Preferred Means Research Articles

Direct Cash Transfers in Emerging Economies: The Case of India

Social welfare systems across the developing world have witnessed a significant transformation in the last 20 years with direct cash transfers becoming an increasingly preferred means of tackling poverty and inequality. While this movement finds its roots in Latin America, a large number of developing countries including India have since modified their welfare systems, incorporating direct cash transfers as an alternative to in kind benefits and subsidies. India’s Direct Benefit Transfer (DBT) system, which has been in existence since the past five years, has 316 schemes under its aegis now. While it would be premature to evaluate its success or failure, it would definitely be an interesting and worthwhile exercise to see how Indian states fare in terms of DBT. With Amartya Sen’s pathbreaking Capability Approach as the premise, this research is a unique attempt to explore and identify variables that determine and impact DBT transfers at the Indian state level using multiple regression. We find that literacy and the JAM (Jan-Dhan, Aadhaar, Mobile) Index emerge as significant variables impacting DBT transfers in states. This study contributes to the current literature on social welfare systems and highlights the importance of development architecture in emerging economies.

A hybrid open-top light-sheet microscope for versatile multi-scale imaging of cleared tissues.

Light-sheet microscopy has emerged as the preferred means for high-throughput volumetric imaging of cleared tissues. However, there is a need for a flexible system that can address imaging applications with varied requirements in terms of resolution, sample size, tissue-clearing protocol, and transparent sample-holder material. Here, we present a 'hybrid' system that combines a unique non-orthogonal dual-objective and conventional (orthogonal) open-top light-sheet (OTLS) architecture for versatile multi-scale volumetric imaging. We demonstrate efficient screening and targeted sub-micrometer imaging of sparse axons within an intact, cleared mouse brain. The same system enables high-throughput automated imaging of multiple specimens, as spotlighted by a quantitative multi-scale analysis of brain metastases. Compared with existing academic and commercial light-sheet microscopy systems, our hybrid OTLS system provides a unique combination of versatility and performance necessary to satisfy the diverse requirements of a growing number of cleared-tissue imaging applications.

Increasing uptake to a lung cancer screening programme: building with communities through co-design

BackgroundLung cancer is the most common cause of cancer death in the UK. Low-dose computed tomography (LDCT) screening has been shown to identify lung cancer at an earlier stage. A risk stratified approach to LDCT referral is recommended. Those at higher risk of developing lung cancer (aged 55 + , smoker, deprived area) are least likely to participate in such a programme and, therefore, it is necessary to understand the barriers they face and to develop pathways for implementation in order to increase uptake.MethodsA 2-phased co-design process was employed to identify ways to further increase opportunity for uptake of a lung cancer screening programme, using a risk indicator for LDCT referral, amongst people who could benefit most. Participants were members of the public at high risk from developing lung cancer and professionals who may provide or signpost to a future lung cancer screening programme. Phase 1: interviews and focus groups, considering barriers, facilitators and pathways for provision. Phase 2: interactive offline booklet and online surveys with professionals. Qualitative data was analysed thematically, while descriptive statistics were conducted for quantitative data.ResultsIn total, ten barriers and eight facilitators to uptake of a lung cancer screening programme using a biomarker blood test for LDCT referral were identified. An additional four barriers and four facilitators to provision of such a programme were identified. These covered wider themes of acceptability, awareness, reminders and endorsement, convenience and accessibility. Various pathway options were evidenced, with choice being a key facilitator for uptake. There was a preference (19/23) for the provision of home test kits but 7 of the 19 would like an option for assistance, e.g. nurse, pharmacist or friend. TV was the preferred means of communicating about the programme and fear was the most dominant barrier perceived by members of the public.ConclusionCo-design has provided a fuller understanding of the barriers, facilitators and pathways for the provision of a future lung cancer screening programme, with a focus on the potential of biomarker blood tests for the identification of at-risk individuals. It has also identified possible solutions and future developments to enhance uptake, e.g. Embedding the service in communities, Effective communication, Overcoming barriers with options. Continuing the process to develop these solutions in a collaborative way helps to encourage the personalised approach to delivery that is likely to improve uptake amongst groups that could benefit most.

Negative hydrogen ion sources for particle accelerators: Sustainability issues and recent improvements in long-term operations

High brightness, negative hydrogen ion sources are used extensively in scientific facilities operating worldwide. Negative hydrogen beams have become the preferred means of filling circular accelerators and storage rings as well as enabling efficient extraction from cyclotrons. Several well-known facilities now have considerable experience with operating a variety of sources such as RF-, filament-, magnetron- and Penning-type H- ion sources. These facilities include the US Spallation Neutron Source (SNS), Japan Proton Accelerator Research Complex (J-PARC), Rutherford Appleton Laboratory (RAL-ISIS), Los Alamos Neutron Science Center (LANSCE), Fermi National Accelerator Laboratory (FNAL), Brookhaven National Laboratory (BNL), numerous installations of D-Pace (licenced by TRIUMF) ion sources used mainly on cyclotrons and, most recently, the CERN-LINAC-1 injector. This report first summarizes the current performance of these ion sources in routine, daily operations with attention toward source service-periods and availability metrics. Sustainability issues encountered at each facility are also reported and categorized to identify areas of common concern and key issues. Recent ion source improvements to address these issues are also discussed as well as plans for meeting future facility upgrade requirements.

CHARAKTERYSTYKA CECH ROZRODU KRÓW REKORDZISTEK POD WZGLĘDEM ŻYCIOWEJ PRODUKCYJNOŚCI MLECZNEJ

The aim of this study was to characterise basic reproduction indexes and to investigate the effect of selected factors on values of analysed fertility parameters in cows (100 head) with record lifetime milk yields. The experiments were conducted on Polish Holstein-Friesian Black- -and-White cattle. Cows with lifetime milk yields of min. 100 thousand kg milk were considered record holders. Animals were selected at random from herds covered by performance testing in the Poznań testing region in the years 2003–2016. It was shown that analysed cows with record lifetime milk yields exhibited slightly reduced fertility. The animals had the preferred mean age at first calving and adequate average length of pregnancy. Relatively high numbers of semen doses required for successful insemination resulted in an extended length of calving interval, interpregnancy period and artificial mating service.In the management of dairy cow herds focusing on high lifetime productivity and fertility traits it is recommended to control reproduction so that calvings take place in winter and cows calve for the first time at the age of maximum 27 months.

Development of an industry-funded fishery-independent survey and associated indices for managing a deep sea crab resource in Western Australia

The inclusion of fishery-independent data in stock assessments has been shown to have positive stock and financial outcomes for fisheries. A co-management approach between the government and commercial fishers in this limited-entry fishery led to the successful implementation of industry-funded, fishery-independent surveys of crystal crab, a deep water Geryonid crab, in two areas off Western Australia.While the instigation of these surveys was driven by a need for improved abundance indices for stock assessment, they have also provided an opportunity to better understand stock dynamics and composition. Structuring the surveys across the depth distribution (400–700 m) of crystal crabs demonstrated an apparent lack of depth-related size stratification in crystal crabs with large crabs captured throughout the species depth distribution. Female crabs, which mature below the legal minimum size for harvest, were a minor component of the catch and were more prevalent at the shallower end of their depth distribution. There also appeared to be a movement of pre-molt crabs to the periphery of their distribution (shallow and deep), in preparation to molt.There was a slight decline in the fishery-independent abundance (FIA) index from 2017 to 2019 mirroring the pattern displayed by the current standardized commercial catch rate, with an increase during the most recent survey (2020). The FIA index will be incorporated as an additional data source for the weight of evidence and size-structured integrated model for the assessment of the crystal crab resource off the west coast of Western Australia.The surveys, which were funded by industry and supported by government research staff onboard, have proved cost-effective, robust and sustainable, and a preferable means by which fishery-independent data could be collected for this commercially important Geryonid crab. The cost of the survey was partially offset by the retention of the legal catch. Such a collaborative model could be applied in fisheries world-wide to address the inherent biases of commercially-derived indices and the ever-increasing financial constraints on regulators to conduct stock assessments.

SARS-CoV-2 and the Vaccination Hype

The engineered spike protein of SARS-COV-2, and the corresponding infectious disease COVID-19 attributed to it, hold in their grip a large portion of humanity. The global race for a counter strategy quickly turned into a search for a vaccine as the preferred means to contain the virus. An unusually rapid development of different and completely new classes of experimental therapies that would widely be referred to as “vaccines” raised questions about safety, especially with regard to emergency use approval (EUA) being granted with unprecedented urgency and hardly any critical scrutiny. At present, independent researchers, even some former proponents and insiders, of the currently ongoing global experiment represented as a “vaccination” campaign point primarily to the lack of public safety studies based on empirical datasets that should be obtainable for the tens of millions, even hundreds of millions, of doses of mRNA and DNA vector therapeutics being distributed as “vaccines”. Studies regarding efficacy and “side effects” (sometimes fatalities or permanent iatrogenic injuries) of these experimental therapies have been by-passed in favor of short-term field data from real patients which inevitably raises scientific and ethical questions particularly in view of the fact that the persons and entities responsible for public safety hold deep financial and other vested interests in speeding along the distribution of the experimental pharmaceutical products. The lack of an open discussion about the experimental therapies for COVID-19 now being applied across all age groups, even children hardly impacted by COVID-19, is worrying. The core principle of open debate without pre-conceptions or vested interests in outcomes has been and continues to be utterly ignored. We hope to engage scientific discussion with the hope of helping decision-makers, the general public, and the media alike to consider the subject-matter of what is at stake in a context of reason rather than panic.

Whatsapp and Telephone Calls as Suitable Media of Service of Hearing Notice in Nigeria: Reviewing The Supreme Court Decision in Compact Manifold & Energy Services Ltd v Pazan Services Nig Ltd

This article uses the desk-based methodology to appraise the Supreme Court decision in Compact Manifold & Energy Services Ltd v Pazan Services Nig Ltd. In the case, the court held that the service of hearing notice through a text message by the registry of a court to a phone number supplied by the counsel, in this age of prevalence of information technology, is good and sufficient notice of an adjournment. The article argues that, while information technology is dominant, sending a text message, without evidence of its delivery, does not constitute service. It goes further to argue that even if the text is sent, it is common for its delivery to fail or for it to be delayed inordinately due to an unstable network. Even where the text message is delivered, the possibility of the counsel not seeing it cannot be ruled out. Thus, a text message, in a clime with unsteady mobile telecommunication services, may not be a proper medium of service. The article concludes by maintaining that when using a phone call and Whatsapp massaging, receipt of messages can be ascertained and therefore, these are preferable means of valid and sufficient service of hearing notice. Unlike these two mediums, a text message has limitations. In fact, service via Whatsapp has been held to constitute valid service. The article makes vital arguments on the impropriety of service via text message and makes recommendations on reliable means of effecting service.

Identifying and modeling the dynamic evolution of niche preferences

• We propose the methods to identify and model the dynamic evolution of niche preferences. • Our methods introduce a binary variable to automatically distinguish the general preferences and niche preferences from user-generated content. • Extensive experiments indicate that the proposed methods can effectively identify the niche preferences, model the evolutionary trends, and discover targeted users. The niche market is an appropriate place for the nascent small and medium-sized enterprises (SMEs) to acquire a small market share to expand their operations. Niche preferences serve as the cornerstone for discovering niche markets. However, current research about niche markets ignores the meanings and dynamic evolution of niche preferences, which does not benefit the SMEs in choosing the suitable niche markets and the best timing of entry. In this study, we propose three methods to model and identify niche preference. The niche preference (NP) method introduces a binary variable to automatically distinguish the general preferences and niche preferences from user-generated content. The dynamic niche preference (DNP) method is able to model and identify the evolution of niche preferences incorporating the time element. The online DNP method can handle large text streams of data compared to the DNP. The findings then are used to identify the meaning of niche preferences for the niche market and to model the evolutionary trends. Experimental results in the real-world dataset indicate that the proposed methods effectively identify the niche preferences, model the evolutionary trends, and discover targeted users.

Green synthesis of copper nanoparticles using aqueous extracts from Hyptis suaveolens (L.)

Copper nanoparticles (CuNPs) with antimicrobial and cytotoxic properties were obtained using extracts from Hyptis suaveolens (L.) commonly called wild tulsi. Green synthesis using plant extracts is a preferred means to obtain nanoparticles because of the simplicity, efficiency, and clean process. Plant extracts contain phytochemicals that provide microbial and other medical properties to the nanoparticles. In this study, Hyptis suaveolens (L.) was treated in water and the extracts obtained were used to synthesize copper nanoparticles. Transmission electron microscopy (TEM) images showed that the synthesized copper nanoparticles are spherical in shape with an average diameter of 7.2 nm. X-ray diffraction (XRD) and selected area electron diffraction (SAED) analysis showed that the particles were mostly of copper 92% and about 8% of oxygen indicating partial conversion of the copper sulphate into copper oxide. Plasmonic absorbance also indicated that the nanoparticles were predominantly made of copper. The nanoparticles showed excellent antimicrobial activity against bacteria and fungi in the lowest concentration tested. Both wild tulsi extract (WTE) and wild tulsi nanoparticle (WTN) were non-toxic on NIH 3T3 cells at lower concentrations tested, however, WTN showed cytotoxicity at higher concentrations and with extended incubation times.

India and US FONOPs: Oceans Apart

India and the United States have recently and rapidly consolidated a significant bilateral defence partnership, have a clear appetite for bilateral and quadrilateral maritime cooperation, and appear to share a common commitment to the rules and norms that govern the maritime domain. Yet the US decision to undertake and publicise a freedom-of-navigation operation targeting India in April 2021 again highlighted the two countries’ divergent interpretations of the United Nations Convention on the Law of the Sea (UNCLOS) and of customary international law. This divergence has its origins in differences in Washington’s and New Delhi’s historical engagement with UNCLOS and their preferred means of achieving security and status in the Indo-Pacific. Such differences currently preclude a deep bilateral consensus on maritime order and a common multilateral position within the Quadrilateral Security Dialogue.

Dream, Bliss, and the Shaping of Emotional Meaning in Beowulf

<i>Dream</i>, <i>Bliss</i>, and the Shaping of Emotional Meaning in <i>Beowulf</i>

Evaluating the Management of Public Private Partnerships for the Provision of Affordable Housing in Nigeria

The Impact of Public Private Partnership is beginning to be more pronounced in emerging markets like Kenya and Nigeria as a preferred means for the delivery of Infrastructure and Housing. In terms of its popularity, the adoption and growth of Public private partnerships has been traced to under performance of Government Budgeting and lack of sufficient funding available to government for financing the different strategically important and development focused projects (including Social Housing), this is also in addition to governments poor risk management capabilities. The challenges facing public funding and its impact on the country’s development have increased the potential for public-private partnerships as an alternative to infrastructure and housing. The study examined the impact of public-private partnerships on affordable housing in Nigeria. It also includes other purposes; examining the impact of management contracts on the provision of affordable housing in Nigeria to identify the impact of the joint venture on the provision of affordable housing in Nigeria. The research adopted the survey research plan and used a structured questionnaire as a tool for data collection. Data analysis was performed in addition to mean and percentage descriptive statistics, as well as correlation and regression analysis. The results showed that Build Own Operate & Transfer Policy has a significant impact on the provision of affordable housing in Nigeria and Lease Contracts has a positive impact on the provision of affordable housing in Nigeria. The study concludes that for public-private partnerships to flourish and achieve affordable housing, each partnership must identify measures of success, be able to quantify and monitor their performance, and identify and address emerging issues. It was suggested that the government take responsibility for ensuring that an enabling institutional environment and infrastructure is provided to support PPP execution. It was also proposed that the government adopt and establish a Viability Gap funding framework to attract private sector participation. As alternative and effective sources of funding will promote affordability and enable public-private partnerships to thrive for the identification, development, funding, implementation, and successful management of affordable housing PPP’s in Nigeria.

Knowledge, attitudes, and perceptions toward informed consent and its implications among dental professionals in South India: A cross-sectional study

Objectives: To assess the current knowledge, attitudes, and perceptions toward informed consent and legal conflicts among Dental professionals in the Dental colleges of South India. Methods: This descriptive cross-sectional study was carried out at eight dental teaching institutions of Andhra Pradesh and Telangana. A structured close-ended questionnaire was used to obtain data from the dentists, including the postgraduates and teaching staff. The aim was to assess the knowledge on informed consent in the routine practice of dentistry. Results: A total of 450 professionals were approached; among them, 368 were included in the survey. Independent variables such as age, gender, clinical practice experience, and levels of designation were assessed for association with perceptions of informed consent. Majority of the study population felt the necessity of informed consent in daily dental practices. In addition, 75.2% of the professional population were aware of legal conflicts as they reported that if a doctor working in an institution does fault in providing treatment services without consent, then they will be liable before the law. There was a statistically significant association between the age of the study population and their attitude toward the necessity of consent in treating patients (P = 0.03). Similarly, there were variations in the opinions of gender toward the nature of informed consent, which was proved to be statistically significant (P = 0.027). Moreover, clinical practice experience was significantly associated with knowledge of informed consent evolution and types of consent required for a child between 7 and 17 years of age (P = 0.002 and 0.028), respectively. Conclusion: About 86% of the surveyed dentists are aware of the importance of informed consent in practical dentistry and consider it as an ethical and legal obligation. Moreover, expressed consent is the preferred means of obtaining consent from patients for the most dental procedure. Majority (89%) of them responded that the questionnaire gave them additional information about lawsuits and preferred streamlining the process of informed consent through Institutional review boards to avoid legal conflicts.

ICT usage by farm women: Access and preferences

Agriculture is the mainstay of Indian economy and women play an important role in it. The trends in global markets greatly influence the agricultural practices and decision making at local level which has transformed agriculture largely into an information driven enterprise. Information and Communication Technology (ICT) holds huge potential in dissemination of agriculture related information to rural masses for their capacity building. ICT has emerged as a major tool for rural development as it may effectively be used to address issues like agriculture, education, entertainment, health, animal health, news and many more. However, timely access to the critical information is a challenge for rural masses in general and rural women specifically due to various constraints. The present study was conducted in Ropar district of Punjab to examine the usage of various media means by rural women, factors affecting the access to information and their preference of ICT means for obtaining agricultural and non agricultural information. The results revealed that socio economic status of rural women has largely influenced their access to information. Further, mobile phone was the most preferred mean for accessing information by farm women irrespective of the land holding. However, television and radio were the two most preferred media means adopted by farm women to obtain agriculture and non agriculture related information. Appropriate training and awareness programmes should be promoted to farm women by using ICT tools.

Stilistika Al-Qur’an

This paper reveals the linguistic phenomenon of the Qur'an with the central theme of forms of communication in Surah as-Syu'ara'. The problems studied include stylistics from aspects of phonology, morphology, syntax, and semantics in verses relating to forms of communication, which are limited to surah ash-Syu'ara'. In Surah ash-syu'ara' there are several verses that contain several communisms, so the author is interested in analyzing using stylistics to reveal the linguistic phenomena of these verses. This paper is expected to be a reference for the development of other linguistic studies that take the same object, namely the Qur'an. This writing proves and shows that there is a spectacular value charge in the language of the Qur'an which is known as the content of i'jaz al-Qur'an. The theory used is the stylistic theory which the author limits to only three things: preference for lafadz, preference for sentences or the preferred meaning in a sentence, and deviations or deviations from the general rules of grammar. the object of the study is the construction of various forms of communication in the surah ash-Syu'ara'.&#x0D;

Access, utilization, and awareness for clinical genetic testing in autism spectrum disorder in Sweden: A survey study.

Clinical genetic testing is recommended for individuals diagnosed with autism spectrum disorder. There are only a few reports of how these recommendations are followed and especially missing for European countries. We aimed to analyze the rate of access, utilization, and awareness of clinical genetic testing among autistic individuals in Sweden through online surveys targeting parents with at least one autistic child and autistic adolescents (from 15 years) and adults. In total, 868 parents of autistic children and 213 autistic adolescents or adults completed the survey. Only 9.1% (n = 79) of parents and 2.8% (n = 6) of autistic adolescents/adults reported having received a referral for clinical genetic testing after autism spectrum disorder diagnosis. The autistic children offered a referral were younger at diagnosis (p < 0.001) and more likely to have an additional neurodevelopmental diagnosis (p < 0.01), including intellectual disability (p < 0.001) or a language disorder (p < 0.001). Genetic counseling was provided to less than half of the families that were referred for clinical genetic testing. Finally, we report that both respondent groups preferred to be informed by written text and an expert in genetics about clinical genetic testing. This study highlights a lack of awareness and access to clinical genetic testing after autism spectrum disorder diagnosis in Sweden and demonstrates the need for additional studies on how clinical guidelines for genetic testing are followed in different countries.Lay abstractSeveral medical professional societies recommend clinical genetic testing for autistic individuals as many genetic conditions are linked to autism. However, it is unclear to what extent autistic individuals and parents of autistic children are offered clinical genetic testing. We conducted a community-based survey to estimate the access, utilization, and awareness for clinical genetic testing in Sweden. In total, 868 parents of autistic children and 213 autistic adolescents or adults participated as respondents. The referral rate for clinical genetic testing after autism spectrum disorder diagnosis was low, with only 9.1% for the autistic children as reported by their parents and 2.8% for autistic adolescents/adults. The autistic children who got referrals were more likely to have intellectual disability and language disorder. We also report that awareness of the clinical genetic testing possibility was low in both respondent groups. We also highlight preferred communication means and needs for information before clinical genetic testing. Our results show that utilization and access are low in Sweden, and more studies should be conducted to report these rates in different countries to analyze the effects of clinical genetic testing on healthcare for autistic individuals. Our results highlight the most important information for the families and how the information should be communicated prior to clinical genetic testing.

The Experience of Family Members in Long-Term Care Facilities During the SARS COV2 (COVID-19) Pandemic

In-person visits are one form of care support offered by family members for residents in a Long-term Care Facility (LTCF). Family member visitation may extend to close social relationships with the residential care staff, which can be important in managing care. The long-term care population has been significantly impacted by a high number of SARS-COV2 (Covid-19) cases in morbidity and mortality but, in-person visits were limited due the public health concern. This study aimed to describe the experience of family members of persons in LTCFs during the Covid-19 pandemic. We used an online survey of 34 questions. Forty-six family members were recruited through online caregiver support platforms, and 22 completed the survey. Average participant age was 57. Majority were female with high-moderate (M=3.48) Kessler psychological distress scores. Participants reported less frequent communication with their family members in LTCFs. Difficult to reach nursing staff, who were the primary contact, was a concern. Their preferred means of communication was the telephone followed by window visits; residents preference remained for in-person visits followed by telephone. Participants described a decrease in relationship closeness with staff and a decrease in confidence in the quality of care. These results, limited by sample size, offer a beginning insight into the importance of communication between the family member and nursing staff, including the contact frequency. Structural disparities such as LTCF nursing staff levels may partly explain these deficits in supporting families during the Covid-19 pandemic. Opportunities to support family members remain a needed focus of long-term care reforms.

COVID-19 as a window of opportunity for cycling: Evidence from the first wave

Across the world, the COVID-19 pandemic has forced people to reconsider their habits in terms of how they work, how they interact with each other, and of their mobility. During lockdowns, mobility was in general significantly reduced. Means of collective transportation were used much less, and people preferred means of individual transport. Evidence from some cities suggests that people turned to cycling as a resilient and reliable option with a small risk of contagiousness. This spike in demand led some governments to respond by opening additional bike lanes, reducing the fees of bike-sharing systems, banning cars on selected streets, or giving monetary incentives for the purchase of new bikes. We analyze the bike traffic in Basel and Zurich, two major Swiss cities. Throughout the pandemic, no specific measure to promote cycling was implemented in any of the two cities; we can thus see latent demand patterns exposed when conditions change. As cycling depends on the season and weather, we incorporate these data and correct the traffic counts hereby. We can identify a distinct change in cycling traffic over the course of the day. During the lockdown period, relatively more traffic is observed in the afternoon, possibly associated with leisure activities. Furthermore, there is a short-term drop in the corrected cycling traffic and a fast recovery, demonstrating cycling as a resilient transport mode. Soon bike traffic reached pre-lockdown levels, but no significant increase could be identified, possibly attributed to the absence of explicit policy measures. We furthermore survey a panel of bike policy experts to identify policy actions that could be taken in Basel and Zurich to increase bike usage. The COVID-19 pandemic disrupts life as we know it, leading people to reconsider their travel choices. Given authorities' desire to increase bike usage, it represents a window of opportunity to test new policy measures, increase bike trips of active cyclists, and attract new cyclists. As long as this window is open, people are susceptible to policy measures to reconsidering past choices. However, if no policy measures are conducted during the pandemic, as in the case study, it is likely that bike usage is not increased in the long run. Authorities are well-advised to take this opportunity to strengthen cycling and to lead to a more resilient, accessible, safe, and sustainable urban transport system.

Primary Care Physicians’ Perspectives in Leading Breast Cancer Follow-Up Care

IntroductionLimited data exist on the barriers associated with transitioning breast cancer follow-up care to primary care physicians (PCPs). This study aimed to describe the current perspectives of PCPs in managing breast cancer follow-up. MethodAn online survey was distributed to PCPs in Toronto, ON, Canada. Questions examined PCPs’ view of transitioning breast cancer follow-up care to their practices. ResultsOf 800 PCPs invited, 126 responded (response rate: 15.7%). The types of practice models amongst respondents included blended capitation (42.9%), blended salary (27%), and fee-for-service (17.5%). Seventy-seven percent of respondents stated they provided follow-up care. Approximately half of the respondents stated they were somewhat comfortable providing follow-up care. PCP-led follow-up care was considered either very (49.2%) or somewhat appropriate (30.2%). When asked about financial remuneration, 43.7% of respondents stated it was somewhat important. The factors that influenced the feasibility of PCP-led follow-up care included receipt of a detailed follow-up care plan provided by the specialist after discharge (81%), the ability to re-refer to specialists rapidly (56.3%), and the ability to obtain regular updates of best practice changes (59.5%). The preferred means of educational updates included E-mail (40.5%), continuing medical education events (30.2%), and electronic medical records (19.8%). When the fee model was taken into consideration there was no significant difference in opinions regarding follow-up care. ConclusionsTransitioning to a PCP-led model was supported by most of the PCPs who participated in this study. Their perspective on PCP-led follow up care and barriers associated with implementation of this model of care needs to be further explored with future studies that include larger sample size and a more diverse PCP population.