A prospective audit examining non-attendance at a surgical outpatients clinic in Mater Dei Hospital, Malta, and methods to reduce this problem

Non-attendance at hospital outpatient clinics is a longstanding issue that has potentially serious clinical implications, and contributes a significant financial burden to health care services. The aims of this study were to identify the rate of non-attendance at a surgical outpatients clinic in Mater Dei Hospital, Malta, ascertain the reasons for non-attendance, and to identify patients’ opinions on the implementation of a text-messaging reminder system as a means of reducing the non- attendance rate. Four outpatient clinics were observed over one month and the total number of appointments documented. Non-attenders were contacted via telephone call and asked to explain their non-attendance and whether a text-messaging reminder system may have increased their likelihood of attendance. Of the 266 appointments (217 females, 49 males, mean age 56 + 16 years), 80 patients failed to turn up, representing a 30% non-attendance rate. The main reasons for non-attendance were forgetfulness (53%), and unawareness of the appointment (26%). 90% of non-attenders stated that a text-messaging reminder might have prevented them missing their appointment, with 97% suggesting that such as system would be an acceptable method of trying to reduce this problem. Thus application of a text- messaging reminder system represents a potential solution for reducing the high rate of missed outpatient appointments, which is both cost effective and well accepted by patients.peer-reviewe

Experiences of clinicians using mindfulness-based therapy with adult survivors of childhood sexual abuse: a qualitative analysis

The long-term devastation caused by childhood sexual abuse among adult survivors has been well documented within the literature. Similarly, numerous studies have addressed efficacy of various treatment modalities targeting psychological sequelae associated with such abuse. However, despite the recent rise in popularity of mindfulness within the field of psychology, as well as indication of tremendous psychological benefits associated with such practice, few studies have sought to understand the connection between mindfulness and healing among abuse survivors. The current study attempts to bridge the gap in the literature by examining the experiences of clinicians using mindfulness as a framework for their treatment of adult childhood sexual abuse victims. Participants (N=6) were recruited from the Los Angeles area and the qualitative design utilized semi-structured interviews as a means of data collection. Grounded theory analysis of the data revealed a complex and dynamic interplay of elements that captured the nature of mindfully framed treatment with abuse survivors. Results suggested that core elements of mindfulness practice, along with therapeutic conditions and factors related to the therapist\u27s way of being, allow growth and change within the client. However, it was further revealed that the interplay of such elements was surrounded by the tremendous impact of a clinician\u27s personal mindfulness practice, which fostered essential healing elements. While the observed results provide no conclusive data, the importance of environmental conditions, as well as therapeutic presence, rather than a focus on specific techniques or interventions suggests implications for work with abuse survivors. Additionally, it is hoped that further research continues to observe mindfulness and provide support for its implementation as a viable and effective treatment for trauma survivors

Session A, 2015 Second Place: The Art of War Against Tabanidae, a Survey of Tabanidae at the Cranberry Lake Biological Station

Some of the most notorious insect pests in the world are members of the family Tabanidae. At the Cranberry Lake Biological Station, several species of Tabanidae’s occupy the area and use the students for blood meals, before depositing their eggs on plants overhanging water. To investigate solutions to this parasitism of CLBS, we placed an experimental trap alongside the standard Malaise trap at two locations, in an attempt to determine their habitat preferences and time of peak activity. We recorded the number of flies in each trap every two hours, over a twelve hour period. We also conducted a search for Tabanid eggs, in hopes of seeing if there is any preference of plant species and location, and how many clutches were invested by the female Tabanids into a single oviposition location. Because the experimental trap caught significantly more butterflies than any other insect, they were removed from the study to prevent further unnecessary casualties. It was discovered that the time of peak activity averaged around 5:00 pm, and that weather played a vital role in the levels of this activity. We also determined that there is a significant difference in adult habitat and oviposition location preferences, more commonly choosing stagnant over fast running water

An Adaptive, Parallel Algorithm for Approximating the Generalized Voronoi Diagram

A Generalized Voronoi Diagram (GVD) partitions a space into regions based on the distance between arbitrarily-shaped objects. Each region contains exactly one object, and consists of all points closer to that object than any other. GVDs have applications in pathfinding, medical analysis, and simulation. Computing the GVD for many datasets is computationally intensive. Standard techniques rely on uniform gridding of the space, causing failure when the number of voxels becomes prohibitively large. Other techniques use adaptive space subdivision which avoid failure at the expense of efficiency. Unlike previous approaches, we are able to break up the construction of GVDs into novel work items. We then solve these items in parallel on graphics cards, improving performance. Using these techniques, GVD construction becomes much more efficient, practical, and applicable

Development of the Wheelchair outcomes Assessment Tool for Children (WATCh):A patient-centred outcome measure for young wheelchair users

<div><p>Objective</p><p>To develop a patient-centred outcome measure (PCOM) for use with children and young people accessing National Health Service (NHS) wheelchair and posture services. Identifying and addressing outcomes of most importance to young wheelchair users (≤ 18 years) will help services maximise the benefits achievable within available resources.</p><p>Methods</p><p>A mixed-methods approach was used, involving questionnaire surveys and qualitative interviews, and building on previous work identifying how young wheelchair users define health-related quality of life (HRQoL). Framework analysis was used to analyse the interview transcripts. Survey questionnaires seeking views on the importance of a range of outcomes were completed by 21 young wheelchair users or their parents. Subsequent face-to-face interviews with 11 parents or dyads of parents and young wheelchair users explored these responses and identified novel outcomes. Interviewees also scored and recorded satisfaction levels for their key outcomes.</p><p>Results</p><p>All outcomes proposed in the survey were rated as ‘extremely important’ by at least one respondent, as were additional outcomes uncovered in the qualitative data. In consultation with the service providers and service users, the Wheelchair outcomes Assessment Tool for Children (WATCh) was developed to allow service users and providers to identify, score and monitor individual users’ most important outcomes. The final WATCh tool comprises 16 outcome options, of which service users select five to be monitored. The tool will be used to measure key outcomes identified by service users before and after wheelchair provision.</p></div

MS/MS library facilitated MRM quantification of native peptides prepared by denaturing ultrafiltration

Naturally occurring native peptides provide important information about physiological states of an organism and its changes in disease conditions but protocols and methods for assessing their abundance are not well-developed. In this paper, we describe a simple procedure for the quantification of non-tryptic peptides in body fluids. The workflow includes an enrichment step followed by two-dimensional fractionation of native peptides and MS/MS data management facilitating the design and validation of LC- MRM MS assays. The added value of the workflow is demonstrated in the development of a triplex LC-MRM MS assay used for quantification of peptides potentially associated with the progression of liver disease to hepatocellular carcinoma

Data Interoperability and Information Security in Healthcare

Interoperability represents the accurate exchange of information and the use of the information for effective decision making. For information exchange to be interoperable, it must be widely interpretable between multiple information systems. At a more granular level, it focuses on the accuracy, consistency and reliability of information exchanged between systems. The healthcare industry has defined many problems when it comes to the best practice of interoperability. Technical, financial, and managerial barriers are present that produce large scale complex problems for the whole industry. Although, a variety of potential solutions have been developed. Some have even been implemented already focusing on semantics, standardization, patient privacy and security. The private and government sectors of the economy have produced new legal and economic incentives, product innovations, along with widely available educational resources that have shown success. Overall improvements will increase quality of care, patient safety, and decrease associated costs across the entire healthcare industry