed 30 days. The priority 1 surgical indications of the distinct surgical services in Galicia were obtained and reviewed and were then sent for validation to the scientific societies. To reduce waiting times to less than 30 days, a procedure of periodic patient monitoring was established, with allocation of tasks to all the parties involved. Comparison of the mean waiting times before and after the implantation of periodic monitoring showed that this procedure reduced the mean waiting time by 55.7%. The mean waiting time was reduced in all the surgical specialities except one. In almost all of the surgical specialities, the procedure established reduced the number of patients on the waiting lists and the mean

  4. Mathematical Models of Waiting Time.

    Science.gov (United States)

    Gordon, Sheldon P.; Gordon, Florence S.

    1990-01-01

    Considered are several mathematical models that can be used to study different waiting situations. Problems involving waiting at a red light, bank, restaurant, and supermarket are discussed. A computer program which may be used with these problems is provided. (CW)

  5. Iran - waiting and watching

    Energy Technology Data Exchange (ETDEWEB)

    Malhotra, T. C.

    2007-07-01

    Global oil companies are reported to be divided on the issue of possible energy deals in Iran. Some companies may adopt wait and watch policy before singing a fresh deal with Iran, but there are some oil companies, those are still interested to sign a deal with Iran, despite the risks, even as Tehran decided to expand its uranium enrichment programme rather than complying with a UN Security Council ultimatum to freeze it, which clears the path for further harsher sanctions (author) (ml)

  6. Caracterização dos cuidadores de candidatos a transplante do coração na UNIFESP Characterization of the patients' caregivers on the waiting list for heart transplant at UNIFESP

    Directory of Open Access Journals (Sweden)

    Regimar Carla Machado

    2007-12-01

    Full Text Available OBJETIVOS: Identificar e caracterizar o principal cuidador dos pacientes candidatos a transplante do coração; comparar as diferenças entre as informações coletadas com os pacientes e cuidadores; e classificar os cuidadores segundo a sua dedicação e eficiência na assistência ao paciente, correlacionando-os aos dados sociodemográficos. MÉTODOS: Estudo descritivo realizado de outubro de 2004 a março de 2005, no ambulatório da UNIFESP, por meio de entrevista estruturada, com amostragem de 21 pacientes e seus cuidadores. RESULTADOS: O principal cuidador era membro da família (95%, na maioria das vezes, o cônjuge, sendo 13 (81% mulheres e três (19% homens, com idade variando de 24 a 65 anos (média de 44,3. Declararam-se 56% casados; 43,8% católicos; 29% cursaram o ensino fundamental, 24% completaram o ensino médio e 14% tinham nível superior. Atividade profissional era exercida por 68,8% e 81,4% possuíam renda própria. Todos os cuidadores residiam na mesma casa que o paciente. Estabelecido um escore, classificaram-se os cuidadores em oito (50% "bons", sete (43,7% "regulares" e apenas um (6,3% foi considerado "ruim". Não encontramos correlação estatisticamente significante entre o escore e as variáveis escolaridade, atividade profissional e renda. CONCLUSÃO: É importante determinar os instrumentos para o reconhecimento e caracterização do cuidador. Neste estudo, identificou-se um familiar (cônjuge, do sexo feminino, com idade média de 44,3 anos, renda própria, classificados, na maioria, como "bons" ou "regulares", não havendo correlação com escolaridade, atividade profissional e renda. Novos estudos complementares, com casuística maior, deverão estabelecer a relação entre o papel do cuidador e os resultados do transplante cardíaco.OBJECTIVES: To identify and describe the main caregiver of the patients on the heart transplant waiting list; to compare relevant information provided by patients and caregivers, and

  7. The acceptability of waiting times for elective general surgery and the appropriateness of prioritising patients

    Directory of Open Access Journals (Sweden)

    Knol Dirk L

    2007-02-01

    Full Text Available Abstract Background Problematic waiting lists in public health care threaten the equity and timeliness of care provision in several countries. This study assesses different stakeholders' views on the acceptability of waiting lists in health care, their preferences for priority care of patients, and their judgements on acceptable waiting times for surgical patients. Methods A questionnaire survey was conducted among 257 former patients (82 with varicose veins, 86 with inguinal hernia, and 89 with gallstones, 101 surgeons, 95 occupational physicians, and 65 GPs. Judgements on acceptable waiting times were assessed using vignettes of patients with varicose veins, inguinal hernia, and gallstones. Results Participants endorsed the prioritisation of patients based on clinical need, but not on ability to benefit. The groups had significantly different opinions (p Acceptable waiting times ranged between 2 and 25 weeks depending on the type of disorder (p Conclusion The explicit prioritisation of patients seems an accepted means for reducing the overall burden from waiting lists. The disagreement about appropriate prioritisation criteria and the need for uniformity, however, raises concern about equity when implementing prioritisation in daily practice. Single factor waiting time thresholds seem insufficient for securing timely care provision in the presence of long waiting lists as they do not account for the different consequences of waiting between patients.

  8. Waiting Lines and Customer Satisfaction

    OpenAIRE

    Sridhar, M. S.

    2001-01-01

    The paper points out certain quantitative methods largely ignored by library service providers, highlights the importance of customer participation in service delivery process, examines the concepts service quality and customer satisfaction, emphasizes the need for appropriately handling waiting lines in service organisations, presents briefly the theory of waiting lines (queuing theory), psychology of customers in waiting lines with illustrations from library situations, discusses ways and m...

  9. Perceptions of cardiac rehabilitation patients, specialists and rehabilitation programs regarding cardiac rehabilitation wait times

    Directory of Open Access Journals (Sweden)

    Grace Sherry L

    2012-08-01

    Full Text Available Abstract Background In 2006, the Canadian Cardiovascular Society (CCS Access to Care Working Group recommended a 30-day wait time benchmark for cardiac rehabilitation (CR. The objectives of the current study were to: (1 describe cardiac patient perceptions of actual and ideal CR wait times, (2 describe and compare cardiac specialist and CR program perceptions of wait times, as well as whether the recommendations are appropriate and feasible, and (3 investigate actual wait times and factors that CR programs perceive to affect these wait times. Methods Postal and online surveys to assess perceptions of CR wait times were administered to CR enrollees at intake into 1 of 8 programs, all CCS member cardiac specialists treating patients indicated for CR, and all CR programs listed in Canadian directories. Actual wait times were ascertained from the Canadian Cardiac Rehabilitation Registry. The design was cross-sectional. Responses were described and compared. Results Responses were received from 163 CR enrollees, 71 cardiac specialists (9.3% response rate, and 92 CR programs (61.7% response rate. Patients reported that their wait time from hospital discharge to CR initiation was 65.6 ± 88.4 days (median, 42 days, while their ideal median wait time was 28 days. Most patients (91.5% considered their wait to be acceptable, but ideal wait times varied significantly by the type of cardiac indication for CR. There were significant differences between specialist and program perceptions of the appropriate number of days to wait by most indications, with CR programs perceiving shorter waits as appropriate (p  Conclusions Wait times following access to cardiac rehabilitation are prolonged compared with consensus recommendations, and yet are generally acceptable to most patients. Wait times following percutaneous coronary intervention in particular may need to be shortened. Future research is required to provide an evidence base for wait time

  10. Análise da mortalidade na lista de espera de fígado no Paraná, Brasil: o que devemos fazer para enfrentar a escassez de órgãos? Analysis of liver waiting list mortality in Paraná, Brazi: what shall we do to face organ shortage?

    Directory of Open Access Journals (Sweden)

    Fábio Silveira

    2012-06-01

    Full Text Available RACIONAL: O transplante hepático é a melhor modalidade terapêutica para pacientes em estágio final de doença hepática. Minimização de morte, enquanto se espera o procedimento, envolve priorização de acordo com o estado clínico e a alocação adequada de fígados de doadores. OBJETIVO: Análise da mortalidade na lista de espera de fígado no estado do Paraná, PR, Brasil. MÉTODOS: Foram analisados ​​os dados sobre todos os pacientes (n = 65 que foram registrados na lista de espera de fígado durante um período de 32 meses. RESULTADOS: A morte em lista de espera foi de 41,5% (n = 27. Nenhuma diferença estatística foi observada em relação aos MELD / MELD-Na entre o grupo que faleceu (19,88 / 21,6 e não morreu (17,28 / 19,47. MELD-Na previu maior mortalidade, especialmente no subgrupo de pacientes com gravidade intermediária da doença (classe B previsto pelo escore de CTP. CONCLUSÃO: É crítica a escassez de doadores de órgãos nessa região e a taxa de mortalidade em lista de espera excede em muito o risco inerente de um transplante de fígado, especialmente entre pacientes com MELD mais baixos. É desejável a utilização de um protocolo agressivo de doadores com critérios expandidos, split liver e transplante de doador vivo.BACKGROUND: Orthotopic liver transplantation is the best therapeutic modality for patients with end stage of liver disease. Minimization of death, while waiting for the procedure, involves accurate priorization according to clinical status and appropriate allocation of donor livers. AIM: The mortality analysis in the liver waiting list in Paraná state, PR, Brazil. METHODS: Were analyzed the data on all patients (n=65 who were registered on the liver waiting list during a 32 months period in the state of Paraná, southern Brazil. RESULTS: The death rated in waiting list was 41,5% (n=27. No statistic difference was observed regarding the MELD/MELD-Na scores between the group who died (19,88/21,6 and

  11. Pressão pulmonar aferida pela ecocardiografia em pacientes chagásicos indicados para transplante cardíaco Pulmonary pressure by echocardiophy in chagasic patients on heart transplant waiting list

    Directory of Open Access Journals (Sweden)

    Cláudio Léo Gelape

    2011-03-01

    pulmonary hypertension is a prognostic marker. OBJECTIVE: The aim of this study is to correlate pulmonary hypertension measured by echocardiogram versus catheterization in pre-heart transplant patients on waiting list. METHODS: Data from 90 patients of the Clinical Hospital UFMG were collected between 2004 and 2009. All the patients took an echo and catheterization as an integral part of pre-heart transplant. Mean age was 45.5 years old, 68 (75.6% male. Fourty-two (46.7% were Chagas' disease patients, 32 (35.6% presented idiopathic dilated cardiomyopathy, 10 (11.1% had ischemic cardyomiopathy. RESULTS: The mean eco-PASP was 45 ± 12mmHg. The mean cat-PASP was 47 ±14mmHg. The eco-PASP-Chagas was 41.7 ±12,5 mmHg and non-Chagas 47.6 ±12.8 mmHg P=0.04. The cat-PASP-Chagas was 46 ±12.1 mmHg and non-Chagas 48.7 ±12.8 mmHg P=0.43. Eight patients had cat-PASP>60. The correlation between eco-PASP and cat-PASP in Chagas' patients was r=0.45; P=0.008 and in the non-Chagas was r=0.66; P32,5mmHg has a sensitivity of 79% and specificity of 75% to diagnose PH, with an area under the curve of 0.819. The eco-PASP-non-Chagas>35.5 mmHg has a sensitivity of 82% and a specificity of 70% to diagnose PH, with an area under the curve of 0.776. CONCLUSIONS: There is a good correlation between eco-PASP and cat-PASP (r=0.54 in pre-heart transplant patients. The eco-PASP was lower in the Chagas' group. The echocardiogram is an important method to diagnosis and control pulmonary pressure in pre-heart transplant, specifically in Chagas' patients. The catheterization is still important to evaluate pulmonary reactivity during vasodilation test.

  12. Waiting experience in railway environments

    NARCIS (Netherlands)

    Hagen, van Mark; Galetzka, Mirjam; Pruyn, Ad Th.

    2014-01-01

    At railway stations, waiting time is usually an unavoidable aspect of the journey for train passengers. According to the attentional model of time, pleasant surroundings and other forms of distraction reduce perceived waiting time. Not every individual reacts identically in the same surroundings. Pa

  13. The eCALM Trial-eTherapy for cancer appLying mindfulness: online mindfulness-based cancer recovery program for underserved individuals living with cancer in Alberta: protocol development for a randomized wait-list controlled clinical trial

    Directory of Open Access Journals (Sweden)

    Zernicke Kristin A

    2013-02-01

    Full Text Available Abstract Background Elevated stress can exacerbate cancer symptom severity, and after completion of primary cancer treatments, many individuals continue to have significant distress. Mindfulness-Based Cancer Recovery (MBCR is an 8-week group psychosocial intervention consisting of training in mindfulness meditation and yoga designed to mitigate stress, pain, and chronic illness. Efficacy research shows face-to-face (F2F MBCR programs have positive benefits for cancer patients; however barriers exist that impede participation in F2F groups. While online MBCR groups are available to the public, none have been evaluated. Primary objective: determine whether underserved patients are willing to participate in and complete an online MBCR program. Secondary objectives: determine whether online MBCR will mirror previous efficacy findings from F2F MBCR groups on patient-reported outcomes. Method/design The study includes cancer patients in Alberta, exhibiting moderate distress, who do not have access to F2F MBCR. Participants will be randomized to either online MBCR, or waiting for the next available group. An anticipated sample size of 64 participants will complete measures online pre and post treatment or waiting period. Feasibility will be tracked through monitoring numbers eligible and participating through each stage of the protocol. Discussion 47 have completed/completing the intervention. Data suggest it is possible to conduct a randomized waitlist controlled trial of online MBCR to reach underserved cancer survivors. Trial registration Clinical Trials.gov Identifier: NCT01476891

  14. Evaluación nutricional de pacientes candidatos a lista de espera de trasplante renopancreático Nutritional assessment of patients candidates for waiting list simultaneous kidney pancreas transplantation

    Directory of Open Access Journals (Sweden)

    M.ª L. Iglesias

    2010-06-01

    subjective parameters of evaluation nutritional. Materials and methods: We included 45 patients with type 1 diabetes ERD interned in the Hospital Italiano of Buenos Aires for assessing pre Transplantation during the period June 2007-June 2008.Se collected data through a sheet produced by themselves. As parameter anthropometric was calculated body mass index (BMI by the formula Quetelet (post dialysis Weight (kg / height 2 (m and was ranked as the ranges proposed by the committee of experts from WHO. As a subjective argument took place the Subjective Global Valuation (VGS, which ranked patients in well-nourished (A, mild malnourished (B, moderately malnourished (C and severely malnourished (D. As biochemical parameters of the data was recorded serum albumin (g / dl to hospitalizations and this data was obtained from the patient's medical history. Results: The value of the average BMI of the total population was 21.83 ± 2.65. According to the sex values were: 21.83 ± 2.39 and 21.82 ± 2.95 for male and female respectively. The nutritional status according to this indicator was anthropometric Normal in 89% of cases. The 6.66% of the cases submitted 13.33% pre malnutrition and obesity. We found no cases with obesity. Taking into account the albumin 47.45% of patients presented moderate risk of morbidity and mortality. According to GSV 62.22% were classified as well-nourished (Class A. It was the equitable proportion of women and hombres.33, 33% were classified as mild malnourished (Class B. Only 2 cases (8.88% had moderate malnutrition (Class C. None presented malnutrition Graves (Class C. Conclussion: In our study we can see that patients are candidates for waiting list while normal BMI have presented evidence of nutritional risk when one takes into account the VGS and the average value of albumin.

  15. Priorización de pacientes en lista de espera para prótesis de rodilla y cadera: la opinión de los pacientes Prioritization of patients on the waiting list for hip and knee replacement: the patients' views

    Directory of Open Access Journals (Sweden)

    Antonio Escobar

    2005-10-01

    Full Text Available Objetivo: Explorar la opinión de los pacientes sobre criterios de priorización para las listas de espera en las intervenciones de prótesis de cadera y rodilla. Este estudio se enmarca en un proyecto más amplio, cuyo objetivo es elaborar un instrumento de criterios de priorización para las intervenciones de prótesis de cadera y rodilla. Material y métodos: Se realizó un estudio descriptivo con metodología de corte cualitativo, que proporciona información muy valiosa sobre cómo mejorar diferentes aspectos de la práctica clínica y detectar soluciones que ayuden en la toma de decisiones. Se establecieron 4 grupos focales en 2 momentos: 2 antes de la elaboración del instrumento de criterios de priorización y 2 después, con pacientes en lista de espera para ser intervenidos de prótesis de rodilla o cadera. Resultados: Un total de 31 pacientes participaron en los grupos focales. Todos los pacientes mostraron descontento con el funcionamiento de las listas de espera en la actualidad. El dolor, la limitación de la capacidad funcional y la repercusión que todo ello supone en el papel social de los pacientes fueron los aspectos más destacados en las reuniones. Conclusiones: A pesar de que el instrumento vaya a ser manejado por los profesionales, la participación de los pacientes en su elaboración y cumplimentación permite no sólo que se sientan más implicados en el proceso asistencial, sino también que la información recogida sea más completa y, al mismo tiempo, más representativa de la situación en la que se encuentran estos pacientes.Objective: To identify patients' views on the criteria used to prioritize patients on the waiting list for total hip or knee prostheses. This study is part of a wider project whose objective is to design an instrument to prioritize patients on the waiting list for both procedures. Material and methods: We performed a descriptive study with qualitative methodology that provides valuable

  16. The surgical waiting time initiative: A review of the Nigerian situation

    Directory of Open Access Journals (Sweden)

    Imran Haruna Abdulkareem

    2014-01-01

    Full Text Available The concept of surgical waiting time initiative (SWAT was introduced in developed countries to reduce elective surgery waiting lists and increase efficiency of care. It was supplemented by increasing popularity of day surgery, which shortens elective waiting lists and minimises cancellations. It is established in Western countries, but not in developing countries like Nigeria where it is still evolving. A search was carried out in Pub Med, Google, African journals online (AJOL, Athens and Ovid for relevant publications on elective surgery waiting list in Nigeria, published in English language. Words include waiting/wait time, waiting time initiative, time to surgery, waiting for operations, waiting for intervention, waiting for procedures and time before surgery in Nigeria. A total of 37 articles published from Nigeria in relation to various waiting times were found from the search and fulfilled the inclusion criteria. Among them, 11 publications (29.7% were related to emergency surgery waiting times, 10 (27% were related to clinic waiting times, 9 (24.3% were related to day case surgery, 2 (5.5% were related to investigation waiting times and only 5 (13.5% articles were specifically published on elective surgery waiting times. A total of 9 articles (24.5% were published from obstetrics and gynaecology (OG, 7 (19% from general surgery, 5 (13.5% from public health, 3 (8% from orthopaedics, 3 (8% from general practice (GP, 3 (8% from paediatrics/paediatric surgery, 2 (5.5% from ophthalmology, 1 (2.7% from ear, nose and throat (ENT, 1 (2.7% from plastic surgery, 1 (2.7% from urology and only 1 (2.7% article was published from dental/maxillofacial surgery. Waiting times mean different things to different health practitioners in Nigeria. There were only 5/37 articles (13.5% specifically related to elective surgery waiting times in Nigerian hospitals, which show that the concept of the SWAT is still evolving in Nigeria. Of the 37, 11 (24

  17. Strategy as active waiting.

    Science.gov (United States)

    Sull, Donald N

    2005-09-01

    Successful executives who cut their teeth in stable industries or in developed countries often stumble when they face more volatile markets. They falter, in part, because they assume they can gaze deep into the future and develop a long-term strategy that will confer a sustainable competitive advantage. But visibility into the future of volatile markets is sharply limited because so many different variables are in play. Factors such as technological innovation, customers' evolving needs, government policy, and changes in the capital markets interact with one another to create unexpected outcomes. Over the past six years, Donald Sull, an associate professor at London Business School, has led a research project examining some of the world's most volatile markets, from national markets like China and Brazil to industries like enterprise software, telecommunications, and airlines. One of the most striking findings from this research is the importance of taking action during comparative lulls in the storm. Huge business opportunities are relatively rare; they come along only once or twice in a decade. And, for the most part, companies can't manufacture those opportunities; changes in the external environment converge to make them happen. What managers can do is prepare for these golden opportunities by managing smart during the comparative calm of business as usual. During these periods of active waiting, leaders must probe the future and remain alert to anomalies that signal potential threats or opportunities; exercise restraint to preserve their war chests; and maintain discipline to keep the troops battle ready. When a golden opportunity or"sudden death"threat emerges, managers must have the courage to declare the main effort and concentrate resources to seize the moment.

  18. Wait for It

    Institute of Scientific and Technical Information of China (English)

    李义华

    1998-01-01

    朋友,你想购买电脑吗?本文的观点是:Wait for It!或曰:且慢! 东南亚的金融危机使其货币大幅度贬值。钱不值钱了,去购买电脑,从本质言,当然是一件“伤心”之举。因为:…bought with devalued coin,is significantly more expensive. 然而,货币之贬值并非劝君缓购电脑的根本原因所在: But it’s not just currency fluctuations that should influence your buying decision.There are also some other reasons—mostly centring on a computer’s most costlycomponent:the processor chip. processor chip者,俗称计算机的心脏——“芯片”也。现在已在使用Pentium 2chips,它与Pentium 166 megahertz processor chips的区别如何呢?本文介绍如下: …but with standard Pentium 166 megahertz processor chips from U.S.manufacturer Intel still costing,$380 a throw,and the latest Pentium 2 chips,whichrun at least double the speed of old-style Pentiums,costing three times that. 基于以上情况,the latest Pentium 2 chips是否会因货币的贬值而降价呢?老百姓的这个善良愿望和简单的推理是有违市场经济规律的: Consumer spending is generally more exposed to poor economic conditions,so thefa

  19. 46 CFR 9.10 - Waiting time.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Waiting time. 9.10 Section 9.10 Shipping COAST GUARD... § 9.10 Waiting time. The same construction should be given the act when charging for waiting time as... for duty the waiting time amounts to at least one hour....

  20. A model to prioritize access to elective surgery on the basis of clinical urgency and waiting time

    Directory of Open Access Journals (Sweden)

    Santori Gregorio

    2009-01-01

    Full Text Available Abstract Background Prioritization of waiting lists for elective surgery represents a major issue in public systems in view of the fact that patients often suffer from consequences of long waiting times. In addition, administrative and standardized data on waiting lists are generally lacking in Italy, where no detailed national reports are available. This is true although since 2002 the National Government has defined implicit Urgency-Related Groups (URGs associated with Maximum Time Before Treatment (MTBT, similar to the Australian classification. The aim of this paper is to propose a model to manage waiting lists and prioritize admissions to elective surgery. Methods In 2001, the Italian Ministry of Health funded the Surgical Waiting List Info System (SWALIS project, with the aim of experimenting solutions for managing elective surgery waiting lists. The project was split into two phases. In the first project phase, ten surgical units in the largest hospital of the Liguria Region were involved in the design of a pre-admission process model. The model was embedded in a Web based software, adopting Italian URGs with minor modifications. The SWALIS pre-admission process was based on the following steps: 1 urgency assessment into URGs; 2 correspondent assignment of a pre-set MTBT; 3 real time prioritization of every referral on the list, according to urgency and waiting time. In the second project phase a prospective descriptive study was performed, when a single general surgery unit was selected as the deployment and test bed, managing all registrations from March 2004 to March 2007 (1809 ordinary and 597 day cases. From August 2005, once the SWALIS model had been modified, waiting lists were monitored and analyzed, measuring the impact of the model by a set of performance indexes (average waiting time, length of the waiting list and Appropriate Performance Index (API. Results The SWALIS pre-admission model was used for all registrations in the

  1. Operations methods waiting line applications

    CERN Document Server

    Shaw, Ken

    2012-01-01

    The intent of this book is to help business practitioners and students expand their knowledge of how waiting line analysis can be used to address situations beyond the simple examples they were presented in basic operations courses. Throughout the book, practical examples are given and worked out to aid in understanding the material presented. Some emphasis is given to the caveats in applying waiting line theory and the importance of being aware of the assumptions used in developing that theory. The first chapters begin with a review of those simple examples and the terminology used for wai

  2. Cognitive performance and mood in patients on the waiting list for liver transplantation and their relation to the model for end-stage liver disease Desempenho cognitivo e humor em pacientes em lista de espera de transplante de fígado e suas relações com modelo para doença hepática e fase terminal

    Directory of Open Access Journals (Sweden)

    Eliane C. Miotto

    2010-02-01

    Full Text Available OBJECTIVE: To investigate the links between depression and cognitive functioning in patients with Hepatitis C and other chronic liver diseases with and without the use of alcohol on the waiting list for liver transplantation and their associations with the MELD classification. METHOD: 40 patients were evaluated on a waiting list for liver transplant by a battery of neuropsychological tests, depression scales and interview at the Liver Transplant Service, of the Hospital das Clínicas University of São Paulo Medical School. RESULTS: After splitting the sample according to the education, the results showed statistical significance in the comparisons between groups of MELD > 15 and OBJETIVO: Investigar as relações entre depressão e funcionamento cognitivo em pacientes portadores de hepatite C e demais doenças hepáticas crônicas com e sem uso de álcool em fila de espera para transplante hepático e suas relações com a classificação MELD. MÉTODO: Foram avaliados 40 pacientes em lista de espera para transplante hepático por bateria de testes neuropsicológicos, escalas de depressão e entrevista no Serviço de Transplante do Fígado do HC-FMUSP. RESULTADOS: Após divisão da amostra por escolaridade os resultados mostraram significância estatística nas comparações entre grupos de MELD > 15 e <15 nas funções: QI estimado, memória episódica de evocação tardia e de reconhecimento visuo-espacial e memória de curto prazo. CONCLUSÃO: As dificuldades encontradas, comuns ao quadro de encefalopatia hepática, corroboram a literatura pesquisada e enfatizam a necessidade de se investigar de maneira mais detalhada o funcionamento cognitivo destes pacientes, uma vez que diferentes condutas podem ser adotadas.

  3. Waiting time guarantee - an update

    DEFF Research Database (Denmark)

    Socha, Karolina; Bech, Mickael

    2008-01-01

    The rule of extended free choice of hospital, in force since 2002, provides patients with an option to choose a private hospital if the public system is unable to provide a treatment within the guaranteed waiting time of one month. In June 2008 the Government declared in their yearly budget agree...

  4. Review of "Waiting for Superman"

    Science.gov (United States)

    Dutro, Elizabeth

    2011-01-01

    "Waiting for Superman" offers what appear to be straightforward, commonsense solutions to inequities in schooling. The film argues that heroic action can be taken to fix what it portrays as the disaster of public schooling. The film disregards poverty as a factor in school performance and connection--and therefore never addresses anti-poverty…

  5. Brazil well worth the wait

    Energy Technology Data Exchange (ETDEWEB)

    Duey, R.

    1999-11-01

    Oil companies weren't the only ones waiting for Brazil to make up its mind about privatizing its oil and gas industry. Seismic firms are flocking to the area in droves to work their spec magic. Exploratory activities in these large offshore blocks are described.

  6. Reactions to a Targeted Intervention to Increase Fecal Occult Blood Testing among Average-Risk Adults Waiting for Screening Colonoscopy

    Directory of Open Access Journals (Sweden)

    S Elizabeth McGregor

    2011-01-01

    Full Text Available BACKGROUND: Increasing demand combined with limited capacity has resulted in long wait times for average-risk adults referred for screening colonoscopy for colorectal cancer. Management of patients on these growing wait lists is an emerging clinical issue.

  7. Perfil dos pacientes na Lista Única de Espera para transplante cardíaco no estado do Ceará Perfil de los pacientes en la lista única de espera para transplante cardíaco en el estado de Ceará Profile of patients in the Unified Waiting List for heart transplantation in state of Ceará

    Directory of Open Access Journals (Sweden)

    Francisca Elisângela Teixeira Lima

    2010-07-01

    descriptivo, documental y retrospectivo, con abordaje cuantitativo. Desarrollado en la Central de Transplante del Estado de Ceará, con 156 pacientes incluidos en la Lista Única de Espera del año 1999 al 2006. Los datos fueron organizados en figuras. RESULTADOS: Fueron encontrados: 80% del sexo masculino; 22,4% adultos jóvenes (20 a 40 años y 56,4% adultos de media edad (40 a 64 años, con una media de 36 años; 79% procedentes de Fortaleza-CE; 91% tenían miocardiopatía como causa del transplante cardíaco. Entre esos pacientes 102 (69% fueron transplantados; 37 (25% evolucionaron a óbito antes del transplante; y 8 (6% fueron excluidos por mejoría o empeoramiento del cuadro clínico. CONCLUSIÓN: Los pacientes de la Lista Única de Espera para transplante cardíaco en el Estado de Ceará, en el período de 1999 a 2006, eran del sexo masculino (80%, con franja etaria variando de 1 a 71 años, con predominio de miocardiopatía dilatada (53,4%, y el tiempo medio de espera fue de 136 días hasta el día del transplante cardíaco.BACKGROUND: Organ transplants have increased considerably in recent years because of technological developments and society's awareness for organ donation. OBJECTIVE: To describe the characteristics of the single list of patients waiting for heart transplantation; to identify the main heart diseases; and determine the average time a patient stays in the list until the surgery. METHODS: This is a descriptive, documentary and retrospective study with a quantitative approach. It was developed at the Transplant Center of the State of Ceará, with 156 patients included in Unified Waiting List from 1999 to 2006. Data were organized into figures. RESULTS: There were: 81% males; 22.4% of young adults (20 to 40 years old and 56.4% middle-aged adults (40 to 64 years old, averaging 36 years old; 79% from Fortaleza-CE; 91% with cardiomyopathy as a cause of heart transplantation. Among these, 102 patients (69% were transplanted; 37 (25% died before

  8. Advertising Emergency Department Wait Times

    Science.gov (United States)

    Weiner, Scott G.

    2013-01-01

    Advertising emergency department (ED) wait times has become a common practice in the United States. Proponents of this practice state that it is a powerful marketing strategy that can help steer patients to the ED. Opponents worry about the risk to the public health that arises from a patient with an emergent condition self-triaging to a further hospital, problems with inaccuracy and lack of standard definition of the reported time, and directing lower acuity patients to the higher cost ED setting instead to primary care. Three sample cases demonstrating the pitfalls of advertising ED wait times are discussed. Given the lack of rigorous evidence supporting the practice and potential adverse effects to the public health, caution about its use is advised. PMID:23599836

  9. Advertising emergency department wait times.

    Science.gov (United States)

    Weiner, Scott G

    2013-03-01

    Advertising emergency department (ED) wait times has become a common practice in the United States. Proponents of this practice state that it is a powerful marketing strategy that can help steer patients to the ED. Opponents worry about the risk to the public health that arises from a patient with an emergent condition self-triaging to a further hospital, problems with inaccuracy and lack of standard definition of the reported time, and directing lower acuity patients to the higher cost ED setting instead to primary care. Three sample cases demonstrating the pitfalls of advertising ED wait times are discussed. Given the lack of rigorous evidence supporting the practice and potential adverse effects to the public health, caution about its use is advised.

  10. Repetition in Waiting for Godot

    Institute of Scientific and Technical Information of China (English)

    李想; 魏妍

    2015-01-01

    Waiting for Godot is one of the most famous plays written by Samuel Barclay Beckett, and also is the founding work of“Theatre of the Absurd”. In the drama, repetitive phenomena shed light on the whole construction considerably. All the charac-ters were helpless and unthinking. Their dialogues were simple, nonsense and repetitive. Two scenes were cyclical. Repetition was used subtly in order to express the theme of the play, showing mental crisis after depravation of WWII.

  11. Queues with waiting time dependent service

    DEFF Research Database (Denmark)

    Bekker, R.; Koole, G. M.; Nielsen, Bo Friis

    2011-01-01

    Motivated by service levels in terms of the waiting-time distribution seen, for instance, in call centers, we consider two models for systems with a service discipline that depends on the waiting time. The first model deals with a single server that continuously adapts its service rate based...... on the waiting time of the first customer in line. In the second model, one queue is served by a primary server which is supplemented by a secondary server when the waiting of the first customer in line exceeds a threshold. Using level crossings for the waiting-time process of the first customer in line, we...

  12. 28 CFR 345.33 - Waiting list hiring exceptions.

    Science.gov (United States)

    2010-07-01

    ... provisions of this part will have the same benefits as any intra-industry transfer. (d) Disciplinary... assist in paying a significant financial obligation or for release preparation, the unit team...

  13. HIV MANAGEMENT ON A NEVER-ENDING WAITING LIST

    African Journals Online (AJOL)

    An initial Internet-based search for 'criteria' for patient selection for HIV/AIDS ... Even if the target of 100 000 on treatment were reached, this would still leave .... ARVs cannot be accessed by the 'average man on the street' but rather only by ...

  14. Waiting for surgery from the patient perspective

    Directory of Open Access Journals (Sweden)

    Tracey Carr

    2009-10-01

    Full Text Available Tracey Carr1, Ulrich Teucher2, Jackie Mann4, Alan G Casson31Health Sciences, 2Department of Psychology, 3Department of Surgery, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; 4Acute Care, Saskatoon Health Region, Saskatoon, Saskatchewan, CanadaAbstract: The aim of this study was to perform a systematic review of the impact of waiting for elective surgery from the patient perspective, with a focus on maximum tolerance, quality of life, and the nature of the waiting experience. Searches were conducted using Medline, PubMed, CINAHL, EMBASE, and HealthSTAR. Twenty-seven original research articles were identified which included each of these three themes. The current literature suggested that first, patients tend to state longer wait times as unacceptable when they experienced severe symptoms or functional impairment. Second, the relationship between length of wait and health-related quality of life depended on the nature and severity of proposed surgical intervention at the time of booking. Third, the waiting experience was consistently described as stressful and anxiety provoking. While many patients expressed anger and frustration at communication within the system, the experience of waiting was not uniformly negative. Some patients experienced waiting as an opportunity to live full lives despite pain and disability. The relatively unexamined relationship between waiting, illness and patient experience of time represents an area for future research.Keywords: wait time, scheduled surgery, patient perspective, literature review

  15. Mobile Technology Waiting for the 3G Rush

    Institute of Scientific and Technical Information of China (English)

    HAYET SELLAMI

    2006-01-01

    @@ China is potentially the biggest third generation (3G) mobile market in the world, and everyone is eager to grab a piece of the pie. Foreign carriers are still not allowed to apply for licences since China's decision regarding licensing and adoption of 3G mobile services is still pending, but the waiting list is long. Both Chinese officials and industry executives have stated that they want 3G in place in time for the August 2008 Olympic Games held in Beijing. This tight deadline leaves no room for failure.

  16. Wait too long to talk about kidney disease and you could be waiting for a kidney.

    Science.gov (United States)

    ... Home Current Issue Past Issues Public Service Announcement Kidney Disease Past Issues / Summer 2006 Table of Contents ... Javascript on. Wait too long to talk about kidney disease and you could be waiting for a ...

  17. Interventions to reduce waiting times for elective procedures.

    Science.gov (United States)

    Ballini, Luciana; Negro, Antonella; Maltoni, Susanna; Vignatelli, Luca; Flodgren, Gerd; Simera, Iveta; Holmes, Jane; Grilli, Roberto

    2015-02-23

    Long waiting times for elective healthcare procedures may cause distress among patients, may have adverse health consequences and may be perceived as inappropriate delivery and planning of health care. To assess the effectiveness of interventions aimed at reducing waiting times for elective care, both diagnostic and therapeutic. We searched the following electronic databases: Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (1946-), EMBASE (1947-), the Cumulative Index to Nursing and Allied Health Literature (CINAHL), ABI Inform, the Canadian Research Index, the Science, Social Sciences and Humanities Citation Indexes, a series of databases via Proquest: Dissertations & Theses (including UK & Ireland), EconLit, PAIS (Public Affairs International), Political Science Collection, Nursing Collection, Sociological Abstracts, Social Services Abstracts and Worldwide Political Science Abstracts. We sought related reviews by searching the Cochrane Database of Systematic Reviews and the Database of Abstracts of Reviews of Effectiveness (DARE). We searched trial registries, as well as grey literature sites and reference lists of relevant articles. We considered randomised controlled trials (RCTs), controlled before-after studies (CBAs) and interrupted time series (ITS) designs that met EPOC minimum criteria and evaluated the effectiveness of any intervention aimed at reducing waiting times for any type of elective procedure. We considered studies reporting one or more of the following outcomes: number or proportion of participants whose waiting times were above or below a specific time threshold, or participants' mean or median waiting times. Comparators could include any type of active intervention or standard practice. Two review authors independently extracted data from, and assessed risk of bias of, each included study, using a standardised form and the EPOC 'Risk

  18. Consumer Perception and Evaluation of Waiting Time

    NARCIS (Netherlands)

    G. Antonides (Gerrit); P.C. Verhoef (Peter)

    2000-01-01

    textabstractTelephone waiting times for a commercial service were varied in two different experiments. In the first experiment, the telephone rate was either zero or fixed at Dfl.1.- (approx. $0.40) per minute. Consumer perceptions of waiting times could be described best by a psychophysical power f

  19. The Religious Meaning in "Waiting for Godot"

    Science.gov (United States)

    Wang, Jing

    2011-01-01

    "Waiting for Godot" is one of the classic works of theater of the absurd. The play seems absurd but with a deep religious meaning. This text tries to explore the theme in four parts of God and man, breaking the agreement, repentance and imprecation and waiting for salvation.

  20. Opportunities for Network Coding: To Wait or Not to Wait

    CERN Document Server

    Hsu, Yu-Pin; Ramasamy, Solairaja; Gautam, Natarajan; Sprintson, Alex; Shakkottai, Srinivas

    2011-01-01

    It has been well established that reverse-carpooling based network coding can significantly improve the efficiency of multi-hop wireless networks. However, in a stochastic environment when there are no opportunities to code because of packets without coding pairs, should these packets wait for a future opportunity or should they be transmitted without coding? To help answer that question we formulate a stochastic dynamic program with the objective of minimizing the long-run average cost per unit time incurred due to transmissions and delays. In particular, we develop optimal control actions that would balance between costs of transmission against those of delays. In that process we seek to address a crucial question: what should be observed as the state of the system We analytically show that just the queue lengths is enough if it can be modeled as a Markov process. Subsequently we show that a stationary policy based on queue lengths is optimal and describe a procedure to find such a policy. We further substa...

  1. In the queue for total joint replacement: patients' perspectives on waiting times. Ontario Hip and Knee Replacement Project Team.

    Science.gov (United States)

    Llewellyn-Thomas, H A; Arshinoff, R; Bell, M; Williams, J I; Naylor, C D

    1998-02-01

    We assessed patients on the waiting lists of a purposive sample of orthopaedic surgeons in Ontario, Canada, to determine patients' attitudes towards time waiting for hip or knee replacement. We focused on 148 patients who did not have a definite operative date, obtaining complete information on 124 (84%). Symptom severity was assessed with the Western Ontario/McMaster Osteoarthritis Index and a disease-specific standard gamble was used to elicit patients' overall utility for their arthritic state. Next, in a trade-off task, patients considered a hypothetical choice between a 1-month wait for a surgeon who could provide a 2% risk of post-operative mortality, or a 6-month wait for joint replacement with a 1% risk of post-operative mortality. Waiting times were then shifted systematically until the patient abandoned his/her initial choice, generating a conditional maximal acceptable wait time. Patients were divided in their attitudes, with 57% initially choosing a 6-month wait with a 1% mortality risk. The overall distribution of conditional maximum acceptable wait time scores ranged from 1 to 26 months, with a median of 7 months. Utility values were independently but weakly associated with patients' tolerance of waiting times (adjusted R-square = 0.059, P = 0.004). After splitting the sample along the median into subgroups with a relatively 'low' and 'high' tolerance for waiting, the subgroup with the apparently lower tolerance for waiting reported lower utility scores (z = 2.951; P = 0.004) and shorter times since their surgeon first advised them of the need for surgery (z = 3.014; P = 0.003). These results suggest that, in the establishment and monitoring of a queue management system for quality-of-life-enhancing surgery, patients' own perceptions of their overall symptomatic burden and ability to tolerate delayed relief should be considered along with information derived from clinical judgements and pre-weighted health status instruments.

  2. Financial cost to institutions on patients waiting for gall bladder disease surgery.

    Science.gov (United States)

    Waqas, Ahmed; Qasmi, Shahzad Ahmed; Kiani, Faran; Raza, Ahmed; Khan, Khizar Ishtiaque; Manzoor, Shazia

    2014-01-01

    The aim of this study was to determine the financial costs to institution on patients waiting for gall bladder disease surgery and suggest measures to reduce them. This multi-centre prospective descriptive survey was performed on all patients who underwent an elective cholecystectomy by three consultants at secondary care hospitals in Pakistan between Jan 2010 to Jan 2012. Data was collected on demographics, the duration of mean waiting time, specific indications and nature of disease for including the patients in the waiting list, details of emergency re-admissions while awaiting surgery, investigations done, treatment given and expenditures incurred on them during these episodes. A total of 185 patients underwent elective open cholecystectomy. The indications for listing the patients for surgery were biliary colic in 128 patients (69%), acute cholecystitis in 43 patients (23%), obstructive jaundice in 8 patients (4.5%) and acute pancreatitis in 6 patients (3.2%). 146 (78.9%) and 39 (21.1%) of patients were listed as outdoor electives and indoor emergencies respectively. Of the 185 patients, 54 patients (29.2%) were re-admitted. Financial costs in Pakistani rupees per episode of readmission were 23050 per episode in total and total money spent on all readmissions was Rs. 17,05,700/-. Financial costs on health care institutions due to readmissions in patients waiting for gall bladder disease surgery are high. Identifying patients at risk for these readmissions and offering them early laparoscopic cholecystectomy is very important.

  3. Waiting time distributions in financial markets

    Science.gov (United States)

    Sabatelli, L.; Keating, S.; Dudley, J.; Richmond, P.

    2002-05-01

    We study waiting time distributions for data representing two completely different financial markets that have dramatically different characteristics. The first are data for the Irish market during the 19th century over the period 1850 to 1854. A total of 10 stocks out of a database of 60 are examined. The second database is for Japanese yen currency fluctuations during the latter part of the 20th century (1989-1992). The Irish stock activity was recorded on a daily basis and activity was characterised by waiting times that varied from one day to a few months. The Japanese yen data was recorded every minute over 24 hour periods and the waiting times varied from a minute to a an hour or so. For both data sets, the waiting time distributions exhibit power law tails. The results for Irish daily data can be easily interpreted using the model of a continuous time random walk first proposed by Montroll and applied recently to some financial data by Mainardi, Scalas and colleagues. Yen data show a quite different behaviour. For large waiting times, the Irish data exhibit a cut off; the Yen data exhibit two humps that could arise as result of major trading centres in the World.

  4. Use of queue modelling in the analysis of elective patient treatment governed by a maximum waiting time policy

    DEFF Research Database (Denmark)

    Kozlowski, Dawid; Worthington, Dave

    2015-01-01

    Many public healthcare systems struggle with excessive waiting lists for elective patient treatment. Different countries address this problem in different ways, and one interesting method entails a maximum waiting time guarantee. Introduced in Denmark in 2002, it entitles patients to treatment at...... by hospital planners and strategic decision makers....... at a private hospital in Denmark or at a hospital abroad if the public healthcare system is unable to provide treatment within the stated maximum waiting time guarantee. Although clearly very attractive in some respects, many stakeholders have been very concerned about the negative consequences of the policy...... on the utilization of public hospital resources. This paper illustrates the use of a queue modelling approach in the analysis of elective patient treatment governed by the maximum waiting time policy. Drawing upon the combined strengths of analytic and simulation approaches we develop both continuous-time Markov...

  5. Protocol to Exploit Waiting Resources for UASNs

    Directory of Open Access Journals (Sweden)

    Li-Ling Hung

    2016-03-01

    Full Text Available The transmission speed of acoustic waves in water is much slower than that of radio waves in terrestrial wireless sensor networks. Thus, the propagation delay in underwater acoustic sensor networks (UASN is much greater. Longer propagation delay leads to complicated communication and collision problems. To solve collision problems, some studies have proposed waiting mechanisms; however, long waiting mechanisms result in low bandwidth utilization. To improve throughput, this study proposes a slotted medium access control protocol to enhance bandwidth utilization in UASNs. The proposed mechanism increases communication by exploiting temporal and spatial resources that are typically idle in order to protect communication against interference. By reducing wait time, network performance and energy consumption can be improved. A performance evaluation demonstrates that when the data packets are large or sensor deployment is dense, the energy consumption of proposed protocol is less than that of existing protocols as well as the throughput is higher than that of existing protocols.

  6. Protocol to Exploit Waiting Resources for UASNs.

    Science.gov (United States)

    Hung, Li-Ling; Luo, Yung-Jeng

    2016-03-08

    The transmission speed of acoustic waves in water is much slower than that of radio waves in terrestrial wireless sensor networks. Thus, the propagation delay in underwater acoustic sensor networks (UASN) is much greater. Longer propagation delay leads to complicated communication and collision problems. To solve collision problems, some studies have proposed waiting mechanisms; however, long waiting mechanisms result in low bandwidth utilization. To improve throughput, this study proposes a slotted medium access control protocol to enhance bandwidth utilization in UASNs. The proposed mechanism increases communication by exploiting temporal and spatial resources that are typically idle in order to protect communication against interference. By reducing wait time, network performance and energy consumption can be improved. A performance evaluation demonstrates that when the data packets are large or sensor deployment is dense, the energy consumption of proposed protocol is less than that of existing protocols as well as the throughput is higher than that of existing protocols.

  7. Time while waiting: patients' experiences of scheduled surgery.

    Science.gov (United States)

    Carr, Tracey; Teucher, Ulrich C; Casson, Alan G

    2014-12-01

    Research on patients' experiences of wait time for scheduled surgery has centered predominantly on the relative tolerability of perceived wait time and impacts on quality of life. We explored patients' experiences of time while waiting for three types of surgery with varied wait times--hip or knee replacement, shoulder surgery, and cardiac surgery. Thirty-two patients were recruited by their surgeons. We asked participants about their perceptions of time while waiting in two separate interviews. Using interpretative phenomenological analysis (IPA), we discovered connections between participant suffering, meaningfulness of time, and agency over the waiting period and the lived duration of time experience. Our findings reveal that chronological duration is not necessarily the most relevant consideration in determining the quality of waiting experience. Those findings helped us create a conceptual framework for lived wait time. We suggest that clinicians and policy makers consider the complexity of wait time experience to enhance preoperative patient care.

  8. Housing Lease Market: Waiting to Be Explored

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    @@ Want to buy a house in China? As an expat, you have to wait at least one year to qualify for leasing after going through a series of complex procedures.If you are a newcomer to China or are staying heretemporarily, in the light of the high costs of hotel accommodations, perhaps renting an apartment is your best bet.

  9. Waiting on More than 64 Handles

    Science.gov (United States)

    2015-10-01

    parameter stuct is comprised of an array of handles with a maximum size of MAX_WAIT_OBJECTS and an integer holding the total quantity. Once all the...GIDEP Operations Center P.O. Box 8000 Corona , CA 91718-8000 gidep@gidep.org UNCLASSIFIED Approved for public release; distribution is unlimited. 4 Patricia Alameda Patricia Alameda Andrew Pskowski

  10. Health-related quality of life in patients waiting for major joint replacement. A comparison between patients and population controls

    Directory of Open Access Journals (Sweden)

    Seitsalo Seppo

    2006-01-01

    Full Text Available Abstract Background Several quality-of-life studies in patients awaiting major joint replacement have focused on the outcomes of surgery. Interest in examining patients on the elective waiting list has increased since the beginning of 2000. We assessed health-related quality of life (HRQoL in patients waiting for total hip (THR or knee (TKR replacement in three Finnish hospitals, and compared patients' HRQoL with that of population controls. Methods A total of 133 patients awaiting major joint replacement due to osteoarthritis (OA of the hip or knee joint were prospectively followed from the time the patient was placed on the waiting list to hospital admission. A sample of controls matched by age, gender, housing and home municipality was drawn from the computerised population register. HRQoL was measured by the generic 15D instrument. Differences between patients and the population controls were tested by the independent samples t-test and between the measurement points by the paired samples t-test. A linear regression model was used to explain the variance in the 15D score at admission. Results At baseline, 15D scores were significantly different between patients and the population controls. Compared with the population controls, patients were worse off on the dimensions of moving (P Conclusion Although patients' HRQoL did not deteriorate while waiting, a consistently worse HRQoL was observed in patients waiting for major joint replacement compared with population controls.

  11. Waiting time distribution in M/D/1 queueing systems

    DEFF Research Database (Denmark)

    Iversen, Villy Bæk; Staalhagen, Lars

    1999-01-01

    The well-known formula for the waiting time distribution of M/D/1 queueing systems is numerically unsuitable when the load is close to 1.0 and/or the results for a large waiting time are required. An algorithm for any load and waiting time is presented, based on the state probabilities of M/D/1...

  12. [SPCCTV and SPC Recommendations Related to the Waiting Times for Cardiac Surgery].

    Science.gov (United States)

    Neves, José Pedro; Pereira, Hélder; Sousa-Uva, Miguel; Gavina, Cristina; Leite Moreira, Adelino; Loureiro, Maria José; Silva Cardoso, José

    2014-01-01

    Appointed jointly by the Portuguese Society for Cardiothoracic and Vascular Surgery (SPCCTV) and by the Portuguese Society of Cardiology (SPC), the Working Group related to the Waiting Times for Cardiac Surgery was created with the aim of developing practical recommendations about clinically acceptable waiting times for the three critical phases of the care of adults with a cardiac disease that require surgery or an intervention: cardiology appointments; diagnostic process and invasive therapy. Cardiac surgery has its own characteristics, not comparable to other surgical specialties and, therefore, it is important to reduce its maximum waiting times and, also, increase the efficacy of the systems which are responsible to monitor and trace the patient. The information given in this document was based, mostly, in available clinical information. The methodology used to establish the criteria was based on studies regarding disease's natural history, clinical studies that compared medical treatment with intervention, retrospective and prospective analysis of patients included on a waiting list, and experts or working groups' opinions. After this first step, marked by this publication, the SPCCTV and the SPC PSC should be considered as natural interlocutors about this matter and they are committed to decisively contribute to the definition of operational strategies through the adaption of the clinical evidence with reality and with the available resources.

  13. Neural activity of orbitofrontal cortex contributes to control of waiting.

    Science.gov (United States)

    Xiao, Xiong; Deng, Hanfei; Wei, Lei; Huang, Yanwang; Wang, Zuoren

    2016-09-01

    The willingness to wait for delayed reward and information is of fundamental importance for deliberative behaviors. The orbitofrontal cortex (OFC) is thought to be a core component of the neural circuitry underlying the capacity to control waiting. However, the neural correlates of active waiting and the causal role of the OFC in the control of waiting still remain largely unknown. Here, we trained rats to perform a waiting task (waiting for a pseudorandom time to obtain the water reward), and recorded neuronal ensembles in the OFC throughout the task. We observed that subset OFC neurons exhibited ramping activities throughout the waiting process. Receiver operating characteristic analysis showed that neural activities during the waiting period even predicted the trial outcomes (patient vs. impatient) on a trial-by-trial basis. Furthermore, optogenetic activation of the OFC during the waiting period improved the waiting performance, but did not influence rats' movement to obtain the reward. Taken together, these findings reveal that the neural activity in the OFC contributes to the control of waiting.

  14. Policy strategies to reduce waits for elective care: a synthesis of international evidence.

    Science.gov (United States)

    Kreindler, Sara A

    2010-01-01

    This synthesis seeks to assess and explain the effectiveness of policy interventions to reduce elective wait times or lists. PubMed, EMBASE, EconLit, and grey literature were systematically searched for relevant studies and reviews. Strategies with the strongest evidence base include paying for activity, buying capacity locally and setting targets with strong incentives. There is also evidence for improving the use of existing capacity. Limiting demand through rationing can reduce waits, but is ethically problematic. Short-term injections of funding, cross-border treatment schemes, unenforced targets and promotion of private health insurance had the weakest evidence. Available evidence favours options that act fairly directly on supply, demand or local organizations' behaviour, over indirect strategies that depend on a 'domino effect'. Further research is needed to determine how to achieve major, system-wide improvements in the use of capacity.

  15. Deadlocks and waiting times in traffic jam

    OpenAIRE

    Mukherji, Sutapa; Bhattacharjee, Somendra M.

    1997-01-01

    In a city of right moving and upmoving cars with hardcore constraint, traffic jam occurs in the form of bands. We show how the bands are destroyed by a small number of strictly left moving cars yielding a deadlock phase with a rough edge of left cars. We also show that the probability of waiting time at a signal for a particular tagged car has a power law dependence on time, indicating the absence of any characteristic time scale for an emergent traffic jam. The exponent is same for both the ...

  16. In the post-colonial waiting room

    DEFF Research Database (Denmark)

    Adler-Nissen, Rebecca; Gad, Ulrik Pram

    2017-01-01

    This chapter investigates this puzzle of choosing non-sovereignty in a postcolonial setting. Historically, the question of freedom from imperial hegemony has been linked to how Western colonialism involved keeping the colonized in ‘the waiting room of history’ by insisting that they were not yet...... the colonizers leave so that the colonized people could decide for themselves. Many anti-imperial struggles settled for nation-states each acquiring a separate, formal sovereignty-based international status. More recent versions of postcolonialism, inspired by poststructuralism and critical constructivism, have...

  17. Using Social Media While Waiting in Pain: A Clinical 12-Week Longitudinal Pilot Study.

    Science.gov (United States)

    Merolli, Mark; Gray, Kathleen; Martin-Sanchez, Fernando; Mantopoulos, Steven; Hogg, Malcolm

    2015-08-07

    Chronic pain places an enormous burden on health care systems. Multidisciplinary pain management services are well documented as an effective means to improve patient outcomes. However, waiting lists to access these services are long and outcomes deteriorate. Innovative solutions such as social media are gaining attention as a way to decrease this burden and improve outcomes. It is a challenge to design research that demonstrates whether social media are acceptable to patients and clinically effective. The aim was to conduct a longitudinal pilot study to understand what aspects of research design are key to the success of running a larger-scale study of social media use in the clinical management of chronic pain. A 12-week study examined social media use by patients on the waiting list for the Royal Melbourne Hospital Pain Management Service. Selected social media resources were suggested for use by patients waiting for an appointment at the clinic. Patients filled out measures for pain interference and pain self-efficacy before and after the study. Follow-up was conducted at monthly intervals via telephone semistructured interviews to discuss engagement and garner individual perceptions towards social media use. A social media-use instrument was also administered as part of the after-study questionnaire. Targeted recruitment refined 235 patient referrals to 138 (58.7%) suitable potential participants. Contact was made with 84 out of 138 (60.9%) patients. After a further exclusion of 54 out of 84 (64%) patients for various reasons, this left 30 out of 84 (36%) patients fitting the inclusion criteria and interested in study participation. A final study cohort of 17 out of 30 (57%) was obtained. Demographics of the 17 patients were mixed. Low back pain was the primary condition reported as leading to chronic pain. Semistructured interviews collected data from 16 out of 17 (94%) patients who started the trial, and at final follow-up 9 out of 17 (53%) patients

  18. Revisiting Waiting Times in DNA evolution

    CERN Document Server

    Nicodeme, Pierre

    2012-01-01

    Transcription factors are short stretches of DNA (or $k$-mers) mainly located in promoters sequences that enhance or repress gene expression. With respect to an initial distribution of letters on the DNA alphabet, Behrens and Vingron consider a random sequence of length $n$ that does not contain a given $k$-mer or word of size $k$. Under an evolution model of the DNA, they compute the probability $\\mathfrak{p}_n$ that this $k$-mer appears after a unit time of 20 years. They prove that the waiting time for the first apparition of the $k$-mer is well approximated by $T_n=1/\\mathfrak{p}_n$. Their work relies on the simplifying assumption that the $k$-mer is not self-overlapping. They observe in particular that the waiting time is mostly driven by the initial distribution of letters. Behrens et al. use an approach by automata that relaxes the assumption related to words overlaps. Their numerical evaluations confirms the validity of Behrens and Vingron approach for non self-overlapping words, but provides up to 44...

  19. Definitive Chemoradiotherapy ("Watch-and-Wait" Approach).

    Science.gov (United States)

    Goodman, Karyn A

    2016-07-01

    Preoperative chemoradiotherapy (CRT) followed by total mesorectal excision has been the standard of care for locally advanced patients with rectal cancer. Some patients achieve a pathologic complete response (pCR) to CRT and the oncologic outcomes are particularly favorable in this group. The role of surgery in patients with a pCR is now being questioned as radical rectal resection is associated with significant morbidity and long-term effects on quality of life. In an attempt to better tailor therapy, there is an interest in a "watch-and-wait" approach in patients who have a clinical complete response (cCR) after CRT with the goal of omitting surgery and allowing for organ preservation. However, a cCR does not always indicate a pCR, and improved clinical and imaging modalities are needed to better predict which patients have achieved a pCR and therefore can safely undergo a "watch-and-wait" approach. This article reviews the current data on nonoperative management and on-going controversies associated with this approach.

  20. 'Waiting for' and 'waiting in' public and private hospitals: a qualitative study of patient trust in South Australia.

    Science.gov (United States)

    Ward, Paul R; Rokkas, Philippa; Cenko, Clinton; Pulvirenti, Mariastella; Dean, Nicola; Carney, A Simon; Meyer, Samantha

    2017-05-05

    Waiting times for hospital appointments, treatment and/or surgery have become a major political and health service problem, leading to national maximum waiting times and policies to reduce waiting times. Quantitative studies have documented waiting times for various types of surgery and longer waiting times in public vs private hospitals. However, very little qualitative research has explored patient experiences of waiting, how this compares between public and private hospitals, and the implications for trust in hospitals and healthcare professionals. The aim of this paper is to provide a deep understanding of the impact of waiting times on patient trust in public and private hospitals. A qualitative study in South Australia, including 36 in-depth interviews (18 from public and 18 from private hospitals). Data collection occurred in 2012-13, and data were analysed using pre-coding, followed by conceptual and theoretical categorisation. Participants differentiated between experiences of 'waiting for' (e.g. for specialist appointments and surgery) and 'waiting in' (e.g. in emergency departments and outpatient clinics) public and private hospitals. Whilst 'waiting for' public hospitals was longer than private hospitals, this was often justified and accepted by public patients (e.g. due to reduced government funding), therefore it did not lead to distrust of public hospitals. Private patients had shorter 'waiting for' hospital services, increasing their trust in private hospitals and distrust of public hospitals. Public patients also recounted many experiences of longer 'waiting in' public hospitals, leading to frustration and anxiety, although they rarely blamed or distrusted the doctors or nurses, instead blaming an underfunded system and over-worked staff. Doctors and nurses were seen to be doing their best, and therefore trustworthy. Although public patients experienced longer 'waiting for' and 'waiting in' public hospitals, it did not lead to widespread distrust

  1. TSA Security Checkpoint Wait Times – API (PMIS)

    Data.gov (United States)

    Department of Homeland Security — TSA operational data including: Airport wait time (hourly) data Airport throughput (hourly) data Prohibited item (hourly) data Monthly Objectives Report (MOR) data...

  2. Which patients wait longer to be seen and when? A waiting time study in the emergency department.

    Science.gov (United States)

    Elkum, N; Fahim, M; Shoukri, M; Al-Madouj, A

    2009-01-01

    We investigated the waiting time for patients before seeing a physician in the emergency department of a tertiary care hospital in Riyadh, Saudi Arabia. Bi- and multivariate analyses of routine data for 2187 patients determined the association between selected patient characteristics and waiting time. The median waiting time between triage and being seen by a physician was 35.0 min (range 1.0-325.0 min). Age, day of arrival, time of arrival and triage category were significantly associated with waiting time. Older patients and those arriving on Sundays and Wednesdays waited longer. Variability in waiting times could be addressed by more standardized triage policies, but may also be influenced by other clinical or non-clinical factors that required further investigation.

  3. Regional differences in waiting time to pregnancy

    DEFF Research Database (Denmark)

    Juul, Svend; Karmaus, W; Olsen, Jørn

    1999-01-01

    of the pregnancies were planned (64%) and approximately 14% were the result of contraceptive failures. The study shows that smoking, body mass index, age and parity did not explain the differences in fecundity found between the centres. Regional differences in fecundity exist and the causes may be genetic or due......The objective of this study was examine geographical variation in couple fecundity in Europe. The study was based upon all recently pregnant (or still pregnant) women within well-defined geographical areas in Europe (Denmark, Germany, Italy, Sweden and France) at a given time period in 1992....... Altogether, 4035 women responded to a highly structured questionnaire. Highest fecundity was found in Southern Italy and Northern Sweden; lowest fecundity was seen in data from the East German centre. Approximately 16% of the study population had a waiting time of more than 12 months to become pregnant. Most...

  4. What Are We Waiting For Customer Wait Time, Fill Rate, And Marine Corps Equipment Operational Availability

    Science.gov (United States)

    2016-12-01

    their Performance Based Logistics ( PBL ) Support Guidebook, but adds a time element by defining the term as “the volume of requisitions satisfied within...41(1), 19–23. Defense Contract Management Agency. (2002). Performance based logistics ( PBL ) support guidebook. Retrieved from: https://acc.dau.mil...adl/en-US/54825/file/ 18745/ PBL -GUIDE.doc Department of Defense. (2000). Customer wait time and time definite delivery (DODI 4140.61). Washington, DC

  5. Waiting Time Policies in the Health Care Sector. What Works?

    DEFF Research Database (Denmark)

    Christiansen, Terkel; Bech, Mickael

    2013-01-01

    choice of hospital for somatic and psychiatric patients, short maximum waiting time guarantee for life-threatening diseases coupled with care packages for cancer and heart diseases and extra-activity targeted hospital grants. There are good reasons to believe that these policies have reduced waiting...

  6. Waiting for Merlot: anticipatory consumption of experiential and material purchases.

    Science.gov (United States)

    Kumar, Amit; Killingsworth, Matthew A; Gilovich, Thomas

    2014-10-01

    Experiential purchases (money spent on doing) tend to provide more enduring happiness than material purchases (money spent on having). Although most research comparing these two types of purchases has focused on their downstream hedonic consequences, the present research investigated hedonic differences that occur before consumption. We argue that waiting for experiences tends to be more positive than waiting for possessions. Four studies demonstrate that people derive more happiness from the anticipation of experiential purchases and that waiting for an experience tends to be more pleasurable and exciting than waiting to receive a material good. We found these effects in studies using questionnaires involving a variety of actual planned purchases, in a large-scale experience-sampling study, and in an archival analysis of news stories about people waiting in line to make a purchase. Consumers derive value from anticipation, and that value tends to be greater for experiential than for material purchases.

  7. Cardiac evaluation in pediatric patients waiting for liver transplantation

    Directory of Open Access Journals (Sweden)

    Seyed Mohsen Dehghani, Naser Honar, Hamid Amoozegar, Ahad Eshraghian, Mohammad Borzooei, Mohammad Hadi Imanieh, Seyed Ali Malek-Hosseini

    2010-01-01

    Full Text Available Background: Cardiovascular abnormalities are among common complication in patients with cirrhosis waiting for liver transplantation (LT. The aim of the present study was to investigate cardiac abnormalities among pediatric liver transplant candidates.Methods: We prospectively evaluated the pediatric patient aged less than 18 years listed for LT between 2006 and 2008. Besides history taking and physical examination all the patients underwent electrocardiogram, chest radiograph, contrast echocardiography and color Doppler echocardiography, as well as arterial blood gas analyses.Results: Totally 89 patients with mean age of 8.1±4.6 years were included in the study. The most common causes for liver disease were cryptogenic cirrhosis followed by biliary atresia and autoimmune cirrhosis. Clubbing was found in 27 out of 89 patients and was the most common abnormalities in physical examination. In 22 patients (24.7% heart murmur was heard by a pediatric cardiologist. Sixty nine patients (77.5% had normal cardiac findings in chest radiograph. Cardiomegaly was found in 17 (19.1% patients as the most common abnormal finding in chest radiograph. Electrocardiogram showed sinus tachycardia in 16 (18% patients. Eleven patients (12.4% had tricuspid regurgitation as the most common abnormal findings in echocardiography. Thirteen (14.6% patients had positive contrast echocardiography in favor of intrapulmonary shunt.Conclusion: As the leading cause of post transplant death after graft rejection are cardiovascular complications cardiac evaluation should be considered in all pediatric patients before LT to lower morbidity and mortality during and after transplantation.

  8. Real waiting times for surgery. Proposal for an improved system for their management

    Directory of Open Access Journals (Sweden)

    Ignacio Abásolo

    2014-05-01

    Conclusion: Total waiting times are between two and five times higher than those officially published. The relationship between the waiting times at each stage of the medical procedure may be used to decrease variability and maximum waiting times.

  9. Reducing outpatient waiting time: a simulation modeling approach.

    Science.gov (United States)

    Aeenparast, Afsoon; Tabibi, Seyed Jamaleddin; Shahanaghi, Kamran; Aryanejhad, Mir Bahador

    2013-09-01

    The objective of this study was to provide a model for reducing outpatient waiting time by using simulation. A simulation model was constructed by using the data of arrival time, service time and flow of 357 patients referred to orthopedic clinic of a general teaching hospital in Tehran. The simulation model was validated before constructing different scenarios. In this study 10 scenarios were presented for reducing outpatient waiting time. Patients waiting time was divided into three levels regarding their physicians. These waiting times for all scenarios were computed by simulation model. According to the final scores the 9th scenario was selected as the best way for reducing outpatient's waiting time. Using the simulation as a decision making tool helps us to decide how we can reduce outpatient's waiting time. Comparison of outputs of this scenario and the based- case scenario in simulation model shows that combining physician's work time changing with patient's admission time changing (scenario 9) would reduce patient waiting time about 73.09%. Due to dynamic and complex nature of healthcare systems, the application of simulation for the planning, modeling and analysis of these systems has lagged behind traditional manufacturing practices. Rapid growth in health care system expenditures, technology and competition has increased the complexity of health care systems. Simulation is a useful tool for decision making in complex and probable systems.

  10. Waiting Time Increases Risk of Attrition in Gambling Disorder Treatment

    DEFF Research Database (Denmark)

    Linnet, Jakob; Pedersen, Anders Sune

    2014-01-01

    completion in gambling disorder. We compared 48 gambling disorder sufferers with a 56% completion rate (21 non-completers and 27 completers). Binomial logistic regression analysis showed that waiting time from initial contact to the first session with a therapist was a significant predictor of risk...... of attrition: longer waiting times were associated with increased risk of attrition. Age, gender, or comorbidity was not associated with an increased risk of attrition. These data suggest that gambling disorder sufferers benefit from fast access to treatment, and that longer waiting time increases the risk...

  11. Waiting time distribution for continuous stochastic systems.

    Science.gov (United States)

    Gernert, Robert; Emary, Clive; Klapp, Sabine H L

    2014-12-01

    The waiting time distribution (WTD) is a common tool for analyzing discrete stochastic processes in classical and quantum systems. However, there are many physical examples where the dynamics is continuous and only approximately discrete, or where it is favourable to discuss the dynamics on a discretized and a continuous level in parallel. An example is the hindered motion of particles through potential landscapes with barriers. In the present paper we propose a consistent generalization of the WTD from the discrete case to situations where the particles perform continuous barrier crossing characterized by a finite duration. To this end, we introduce a recipe to calculate the WTD from the Fokker-Planck (Smoluchowski) equation. In contrast to the closely related first passage time distribution (FPTD), which is frequently used to describe continuous processes, the WTD contains information about the direction of motion. As an application, we consider the paradigmatic example of an overdamped particle diffusing through a washboard potential. To verify the approach and to elucidate its numerical implications, we compare the WTD defined via the Smoluchowski equation with data from direct simulation of the underlying Langevin equation and find full consistency provided that the jumps in the Langevin approach are defined properly. Moreover, for sufficiently large energy barriers, the WTD defined via the Smoluchowski equation becomes consistent with that resulting from the analytical solution of a (two-state) master equation model for the short-time dynamics developed previously by us [Phys. Rev. E 86, 061135 (2012)]. Thus, our approach "interpolates" between these two types of stochastic motion. We illustrate our approach for both symmetric systems and systems under constant force.

  12. The Origin of the Solar Flare Waiting-Time Distribution

    CERN Document Server

    Wheatland, M S

    2000-01-01

    It was recently pointed out that the distribution of times between solar flares (the flare waiting-time distribution) follows a power law, for long waiting times. Based on 25 years of soft X-ray flares observed by Geostationary Operational Environmental Satellite (GOES) instruments it is shown that 1. the waiting-time distribution of flares is consistent with a time-dependent Poisson process, and 2. the fraction of time the Sun spends with different flaring rates approximately follows an exponential distribution. The second result is a new phenomenological law for flares. It is shown analytically how the observed power-law behavior of the waiting times originates in the exponential distribution of flaring rates. These results are argued to be consistent with a non-stationary avalanche model for flares.

  13. Moderate alcohol consumption and waiting time to pregnancy

    DEFF Research Database (Denmark)

    Juhl, Mette; Andersen, Anne-Marie Nybo; Grønbæk, Morten;

    2001-01-01

    BACKGROUND: Recent research indicates that even a moderate consumption of alcohol in women trying to become pregnant is associated with longer waiting time to pregnancy. The findings, though, are based upon few observations. METHODS: Self-reported data on alcohol intake and waiting time...... to pregnancy (0-2, 3-5, 6-12 and >12 months) was used for 39 612 pregnant women, recruited to the Danish National Birth Cohort within the first 24 weeks of pregnancy from 1997 to 2000. Main outcome measures were odds ratios (OR) for a prolonged waiting time to pregnancy according to alcohol intake. RESULTS......: In nulliparous women neither moderate nor high alcohol intake was related with longer waiting time to pregnancy compared with a low intake. In parous women, a modest association was seen only among those with an intake of >14 drinks per week (subfecundity OR 1.3; 95% confidence interval 1.0-1.7). Women who...

  14. Wait Time for Treatment in Hospital Emergency Departments: 2009

    Science.gov (United States)

    ... more patients with fewer EDs and with fewer hospital beds. Patients not requiring immediate care have longer wait ... has been made (e.g., because an inpatient bed elsewhere in the hospital is not yet available) ( 4 ). Data source and ...

  15. Truckers' Poor Health: An Accident Waiting to Happen?

    Science.gov (United States)

    ... https://medlineplus.gov/news/fullstory_163147.html Truckers' Poor Health: An Accident Waiting to Happen? Multiple medical ... pain and diabetes -- that have been linked with poor driving performance. Truck drivers with three or more ...

  16. First passage times: Busy periods and waiting times

    Institute of Scientific and Technical Information of China (English)

    徐光煇; 袁学明

    1995-01-01

    General expressions of first passage times for denumerable Markov processes are discussed and computation problems for busy periods and waiting times for queues corresponding to Markov processes are studied. In particular, the simplified algorithms for busy periods and waiting times for queues corresponding to G//M/1 type and M/G/1 type Markov processes are derived and some numerical examples are presented.

  17. Anomalous waiting times in high-frequency financial data

    CERN Document Server

    Scalas, E; Luckock, H; Mainardi, F; Mantelli, M; Raberto, M; Scalas, Enrico; Gorenflo, Rudolf; Luckock, Hugh; Mainardi, Francesco; Mantelli, Maurizio; Raberto, Marco

    2004-01-01

    In high-frequency financial data not only returns, but also waiting times between consecutive trades are random variables. Therefore, it is possible to apply continuous-time random walks (CTRWs) as phenomenological models of the high-frequency price dynamics. An empirical analysis performed on the 30 DJIA stocks shows that the waiting-time survival probability for high-frequency data is non-exponential. This fact imposes constraints on agent-based models of financial markets.

  18. Longer wait times affect future use of VHA primary care.

    Science.gov (United States)

    Wong, Edwin S; Liu, Chuan-Fen; Hernandez, Susan E; Augustine, Matthew R; Nelson, Karin; Fihn, Stephan D; Hebert, Paul L

    2017-07-29

    Improving access to the Veterans Health Administration (VHA) is a high priority, particularly given statutory mandates of the Veterans Access, Choice and Accountability Act. This study examined whether patient-reported wait times for VHA appointments were associated with future reliance on VHA primary care services. This observational study examined 13,595 VHA patients dually enrolled in fee-for-service Medicare. Data sources included VHA administrative data, Medicare claims and the Survey of Healthcare Experiences of Patients (SHEP). Primary care use was defined as the number of face-to-face visits from VHA and Medicare in the 12 months following SHEP completion. VHA reliance was defined as the number of VHA visits divided by total visits (VHA+Medicare). Wait times were derived from SHEP responses measuring the usual number of days to a VHA appointment with patients' primary care provider for those seeking immediate care. We defined appointment wait times categorically: 0 days, 1day, 2-3 days, 4-7 days and >7 days. We used fractional logistic regression to examine the relationship between wait times and reliance. Mean VHA reliance was 88.1% (95% CI = 86.7% to 89.5%) for patients reporting 0day waits. Compared with these patients, reliance over the subsequent year was 1.4 (p = 0.041), 2.8 (p = 0.001) and 1.6 (p = 0.014) percentage points lower for patients waiting 2-3 days, 4-7 days and >7 days, respectively. Patients reporting longer usual wait times for immediate VHA care exhibited lower future reliance on VHA primary care. Longer wait times may reduce care continuity and impact cost shifting across two federal health programs. Copyright © 2017. Published by Elsevier Inc.

  19. Monitor to investigate trust for making patients wait too long.

    Science.gov (United States)

    2014-10-01

    HEALTH REGULATOR Monitor has launched an investigation into Yorkshire Teaching Hospital NHS Foundation Trust after finding that some patients had been waiting too long to be assessed for emergency care. The regulator believes that repeated failures to ensure patients were seen soon enough may indicate wider problems at the trust, which has failed to meet the quarterly national emergency department waiting time target five times in nearly two years.

  20. Interior effects on comfort in healthcare waiting areas.

    Science.gov (United States)

    Bazley, C; Vink, P; Montgomery, J; Hedge, A

    2016-07-21

    This study compared the effects of pre-experience and expectations on participant comfort upon waking, arrival to, and after an appointment, as well as the assessment of properly placed Feng Shui elements in three healthcare waiting rooms. Participants assessed comfort levels using self-report surveys. The researcher conducted 'intention interviews' with each doctor to assess the goals of each waiting area design, and conducted a Feng Shui assessment of each waiting area for properly placed Feng Shui elements. The waiting area designed by the Feng Shui expert rated 'most comfortable', followed by the waiting area design by a doctor, and the lowest comfort rating for the conventional waiting room design. Results show a sufficiently strong effect to warrant further research. Awareness of the external environment, paired with pre-experience and expectation, influences comfort for people over time. Fostering and encouraging a holistic approach to comfort utilizing eastern and western concepts and ergonomic principles creates a sense of "placeness" and balance in the design for comfort in built environments. This is new research information on the influences of the comfort experience over time, to include pre-experience, expectations and the placement of elements in the external environment.

  1. The interim service preferences of parents waiting for children's mental health treatment: a discrete choice conjoint experiment.

    Science.gov (United States)

    Cunningham, Charles E; Chen, Yvonne; Deal, Ken; Rimas, Heather; McGrath, Patrick; Reid, Graham; Lipman, Ellen; Corkum, Penny

    2013-08-01

    Parents seeking help for children with mental health problems are often assigned to a waiting list. We used a discrete choice conjoint experiment to model preferences for interim services that might be used while waiting for the formal assessment and treatment process to begin. A sample of 1,059 parents (92 % mothers) seeking mental health services for 4 to 16 year olds chose between hypothetical interim services composed by experimentally varying combinations of the levels of 13 interim service attributes. Latent Class analysis yielded a four-segment solution. All segments preferred interim options helping them understand how agencies work, enhancing their parenting knowledge and skill, and providing an opportunity to understand or begin dealing with their own difficulties. The Group Contact segment (35.1 %) preferred interim services in meetings with other parents, supported by phone contacts, frequent checkup calls, and wait-time updates. Virtual Contact parents (29.2 %) preferred to meet other parents in small internet chat groups supported by e-mail contact. Membership in this segment was linked to higher education and computer skills. Frequent Contact parents (24.4 %) preferred face-to-face interim services supported by weekly progress checks and wait time updates. Limited Contact parents (11.3 %) were less intent on using interim services. They preferred to pursue interim services alone, with contacts by phone, supported by fewer check-up calls and less frequent wait time updates. All segments were more likely to enroll in interim services involving their child.

  2. Decline in Health-Related Quality of Life reported by more than half of those waiting for joint replacement surgery: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Osborne Richard H

    2011-05-01

    Full Text Available Abstract Background In many healthcare systems, people with severe joint disease wait months to years for joint replacement surgery. There are little empirical data on the health consequences of this delay and it is unclear whether people with substantial morbidity at entry to the waiting list continue to deteriorate further while awaiting surgery. This study investigated changes in Health-Related Quality of Life (HRQoL, health status and psychological distress among people waiting for total hip (THR and knee replacement (TKR surgery at a major metropolitan Australian public hospital. Methods 134 patients completed questionnaires including the Assessment of Quality of Life (AQoL instrument, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC and Kessler Psychological Distress Scale after entering an orthopaedic waiting list (baseline and before surgery (preadmission. To quantify potential decline in wellbeing, we calculated the proportion of people experiencing clinically important deterioration using published guidelines and compared HRQoL and psychological distress outcomes with population norms. Results Most participants (69% waited ≥6 months for surgery (median 286 days, IQR 169-375 days. Despite poor physical and psychological wellbeing at baseline, there was an overall deterioration in HRQoL during the waiting period (mean AQoL change -0.04, 95%CI -0.08 to -0.01, with 53% of participants experiencing decline in HRQoL (≥0.04 AQoL units. HRQoL prior to surgery remained substantially lower than Australian population norms (mean sample AQoL 0.37, 95%CI 0.33 to 0.42 vs mean population AQoL 0.83, 95%CI 0.82 to 0.84. Twenty-five per cent of participants showed decline in health status (≥9.6 WOMAC units over the waiting period and prevalence of high psychological distress remained high at preadmission (RR 3.5, 95%CI 2.8 to 4.5. Most participants considered their pain (84%, fatigue (76%, quality of life (73% and confidence

  3. 5 CFR 531.405 - Waiting periods for within-grade increase.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Waiting periods for within-grade increase... REGULATIONS PAY UNDER THE GENERAL SCHEDULE Within-Grade Increases § 531.405 Waiting periods for within-grade increase. (a) Length of waiting period. (1) For an employee with a scheduled tour of duty, the waiting...

  4. Effects of waiting on the satisfaction with the service: Beyond objective time measures

    NARCIS (Netherlands)

    Pruyn, Adriaan T.H.; Smidts, Ale

    1998-01-01

    A major concern for service managers is to counteract negative effects of waiting. In this study, the effects of objective waiting time and waiting environment on satisfaction with the service were investigated. Two elements of the waiting environment were distinguished: the attractiveness of the

  5. Effect of emergency physician burnout on patient waiting times.

    Science.gov (United States)

    De Stefano, Carla; Philippon, Anne-Laure; Krastinova, Evguenia; Hausfater, Pierre; Riou, Bruno; Adnet, Frederic; Freund, Yonathan

    2017-07-04

    Burnout is common in emergency physicians. This syndrome may negatively affect patient care and alter work productivity. We seek to assess whether burnout of emergency physicians impacts waiting times in the emergency department. Prospective study in an academic ED. All patients who visited the main ED for a 4-month period in 2016 were included. Target waiting times are assigned by triage nurse to patients on arrival depending on their severity. The primary endpoint was an exceeded target waiting time for ED patients. All emergency physicians were surveyed by a psychologist to assess their level of burnout using the Maslach Burnout Inventory. We defined the level of burnout of the day in the ED as the mean burnout level of the physicians working that day (8:30 to the 8:30 the next day). A logistic regression model was performed to assess whether burnout level of the day was independently associated with prolonged waiting times, along with previously reported predictors. Target waiting time was exceeded in 7524 patients (59%). Twenty-six emergency physicians were surveyed. Median burnout score was 35 [Interquartile (24-49)]. A burnout level of the day higher than 35 was independently associated with an exceeded target waiting time (adjusted odds ratio 1.54, 95% confidence interval 1.39-1.70), together with previously reported predictors (i.e., day of the week, time of the day, trauma, age and daily census). Burnout of emergency physicians was independently associated with a prolonged waiting time for patients visiting the ED.

  6. The coronal mass ejection waiting-time distribution

    CERN Document Server

    Wheatland, M S

    2003-01-01

    The distribution of times $\\Delta t$ between coronal mass ejections (CMEs) in the Large Angle and Spectrometric Coronagraph (LASCO) CME catalog for the years 1996-2001 is examined. The distribution exhibits a power-law tail $\\propto (\\Delta t)^{\\gamma}$ with an index $\\gamma\\approx -2.36\\pm 0.11$ for large waiting times ($\\Delta t>10 {\\rm hours}$). The power-law index of the waiting-time distribution varies with the solar cycle: for the years 1996-1998 (a period of low activity), the power-law index is $\\gamma\\approx-1.86\\pm 0.14$, and for the years 1999-2001 (a period of higher activity), the index is $\\gamma\\approx-2.98\\pm 0.20$. The observed CME waiting-time distribution, and its variation with the cycle, may be understood in terms of CMEs occurring as a time-dependent Poisson process. The CME waiting-time distribution is compared with that for greater than C1 class solar flares in the Geostationary Operational Environmental Satellite (GOES) catalog for the same years. The flare and CME waiting-time distri...

  7. Canadians with Health Problems: Their Use of Specialized Services and Their Waiting Experiences

    OpenAIRE

    2008-01-01

    Improving access to healthcare has been a consistent priority for Canadians. In particular, reducing patient waiting times for health services has been a prominent policy issue. Across the country, governments are using a range of strategies to reduce patient waiting times for care, with a particular focus on reducing waits for specialized services. Although information is emerging on waits for selected procedures, there is limited information on whether the utilization of services or waiting...

  8. The effectiveness of interventions aimed at reducing anxiety in health care waiting spaces: a systematic review of randomized and nonrandomized trials.

    Science.gov (United States)

    Biddiss, Elaine; Knibbe, Tara Joy; McPherson, Amy

    2014-08-01

    Reducing waiting anxiety is an important objective of patient-centered care. Anxiety is linked to negative health outcomes, including longer recovery periods, lowered pain thresholds, and for children in particular, resistance to treatment, nightmares, and separation anxiety. The goals of this study were (1) to systematically review published research aimed at reducing preprocedural waiting anxiety, and (2) to provide directions for future research and development of strategies to manage preprocedural waiting anxiety in health care environments. We performed a systematic review of the literature via ISI Web of Knowledge, PubMed, PsycINFO, EMBASE, CINAHL, and Medline. Included in this review were studies describing measurable outcomes in response to interventions specifically intended to improve the waiting experience of patients in health care settings. Primary outcomes of interest were stress and anxiety. Exclusion criteria included (a) studies aimed at reducing wait times and management of waiting lists only, (b) waiting in non-health care settings, (c) design of health care facilities with nonspecific strategies pertaining to waiting spaces, (d) strategies to reduce pain or anxiety during the course of medical procedures, and (e) interventions such as massage, acupuncture, or hypnosis that require dedicated staff and/or private waiting environments to administer. We identified 8690 studies. Forty-one articles met the inclusion criteria. In adult populations, 33 studies were identified, wherein the effects of music (n = 25), aromatherapy (n = 6), and interior design features (n = 2) were examined. Eight pediatric studies were identified investigating play opportunities (n = 2), media distractions (n = 2), combined play opportunities and media distractions (n = 3), and music (n = 1). Based on results from 1129 adult participants in the 14 studies that evaluated music and permitted meta-analysis, patients who listened to music before a medical procedure exhibited a

  9. Coping with worry while waiting for diagnostic results

    DEFF Research Database (Denmark)

    Lou, Stina; Nielsen, Camilla P; Hvidman, Lone;

    2016-01-01

    ' during this period, however, not enough is known about how high-risk women and their partners cope while waiting for diagnostic results. The aim of this study was to identify the strategies employed to cope with worry and uncertainty. METHODS: Qualitative, semi-structured interviews with 16 high......BACKGROUND: It is well documented that pregnant women experience increased worry and uncertainty following a high-risk prenatal screening result. While waiting for diagnostic results this worry continues to linger. It has been suggested that high-risk women put the pregnancy mentally 'on hold......-risk couples who underwent diagnostic testing. The couples were recruited at a university hospital fetal medicine unit in Denmark. Data were analysed using thematic analysis. RESULTS: All couples reported feeling worried and sad upon receiving a high-risk screening result. While waiting for diagnostic results...

  10. Blood pressure self-measurement in the obstetric waiting room

    DEFF Research Database (Denmark)

    Wagner, Stefan; Kamper, Christina H.; Toftegaard, Thomas Skjødeberg

    2013-01-01

    a reliable blood pressure reading. Results: We found that the patients did not adhere to given instructions when performing blood pressure self-measurement in the waiting room. None of the 81 patients adhered to all six inves- tigated recommendations, while around a quarter adhered to five out of six......Background: Pregnant diabetic patients are often required to self- measure their blood pressure in the waiting room before consulta- tion. Currently used blood pressure devices do not guarantee valid measurements when used unsupervised. This could lead to misdi- agnosis and treatment error. The aim...... of this study was to investigate current use of blood pressure self-measurement in the waiting room in order to identify challenges that could influence the resulting data quality. Also, we wanted to investigate the potential for addressing these challenges with e-health and telemedicine technology. Subjects...

  11. Protocol to Exploit Waiting Resources for UASNs †

    Science.gov (United States)

    Hung, Li-Ling; Luo, Yung-Jeng

    2016-01-01

    The transmission speed of acoustic waves in water is much slower than that of radio waves in terrestrial wireless sensor networks. Thus, the propagation delay in underwater acoustic sensor networks (UASN) is much greater. Longer propagation delay leads to complicated communication and collision problems. To solve collision problems, some studies have proposed waiting mechanisms; however, long waiting mechanisms result in low bandwidth utilization. To improve throughput, this study proposes a slotted medium access control protocol to enhance bandwidth utilization in UASNs. The proposed mechanism increases communication by exploiting temporal and spatial resources that are typically idle in order to protect communication against interference. By reducing wait time, network performance and energy consumption can be improved. A performance evaluation demonstrates that when the data packets are large or sensor deployment is dense, the energy consumption of proposed protocol is less than that of existing protocols as well as the throughput is higher than that of existing protocols. PMID:27005624

  12. Waiting for Art: The Experience of Real Time in Sculpture

    Directory of Open Access Journals (Sweden)

    Elizabeth Buhe

    2011-05-01

    Full Text Available Why and how does some contemporary art make us wait, and why does the beholder choose to stay? This study seeks to answer this question by exploring what happens to the viewer while waiting in front of a “time sculpture,” a term coined here to mean a three-dimensional artwork that is dynamic over a set period of time. Through an analysis of select works by artists Anish Kapoor, Amelia Whitelaw, Michael Sailstorfer, and Roman Signer, the article posits that while in front of these time sculptures, the viewer experiences an anxiety of waiting and temporal confusion that glues him to the spot. Ultimately, by drawing upon Henri Bergson’s concept of duration, the essay suggests that the viewership of time sculpture allows for a heightened state of perception. Normal 0 false false false EN-US X-NONE X-NONE

  13. Evolving Lists

    Institute of Scientific and Technical Information of China (English)

    JOEI; VILLARAMA

    2009-01-01

    More than two years ago, I wrote a list of the top 10 reasons I love living in China. It was published in a local expats’ magazine and somebody from a radio station spotted it and invited me to talk about the article on the air, a hilarious, comedic if not surreal experience for any foreigner.

  14. On the Absurd Characteristics in Waiting for Godot

    Institute of Scientific and Technical Information of China (English)

    任欢

    2016-01-01

    In 1950s and 1960s,a literature school,called “Absurd Theatre”prevailed in Europe and America.It subverts the inherent charac-teristics of the traditional play by demonstrating plays in an unexpected way.The plays,without plots,conflicts,or exciting scenes,aim at reflecting the meaninglessness,hopelessness,emptiness and nothingness of man.Waiting for Godot,an archetypical work of “Absurd Theatre”,classically ex-pounds the absurd situation man are in.This thesis is devoted to analyzing the absurd characteristics in Waiting for Godot from different perspectives.

  15. Mean waiting time approximation for a real time polling system

    Institute of Scientific and Technical Information of China (English)

    Cao Chunsheng; Yin Rupo; Zhang Weidong; Cai Yunze

    2007-01-01

    This paper considers a novel polling system with two classes of message which can experience an upper bounded time before being served . The station serves these two classes with mixed service discipline , one class with exhaustive service discipline, and the other with gated service discipline. Using iterative method, we have developed an approximation method to obtain the mean waiting time for each message class . The performance of approximation has been compared with the simulation results . The expression for the upper bound of waiting time is given too .

  16. [Waiting time for treatment shall be calculated correctly].

    Science.gov (United States)

    Pedersen, Jørgen Ejler

    2011-05-23

    Every system is perfectly designed to achieve the results it gets and in the Danish health care system there is a significant waiting time for the patients. If we want this result to change, we have to change something in the system, but before we do that, we need to understand the system. With queuing theory as a frame of reference, the anatomy and physiology of waiting time is illuminated in order to bring additional knowledge into the design of systems in health care.

  17. Levelled bed occupancy and controlled waiting lists using Master surgical schedules

    NARCIS (Netherlands)

    L. Evers (Lanah); J.M. van Oostrum (Jeroen); A.P.M. Wagelmans (Albert)

    2010-01-01

    textabstractScheduling surgical patients is one of the complex organizational tasks hospitals face daily. Master surgical scheduling is one way to optimize utilization of scarce resources and to create a more predictable outflow from the operating room towards subsequent hospital departments. The pa

  18. Drinking in the last chance saloon: luck egalitarianism, alcohol consumption, and the organ transplant waiting list

    DEFF Research Database (Denmark)

    Albertsen, Andreas

    2016-01-01

    such differentiation, luck egalitarianism provides a clearer rationale of fairness, acknowledges the need for individual assessments of responsibility, and requires initiatives both inside and outside of the allocation systems aimed at mitigating the influence from social circumstances. Furthermore, the concrete...... egalitarianism, assesses distributions as just if, and only if, people's relative positions reflect their exercises of responsibility. There is a principled luck egalitarian case for giving lower priority to those who are responsible for their need. Compared to the existing literature favouring...... policies that luck egalitarians can recommend are neither too harsh on those who make imprudent choices nor excessively intrusive towards those whose exercises of responsibility are assessed....

  19. Drinking in the last chance saloon: luck egalitarianism, alcohol consumption, and the organ transplant waiting list

    DEFF Research Database (Denmark)

    Albertsen, Andreas

    2016-01-01

    The scarcity of livers available for transplants forces tough choices upon us. Lives for those not receiving a transplant are likely to be short. One large group of potential recipients needs a new liver because of alcohol consumption, while others suffer for reasons unrelated to their own...

  20. Waiting list paradox: Danish cancer patients diagnosed fast have higher mortality after diagnosis

    DEFF Research Database (Denmark)

    Tørring, Marie Louise

    BACKGROUND: Delay in the diagnosis of cancer is generally considered unacceptable. However, observational studies often show an inverse association between the length of the diagnostic interval and mortality. Paradoxically, patients diagnosed more rapidly have higher mortality rates than patients...... in Denmark. We speculate that GPs and hospital doctors are able to distinguish more or less aggressive malignancies and organise the course of referral accordingly....

  1. Levelled bed occupancy and controlled waiting lists using Master surgical schedules

    NARCIS (Netherlands)

    L. Evers (Lanah); J.M. van Oostrum (Jeroen); A.P.M. Wagelmans (Albert)

    2010-01-01

    textabstractScheduling surgical patients is one of the complex organizational tasks hospitals face daily. Master surgical scheduling is one way to optimize utilization of scarce resources and to create a more predictable outflow from the operating room towards subsequent hospital departments. The

  2. 24 CFR 960.206 - Waiting list: Local preferences in admission to public housing program.

    Science.gov (United States)

    2010-04-01

    ... otherwise denying admission to the program based on the race, color, ethnic origin, gender, religion... a preference for persons with a specific disability. (4) Preference for victims of domestic violence... victims of domestic violence. (5) Preference for single persons who are elderly, displaced, homeless or...

  3. 24 CFR 982.207 - Waiting list: Local preferences in admission to program.

    Science.gov (United States)

    2010-04-01

    ... crime of violence (as defined in 18 U.S.C. 16). (b) Particular local preferences—(1) Residency..., color, ethnic origin, gender, religion, disability, or age of any member of an applicant family. (iv) A...) Preference for victims of domestic violence. The PHA should consider whether to adopt a local preference...

  4. Introducing waiting times for health care in a labor supply model for sickness absence

    Directory of Open Access Journals (Sweden)

    Daniela Andrén

    2014-08-01

    Full Text Available This paper studies the association between waiting times for different health care services and the duration of sick leave, using a Swedish register database supplemented with information from questionnaires for 3,653 employees. The duration of sick leave is positively associated with waiting two weeks or more for primary care, technical investigations and specialists, compared to waiting one week or less. Except for waiting for a specialist, there is no indication that waiting four weeks or more is associated with longer durations of sick leave than waiting two to three weeks. Long waiting times for surgery is negatively associated with the duration of sick leave, which might be explained by prioritizing where patients with longer waiting times are those with less severe conditions. Including these waiting time variables did not induce substantial changes on the impact of traditional labor supply variables, which suggests that the parameter estimates of traditional variables are relatively robust.

  5. Waiting for care in Canada: findings from the health services access survey.

    Science.gov (United States)

    Sanmartin, Claudia; Pierre, Fritz; Tremblay, Stéphane

    2006-11-01

    Waiting for care has been and continues to be a major issue for the healthcare sector in Canada. While considerable gains have been made regarding valid and reliable information on waiting times, gaps remain. Statistics Canada continues to provide information regarding patients' experiences in accessing care at the national and provincial levels, including how long individuals waited for specialized services, through the Health Services Access Survey. The survey offers several advantages, including waiting time information that is comparable across time and space, enhanced patient information and information regarding patients' experiences in waiting for care. The results for 2005 indicate that median waiting time for all specialized services was between 3 and 4 weeks and remained relatively stable between 2003 and 2005. Waiting times for specialist visits did not vary by income. In addition to being asked how long they waited, individuals were asked about their experiences in waiting for care. While the majority of individuals waiting for care indicated that their waiting time was acceptable, there continues to be a proportion of Canadians who feel they are waiting an unacceptably long time for care. Between 11% and 18% of individuals waiting for care indicated that their life was affected by waiting.

  6. Reducing wait time in a hospital pharmacy to promote customer service.

    Science.gov (United States)

    Slowiak, Julie M; Huitema, Bradley E; Dickinson, Alyce M

    2008-01-01

    The purpose of this study was to compare the effects of 2 different interventions on wait times at a hospital outpatient pharmacy: (1) giving feedback to employees about customer satisfaction with wait times and (2) giving a combined intervention package that included giving more specific feedback about actual wait times and goal setting for wait time reduction in addition to the customer satisfaction feedback. The relationship between customer satisfaction ratings and wait times was examined to determine whether wait times affected customer service satisfaction. Participants were 10 employees (4 pharmacists and 6 technicians) of an outpatient pharmacy. Wait times and customer satisfaction ratings were collected for "waiting customers." An ABCBA' within-subjects design was used to assess the effects of the interventions on both wait time and customer satisfaction, where A was the baseline (no feedback and no goal setting); B was the customer satisfaction feedback; C was the customer satisfaction feedback, the wait time feedback, and the goal setting for wait time reduction; and A' was a follow-up condition that was similar to the original baseline condition. Wait times were reduced by approximately 20%, and there was concomitant increased shift in levels of customer satisfaction, as indicated by the correlation between these variables (r = -0.57 and P customer's wait time. Data from this study may provide useful preliminary benchmarking data for standard pharmacy wait times.

  7. SOLVABLE CASES OF THE NO-WAIT FLOWSHOP SCHEDULING PROBLEM

    NARCIS (Netherlands)

    VANDERVEEN, JAA; VANDAL, R

    1991-01-01

    The no-wait flow-shop scheduling problem (NWFSSP) with a makespan objective function is considered. As is well known, this problem is NP-hard for three or more machines. Therefore, it is interesting to consider special cases, i.e. special structured processing time matrices, that allow polynomial

  8. Waiting Time Dynamics in Two-Dimensional Infrared Spectroscopy

    NARCIS (Netherlands)

    Jansen, Thomas L. C.; Knoester, Jasper

    We review recent work on the waiting time dynamics of coherent two-dimensional infrared (2DIR) spectroscopy. This dynamics can reveal chemical and physical processes that take place on the femto- and picosecond time scale, which is faster than the time scale that may be probed by, for example,

  9. Waiting to go into a Danish Nursing Home - Generations Review

    DEFF Research Database (Denmark)

    Kofod, Jens Erik

    2006-01-01

    that their relationship toward their home care assistant became increasingly important as they waited to go into the nursing home. Assessments for home care were constrained by municipal authorities and their regulations, and the overall attitude was that the needs of older people were not being appropriately defined...

  10. Waiting Time Policies in the Health Care Sector. What Works?

    DEFF Research Database (Denmark)

    Christiansen, Terkel; Bech, Mickael

    2013-01-01

    times. In addition, a range of other measures may indirectly have affected waiting times, such as a general increase in spending on health care, the general practitioners’ role as gate-keepers, increased use of activity-based hospital reimbursement, increasing use of private heath insurance and private...

  11. Determinants of Patient Waiting Time in the General Outpatient ...

    African Journals Online (AJOL)

    Waiting time is a tangible aspect of practice that patients .... their consent to participate in the study were selected (inclusion ... or the other, 36.5% (35/96) had up to tertiary education while ..... Department of Statistics Malaysia; ... Health Policy.

  12. Waiting to Drive (A Minute of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2015-04-09

    Over the past 10 years, the number of fatal motor-vehicle crashes involving teenage drivers has declined by more than 50 percent. This podcast discusses the trend of teens waiting until they are older to drive.  Created: 4/9/2015 by MMWR.   Date Released: 4/9/2015.

  13. Potential impact of enhanced practice efficiency on endoscopy waiting times.

    LENUS (Irish Health Repository)

    Harewood, G C

    2009-06-01

    With the growing demand on endoscopy services, optimising practice efficiency has assumed increasing importance. Prior research has identified practice changes, which increase the efficiency in endoscopy. In this study, the potential impact of these practice changes on the current and projected future endoscopy waiting times at our institution was assessed.

  14. Quality improvement cycles that reduced waiting times at Tshwane ...

    African Journals Online (AJOL)

    TDH is a level-one hospital, delivering services in the centre of Pretoria since February 2006. ... finding better ways to provide better care and service.11 The QI cycle is a recognised tool for analysing and improving the efficiency and quality ..... in reducing waiting times and improving patient satisfaction.14 The need for ...

  15. U.S. tells CERN to wait for support

    CERN Multimedia

    Mervis, J

    1995-01-01

    The US has put off CERN's request for a $300 million contribution to help build the Large Hadron Collider. Department of Energy officials asserted that such a decision must wait until after the budget is finalized. House Science Committee Chairman Robert Walker also claimed it was too early to make a decision.

  16. Did Not Wait Patient Management Strategy (DNW PMS) Study.

    LENUS (Irish Health Repository)

    2012-02-01

    Objectives This study was undertaken to assess the usefulness of senior emergency medicine specialists\\' review of all \\'did not wait\\' (DNW) patients\\' triage notes and the recall of at-risk patients. Methods A prospective study of all DNW patients was performed from 1 January to 31 December 2008. Following a daily review of charts of those who failed to wait to be seen, those patients considered to be at risk of adverse outcome were contacted by the liaison team and advised to return. Data were gathered on all DNW patients on the Oracle database and interrogated using the Diver solution. Results 2872 (6.3%) of 45 959 patients did not wait to be seen. 107 (3.7%) were recalled on the basis of senior emergency medicine doctor review of the patients\\' triage notes. Variables found to be associated with increased likelihood of being recalled included triage category (p<0.001), male sex (p<0.004) and certain clinical presentations. The presenting complaints associated with being recalled were chest pain (p<0.001) and alcohol\\/drug overdose (p=0.001). 9.4% of DNW patients required admission following recall. Conclusion The systematic senior doctor review of triage notes led to 3.7% of patients who failed to wait being recalled. 9.4% of those recalled required acute admission. The daily review of DNW patients\\' triage notes and the recalling of at-risk patients is a valuable addition to our risk management strategy.

  17. Did Not Wait Patient Management Strategy (DNW PMS) Study.

    LENUS (Irish Health Repository)

    O'Keeffe, Fran

    2011-06-14

    Objectives This study was undertaken to assess the usefulness of senior emergency medicine specialists\\' review of all \\'did not wait\\' (DNW) patients\\' triage notes and the recall of at-risk patients. Methods A prospective study of all DNW patients was performed from 1 January to 31 December 2008. Following a daily review of charts of those who failed to wait to be seen, those patients considered to be at risk of adverse outcome were contacted by the liaison team and advised to return. Data were gathered on all DNW patients on the Oracle database and interrogated using the Diver solution. Results 2872 (6.3%) of 45 959 patients did not wait to be seen. 107 (3.7%) were recalled on the basis of senior emergency medicine doctor review of the patients\\' triage notes. Variables found to be associated with increased likelihood of being recalled included triage category (p<0.001), male sex (p<0.004) and certain clinical presentations. The presenting complaints associated with being recalled were chest pain (p<0.001) and alcohol\\/drug overdose (p=0.001). 9.4% of DNW patients required admission following recall. Conclusion The systematic senior doctor review of triage notes led to 3.7% of patients who failed to wait being recalled. 9.4% of those recalled required acute admission. The daily review of DNW patients\\' triage notes and the recalling of at-risk patients is a valuable addition to our risk management strategy.

  18. The Ultimate $uperpower: Supersized Dollars Drive "Waiting for "Superman"" Agenda

    Science.gov (United States)

    Miner, Barbara

    2011-01-01

    For nearly 40 years, according to this author, "follow the money" has been an axiom in both journalism and politics--although, as Shakespeare might complain, one "more honour'd in the breach than the observance." It is useful to resurrect the axiom in analyzing the multimedia buzz and policy debates swirling around the movie "Waiting for…

  19. Waiting in the queue on Hotelling’s Main Street

    NARCIS (Netherlands)

    Peters, H.J.M.; Schröder, M.J.W.; Vermeulen, A.J.

    2015-01-01

    We consider a variant of Hotelling’s location model that was proposed by Kohlberg (1983): when choosing a firm, consumers take travel time and also (expected) waiting time, which again depends on the number of consumers choosing that firm, into consideration. If we assume that firms are symmetric, t

  20. Reallocation of beds to reduce waiting time for cardiac surgery

    NARCIS (Netherlands)

    Akkerman, Renzo; Knip, Marrig

    2002-01-01

    Waiting time for cardiac surgery is a significant problem in the current medical world. The fact that patients length of stay varies considerably makes effective hospital operation a hard job. In this paper, the patients length of stay is analyzed. Three scenarios for hospital management are

  1. EVALUTION OF THE SINGLE INTERCITY FREIGHT TRANSPORTATION WAITING TIME

    Directory of Open Access Journals (Sweden)

    N. Ponomariova

    2015-07-01

    Full Text Available The example of vechicle operation on the pendulum intercity route during single freightages processing is considered. Two approaches to the definition of the single freightage waiting time by the carrier are proposed. These approaches allow to take into account the probability of the single freightage obtaining by the carrier during the different load level of the transport enterprise capacity.

  2. Waiting time for radiotherapy in women with cervical cancer

    Directory of Open Access Journals (Sweden)

    Maria Isabel do Nascimento

    2015-01-01

    Full Text Available ABSTRACT OBJECTIVE To describe the waiting time for radiotherapy for patients with cervical cancer. METHODS This descriptive study was conducted with 342 cervical cancer cases that were referred to primary radiotherapy, in the Baixada Fluminense region, RJ, Southeastern Brazil, from October 1995 to August 2010. The waiting time was calculated using the recommended 60-day deadline as a parameter to obtaining the first cancer treatment and considering the date at which the diagnosis was confirmed, the date of first oncological consultation and date when the radiotherapy began. Median and proportional comparisons were made using the Kruskal Wallis and Chi-square tests. RESULTS Most of the women (72.2% began their radiotherapy within 60 days from the diagnostic confirmation date. The median of this total waiting time was 41 days. This median worsened over the time period, going from 11 days (1995-1996 to 64 days (2009-2010. The median interval between the diagnostic confirmation and the first oncological consultation was 33 days, and between the first oncological consultation and the first radiotherapy session was four days. The median waiting time differed significantly (p = 0.003 according to different stages of the tumor, reaching 56 days, 35 days and 30 days for women whose cancers were classified up to IIA; from IIB to IIIB, and IVA-IVB, respectively. CONCLUSIONS Despite most of the women having had access to radiotherapy within the recommended 60 days, the implementation of procedures to define the stage of the tumor and to reestablish clinical conditions took a large part of this time, showing that at least one of these intervals needs to be improved. Even though the waiting times were ideal for all patients, the most advanced cases were quickly treated, which suggests that access to radiotherapy by women with cervical cancer has been reached with equity.

  3. The experiences of adults who are on dialysis and waiting for a renal transplant from a deceased donor: a systematic review.

    Science.gov (United States)

    Burns, Tania; Fernandez, Ritin; Stephens, Moira

    2015-03-12

    Kidney transplantation has been recognized as the best renal replacement therapy option for people with end stage renal disease. With an estimated 170,000 people waiting for a kidney transplant around the world and a limited supply of donor organs, the waiting time is often prolonged for many years. The aim of this review was to examine the existing evidence of patients' experiences of living on dialysis and waiting for a renal transplant from a deceased donor. This review considered studies that included adult patients aged 18 years and over who had been on dialysis (hemodialysis or peritoneal dialysis) for up to 15 years and who were waiting for a renal transplant from a deceased donor. Types of intervention(s)/phenomena of interest: The phenomena of interest were the experiences of adults waiting for a renal transplant from a deceased donor and more specifically, the impact of waiting on their lifestyle and day to day living. Types of studies: This review considered studies that focused on qualitative data including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research and feminist research. Types of outcomes: This review considered studies that included the experiences of people who were waiting on dialysis for a kidney transplant from a deceased donor. The search strategy aimed to find both published and unpublished studies through electronic databases, reference list searches and the World Wide Web. Extensive searches were undertaken of the CINAHL, Embase, Medline and PsychInfo databases of published literature, the Cochrane Database of Systematic Reviews and the Virginia Henderson International Nursing Library, OpenGrey and the New York Academy of Medicine databases of unpublished literature. Each study was assessed for methodological quality by two independent reviewers using the Joanna Briggs Institute Qualitative Assessment and Review Instrument checklist. Disagreements between the reviewers were resolved

  4. How goal disturbance, coping and chest pain relate to quality of life: A study among patients waiting for PTCA.

    Science.gov (United States)

    Echteld, M A; van Elderen, T M; van der Kamp, L J

    2001-01-01

    This article describes psychological correlates of quality of life (QOL) in patients on a waiting list for percutaneous transluminal coronary angioplasty (PTCA). Variables were selected based on a theoretical model describing psychological correlates of QOL in PTCA patients. This model was based on self-regulation and stress-coping theories. The variables in the model are stress appraisal, coping, coping resources, and general and disease-specific QOL variables. Respondents were 122 patients on a 3-month waiting list for a PTCA. Results indicated that PTCA patients had a poorer QOL than matched healthy controls. Using a path analysis approach to regression analysis, it appeared that goal disturbance, avoidant coping, approach coping, and chest pain were related to QOL. More specifically, chest pain and goal disturbance were only related to health-related QOL and negative affect. Both approach and avoidant coping were related to QOL variables. Results could be explained adequately using self-regulation theory. Recommendations for future research and for form and content of rehabilitation programmes were made.

  5. To Minimize the Waiting Time and Waiting Time Cost of Dumpers, Waiting in a Queue for Loader at Stone Crusher Plant Mine by Using the Single and Multi-Channel Queuing Theory.

    Directory of Open Access Journals (Sweden)

    Vaibhav Singh

    2014-09-01

    Full Text Available Waiting line problems arise because there is too much demand on the facilities so that we can say that there is an excess of waiting time or inadequate number of service facilities. At the stone crusher plant mine the dumpers come to load from the loader. The crusher plant has 11 dumpers and these 11 dumpers make 88 trips during 8-hour day. The company has one loader to load all the dumpers, which results in a formation of long waiting line or queue. Due to this queue there is a long waiting time in queue of dumpers and cost associated with waiting time of dumpers. Queuing theory can quite effectively analyze such queuing phenomenon. In this research paper I have applied the queuing theory to the stone crusher plant mine, where the queue of dumpers formed at the loading station. By applying the single channel queuing theory I analyzed the current situation of the stone crusher plant mine and find the problems of the current system. To overcome the above problems I have applied the multi-channel queuing theory to minimize the waiting time in queue of dumpers and very high cost associated with waiting time of dumpers. In the new system not only waiting time in queue of dumpers and very high cost associated with waiting time of dumpers is reduced but also there is an efficient utilization of dumpers and loaders along with provide the profitable situation to the crusher plant.

  6. Patient satisfaction with ambulatory healthcare services: waiting time and filling time.

    Science.gov (United States)

    Dansky, K H; Miles, J

    1997-01-01

    Customer satisfaction is an important measure of service quality in healthcare organizations. This study investigated the relationship between patient waiting and satisfaction with ambulatory healthcare services, with waiting times divided into segments of the patient-care episode. Two management techniques to alter perceptions of waiting were also examined. Regression models measuring the effect of waiting times on satisfaction found that the total time spent waiting for the clinician was the most significant predictor of patient satisfaction. Informing patients how long their wait would be and being occupied during the wait were also significant predictors of patient satisfaction. These results show that waiting times, even if they cannot be shortened, can be managed more effectively to improve patient satisfaction.

  7. Non-Poissonian Distribution of Tsunami Waiting Times

    Science.gov (United States)

    Geist, E. L.; Parsons, T.

    2007-12-01

    Analysis of the global tsunami catalog indicates that tsunami waiting times deviate from an exponential distribution one would expect from a Poisson process. Empirical density distributions of tsunami waiting times were determined using both global tsunami origin times and tsunami arrival times at a particular site with a sufficient catalog: Hilo, Hawai'i. Most sources for the tsunamis in the catalog are earthquakes; other sources include landslides and volcanogenic processes. Both datasets indicate an over-abundance of short waiting times in comparison to an exponential distribution. Two types of probability models are investigated to explain this observation. Model (1) is a universal scaling law that describes long-term clustering of sources with a gamma distribution. The shape parameter (γ) for the global tsunami distribution is similar to that of the global earthquake catalog γ=0.63-0.67 [Corral, 2004]. For the Hilo catalog, γ is slightly greater (0.75-0.82) and closer to an exponential distribution. This is explained by the fact that tsunamis from smaller triggered earthquakes or landslides are less likely to be recorded at a far-field station such as Hilo in comparison to the global catalog, which includes a greater proportion of local tsunamis. Model (2) is based on two distributions derived from Omori's law for the temporal decay of triggered sources (aftershocks). The first is the ETAS distribution derived by Saichev and Sornette [2007], which is shown to fit the distribution of observed tsunami waiting times. The second is a simpler two-parameter distribution that is the exponential distribution augmented by a linear decay in aftershocks multiplied by a time constant Ta. Examination of the sources associated with short tsunami waiting times indicate that triggered events include both earthquake and landslide tsunamis that begin in the vicinity of the primary source. Triggered seismogenic tsunamis do not necessarily originate from the same fault zone

  8. List based prefetch

    Energy Technology Data Exchange (ETDEWEB)

    Boyle, Peter; Christ, Norman; Gara, Alan; Kim, Changhoan; Mawhinney, Robert; Ohmacht, Martin; Sugavanam, Krishnan

    2014-08-12

    A list prefetch engine improves a performance of a parallel computing system. The list prefetch engine receives a current cache miss address. The list prefetch engine evaluates whether the current cache miss address is valid. If the current cache miss address is valid, the list prefetch engine compares the current cache miss address and a list address. A list address represents an address in a list. A list describes an arbitrary sequence of prior cache miss addresses. The prefetch engine prefetches data according to the list, if there is a match between the current cache miss address and the list address.

  9. How Tolerable is Delay? Consumers' Evaluations of Internet Web Sites After Waiting

    NARCIS (Netherlands)

    Dellaert, B.G.C.; Kahn, B.

    1998-01-01

    How consumers’ waiting times affect their retrospective evaluations of Internet Web Sites is investigated in four computer-based experiments. Results show that waiting can but does not always negatively affect evaluations of Web Sites. Results also show that the potential negative effects of waiting

  10. Nursing interventions for family members waiting during cardiac procedures.

    Science.gov (United States)

    Trecartin, Kelly; Carroll, Diane L

    2011-08-01

    Anxiety is shared by patients and family members (FMs) and can increase throughout the FMs waiting during invasive cardiac procedures (ICP). The purpose of this study was to measure the effects of an informational report (IR) and a postprocedure visit (PPV), on the anxiety of waiting FMs. There were 151 FMs assigned to 3 groups; Group 1 (50 FMs: standard of care [SOC]), Group 2 (50 FMs: SOC + IR), and Group 3 (51 FMs: SOC + IR + PPV). Pre/ postvariables measured were: blood pressure (BP), heart rate (HR), skin temperature (ST), and anxiety. When comparing the BP, HR, ST, and anxiety there were no differences between groups with either SOC or IR. There was a significant reduction in anxiety, from baseline to the PPV in Group 3 (F = 10.1; p < .000). A PPV had an impact on FMs and a PPV should be incorporated as a nursing intervention during ICP.

  11. Renewal processes based on generalized Mittag-Leffler waiting times

    Science.gov (United States)

    Cahoy, Dexter O.; Polito, Federico

    2013-03-01

    The fractional Poisson process has recently attracted experts from several fields of study. Its natural generalization of the ordinary Poisson process made the model more appealing for real-world applications. In this paper, we generalized the standard and fractional Poisson processes through the waiting time distribution, and showed their relations to an integral operator with a generalized Mittag-Leffler function in the kernel. The waiting times of the proposed renewal processes have the generalized Mittag-Leffler and stretched-squashed Mittag-Leffler distributions. Note that the generalizations naturally provide greater flexibility in modeling real-life renewal processes. Algorithms to simulate sample paths and to estimate the model parameters are derived. Note also that these procedures are necessary to make these models more usable in practice. State probabilities and other qualitative or quantitative features of the models are also discussed.

  12. Mandatory weight loss during the wait for bariatric surgery.

    Science.gov (United States)

    Glenn, Nicole M; Raine, Kim D; Spence, John C

    2015-01-01

    Mandatory presurgical, behavior-induced weight loss, although not standard, is a relatively common practice among bariatric surgical clinics. We explore the patient's experience of this practice using phenomenology. We gathered experiential accounts from 7 individuals waiting to have the procedure at a large publically funded clinic in western Canada. In writing this article, we focused on four phenomenological themes: "just nod your head and carry on"-silencing through the ideal; waiting and weighing-promoting weight consciousness to the weight conscious; paying for surgical approval through weight loss; and presurgical weight loss and questioning the need for weight loss surgery altogether. We contrast the experiential findings with the clinical literature to question the impact and possible (unintended or unexpected) effects the practice might have, particularly on patients' lives. We situate this article within a larger discussion about the possible contribution of experiential knowledge to clinical guidelines, practices, and pedagogies. © The Author(s) 2014.

  13. The Effects of Waiting for Treatment: A Meta-Analysis of Waitlist Control Groups in Randomized Controlled Trials for Social Anxiety Disorder.

    Science.gov (United States)

    Steinert, Christiane; Stadter, Katja; Stark, Rudolf; Leichsenring, Falk

    2016-07-22

    Social anxiety disorder (SAD) is a highly prevalent mental disorder. However, little is known about how SAD changes in subjects who do not receive treatment. Waitlist control groups (WLCGs) are frequently included in randomized controlled trials (RCTs) on the treatment of mental disorders. Data from WLCGs are of value as they provide information on the untreated short-term course of a disorder and may serve as disorder-specific norms of change (benchmarks) against which treatment outcomes of SAD can be compared. Thus, we performed a meta-analysis focusing on the effects occurring in WLCGs of RCTs for SAD. Our study was conducted along the PRISMA guidelines. Thirty RCTs (total n = 2460) comprising 30 WLCGs and 47 treatment groups were included. Mean waiting time was 10.6 weeks. The pooled effect of waiting on SAD measures was g = 0.128 (95% CI: 0.057-0.199). Effects regarding other forms of anxiety, depression and functioning were of similarly small size. In contrast, change in the treatment groups was large, both within (g = 0.887) and between groups (g = 0.860). Our results show that for SAD, changes occurring in WLCGs of RCTs are small. The findings may serve as benchmarks in pilot studies of a new treatment or as an additional comparison in studies comparing two active treatments. For psychotherapy research in general, the small effect sizes found in WLCGs confirm that testing a treatment against a waiting list is not a very strict test. Further research on WLCGs in specific mental disorders is required, for example examining the expectancies of patients randomized to waiting. Copyright © 2016 John Wiley & Sons, Ltd. Key Practitioner Message In clinical practice, patients suffering from a mental disorder often have to wait for treatment. By analyzing data from waitlist control groups we can gain estimates of symptom change that occur during waiting. It could be seen that waiting for treatment only results in a negligible effect. Thus, in the

  14. Reducing pharmacy wait time to promote customer service: a follow-up study.

    Science.gov (United States)

    Slowiak, Julie M; Huitema, Bradley E

    2015-01-01

    The present study had 3 objectives: (1) to evaluate the effects of 2 different interventions (feedback regarding customer satisfaction with wait time and combined feedback and goal setting) on wait time in a hospital outpatient pharmacy; (2) to assess the extent to which the previously applied interventions maintained their effects; and (3) to evaluate the differences between the effects of the original study and those of the present follow-up study. Participants were 10 employees (4 pharmacists and 6 technicians) of an outpatient pharmacy. Wait times and customer satisfaction ratings were collected for "waiting customers." An ABCB within-subjects design was used to assess the effects of the interventions on both wait time and customer satisfaction, where A was the baseline (no feedback and no goal setting); B was the customer satisfaction feedback; and C was the customer satisfaction feedback, the wait time feedback, and the goal setting for wait time reduction. Wait time decreased after baseline when the combined intervention was introduced, and wait time increased with the reintroduction of satisfaction feedback (alone). The results of the replication study confirm the pattern of the results of the original study and demonstrate high sensitivity of levels of customer satisfaction with wait time. The most impressive result of the replication is the nearly 2-year maintenance of lower wait time between the end of the original study and the beginning (baseline) of the replication.

  15. Cytomegalovirus and Toxoplasma gondii seroprevalence in a Brazilian liver transplant waiting

    Directory of Open Access Journals (Sweden)

    R. A. M. B. Almeida

    2007-01-01

    Full Text Available Cytomegalovirus (CMV disease is a major cause of morbidity and mortality in solid organ transplantation. Disseminated toxoplasmosis after liver transplantation is a rare but fatal event. Serologic screening of the donor and the recipient is essential to prophylactic management, early diagnosis and therapeutic strategies to minimize the consequences of these infections. The aim of the present study was to determine the seroprevalence of CMV and Toxoplasma gondii (TG in a Brazilian liver transplant waiting list (LTWL. Serological data were collected from 44 candidates on the LTWL between May 2003 and November 2004. Serological investigation of antibodies IgM and IgG against CMV (anti-CMV and TG (anti-T. gondii was performed using fluorometry commercial kits. IgG anti-CMV was positive in 37 patients (94.9% out of 39 available results. There were not IgM anti-CMV positive results. Out of 36 analyzed patients, 22 (61.1% presented positive IgG anti-T. gondii and none had positive IgM anti-T. gondii. The high CMV seroprevalence among our LTWL reinforces the need for appropriate protocols to avoid related complications, like reactivation and superinfection by CMV. Environmental and drug prophylactic strategies against primary infection and reactivation, as well as early diagnosis and treatment of toxoplasmosis complications, are essential for the good outcome of transplant patients.

  16. Watch and wait approach to rectal cancer: A review

    Institute of Scientific and Technical Information of China (English)

    Marcos; E; Pozo; Sandy; H; Fang

    2015-01-01

    In 2014, there were an estimated 136800 new cases of colorectal cancer, making it the most common gastrointestinal malignancy. It is the second leadingcause of cancer death in both men and women in the United States and over one-third of newly diagnosed patients have stage Ⅲ(node-positive) disease. For stage Ⅱ and Ⅲ colorectal cancer patients, the mainstay of curative therapy is neoadjuvant therapy, followed by radical surgical resection of the rectum. However, the consequences of a proctectomy, either by low anterior resection or abdominoperineal resection, can lead to very extensive comorbidities, such as the need for a permanent colostomy, fecal incontinence, sexual and urinary dysfunction, and even mortality. Recently, trends of complete regression of the rectal cancer after neoadjuvant chemoradiation therapy have been confirmed by clinical and radiographic evaluationthis is known as complete clinical response(cC R). The "watch and wait" approach was first proposed by Dr. Angelita Habr-Gama in Brazil in 2009. Those patients with c CR are followed with close surveillance physical examinations, endoscopy, and imaging. Here, we review management of rectal cancer, the development of the "watch and wait" approach and its outcomes.

  17. Healthcare Use for Pain in Women Waiting for Gynaecological Surgery

    Directory of Open Access Journals (Sweden)

    Sarah Walker

    2016-01-01

    Full Text Available Background. Pain while waiting for surgery may increase healthcare utilization (HCU preoperatively. Objective. Examine the association between preoperative pain and HCU in the year prior to gynecological surgery. Methods. 590 women waiting for surgery in a Canadian tertiary care centre were asked to report on HCU in the year before surgery. Pain was assessed using the Brief Pain Inventory. Results. 33% reported moderate to severe pain intensity and interference in the week before surgery. Sixty-one percent (n=360 reported a total of 2026 healthcare visits, with 21% (n=126 reporting six or more visits in the year before surgery. After controlling for covariates, women with moderate to severe (>3/10 pain intensity/interference reported higher odds of overall HCU (≥3 pain-related visits to family doctor or specialist in the past year or ≥1 to emergency/walk-in clinic compared to women with no or mild pain. Lower body mass index (BMI < 30 versus ≥30 and anxiety and/or depression were associated with emergency department or walk-in visits but not visits to family doctors or specialists. Conclusions. There is a high burden of pain in women awaiting gynecological surgery. Decisions about resource allocation should consider the impact of pain on individuals and the healthcare system.

  18. Improved Appliance Coordination Scheme with Waiting Time in Smart Grids

    Directory of Open Access Journals (Sweden)

    Firas A. Al Balas

    2016-04-01

    Full Text Available Smart grids aim to merge the advances in communications and information technologies with traditional power grids. In smart grids, users can generate energy and sell it to the local utility supplier. The users can reduce energy consumption by shifting appliances’ start time to off-peak hours. Many researchers have proposed techniques to reduce the previous issue for home appliances, such as the Appliances Coordination (ACORD scheme and Appliances Coordination with Feed In (ACORD-FI scheme. The goal of this work is to introduce an efficient scheme to reduce the total cost of energy bills by utilizing the ACORD-FI scheme to obtain an effective solution. In this work three scheduling schemes are proposed: the Appliances Coordination by Giving Waiting Time (ACORD-WT, the Appliances Coordination by Giving Priority (ACORD-P, and using photovoltaic (PV with priority and waiting time scheduling algorithms. A simulator written in C++ is used to test the performance of the proposed schemes using. The performance metric used is the total savings in the cost of the energy bill in dollars. The first comparison for the proposed schemes with the ACORD-FI, and the results show that the efficiency of the proposed ACORD-WT is better than the ACORD-FI, regardless of the number of appliances. Moreover, the proposed ACORD-P, is also better than the standard ACORD-FI.

  19. No-Wait Flexible Flow Shop Scheduling with Due Windows

    Directory of Open Access Journals (Sweden)

    Rong-Hwa Huang

    2015-01-01

    Full Text Available To improve capacity and reduce processing time, the flow shop with multiprocessors (FSMP system is commonly used in glass, steel, and semiconductor production. No-wait FSMP is a modern production system that responds to periods when zero work is required in process production. The production process must be continuous and uninterrupted. Setup time must also be considered. Just-in-time (JIT production is very popular in industry, and timely delivery is important to customer satisfaction. Therefore, it is essential to consider the time window constraint, which is also very complex. This study focuses on a no-wait FSMP problem with time window constraint. An improved ant colony optimization (ACO, known as ant colony optimization with flexible update (ACOFU, is developed to solve the problem. The results demonstrate that ACOFU is more effective and robust than ACO when applied to small-scale problems. ACOFU has superior solution capacity and robustness when applied to large-scale problems. Therefore, this study concludes that the proposed algorithm ACOFU performs excellently when applied to the scheduling problem discussed in this study.

  20. Surviving the wait: defining support while awaiting breast cancer surgery.

    Science.gov (United States)

    Dickerson, Suzanne S; Alqaissi, Nesreen; Underhill, Meghan; Lally, Robin M

    2011-07-01

    This paper is a report of a descriptive study of the common meanings, shared experiences and practices of social support of women within the days between breast cancer diagnosis and treatment initiation. Support needs, types of social support and support outcomes during and after breast cancer treatment have been explored worldwide. However, to promote women's psychological wellbeing it is essential to understand how women define support in the highly stressful period initially following diagnosis. Secondary analysis of narrative texts using interpretive phenomenology from 18 women in the Midwestern United States newly diagnosed with breast cancer who were interviewed in 2005 for a study of women's pretreatment thought processes. 'Surviving the wait for surgery by balancing support needs to maintain a hopeful outlook' was the overarching pattern linking six other related themes: (1) controlling access to information for self and to others, (2) knowing which supportive network members to access, (3) controlling anxiety through distraction to maintain hope while waiting, (4) being in good hands and comfortable with decision (provider support), (5) protecting others through concealment and being strong to maintain hope and (6) accepting care from others vs. maintaining a nurturing role. Implications for nurses working with women in the days following breast cancer diagnosis include assessing women's definitions and availability of support; respecting varied needs for informational support; providing a supportive clinical environment; educating clinicians, family and friends regarding unsupportive responses within the cultural context and validating women's control and balancing of support needs. © 2011 Blackwell Publishing Ltd.

  1. Cigarette smoking and waiting time to pregnancy: results of a pilot study.

    Science.gov (United States)

    Zilaitiene, Birute; Dirzauskas, Marius; Preiksa, Romualdas Tomas; Matulevicius, Valentinas

    2007-01-01

    Waiting time to pregnancy is an important characteristic of human reproductive health, which has not been investigated in Lithuania until now. Data on waiting time to pregnancy have been collected from medical records of 111 women admitted to the Department of Obstetrics, Klaipeda Hospital. Seven women in whom pregnancy was the result of infertility treatment were excluded from the analysis, and the rest 104 cases were analyzed. We evaluated waiting time to pregnancy in respect to the age of couples, contraceptive use, cigarette smoking of both partners, and some other features of obstetric history. The mean waiting time to pregnancy in the cohort was 5.21+/-7.03 months. If both partners smoked, the mean waiting time to pregnancy was significantly longer than in nonsmoking couples (7.68+/-9.41 vs. 4.30+/-5.73, Pus to plan and implement a larger-scale study of waiting time to pregnancy in Lithuanian population.

  2. The impact of different prioritisation policies on waiting times: case studies of Norway and Scotland.

    Science.gov (United States)

    Januleviciute, Jurgita; Askildsen, Jan Erik; Kaarboe, Oddvar; Holmås, Tor Helge; Sutton, Matt

    2013-11-01

    We investigate the distributional consequences of two different waiting times initiatives, one in Norway, and one in Scotland. The primary focus of Scotland's recent waiting time reforms, introduced in 2003, and modified in 2005 and 2007, has been on reducing maximum waiting times through the imposition of high profile national targets accompanied by increases in resources. In Norway, the focus of the reform introduced in September 2004, has been on assigning patients referred to hospital a maximum waiting time based on disease severity, the expected benefit and the cost-effectiveness of the treatment. We use large, national administrative datasets from before and after each of these reforms and assign priority groups based on the maximum waiting times stipulated in medical guidelines. The analysis shows that the lowest priority patients benefited most from both reforms. This was at the cost of longer waiting times for patients that should have been given higher priority in Norway, while Scotland's high priority patients remained unaffected.

  3. Waiting time disparities in breast cancer diagnosis and treatment: a population-based study in France.

    Science.gov (United States)

    Molinié, F; Leux, C; Delafosse, P; Ayrault-Piault, S; Arveux, P; Woronoff, A S; Guizard, A V; Velten, M; Ganry, O; Bara, S; Daubisse-Marliac, L; Tretarre, B

    2013-10-01

    Waiting times are key indicators of a health's system performance, but are not routinely available in France. We studied waiting times for diagnosis and treatment according to patients' characteristics, tumours' characteristics and medical management options in a sample of 1494 breast cancers recorded in population-based registries. The median waiting time from the first imaging detection to the treatment initiation was 34 days. Older age, co-morbidity, smaller size of tumour, detection by organised screening, biopsy, increasing number of specimens removed, multidisciplinary consulting meetings and surgery as initial treatment were related to increased waiting times in multivariate models. Many of these factors were related to good practices guidelines. However, the strong influence of organised screening programme and the disparity of waiting times according to geographical areas were of concern. Better scheduling of diagnostic tests and treatment propositions should improve waiting times in the management of breast cancer in France.

  4. The effect of waiting times on demand and supply for elective surgery: Evidence from Italy.

    Science.gov (United States)

    Riganti, Andrea; Siciliani, Luigi; Fiorio, Carlo V

    2017-09-01

    Waiting times are a major policy concern in publicly funded health systems across OECD countries. Economists have argued that, in the presence of excess demand, waiting times act as nonmonetary prices to bring demand for and supply of health care in equilibrium. Using administrative data disaggregated by region and surgical procedure over 2010-2014 in Italy, we estimate demand and supply elasticities with respect to waiting times. We employ linear regression models with first differences and instrumental variables to deal with endogeneity of waiting times. We find that demand is inelastic to waiting times while supply is more elastic. Estimates of demand elasticity are between -0.15 to -0.24. Our results have implications on the effectiveness of policies aimed at increasing supply and their ability to reduce waiting times. Copyright © 2017 John Wiley & Sons, Ltd.

  5. General Anesthetic Versus Light Sedation: Effect on Pediatric Endoscopy Wait Times

    Directory of Open Access Journals (Sweden)

    Christine Edwards

    2013-01-01

    Full Text Available BACKGROUND: Wait times are an important measure of health care system effectiveness. There are no studies describing wait times in pediatric gastroenterology for either outpatient visits or endoscopy. Pediatric endoscopy is performed under light sedation or general anesthesia. The latter is hypothesized to be associated with a longer wait time due to practical limits on access to anesthesia in the Canadian health care system.

  6. Time to Endoscopy in Patients with Colorectal Cancer: Analysis of Wait-Times

    Directory of Open Access Journals (Sweden)

    Renée M. Janssen

    2016-01-01

    Full Text Available Objective. The Canadian Association of Gastroenterology Wait Time Consensus Group recommends that patients with symptoms associated with colorectal cancer (CRC should have an endoscopic examination within 2 months. However, in a recent survey of Canadian gastroenterologists, wait-times for endoscopy were considerably longer than the current guidelines recommend. The purpose of this study was to evaluate wait-times for colonoscopy in patients who were subsequently found to have CRC through the Division of Gastroenterology at St. Paul’s Hospital (SPH. Methods. This study was a retrospective chart review of outpatients seen for consultation and endoscopy ultimately diagnosed with CRC. Subjects were identified through the SPH pathology database for the inclusion period 2010 through 2013. Data collected included wait-times, subject characteristics, cancer characteristics, and outcomes. Results. 246 subjects met inclusion criteria for this study. The mean wait-time from primary care referral to first office visit was 63 days; the mean wait-time to first endoscopy was 94 days. Patients with symptoms waited a mean of 86 days to first endoscopy, considerably longer than the national recommended guideline of 60 days. There was no apparent effect of length of wait-time on node positivity or presence of distant metastases at the time of diagnosis. Conclusion. Wait-times for outpatient consultation and endoscopic evaluation at the St. Paul’s Hospital Division of Gastroenterology exceed current guidelines.

  7. Norwegian Priority Setting in Practice – an Analysis of Waiting Time Patterns Across Medical Disciplines

    Directory of Open Access Journals (Sweden)

    Jurgita Januleviciute Gangstøe

    2016-06-01

    Full Text Available Background: Different strategies for addressing the challenge of prioritizing elective patients efficiently and fairly have been introduced in Norway. In the time period studied, there were three possible outcomes for elective patients that had been through the process of priority setting: (i high priority with assigned individual maximum waiting time; (ii low priority without a maximum waiting time; and (iii refusal (not in need for specialized services. We study variation in priority status and waiting time of the first two groups across different medical disciplines. Methods: Data was extracted from the Norwegian Patient Register (NPR and contains information on elective referrals to 41 hospitals in the Western Norway Regional Health Authority in 2010. The hospital practice across different specialties was measured by patient priority status and waiting times. The distributions of assigned maximum waiting times and the actual ones were analyzed using standard Kernel density estimation. The perspective of the planning process was studied by measuring the time interval between the actual start of healthcare and the maximum waiting time. Results: Considerable variation was found across medical specialties concerning proportion of priority patients and their maximum waiting times. The degree of differentiation in terms of maximum waiting times also varied by medical discipline. We found that the actual waiting time was very close to the assigned maximum waiting time. Furthermore, there was no clear correspondence between the actual waiting time for patients and their priority status. Conclusion: Variations across medical disciplines are often interpreted as differences in clinical judgment and capacity. Alternatively they primarily reflect differences in patient characteristics, patient case-mix, as well as capacity. One hypothesis for further research is that the introduction of maximum waiting times may have contributed to push the actual

  8. Whittling Down the Wait Time: Exploring Models to Minimize the Delay from Initial Concern to Diagnosis and Treatment of Autism Spectrum Disorder.

    Science.gov (United States)

    Gordon-Lipkin, Eliza; Foster, Jessica; Peacock, Georgina

    2016-10-01

    The process from initial concerns to diagnosis of autism spectrum disorder (ASD) can be a long and complicated process. The traditional model for evaluation and diagnosis of ASD often consists of long wait-lists and evaluations that result in a 2-year difference between the earliest signs of ASD and mean age of diagnosis. Multiple factors contribute to this diagnostic bottleneck, including time-consuming evaluations, cost of care, lack of providers, and lack of comfort of primary care providers to diagnose autism. This article explores innovative clinical models that have been implemented to address this as well as future directions and opportunities.

  9. Empowered citizen 'health hackers' who are not waiting.

    Science.gov (United States)

    Omer, Timothy

    2016-08-17

    Due to the easier access to information, the availability of low cost technologies and the involvement of well educated, passionate patients, a group of citizen 'Health Hackers', who are building their own medical systems to help them overcome the unmet needs of their conditions, is emerging. This has recently been the case in the type 1 diabetes community, under the movement #WeAreNotWaiting, with innovative use of current medical devices hacked to access data and Open-Source code producing solutions ranging from remote monitoring of diabetic children to producing an Artificial Pancreas System to automate the management and monitoring of a patient's condition. Timothy Omer is working with the community to utilise the technology already in his pocket to build a mobile- and smartwatch-based Artificial Pancreas System.

  10. Computation and evaluation of scheduled waiting time for railway networks

    DEFF Research Database (Denmark)

    Landex, Alex

    2010-01-01

    Timetables are affected by scheduled waiting time (SWT) that prolongs the travel times for trains and thereby passengers. SWT occurs when a train hinders another train to run with the wanted speed. The SWT affects both the trains and the passengers in the trains. The passengers may be further aff...... timetable by analysing different timetables and/or plans of operation. This article presents methods to examine SWT by simulation for both trains and passengers in entire railway networks....... affected due to longer transfer times to other trains. SWT can be estimated analytically for a given timetable or by simulation of timetables and/or plans of operation. The simulation of SWT has the benefit that it is possible to examine the entire network. This makes it possible to improve the future...

  11. Determining prescription durations based on the parametric waiting time distribution

    DEFF Research Database (Denmark)

    Støvring, Henrik; Pottegård, Anton; Hallas, Jesper

    2016-01-01

    ). When the IAD consisted of a mixture of two Log-Normal distributions, but was analyzed with a single Log-Normal distribution, relative bias did not exceed 9%. Using a Log-Normal FRD, we estimated prescription durations of 117, 91, 137, and 118 days for NSAIDs, warfarin, bendroflumethiazide...... two-component mixture model for the waiting time distribution (WTD). The distribution component for prevalent users estimates the forward recurrence density (FRD), which is related to the distribution of time between subsequent prescription redemptions, the inter-arrival density (IAD), for users......, and the method was applied to empirical data for four model drugs: non-steroidal anti-inflammatory drugs (NSAIDs), warfarin, bendroflumethiazide, and levothyroxine. RESULTS: Simulation studies found negligible bias when the data-generating model for the IAD coincided with the FRD used in the WTD estimation (Log-Normal...

  12. Enabling narrative pedagogy: inviting, waiting, and letting be.

    Science.gov (United States)

    Ironside, Pamela M

    2014-01-01

    This article describes how teachers enable Narrative Pedagogy in their courses by explicating the Concernful Practice Inviting: Waiting and Letting Be. Narrative Pedagogy, a research-based, phenomenological approach to teaching and learning, extends conventional pedagogies and offers nursing faculty an alternative way of transforming their schools and courses. Using hermeneutic phenomenology, interview data collected over a 10-year period were analyzed by coding practical examples of teachers' efforts to enact Narrative Pedagogy. When Narrative Pedagogy is enacted, teachers and students focus on thinking and learning together about nursing phenomena and seek new understandings about how they may provide care in the myriad situations they encounter. Although the Concernful Practices co-occur, explicating inviting experiences can assist new teachers, and those seeking to extend their pedagogical literacy, by providing new understandings of how Narrative Pedagogy can be enacted.

  13. Patient and staff perspective of a nurse-led support programme for patients waiting for cardiac surgery: participant perspective of a cardiac support programme.

    Science.gov (United States)

    Goodman, Helen; Davison, June; Preedy, Michael; Peters, Emma; Waters, Phillip; Persaud-Rai, Bibi; Shuldham, Caroline; Pepper, John; Cowie, Martin R

    2009-03-01

    A nurse-led support and education programme for patients waiting for coronary artery bypass surgery was evaluated in a randomised controlled trial of 188 patients at a tertiary centre in the UK. To add a qualitative perspective to the evaluation by exploring patients' experience while taking part in the trial and staff views of the patients' experience and the intervention. A purposive sample of 19 patients was interviewed and the transcriptions read to staff during focus groups. They discussed what they learned from the stories and their own experience of the programme. The patients appreciated support from the nurses but felt communication and physical assessment could be improved. The patients varied in their understanding of the programme and their degree of motivation to improve their health. The staff varied in their approach to preparing patients for surgery. External factors influencing the intervention's impact were length of time on the waiting list and the increasing contribution of local rehabilitation services. Staff need to improve communication both between themselves and with the patients. Patients appreciate physical and psychological preparation for surgery, but the waiting period is not the optimal time to address their risk factors for coronary disease.

  14. The model for end-stage liver disease score-based system predicts short term mortality better than the current Child-Turcotte-Pugh score-based allocation system during waiting for deceased liver transplantation.

    Science.gov (United States)

    Hong, Geun; Lee, Kwang-Woong; Suh, Sukwon; Yoo, Tae; Kim, Hyeyoung; Park, Min-Su; Choi, Youngrok; Yi, Nam-Joon; Suh, Kyung-Suk

    2013-08-01

    To adopt the model for end-stage liver disease (MELD) score-based system in Korea, the feasibility should be evaluated by analysis of Korean database. The aim of this study was to investigate the feasibility of the MELD score-based system compared with the current Child-Turcotte-Pugh (CTP) based-system and to suggest adequate cut-off to stratify waiting list mortality among Korean population. We included 788 adult patients listed in waiting list in Seoul National University Hospital from January 2008 to May 2011. The short-term survival until 6 months after registration was evaluated. Two hundred forty six (31.2%) patients underwent live donor liver transplantation and 353 (44.8%) patients were still waiting and 121 (15.4%) patients were dropped out due to death. Significant difference was observed when MELD score 24 and 31 were used as cut-off. Three-months survival of Status 2A was 70.2%. However, in Status 2A patients whose MELD score less than 24 (n=82), 86.6% of patients survived until 6 month. Furthermore, patients with high MELD score (≥31) among Status 2B group showed poorer survival rate (45.8%, 3-month) than Status 2A group. In conclusion, MELD score-based system can predict short term mortality better and select more number of high risk patients in Korean population.

  15. Waiting for Treatment for Chronic Pain – a Survey of Existing Benchmarks: Toward Establishing Evidence-Based Benchmarks for Medically Acceptable Waiting Times

    Directory of Open Access Journals (Sweden)

    Mary E Lynch

    2007-01-01

    Full Text Available As medical costs escalate, health care resources must be prioritized. In this context, there is an increasing need for benchmarks and best practices in wait time management. In December 2005, the Canadian Pain Society struck a Task Force to identify benchmarks for acceptable wait times for treatment of chronic pain. The task force mandate included a systematic review and survey to identify national or international wait time benchmarks for chronic pain, proposed or in use, along with a review of the evidence upon which they are based. An extensive systematic review of the literature and a survey of International Association for the Study of Pain Chapter Presidents and key informants has identified that there are no established benchmarks or guidelines for acceptable wait times for the treatment of chronic pain in use in the world. In countries with generic guidelines or wait time standards that apply to all outpatient clinics, there have been significant challenges faced by pain clinics in meeting the established targets. Important next steps are to ensure appropriate additional research and the establishment of international benchmarks or guidelines for acceptable wait times for the treatment of chronic pain. This will facilitate advocacy for improved access to appropriate care for people suffering from chronic pain around the world.

  16. Waiting for Godot is an Irish Endgame: A Postcolonial Reading of Samuel Beckett’s Waiting for Godot and Endgame

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    Sayyed Rahim Moosavinia

    2013-01-01

    Full Text Available Irish National Drama is very sensitive when it comes to the issue of English Colonization, colonial forces, independence and the matter of post-colonial. In fact, a kind of Irish consciousness is present in all the dramas of this nation and all playwrights in this trend- even indirectly or by implication- have tried to portray these matters through their works. This study is an attempt to prove the claim that even a playwright like Samuel Beckett, whose works have been written out of the canon of Irish Literature because of living on exile, adopting another language or semi-taboo labels like Absurdism, Universality and Placlessness, can be read in light postcolinalism. To this aim, two of Beckett’s plays Waiting for Godot and End Game are chosen here as the representative and put into explication. Keywords: Irish, postcolonialsim, absurdism, universality, placlessness, colonizer, colonized

  17. A Modern Review of Waiting for Godot-A Study of absurdity in the play

    Institute of Scientific and Technical Information of China (English)

    陈子丽; 陈启亮

    2013-01-01

    Waiting for Godot is often regarded as Beckett’s masterpiece. This paper is to explore the possible themes in the play. Waiting for the unrealizable tomorrow is a most dominant theme of the play. Through a brief analysis of the plot, the dominant theme can be demonstrated very clearly.

  18. The waiting time distribution as a graphical approach to epidemiologic measures of drug utilization

    DEFF Research Database (Denmark)

    Hallas, J; Gaist, D; Bjerrum, L

    1997-01-01

    of the window. After a few months, the graph will be dominated by new, incident users. As examples, we present waiting time distributions for insulin, ulcer drugs, systemic corticosteroids, antidepressants, and disulfiram. Appropriately analyzed and interpreted, the waiting time distributions can provide...

  19. Waiting Endurance Time Estimation of Electric Two-Wheelers at Signalized Intersections

    Directory of Open Access Journals (Sweden)

    Mei Huan

    2014-01-01

    Full Text Available The paper proposed a model for estimating waiting endurance times of electric two-wheelers at signalized intersections using survival analysis method. Waiting duration times were collected by video cameras and they were assigned as censored and uncensored data to distinguish between normal crossing and red-light running behavior. A Cox proportional hazard model was introduced, and variables revealing personal characteristics and traffic conditions were defined as covariates to describe the effects of internal and external factors. Empirical results show that riders do not want to wait too long to cross intersections. As signal waiting time increases, electric two-wheelers get impatient and violate the traffic signal. There are 12.8% of electric two-wheelers with negligible wait time. 25.0% of electric two-wheelers are generally nonrisk takers who can obey the traffic rules after waiting for 100 seconds. Half of electric two-wheelers cannot endure 49.0 seconds or longer at red-light phase. Red phase time, motor vehicle volume, and conformity behavior have important effects on riders’ waiting times. Waiting endurance times would decrease with the longer red-phase time, the lower traffic volume, or the bigger number of other riders who run against the red light. The proposed model may be applicable in the design, management and control of signalized intersections in other developing cities.

  20. Impact of waiting on the perception of service quality in nuclear medicine

    NARCIS (Netherlands)

    De Man, S; Vlerick, P; Gemmel, P; De Bondt, P; Matthys, D; Dierckx, RA

    2005-01-01

    Background This is the first study examining the link between waiting and various dimensions of perceived service quality in nuclear medicine. Methods We tested the impact of selected waiting experience variables on the evaluation of service quality, measured using the Servqual tool, of 406 patients

  1. First in Line Waiting Times as a Tool for Analysing Queueing Systems

    DEFF Research Database (Denmark)

    Koole, G. M.; Nielsen, Bo Friis; Nielsen, Thomas Bang

    2012-01-01

    We introduce a new approach to modelling queueing systems where the priority or the routing of customers depends on the time the first customer has waited in the queue. This past waiting time of the first customer in line, WFIL, is used as the primary variable for our approach. A Markov chain is ...

  2. Waiting Time: The De-Subjectification of Children in Danish Asylum Centres

    Science.gov (United States)

    Vitus, Kathrine

    2010-01-01

    This article analyses the relationship between time and subjectification, focusing on the temporal structures created within Danish asylum centres and politics, and on children's experiences of and reactions to open-ended waiting. Such waiting leads to existential boredom which manifests in the children as restlessness, fatigue and despair. The…

  3. Waiting Time: The De-Subjectification of Children in Danish Asylum Centres

    Science.gov (United States)

    Vitus, Kathrine

    2010-01-01

    This article analyses the relationship between time and subjectification, focusing on the temporal structures created within Danish asylum centres and politics, and on children's experiences of and reactions to open-ended waiting. Such waiting leads to existential boredom which manifests in the children as restlessness, fatigue and despair. The…

  4. Access to Specialist Gastroenterology Care in Canada: The Practice Audit in Gastroenterology (PAGE Wait Times Program

    Directory of Open Access Journals (Sweden)

    David Armstrong

    2008-01-01

    Full Text Available BACKGROUND: Canadian wait time data are available for the treatment of cancer and heart disease, as well as for joint replacement, cataract surgery and diagnostic imaging procedures. Wait times for gastroenterology consultation and procedures have not been studied, although digestive diseases pose a greater economic burden in Canada than cancer or heart disease.

  5. General practice cooperatives : long waiting times for home visits due to long distances?

    NARCIS (Netherlands)

    Giesen, P.H.J.; Lin, N.G.C.B. van; Mokkink, H.G.A.; Bosch, W.J.H.M. van den; Grol, R.P.T.M.

    2007-01-01

    BACKGROUND: The introduction of large-scale out-of-hours GP cooperatives has led to questions about increased distances between the GP cooperatives and the homes of patients and the increasing waiting times for home visits in urgent cases. We studied the relationship between the patient's waiting

  6. Hydrography - Integrated List Attaining

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This layer shows only attaining segments of the Integrated List. The Streams Integrated List represents stream assessments in an integrated format for the Clean...

  7. National List of Beaches

    Data.gov (United States)

    U.S. Environmental Protection Agency — EPA has published a list of coastal recreation waters adjacent to beaches (or similar points of access) used by the public in the U.S. The list, required by the...

  8. Acronym master list

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-06-01

    This document is a master list of acronyms and other abbreviations that are used by or could be useful to, the personnel at Los Alamos National Laboratory. Many specialized and well-known abbreviations are not included in this list.

  9. 76 FR 42471 - Premerger Notification; Reporting and Waiting Period Requirements

    Science.gov (United States)

    2011-07-19

    ... an acquiring person that, despite its best efforts, cannot obtain more granular information about the.... It is thus in the best interests of the acquiring person to limit the list of minority holdings in... shared with prospective buyers.'' Sellers will sometimes create a Confidential Information Memorandum and...

  10. A RFID-based JIT Application for Least Waiting Time for Dynamic Smart Diet Customers

    Directory of Open Access Journals (Sweden)

    Chen Long-Fei

    2017-01-01

    Full Text Available Waiting in queue is part of everyone’s life. A day may include several different waiting in queue. Waiting in line is always a bit of phenomena for a prosperous restaurant at dinner time. How to manage the queues and keep their feet into customers is the operating challenge facing everyone manager. In addition, rising energy costs and growing demand for protection of the environment call for a shorter waiting queue. Thus, we devise a dynamic smart diet App manager to reduce customer waiting time through radio frequency identification (RFID and just in time (JIT principle to reduce inventory of restaurant food materials, thereby increasing customer satisfaction and loyalty, and improving revenue and social responsibility.

  11. A state of limbo: the politics of waiting in neo-liberal Latvia.

    Science.gov (United States)

    Ozoliņa-Fitzgerald, Liene

    2016-09-01

    This article presents an ethnographic study of politics of waiting in a post-Soviet context. While activation has been explored in sociological and anthropological literature as a neo-liberal governmental technology and its application in post-socialist context has also been compellingly documented, waiting as a political artefact has only recently been receiving increased scholarly attention. Drawing on ethnographic fieldwork at a state-run unemployment office in Riga, this article shows how, alongside activation, state welfare policies also produce passivity and waiting. Engaging with the small but developing field of sociological literature on the politics of waiting, I argue that, rather than interpreting it as a clash between 'neo-liberal' and 'Soviet' regimes, we should understand the double-move of activation and imposition of waiting as a key mechanism of neo-liberal biopolitics. This article thus extends the existing theorizations of the temporal politics of neo-liberalism.

  12. List scheduling revisited

    NARCIS (Netherlands)

    Schutten, Johannes M.J.

    1996-01-01

    We consider the problem of scheduling n jobs on m identical parallel machines to minimize a regular cost function. The standard list scheduling algorithm converts a list into a feasible schedule by focusing on the job start times. We prove that list schedules are dominant for this type of problem.

  13. Retail Shopping Lists

    DEFF Research Database (Denmark)

    Schmidt, Marcus

    2012-01-01

    The paper addresses consumers' shopping lists. The current study is based on a survey of 871 lists collected at retail grocery stores. Most items on shopping lists appear on the product category level rather than the brand level. The importance of the brand level varies considerably across product....... The paper ends with a discussion and with suggestions for future research....

  14. Waiting time dynamics in two-dimensional infrared spectroscopy.

    Science.gov (United States)

    Jansen, Thomas L C; Knoester, Jasper

    2009-09-15

    We review recent work on the waiting time dynamics of coherent two-dimensional infrared (2DIR) spectroscopy. This dynamics can reveal chemical and physical processes that take place on the femto- and picosecond time scale, which is faster than the time scale that may be probed by, for example, nuclear magnetic resonance spectroscopy. A large number of chemically relevant processes take place on this time scale. Such processes range from forming and breaking hydrogen bonds and proton transfer to solvent exchange and vibrational population transfer. In typical 2DIR spectra, multiple processes contribute to the waiting time dynamics and the spectra are often congested. This makes the spectra challenging to interpret, and the aid of theoretical models and simulations is often needed. To be useful, such models need to account for all dynamical processes in the sample simultaneously. The numerical integration of the Schrodinger equation (NISE) method has proven to allow for a very general treatment of the dynamical processes. It accounts for both the motional narrowing resulting from solvent-induced frequency fluctuations and population transfer between coupled vibrations. At the same time, frequency shifts arising from chemical-exchange reactions and changes of the transition dipoles because of either non-Condon effects or molecular reorientation are included in the treatment. This method therefore allows for the disentanglement of all of these processes. The NISE method has thus far been successfully applied to study chemical-exchange processes. It was demonstrated that 2DIR is not only sensitive to reaction kinetics but also to the more detailed reaction dynamics. NISE has also been applied to the study of population transfer within the amide I band (CO stretch) and between the amide I and amide II bands (CN stretch and NH bend) in polypeptides. From the amide I studies, it was found that the population transfer can be used to enhance cross-peaks that act as

  15. Title III List of Lists -- Data Tool

    Data.gov (United States)

    U.S. Environmental Protection Agency — This list was prepared to help firms handling chemicals determine whether they need to submit reports under sections 302, 304, or 313 of the Emergency Planning and...

  16. Genetic progression and the waiting time to cancer.

    Directory of Open Access Journals (Sweden)

    Niko Beerenwinkel

    2007-11-01

    Full Text Available Cancer results from genetic alterations that disturb the normal cooperative behavior of cells. Recent high-throughput genomic studies of cancer cells have shown that the mutational landscape of cancer is complex and that individual cancers may evolve through mutations in as many as 20 different cancer-associated genes. We use data published by Sjöblom et al. (2006 to develop a new mathematical model for the somatic evolution of colorectal cancers. We employ the Wright-Fisher process for exploring the basic parameters of this evolutionary process and derive an analytical approximation for the expected waiting time to the cancer phenotype. Our results highlight the relative importance of selection over both the size of the cell population at risk and the mutation rate. The model predicts that the observed genetic diversity of cancer genomes can arise under a normal mutation rate if the average selective advantage per mutation is on the order of 1%. Increased mutation rates due to genetic instability would allow even smaller selective advantages during tumorigenesis. The complexity of cancer progression can be understood as the result of multiple sequential mutations, each of which has a relatively small but positive effect on net cell growth.

  17. Models of emergency departments for reducing patient waiting times.

    Science.gov (United States)

    Laskowski, Marek; McLeod, Robert D; Friesen, Marcia R; Podaima, Blake W; Alfa, Attahiru S

    2009-07-02

    In this paper, we apply both agent-based models and queuing models to investigate patient access and patient flow through emergency departments. The objective of this work is to gain insights into the comparative contributions and limitations of these complementary techniques, in their ability to contribute empirical input into healthcare policy and practice guidelines. The models were developed independently, with a view to compare their suitability to emergency department simulation. The current models implement relatively simple general scenarios, and rely on a combination of simulated and real data to simulate patient flow in a single emergency department or in multiple interacting emergency departments. In addition, several concepts from telecommunications engineering are translated into this modeling context. The framework of multiple-priority queue systems and the genetic programming paradigm of evolutionary machine learning are applied as a means of forecasting patient wait times and as a means of evolving healthcare policy, respectively. The models' utility lies in their ability to provide qualitative insights into the relative sensitivities and impacts of model input parameters, to illuminate scenarios worthy of more complex investigation, and to iteratively validate the models as they continue to be refined and extended. The paper discusses future efforts to refine, extend, and validate the models with more data and real data relative to physical (spatial-topographical) and social inputs (staffing, patient care models, etc.). Real data obtained through proximity location and tracking system technologies is one example discussed.

  18. Advanced access: reducing waiting and delays in primary care.

    Science.gov (United States)

    Murray, Mark; Berwick, Donald M

    2003-02-26

    Delay of care is a persistent and undesirable feature of current health care systems. Although delay seems to be inevitable and linked to resource limitations, it often is neither. Rather, it is usually the result of unplanned, irrational scheduling and resource allocation. Application of queuing theory and principles of industrial engineering, adapted appropriately to clinical settings, can reduce delay substantially, even in small practices, without requiring additional resources. One model, sometimes referred to as advanced access, has increasingly been shown to reduce waiting times in primary care. The core principle of advanced access is that patients calling to schedule a physician visit are offered an appointment the same day. Advanced access is not sustainable if patient demand for appointments is permanently greater than physician capacity to offer appointments. Six elements of advanced access are important in its application balancing supply and demand, reducing backlog, reducing the variety of appointment types, developing contingency plans for unusual circumstances, working to adjust demand profiles, and increasing the availability of bottleneck resources. Although these principles are powerful, they are counter to deeply held beliefs and established practices in health care organizations. Adopting these principles requires strong leadership investment and support.

  19. STS-103 crew wait inside Discovery for simulated countdown exercise

    Science.gov (United States)

    1999-01-01

    STS-103 Mission Commander Curtis L. Brown Jr. sits inside orbiter Discovery waiting for the start of a simulated countdown exercise. The simulation is part of Terminal Countdown Demonstration Test (TCDT) activities. The TCDT also provides the crew with emergency egress training and opportunities to inspect their mission payload in the orbiter's payload bay. Other crew members taking part in the TCDT are Pilot Scott J. Kelly, and Mission Specialists Steven L. Smith, C. Michael Foale (Ph.D.), John M. Grunsfeld (Ph.D.), Jean-Fran'''ois Clervoy of France, and Claude Nicollier of Switzerland. Clervoy and Nicollier are with the European Space Agency. STS-103 is a 'call-up' mission due to the need to replace and repair portions of the Hubble Space Telescope, including the gyroscopes that allow the telescope to point at stars, galaxies and planets. The STS-103 crew will be replacing a Fine Guidance Sensor, an older computer with a new enhanced model, an older data tape recorder with a solid-state digital recorder, a failed spare transmitter with a new one, and degraded insulation on the telescope with new thermal insulation. The crew will also install a Battery Voltage/Temperature Improvement Kit to protect the spacecraft batteries from overcharging and overheating when the telescope goes into a safe mode. Four EVA's are planned to make the necessary repairs and replacements on the telescope. The mission is targeted for launch Dec. 6 at 2:37 a.m. EST.

  20. Canadians with health problems: their use of specialized services and their waiting experiences.

    Science.gov (United States)

    Ho, Thi; Morris, Kathleen

    2008-08-01

    Improving access to healthcare has been a consistent priority for Canadians. In particular, reducing patient waiting times for health services has been a prominent policy issue. Across the country, governments are using a range of strategies to reduce patient waiting times for care, with a particular focus on reducing waits for specialized services. Although information is emerging on waits for selected procedures, there is limited information on whether the utilization of services or waiting experiences of Canadians with health problems are different from those of the general population. Data from the Health Services Access Survey (2001-2005) were used to compare waiting experiences for specialized services between adults with health problems and healthier adults. The specialized services included specialist visits for a new illness or condition, non-emergency surgery and diagnostic tests. National-level estimates revealed that adults with health problems were more likely to self-report that they required specialized services. However, the median waiting times for these services were comparable to those of healthier adults.

  1. Public views on a wait time management initiative: a matter of communication

    Directory of Open Access Journals (Sweden)

    Laupacis Andreas

    2010-08-01

    Full Text Available Abstract Background Many countries have tried to reduce waiting times for health care through formal wait time reduction strategies. Our paper describes views of members of the public about a wait time management initiative - the Ontario Wait Time Strategy (OWTS (Canada. Scholars and governmental reports have advocated for increased public involvement in wait time management. We provide empirically derived recommendations for public engagement in a wait time management initiative. Methods Two qualitative studies: 1 an analysis of all emails sent by the public to the (OWTS email address; and 2 in-depth interviews with members of the Ontario public. Results Email correspondents and interview participants supported the intent of the OWTS. However they wanted more information about the Strategy and its actions. Interview participants did not feel they were sufficiently made aware of the Strategy and email correspondents requested additional information beyond what was offered on the Strategy's website. Moreover, the email correspondents believed that some of the information that was provided on the Strategy's website and through the media was inaccurate, misleading, and even dishonest. Interview participants strongly supported public involvement in the OWTS priority setting. Conclusions Findings suggest the public wanted increased communication from and with the OWTS. Effective communication can facilitate successful public engagement, and in turn fair and legitimate priority setting. Based on the study's findings we developed concrete recommendations for improving public involvement in wait time management.

  2. Reconciliation of Waiting Time Statistics of Solar Flares Observed in Hard X-Rays

    CERN Document Server

    Aschwanden, Markus J

    2010-01-01

    We study the waiting time distributions of solar flares observed in hard X-rays with ISEE-3/ICE, HXRBS/SMM, WATCH/GRANAT, BATSE/CGRO, and RHESSI. Although discordant results and interpretations have been published earlier, based on relatively small ranges ($< 2$ decades) of waiting times, we find that all observed distributions, spanning over 6 decades of waiting times ($\\Delta t \\approx 10^{-3}- 10^3$ hrs), can be reconciled with a single distribution function, $N(\\Delta t) \\propto \\lambda_0 (1 + \\lambda_0 \\Delta t)^{-2}$, which has a powerlaw slope of $p \\approx 2.0$ at large waiting times ($\\Delta t \\approx 1-1000$ hrs) and flattens out at short waiting times $\\Delta t \\lapprox \\Delta t_0 = 1/\\lambda_0$. We find a consistent breakpoint at $\\Delta t_0 = 1/\\lambda_0 = 0.80\\pm0.14$ hours from the WATCH, HXRBS, BATSE, and RHESSI data. The distribution of waiting times is invariant for sampling with different flux thresholds, while the mean waiting time scales reciprocically with the number of detected event...

  3. Age Dating Fluvial Sediment Storage Reservoirs to Construct Sediment Waiting Time Distributions

    Science.gov (United States)

    Skalak, K.; Pizzuto, J. E.; Benthem, A.; Karwan, D. L.; Mahan, S.

    2015-12-01

    Suspended sediment transport is an important geomorphic process that can often control the transport of nutrients and contaminants. The time a particle spends in storage remains a critical knowledge gap in understanding particle trajectories through landscapes. We dated floodplain deposits in South River, VA, using fallout radionuclides (Pb-210, Cs-137), optically stimulated luminescence (OSL), and radiocarbon dating to determine sediment ages and construct sediment waiting time distributions. We have a total of 14 age dates in two eroding banks. We combine these age dates with a well-constrained history of mercury concentrations on suspended sediment in the river from an industrial release. Ages from fallout radionuclides document sedimentation from the early 1900s to the present, and agree with the history of mercury contamination. OSL dates span approximately 200 to 17,000 years old. We performed a standard Weibull analysis of nonexceedance to construct a waiting time distribution of floodplain sediment for the South River. The mean waiting time for floodplain sediment is 2930 years, while the median is approximately 710 years. When the floodplain waiting time distribution is combined with the waiting time distribution for in-channel sediment storage (available from previous studies), the mean waiting time shifts to approximately 680 years, suggesting that quantifying sediment waiting times for both channel and floodplain storage is critical in advancing knowledge of particle trajectories through watersheds.

  4. Informing Healthcare Waiting Area Design Using Transparency Attributes: A Comparative Preference Study.

    Science.gov (United States)

    Jiang, Shan; Powers, Matthew; Allison, David; Vincent, Ellen

    2017-07-01

    This study aimed to explore people's visual preference for waiting areas in general hospital environments designed with transparency attributes that fully integrate nature. Waiting can be a tedious and frustrating experience among people seeking healthcare treatments and negatively affect their perception of the quality of care. Positive distractions and supportive designs have gained increasing attraction to improve people's waiting experience. Nature, which has shown therapeutic effects according to a growing amount of evidence, could be a distinguished positive distraction in waiting areas. Additionally, the theory of transparency was operationalized to indicate a spatial continuity between the external nature and the built interiors in general healthcare waiting area design. A survey method was adopted in the study. Twenty-one images of general healthcare waiting areas depicting three design typologies were preselected following a strict procedure, including designs with (a) no window views, (b) limited window views to nature, and (c) transparent spaces with maximum natural views. Ninety-five student participants rated the images based on their visual preference using a Likert-type scale. The results showed that transparent waiting areas were significantly preferred. A significant positive relationship existed between the level of transparency and people's preference scores. The factor analysis indicated additional supportive features that may affect people's preferences, including daylight, perceived warmth, noninstitutional furniture arrangement, visual orientation, and the use of natural materials for interior design. However, these tentative results need to be furthered tested with the real patient population as the next step of this study.

  5. Outpatient waiting time in health services and teaching hospitals: a case study in Iran.

    Science.gov (United States)

    Mohebbifar, Rafat; Hasanpoor, Edris; Mohseni, Mohammad; Sokhanvar, Mobin; Khosravizadeh, Omid; Mousavi Isfahani, Haleh

    2013-11-10

    One of the most important indexes of the health care quality is patient's satisfaction and it takes place only when there is a process based on management. One of these processes in the health care organizations is the appropriate management of the waiting time process. The aim of this study is the systematic analyzing of the outpatient waiting time. This descriptive cross sectional study conducted in 2011 is an applicable study performed in the educational and health care hospitals of one of the medical universities located in the north west of Iran. Since the distributions of outpatients in all the months were equal, sampling stage was used. 160 outpatients were studied and the data was analyzed by using SPSS software. Results of the study showed that the waiting time for the outpatients of ophthalmology clinic with an average of 245 minutes for each patient allocated the maximum time among the other clinics for itself. Orthopedic clinic had the minimal waiting time including an average of 77 minutes per patient. The total average waiting time for each patient in the educational hospitals under this study was about 161 minutes. by applying some models, we can reduce the waiting time especially in the realm of time and space before the admission to the examination room. Utilizing the models including the one before admission, electronic visit systems via internet, a process model, six sigma model, queuing theory model and FIFO model, are the components of the intervention that reduces the outpatient waiting time.

  6. Wait-time, classroom discourse, and the influence of sociocultural factors in science teaching

    Science.gov (United States)

    Jegede, Olugbemiro J.; Olajide, Janet O.

    Wait-time, a variable related to questioning in a teaching-learning situation, has been found to have implications for the inquiry mode of science teaching especially in Western classroom environments. Aside from the fact that the literature is very sparse in this area about what obtains in developing countries, nothing appears to be available with regard to how wait-time interacts with the sociocultural factors within non-Western science classrooms. In a non-Western country such as Nigeria where most science programs in schools are inquiry-oriented, do teachers take notice of, and effectively use, wait-time in the teaching-learning process? Are science teachers able to effectively use the mediating role of sociocultural factors in science teaching in a traditional environment which expects children to be seen only and not heard? The main purpose of this study was to investigate the wait-time of Nigerian integrated science teachers in relation to the amount of students' participation in inquiry. This study also investigated the relationship between wait-time and sociocultural attitudinal factors prevalent in traditional societies. The instruments used for data collection were the Hough's Observational Schedule and a modified version of the Socio-Cultural Environment Scale (SCES); a stop-watch was used to measure the wait-time of audio-recorded integrated science lessons of 37 integrated science teachers from selected junior secondary schools in Kaduna State, Nigeria. The results showed that the average wait-time TT and wait-time ST of the integrated science teachers was 3.0 seconds and 0.7 seconds, respectively. The study reported the amount of student participation in the student-teacher classroom discourse to be very low. Wait-time was also shown to have a strong relationship with sociocultural factors of authoritarianism, goal structure, societal expectation, and traditional worldview. The pedagogical and curricular implications of the results have been

  7. Adjusting patients streaming initiated by a wait time threshold in emergency department for minimizing opportunity cost.

    Science.gov (United States)

    Kim, Byungjoon B J; Delbridge, Theodore R; Kendrick, Dawn B

    2017-07-10

    Purpose Two different systems for streaming patients were considered to improve efficiency measures such as waiting times (WTs) and length of stay (LOS) for a current emergency department (ED). A typical fast track area (FTA) and a fast track with a wait time threshold (FTW) were designed and compared effectiveness measures from the perspective of total opportunity cost of all patients' WTs in the ED. The paper aims to discuss these issues. Design/methodology/approach This retrospective case study used computerized ED patient arrival to discharge time logs (between July 1, 2009 and June 30, 2010) to build computer simulation models for the FTA and fast track with wait time threshold systems. Various wait time thresholds were applied to stream different acuity-level patients. National average wait time for each acuity level was considered as a threshold to stream patients. Findings The fast track with a wait time threshold (FTW) showed a statistically significant shorter total wait time than the current system or a typical FTA system. The patient streaming management would improve the service quality of the ED as well as patients' opportunity costs by reducing the total LOS in the ED. Research limitations/implications The results of this study were based on computer simulation models with some assumptions such as no transfer times between processes, an arrival distribution of patients, and no deviation of flow pattern. Practical implications When the streaming of patient flow can be managed based on the wait time before being seen by a physician, it is possible for patients to see a physician within a tolerable wait time, which would result in less crowded in the ED. Originality/value A new streaming scheme of patients' flow may improve the performance of fast track system.

  8. Improving Wait Times to Care for Individuals with Multimorbidities and Complex Conditions Using Value Stream Mapping

    Directory of Open Access Journals (Sweden)

    Tara Sampalli

    2015-07-01

    Full Text Available Background Recognizing the significant impact of wait times for care for individuals with complex chronic conditions, we applied a LEAN methodology, namely – an adaptation of Value Stream Mapping (VSM to meet the needs of people with multiple chronic conditions and to improve wait times without additional resources or funding. Methods Over an 18-month time period, staff applied a patient-centric approach that included LEAN methodology of VSM to improve wait times to care. Our framework of evaluation was grounded in the needs and perspectives of patients and individuals waiting to receive care. Patient centric views were obtained through surveys such as Patient Assessment of Chronic Illness Care (PACIC and process engineering based questions. In addition, LEAN methodology, VSM was added to identify non-value added processes contributing to wait times. Results The care team successfully reduced wait times to 2 months in 2014 with no wait times for care anticipated in 2015. Increased patient engagement and satisfaction are also outcomes of this innovative initiative. In addition, successful transformations and implementation have resulted in resource efficiencies without increase in costs. Patients have shown significant improvements in functional health following Integrated Chronic Care Service (ICCS intervention. The methodology will be applied to other chronic disease management areas in Capital Health and the province. Conclusion Wait times to care in the management of multimoribidities and other complex conditions can add a significant burden not only on the affected individuals but also on the healthcare system. In this study, a novel and modified LEAN methodology has been applied to embed the voice of the patient in care delivery processes and to reduce wait times to care in the management of complex chronic conditions.

  9. The Influence of Ambient Scent and Music on Patients' Anxiety in a Waiting Room of a Plastic Surgeon

    NARCIS (Netherlands)

    Fenko, Anna; Loock, Caroline

    2014-01-01

    OBJECTIVE: This study investigates the influence of ambient scent and music, and their combination, on patients' anxiety in a waiting room of a plastic surgeon. BACKGROUND: Waiting for an appointment with a plastic surgeon can increase a patient's anxiety. It is important to make the waiting time be

  10. The Influence of Ambient Scent and Music on Patients' Anxiety in a Waiting Room of a Plastic Surgeon

    NARCIS (Netherlands)

    Fenko, Anna; Loock, Caroline

    2014-01-01

    OBJECTIVE: This study investigates the influence of ambient scent and music, and their combination, on patients' anxiety in a waiting room of a plastic surgeon. BACKGROUND: Waiting for an appointment with a plastic surgeon can increase a patient's anxiety. It is important to make the waiting time

  11. Race/ethnicity and the receipt of watchful waiting for the initial management of prostate cancer.

    Science.gov (United States)

    Shavers, Vickie L; Brown, Martin L; Potosky, Arnold L; Klabunde, Carrie N; Davis, W W; Moul, Judd W; Fahey, Angela

    2004-02-01

    Several recent studies have noted that African Americans disproportionately receive "watchful waiting" for the initial management of their prostate cancer. To determine whether racial/ethnic differences in the receipt of watchful waiting are explained by differences in clinical presentation and life expectancy at the time of diagnosis, we examined Surveillance, Epidemiology, and End Results (SEER)-Medicare data for men diagnosed with prostate cancer in 1994 to 1996. Race/ethnicity, comorbidity, stage, grade, age, and expected lifespan and their association with the receipt of watchful waiting were examined in multivariate logistic regression analyses. Race-stratified logistic regression analyses were also used to examine racial/ethnic variation in the association of clinical and demographic factors with the receipt of watchful waiting among African-American, Hispanic, and non-Hispanic white men. African-American (odds ratio [OR], 1.4; 95% confidence interval [CI], 1.3 to 1.6) and Hispanic men (OR, 1.3; 95% CI, 1.1 to 1.5) were significantly more likely than non-Hispanic white men to receive watchful waiting in a multivariate model adjusted for age, comorbidity, stage, grade, and life expectancy. Advanced stage and grade, lower life expectancy, older age, and high comorbidity indices were also significantly associated with an increase in the odds of receipt of watchful waiting in multivariate analyses. In general, the association between the receipt of watchful waiting and the clinical characteristics (i.e., stage, grade, and age) were similar for the three racial/ethnic groups. In race-stratified logistic regression analyses, life expectancy was associated with an increase in the odds of receiving watchful waiting but results were statistically significant for whites only. There was also a statistically significant increase in the odds of receiving watchful waiting for African-American and white men with high comorbidity indices but not Hispanic men. The odds of

  12. A Directed Continuous Time Random Walk Model with Jump Length Depending on Waiting Time

    Directory of Open Access Journals (Sweden)

    Long Shi

    2014-01-01

    Full Text Available In continuum one-dimensional space, a coupled directed continuous time random walk model is proposed, where the random walker jumps toward one direction and the waiting time between jumps affects the subsequent jump. In the proposed model, the Laplace-Laplace transform of the probability density function P(x,t of finding the walker at position x at time t is completely determined by the Laplace transform of the probability density function φ(t of the waiting time. In terms of the probability density function of the waiting time in the Laplace domain, the limit distribution of the random process and the corresponding evolving equations are derived.

  13. Gradual vs. wait-and-gradual discontinuation in antipsychotic switching: A meta-analysis.

    Science.gov (United States)

    Takeuchi, Hiroyoshi; Thiyanavadivel, Sadhana; Agid, Ofer; Remington, Gary

    2017-02-24

    To address whether wait discontinuation (i.e., introducing the new antipsychotic while maintaining the first for a period before initiating its discontinuation) is superior to non-wait discontinuation (i.e., initiating the first antipsychotic's discontinuation when introducing the new antipsychotic) in antipsychotic switching, we conducted a meta-analysis of randomized controlled trials comparing gradual vs. wait-and-gradual antipsychotic discontinuation in patients with schizophrenia. The meta-analysis of 5 studies (n=410) demonstrated no significant differences in any clinical outcomes, including study discontinuation, psychopathology, extrapyramidal symptoms, and treatment-emergent adverse events, between the two groups. These findings indicate either strategy can be used in clinical practice.

  14. Spatial structure increases the waiting time for cancer

    Science.gov (United States)

    Martens, Erik A.; Kostadinov, Rumen; Maley, Carlo C.; Hallatschek, Oskar

    2011-11-01

    Cancer results from a sequence of genetic and epigenetic changes that lead to a variety of abnormal phenotypes including increased proliferation and survival of somatic cells and thus to a selective advantage of pre-cancerous cells. The notion of cancer progression as an evolutionary process has been attracting increasing interest in recent years. A great deal of effort has been made to better understand and predict the progression to cancer using mathematical models; these mostly consider the evolution of a well-mixed cell population, even though pre-cancerous cells often evolve in highly structured epithelial tissues. In this study, we propose a novel model of cancer progression that considers a spatially structured cell population where clones expand via adaptive waves. This model is used to assess two different paradigms of asexual evolution that have been suggested to delineate the process of cancer progression. The standard scenario of periodic selection assumes that driver mutations are accumulated strictly sequentially over time. However, when the mutation supply is sufficiently high, clones may arise simultaneously on distinct genetic backgrounds, and clonal adaptation waves interfere with each other. We find that in the presence of clonal interference, spatial structure increases the waiting time for cancer, leads to a patchwork structure of non-uniformly sized clones and decreases the survival probability of virtually neutral (passenger) mutations, and that genetic distance begins to increase over a characteristic length scale Lc. These characteristic features of clonal interference may help us to predict the onset of cancers with pronounced spatial structure and to interpret spatially sampled genetic data obtained from biopsies. Our estimates suggest that clonal interference likely occurs in the progression of colon cancer and possibly other cancers where spatial structure matters.

  15. DNW--"did not wait" or "demographic needing work": a study of the profile of patients who did not wait to be seen in an Irish emergency department.

    LENUS (Irish Health Repository)

    Gilligan, P

    2009-11-01

    Patients who fail to wait for medical assessment in the emergency department (ED) have been referred to in the international literature as "did not wait" (DNW) or "left without being seen" (LWBS) patients or, indeed, simply as "walkouts". This is taken as a performance indicator internationally. In common with many countries, Ireland has very considerable problems in the delivery of ED care due largely to inadequate resources and the inappropriate use of EDs as holding bays for admitted patients. This is the first study of this size to profile the DNW phenomenon in Ireland.

  16. Wait watchers. Smart organizations are demonstrating that while they can't erase ED wait times, they can leverage technology to keep patients better informed.

    Science.gov (United States)

    Gamble, Kate Huvane

    2010-04-01

    Increases in ED visits are significantly affecting patient access, quality, cost and care management--a trend that is expected to continue. A number of organizations are dealing with the increased demand for services by implementing technologies to keep patients better informed of wait times. Publishing ED wait times online offers hospitals a way to communicate information to patients quickly without requiring a significant investment from the IT staff. Hospitals are also utilizing visibility boards to keep both patients and staff updated on patient conditions and room status.

  17. Study on the interaction between the food and beverage servicescape and customer waiting experience

    National Research Council Canada - National Science Library

    Yang, Chih-Yun

    2014-01-01

    .... Very few studies conducted in-depth analysis and discus¬sion of how external environmental factors affect the experience of customer waiting, which it was also viewed as a negative factor that decreases customer satisfaction toward service...

  18. The ecology of the patient visit: physical attractiveness, waiting times, and perceived quality of care.

    Science.gov (United States)

    Becker, Franklin; Douglass, Stephanie

    2008-01-01

    This study examined the relationship between the attractiveness of the physical environment of healthcare facilities and patient perceptions of quality, service, and waiting time through systematic observations and patient satisfaction surveys at 7 outpatient practices at Weill Cornell Medical Center. Findings indicate positive correlations between more attractive environments and higher levels of perceived quality, satisfaction, staff interaction, and reduction of patient anxiety. The comparison of actual observed time and patients' perception of time showed that patients tend to overestimate shorter waiting times and underestimate longer waiting times in both the waiting area and the examination room. Further examinations of the way outpatient-practice environments impact patient and staff perceptions and how those perceptions impact behavior and medical outcomes are suggested.

  19. Asymptotic inference for waiting times and patiences in queues with abandonment

    DEFF Research Database (Denmark)

    Gorst-Rasmussen, Anders; Hansen, Martin Bøgsted

    2009-01-01

    Motivated by applications in call center management, we propose a framework based on empirical process techniques for inference about waiting time and patience distributions in multiserver queues with abandonment. The framework rigorises heuristics based on survival analysis of independent...

  20. Reducing Wait Times through Operations Research: Optimizing the Use of Surge Capacity.

    Science.gov (United States)

    Patrick, Jonathan; Puterman, Martin L

    2008-02-01

    Widespread public demand for improved access, political pressure for shorter wait times, a stretched workforce, an aging population and overutilized equipment and facilities challenge healthcare leaders to adopt new management approaches. This paper highlights the significant benefits that can be achieved by applying operations research (OR) methods to healthcare management. It shows how queuing theory provides managers with insights into the causes for excessive wait times and the relationship between wait times and capacity. It provides a case study of the use of several OR methods, including Markov decision processes, linear programming and simulation, to optimize the scheduling of patients with multiple priorities. The study shows that by applying this approach, wait time targets can be attained with the judicious use of surge capacity in the form of overtime. It concludes with some policy insights.

  1. Set methods of left-turn waiting zone at signalized intersection

    Institute of Scientific and Technical Information of China (English)

    DING Wei; YANG Xiao-guang; YANG Xiao-long

    2009-01-01

    To maximize the number of vehicles passing by the stop-line in a cycle and improve the operation ef-ficiency of intersection in China, the settlement of left-turn lane waiting-zone is becoming prevailing. Based on conflicting-point method, the internal mechanism of left-turn flow after stopping line was analyzed through taking postposition left-turn lane waiting-zone intersection for instance. The relationship between the first left-turn vehi-cle and the last vehicle of previous phase passing the conflicting point was expounded. According to the time of successive arriving of two vehicle flows at conflicting-point, the reasonable layout for waiting area of left-turn ve-hicles was researched when the clearance index was less than O. The results suggest that the appropriate layoutfor waiting area of left-turning vehicles can improve the operation efficiency of intersections.

  2. Reconciliation of Waiting Time Statistics of Solar Flares Observed in Hard X-rays

    Science.gov (United States)

    Aschwanden, Markus J.; McTiernan, James M.

    2010-07-01

    We study the waiting time distributions of solar flares observed in hard X-rays with ISEE-3/ICE, HXRBS/SMM, WATCH/GRANAT, BATSE/CGRO, and RHESSI. Although discordant results and interpretations have been published earlier, based on relatively small ranges (<2 decades) of waiting times, we find that all observed distributions, spanning over 6 decades of waiting times (Δt ≈ 10-3-103 hr), can be reconciled with a single distribution function, N(Δt) vprop λ0(1 + λ0Δt)-2, which has a power-law slope of p ≈ 2.0 at large waiting times (Δt ≈ 1-1000 hr) and flattens out at short waiting times Δt <~ Δt 0 = 1/λ0. We find a consistent breakpoint at Δt 0 = 1/λ0 = 0.80 ± 0.14 hr from the WATCH, HXRBS, BATSE, and RHESSI data. The distribution of waiting times is invariant for sampling with different flux thresholds, while the mean waiting time scales reciprocically with the number of detected events, Δt 0 vprop 1/n det. This waiting time distribution can be modeled with a nonstationary Poisson process with a flare rate λ = 1/Δt that varies as f(λ) vprop λ-1exp - (λ/λ0). This flare rate distribution requires a highly intermittent flare productivity in short clusters with high rates, separated by relatively long quiescent intervals with very low flare rates.

  3. 'He Thinks He's Entangled in a Net': the Web of Continental Associations in Waiting for Godot

    Directory of Open Access Journals (Sweden)

    Amy Burnside

    2011-01-01

    Full Text Available 'He Thinks He's Entangled in a Net': the Web of Continental Associations in Waiting for Godot Amy Burnside, Queen's University BelfastFollow Recommended Citation Burnside, Amy (2013 "'He Thinks He's Entangled in a Net': the Web of Continental Associations in Waiting for Godot," Journal of Franco-Irish Studies: Vol. 3: Iss. 1, Article 7. Available at: http://arrow.dit.ie/jofis/vol3/iss1/7

  4. Minimizing the Message Waiting Time in Single-Hop Multichannel Systems

    OpenAIRE

    Martelli, Francesca; Bonuccelli, Maurizio

    2010-01-01

    In this paper, we examine the problem of packet scheduling in a single-hop multichannel systems, with the goal of minimizing the average message waiting time. Such an objective function represents the delay incurred by the users before receiving the desired data. We show that the problem of finding a schedule with minimum message waiting time, is NP-complete, by means of polynomial time reduction of the time table design problem to our problem. We present also several heuristics which result ...

  5. Discrimination in waiting times by insurance type and financial soundness of German acute care hospitals.

    Science.gov (United States)

    Schwierz, Christoph; Wübker, Achim; Wübker, Ansgar; Kuchinke, Björn A

    2011-10-01

    This paper shows that patients with private health insurance (PHI) are being offered significantly shorter waiting times than patients with statutory health insurance (SHI) in German acute hospital care. This behavior may be driven by the higher expected profitability of PHI relative to SHI holders. Further, we find that hospitals offering private insurees shorter waiting times when compared with SHI holders have a significantly better financial performance than those abstaining from or with less discrimination.

  6. Wait and consult times for primary healthcare services in central Mozambique: a time-motion study

    Directory of Open Access Journals (Sweden)

    Bradley H. Wagenaar

    2016-08-01

    Full Text Available Background: We describe wait and consult times across public-sector clinics and identify health facility determinants of wait and consult times. Design: We observed 8,102 patient arrivals and departures from clinical service areas across 12 public-sector clinics in Sofala and Manica Provinces between January and April 2011. Negative binomial generalized estimating equations were used to model associated health facility factors. Results: Mean wait times (in minutes were: 26.1 for reception; 43.5 for outpatient consults; 58.8 for antenatal visits; 16.2 for well-child visits; 8.0 for pharmacy; and 15.6 for laboratory. Mean consultation times (in minutes were: 5.3 for outpatient consults; 9.4 for antenatal visits; and 2.3 for well-child visits. Over 70% (884/1,248 of patients arrived at the clinic to begin queuing for general reception prior to 10:30 am. Facilities with more institutional births had significantly longer wait times for general reception, antenatal visits, and well-child visits. Clinics in rural areas had especially shorter wait times for well-child visits. Outpatient consultations were significantly longer at the smallest health facilities, followed by rural hospitals, tertiary/quaternary facilities, compared with Type 1 rural health centers. Discussion: The average outpatient consult in Central Mozambique lasts 5 min, following over 40 min of waiting, not including time to register at most clinics. Wait times for first antenatal visits are even longer at almost 1 h. Urgent investments in public-sector human resources for health alongside innovative operational research are needed to increase consult times, decrease wait times, and improve health system responsiveness.

  7. Managing waiting times to predict no-shows and cancelations at a children’s hospital

    Directory of Open Access Journals (Sweden)

    Miguel Rodríguez-García

    2016-12-01

    Full Text Available Purpose: Since long waits in hospitals have been found to be related to high rates of no-shows and cancelations, managing waiting times should be considered as an important tool that hospitals can use to reduce missed appointments. The aim of this study is to analyze patients’ behavior in order to predict no-show and cancelation rates correlated to waiting times. Design/methodology/approach: This study is based on the data from a US children’s hospital, which includes all the appointments registered during one year of observation. We used the call-appointment interval to establish the wait time to get an appointment. Four different types of appointment-keeping behavior and two types of patients were distinguished: arrival, no-show, cancelation with no reschedule, and cancelation with reschedule; and new and established patients. Findings: Results confirmed a strong impact of long waiting times on patients’ appointment-keeping behavior, and the logarithmic regression was found as the best-fit function for the correlation between variables in all cases. The correlation analysis showed that new patients tend to miss appointments more often than established patients when the waiting time increases. It was also found that, depending on the patients’ appointment distribution, it might get more complicated for hospitals to reduce missed appointments as the waiting time is reduced. Originality/value: The methodology applied in our study, which combines the use of regression analysis and patients’ appointment distribution analysis, would help health care managers to understand the initial implications of long waiting times and to address improvement related to patient satisfaction and hospital performance.

  8. Intake of wine, beer and spirits and waiting time to pregnancy

    DEFF Research Database (Denmark)

    Juhl, Mette; Olsen, Jørn; Andersen, Anne-Marie Nybo

    2003-01-01

    A high intake of alcohol may prolong waiting time to pregnancy, whereas a moderate intake may have no or perhaps even a positive effect on fecundity. In previous studies on fecundity, different types of beverages have not been taken into consideration, although moderate wine drinkers appear to ha...... fewer strokes, lung and digestive tract cancers, and overall mortality than both abstainers and moderate drinkers of beer or spirits. We examined the association between different types of alcoholic beverages and waiting time to pregnancy....

  9. FACTORS INFLUENCING WAITING TIME IN OUTPATIENT PHARMACY OF LAGOS UNIVERSITY TEACHING HOSPITAL

    Directory of Open Access Journals (Sweden)

    Ndukwe Henry C.

    2011-10-01

    Full Text Available Time, money and expertise are resources that are indispensable to productivity, performance, efficiency, success and growth of any health institution. This research was aimed at identifying and measuring some of the factors influencing patient waiting time in an outpatient pharmacy. The study employed the use of time monitoring card and time study analysis to volunteered participants. A situation analysis conducted revealed an average of 167 minutes of waiting time. The dispensing time averaged 17.65 minutes, and 67.97% of total waiting time by the patient was due to delay components. The major delay components included patient queues for billing of prescription sheets, payment to the cashier and subsequent time wait before drugs are dispensed. The total waiting time for the dispensing process averaged 55.11 minutes. Generally, there were undue delays caused by the dispensing procedure with a 32.03% lag of processing components and operations in the pharmacy. Factors indentified to influence the outpatient waiting time included, queuing and queuing characteristics-type and integrity of queue, adherence to hospital visits and medication for special disease programs, dispensing time, average waiting time (service time plus queuing time, nature of illness or disease presentation, admission status of patient(s, accrued time from other health services provided to the patient prior to services provided by the pharmacist, incentives for providing efficient services, management structures and operational procedures of outpatient hospital pharmacy, implementation of legal rights on waiting time, inadequate treatment or dispensing facilities, technological innovations of automation and computerization , service efficiency and internal operational factors.

  10. Using Queuing Theory and Simulation Modelling to Reduce Waiting Times in An Iranian Emergency Department.

    Science.gov (United States)

    Haghighinejad, Hourvash Akbari; Kharazmi, Erfan; Hatam, Nahid; Yousefi, Sedigheh; Hesami, Seyed Ali; Danaei, Mina; Askarian, Mehrdad

    2016-01-01

    Hospital emergencies have an essential role in health care systems. In the last decade, developed countries have paid great attention to overcrowding crisis in emergency departments. Simulation analysis of complex models for which conditions will change over time is much more effective than analytical solutions and emergency department (ED) is one of the most complex models for analysis. This study aimed to determine the number of patients who are waiting and waiting time in emergency department services in an Iranian hospital ED and to propose scenarios to reduce its queue and waiting time. This is a cross-sectional study in which simulation software (Arena, version 14) was used. The input information was extracted from the hospital database as well as through sampling. The objective was to evaluate the response variables of waiting time, number waiting and utilization of each server and test the three scenarios to improve them. Running the models for 30 days revealed that a total of 4088 patients left the ED after being served and 1238 patients waited in the queue for admission in the ED bed area at end of the run (actually these patients received services out of their defined capacity). The first scenario result in the number of beds had to be increased from 81 to179 in order that the number waiting of the "bed area" server become almost zero. The second scenario which attempted to limit hospitalization time in the ED bed area to the third quartile of the serving time distribution could decrease the number waiting to 586 patients. Doubling the bed capacity in the emergency department and consequently other resources and capacity appropriately can solve the problem. This includes bed capacity requirement for both critically ill and less critically ill patients. Classification of ED internal sections based on severity of illness instead of medical specialty is another solution.

  11. [The electric heart assist device for patients on the waiting list for a heart transplant: a bridge too far

    NARCIS (Netherlands)

    Verheugt, F.W.A.

    2002-01-01

    Left-ventricular assist devices are being increasingly used as a bridge to heart transplantation in patients with end-stage heart failure. However, current evidence does not support their widespread application for this indication. Other indications such as cardiogenic shock in acute myocardial infa

  12. The effect of gym training on multiple outcomes in Parkinson's disease: a pilot randomised waiting-list controlled trial.

    Science.gov (United States)

    Poliakoff, Ellen; Galpin, Adam J; McDonald, Kathryn; Kellett, Mark; Dick, Jeremy P R; Hayes, Sue; Wearden, Alison J

    2013-01-01

    There is accumulating evidence for the benefits of exercise in Parkinson's disease (PD), but less is known about group exercise interventions. We evaluated the effect of gym-training programme on people with PD. Thirty-two adults with mild to moderate PD, not currently exercising formally, were randomised to an immediate 20-week biweekly gym training programme at a local leisure complex, or a 10-week programme starting 10 weeks later. Assessments at baseline (T1), 10 weeks (T2) and 20 weeks (T3) included reaction time, motor performance (UPDRS), quality of life and illness perceptions. Experiences of the programme were assessed via questionnaire and a focus group. Overall UPDRS motor function score did not change over time. However, gym training was associated with significant improvements in reaction times and some timed tests in the immediate training group (T1-T2). The delayed group showed similar improvements following gym training (T2-T3). Participants reported enjoyment, obtaining social benefits, and increased confidence. However, the questionnaire measures did not show improvements in subjective health ratings or illness perceptions. Although benefits were not apparent in the questionnaire measures or overall UPDRS scores, our findings suggest that a 10-week gym training programme in a community setting can provide some benefits for people with PD.

  13. Significant cohort of non-alcoholic fatty liver disease with portal vein thrombosis in transplant waiting list

    Institute of Scientific and Technical Information of China (English)

    Metin; Basaranoglu; Sonia; M; Najjar; Ali; Ebag; Demirbag; Hakan; Senturk

    2016-01-01

    AIM: To characterize non-alcoholic fatty liver disease(NAFLD) presentation with esophageal varices. METHODS: We carried out a retrospective cohort study on 258 patients with esophageal varices at a single tertiary referral center. These patients underwent diagnosis of several liver diseases, including: NAFLDassociated cirrhosis, hepatitis B, hepatitis C, Wilson disease, autoimune liver diseases, and others. RESULTS: Of the 258 patients, 39% of patients exhibited esophageal varices due to NAFLD-associated cirrhosis. Of the 38(14.7%) patients developed hepatocellular carcinoma during follow-up, 52% were due to hepatitis B, 26% due to hepatitis C and 13.2% due to NAFLD. Of the 258 patients, 50.0% with NAFLD, 33.3% with hepatitis B, 26.3% with hepatitis C, and 58.3% with other diseases were alive at the end of the 5-year period with a significant difference according to the Kaplan-Meier log Rank test(P = 0.040). Portal vein thrombosis was detected in 47.5% of patients with NAFLD, in 29% of patients with hepatitis B, in 17% of patients with hepatitis C, and in 62% of patients with other related diseases(P < 0.0001). CONCLUSION: Our study showed a proportionally greater elevation in liver transplant candidacy in patients with NAFLD and portal vein thrombosis. Older patients were more prone to developing cirrhosis, hepatocellular carcinoma and a high mortality rate. However, younger patients exhibited more portal vein thrombosis and gastric varices.

  14. Waiting times for diagnosis and treatment of head and neck cancer in Denmark in 2010 compared to 1992 and 2002

    DEFF Research Database (Denmark)

    Lyhne, N M; Christensen, A; Alanin, M C

    2013-01-01

    BACKGROUND AND AIM: Significant tumour progression was observed during waiting time for treatment of head and neck cancer. To reduce waiting times, a Danish national policy of fast track accelerated clinical pathways was introduced in 2007. This study describes changes in waiting time and the pot......BACKGROUND AND AIM: Significant tumour progression was observed during waiting time for treatment of head and neck cancer. To reduce waiting times, a Danish national policy of fast track accelerated clinical pathways was introduced in 2007. This study describes changes in waiting time...... and the potential influence of fast track by comparing waiting times in 2010 to 2002 and 1992. METHODS: Charts of all new patients diagnosed with squamous cell carcinoma of the oral cavity, pharynx and larynx at the five Danish head and neck oncology centres from January to April 2010 (n=253) were reviewed...

  15. The design and testing of interactive hospital spaces to meet the needs of waiting children.

    Science.gov (United States)

    Biddiss, Elaine; McPherson, Amy; Shea, Geoffrey; McKeever, Patricia

    2013-01-01

    To design an innovative interactive media display in a pediatric hospital clinic waiting space that addresses the growing demand for accessible, contact-surface-free options for play. In healthcare settings, waiting can be anxiety provoking for children and their accompanying family members. Opportunities for positive distraction have been shown to reduce waiting anxiety, leading to positive health outcomes. An interactive media display, ScreenPlay, was created and evaluated using a participatory design approach and a combination of techniques including quality function deployment and mixed data elicitation methods (questionnaires, focus groups, and observations). The user and organizational design requirements were established and used to review contemporary strategies for positive distraction in healthcare waiting spaces and to conceptualize and test ScreenPlay. Ten staff members, 11 children/youths, and 6 parents participated in the design and evaluation of ScreenPlay. ScreenPlay provided a positive, engaging experience without the use of contact surfaces through which infections can be spread. It was accessible to children, youth, and adults of all motor abilities. All participants strongly agreed that the interactive media display would improve the healthcare waiting experience. ScreenPlay is an interactive display that is the result of a successful model for the design of healthcare waiting spaces that is collaborative, interdisciplinary, and responsive to the needs of its community. Design process, healing environments, hospital, interdisciplinary, pediatric.

  16. Watchful waiting for minor depression in primary care: remission rates and predictors of improvement.

    Science.gov (United States)

    Hegel, Mark T; Oxman, Thomas E; Hull, Jay G; Swain, Karin; Swick, Holly

    2006-01-01

    The objectives of this study were to determine remission rates and predictors of improvement for minor depression following a 1-month watchful waiting period in primary care and to describe the watchful waiting processes. Prior to randomization into a clinical trial for minor depression, 111 participants were entered into a 1-month watchful waiting period. Depression severity and predictors of improvement were measured at the start of watchful waiting. At the end of watchful waiting, remission rates were calculated and predictor variables were analyzed for their contribution toward predicting improvement. Remission rates were low, ranging from 9% to 13%, depending on the measure. Avoidant coping style and frequency of engaging in active pleasant events at baseline accounted for the majority of change in depression. During watchful waiting, about one fifth of the sample (21%) had at least one contact with their physician and 27% reported using self-initiated treatments. There is a low likelihood of spontaneous remission for treatment-seeking samples with minor depression in primary care. An avoidant coping style seriously interferes with remission, and engaging in regular active pleasant events confers an advantage. Feasible interventions for primary care that promote activity and decrease avoidant coping styles may improve outcomes. These findings may not generalize to community and non-treatment-seeking samples.

  17. Group Enrollment and Open Gym Format Decreases Cardiac Rehabilitation Wait Times.

    Science.gov (United States)

    Bachmann, Justin M; Klint, Zachary W; Jagoda, Allison M; McNatt, Jeremy K; Abney, Lesa R; Huang, Shi; Liddle, David G; Frontera, Walter R; Freiberg, Matthew S

    2017-09-01

    Wait times for the first cardiac rehabilitation (CR) session are inversely related to CR participation rates. We hypothesized that changing from individually scheduled appointments to a group enrollment and open gym format, in which patients were enrolled during group intake sessions and could arrive for subsequent CR sessions any time during open gym periods, would decrease wait times. A total of 603 patients enrolled in CR at Vanderbilt University Medical Center from July 2012 to December 2014 were included in the study. We evaluated the effect of changing to a group enrollment and open gym format after adjusting for referral diagnosis, insurance status, seasonality, and other factors. We compared outcomes, including exercise capacity and quality of life, between the 2 groups. Patients in the group enrollment and open gym format had significantly lower average wait times than those receiving individual appointments (14.9 vs 19.5 days, P < .001). After multivariable adjustment, the new CR delivery model was associated with a 22% (3.7 days) decrease in average wait times (95% CI, 1.9-5.6, P < .001). Patients completing CR had equally beneficial changes in 6-minute walk distance and Patient Health Questionnaire scores between the 2 groups, although there was no significant difference in participation rates or the number of sessions attended. Implementation of a group enrollment and open gym format was associated with a significant decrease in wait times for first CR sessions. This CR delivery model may be an option for programs seeking to decrease wait times.

  18. Waiting time distribution revealing the internal spin dynamics in a double quantum dot

    Science.gov (United States)

    Ptaszyński, Krzysztof

    2017-07-01

    Waiting time distribution and the zero-frequency full counting statistics of unidirectional electron transport through a double quantum dot molecule attached to spin-polarized leads are analyzed using the quantum master equation. The waiting time distribution exhibits a nontrivial dependence on the value of the exchange coupling between the dots and the gradient of the applied magnetic field, which reveals the oscillations between the spin states of the molecule. The zero-frequency full counting statistics, on the other hand, is independent of the aforementioned quantities, thus giving no insight into the internal dynamics. The fact that the waiting time distribution and the zero-frequency full counting statistics give a nonequivalent information is associated with two factors. Firstly, it can be explained by the sensitivity to different timescales of the dynamics of the system. Secondly, it is associated with the presence of the correlation between subsequent waiting times, which makes the renewal theory, relating the full counting statistics and the waiting time distribution, no longer applicable. The study highlights the particular usefulness of the waiting time distribution for the analysis of the internal dynamics of mesoscopic systems.

  19. Waiting time distribution for electron transport in a molecular junction with electron-vibration interaction

    Science.gov (United States)

    Kosov, Daniel S.

    2017-02-01

    On the elementary level, electronic current consists of individual electron tunnelling events that are separated by random time intervals. The waiting time distribution is a probability to observe the electron transfer in the detector electrode at time t +τ given that an electron was detected in the same electrode at an earlier time t. We study waiting time distribution for quantum transport in a vibrating molecular junction. By treating the electron-vibration interaction exactly and molecule-electrode coupling perturbatively, we obtain the master equation and compute the distribution of waiting times for electron transport. The details of waiting time distributions are used to elucidate microscopic mechanism of electron transport and the role of electron-vibration interactions. We find that as nonequilibrium develops in the molecular junction, the skewness and dispersion of the waiting time distribution experience stepwise drops with the increase of the electric current. These steps are associated with the excitations of vibrational states by tunnelling electrons. In the strong electron-vibration coupling regime, the dispersion decrease dominates over all other changes in the waiting time distribution as the molecular junction departs far away from the equilibrium.

  20. [Reducing patient waiting time for the outpatient phlebotomy service using six sigma].

    Science.gov (United States)

    Kim, Yu Kyung; Song, Kyung Eun; Lee, Won Kil

    2009-04-01

    One of the challenging issues of the outpatient phlebotomy services at most hospitals is that patients have a long wait. The outpatient phlebotomy team of Kyungpook National University Hospital applied six sigma breakthrough methodologies to reduce the patient waiting time. The DMAIC (Define, Measure, Analyze, Improve, and Control) model was employed to approach the project. Two hundred patients visiting the outpatient phlebotomy section were asked to answer the questionnaires at inception of the study to ascertain root causes. After correction, we surveyed 285 patients for same questionnaires again to follow-up the effects. A defect was defined as extending patient waiting time so long and at the beginning of the project, the performance level was 2.61 sigma. Using fishbone diagram, all the possible reasons for extending patient waiting time were captured, and among them, 16 causes were proven to be statistically significant. Improvement plans including a new receptionist, automatic specimen transport system, and adding one phlebotomist were put into practice. As a result, the number of patients waited more than 5 min significantly decreased, and the performance level reached 3.0 sigma in December 2007 and finally 3.35 sigma in July 2008. Applying the six sigma, the performance level of waiting times for blood drawing exceeding five minutes were improved from 2.61 sigma to 3.35 sigma.

  1. Basic Library List.

    Science.gov (United States)

    Duren, William L., Jr.

    Reported is an initial attempt to define a minimal college mathematics library. Included is a list of some 300 books, from which approximately 170 are to be chosen to form a basic library in undergraduate mathematics. The areas provided for in this list include Algebra, Analysis, Applied Mathematics, Geometry, Topology, Logic, Foundations and Set…

  2. Listed But Less Profitable

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    For the first time in the last three years, China’s listed companies reported lower profit growth By October 31, most of the companies listed in China’s A-share market had published their performance for the third quarter. Reports or corporate ann

  3. Interest Check List.

    Science.gov (United States)

    Bureau of Employment Security (DOL), Washington, DC.

    The original edition of the Department of Labor Interest Check List aims at helping students decide what kinds of work they would like and lists activities that are found in a broad range of industries and occupations. The student is advised to read each of approximately 175 items and indicate how he feels about the activity described by placing a…

  4. Scientific Serial Lists

    Directory of Open Access Journals (Sweden)

    Dana L. Roth

    1972-03-01

    Full Text Available This article describes the need for user-oriented serial lists and the development of such a list in the California Institute of Technology library. The results of conversion from EAM to EDP equipment and subsequent utilization of COM (Computer-Output-Microfilm is reported.

  5. Methodology for Analysis, Modeling and Simulation of Airport Gate-waiting Delays

    Science.gov (United States)

    Wang, Jianfeng

    This dissertation presents methodologies to estimate gate-waiting delays from historical data, to identify gate-waiting-delay functional causes in major U.S. airports, and to evaluate the impact of gate operation disruptions and mitigation strategies on gate-waiting delay. Airport gates are a resource of congestion in the air transportation system. When an arriving flight cannot pull into its gate, the delay it experiences is called gate-waiting delay. Some possible reasons for gate-waiting delay are: the gate is occupied, gate staff or equipment is unavailable, the weather prevents the use of the gate (e.g. lightning), or the airline has a preferred gate assignment. Gate-waiting delays potentially stay with the aircraft throughout the day (unless they are absorbed), adding costs to passengers and the airlines. As the volume of flights increases, ensuring that airport gates do not become a choke point of the system is critical. The first part of the dissertation presents a methodology for estimating gate-waiting delays based on historical, publicly available sources. Analysis of gate-waiting delays at major U.S. airports in the summer of 2007 identifies the following. (i) Gate-waiting delay is not a significant problem on majority of days; however, the worst delay days (e.g. 4% of the days at LGA) are extreme outliers. (ii) The Atlanta International Airport (ATL), the John F. Kennedy International Airport (JFK), the Dallas/Fort Worth International Airport (DFW) and the Philadelphia International Airport (PHL) experience the highest gate-waiting delays among major U.S. airports. (iii) There is a significant gate-waiting-delay difference between airlines due to a disproportional gate allocation. (iv) Gate-waiting delay is sensitive to time of a day and schedule peaks. According to basic principles of queueing theory, gate-waiting delay can be attributed to over-scheduling, higher-than-scheduled arrival rate, longer-than-scheduled gate-occupancy time, and reduced gate

  6. The Politics of Security Lists

    NARCIS (Netherlands)

    de Goede, M.; Sullivan, G.

    2016-01-01

    The List, one of the most archaic means of written enumeration and classification, has made a forceful recurrence in the post-9/11 global security landscape. From terrorist sanctions lists and No-Fly lists to "kill-lists" for drone warfare; from the privately compiled lists of risky banking clients

  7. Moving toward the utilization of all donated liver grafts. The "b-list" concept.

    Science.gov (United States)

    Vrochides, D; Metrakos, P

    2012-10-01

    The number of available liver grafts is not sufficient to meet the current demand. A significant number of patients succumb before they receive a liver graft. However, approximately 10% of marginal livers are considered unsuitable for donation and are discarded. Calculating the primary non-function probability for any given liver graft can be performed using prognostic tools, such as the Donor Risk Index and the Eurotransplant Donor Risk Index. On the other hand, mortality on the waiting list, which is sometimes more than 15% per year of enlistment, directly correlates with its size, the graft supply and the gravity of the potential recipients' clinical condition. Up to 30% of the potential recipients will never receive a graft. The purpose of this invited commentary is to examine whether the literature supports the utilization of the marginal liver grafts that would otherwise be discarded. It appears that there is sufficient evidence in favor of the development of a "B-list" for potential liver graft recipients. It should comprise all of the candidates who were definitely removed from the primary waiting list or were never included. The potential "B-list" recipients should only be eligible to receive grafts that would otherwise be discarded, i.e., "B-livers". Enrollment in a "B-list" might not only increase the overall patient survival (enlisted and transplanted combined) but might also improve candidate quality of life by maintaining their hope for a cure.

  8. Radiotherapy waiting times for women with breast cancer: a population-based cohort study

    Directory of Open Access Journals (Sweden)

    Sainsbury Richard

    2007-05-01

    Full Text Available Abstract Background Waiting times for cancer patients are a national priority in the UK. Previous studies have shown variation between cancer networks in the time between diagnosis and start of radiotherapy for all cancer patients. Studies of the relationship between delay in receiving treatment and survival of breast cancer patients have been inconsistent. This study aimed to examine factors associated with waiting times for radiotherapy for breast cancer patients. Methods 35,354 women resident in South East England and diagnosed with breast cancer between 1992 and 2001 who received radiotherapy within six months of diagnosis were identified from the Thames Cancer Registry. Time to radiotherapy was measured from either the date of diagnosis or the start of the previous treatment, whichever was shorter. Unadjusted and adjusted logistic regression models were fitted to examine whether patients received radiotherapy within 60 days of their diagnosis or previous treatment. Results The adjusted proportions of patients receiving radiotherapy within 60 days varied significantly between different cancer networks (range: 43% to 81%, and decreased from 68% in 1992 to 33% in 2001. After adjustment there was no association between deprivation of area of residence, age or stage and radiotherapy wait. Median time waited to radiotherapy increased over the study period whether measured from the start of chemotherapy, hormone therapy, surgery or the date of diagnosis. Conclusion This study covered a period of time before the investment following the Cancer Plan of 2000. Results are consistent with other findings suggesting variation between cancer networks and increasing waits over time. Further studies should examine different methods of measuring waiting time, the causes and consequences of waits for radiotherapy and the effect of current initiatives and investments.

  9. Activation of dorsal raphe serotonin neurons is necessary for waiting for delayed rewards.

    Science.gov (United States)

    Miyazaki, Kayoko W; Miyazaki, Katsuhiko; Doya, Kenji

    2012-08-01

    The forebrain serotonergic system is a crucial component in the control of impulsive behaviors. We previously reported that the activity of serotonin neurons in the midbrain dorsal raphe nucleus increased when rats performed a task that required them to wait for delayed rewards. However, the causal relationship between serotonin neural activity and the tolerance for the delayed reward remained unclear. Here, we test whether the inhibition of serotonin neural activity by the local application of the 5-HT(1A) receptor agonist 8-hydroxy-2-(di-n-propylamino) tetralin in the dorsal raphe nucleus impairs rats' tolerance for delayed rewards. Rats performed a sequential food-water navigation task that required them to visit food and water sites alternately via a tone site to get rewards at both sites after delays. During the short (2 s) delayed reward condition, the inhibition of serotonin neural activity did not significantly influence the numbers of reward choice errors (nosepoke at an incorrect reward site following a conditioned reinforcer tone), reward wait errors (failure to wait for the delayed rewards), or total trials (sum of reward choice errors, reward wait errors, and acquired rewards). By contrast, during the long (7-11 s) delayed reward condition, the number of wait errors significantly increased while the numbers of total trials and choice errors did not significantly change. These results indicate that the activation of dorsal raphe serotonin neurons is necessary for waiting for long delayed rewards and suggest that elevated serotonin activity facilitates waiting behavior when there is the prospect of forthcoming rewards.

  10. Using Queuing Theory and Simulation Modelling to Reduce Waiting Times in An Iranian Emergency Department

    Directory of Open Access Journals (Sweden)

    Hourvash Akbari Haghighinejad

    2016-01-01

    Full Text Available Background: Hospital emergencies have an essential role in health care systems. In the last decade, developed countries have paid great attention to overcrowding crisis in emergency departments. Simulation analysis of complex models for which conditions will change over time is much more effective than analytical solutions and emergency department (ED is one of the most complex models for analysis. This study aimed to determine the number of patients who are waiting and waiting time in emergency department services in an Iranian hospital ED and to propose scenarios to reduce its queue and waiting time. Methods: This is a cross-sectional study in which simulation software (Arena, version 14 was used. The input information was extracted from the hospital database as well as through sampling. The objective was to evaluate the response variables of waiting time, number waiting and utilization of each server and test the three scenarios to improve them. Results: Running the models for 30 days revealed that a total of 4088 patients left the ED after being served and 1238 patients waited in the queue for admission in the ED bed area at end of the run (actually these patients received services out of their defined capacity. The first scenario result in the number of beds had to be increased from 81 to179 in order that the number waiting of the “bed area” server become almost zero. The second scenario which attempted to limit hospitalization time in the ED bed area to the third quartile of the serving time distribution could decrease the numberwaiting to 586 patients. Conclusion: Doubling the bed capacity in the emergency department and consequently other resources and capacity appropriately can solve the problem. This includes bed capacity requirement for both critically ill and less critically ill patients. Classification of ED internal sections based on severity of illness instead of medical specialty is another solution.

  11. Using a Time Timer to increase appropriate waiting behavior in a child with developmental disabilities.

    Science.gov (United States)

    Grey, Ian; Healy, Olive; Leader, Geraldine; Hayes, Deirdre

    2009-01-01

    This study aimed to examine the use of a predictive stimulus (Time Timer) and delayed reinforcement to increase appropriate waiting behavior in a child with developmental disabilities and problem behavior maintained by access to tangible items and activities. The study employed a changing criterion design across settings to gradually increase reinforcement delay from 1s to 10 min. Firstly a baseline phase was conducted to measure the duration of appropriate waiting behavior to access tangible reinforcers/activities. Phase 2 involved the use of a red cue card and the verbal instruction "wait". Phase 3 involved the introduction of the Time Timer with the cue card attached, and the verbal instruction "wait". Finally, Phase 4 utilised the Time Timer without the cue card. This method was an effective strategy for increasing appropriate waiting behavior with this participant in a school setting. The role of adding a concurrent activity during the reinforcement delay, using cues to predict reinforcement, future generalization, maintenance and the teaching of functionally equivalent skills are discussed.

  12. Study of Sound Environment Influenced by the Crowd in Waiting Areas in General Hospitals

    Institute of Scientific and Technical Information of China (English)

    Xin Qin; Jian Kang; Hong Jin

    2014-01-01

    In this study, the crowd has been investigated and analyzed in waiting areas in large general hospitals in China in order to find the rules the variations of sound environment with the change of crowd. The field investigation, questionnaire, field-testing and computer simulation have been adopted. The results show that:the social/demographic characteristics of staff and patients are not significantly related to the satisfaction evaluation of sound environment;there is a significant correlation between the population density and LAeq of the background noise in waiting areas;when population density is 0, the LAeq of background noise is not 0 in waiting areas; the loudspeaker should be set in the waiting areas. Loudspeaker arrangements should be integrated into the ceiling lamp or construct facilities along the depth direction of the layout, and the two adjacent speakers recommended distance should be controlled at about 4 m. If the population density is controlled in the reasonable range, and sound absorption, noise reduction processing and electronic queuing system are adopted, sound environment of waiting areas will be built with noise interference relatively small in different population densities.

  13. Priority List : Beaver Creek

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — Priority list of water rights at Beaver Creek owned by the State of Colorado or federal Fish and Wildlife. This document also has designs for Parshall flumes and...

  14. Blazar Monitoring List

    Data.gov (United States)

    National Aeronautics and Space Administration — This is a compilation of sources in major blazar monitoring programs. This list contains all blazars known to be regularly monitored, plus all the MOJAVE- &...

  15. Contaminant Candidate List 3

    Data.gov (United States)

    U.S. Environmental Protection Agency — CCL 3 is a list of contaminants that are currently not subject to any proposed or promulgated national primary drinking water regulations, that are known or...

  16. Contaminant Candidate List 1

    Data.gov (United States)

    U.S. Environmental Protection Agency — CCL 1 is a list of contaminants that are currently not subject to any proposed or promulgated national primary drinking water regulations, that are known or...

  17. Contaminant Candidate List 2

    Data.gov (United States)

    U.S. Environmental Protection Agency — CCL 2 is a list of contaminants that are currently not subject to any proposed or promulgated national primary drinking water regulations, that are known or...

  18. License Address List

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Address list generated from National Saltwater Angler Registry. Used in conjunction with an address-based sample as per survey design.

  19. Green Power Partner List

    Science.gov (United States)

    The U.S. EPA's Green Power Partnership is a voluntary program designed to reduce the environmental impact of electricity generation by promoting renewable energy. There are thousands of Green Power Partners, all listed on this page.

  20. Retrofitting Listed Buildings

    DEFF Research Database (Denmark)

    Rasmussen, Torben Valdbjørn

    2011-01-01

    The paper presents a case study where the energy demand for a listed building constructed in 1900 is reduced. Many older buildings are listed and have restrictions that include the entire building or that include only its exterior. For the building presented, only its exterior facade is listed....... The paper demonstrates measures for the improvement of the thermal insulation of the building with solid brick walls. Durable customised measures are shown. The customised measures are required not to change the overall exterior architecture as the building is considered to contribute to the uniqueness...... of the local urban environment and therefore listed. The reduced energy demand, related to individual measures, is estimated and building physics requirements are addressed together with the economic options for evaluating the profitability....

  1. Goat production check list

    DEFF Research Database (Denmark)

    Henriksen, Jørgen; Nielsen, Mette Benedicte Olaf; Madsen, Jørgen

    2009-01-01

    This check list, financed by DanChurchAid, highlights all issues should be carefully investigated before investing in distribution of goats and in interventions to assist poor rural communities to improve their livelihood through goat production.......This check list, financed by DanChurchAid, highlights all issues should be carefully investigated before investing in distribution of goats and in interventions to assist poor rural communities to improve their livelihood through goat production....

  2. Goat production check list

    DEFF Research Database (Denmark)

    Henriksen, Jørgen; Nielsen, Mette Benedicte Olaf; Madsen, Jørgen

    2009-01-01

    This check list, financed by DanChurchAid, highlights all issues should be carefully investigated before investing in distribution of goats and in interventions to assist poor rural communities to improve their livelihood through goat production.......This check list, financed by DanChurchAid, highlights all issues should be carefully investigated before investing in distribution of goats and in interventions to assist poor rural communities to improve their livelihood through goat production....

  3. An exploration of the basis for patient complaints about the oldness of magazines in practice waiting rooms: cohort study

    OpenAIRE

    Arroll, Bruce; Alrutz, Stowe; Moyes, Simon

    2014-01-01

    Objective To explore the basis for patient complaints about the oldness of most magazines in practice waiting rooms. Design Cohort study. Setting Waiting room of a general practice in Auckland, New Zealand. Participants 87 magazines stacked into three mixed piles and placed in the waiting room: this included non-gossipy magazines (Time magazine, the Economist, Australian Women’s Weekly, National Geographic, BBC History) and gossipy ones (not identified for fear of litigation). Gossipy was def...

  4. Waiting for Shadows from the Distant Solar System

    Science.gov (United States)

    Kohler, Susanna

    2016-03-01

    How can we hope to measure the hundreds of thousands of objects in our distant solar system? A team of astronomers is harnessing citizen science to begin to tackle this problem!A light curve from an occultation collected by a RECON site in Quincy, California. As the objects shadow passes, the background stars light dims. [RECON/Charley Arrowsmith (Feather River College)]Occultation InformationEstimates currently place the number of Kuiper belt objects larger than 100 km across at over 100,000. Knowing the sizes and characteristics of these objects is important for understanding the composition of the outer solar system and constraining models of the solar systems formation and evolution.Unfortunately, measuring small, dim bodies at large distances is incredibly difficult! One of the best ways to obtain the sizes of these objects is to watch as they occult a distant star. Timing the object as it passes across the face of the star can give us a good measure of its size and shape, when observed from multiple stations in the path of the shadow.An Extended NetworkOccultations by nearby objects (like main-belt asteroids) can be predicted fairly accurately, but those by trans-Neptunian objects are much more poorly constrained. Only ~900 trans-Neptunian objects have approximately known paths, and occultation-shadow predictions for these objects are often only accurate to ~1000km on the Earths surface. So how can we ensure that theres a telescope in the right location, ready to observe when an occultation occurs?Map of the 56 RECON sites distributed over 2000 km in the western United States. [Buie et al. 2016]The simplest answer is to set up a huge network of observing stations, and wait for the shadows to come to the network. With this approach, even if the predicted path isnt precisely known, some of the stations will still observe the occultation.Due to the number of stations needed, this project lends itself perfectly to citizen science. In a recently published paper by

  5. Estimating the waiting time of multi-priority emergency patients with downstream blocking.

    Science.gov (United States)

    Lin, Di; Patrick, Jonathan; Labeau, Fabrice

    2014-03-01

    To characterize the coupling effect between patient flow to access the emergency department (ED) and that to access the inpatient unit (IU), we develop a model with two connected queues: one upstream queue for the patient flow to access the ED and one downstream queue for the patient flow to access the IU. Building on this patient flow model, we employ queueing theory to estimate the average waiting time across patients. Using priority specific wait time targets, we further estimate the necessary number of ED and IU resources. Finally, we investigate how an alternative way of accessing ED (Fast Track) impacts the average waiting time of patients as well as the necessary number of ED/IU resources. This model as well as the analysis on patient flow can help the designer or manager of a hospital make decisions on the allocation of ED/IU resources in a hospital.

  6. Improving Waiting Time of Tasks Scheduled Under Preemptive Round Robin Using Changeable Time Quantum

    CERN Document Server

    Mostafa, Samih Mohemmed

    2010-01-01

    Minimizing waiting time for tasks waiting in the queue for execution is one of the important scheduling cri-teria which took a wide area in scheduling preemptive tasks. In this paper we present Changeable Time Quan-tum (CTQ) approach combined with the round-robin algorithm, we try to adjust the time quantum according to the burst times of the tasks in the ready queue. There are two important benefits of using (CTQ) approach: minimizing the average waiting time of the tasks, consequently minimizing the average turnaround time, and keeping the number of context switches as low as possible, consequently minimizing the scheduling overhead. In this paper, we consider the scheduling problem for preemptive tasks, where the time costs of these tasks are known a priori. Our experimental results demonstrate that CTQ can provide much lower scheduling overhead and better scheduling criteria.

  7. Intake of wine, beer and spirits and waiting time to pregnancy

    DEFF Research Database (Denmark)

    Juhl, Mette; Olsen, Jørn; Andersen, Anne-Marie Nybo

    2003-01-01

    appear to have fewer strokes, lung and digestive tract cancers, and overall mortality than both abstainers and moderate drinkers of beer or spirits. We examined the association between different types of alcoholic beverages and waiting time to pregnancy. METHODS: Self-reported data were used for 29......,844 pregnant women, recruited to the Danish National Birth Cohort in 1997-2000. Main outcome measures were odds ratios for a prolonged waiting time to pregnancy according to consumption of wine, beer and spirits. RESULTS: All levels of wine intake compared with non-wine drinking or with consumption of beer...... or spirits had subfecundity odds ratios between 0.7 and 0.9. No association was seen regarding beer drinking, while the association with spirits was J-shaped. CONCLUSION: Our findings suggest that wine drinkers have slightly shorter waiting times to pregnancy than both non-wine drinkers and consumers...

  8. Impact of different discharge patterns on bed occupancy rate and bed waiting time: a simulation approach.

    Science.gov (United States)

    Zhu, Zhecheng

    2011-01-01

    Beds are one of the most important resources in a healthcare system. How to manage beds efficiently is an important indicator of the efficiency of the healthcare system. Bed management is challenging to many healthcare service providers in many aspects. In recent years, population growth and aging society impose extra pressure on bed requirement. There are usually two key performance indicators of a bed management system: bed occupancy rate and bed waiting time. In this paper, different discharge patterns and their impacts on the bed occupancy rate and bed waiting time are studied. A discrete event simulation model is constructed to evaluate the existing discharge pattern in a Singapore regional hospital using actual hospital admission and discharge transaction data. Then different discharge patterns are tested in the same context. Simulation results show that a proper discharge pattern significantly smoothes the fluctuation of bed occupancy rate and reduce the bed waiting time.

  9. Identification of waiting time distribution of M/G/1, Mx/G/1, GIr/M/1 queueing systems

    Directory of Open Access Journals (Sweden)

    A. Ghosal

    1988-01-01

    Full Text Available This paper brings out relations among the moments of various orders of the waiting time of the 1st customer and a randomly selected customer of an arrival group for bulk arrivals queueing models, and as well as moments of the waiting time (in queue for M/G/1 queueing system. A numerical study of these relations has been developed in order to find the (β1,β2 measures of waiting time distribution in a comutable form. On the basis of these measures one can look into the nature of waiting time distribution of bulk arrival queues and the single server M/G/1 queue.

  10. The control of deliberate waiting strategies in a stop-signal task

    Directory of Open Access Journals (Sweden)

    R.P. Sylwan

    2004-06-01

    Full Text Available To inhibit an ongoing flow of thoughts or actions has been largely considered to be a crucial executive function, and the stop-signal paradigm makes inhibitory control measurable. Stop-signal tasks usually combine two concurrent tasks, i.e., manual responses to a primary task (go-task are occasionally countermanded by a stimulus which signals participants to inhibit their response in that trial (stop-task. Participants are always instructed not to wait for the stop-signal, since waiting strategies cause the response times to be unstable, invalidating the data. The aim of the present study was to experimentally control the strategies of waiting deliberately for the stop-signal in a stop-task by means of an algorithm that measured the variation in the reaction times to go-stimuli on-line, and displayed a warning legend urging participants to be faster when their reaction times were more than two standard deviations of the mean. Thirty-four university students performed a stop-task with go- and stop-stimuli, both of which were delivered in the visual modality and were lateralized within the visual field. The participants were divided into two groups (group A, without the algorithm, vs group B, with the algorithm. Group B exhibited lower variability of reaction times to go-stimuli, whereas no significant between-group differences were found in any of the measures of inhibitory control, showing that the algorithm succeeded in controlling the deliberate waiting strategies. Differences between deliberate and unintentional waiting strategies, and anxiety as a probable factor responsible for individual differences in deliberate waiting behavior, are discussed.

  11. Escoliose idiopática do adolescente (eia: perfil clínico e radiográfico da lista de espera para tratamento cirúrgico em hospital terciário de alta complexidade do Sistema Público de Saúde Brasileiro Escoliosis idiopática del adolescente (eia: perfil clínico y la radiografía de la lista de espera para el tratamiento quirúrgico en el hospital de tercer nivel de alta complejidad del Sistema Brasileño de Salud Pública Adolescent idiopathic scoliosis (ais: clinical and radiographic profile of waiting list for surgical treatment in tertiary hospital high complexity of Brazilian Public Heatlth System

    Directory of Open Access Journals (Sweden)

    Paulo Candido de Lima Júnior

    2011-01-01

    Moe, la clasificación de King y otros, y Lenke et al en el momento de la indicación de tratamiento quirúrgico y el tiempo de espera para la cirugía. RESULTADOS: De los 51 pacientes, 42 mujeres y 9 hombres, edad promedio de 15,53 años (10-46 años. Todos los pacientes tenían edades comprendidas entre 10 y 17 años al momento del diagnóstico. El promedio de espera fue de 25,41 meses (desde 2 a 180 meses. El promedio de edad de la menarquía fue 12,13 años (11-14 años, 10 pacientes no tenían la menarquía, y 23 pacientes con esqueleto inmaduro (Risser cero a tres. La curva primaria promedio fue de 60,4 grados (que va desde 40 hasta 120 grados. Los tipos de curva de las más frecuentes fueron de tipo King III y 19 pacientes con Lenke 1BN con 11 pacientes. CONCLUSIÓN: DEBIDO a la morbilidad se definen en la literatura en pacientes con EIA no tratadas y el número de la muestra, es las medidas apropiadas en términos de política pública para el tratamiento de estos pacientes en nuestro país.OBJECTIVE: To describe through descriptive cross-sectional study, the clinical and radiographic parameters of patients with adolescent idiopathic scoliosis (AIS that are on the waiting list for elective surgery in a tertiary university hospital of high complexity of the SUS. METHODS: To define the clinical and radiographic profile, the following data were collected: menarche, sex, age, Risser sign, Cobb value, Nash-Moe, classification of King et al. and Lenke et al., at the time of indication for surgical treatment, and waiting time for surgery. RESULTS: Of the 51 patients, 42 were females and 9 males, mean age was 15.53 years (10-46 years. All patients were aged between 10 and 17 years at diagnosis. The average wait was 25.41 months (ranging from 2 to 180 months. The average age at menarche was 12.13 years (11-14 years, 10 patients had no menarche, and 23 skeletally immature patients (Risser zero to three. The average primary curve was 60.4 degrees (ranging from 40 to 120

  12. Mass measurement on the rp-process waiting point {sup 72}Kr

    Energy Technology Data Exchange (ETDEWEB)

    Rodriguez, D. [Gesellschaft fuer Schwerionenforschung mbH, Darmstadt (Germany); Kolhinen, V.S. [Jyvaeskylae Univ. (Finland); Audi, G. [CSNSM-IN2P3-Centre National de la Recherche Scientifique (CNRS), 91 - Orsay (FR)] [and others

    2004-06-01

    The mass of one of the three major waiting points in the astrophysical rp-process {sup 72}Kr was measured for the first time with the Penning trap mass spectrometer ISOLTRAP. The measurement yielded a relative mass uncertainty of {delta}m/m=1.2 x 10{sup -7} ({delta}m=8 keV). Other Kr isotopes, also needed for astrophysical calculations, were measured with more than one order of magnitude improved accuracy. We use the ISOLTRAP masses of{sup 72-74}Kr to reanalyze the role of the {sup 72}Kr waiting point in the rp-process during X-ray bursts. (orig.)

  13. A study on iron ore transportation model with penalty value of transportation equipment waiting

    Directory of Open Access Journals (Sweden)

    Kailing Pan

    2017-03-01

    Full Text Available As some steel enterprises are at a disadvantage in the choice of the mode of transportation, this paper made further studies of the characteristics of the iron ore logistics, taking comprehensive consideration of optimizing the waiting time under the conditions with limited loading capacity and setting up a procedural model of the iron ore logistics system with minimum cost of transportation, storage, loading, unloading, and transportation equipment waiting. Finally, taking the iron ore transport system of one steel enterprise as example, the solution and the validity of the model were analyzed and verified in this paper.

  14. Mass Measurement on the rp-Process Waiting Point 72Kr

    CERN Document Server

    Rodríguez, D; Audi, G; Äystö, J; Beck, D; Blaum, K; Bollen, G; Herfurth, F; Jokinen, A; Kellerbauer, A G; Kluge, H J; Oinonen, M; Schatz, H; Sauvan, E; Schwarz, S

    2004-01-01

    The mass of one of the three major waiting points in the astrophysical rp-process 72Kr was measured for the first time with the Penning trap mass spectrometer ISOLTRAP. The measurement yielded a relative mass uncertainty of delta m/m = 1.2x10-7 (delta m=8keV). Other Kr isotopes, also needed for astrophysical calculations, were measured with more than one order of magnitude improved accuracy. We use the ISOLTRAP masses of 72-74Kr to reanalyse the role of the 72Kr waiting point in the rp-process during X-ray bursts.

  15. Study on the interaction between the food and beverage servicescape and customer waiting experience

    Directory of Open Access Journals (Sweden)

    Yang, Chih-Yun

    2014-11-01

    Full Text Available Past research on the customer waiting experience tended to focus on two primary areas, namely managing the wait and managing the perception of the wait. Very few studies conducted in-depth analysis and discus¬sion of how external environmental factors affect the experience of customer waiting, which it was also viewed as a negative factor that decreases customer satisfaction toward service. However, in reality, the waiting experience can be positive as a result of certain environmental factors, and subsequently increases customer satisfaction toward the service. This study aimed to further examine the potential influencing factors arising from the servicescape during the customer waiting process, and the interaction between the servicescape and customers during their wait time. This paper is based on the causal feedback loop. A system dynamics perspective was applied to construct a conceptual systems model showing the interaction between the servi¬cescape and the customer waiting experience.Estudios previos sobre la experiencia de espera de los clients suelen centrarse sobre todo en dos áreas: la gestión de la espera y la gestión de la experiencia de espera. Existen muy pocos estudios que hayan realizado análisis y discusiones en profundidad sobre cómo los factores ambientales externos afectan a la experiencia de espera de los clientes, que se ha considerado siempre como un factor negativo que reduce la satisfacción del cliente hacia el servicio. Sin embargo, la experiencia de espera puede incrementar en reali¬dad la satisfacción del cliente hacia el servicio. Este estudio pretende profundizar en la influencia potencial de los factores que surgen del “servicescape” durante el proceso de espera del cliente, así como la interacción entre el “servicescape” y los clientes durante el tiempo de espera. Ese artículo se basa en el bucle de retroa¬limentación causal. Desde la perspectiva de la dinámica de sistemas se construye un

  16. Liste des intrants 2015

    OpenAIRE

    Speiser, Bernhard; Tamm, Lucius; Maurer, Veronika; Berner, Alfred; Schneider, Claudia; Chevillat, Véronique

    2015-01-01

    La liste des intrants contient tous les produits phytosanitaires, les engrais, les substrats du commerce, les produits de lutte contre les mouches des étables, les agents d'ensilage, les aliments minéraux et complémentaires, les produits pour la désinfection des stabulations et les produits contre les maladies des abeilles autorisés pour l'agriculture biologique. Cette liste est contraignante pour les producteurs de Bio Suisse. Sur les fermes Bio Suisse, seuls les produits mentionnés sont aut...

  17. STAFF VACANCY LIST

    CERN Multimedia

    Human Resources Division

    2002-01-01

    For economy reasons, it has been decided to stop printing and distributing this list to Staff Members. It can be found on the Web (LIST). Divisional Administrative Officers will receive an updated printed copy on a monthly basis and are asked to display this in a public place in their division. Copies will also be posted on the notice boards of the Administration Building (No. 60) in the glass-fronted cabinet (close to the lifts) and also on the notice board close to the Post Office. A copy will also be given to the Reception (Building No. 33). Human Resources Division Tel. 74606

  18. To Construction and Standardization of the Waiting Anxiety Questionnaire (WAQ in Iran.

    Directory of Open Access Journals (Sweden)

    Sodeh Tavakkoli

    2014-09-01

    Full Text Available This study aimed to develop and validate a questionnaire to measure waiting anxiety.This was a cross-sectional study. Extensive review of literature and expert opinions were used to develop and validate the waiting anxiety questionnaire. A sample of 321 participants was recruited through random cluster sampling (n= 190 Iranian men and n= 131 women. The participants filled out WAQ, the Speilberger's State-Trait Anxiety Inventory (STAI, Burtner Rating scale (BRS and Eysenk Personality questionnaire (EPQ for adults.Internal consistency of WAQ was revealed, meaning that all the 20 items were highly correlated with the total score. The Cronbach alpha equaled 0.83 for the Waiting Anxiety Questionnaire. The Pearson correlation coefficient of the questionnaire with the STAI, BRS and extraversion and neuroticism subscales of EPQ was 0.65, 0.78, - 0.47 and 0.43, respectively, which confirmed its convergent and divergent validity. Factors analysis extracting four cognitive, behavioral, sentimental and physiological factors could explain 67% of the total variance with an Eigen value of greater than 1.Our findings suggest that WAQ possesses appropriate validity and reliability to measure the individuals' anxiety during the waiting time.

  19. Treatment outcome of supraglottoplasty vs. wait-and-see policy in patients with laryngomalacia

    NARCIS (Netherlands)

    van der Heijden, Martijn; Dikkers, Frederik G; Halmos, Gyorgy B

    2016-01-01

    In most cases, laryngomalacia presents as a mild disease, and the symptoms resolve after wait-and-see policy. Up to 20 % of patients present with severe laryngomalacia and may require surgery (i.e. supraglottoplasty); however, the indication for surgery is not firmly established yet. The goal of thi

  20. Factors Associated with Waiting Time for Breast Cancer Treatment in a Teaching Hospital in Ghana

    Science.gov (United States)

    Dedey, Florence; Wu, Lily; Ayettey, Hannah; Sanuade, Olutobi A.; Akingbola, Titilola S.; Hewlett, Sandra A.; Tayo, Bamidele O.; Cole, Helen V.; de-Graft Aikins, Ama; Ogedegbe, Gbenga; Adanu, Richard

    2016-01-01

    Background: Breast cancer is the leading cause of cancer-related mortality among women in Ghana. Data are limited on the predictors of poor outcomes in breast cancer patients in low-income countries; however, prolonged waiting time has been implicated. Among breast cancer patients who received treatment at Korle Bu Teaching Hospital, this study…

  1. Burst wait time simulation of CALIBAN reactor at delayed super-critical state

    Energy Technology Data Exchange (ETDEWEB)

    Humbert, P. [Commissariat a l' Energie Atomique CEA, Centre de Bruyeres-le-Chatel, 91297 Arpajon (France); Authier, N.; Richard, B.; Grivot, P.; Casoli, P. [Commissariat a l' Energie Atomique CEA, Centre de Valduc, 21120 Is-sur-Tille (France)

    2012-07-01

    In the past, the super prompt critical wait time probability distribution was measured on CALIBAN fast burst reactor [4]. Afterwards, these experiments were simulated with a very good agreement by solving the non-extinction probability equation [5]. Recently, the burst wait time probability distribution has been measured at CEA-Valduc on CALIBAN at different delayed super-critical states [6]. However, in the delayed super-critical case the non-extinction probability does not give access to the wait time distribution. In this case it is necessary to compute the time dependent evolution of the full neutron count number probability distribution. In this paper we present the point model deterministic method used to calculate the probability distribution of the wait time before a prescribed count level taking into account prompt neutrons and delayed neutron precursors. This method is based on the solution of the time dependent adjoint Kolmogorov master equations for the number of detections using the generating function methodology [8,9,10] and inverse discrete Fourier transforms. The obtained results are then compared to the measurements and Monte-Carlo calculations based on the algorithm presented in [7]. (authors)

  2. Stroke Education in an Emergency Department Waiting Room: a Comparison of Methods

    Directory of Open Access Journals (Sweden)

    Yu-Feng Yvonne Chan1

    2015-03-01

    Full Text Available Background: Since the emergency department (ED waiting room hosts a large, captive audience of patients and visitors, it may be an ideal location for conduct-ing focused stroke education. The aim of this study was to assess the effective-ness of various stroke education methods.Methods: Patients and visitors of an urban ED waiting room were randomized into one of the following groups: video, brochure, one-to-one teaching, combi-nation of these three methods, or control group. We administered a 13-question multiple-choice test to assess stroke knowledge prior to, immediately after, and at 1 month post-education to patients and visitors in the ED waiting room.Results: Of 4 groups receiving education, all significantly improved their test scores immediately post intervention (test scores 9.4±2.5-10.3±2.0, P<0.01. At 1 month, the combination group retained the most knowledge (9.4±2.4 exceed-ing pre-intervention and control scores (both 6.7±2.6, P<0.01.Conclusion: Among the various stroke education methods delivered in the ED waiting room, the combination method resulted in the highest knowledge reten-tion at 1-month post intervention.

  3. Group Therapy with Patients in the Waiting Room of an Oncology Clinic.

    Science.gov (United States)

    Arnowitz, Edward; And Others

    1983-01-01

    Describes a therapy group for cancer patients, conducted by cotherapists in an oncology waiting room. Group members provided mutual support and shared concerns and coping methods. Medical staff members became more involved and were more able to address the affective needs of the patients and their families. (JAC)

  4. A delay discounting task produces a greater likelihood of waiting than a deferred gratification task.

    Science.gov (United States)

    Young, Michael E; McCoy, Anthony W

    2015-01-01

    A first-person-shooter video game was adapted for the study of choice between smaller sooner and larger later outcomes to compare the behavioral patterns produced by deferred gratification (DG) and delay discounting (DD) tasks. Participants played a game in which they could either fire their weapon sooner and do a small amount of damage or wait a few seconds to fire their weapon and do a larger amount of damage. For the DD task, a failure to fire within one second committed the player to waiting for the larger later outcome thus removing the opportunity to defect during the delay that is present in the DG task. The incentive structure changed multiple times during game play so that at times the optimal decision was to choose the smaller sooner outcome whereas at other times the optimal decision was to wait for the larger later outcome. Players assigned to the DD task showed a greater tendency to wait and lower sensitivity to the changing incentives.

  5. School, Activism and Politics at the Movies: Educator Reactions to the Film "Waiting for 'Superman'"

    Science.gov (United States)

    Wessel Powell, Christy

    2014-01-01

    Context: The documentary film about U.S. education reform, "Waiting for 'Superman'," was met with acclaim and controversy when released to theaters in 2010, and again when launching its grassroots "host a screening" campaign in 2011. The campaign ran concurrent with 2011 state legislative sessions, during which several states…

  6. Stress reducing effects of real and artificial nature in a hospital waiting room

    NARCIS (Netherlands)

    Beukeboom, C.J.; Langeveld, D.; Tanja-Dijkstra, K.

    2012-01-01

    Objectives: This field study investigated the potential stress-reducing effects of exposure to real or artificial nature on patients in a hospital waiting room. Additionally, it was investigated whether perceived attractiveness of the room could explain these effects. Design: In this

  7. Reviewing Policy: Starting the Wrong Conversations--The Public School Crisis and "Waiting for Superman"

    Science.gov (United States)

    Swalwell, Katy; Apple, Michael W.

    2011-01-01

    The documentary "Waiting for Superman" has become one of those rare things, a (supposed) documentary that generates a wider audience. It also is one of the more recent embodiments of what Nancy Fraser (1989) labels as the "politics of needs and needs discourses." Dominant groups listen carefully to the language and issues that…

  8. Popular Media Portrayals of Inequity and School Reform in "The Wire" and "Waiting for 'Superman'"

    Science.gov (United States)

    Gerstl-Pepin, Cynthia

    2015-01-01

    Two popular media forms are examined--the documentary film "Waiting for 'Superman'" and the HBO television series, "The Wire"--that present distinct, and at times conflicting, depictions of how to address educational inequity. Qualitative media content analysis was used to analyze the two media documents and to situate them…

  9. Waiting for Superman: Neoliberal Educational Reform and the Craft of Filmic Direction

    Science.gov (United States)

    Prado, Jose; Montez de Oca, Jeffrey

    2014-01-01

    The Waiting for Superman (WFS) cultural project and its push to transform the public school system has had great appeal among those sympathetic and unsympathetic to the victims of exclusionary and exploitative school agendas. To address the workings of hegemony in the WFS cultural project the authors examine three general scenes in the WFS trailer…

  10. Predictors of fecundability and conception waits among the Dogon of Mali.

    Science.gov (United States)

    Strassmann, B I; Warner, J H

    1998-02-01

    Surprisingly little is known about the mechanisms that underlie variation in female fertility in humans. Data on this topic are nonetheless vital to a number of pragmatic and theoretical enterprises, including population planning, infertility treatment and prevention, and evolutionary ecology. Here we study female fertility by focusing on one component of the interbirth interval: the waiting time to conception during menstrual cycling. Our study population is a Dogon village of 460 people in Mali, West Africa. This population is pronatalist and noncontracepting. In accordance with animist beliefs, the women spend five nights sleeping at a menstrual hut during menses. By censusing the women present at the menstrual huts in the study village on each of 736 consecutive nights, we were able to monitor women's conception waits prospectively. Hormonal profiles confirm the accuracy of the data on conception waits obtained from the menstrual hut census (Strassmann [1996], Behavioral Ecology 7:304-315). Using survival analysis, we identified significant predictors of the waiting time to conception: wife's age (years), husband's age ( 49 years), marital duration (years), gravidity (number of prior pregnancies), and breast-feeding status. Additional variables were not significant, including duration of postpartum amenorrhea, sex of the last child, nutritional status, economic status, polygyny, and marital status (fiancée vs. married). We fit both continuous and discrete time survival models, but the former appeared to be a better choice for these data.

  11. [Immunization educational game in general practice waiting rooms. A comparative study].

    Science.gov (United States)

    Rolland, Marie-Aude; Gignon, Maxime

    2015-01-01

    The general practitioner’s (GP) waiting room is an ideal place to conduct health education actions. The use of tools in GP waiting rooms would appear to be a useful approach, but the available tools are not very efficient. The objective of this study was to study the efficacy of a game compared with two other health education strategies. A comparative study was conducted in two general practices. 212 patients were divided into three groups using a paper-game or a booklet or nothing in the waiting room, before a discussion about immunization with the practitioner. The capacity of the tool to encourage questions about immunization was estimated by the GP at the end of the consultation by a questionnaire. The use of a tool in the waiting room facilitated the discussion between patients and practitioners (34% vs 12%, pgame induced longer discussions than the booklet (1 minute 32 seconds vs 1 minute 14 seconds, pgame and the booklet had a comparable acceptability. Using a multistep education strategy facilitated discussion between the patient and the practitioner. However, the GP is required to trigger the conversation.

  12. A Desperate Comedy: Hope and Alienation in Samuel Beckett's "Waiting

    Science.gov (United States)

    Scott, Alan

    2013-01-01

    This article is both a personal response to Samuel Beckett's "Waiting for Godot" and an examination of the concept within literature of making the strange familiar and making the familiar strange. It discusses the educative force and potential of Beckett's strangers in a strange world by examining my own personal experiences…

  13. Watchful waiting versus colorectal resection after polypectomy for malignant colorectal polyps

    DEFF Research Database (Denmark)

    Levic, Katarina; Kjær, Monica; Bulut, Orhan;

    2015-01-01

    analysis of prospectively collected data on 50 patients with unexpected malignancy after a polypectomy treated between January 2003 and January 2008. A total of 27 patients (54%) were treated with watchful waiting, and 23 (46%) underwent subsequent surgery. The Mann-Whitney U-test and chi-square test were...

  14. Cervical collar or physiotherapy versus wait and see policy for recent onset cervical radiculopathy: randomised trial.

    NARCIS (Netherlands)

    B. Kuijper (Barbara); J.T. Tans; A. Beelen (Anita); F. Nollet (Frans); M. de Visser (Marianne)

    2009-01-01

    textabstractOBJECTIVE: To evaluate the effectiveness of treatment with collar or physiotherapy compared with a wait and see policy in recent onset cervical radiculopathy. DESIGN: Randomised controlled trial. SETTING: Neurology outpatient clinics in three Dutch hospitals. PARTICIPANTS: 205 patients w

  15. Universal law for waiting internal time in seismicity and its implication to earthquake network

    CERN Document Server

    Abe, Sumiyoshi

    2012-01-01

    In their paper (Europhys. Lett., 71 (2005) 1036), Carbone, Sorriso-Valvo, Harabaglia and Guerra showed that "unified scaling law" for conventional waiting times of earthquakes claimed by Bak et al. (Phys. Rev. Lett., 88 (2002) 178501) is actually not universal. Here, instead of the conventional time, the concept of the internal time termed the event time is considered for seismicity. It is shown that, in contrast to the conventional waiting time, the waiting event time obeys a power law. This implies the existence of temporal long-range correlations in terms of the event time with no sharp decay of the crossover type. The discovered power-law waiting event-time distribution turns out to be universal in the sense that it takes the same form for seismicities in California, Japan and Iran. In particular, the parameters contained in the distribution take the common values in all these geographical regions. An implication of this result to the procedure of constructing earthquake networks is discussed.

  16. Maternity waiting facilities for improving maternal and neonatal outcome in low-resource countries

    NARCIS (Netherlands)

    van Lonkhuijzen, L.; Stekelenburg, J.; van Roosmalen, J.

    2009-01-01

    Background A Maternity Waiting Home (MWH) is a facility, within easy reach of a hospital or health centre which provides Emergency Obstetric Care (EmOC). Women may stay in the MWH at the end of their pregnancy and await labour. Once labour starts, women move to the health facility so that labour and

  17. Epidemiology of grey mould in annual waiting-bed production of strawberry.

    NARCIS (Netherlands)

    Boff, P.; Kastelein, P.; Kraker, de J.; Gerlagh, M.; Köhl, J.

    2001-01-01

    The epidemiology of Botrytis cinerea was studied in five annual strawberry crops using waiting-bed transplants, a system widely adopted in the Netherlands. On dead leaves of transplants the incidence of B. cinerea varied from 26.7 o 52.6°but the leaf area with potential sporulation was low (3.5–15.6

  18. Impact of adjustment measures on reducing outpatient waiting time in a community hospital: application of a computer simulation

    Institute of Scientific and Technical Information of China (English)

    CHEN Bai-lian; LI En-dong; Kazunobu Yamawuchi; Ken Kato; Shinji Naganawa; MIAO Wei-jun

    2010-01-01

    Background As an important determinant of patient satisfaction, waiting time, has gained increasing attention in the field of health care services. The present study aimed to illustrate the distribution characteristics of waiting time in a community hospital and explore the impact of potential measures to reduce outpatient waiting time based on a computer simulation approach. Methods During a one-month study period in 2006, a cross-sectional study was conducted in a community hospital located in Shanghai, China. Baseline data of outpatient waiting time were calculated according to the records of registration time and payment time. A simulation technique was adopted to investigate the impact of perspective reform methods on reducing waiting time. Results Data from a total of 10 092 patients and 26 816 medical consultations were collected in the study and 19 947 medical consultations were included. The average of the total visit time for outpatients in this hospital was 43.6 minutes in the morning, 19.1 minutes in the afternoon, and 34.3 minutes for the whole day studied period. The simulation results suggested that waiting time for outpatients could be greatly reduced through the introduction of appointment system and flexible demand-orientated doctor scheduling according to the numbers of patients waiting at different time of the workday. Conclusion Adoption of an appointment system and flexible management of doctor scheduling may be effective way to achieve decreased waiting time.

  19. The Impact of Waiting Time on Health Gains from Surgery: Evidence from a National Patient-reported Outcome Dataset.

    Science.gov (United States)

    Nikolova, Silviya; Harrison, Mark; Sutton, Matt

    2016-08-01

    Reducing waiting times has been a major focus of the English National Health Service for many years, but little is known about the impact on health outcomes. The collection of data on patient-reported outcome measures for all patients undergoing four large-volume procedures facilitates analysis of the impact of waiting times on patient outcomes. The availability of patient-reported outcome measures before and after surgery allows us to estimate the impact of waiting times on the effectiveness of treatment, controlling for pre-surgery health and the endogeneity of waiting times caused by prioritisation with respect to pre-intervention health. We find that waiting time has a negative and statistically significant impact on the health gain from hip and knee replacement surgery and no impact on the effectiveness of varicose vein and hernia surgery. The magnitude of this effect at patient level is small, 0.1% of the outcome measure range for each additional week of waiting. However, the value of this effect is substantially larger than existing estimates of the disutility experienced during the waiting period. The health losses associated with an additional week of waiting for annual populations of hip and knee replacement patients are worth £11.1m and £11.5m, respectively. Copyright © 2015 John Wiley & Sons, Ltd.

  20. To wait or to pay for medical treatment? Restraining ex-post moral hazard in health insurance.

    Science.gov (United States)

    Felder, Stefan

    2008-12-01

    We explore the hierarchy of two instruments, waiting time and coinsurance for medical treatment, for optimally solving the tradeoff between the economic gains from risk sharing and the losses from moral hazard. We show that the optimal waiting time is zero, given that the coinsurance rate is optimally set.

  1. Changing Course: Exploring Impacts of "Waiting for Superman" on Future Teachers' Perspectives on the State of Education

    Science.gov (United States)

    Jensen, Aaron; Janak, Edward; Slater, Timothy F.

    2012-01-01

    The controversial video documentary "Waiting for Superman," released in 2010, has helped to ignite a firestorm of national debate on current educational reforms in the United States. The purpose of this study is to determine the possible impacts of the video documentary "Waiting for Superman" potentially influencing pre-service…

  2. List coloring with requests

    OpenAIRE

    Dvořák, Zdeněk; Norin, Sergey; Postle, Luke

    2016-01-01

    Let G be a graph with a list assignment L. Suppose a preferred color is given for some of the vertices; how many of these preferences can be respected when L-coloring G? We explore several natural questions arising in this context, and propose directions for further research.

  3. The Christmas list

    CERN Multimedia

    James Gillies

    2010-01-01

    List making seems to be among mankind’s favourite activities, particularly as the old year draws to a close and the new one begins. It seems that we all want to know what the top 100 annoying pop songs are, who are the world’s most embarrassing people and what everyone’s been watching on TV. The transition from 2009 to 2010 was no different, but some of the latest batch of lists have a few surprising entries. According to the Global Language Monitor, ‘twitter’ was the top word of 2009. No surprises there, but ‘hadron’ came in at number 8 on the list. ‘King of pop’ was top phrase, according to the same source, but ‘god particle’ came in at number 10. And while ‘Barack Obama’ was the name of the year, ‘Large Hadron Collider’ came in at number four. The Global Language Monitor was not the only organization whose lists included particle physics references. &ls...

  4. Iterative List Decoding

    DEFF Research Database (Denmark)

    Justesen, Jørn; Høholdt, Tom; Hjaltason, Johan

    2005-01-01

    We analyze the relation between iterative decoding and the extended parity check matrix. By considering a modified version of bit flipping, which produces a list of decoded words, we derive several relations between decodable error patterns and the parameters of the code. By developing a tree...... of codewords at minimal distance from the received vector, we also obtain new information about the code....

  5. Making Lists, Enlisting Scientists

    DEFF Research Database (Denmark)

    Jensen, Casper Bruun

    2011-01-01

    was the indicator conceptualised? How were notions of scientific knowledge and collaboration inscribed and challenged in the process? The analysis shows a two-sided process in which scientists become engaged in making lists but which is simultaneously a way for research policy to enlist scientists. In conclusion...

  6. Water Conservation Resource List.

    Science.gov (United States)

    NJEA Review, 1981

    1981-01-01

    Alarmed by the growing water shortage, the New Jersey State Office of Dissemination has prepared this annotated list of free or inexpensive instructional materials for teaching about water conservation, K-l2. A tipsheet for home water conservation is appended. (Editor/SJL)

  7. List manipulation in Turbo Prolog

    Directory of Open Access Journals (Sweden)

    V.Cotelea

    1995-06-01

    Full Text Available The present paper is concerned with list processing in Turbo Prolog language. It doesn't claim to be an exhaustive description of operations which can be performed upon lists. Nevertheless adduced programs are most representative, more or less known to specialists in logic programming domain. By means of examples are explained the list manipulation techniques, use of recursion, declarative comparison of predicates, analysis and fixation of acceptable prototypes and some problems of predicates' inconsistency. Index terms. Prolog, list, recursion.

  8. Transition in the waiting-time distribution of price-change events in a global socioeconomic system

    Science.gov (United States)

    Zhao, Guannan; McDonald, Mark; Fenn, Dan; Williams, Stacy; Johnson, Nicholas; Johnson, Neil F.

    2013-12-01

    The goal of developing a firmer theoretical understanding of inhomogeneous temporal processes-in particular, the waiting times in some collective dynamical system-is attracting significant interest among physicists. Quantifying the deviations between the waiting-time distribution and the distribution generated by a random process may help unravel the feedback mechanisms that drive the underlying dynamics. We analyze the waiting-time distributions of high-frequency foreign exchange data for the best executable bid-ask prices across all major currencies. We find that the lognormal distribution yields a good overall fit for the waiting-time distribution between currency rate changes if both short and long waiting times are included. If we restrict our study to long waiting times, each currency pair’s distribution is consistent with a power-law tail with exponent near to 3.5. However, for short waiting times, the overall distribution resembles one generated by an archetypal complex systems model in which boundedly rational agents compete for limited resources. Our findings suggest that a gradual transition arises in trading behavior between a fast regime in which traders act in a boundedly rational way and a slower one in which traders’ decisions are driven by generic feedback mechanisms across multiple timescales and hence produce similar power-law tails irrespective of currency type.

  9. Scheduling a three-machine no-wait flowshop with separated setup time

    Institute of Scientific and Technical Information of China (English)

    CHANG Jun-lin; SHAO Hui-he

    2006-01-01

    In many practical flowshop production environments, there is no intermediate storage space available to keep partially completed jobs between any two machines. The workflow has to be continuous, implying that the no-wait conditions must be abided, which is typical in steel and plastic production. We discuss the threemachine no-wait flowshop scheduling problem where the setup times are considered as separated from processing times and sequence independent. The scheduling goal is to minimize the total flowtime. An optimal property and two heuristic algorithms for this problem are proposed. Evaluated over a large number of problems, the proposed heuristics are found that they can yield good solutions effectively with low computational complexity, and have more obvious advantage for the large size problem compared with the existing one.

  10. Reliable blood pressure self-measurement in the obstetric waiting room

    DEFF Research Database (Denmark)

    Wagner, Stefan; Kamper, C. H.; Rasmussen, Niels H

    2014-01-01

    patients scheduled for self-measuring their blood pressure (BP) in the waiting room at an obstetrics department's outpatient clinic to perform an additional BPSM using ValidAid. We then compared the automatically measured and classified values from ValidAid with our manual observations. Results: We found......Background: Patients often fail to adhere to clinical recommendations when using current blood pressure self-measurement (BPSM) methods and equipment. As existing BPSM equipment is not able to detect non-adherent behavior, this could result in misdiagnosis and treatment error. To overcome...... that a) the pregnant diabetics did not adhere to given instructions when performing BPSM in the waiting room, and that b) the ValidAid system was able to accurately classify patient adherence to the modeled recommendations. Conclusions: A new method for ensuring reliable BPSM based on the ValidAid system...

  11. Outcome Probability versus Magnitude: When Waiting Benefits One at the Cost of the Other

    Science.gov (United States)

    Young, Michael E.; Webb, Tara L.; Rung, Jillian M.; McCoy, Anthony W.

    2014-01-01

    Using a continuous impulsivity and risk platform (CIRP) that was constructed using a video game engine, choice was assessed under conditions in which waiting produced a continuously increasing probability of an outcome with a continuously decreasing magnitude (Experiment 1) or a continuously increasing magnitude of an outcome with a continuously decreasing probability (Experiment 2). Performance in both experiments reflected a greater desire for a higher probability even though the corresponding wait times produced substantive decreases in overall performance. These tendencies are considered to principally reflect hyperbolic discounting of probability, power discounting of magnitude, and the mathematical consequences of different response rates. Behavior in the CIRP is compared and contrasted with that in the Balloon Analogue Risk Task (BART). PMID:24892657

  12. Analyzing patient's waiting time in emergency & trauma department in public hospital - A case study

    Science.gov (United States)

    Roslan, Shazwa; Tahir, Herniza Md; Nordin, Noraimi Azlin Mohd; Zaharudin, Zati Aqmar

    2014-09-01

    Emergency and Trauma Department (ETD) is an important element for a hospital. It provides medical service, which operates 24 hours a day in most hospitals. However overcrowding is not exclusion for ETD. Overflowing occurs due to affordable services provided by public hospitals, since it is funded by the government. It is reported that a patient attending ETD must be treated within 90 minutes, in accordance to achieve the Key Performance Indicator (KPI). However, due to overcrowd situations, most patients have to wait longer than the KPI standard. In this paper, patient's average waiting time is analyzed. Using Chi-Square Test of Goodness, patient's inter arrival per hour is also investigated. As conclusion, Monday until Wednesday was identified as the days that exceed the KPI standard while Chi-Square Test of Goodness showed that the patient's inter arrival is independent and random.

  13. Is Waiting the Hardest Part? Comparing the Emotional Experiences of Awaiting and Receiving Bad News.

    Science.gov (United States)

    Sweeny, Kate; Falkenstein, Angelica

    2015-11-01

    Awaiting uncertain news is stressful, but is it more stressful than receiving bad news? We compared these emotional experiences in two studies. Participants in Study 1 reflected on a personal experience awaiting news that ultimately turned out badly, and participants in Study 2 were law graduates awaiting their results on the bar exam who ultimately failed the exam. In Study 1, participants were ambivalent as to whether awaiting or receiving bad news was more difficult, and emotion ratings in both studies confirmed this ambivalence. Anxiety was higher in anticipation of bad news (at least at the moment of truth) than in the face of it, whereas other negative emotions were more intense following the news than during the waiting period. Thus, whether waiting is "the hardest part" depends on whether one prefers to be racked with anxiety or afflicted with other negative emotions such as anger, disappointment, depression, and regret.

  14. Mass measurements beyond the major r-process waiting point $^{80}$Zn

    CERN Document Server

    Baruah, S; Blaum, K; Dworschak, M; George, S; Guenaut, C; Hager, U; Herfurth, F; Herlert, A; Kellerbauer, A G; Kluge, H J; Lunney, D; Schatz, H; Schweikhard, L; Yazidjian, C

    2008-01-01

    High-precision mass measurements on neutron-rich zinc isotopes $^{71m,72-81}$Zn have been performed with the Penning trap mass spectrometer ISOLTRAP. For the first time the mass of $^{81}$Zn has been experimentally determined. This makes $^{80}$Zn the first of the few major waiting points along the path of the astrophysical rapid neutron capture process where neutron separation energy and neutron capture $Q$-value are determined experimentally. As a consequence, the astrophysical conditions required for this waiting point and its associated abundance signatures to occur in $r$-process models can now be mapped precisely. The measurements also confirm the robustness of the $N = 50$ shell closure for $Z = 30$ farther from stability.

  15. Anomalous transport in fluid field with random waiting time depending on the preceding jump length

    Science.gov (United States)

    Zhang, Hong; Li, Guo-Hua

    2016-11-01

    Anomalous (or non-Fickian) transport behaviors of particles have been widely observed in complex porous media. To capture the energy-dependent characteristics of non-Fickian transport of a particle in flow fields, in the present paper a generalized continuous time random walk model whose waiting time probability distribution depends on the preceding jump length is introduced, and the corresponding master equation in Fourier-Laplace space for the distribution of particles is derived. As examples, two generalized advection-dispersion equations for Gaussian distribution and lévy flight with the probability density function of waiting time being quadratic dependent on the preceding jump length are obtained by applying the derived master equation. Project supported by the Foundation for Young Key Teachers of Chengdu University of Technology, China (Grant No. KYGG201414) and the Opening Foundation of Geomathematics Key Laboratory of Sichuan Province, China (Grant No. scsxdz2013009).

  16. Controlling synchrony in oscillatory networks via an act-and-wait algorithm.

    Science.gov (United States)

    Ratas, Irmantas; Pyragas, Kestutis

    2014-09-01

    The act-and-wait control algorithm is proposed to suppress synchrony in globally coupled oscillatory networks in the situation when the simultaneous registration and stimulation of the system is not possible. The algorithm involves the periodic repetition of the registration (wait) and stimulation (act) stages, such that in the first stage the mean field of the free system is recorded in a memory and in the second stage the system is stimulated with the recorded signal. A modified version of the algorithm that takes into account the charge-balanced requirement is considered as well. The efficiency of our algorithm is demonstrated analytically and numerically for globally coupled Landau-Stuart oscillators and synaptically all-to-all coupled FitzHugh-Nagumo as well as Hodgkin-Huxley neurons.

  17. The effect of superfluid hydrodynamics on pulsar glitch sizes and waiting times

    CERN Document Server

    Haskell, Brynmor

    2016-01-01

    Pulsar glitches, sudden jumps in frequency observed in many radio pulsars, may be the macroscopic manifestation of superfluid vortex avalanches on the microscopic scale. Small scale quantum mechanical simulations of vortex motion in a decelerating container have shown that such events are possible and predict power-law distributions for the size of the events, and exponential distributions for the waiting time. Despite a paucity of data, this prediction is consistent with the size and waiting time distributions of most glitching pulsars. Nevertheless a few object appear to glitch quasi-periodically, and exhibit many large glitches, while a recent study of the Crab pulsar has suggested a cut-off deviations from a power-law distribution for smaller glitches. In this paper we incorporate the results of quantum mechanical simulations in a macroscopic scale superfluid hydrodynamics simulation. We show that the effect of vortex coupling to the neutron and proton fluids in the neutron star naturally leads to deviati...

  18. Scheduling queues in the Ethernet switch, considering the waiting time of frames

    Directory of Open Access Journals (Sweden)

    Kizilov Evgeniy

    2016-01-01

    Full Text Available Authors proposes an algorithm to scheduling queues with temporal selection of frames in the Ethernet switches with QoS support, which is based on the waiting time of frames in the queues of different classes. Evaluation of the effectiveness of this algorithm compared to the classical cyclic algorithms by simulation with hierarchical temporal coloured Petri nets using CPN Tools package was conducte.

  19. Scaling of earthquake waiting times and the Olami-Feder-Christensen model

    CERN Document Server

    Hedges, M; Hedges, Morgan; Takacs, George

    2005-01-01

    Waiting-time statistics are generated from the Olami-Feder-Christensen model and shown to mimic some aspects of real seismicity. Preliminary analysis of the model data implies a recently proposed universal scaling law for the distribution in seismicity may be due to a mixing between aftershocks and uncorrelated event pairs, thus having limited application. Earthquake catalog data is also presented to support the argument.

  20. Partitioning of Independent Tasks for Minimizing Completion Time and Total Waiting Time

    Institute of Scientific and Technical Information of China (English)

    章中云; 祝明发; 等

    1991-01-01

    Parallel processors provide fast computing environments for various users.But the real efficiencies of parallel processors intensively depend on the partitioning strategies of tasks over the processors.In this paper,the partitioning problems of independent tasks for homogeneous system of parallel processors are quantitatively studied.We adopt two criteria,minimizing the completion time and the total waiting time, to determine the optimal partitioning strategy.

  1. An Improved Spray and Wait with Probability Choice Routing for Opportunistic Networks

    Directory of Open Access Journals (Sweden)

    Daru Pan

    2012-09-01

    Full Text Available Opportunistic networks are sparse multi-hop ad hoc networks in which nodes exploit any pair-wise contact opportunities to share and forward messages. The main challenge for this environment is that conventional routing schemes do not work properly.  Among the existing Opportunistic Networks routing algorithms, the epidemic routing and probabilistic  routing could provide higher delivery  probability and shorter delays, but is with a large overhead, while the spay and wait routing could reduce the overhead, but is with low delivery probability and high delay.  This paper proposes the Spray and Wait with Probability Choice (SWPC routing, where continuous encounter time is used to describe the encounter opportunity; a delivery probability function is set up to direct the different number of copies to the destination during the spray phase; and a forwarding scheme is implemented in the wait phase. Simulation results show that proposed SWPC shows prominent superiority in the delivery rate, the average delay and the communication overhead, and adapted for the frequently disconnected opportunistic network.

  2. Waiting time distribution of solar energetic particle events modeled with a non-stationary Poisson process

    CERN Document Server

    Li, Chuan; Wang, Linghua; Su, Wei; Fang, Cheng

    2014-01-01

    We present a study of the waiting time distributions (WTDs) of solar energetic particle (SEP) events observed with the spacecraft $WIND$ and $GOES$. Both the WTDs of solar electron events (SEEs) and solar proton events (SPEs) display a power-law tail $\\sim \\Delta t^{-\\gamma}$. The SEEs display a broken power-law WTD. The power-law index is $\\gamma_{1} =$ 0.99 for the short waiting times ($$100 hours). The break of the WTD of SEEs is probably due to the modulation of the corotating interaction regions (CIRs). The power-law index $\\gamma \\sim$ 1.82 is derived for the WTD of SPEs that is consistent with the WTD of type II radio bursts, indicating a close relationship between the shock wave and the production of energetic protons. The WTDs of SEP events can be modeled with a non-stationary Poisson process which was proposed to understand the waiting time statistics of solar flares (Wheatland 2000; Aschwanden $\\&$ McTiernan 2010). We generalize the method and find that, if the SEP event rate $\\lambda = 1/\\Delt...

  3. Probabilistic model of waiting times between large failures in sheared media.

    Science.gov (United States)

    Brinkman, Braden A W; LeBlanc, Michael P; Uhl, Jonathan T; Ben-Zion, Yehuda; Dahmen, Karin A

    2016-01-01

    Using a probabilistic approximation of a mean-field mechanistic model of sheared systems, we analytically calculate the statistical properties of large failures under slow shear loading. For general shear F(t), the distribution of waiting times between large system-spanning failures is a generalized exponential distribution, ρ_{T}(t)=λ(F(t))P(F(t))exp[-∫_{0}^{t}dτλ(F(τ))P(F(τ))], where λ(F(t)) is the rate of small event occurrences at stress F(t) and P(F(t)) is the probability that a small event triggers a large failure. We study the behavior of this distribution as a function of fault properties, such as heterogeneity or shear rate. Because the probabilistic model accommodates any stress loading F(t), it is particularly useful for modeling experiments designed to understand how different forms of shear loading or stress perturbations impact the waiting-time statistics of large failures. As examples, we study how periodic perturbations or fluctuations on top of a linear shear stress increase impact the waiting-time distribution.

  4. Maternity waiting homes and institutional birth in Nicaragua: policy options and strategic implications.

    Science.gov (United States)

    García Prado, Ariadna; Cortez, Rafael

    2012-01-01

    With the aim of promoting institutional births and reducing the high maternal and child mortality rates in rural and poor zones, the government of Nicaragua is supporting the creation of maternity waiting homes. This study analyzes that strategy and examines the factors associated with the use of maternity waiting homes and institutional birth. To that end, we apply a quantitative approach, by means of an econometric analysis of the data extracted from surveys conducted in 2006 on a sample of women and parteras or traditional birth attendants, as well as a qualitative approach based on interviews with key informants. Results indicate that although the operation of the maternity waiting homes is usually satisfactory, there is still room for improvement along the following lines: (i) disseminating information about the homes to both women and men, as the latter frequently decide the course of women's healthcare, and to parteras, who can play an important role in referring women; (ii) strengthening the postpartum care; (iii) ensuring financial sustainability by obtaining regular financial support from the government to complement contributions from the community; and (iv) strengthening the local management and involvement of the regional government. These measures might be useful for health policy makers in Nicaragua and in other developing countries that are considering this strategy. Copyright © 2011 John Wiley & Sons, Ltd.

  5. Waiting time before release increases the motivation to home in homing pigeons (Columba livia).

    Science.gov (United States)

    Dell'Ariccia, Gaia; Costantini, David; Dell'Omo, Giacomo; Lipp, Hans-Peter

    2009-10-01

    When performing homing experiments with individual releases, pigeons have to wait in a transport box for a certain amount of time before being released and hence perceive the departure of companions. Quite often, the last pigeons disappear straightforward from the release site. The question is whether this reflects improved orientation because of prolonged exposure to the release place or whether it reflects increased homing motivation. By releasing pigeons from a familiar site, we investigated the effects of the time spent at the release site on homing performance, recording pigeons' flights with GPS loggers. Our results show that, despite individual peculiarities of flight patterns, the waiting time at release site had a positive effect on homing speed and time, and reduced the time spent circling around the release point. However, the overall path efficiency as derived from GPS tracking was not influenced. These results suggest that a longer waiting time before release improves homing performance and this is related not only to increased navigational abilities but also to increased homing motivation.

  6. The application of queue theory in cloud computing to reduce the waiting time

    Directory of Open Access Journals (Sweden)

    N.N. Bharkad

    2014-10-01

    Full Text Available Cloud computing is a new technology in computer field to provide on line service to the customers. -Cloud computing has got enormous popularity as it offers dynamic, low-cost computing solutions. To get the service of cloud the user has to be in queue until he is served. Each arriving Cloud computing User (CCU requests Cloud computing Service Provider (CCSP to use the resources, if server is available, the arriving user will seize and hold it for a length of time, which leads to queue length and more waiting time. A new arrival leaves the queue with no service. After service completion the server is made immediately available to others. From the user’s point of view he needs to be served immediately and to prevent waiting the CCSP’s can use infinite servers to reduce waiting time & queue length. The arrival pattern is often Poisson in queuing theory. In this article we analyzed the dynamic behavior of the system with infinite servers by finding various effective measures like response time, average time spend in the system, utilization and throughput.

  7. Tutorial in medical decision modeling incorporating waiting lines and queues using discrete event simulation.

    Science.gov (United States)

    Jahn, Beate; Theurl, Engelbert; Siebert, Uwe; Pfeiffer, Karl-Peter

    2010-01-01

    In most decision-analytic models in health care, it is assumed that there is treatment without delay and availability of all required resources. Therefore, waiting times caused by limited resources and their impact on treatment effects and costs often remain unconsidered. Queuing theory enables mathematical analysis and the derivation of several performance measures of queuing systems. Nevertheless, an analytical approach with closed formulas is not always possible. Therefore, simulation techniques are used to evaluate systems that include queuing or waiting, for example, discrete event simulation. To include queuing in decision-analytic models requires a basic knowledge of queuing theory and of the underlying interrelationships. This tutorial introduces queuing theory. Analysts and decision-makers get an understanding of queue characteristics, modeling features, and its strength. Conceptual issues are covered, but the emphasis is on practical issues like modeling the arrival of patients. The treatment of coronary artery disease with percutaneous coronary intervention including stent placement serves as an illustrative queuing example. Discrete event simulation is applied to explicitly model resource capacities, to incorporate waiting lines and queues in the decision-analytic modeling example.

  8. A Scheduling Method to Reduce Waiting Time for Close-Range Broadcasting

    Directory of Open Access Journals (Sweden)

    Yusuke Gotoh

    2012-01-01

    Full Text Available Due to the recent popularization of digital broadcasting systems, close-range broadcasting using continuous media data, i.e. audio and video, has attracted great attention. For example, in a drama, after a user watches interesting content such as a highlight scene, he/she will watch the main program continuously. In close-range broadcasting, the necessary bandwidth for continuously playing the two types of data increases. Conventional methods reduce the necessary bandwidth by producing an effective broadcast schedule for continuous media data. However, these methods do not consider the broadcast schedule for two types of continuous media data. When the server schedules two types of continuous media data, waiting time that occurs from finishing the highlight scene to starting the main scene, may increase. In this paper, we propose a scheduling method to reduce the waiting time for close-range broadcasting. In our proposed method, by dividing two types of data and producing an effective broadcast schedule considering the available bandwidth, we can reduce the waiting time.

  9. QTL list - PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods | LSDB Archive [Life Science Database Archive metadata

    Lifescience Database Archive (English)

    Full Text Available [ Credits ] BLAST Search Image Search Home About Archive Update History Contact us PGDBj Registered...Policy | Contact Us QTL list - PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods | LSDB Archive ...

  10. Evaluation of two dairy herd reproductive performance indicators that are adjusted for voluntary waiting period

    Directory of Open Access Journals (Sweden)

    Löf Emma

    2012-01-01

    Full Text Available Abstract Background Overall reproductive performance of dairy herds is monitored by various indicators. Most of them do not consider all eligible animals and do not consider different management strategies at farm level. This problem can be alleviated by measuring the proportion of pregnant cows by specific intervals after their calving date or after a fixed time period, such as the voluntary waiting period. The aim of this study was to evaluate two reproductive performance indicators that consider the voluntary waiting period at the herd. The two indicators were: percentage of pregnant cows in the herd after the voluntary waiting period plus 30 days (PV30 and percentage of inseminated cows in the herd after the voluntary waiting period plus 30 days (IV30. We wanted to assess how PV30 and IV30 perform in a simulation of herds with different reproductive management and physiology and to compare them to indicators of reproductive performance that do not consider the herd voluntary waiting period. Methods To evaluate the reproductive indicators we used the SimHerd-program, a stochastic simulation model, and 18 scenarios were simulated. The scenarios were designed by altering the reproductive management efficiency and the status of reproductive physiology of the herd. Logistic regression models, together with receiver operating characteristics (ROC, were used to examine how well the reproductive performance indicators could discriminate between herds of different levels of reproductive management efficiency or reproductive physiology. Results The logistic regression models with the ROC analysis showed that IV30 was the indicator that best discriminated between different levels of management efficiency followed by PV30, calving interval, 200-days not-in calf-rate (NotIC200, in calf rate at100-days (IC100 and a fertility index. For reproductive physiology the ROC analysis showed that the fertility index was the indicator that best discriminated

  11. List coloring digraphs

    OpenAIRE

    2015-01-01

    The dichromatic number $\\vec{\\chi}(D)$ of a digraph $D$ is the least number $k$ such that the vertex set of $D$ can be partitioned into $k$ parts each of which induces an acyclic subdigraph. Introduced by Neumann-Lara in 1982, this digraph invariant shares many properties with the usual chromatic number of graphs and can be seen as the natural analog of the graph chromatic number. In this paper, we study the list dichromatic number of digraphs, giving evidence that this notion generalizes the...

  12. REVIEWER LIST – 2014

    OpenAIRE

    Chief Editor

    2014-01-01

    REVIEWER LIST – 2014 The Editorial Team would like to thank all those who gave generously of their time and expertise in reviewing the papers for the Indian Journal of Community Health in 2014.AAarti Kapil, New Delhi, IndiaAbhishek SinghAmandeep Kaur, Haldwani, IndiaAmit Kaushik, Safai, IndiaAnu Bhardwaj, Ambala, IndiaAnurag Chaudary, Ludhiana, IndiaA R BondArpan YagnikArvind Kumar Singh, Gorakhpur, IndiaAshish Yadav, Meerut, IndiaAthar Ansari, Aligarh, India BBaridalyne Nongkynrih, New Delhi...

  13. An Estimation Method of Waiting Time for Health Service at Hospital by Using a Portable RFID and Robust Estimation

    Science.gov (United States)

    Ishigaki, Tsukasa; Yamamoto, Yoshinobu; Nakamura, Yoshiyuki; Akamatsu, Motoyuki

    Patients that have an health service by doctor have to wait long time at many hospitals. The long waiting time is the worst factor of patient's dissatisfaction for hospital service according to questionnaire for patients. The present paper describes an estimation method of the waiting time for each patient without an electronic medical chart system. The method applies a portable RFID system to data acquisition and robust estimation of probability distribution of the health service and test time by doctor for high-accurate waiting time estimation. We carried out an health service of data acquisition at a real hospital and verified the efficiency of the proposed method. The proposed system widely can be used as data acquisition system in various fields such as marketing service, entertainment or human behavior measurement.

  14. ADAPTATION OF JOHNSON SEQUENCING ALGORITHM FOR JOB SCHEDULING TO MINIMISE THE AVERAGE WAITING TIME IN CLOUD COMPUTING ENVIRONMENT

    Directory of Open Access Journals (Sweden)

    SOUVIK PAL

    2016-09-01

    Full Text Available Cloud computing is an emerging paradigm of Internet-centric business computing where Cloud Service Providers (CSPs are providing services to the customer according to their needs. The key perception behind cloud computing is on-demand sharing of resources available in the resource pool provided by CSP, which implies new emerging business model. The resources are provisioned when jobs arrive. The job scheduling and minimization of waiting time are the challenging issue in cloud computing. When a large number of jobs are requested, they have to wait for getting allocated to the servers which in turn may increase the queue length and also waiting time. This paper includes system design for implementation which is concerned with Johnson Scheduling Algorithm that provides the optimal sequence. With that sequence, service times can be obtained. The waiting time and queue length can be reduced using queuing model with multi-server and finite capacity which improves the job scheduling model.

  15. The Impact of Private versus Social Health Insurance on Offered Waiting Times in German Acute Care Hospitals

    OpenAIRE

    Schwierz, Christoph; Wübker, Ansgar; Kuchinke, Björn A.

    2009-01-01

    This paper shows that patients with private health insurance (PHI) are being offered significantly shorter waiting times than patients with statutory health insurance (SHI) in German acute hospital care. This behavior may be driven by the higher expected profitability of PHI relative to SHI holders. Further,we find that hospitals offering private insurees shorter waiting times as compared to SHI holders have a significantly better financial performance than those abstaining from or with less ...

  16. Waiting times before dental care under general anesthesia in children with special needs in the Children's Hospital of Casablanca

    OpenAIRE

    Badre, Bouchra; Serhier, Zineb; El Arabi, Samira

    2014-01-01

    Introduction Oral diseases may have an impact on quality of children's life. The presence of severe disability requires the use of care under general anesthesia (GA). However, because of the limited number of qualified health personnel, waiting time before intervention can be long. Aim: To evaluate the waiting time before dental care under general anesthesia for children with special needs in Morocco. Methods A retrospective cohort study was carried out in pediatric dentistry unit of the Univ...

  17. Improving Adult ART Clinic Patient Waiting Time by Implementing an Appointment System at Gondar University Teaching Hospital, Northwest Ethiopia

    Directory of Open Access Journals (Sweden)

    Asmamaw Atnafu

    2015-01-01

    Full Text Available Background. Long waiting time has been among the major factors that affect patient satisfaction and health service delivery. The aim of this study was to determine the median waiting time at the Anti-Retroviral Therapy (ART Clinic before and after introduction of an intervention of the systematic appointment system. Methods. Patient waiting time was measured before and after the introduction of an intervention; target population of the study was all adult HIV patients/clients who have visited the outpatient ART Clinic in the study period. 173 patients were included before and after the intervention. Systematic patient appointment system and health education to patients on appointment system were provided as an intervention. The study period was from October 2011 to the end of January 2012. Data were analyzed using SPSS software version 17.0. Independent sample t-test at 95% confidence interval and 5% significance level was used to determine the significance of median waiting time difference between pre- and postintervention periods. Results and Conclusion. The total median waiting time was reduced from 274.8 minutes (IQR 180.6 minutes and 453.6 minutes before intervention to 165 minutes (IQR 120 minutes and 377.4 minutes after intervention (40% decrease, p=0.02. Overall, the study showed that the introduction of the new appointment system significantly reduces patient waiting time.

  18. A Cross-Sectional Survey of Population-Wide Wait Times for Patients Seeking Medical vs. Cosmetic Dermatologic Care.

    Science.gov (United States)

    Yadav, Geeta; Goldberg, Hanna R; Barense, Morgan D; Bell, Chaim M

    2016-01-01

    Though previous work has examined some aspects of the dermatology workforce shortage and access to dermatologic care, little research has addressed the effect of rising interest in cosmetic procedures on access to medical dermatologic care. Our objective was to determine the wait times for Urgent and Non-Urgent medical dermatologic care and Cosmetic dermatology services at a population level and to examine whether wait times for medical care are affected by offering cosmetic services. A population-wide survey of dermatology practices using simulated calls asking for the earliest appointment for a Non-Urgent, Urgent and Cosmetic service. Response rates were greater than 89% for all types of care. Wait times across all types of care were significantly different from each other (all P dermatologic care and shorter wait times and less variation for Cosmetic care. Wait times were significantly longer in regions with lower dermatologist density. Provision of Cosmetic services did not increase wait times for Urgent care. These findings suggest an overall dermatology workforce shortage and a need for a more streamlined referral system for dermatologic care.

  19. Lists2Networks: Integrated analysis of gene/protein lists

    Directory of Open Access Journals (Sweden)

    Ma'ayan Avi

    2010-02-01

    Full Text Available Abstract Background Systems biologists are faced with the difficultly of analyzing results from large-scale studies that profile the activity of many genes, RNAs and proteins, applied in different experiments, under different conditions, and reported in different publications. To address this challenge it is desirable to compare the results from different related studies such as mRNA expression microarrays, genome-wide ChIP-X, RNAi screens, proteomics and phosphoproteomics experiments in a coherent global framework. In addition, linking high-content multilayered experimental results with prior biological knowledge can be useful for identifying functional themes and form novel hypotheses. Results We present Lists2Networks, a web-based system that allows users to upload lists of mammalian genes/proteins onto a server-based program for integrated analysis. The system includes web-based tools to manipulate lists with different set operations, to expand lists using existing mammalian networks of protein-protein interactions, co-expression correlation, or background knowledge co-annotation correlation, as well as to apply gene-list enrichment analyses against many gene-list libraries of prior biological knowledge such as pathways, gene ontology terms, kinase-substrate, microRNA-mRAN, and protein-protein interactions, metabolites, and protein domains. Such analyses can be applied to several lists at once against many prior knowledge libraries of gene-lists associated with specific annotations. The system also contains features that allow users to export networks and share lists with other users of the system. Conclusions Lists2Networks is a user friendly web-based software system expected to significantly ease the computational analysis process for experimental systems biologists employing high-throughput experiments at multiple layers of regulation. The system is freely available at http://www.lists2networks.org.

  20. List effect in apraxia assessment.

    Science.gov (United States)

    Cubelli, Roberto; Bartolo, Angela; Nichelli, Paolo; Della Sala, Sergio

    2006-10-23

    Imitation tests encompassing intermingled meaningful and meaningless items are normally used to assess ideomotor apraxia, implicitly assuming that they would test the lexical and the non-lexical route, respectively. However, these mixed lists might induce a "list composition" effect similar to that found in word recognition studies where familiar material can be processed via the non-lexical route. This hypothesis was put to test by examining praxis skills of 23 left-hemisphere damaged patients using the same gestures in two formats: pure and mixed lists (i.e., meaningless or meaningful gestures administered separately or intermingled, respectively). Results showed that patients performed better on the imitation task when pure lists were used. Moreover, asymmetries of performance were observed. Patient SL scored better in the imitation of meaningful gestures in the pure list than in the mixed list condition. Patient CA performed poorly in the imitation of meaningless gestures only in the mixed list condition. Dissociations observed in imitation tasks could be biased by the use of mixed lists. Also "pure" lists should be used for the diagnosis of imitation deficits in apraxia.

  1. Count Listings in the October 2001 MLA "Job Information List."

    Science.gov (United States)

    ADE Bulletin, 2002

    2002-01-01

    Presents the annual coding of positions listed in the October 2001 Modern Language Association (MLA) "Job Information List." Notes increases in the number of English as well as foreign language positions. Presents numerous additional findings. Includes 10 tables and 5 figures of data. (RS)

  2. The Effectiveness Analysis of Waiting Processes in the Different Branches of a Bank by Queue Model

    Directory of Open Access Journals (Sweden)

    Abdullah ÖZÇİL

    2015-06-01

    Full Text Available Despite the appreciable increase in the number of bank branches every year, nowadays queues for services don’t decrease and even become parts of our daily lives. By minimizing waiting processes the least, increasing customer satisfaction should be one of branch managers’ main goals. A quick and also customer oriented service with high quality is the most important factor for customer loyalty. In this study, Queueing theory, one of Operation Research techniques, is handled and in application, the data are obtained related to waiting in queue of customer in six different branches of two banks operating in Denizli and then they are analyzed by Queueing theory and also calculated the average effectiveness of the system. The study’s data are obtained by six branches of two banks called as A1, A2, A3, B1, B2 and B3. At the end of study it is presented to the company some advices that can bring benefits to the staff and customers. In this study, Queueing theory, one of Operation Research techniques, is handled and in application, the data are obtained related to waiting in queue of customer in three different branches of a bank operating in Denizli and then they are analyzed by Queueing theory and also calculated the average effectiveness of the system. The study’s data are obtained by three branches of the bank called A1, A2 and A3. At last it is presented to the company some advices that can bring more benefits to the staff and clients.

  3. A web-based appointment system to reduce waiting for outpatients: a retrospective study.

    Science.gov (United States)

    Cao, Wenjun; Wan, Yi; Tu, Haibo; Shang, Fujun; Liu, Danhong; Tan, Zhijun; Sun, Caihong; Ye, Qing; Xu, Yongyong

    2011-11-22

    Long waiting times for registration to see a doctor is problematic in China, especially in tertiary hospitals. To address this issue, a web-based appointment system was developed for the Xijing hospital. The aim of this study was to investigate the efficacy of the web-based appointment system in the registration service for outpatients. Data from the web-based appointment system in Xijing hospital from January to December 2010 were collected using a stratified random sampling method, from which participants were randomly selected for a telephone interview asking for detailed information on using the system. Patients who registered through registration windows were randomly selected as a comparison group, and completed a questionnaire on-site. A total of 5641 patients using the online booking service were available for data analysis. Of them, 500 were randomly selected, and 369 (73.8%) completed a telephone interview. Of the 500 patients using the usual queuing method who were randomly selected for inclusion in the study, responses were obtained from 463, a response rate of 92.6%. Between the two registration methods, there were significant differences in age, degree of satisfaction, and total waiting time (P0.05). Being ignorant of online registration, not trusting the internet, and a lack of ability to use a computer were three main reasons given for not using the web-based appointment system. The overall proportion of non-attendance was 14.4% for those using the web-based appointment system, and the non-attendance rate was significantly different among different hospital departments, day of the week, and time of the day (Pweb-based appointment system could significantly increase patient's satisfaction with registration and reduce total waiting time effectively. However, further improvements are needed for broad use of the system.

  4. A web-based appointment system to reduce waiting for outpatients: A retrospective study

    Directory of Open Access Journals (Sweden)

    Cao Wenjun

    2011-11-01

    Full Text Available Abstract Background Long waiting times for registration to see a doctor is problematic in China, especially in tertiary hospitals. To address this issue, a web-based appointment system was developed for the Xijing hospital. The aim of this study was to investigate the efficacy of the web-based appointment system in the registration service for outpatients. Methods Data from the web-based appointment system in Xijing hospital from January to December 2010 were collected using a stratified random sampling method, from which participants were randomly selected for a telephone interview asking for detailed information on using the system. Patients who registered through registration windows were randomly selected as a comparison group, and completed a questionnaire on-site. Results A total of 5641 patients using the online booking service were available for data analysis. Of them, 500 were randomly selected, and 369 (73.8% completed a telephone interview. Of the 500 patients using the usual queuing method who were randomly selected for inclusion in the study, responses were obtained from 463, a response rate of 92.6%. Between the two registration methods, there were significant differences in age, degree of satisfaction, and total waiting time (P P > 0.05. Being ignorant of online registration, not trusting the internet, and a lack of ability to use a computer were three main reasons given for not using the web-based appointment system. The overall proportion of non-attendance was 14.4% for those using the web-based appointment system, and the non-attendance rate was significantly different among different hospital departments, day of the week, and time of the day (P Conclusion Compared to the usual queuing method, the web-based appointment system could significantly increase patient's satisfaction with registration and reduce total waiting time effectively. However, further improvements are needed for broad use of the system.

  5. Asymptotic inference for waiting times and patiences in queues with abandonment

    DEFF Research Database (Denmark)

    Gorst-Rasmussen, Anders; Hansen, Martin Bøgsted

    confidence intervals and statistical tests, including a simple bootstrap two-sample test for comparing patience distributions. The methods are exemplified in a small simulation study, and a real data example is given involving comparison of patience distributions for two customer classes in a call center.......Motivated by applications in call center management, we propose a framework based on empirical process techniques for inference about the waiting time and patience distribution in multiserver queues with abandonment. The framework rigorises heuristics based on survival analysis of independent...

  6. Weak interaction rates for Kr and Sr waiting-point nuclei under rp-process conditions

    Energy Technology Data Exchange (ETDEWEB)

    Sarriguren, P., E-mail: sarriguren@iem.cfmac.csic.e [Instituto de Estructura de la Materia, CSIC, Serrano 123, E-28006 Madrid (Spain)

    2009-10-12

    Weak interaction rates are studied in neutron deficient Kr and Sr waiting-point isotopes in ranges of densities and temperatures relevant for the rp process. The nuclear structure is described within a microscopic model (deformed QRPA) that reproduces not only the half-lives but also the Gamow-Teller strength distributions recently measured. The various sensitivities of the decay rates to both density and temperature are discussed. Continuum electron capture is shown to contribute significantly to the weak rates at rp-process conditions.

  7. SOME NEW RESULTS ON WAITING TIME AND BUSY TIME IN M/G/1 QUEUE

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    This paper considers an M/G/1 queue with Poisson rate λ > 0 and servicetime distribution G(t) which is supposed to have finite mean 1/μ. The following questions are first studied: (a) The closed bounds of the probability that waiting time is more than a fixed value; (b)The total busy time of the server, which including the distribution,probability that are more than a fixed value during a given time interval (0, t], and the expected value. Some new and important results are obtained by theories of the classes of life distributions and renewal process.

  8. Minimizing makespan for a no-wait flowshop using genetic algorithm

    Indian Academy of Sciences (India)

    Imran Ali Chaudhry; Abdul Munem Khan

    2012-12-01

    This paper explains minimization of makespan or total completion time for -jobs, -machine, no-wait flowshop problem (NW-FSSP). A spread sheet based general purpose genetic algorithm is proposed for the NW-FSSP. The example analysis shows that the proposed approach produces results are comparable to the previous approaches cited in the literature. Additionally, it is demonstrated that the current application is a general purpose approach whereby the objective function can be tailored without any change in the logic of the GA routine.

  9. Waiting time and the psychosocial consequences of false-positive mammography

    DEFF Research Database (Denmark)

    Heleno, Bruno M.; Siersma, Volkert; Brodersen, John

    2015-01-01

    Background: There is wide variation in the psychosocial response to false-positive mammography. We aimed to assess whether women having to wait longer to exclude cancer had increased psychosocial consequences that persisted after cancer was ruled out. Findings: We selected women with false......-positive mammography (n = 272), screened for breast cancer in Copenhagen and Funen (Denmark) over a 1-year period. We measured psychosocial consequences immediately before women attended their recall visit and 1, 6, 18 and 36 months after women received their final diagnosis. After women were told that cancer had been...

  10. Application of Queuing Analytic Theory to Decrease Waiting Times in Emergency Department: Does it Make Sense?

    Science.gov (United States)

    Alavi-Moghaddam, Mostafa; Forouzanfar, Reza; Alamdari, Shahram; Shahrami, Ali; Kariman, Hamid; Amini, Afshin; Pourbabaee, Shokooh; Shirvani, Armin

    2012-01-01

    Patients who receive care in an emergency department (ED), are usually unattended while waiting in queues. This study was done to determine, whether the application of queuing theory analysis might shorten the waiting times of patients admitted to emergency wards. This was an operational study to use queuing theory analysis in the ED. In the first phase, a field study was conducted to delineate the performance of the ED and enter the data obtained into simulator software. In the second phase, "ARENA" software was used for modeling, analysis, creating a simulation and improving the movement of patients in the ED. Validity of the model was confirmed through comparison of the results with the real data using the same instrument. The third phase of the study concerned modeling in order to assess the effect of various operational strategies, on the queue waiting time of patients who were receiving care in the ED. In the first phase, it was shown that 47.7% of the 3000 patient records were cases referred for trauma treatment, and the remaining 52.3% were referred for non-trauma services. A total of 56% of the cases were male and 44% female. Maximum input was 4.5 patients per hour and the minimum input was 0.5 per hour. The average length of stay for patients in the trauma section was three hours, while for the non-trauma section it was four hours. In the second phase, modeling was tested with common scenarios. In the third phase, the scenario with the addition of one or more senior emergency resident(s) on each shift resulted in a decreased length of stay from 4 to 3.75 hours. Moreover, the addition of one bed to the Intensive Care Unit (ICU) and/or Critical Care Unit (CCU) in the study hospital, reduced the occupancy rate of the nursing service from 76% to 67%. By adding another clerk to take electrocardiograms (ECG) in the ED, the average time from a request to performing the procedure is reduced from 26 to 18 minutes. Furthermore, the addition of 50% more staff to the

  11. The use of mobile technology in waiting rooms to leverage women's empowerment: A conceptual context.

    Science.gov (United States)

    Reychav, Iris; Parush, Avi; McHaney, Roger; Hazan, Maya; Moshonov, Rami

    2016-10-13

    This article focuses on a conceptual framework that can be applied to the use of mobile technology in the waiting room with the goal of empowering women recently diagnosed with abnormal Pap test results. It further describes trends which indicate a need for improved and timely information dissemination. Genecology practice outpatients report a predominant feeling of worry on receipt of abnormal medical test results, along with a clearly expressed wish for additional information. This research suggests that there is room for improvement in existing processes through use of mobile technology with carefully vetted materials which indicate a doctor is interested in the patient's well-being.

  12. Optimal Research and Numerical Simulation for Scheduling No-Wait Flow Shop in Steel Production

    Directory of Open Access Journals (Sweden)

    Huawei Yuan

    2013-01-01

    Full Text Available This paper considers the m-machine flow shop scheduling problem with the no-wait constraint to minimize total completion time which is the typical model in steel production. First, the asymptotic optimality of the Shortest Processing Time (SPT first rule is proven for this problem. To further evaluate the performance of the algorithm, a new lower bound with performance guarantee is designed. At the end of the paper, numerical simulations show the effectiveness of the proposed algorithm and lower bound.

  13. North Korea: Terrorism List Removal

    Science.gov (United States)

    2008-11-06

    he was officially notifying Congress of his intent to remove North Korea from the list of state sponsors of terrorism after the 45 calender -day...of his intent to remove North Korea from the list of state sponsors of terrorism after 45 calender days. Under U.S. law, the President is required to

  14. A New Academic Word List.

    Science.gov (United States)

    Coxhead, Averil

    2000-01-01

    Describes the development and evaluation of a new academic word list that was completed from a corpus of 3.5 million running words of written academic text by examining the range and frequency of words outside the first 2,000 most frequently occurring words in English. Explains the problems with existing word lists intended to guide materials…

  15. The STAPL pList

    KAUST Repository

    Tanase, Gabriel

    2010-01-01

    We present the design and implementation of the stapl pList, a parallel container that has the properties of a sequential list, but allows for scalable concurrent access when used in a parallel program. The Standard Template Adaptive Parallel Library (stapl) is a parallel programming library that extends C++ with support for parallelism. stapl provides a collection of distributed data structures (pContainers) and parallel algorithms (pAlgorithms) and a generic methodology for extending them to provide customized functionality. stapl pContainers are thread-safe, concurrent objects, providing appropriate interfaces (e.g., views) that can be used by generic pAlgorithms. The pList provides stl equivalent methods, such as insert, erase, and splice, additional methods such as split, and efficient asynchronous (non-blocking) variants of some methods for improved parallel performance. We evaluate the performance of the stapl pList on an IBM Power 5 cluster and on a CRAY XT4 massively parallel processing system. Although lists are generally not considered good data structures for parallel processing, we show that pList methods and pAlgorithms (p-generate and p-partial-sum) operating on pLists provide good scalability on more than 103 processors and that pList compares favorably with other dynamic data structures such as the pVector. © 2010 Springer-Verlag.

  16. Testing List H-Homomorphisms

    CERN Document Server

    Yoshida, Yuichi

    2011-01-01

    Let $H$ be an undirected graph. In the List $H$-Homomorphism Problem, given an undirected graph $G$ with a list constraint $L(v) \\subseteq V(H)$ for each variable $v \\in V(G)$, the objective is to find a list $H$-homomorphism $f:V(G) \\to V(H)$, that is, $f(v) \\in L(v)$ for every $v \\in V(G)$ and $(f(u),f(v)) \\in E(H)$ whenever $(u,v) \\in E(G)$. We consider the following problem: given a map $f:V(G) \\to V(H)$ as an oracle access, the objective is to decide with high probability whether $f$ is a list $H$-homomorphism or \\textit{far} from any list $H$-homomorphisms. The efficiency of an algorithm is measured by the number of accesses to $f$. In this paper, we classify graphs $H$ with respect to the query complexity for testing list $H$-homomorphisms and show the following trichotomy holds: (i) List $H$-homomorphisms are testable with a constant number of queries if and only if $H$ is a reflexive complete graph or an irreflexive complete bipartite graph. (ii) List $H$-homomorphisms are testable with a sublinear n...

  17. On a List of Priests

    DEFF Research Database (Denmark)

    Isager, Signe

    2014-01-01

    The article concerns the fate of an often cited list of priests for Poseidon, which at some point was established and cut into a stele in ancient Halikarnassos. The list could be considered the genealogical table of Halikarnassos: The cult of Poseidon was founded by colonists from Troizen and the...

  18. PROUD: Effects of preoperative long-term immunonutrition in patients listed for liver transplantation

    Directory of Open Access Journals (Sweden)

    Büchler Markus W

    2007-08-01

    Full Text Available Abstract Background Patients with end stage liver disease are characteristically malnourished which is associated with poor outcome. Formulas enriched with arginine, ω-3 fatty acids, and nucleotides, "immunonutrients", potentially improve their nutritional status. This study is designed to evaluate the clinical outcome of long-term "immunonutrition" of patients with end-stage liver disease while on the waiting list for liver transplantation. Methods/design A randomized controlled double blind multi-center clinical trial with two parallel groups comprising a total of 142 newly registered patients for primary liver transplantation has been designed to assess the safety and efficacy of the long-term administration of ORAL IMPACT®, an "immunonutrient" formula, while waiting for a graft. Patients will be enrolled the day of registration on the waiting list for liver transplantation. Study ends on the day of transplantation. Primary endpoints include improved patients' nutritional and physiological status, as measured by mid-arm muscle area, triceps skin fold thickness, grip strength, and fatigue score, as well as patients' health related quality of life. Furthermore, patients will be followed for 12 postoperative weeks to evaluate anabolic recovery after transplantation as shown by reduced post-transplant mechanical ventilation, hospital stay, wound healing, infectious morbidities (pneumonia, intraabdominal abscess, sepsis, line sepsis, wound infection, and urinary tract infection, acute and chronic rejection, and mortality. Discussion Formulas enriched with arginine, ω-3 fatty acids, and nucleotides have been proven to be beneficial in reducing postoperative infectious complications and length of hospital stay among the patients undergoing elective gastrointestinal surgery. Possible mechanisms include downregulation of the inflammatory responses to surgery and immune modulation rather than a sole nutritional effect. Trial registration Clinical

  19. Development of a minimization instrument for allocation of a hospital-level performance improvement intervention to reduce waiting times in Ontario emergency departments

    Directory of Open Access Journals (Sweden)

    Anderson Geoff

    2009-06-01

    Full Text Available Abstract Background Rigorous evaluation of an intervention requires that its allocation be unbiased with respect to confounders; this is especially difficult in complex, system-wide healthcare interventions. We developed a short survey instrument to identify factors for a minimization algorithm for the allocation of a hospital-level intervention to reduce emergency department (ED waiting times in Ontario, Canada. Methods Potential confounders influencing the intervention's success were identified by literature review, and grouped by healthcare setting specific change stages. An international multi-disciplinary (clinical, administrative, decision maker, management panel evaluated these factors in a two-stage modified-delphi and nominal group process based on four domains: change readiness, evidence base, face validity, and clarity of definition. Results An original set of 33 factors were identified from the literature. The panel reduced the list to 12 in the first round survey. In the second survey, experts scored each factor according to the four domains; summary scores and consensus discussion resulted in the final selection and measurement of four hospital-level factors to be used in the minimization algorithm: improved patient flow as a hospital's leadership priority; physicians' receptiveness to organizational change; efficiency of bed management; and physician incentives supporting the change goal. Conclusion We developed a simple tool designed to gather data from senior hospital administrators on factors likely to affect the success of a hospital patient flow improvement intervention. A minimization algorithm will ensure balanced allocation of the intervention with respect to these factors in study hospitals.

  20. Parallel-Batch Scheduling and Transportation Coordination with Waiting Time Constraint

    Directory of Open Access Journals (Sweden)

    Hua Gong

    2014-01-01

    Full Text Available This paper addresses a parallel-batch scheduling problem that incorporates transportation of raw materials or semifinished products before processing with waiting time constraint. The orders located at the different suppliers are transported by some vehicles to a manufacturing facility for further processing. One vehicle can load only one order in one shipment. Each order arriving at the facility must be processed in the limited waiting time. The orders are processed in batches on a parallel-batch machine, where a batch contains several orders and the processing time of the batch is the largest processing time of the orders in it. The goal is to find a schedule to minimize the sum of the total flow time and the production cost. We prove that the general problem is NP-hard in the strong sense. We also demonstrate that the problem with equal processing times on the machine is NP-hard. Furthermore, a dynamic programming algorithm in pseudopolynomial time is provided to prove its ordinarily NP-hardness. An optimal algorithm in polynomial time is presented to solve a special case with equal processing times and equal transportation times for each order.

  1. A Heuristic Genetic Algorithm for No-Wait Flowshop Scheduling Problem

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    No-wait flowshop scheduling problems with the objective to minimize the total flow time is an important sequencing problem in the field of developing production plans and has a wide engineering background.Genetic algorithm (GA) has the capability of global convergence and has been proven effective to solve NP-hard combinatorial optimization problems, while simple heuristics have the advantage of fast local convergence and can be easily implemented.In order to avoid the defect of slow convergence or premature, a heuristic genetic algorithm is proposed by incorporating the simple heuristics and local search into the traditional genetic algorithm.In this hybridized algorithm, the structural information of no-wait flowshops and high-effective heuristics are incorporated to design a new method for generating initial generation and a new crossover operator.The computational results show the developed heuristic genetic algorithm is efficient and the quality of its solution has advantage over the best known algorithm.It is suitable for solving the large scale practical problems and lays a foundation for the application of meta-heuristic algorithms in industrial production.

  2. Waiting for speech therapy: a group to help the under-3s.

    Science.gov (United States)

    Lee, A

    1996-01-01

    It can take up to two years for a child with speech problems to be seen by a speech therapist. The waiting period can be stressful for parents and frustrating for the child, who may begin to show behaviour problems. Group sessions for up to 10 children with speech problems aged 2-3 years and their parents produced positive benefits during the waiting period. The groups were set up and managed by a health visitor with input from a speech and language therapist and outside speakers. The parents learnt how children's communication skills develop and were shown simple techniques for helping their child's speech. They were also helped to understand and manage behaviour problems such as tantrums which may be linked to the child's speech difficulties. The majority of parents confirmed that their children's speech had improved since joining the group. Parents gained mutual support from attending the groups and their children benefited from socialising with the other children. This was a low-cost, flexible scheme set up in response to local needs and demand, showing the benefits of teamwork and of involving parents in their children's treatment and care.

  3. Public reporting on quality, waiting times and patient experience in 11 high-income countries.

    Science.gov (United States)

    Rechel, Bernd; McKee, Martin; Haas, Marion; Marchildon, Gregory P; Bousquet, Frederic; Blümel, Miriam; Geissler, Alexander; van Ginneken, Ewout; Ashton, Toni; Saunes, Ingrid Sperre; Anell, Anders; Quentin, Wilm; Saltman, Richard; Culler, Steven; Barnes, Andrew; Palm, Willy; Nolte, Ellen

    2016-04-01

    This article maps current approaches to public reporting on waiting times, patient experience and aggregate measures of quality and safety in 11 high-income countries (Australia, Canada, England, France, Germany, Netherlands, New Zealand, Norway, Sweden, Switzerland and the United States). Using a questionnaire-based survey of key national informants, we found that the data most commonly made available to the public are on waiting times for hospital treatment, being reported for major hospitals in seven countries. Information on patient experience at hospital level is also made available in many countries, but it is not generally available in respect of primary care services. Only one of the 11 countries (England) publishes composite measures of overall quality and safety of care that allow the ranking of providers of hospital care. Similarly, the publication of information on outcomes of individual physicians remains rare. We conclude that public reporting of aggregate measures of quality and safety, as well as of outcomes of individual physicians, remain relatively uncommon. This is likely to be due to both unresolved methodological and ethical problems and concerns that public reporting may lead to unintended consequences. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  4. Waiting time reduction in intravitreal clinics by optimization of appointment scheduling: balancing demand and supply.

    Science.gov (United States)

    Ugarte, Marta

    2015-01-01

    This study was designed guided by the Model for Improvement framework to reduce waiting times and visit duration in the intravitreal therapy clinic, while improving patient and staff experience. In our aim to provide good quality, patient-centred care and constantly improve, we optimised the appointment profile and patient flow. We involved a multidisciplinary team (one consultant, junior doctors, staff nurses, technicians, and receptionist), as well as patients and relatives, to try to understand the main delays in the clinic. Process mapping, a fishbone diagram, run charts, together with feedback from patients and staff, provided an insight on the possible roots of the delays experienced by our patients. The results of the inquiry led us to take actions focused on optimising appointment scheduling. After implementing the new scheduling profile (with a gap in the middle of the session), various cycles of plan-do-study-act and a comparative, qualitative study by interviewing 10 patients demonstrated that the waiting times decreased, and patients and staff experience improved.

  5. Shape study of the N=Z waiting-point nucleus 72Kr via beta decay

    CERN Document Server

    Briz Monago, Jose Antonio; Nácher González, Enrique

    The Ph.D. thesis entitled “Shape study of the N=Z waiting-point nucleus 72Kr via beta decay” is devoted to the study of the shape of the ground state of the 72Kr nucleus. It is an N=Z nucleus in the mass region A~70-80 where shape transitions and the shape coexistence phenomena have been identified. Furthermore, this nucleus participates in the rp-process as a waiting point due to the slowdown of the process taking place at the arrival to this nucleus. The study of the properties of this nucleus is interesting from the Nuclear Structure point of view, for the phenomena occurring in its mass region and have been predicted for it, and from the Nuclear Astrophysics for the accurate performance of astrophysical calculations. The β+/EC decay of the 72Kr nucleus has been studied through two complementary experiments at the ISOLDE facility at CERN in Geneva (Switzerland). In one of them, the low-spin structure of the daughter nucleus, 72Br, has been revised via conversion electron spectroscopy where the convers...

  6. "Wait and see" vaccinating behaviour during a pandemic: a game theoretic analysis.

    Science.gov (United States)

    Bhattacharyya, Samit; Bauch, Chris T

    2011-07-26

    During the 2009 H1N1 pandemic, many individuals did not seek vaccination immediately but rather decided to "wait and see" until further information was available on vaccination costs. This behaviour implies two sources of strategic interaction: as more individuals become vaccinated, both the perceived vaccination cost and the probability that susceptible individuals become infected decline. Here we analyze the outcome of these two strategic interactions by combining game theory with a disease transmission model during an outbreak of a novel influenza strain. The model exhibits a "wait and see" Nash equilibrium strategy, with vaccine delayers relying on herd immunity and vaccine safety information generated by early vaccinators. This strategic behaviour causes the timing of the epidemic peak to be strongly conserved across a broad range of plausible transmission rates, in contrast to models without such adaptive behaviour. The model exhibits not only feedback mechanisms but also a feed-forward mechanism: a high initial perceived vaccination cost perpetuates high perceived vaccine costs (and lower vaccine coverage) throughout the remainder of the outbreak. This suggests that any effect of risk communication at the start of a pandemic outbreak will be amplified compared to the same amount of risk communication effort distributed throughout the outbreak.

  7. Marginal estimation for multi-stage models: waiting time distributions and competing risks analyses.

    Science.gov (United States)

    Satten, Glen A; Datta, Somnath

    2002-01-15

    We provide non-parametric estimates of the marginal cumulative distribution of stage occupation times (waiting times) and non-parametric estimates of marginal cumulative incidence function (proportion of persons who leave stage j for stage j' within time t of entering stage j) using right-censored data from a multi-stage model. We allow for stage and path dependent censoring where the censoring hazard for an individual may depend on his or her natural covariate history such as the collection of stages visited before the current stage and their occupation times. Additional external time dependent covariates that may induce dependent censoring can also be incorporated into our estimates, if available. Our approach requires modelling the censoring hazard so that an estimate of the integrated censoring hazard can be used in constructing the estimates of the waiting times distributions. For this purpose, we propose the use of an additive hazard model which results in very flexible (robust) estimates. Examples based on data from burn patients and simulated data with tracking are also provided to demonstrate the performance of our estimators.

  8. Nuclear binding around the RP-process waiting points $^{68}$Se and $^{72}$Kr

    CERN Multimedia

    2002-01-01

    Encouraged by the success of mass determinations of nuclei close to the Z=N line performed at ISOLTRAP during the year 2000 and of the recent decay spectroscopy studies on neutron-deficient Kr isotopes (IS351 collaboration), we aim to measure masses and proton separation energies of the bottleneck nuclei defining the flow of the astrophysical rp-process beyond A$\\sim$70. In detail, the program includes mass measurements of the rp-process waiting point nuclei $^{68}$Se and $^{72}$Kr and determination of proton separation energies of the proton-unbound $^{69}$Br and $^{73}$Rb via $\\beta$-decays of $^{69}$Kr and $^{73}$Sr, respectively. The aim of the project is to complete the experimental database for astrophysical network calculations and for the liquid-drop type of mass models typically used in the modelling of the astrophysical rp process in the region. The first beamtime is scheduled for the August 2001 and the aim is to measure the absolute mass of the waiting-point nucleus $^{72}$Kr.

  9. Experiences of supportive care when waiting for a lung re-transplantation.

    Science.gov (United States)

    Ivarsson, Bodil; Ingemansson, Richard; Sjöberg, Trygve

    2017-01-01

    Lung transplant patients and their next of kin share the experiences of illness but little is known in the face of a lung re-transplantation. To describe patients' and next of kin's experiences of supportive care while awaiting lung re-transplantation and the objective was to highlight a small group with special circumstances and needs. Using qualitative content analysis, seven adult patients and seven next of kin were consecutively selected from a regional lung transplantation centre and individually interviewed shortly after decision about lung re-transplantation. The experiences of supportive care were captured in one main category: 'once again haunted by death' and three sub-categories: 'when life turns and death once again snorts down your neck', 'the importance of information', and 'perceptions of support'. A complex interaction between the experience of waiting, and communication patterns, emotional states, and social support was shown. This study provides insights into the complex interaction between the experience of waiting for a second lung transplant and communication patterns, emotional states, social support and social roles between patients, next of kin, healthcare professionals, and the health and social welfare system. There is a need for developing supportive care programme to achieve the best possible care.

  10. Experiences of supportive care when waiting for a lung re-transplantation

    Directory of Open Access Journals (Sweden)

    Bodil Ivarsson

    2017-03-01

    Full Text Available Objectives: Lung transplant patients and their next of kin share the experiences of illness but little is known in the face of a lung re-transplantation. To describe patients’ and next of kin’s experiences of supportive care while awaiting lung re-transplantation and the objective was to highlight a small group with special circumstances and needs. Methods: Using qualitative content analysis, seven adult patients and seven next of kin were consecutively selected from a regional lung transplantation centre and individually interviewed shortly after decision about lung re-transplantation. Results: The experiences of supportive care were captured in one main category: ‘once again haunted by death’ and three sub-categories: ‘when life turns and death once again snorts down your neck’, ‘the importance of information’, and ‘perceptions of support’. A complex interaction between the experience of waiting, and communication patterns, emotional states, and social support was shown. Conclusion: This study provides insights into the complex interaction between the experience of waiting for a second lung transplant and communication patterns, emotional states, social support and social roles between patients, next of kin, healthcare professionals, and the health and social welfare system. There is a need for developing supportive care programme to achieve the best possible care.

  11. "I can't wait to find out what Nature has in store for us"

    CERN Multimedia

    Anaïs Schaeffer

    2012-01-01

    Professor Guido Altarelli, a physicist at CERN and the University of Rome, has received two prizes since the beginning of the year: the Julius Wess prize awarded by the Karlsruhe Institute of Technology (KIT) and the Sakurai prize awarded by the American Physical Society.   Guido Altarelli (left), receiving the Julius Wess prize in Karlsruhe on 16 January. It's been a good start to the year for Guido Altarelli. After receiving two prestigious prizes in the space of a few weeks for achievements during his long career, all he's waiting for is the Higgs boson! "I can't wait to find out what Nature has in store for us!", he smiles. Hardly surprising when you think that Altarelli has been looking for the answers since the very start of his career in particle physics. As a theorist at CERN for over twenty years, he has always worked closely with the experiments, first at the SPS, then at LEP and now at the LHC. Today, following the significant progress in...

  12. Safety evaluation of signalized intersections with left-turn waiting area in China.

    Science.gov (United States)

    Jiang, Xinguo; Zhang, Guopeng; Bai, Wei; Fan, Wenbo

    2016-10-01

    In recent years the metropolitans in China have seen the surging installations of the left-turn waiting area (LWA) at the signalized intersections. The design allows the left-turning vehicles to enter the intersection at the onset of the through green phase (of the same approach) and wait for the exclusive left-turn signal at the LWA. The LWA layout can effectively reduce the probability of stranded and queue overflow of the left-turn vehicles, but no study is conducted yet to assess the safety performance of the signalized intersections with LWA. The paper adopts the traffic conflict technique (represented by post-encroachment time), compares the discrepancy of conflict types between intersections with LWA and without, and develops the severity models to identify the contributing factors for the left-turn conflicts. Results demonstrate that the left-turn volume, driving outside the LWA, running red light, the presence of secondary conflicts, and the rear-end conflicts significantly increase the severities of traffic conflicts at the LWA. The findings serve to provide recommendations to revise the current design standard of the LWA (GB5768-2009) and consequently improve the safety operations of signalized intersections with LWA in China. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Burden of waiting for surveillance CT colonography in patients with screen-detected 6-9 mm polyps

    Energy Technology Data Exchange (ETDEWEB)

    Tutein Nolthenius, Charlotte J. [University of Amsterdam, Department of Radiology, Academic Medical Center, PO Box 22700, Amsterdam (Netherlands); Onze Lieve Vrouwe Gasthuis, Department of Radiology, Amsterdam (Netherlands); Boellaard, Thierry N.; Nio, C.Y.; Bipat, Shandra; Stoker, Jaap [University of Amsterdam, Department of Radiology, Academic Medical Center, PO Box 22700, Amsterdam (Netherlands); Haan, Margriet C. de [Meander Medical Center, Department of Radiology, Amersfoort (Netherlands); Thomeer, Maarten G.J. [Erasmus University Medical Center, Department of Radiology, Rotterdam (Netherlands); Montauban van Swijndregt, Alexander D. [Onze Lieve Vrouwe Gasthuis, Department of Radiology, Amsterdam (Netherlands); Essink-Bot, Marie-Louise [University of Amsterdam, Public Health, Academic Medical Center, PO Box 22700, Amsterdam (Netherlands); Kuipers, Ernst J. [Erasmus University Medical Center, Gastroenterology and Hepatology, Rotterdam (Netherlands); Erasmus University Medical Center, Internal medicine, Rotterdam (Netherlands); Dekker, Evelien [University of Amsterdam, Gastroenterology and Hepatology, Academic Medical Center, PO Box 22700, Amsterdam (Netherlands)

    2016-11-15

    We assessed the burden of waiting for surveillance CT colonography (CTC) performed in patients having 6-9 mm colorectal polyps on primary screening CTC. Additionally, we compared the burden of primary and surveillance CTC. In an invitational population-based CTC screening trial, 101 persons were diagnosed with <3 polyps 6-9 mm, for which surveillance CTC after 3 years was advised. Validated questionnaires regarding expected and perceived burden (5-point Likert scales) were completed before and after index and surveillance CTC, also including items on burden of waiting for surveillance CTC. McNemar's test was used for comparison after dichotomization. Seventy-eight (77 %) of 101 invitees underwent surveillance CTC, of which 66 (85 %) completed the expected and 62 (79 %) the perceived burden questionnaire. The majority of participants (73 %) reported the experience of waiting for surveillance CTC as 'never' or 'only sometimes' burdensome. There was almost no difference in expected and perceived burden between surveillance and index CTC. Waiting for the results after the procedure was significantly more burdensome for surveillance CTC than for index CTC (23 vs. 8 %; p = 0.012). Waiting for surveillance CTC after primary CTC screening caused little or no burden for surveillance participants. In general, the burden of surveillance and index CTC were comparable. (orig.)

  14. Waiting times before dental care under general anesthesia in children with special needs in the Children's Hospital of Casablanca.

    Science.gov (United States)

    Badre, Bouchra; Serhier, Zineb; El Arabi, Samira

    2014-01-01

    Oral diseases may have an impact on quality of children's life. The presence of severe disability requires the use of care under general anesthesia (GA). However, because of the limited number of qualified health personnel, waiting time before intervention can be long. To evaluate the waiting time before dental care under general anesthesia for children with special needs in Morocco. A retrospective cohort study was carried out in pediatric dentistry unit of the University Hospital of Casablanca. Data were collected from records of patients seen for the first time between 2006 and 2011. The waiting time was defined as the time between the date of the first consultation and intervention date. 127 children received dental care under general anesthesia, 57.5% were male and the average age was 9.2 (SD = 3.4). Decay was the most frequent reason for consultation (48%), followed by pain (32%). The average waiting time was 7.6 months (SD = 4.2 months). The average number of acts performed per patient was 13.5. Waiting times were long, it is necessary to take measures to reduce delays and improve access to oral health care for this special population.

  15. Double Stimulation in the Waiting Experiment with Collectives: Testing a Vygotskian Model of the Emergence of Volitional Action.

    Science.gov (United States)

    Sannino, Annalisa

    2016-03-01

    This study explores what human conduct looks like when research embraces uncertainty and distance itself from the dominant methodological demands of control and predictability. The context is the waiting experiment originally designed in Kurt Lewin's research group, discussed by Vygotsky as an instance among a range of experiments related to his notion of double stimulation. Little attention has been paid to this experiment, despite its great heuristic potential for charting the terrain of uncertainty and agency in experimental settings. Behind the notion of double stimulation lays Vygotsky's distinctive view of human beings' ability to intentionally shape their actions. Accordingly, human beings in situations of uncertainty and cognitive incongruity can rely on artifacts which serve the function of auxiliary motives and which help them undertake volitional actions. A double stimulation model depicting how such actions emerge is tested in a waiting experiment conducted with collectives, in contrast with a previous waiting experiment conducted with individuals. The model, validated in the waiting experiment with individual participants, applies only to a limited extent to the collectives. The analysis shows the extent to which double stimulation takes place in the waiting experiment with collectives, the differences between the two experiments, and what implications can be drawn for an expanded view on experiments.

  16. 荒诞的生活幸福的等待--解读贝克特的《等待戈多》%Hap py Waiting in Absurd Life---On Becket’s Waiting for Godot

    Institute of Scientific and Technical Information of China (English)

    任玲

    2013-01-01

    塞缪尔・贝克特创作的荒诞派戏剧《等待戈多》生动诠释了存在主义哲学关于“荒诞”的观念。本文试图从加缪的荒诞哲学角度分析《等待戈多》的荒诞内容及成因,从而揭示主人公的等待看似荒诞,但其本身就是反抗,就是西绪福斯式的幸福。%Samuel Becket’s absurd theatre Waiting for Godot vividly illustrates the concept of Absurdity in ex-istential philosophy.Therefore,from the view of Camus,this paper aims to analyze the absurdity and its causes in Waiting for Godot and reveals that seemingly absurd waiting is resistance and happiness like Sisyphus .

  17. Title III List of Lists -- Raw Data Set

    Data.gov (United States)

    U.S. Environmental Protection Agency — This list was prepared to help firms handling chemicals determine whether they need to submit reports under sections 302, 304, or 313 of the Emergency Planning and...

  18. Exploring implications of Medicaid participation and wait times for colorectal screening on early detection efforts in Connecticut--a secret-shopper survey.

    Science.gov (United States)

    Patel, Vatsal B; Nahar, Richa; Murray, Betty; Salner, Andrew L

    2013-04-01

    , researchers compiled a county-specific list of GI practices throughout Connecticut and conducted a secret-shopper survey by telephone. A standard script and set of questions was formulated and used for each telephone call to GI practices. Data was analyzed in context of statistics available to the public at large from the U.S. Census Bureau. Overall, 46% of all 93 practices and 62% of individual GIs from all 93 practices state-wide reported Medicaid participation. About 35% of surveyed practices were independent practices; 41% of these reported Medicaid participation. About 65% of surveyed practices were group practices; 49% of these reported Medicaid participation. Approximately, 85% of all practices are in Fairfield, Hartford, orNew Haven counties. Of all three counties, New Haven reported the highest Medicaid participation rate by practices; 62% of all practices in New Haven reported participation. Fairfield reported the lowest Medicaid participation rate by practices; 29% of all practices in Fairfield reported participation. When Medicaid participation rates were calculated for total number of gastroenterologists from all practices in a given county (as opposed to participation rates by number of practices), Medicaid participation rates were 80% and 44% for New Haven and Fairfield, respectively. Of all practices in Hartford, only 50% reported Medicaid participation, whereas 67% of the total number of gastroenterologists (as opposed to practices) reported Medicaid participation. According to a recent national survey, 47% of gastroenterologists reported stopping accepting new Medicaid patients. Overall minimum and maximum wait times were reported to be the highest for Hartford, but wait times were long even for smaller counties, reflecting a possible imbalance in supply and demand or inefficiency in allocating the available resources. Only a limited number of gastroenterology practices in Connecticut accept Medicaid patients, notably in selected counties, but in all

  19. Models for Flare Statistics and the Waiting-time Distribution of Solar Flare Hard X-ray Bursts

    Science.gov (United States)

    Wheatland, M. S.; Edney, S. D.

    1999-12-01

    In a previous study (Wheatland, Sturrock, McTiernan 1998), a waiting-time distribution was constructed for solar flare hard X-ray bursts observed by the ICE/ISEE-3 spacecraft. A comparison of the observed distribution with that of a time-dependent Poisson process indicated an overabundance of short waiting times (10~s -- 10~min), implying that the hard X-ray bursts are not independent events. Models for flare statistics assume or predict that flares are independent events -- in particular the avalanche model makes this specific prediction. The results of the previous study may be reconciled with the avalanche picture if individual flares produce several distinct bursts of hard X-ray emission. A detailed comparison of the avalanche model and the ICE/ISEE-3 waiting-time distribution is presented here.

  20. Information technology - Telecommunications and information exchange between systems - Private integrated services network - Inter-exchange signalling protocol - Message waiting indication supplementary service

    CERN Document Server

    International Organization for Standardization. Geneva

    2003-01-01

    Information technology - Telecommunications and information exchange between systems - Private integrated services network - Inter-exchange signalling protocol - Message waiting indication supplementary service

  1. An exploration of the basis for patient complaints about the oldness of magazines in practice waiting rooms: cohort study

    Science.gov (United States)

    Alrutz, Stowe; Moyes, Simon

    2014-01-01

    Objective To explore the basis for patient complaints about the oldness of most magazines in practice waiting rooms. Design Cohort study. Setting Waiting room of a general practice in Auckland, New Zealand. Participants 87 magazines stacked into three mixed piles and placed in the waiting room: this included non-gossipy magazines (Time magazine, the Economist, Australian Women’s Weekly, National Geographic, BBC History) and gossipy ones (not identified for fear of litigation). Gossipy was defined as having five or more photographs of celebrities on the front cover and most gossipy as having up to 10 such images. Interventions The magazines were marked with a unique number on the back cover, placed in three piles in the waiting room, and monitored twice weekly. Main outcome measures Disappearance of magazines less than 2 months old versus magazines 3-12 months old, the overall rate of loss of magazines, and the rate of loss of gossipy versus non-gossipy magazines. Results 47 of the 82 magazines with a visible date on the front cover were aged less than 2 months. 28 of these 47 (60%) magazines and 10 of the 35 (29%) older magazines disappeared (P=0.002). After 31 days, 41 of the 87 (47%, 95% confidence interval 37% to 58%) magazines had disappeared. None of the 19 non-gossipy magazines (the Economist and Time magazine) had disappeared compared with 26 of the 27 (96%) gossipy magazines (Pmagazines and all 19 of the non-gossipy magazines had disappeared by 31 days. The study was terminated at this point. Conclusions General practice waiting rooms contain mainly old magazines. This phenomenon relates to the disappearance of the magazines rather than to the supply of old ones. Gossipy magazines were more likely to disappear than non-gossipy ones. On the grounds of cost we advise practices to supply old copies of non-gossipy magazines. A waiting room science curriculum is urgently needed. PMID:25500116

  2. #DDOD: Establishment Registration & Device Listing

    Data.gov (United States)

    U.S. Department of Health & Human Services — SUMMARY DDOD use case to request means on consolidating multiple data sources (MDR, PMA, 510(k), R&L) in order to build a list of all marketed medical devices....

  3. Clinical Investigator Inspector List (CLIIL)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Clinical Investigator Inspection List (CLIIL) contains names, addresses, and other pertinent information gathered from inspections of clinical investigators who...

  4. STS-107 Master Experiment List

    Science.gov (United States)

    2002-12-01

    A master list of the various experiments conducted aboard the STS-107 Space Mission is presented. The topics include: 1) Biology; 2) Earth and Space Sciences; 3) Physical Sciences; 4) Space Product Development; and 6) Technology Development.

  5. 1986 Wetland Plant List Nevada

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The Wetland Plant List represents the combined efforts of many biologistsworking over the last 10 years to define the wetland flora of the UnitedStates.

  6. Analyzing the waiting time pattern for non-critical patients in the emergency department using six sigma approach

    Science.gov (United States)

    Majid, Noriza; Mohd Suradi, Nur Riza; Ahmad Sabri, Safura

    2013-04-01

    This study was conducted to examine the waiting time of non-critical patients in the Emergency Department (ED) of Universiti Kebangsaan Malaysia Medical Centre (UKMMC) using the approach of six sigma (6σ). The define phase is completed by obtaining customers' critical to quality in UKMMC using survey. In measure phase, data on patients to the ED of UKMMC in May 2009 were gathered. Subsequently, analysis phase is performed using cause-and-effect diagram to identify root causes of the problems. Finally, improvements are proposed based on the identified problems. Results show that waiting time is critical to quality for health services in the ED.

  7. Mass measurement on the rp-process waiting point {sup 72}Kr

    Energy Technology Data Exchange (ETDEWEB)

    Rodriguez, D.; Beck, D.; Herfurth, F.; Kluge, H.-J. [GSI, Darmstadt (Germany); Kolhinen, V.S.; Aeystoe, J.; Jokinen, A. [University of Jyvaeskylae, Jyvaeskylae (Finland); Audi, G. [CSNSM-IN2P3-CNRS, Orsay-Campus (France); Blaum, K. [GSI, Darmstadt (Germany); University of Mainz, Institute of Physics, Mainz (Germany); Bollen, G.; Schwarz, S. [Michigan State University, NSCL, East Lansing, MI (United States); Kellerbauer, A.; Sauvan, E. [CERN, Physics Department, Geneva (Switzerland); Oinonen, M. [University of Helsinki, Helsinki Institute of Physics, Helsinki (Finland); Schatz, H. [Michigan State University, NSCL, East Lansing, MI (United States); Michigan State University, Joint Institute for Nuclear Astrophysics, East Lansing, MI (United States)

    2005-09-01

    With the aim of improving nucleosynthesis calculations, we performed for the first time, a direct high-precision mass measurement on the waiting point in the astrophysical rp-process {sup 72}Kr. We used the ISOLTRAP Penning trap mass spectrometer located at ISOLDE/CERN. The measurement yielded a relative mass uncertainty of {delta}m/m=1.2 x 10{sup -7}. In addition, the masses of {sup 73}Kr and {sup 74}Kr were measured directly with relative mass uncertainties of 1.0 x 10{sup -7} and 3 x 10{sup -8}, respectively. We analyzed the role of {sup 72}Kr in the rp-process during X-ray bursts using the ISOLTRAP and previous mass values of {sup 72-74}Kr. (orig.)

  8. Safe in the city: developing an effective video-based intervention for STD clinic waiting rooms.

    Science.gov (United States)

    Myint-U, Athi; Bull, Sheana; Greenwood, Gregory L; Patterson, Jocelyn; Rietmeijer, Cornelis A; Vrungos, Shelley; Warner, Lee; Moss, Jesse; O'Donnell, Lydia N

    2010-05-01

    There is a strong need for inexpensive, easily administered HIV and STD prevention interventions that are highly replicable and appealing to diverse clinic audiences. This article describes the four-step iterative and collaborative process used by the Safe City Study Group to design and develop a brief video-based intervention: Safe in the City. Step 1 involves identification of an appropriate intervention medium, a theoretical framework, and key messages; Step 2, collaboration with a film company to integrate the framework and key messages into an entertaining product; Step 3, facilitation of a multistep participatory process involving input from members of the priority audience (clinic patients), clinic staff, and community reviewers; and Step 4, pilot-testing to determine structural barriers to patients' viewing the video in clinic waiting rooms. Safe in the City has been demonstrated to reduce incident STDs among clinic patients in three cities in the United States.

  9. Lean-driven improvements slash wait times, drive up patient satisfaction scores.

    Science.gov (United States)

    2012-07-01

    Administrators at LifePoint Hospitals, based in Brentwood, TN, used lean manufacturing techniques to slash wait times by as much as 30 minutes and achieve double-digit increases in patient satisfaction scores in the EDs at three hospitals. In each case, front-line workers took the lead on identifying opportunities for improvement and redesigning the patient-flow process. As a result of the new efficiencies, patient volume is up by about 25% at all three hospitals. At each hospital, the improvement process began with Kaizen, a lean process that involves bringing personnel together to flow-chart the current system, identify problem areas, and redesign the process. Improvement teams found big opportunities for improvement at the front end of the flow process. Key to the approach was having a plan up front to deal with non-compliance. To sustain improvements, administrators gather and disseminate key metrics on a daily basis.

  10. The pattern for waiting time in the context of multiple stochastic process

    CERN Document Server

    Jamali, Tayeb; Farahani, S Vasheghani

    2015-01-01

    The aim here is to provide a deeper understanding on the concept of waiting time in application to multiple stochastic processes. This obliges us to work with the vector stochastic process which enables considering at least two stochastic process at simultaneous time instances. In the present study the plan is to master vector stochastic processes by developing the level crossing method. The reason that the previous level-crossing methods lack generality is based on their individual element studies, where the coupling between the components of the vector stochastic process had been simply neglected. In the present work by introducing the generalized level crossing method, consideration of coupling between the components has become possible. This enables analyzing and hence extracting information out of coupled processes usually faced when working in tensor environments. The results obtained by this technique state that in addition to the point distribution of the vector stochastic process, the coupling plays ...

  11. [Family in the waiting room of an intensive care unit revealed feelings].

    Science.gov (United States)

    Frizon, Gloriana; do Nascimento, Eliane Regina Pereira; Bertoncello, Kátia Cilene Godinho; Martinse, Josiane de Jesus

    2011-03-01

    This is a qualitative study that aims to understand the feelings of relatives of patients admitted to the Intensive Care Unit (ICU). The study was conducted in the ICU of a large general hospital in the western region of Santa Catarina. The data collection occurred in 2009 with a semi structured interview to eighteen families. For data treatment the collective subject discourse was used. Reports emerged of two items related to feelings: hospitalization in the ICU and while waiting to enter the unit. The analysis revealed feelings as pain, anguish, sadness, helplessness,fear, despair, anxiety and expectation infinite. It is hoped that these results may assist in the training of professionals, to host the family and its insertion in the ICU environment as an element to be integrated into nursing care, through actions welcoming, helping them to cope with hospitalization of a relative in a critical unit.

  12. Judge: don't wait for ADA review to file rehab act claim.

    Science.gov (United States)

    1997-06-13

    [Name removed] sued the [name removed] of Alcoholism and Substance Abuse ([name removed]) after he was denied reasonable accommodation for his HIV condition and then was terminated. [Name removed] said [name removed] and three top officials violated the two disability rights statutes as well as his constitutional right to equal protection under the 14th Amendment. According to the suit, [name removed] asked to see [name removed]'s policies on reasonable accommodation but was told there were none. Two months later he sought them again, asking permission to work at home and requesting HIV education for staff and management. Soon after these requests, [name removed] received a negative performance evaluation and was fired. [Name removed] filed Americans with Disabilities Act (ADA) discrimination charges with the Equal Employment Opportunity Commission (EEOC). [Name removed] lost his claims under the Rehabilitation Act because he waited for completion of an administrative review of his allegations under the ADA.

  13. Watchful Waiting for Cases of Pediatric Otitis Media: Modeling Parental Response to Physician Advice.

    Science.gov (United States)

    MacGeorge, Erina L; Smith, Rachel A; Caldes, Emily P; Hackman, Nicole M

    2016-08-01

    Watchful waiting (WW) can reduce unnecessary antibiotic use in the treatment of pediatric otitis media (ear infection), but its utility is impaired by underutilization and noncompliance. Guided by advice response theory, the current study proposes advantage and capacity as factors that predict how caregivers evaluate and respond affectively to WW. Parents (N = 373) of at least 1 child age 5 years or younger completed questionnaires that assessed responses to hypothetical WW advice for their youngest child. Perceptions of advantage from WW and the capacity to monitor and manage symptoms predicted advice quality, physician trust, and future compliance both directly and indirectly through negative affect. The findings suggest the elaboration of advice response theory to include more aspects of advice content evaluation (e.g., advantage) and the influence of negative affect. The study also provides practical guidance for physicians seeking to improve caregiver reception of WW advice.

  14. EMG reactivity and oral habits among facial pain patients in a scheduled-waiting competitive task.

    Science.gov (United States)

    Nicholson, R A; Lakatos, C A; Gramling, S E

    1999-12-01

    For individuals with temporomandibular disorder (TMD) it has been theorized that stressful events trigger oral habits (e.g., teeth grinding), thereby increasing masticatory muscle tension and subsequent pain. Recent research involving adjunctive behaviors found an increase in masseter surface EMG (sEMG) and oral habits when students with TMD symptomatology were placed on a fixed-time reinforcement schedule. The current study used a treatment-seeking community sample with TMD symptomatology in a competitive task designed to be a more naturalistic Fixed Time task. The experiment consisted of Adaptation, Free-Play, Scheduled-Play, and Recovery phases. During the Scheduled-Play phase participants played, and waited to play, an electronic poker game. Results indicated that masseter muscle tension in the Scheduled-Play phase was significantly higher (p oral habits and overall affect were significantly higher (p's oral habits may lead to TMD symptomatology.

  15. The Powerless and Flowerless Waiting of Mary Morris'Female Characters

    Institute of Scientific and Technical Information of China (English)

    段庆艳

    2016-01-01

    Abstraction:This paper is mainly to analyze the ongoing process of transition and disillusion in the life of the female characters in the novel The Waiting Room by Mary Morris.Besides,the male characters in the novel are also play a considerable part in the formation of the theme of the story,which is the condemnation of war.Sex and gender make no difference in face of the disaster of war.Both females and males suffer.The condemnation of war shapes the basic tone of the novel.Morris successfully blamed the war as the suffer causer,the destruction maker and the marriage destroyer.Through the theme of war condemnation,Morris has distinguished herself as a moral writer rather than a domestic story teller.

  16. Change in hearing during 'wait and scan' management of patients with vestibular schwannoma

    DEFF Research Database (Denmark)

    Stangerup, Sven-Eric; Caye-Thomasen, P.; Tos, M.

    2008-01-01

    per cent still had good hearing at the end of the observation period. However, in patients with even a small initial speech discrimination loss, only 55 per cent maintained good hearing at the end of the observation period. Conclusion: After comparing the hearing results of hearing preservation......: At the time of diagnosis, 334 patients (53 per cent) had good hearing and speech discrimination of better than 70 per cent; at the end of the 10-year observation period, this latter percentage was 31 per cent. In 17 per cent of the patients, speech discrimination at diagnosis was 100 per cent; of these, 88...... surgery and of radiation therapy with those of 'wait and scan' management, it appears that, in vestibular schwannoma patients with a small tumour and normal speech discrimination, the main indication for active treatment should be established tumour growth Udgivelsesdato: 2008/7...

  17. [The State, waiting and political domination among the poor: interview with the sociologist Javier Auyero].

    Science.gov (United States)

    Auyero, Javier; Damin, Nicolás

    2014-12-01

    The extensive work of Javier Auyero regarding the poor in Latin America is disturbing in its sociological and political complexity. Instead of falling into the commonplace explorations of how inhabitants at the margins of our cities live, suffer and relate, his twenty years of research have focused on the consequences of neoliberalism in urban marginality. In light of the publication of his last book Patients of the State (2013), Salud Colectiva invited Auyero to reflect on the connections, not always observed, between waiting and political domination in government offices, schools and hospitals. His ethnographic strategy allows him to enter without prejudices into a social universe marked by polarizing political positions. He affirms that in the everyday encounters of poor people with the diverse forms of state power, practices are reproduced – not all of which are equally conscious and planned – that impart a political education and end up turning those who should be citizens into patients of the State.

  18. High-dose chemoradiotherapy and watchful waiting for distal rectal cancer

    DEFF Research Database (Denmark)

    Appelt, Ane L; Pløen, John; Harling, Henrik

    2015-01-01

    BACKGROUND: Abdominoperineal resection is the standard treatment for patients with distal T2 or T3 rectal cancers; however, the procedure is extensive and mutilating, and alternative treatment strategies are being investigated. We did a prospective observational trial to assess whether high-dose...... radiotherapy with concomitant chemotherapy followed by observation (watchful waiting) was successful for non-surgical management of low rectal cancer. METHODS: Patients with primary, resectable, T2 or T3, N0-N1 adenocarcinoma in the lower 6 cm of the rectum were given chemoradiotherapy (60 Gy in 30 fractions......-0) at all timepoints. The most common late toxicity was bleeding from the rectal mucosa; grade 3 bleeding was reported in two (7%) in 30 patients at 1 year and one (6%) of 17 patients at 2 years. There were no unexpected serious adverse reactions or treatment-related deaths. INTERPRETATION: High-dose...

  19. The use of music to aid patients' relaxation in a radiotherapy waiting room

    Energy Technology Data Exchange (ETDEWEB)

    Cooper, Laura [Oncology Department, Cheltenham General Hospital, Sandford Road, Cheltenham, Glos. GL53 7AN (United Kingdom)], E-mail: ljtrooper@hotmail.com; Foster, Irene [Faculty of Health and Social Care, University of West of England, Glenside Campus, Blackberry Hill, Stapleton, Bristol BS16 1DD (United Kingdom)], E-mail: irenejfoster@hotmail.com

    2008-08-15

    Patient-centred practice and increasing user involvement adds impetus to built environmental research within the health care setting. Much work has been centred around stress reduction initiatives for improving health outcomes for patients and staff. This study examined the influence of music choice on patients' anxiety levels whilst seated in a radiotherapy waiting area. Patients' stress levels and perceptions were assessed in the absence/presence of music. The opinions of patients were elicited through a questionnaire following exposure to a range of music types. Music therapy was shown to have clear benefits when individuals enjoyed the music to which they listened. Although clear preferences were indicated, the results were skewed by the negative effects of music not enjoyed by patients. Further investigation needs to take account of the impact of personal variables and the value of 'quiet areas'.

  20. On similarity of binary black hole gravitational-wave skymaps: to observe or to wait?

    CERN Document Server

    Vitale, Salvatore; Katsavounidis, Erik; Klimenko, Sergey; Vedovato, Gabriele

    2016-01-01

    Localization estimates for GW150914, the first binary black hole detected by the LIGO instruments, were shared with partner facilities for electromagnetic follow-up. While the source was a compact binary coalescence (CBC), it was first identified by algorithms that search for unmodeled signals, which produced the skymaps that directed electromagnetic observations. Later on, CBC specific algorithms produced refined versions, which showed significant differences. In this paper we show that those differences were not accidental and that CBC and unmodeled skymaps for binary black holes will frequently be different; we thus provide a way to determine whether to observe electromagnetically as promptly as possible (following a gravitational-wave detection), or to wait until CBC skymaps become available, should they not be available in low latency. We also show that, unsurprisingly, CBC algorithms can yield much smaller searched areas.