Utilization of the out of hours service in Poland: an observational study from Krakow

<p>Abstract</p> <p>Background</p> <p>In 2000 a new GP contract was introduced in Poland. It allowed GPs to subcontract out of hours care to specialized deputizing services. One such service in Kraków provides care to 61 GP practices with a population of 420 000 inhabitants. The aim of this study is to analyze seasonal and geographical variation in out of hours care use and to find the most important factors influencing it.</p> <p>Methods</p> <p>Routinely collected data for 24 months (2003–2004) containing type, date and time of the contacts were used.</p> <p>Results</p> <p>During the study period 238 072 contacts were recorded: 149 911 ambulatory doctor visits, 23 434 home visits and 64 727 nurse procedures. The mean rate of out of hours contacts was: for ambulatory visits 178 per 1000 inhabitants/year (varied between practices from 9 to 696), for home visits 28 (from 1 to 36) and for nurse procedures 77 (from 3 to 327). The highest rate of ambulatory visits was 739 in the age group 0–4, the lowest – 104 in the age group 45–49. The highest rate of home visits was 221 in the age group over 85. The rate of ambulatory GP visits and nurse procedures was negatively correlated with the distance between the location of GP practice and the nearest out of hours clinic. The rate of home visits was positively correlated with the age of the patient.</p> <p>Conclusion</p> <p>Significant differences between practices suggest that non medical factors may play an important role in the patient's decision to see a GP when the surgery is closed. Their influence should be limited to make the system more efficient.</p

Sentinel monitoring of activity of out-of-hours services in Norway in 2007: an observational study

<p>Abstract</p> <p>Background</p> <p>In Norway, no valid activity statistics from the primary health care out-of-hours services or the pre-hospital emergency health care system have previously been available.</p> <p>Methods</p> <p>The National Centre for Emergency Primary Health Care has initiated an enterprise called "The Watchtowers" which consists of a representative sample of seven casualty clinics covering 18 Norwegian municipalities. The purpose of the project is to provide routine information over several years, which will enable monitoring, evaluation and comparison of the activities in the out-of-hours services. This paper presents data from 2007, the first full calendar year for the Watchtowers, analyzes some differences in user patterns for the seven casualty clinics involved, and estimates national figures for the use of casualty clinics and out-of-hours services in Norway.</p> <p>Results</p> <p>A total of 85 288 contacts were recorded during 2007 [399 per 1 000 inhabitants] of which 64 846 contacts were considered non-urgent [76.6%]. There were 53 467 consultations by a doctor [250 per 1 000], 8 073 telephone consultations by doctor [38 per 1 000], 2 783 home visits and call-outs by doctor [13 per 1000] and 20 502 contacts managed by nurses on their own [96 per 1000]. The most common mode of contact was by telephone. Women, young children and elderly had the highest rates of contact.</p> <p>Conclusion</p> <p>Norway has a high rate of contacts to the out-of-hours services compared with some other countries with available data. Valid national figures and future research of these services are important both for local services and policy makers.</p

Utilização da &#946;-galactosidase para prevenção da cristalização em doce de leite Use of &#946;-galactosidase in milk sweet: avoiding lactose crystallization

Este estudo avaliou o efeito da utilização da enzima &#946;-galactosidase sobre a cristalização da lactose no doce de leite. As concentrações de lactase testadas variaram de 0 a 0,4 g/L. O grau de cristalização do produto foi avaliado sensorialmente (teste de ordenação em função de uma escala específica), após 30, 60, 90 e 180 dias de armazenamento à temperatura ambiente, por provadores previamente treinados. O teste de ordenação indicou não haver diferença estatística significativa (P>0,05) entre as amostras em relação à cristalização, tanto aos 30 quanto aos 60 dias de armazenamento, porém aos 90 e 180 dias essa diferença foi significativa entre o controle (T0) e os tratamentos. A utilização de 0,2 g/L de &#946;-galactosidase (23,16% de hidrólise da lactose) foi suficiente para que a arenosidade no doce de leite não fosse percebida sensorialmente pelos provadores, durante todo o período considerado.<br>The effect of using &#946;-galactosidase on the crystallization of lactose in milk sweet has been studied. The concentrations of lactase ranged from 0 to 0.4 g/L of processed milk. The product was subjected to sensorial analysis (crystallization degree ranking test using a specific scale) by trained tasters after 30, 60, 90 e 180 days of storage. The ranking test showed no statistically significant difference between the samples in relation to crystallization, both at 30 and 60 days of storage, but at 90 and 180 days the difference was significant among control (T0) and the treatments. Usage of 0.2 g/L of &#946;-galactosidase (23.16% lactose hydrolysis in milk) was enough to prevent sandiness in milk sweet from being noticed throughout the studied period