Patient Expectations Research Articles

The first hearing aid: are there differences in the expectations of patients treated in the public and private healthcare systems?

One of the treatments for hearing loss (HL) is the use of a Hearing Aid (HA). Evaluating expectations regarding the use of HA provides a broader perspective on HL and allows for the planning and implementation of effective rehabilitation strategies. To assess and compare the expectations of adults and older adults treated in public and private healthcare services regarding the use of HA. This study included 50 patients with HL, with 25 attended in a public health service, and 25 attended in a private service. Participants answered the Expected Consequences of Hearing Aid Ownership (ECHO). Candidates for HA use exhibited higher expectations regarding Positive Effect, that is, the benefits the device can provide in daily life. In the public service, older patients had higher expectations regarding personal image. In the private healthcare service, a significant positive correlation was observed between the Personal Image subscale and the individual's level of education. It can be concluded that expectations regarding hearing aid use were associated with healthcare service type, age, and education level.

ARE THERE RELEVANT DIFFERENCES BETWEEN EXPECTATIONS OF PATIENTS AND THEIR PARTNERS AFTER PENILE REHABILITATION PROGRAMS AFTER NERVE-SPARING PROSTATECTOMY?

ARE THERE RELEVANT DIFFERENCES BETWEEN EXPECTATIONS OF PATIENTS AND THEIR PARTNERS AFTER PENILE REHABILITATION PROGRAMS AFTER NERVE-SPARING PROSTATECTOMY?

The Role of Digital Smile Design in Enhancing Aesthetic Dentistry Outcomes

Digital Smile Design (DSD) has revolutionized aesthetic dentistry by enhancing precision, predictability, and patient satisfaction in smile makeovers. This paper explores the role of DSD in improving aesthetic outcomes through advanced digital tools and patient-centered treatment planning. DSD integrates photography, videography, and specialized software to analyze facial and dental proportions, enabling dentists to design personalized smiles that align with individual aesthetic and functional needs. The study examines the evolution of smile design techniques, highlighting the transition from traditional approaches to technology-driven workflows. It also investigates the key components and workflow of DSD, including data acquisition, digital simulation, and treatment execution. Additionally, the paper discusses the psychological and emotional impact of DSD on patients, emphasizing its role in enhancing confidence and communication between patients and practitioners. Technological advancements, such as artificial intelligence, CAD/CAM systems, and augmented reality, are evaluated for their contribution to refining DSD processes. Despite its benefits, challenges such as high costs, technical complexities, and the need for specialized training are identified as barriers to widespread adoption. Practical recommendations for integrating DSD into dental practices are provided, along with insights into overcoming existing challenges. This study concludes that DSD significantly improves aesthetic dentistry outcomes by bridging the gap between patient expectations and clinical results, while also offering a roadmap for future research and innovation in digital dentistry.

Patients' perspectives regarding antibiotic treatment for acute sinusitis in Norwegian general practice. A qualitative interview study.

The prescription rate for antibiotics for acute sinusitis in primary care remains high, despite evidence showing their limited effectiveness. GPs frequently encounter patient demands for antibiotics, which can influence their decision-making process. This study aimed to explore the help-seeking and expectations of patients experiencing symptoms of acute sinusitis, with a particular focus on their desire for antibiotics. We sought to understand why patients seek their GP for sinusitis, what kind of treatment they hope to receive, and how they perceive their influence on the GP's treatment decision. We conducted 12 semi-structured interviews with patients who had consulted their GP for acute sinusitis from various regions across Norway. The qualitative analysis was performed using systematic text condensation. We developed 3 main themes:1. 'Pain and exhaustion'- Patients primarily consulted their GP for acute sinusitis seeking medication to alleviate pain and accelerate recovery.2. 'I trust the GP, but mainly myself'- While patients expressed trust in their GPs, they also had clear expectations of receiving the specific treatment they sought. 3. 'Antibiotics works'- Most patients associated medication with antibiotics and believed they were effective against sinusitis. Patients with sinusitis primarily visited their GP to seek relief from pain and to obtain medication that they believe could speed up recovery, which often meant antibiotics. These findings suggest a continuing need for measures targeting both doctors and patients to align treatment expectations, improve adherence to clinical guidelines, and adjust patient expectations. Better pain management of sinusitis should be emphasized.

Predictive factors for adherence to intravitreal anti-vascular endothelial growth factor therapy in Palestinian patients with diabetic retinopathy, retinal vein occlusion, and age-related macular degeneration: a retrospective cohort study

BackgroundThe burden of retinal vascular and degenerative diseases on patients and healthcare systems can be significant if patients do not complete scheduled intravitreal injections. This study aimed to identify the factors that influence adherence with follow-up injections in patients with diabetic retinopathy, age-related macular degeneration, and retinal vein occlusion receiving intravitreal injections of anti-vascular endothelial growth factor treatment.MethodsThis study utilized data from patients who received intravitreal anti-vascular endothelial growth factor injections between 2022 and 2023 at An-Najah National University Hospital. Patient information, such as demographic information, number of injections administered, and details of follow-up visits, was obtained from the hospital's electronic records. When electronic records lacked certain information, patients or their relatives were contacted to provide the missing data. Data entry and analysis were performed using chi-square tests and the Statistical Package for Social Sciences. A p-value ≤ 0.05 indicated statistical significance.ResultsA total of 107 patients, 43 (40.2%) were adherent, while 64 (59.8%) were non-adherent. Sex was significantly associated with adherence (P = 0.035), with females more likely to adhere. Planned number of injections correlated with adherence (P = 0.004), as those receiving fewer injections were more adherent. Cost problems negatively impacted adherence (P = 0.016), with non-adherent patients more frequently reporting financial barriers. Positive patient expectations for vision improvement were strongly associated with adherence (P = 0.003). Mobility problems influenced adherence (P = 0.049), as those without mobility issues adhered more. Physical assistance from relatives significantly improved adherence (P = 0.036). Factors not significantly influencing adherence included comorbidities, education level, and insurance status.ConclusionOur study revealed that 60% of patients did not adhere to intravitreal anti-vascular endothelial growth factor treatment injections. Factors influencing adherence included the planned number of injections, cost problems, indication for injections, sex, need for physical assistance, and mobility problems. It is crucial to increase awareness of these factors to prevent complications such as blindness. Raising awareness could lead to improved adherence rates, better treatment outcomes, and positive impacts on patient and community health.

Consensus-Building on Patient Education for Chronic Non-Specific Low Back Pain: A Qualitative Study on Patient Physiotherapist Perspectives.

The scientific literature provides limited insights into patient education. A successful patient-therapist relationship requires active patient participation in back care and conditioning programs, which enhances exercise adherence. As an integral component of rehabilitation, patient education should be incorporated within a patient-centric, therapist-driven approach. This study explores the perspectives of patients and physiotherapists on patient education in the management of chronic non-specific low back pain in Indian settings. Semi-structured interviews were conducted with thirty-three outpatients referred to physiotherapy and online forms were obtained from twenty clinical physiotherapists. The questions investigated the expectations of the patient and the education provided by the physiotherapist. Data saturation was obtained based upon the ceiling effect achieved during data synthesis which was tailed with thematic analysis to identify categories and themes. Themes including "barriers to adherence," "perceived benefits of intervention," "emotional responses to treatment," "clinical challenges in implementation," "recommended modifications to intervention," and "patient-physiotherapist communication dynamics emerged and patients with low back pain considered high expectations from their physiotherapist in terms of education, whereas physiotherapists were providing explanation of condition and prognosis lacking in education. This study emphasised the perspectives of patients to those of physiotherapists. Physiotherapists are advantageously positioned to address the expectations of patients and provide a patient-centric education. For a better outcome on exercise adherence, patient education as an integral part of a rehabilitation programme should be designed considering the expectations of patients, encouraging education of causes, providing materials for retention of exercises and improving the patient-doctor relationship in terms of better prognosis.

Patient satisfaction and quality of life after septoplasty in adults: literature review

Background: Septoplasty is a common surgical procedure designed to correct a deviated nasal septum and relieve symptoms of nasal obstruction. While the primary goal of the surgery is to improve nasal airflow, patient satisfaction and quality of life (QoL) have become important measures of surgical success. Understanding the impact of septoplasty on QoL is essential to optimise patients’ outcomes and refine treatment approaches. Despite its widespread use, number of high-quality studies have been limited. However, in recent years there have been a growing interest in assessing its effectiveness using objective and patient-reported outcomes. Objective: The aim of this literature review is to analyse the effectiveness of septoplasty, including the impact of septoplasty on patient satisfaction and quality of life, and to assess predictors of surgical success. State of knowledge: Septoplasty is a surgical procedure aimed at correcting a deviated nasal septum to improve nasal airflow and relieve obstruction. Recent studies show, that septoplasty leads to significant improvement in nasal breathing, sleep quality, daily functioning, mental state and olfactory function. Psychological factors, preoperative expectations and degree of nasal deviation have been identified as key determinants of surgical outcome. Conclusion: Septoplasty is an effective procedure that leads to significant improvements in quality of life and general satisfaction from surgery. Several factors have been identified that influence surgical outcome including patient mental state, patient expectation, severity of septal deviation and surgical technique. To optimise results, surgeons should focus on refining surgical techniques, patient selection and management of patients’ expectations.

Cellulite – Etiology, Epidemiology and Management

Cellulite is a common dermatologic condition affecting 80-90% of post-pubertal females, particularly on the thighs, buttocks, and hips. It is characterized by dimpling and a "mattress-like" skin appearance, significantly impacting body image and quality of life. More prevalent in Caucasian women, it results from multifactorial causes, including hormonal influences (e.g., estrogen), structural differences in subcutaneous tissues, vascular changes, and low-grade inflammation. Lifestyle and aging further contribute to its severity. Treatments range from topical applications and energy-based devices to minimally invasive procedures, though results are often temporary. Due to its complex etiopathogenesis and structural changes, cellulite remains challenging to treat, necessitating realistic patient expectations and further research for improved and lasting solutions.

Comparative Outcomes of Percutaneous Plantar Fascia Release, Calcaneal Drilling, and Calcaneal Spur Removal versus ESWT in the Treatment of Plantar Fasciitis

This study aimed to compare the clinical outcomes of percutaneous plantar fascia release, calcaneal drilling, and calcaneal spur excision with extracorporeal shock wave therapy (ESWT) in patients with plantar fasciitis resistant to conservative treatment. A total of 52 patients diagnosed with plantar fasciitis and unresponsive to at least six months of conservative therapy between January 2021 and December 2024 were retrospectively analyzed. Patients were divided into two groups: minimally invasive surgery (n = 18) and extracorporeal shock wave therapy (ESWT) (n = 34). Demographic data, symptom duration, standing time at work, return-to-work time, complications, and clinical outcomes were compared using the Visual Analog Scale (VAS), the American Orthopaedic Foot & Ankle Society (AOFAS) score, and the Roles & Maudsley (RM) score. There were no significant differences between the groups in terms of age, gender, body mass index (BMI), symptom duration, or standing time at work (p > 0.05). Return-to-work time was significantly longer in the minimally invasive surgery group (13.8 ± 4.5 vs. 4.3 ± 2.8 days, p = 0.001). While both groups showed comparable clinical improvement at the 6-month follow-up, VAS and AOFAS scores were better maintained in the surgical group at 12 months. In contrast, a decline was observed in the ESWT group (p = 0.001 and p = 0.012). Complication rates were similar between the groups (p = 0.99). Minimally invasive surgery provided more sustainable long-term clinical improvement. On the other hand, ESWT offered a predictable short-term cost advantage and enabled earlier return to work. Considering patient expectations and ease of application, ESWT appears to be an effective and practical treatment option that should be considered before proceeding with minimally invasive surgical interventions.

Exploring the diverse nanomaterials employed in dental prosthesis and implant techniques: An overview

Abstract The landscape of prosthodontics and dental implantology is undergoing a transformative evolution, driven by remarkable advancements in materials science. This review explores the pivotal role of multifaceted materials, ceramics, polymers, metal alloys, and composites in revolutionizing dental restorative procedures. These materials are not only enhancing the mechanical properties and biocompatibility of dental prostheses and implants but also elevating aesthetic outcomes to meet patient expectations. Our discussion highlights how traditional materials like titanium (Ti) and cobalt-chromium (Co–Cr), alongside newer innovations such as zirconia and polymer-based composites, contribute to the restoration and enhancement of oral functions. Furthermore, this article delves into the integration of cutting-edge technologies such as 3D printing and computer-aided design/manufacturing, which synergize with these advanced materials to tailor dental solutions to individual patient needs, thereby improving both functional outcomes and patient satisfaction. As the field progresses, we anticipate future innovations to focus on increasing the sustainability of materials used, refining their properties through nanotechnology, and further personalizing dental care through digital workflows, setting a new standard in the interdisciplinary approach of modern dentistry.

Pharmacological approaches and physical restraint in dental care for individuals with intellectual and neurodevelopmental disabilities and challenging behaviour: a scoping review of patients' and caregivers' experiences.

There is controversy and debate around the use of pharmacological and physical dental behaviour support techniques amongst practitioners treating patients with challenging behaviour and intellectual and neurodevelopmental disabilities. However, the experiences of patients and caregivers remain underexplored. This scoping review aimed to identify the experience of patients with intellectual and neurodevelopemental disabilities and challenging behaviour and their caregivers regarding the use of physical and pharmacological procedures during dental care. A scoping review was conducted, incorporating evidence from both quantitative and qualitative study designs to clarify concepts and identify gaps in the literature, using all the main medical databases. From 1575 screened records, 13 studies were included. Ten were quantitative or mixed-method studies focusing on the acceptance of behaviour support techniques from the caregiver's perspective, particularly for children with special needs. Seven studies were from the Americas, none from Europe or Africa. Two major themes emerged: validity of consent; and the acceptance of different dental behaviour support techniques by parents and caregivers. The most acceptable techniques for parents and caregivers were non-invasive, behaviour based support techniques. When these failed, physical support techniques seemed to be more acceptable than pharmacological approaches (sedation or general anaesthesia), although this may be related to cultural context and/or lack of financial support. No studies reported the patient perspective of behaviour support techniques so no conclusions can be drawn as to which techniques are acceptable from the patient's point of view. Further qualitative studies are essential to explore the experiences and expectations of patients with special dental care needs.

Physician Leadership Is a Global Phenomenon

Historically, the medical profession’s evolution has already passed through many phases of maturation, and clearly, we are in the midst of another major transformation. These evolutionary phases included not only medical science and technology, but also shifting approaches to patient interactions and expectations of society. They have always included the potential for cross-cultural collaboration and learning. Continent by continent and country by country, there are significant differences and preferences in the medical profession, but in today’s world, there is wonderful opportunity to leverage these differences for the betterment of our industry through physician leadership.

The fate of hemiepiphysiodesis implants left in place after skeletal maturity in patients with idiopathic genu valgum.

Hemiepiphysiodesis using tension band plate and screws is a frequently used technique for the correction of lower extremity angular deformities. These implants are often left in place if patients have corrected their alignment on reaching skeletal maturity. There is little information regarding the rate of and reasons for subsequent removal of these deep implants. This retrospective case-control study included patients treated with hemiepiphysiodesis with tension band plate and screws at the distal femur and/or proximal tibia for idiopathic genu valgum and reached skeletal maturity with implants retained. Electronic medical records and radiographs were reviewed for patient characteristics and the need for subsequent removal of implants. Those who had implants removed were compared to those with implants not removed using Student's t-test for continuous variables and chi-square for categorical variables. Forty-six patients met inclusion criteria. Twenty-five of 46 patients (54%) underwent subsequent removal of deep implants, and all cases were due to symptoms related to the plate and screws. Factors associated with removal of deep implants included multiple vs. single rounds of hemiepiphysiodesis (76% vs. 43%, P = 0.02) and plates at the distal medial femur alone (P = 0.004). There were no differences between groups regarding sex, age at hemiepiphysiodesis, height, weight, and BMI. In conclusion, after skeletal maturity, there was a 54% rate of removal of symptomatic hemiepiphysiodesis implants. Factors associated with implant removal include repeat hemiepiphysiodesis and isolated distal medial femur plate position. This information can be used to guide patient and provider expectations as patients transition to adulthood.

Degree and Timing of Sensory Return Following Nipple-Areolar Complex Neurotization During Nipple-Sparing Mastectomy.

Traditional expectations around sensation following nipple-sparing mastectomy include significant or often complete sensory loss of the nipple-areolar complex. Nipple neurotization at the time of mastectomy has proven promising in restoring sensation to the area postoperatively. However, minimal data are available on the degree and timing of sensory return following neurotization. Forty-seven patients (representing 94 breasts) underwent nipple-sparing mastectomy (NSM) with direct-to-implant, prepectoral reconstruction. During the mastectomy, branches of the T4 and T5 lateral intercostal nerves were identified and dissected to preserve length before transection was required oncologically to complete the mastectomy. The nerves were then reconstructed using a nerve allograft or autograft with coaptation to an identified subareolar nerve. Neurosensory testing with a pressure-specified sensory device was performed at several time points postoperatively to quantify return of sensibility. Patients were also given modified BREAST-Q questionnaires at similar time points to assess their perception of sensation return. Nipple sensation decreased markedly in the early months after mastectomy and then slowly returned to baseline by 1 year postoperatively, with 74% of patients achieving pressure-specified sensory device results in the excellent range by 12-month testing. Overall, patients having bilateral risk-reducing mastectomy achieved higher rates of nipple sensory return at 1 year than those having mastectomies as part of cancer treatment. On patient-reported outcomes, 53% of patients reported having a lot or some nipple sensation by 6 months postoperatively, which increased to 70% by 1 year. Ninety-two percent of patients reported responsiveness to touch in their nipples at the 12-month postoperative time point. Nipple-areolar complex neurotization allows for return to baseline nipple sensation on quantitative testing by 1 year postoperatively for the vast majority of patients undergoing the procedure. Similar results are seen for patient-reported outcomes on overall nipple sensation and responsiveness to touch. As adoption of sensation preserving mastectomy techniques becomes more widespread, further investigation into optimal assessment tools and protocols will continue to improve understanding of outcomes and help with patient expectation setting.

Low rate of secondary interventions for post-traumatic osteoarthritis and satisfactory mid-to-long-term outcomes following tibial plateau fractures

BackgroundThe purpose of this study was to quantify the incidence of total knee arthroplasty (TKA) and other osteoarthritis-related procedures following surgical and conservative treatment of tibial plateau fractures (TPF). Secondary goal was to analyse the long-term clinical outcomes and identify risk factors for secondary interventions and poor outcomes.MethodsAll patients diagnosed with TPF at a single level 1 university trauma centre between January 1, 2008 and December 31, 2016 were retrospectively reviewed. Clinical outcomes were measured by use of the Knee injury and Osteoarthritis Outcome Score (KOOS), the International Knee Documentation Committee Score (IKDC) and the Tegner Activity Score (TAS). Joint-preserving interventions and conversions to TKA were recorded as well as demographic data, injury mechanisms, treatment specifics and complications.Results105 cases of TPF, 89 with surgical and 16 with conservative treatment, with a median follow-up of 10.4 years (interquartile range, IQR 9–13), were included. The conversion rate to TKA was 2%, with all cases occurring in the conservative treatment group. 9% underwent a joint-preserving intervention. Higher body mass index (BMI) was associated with an increased risk for secondary intervention (HR 1.4, p = 0.03). The overall KOOS was 78.7 (IQR 69–87) for surgical and 86 (IQR 70–93) for conservative treatment. The IKDC score was 63.6 ± 16.5 for surgical and 66.3 ± 22.2 for conservative treatment and the median TAS was 3 (IQR 3–4 vs. 3–6) for both groups. In the surgical treatment cohort, a negative correlation was found between Schatzker classification (Spearman´s rp = -0.24, p = 0.03), duration of surgery (Spearman´s rp = -0.23, p = 0.03), American Society of Anesthesiologists (ASA) risk classification (Spearman´s rp = -0.28, p = 0.01) and the IKDC score. A higher TAS was observed for non-smokers (median 3, IQR 3–4) compared to smokers (median 2.5, IQR 2–3, p = 0.02).ConclusionsThere was a low incidence of TKA and joint-preserving, osteoarthritis-related procedures following TPF. Both conservative and surgical treatments can achieve satisfactory long-term clinical outcomes, when appropriately indicated. Obese patients are at increased risk for secondary interventions. The expectations of patients with a higher ASA risk score and complex fractures, accompanied by longer surgical times, should be managed carefully to ensure a realistic outlook on functional outcomes.

Expectation fulfillment is associated with good outcomes and patient satisfaction after knee arthroplasty: a prospective study in a multi-ethnic Asian population

We aimed to evaluate the relationship between patient expectations and outcomes after knee arthroplasty (KA) in an Asian population in Singapore. We recruited consecutive patients with severe knee osteoarthritis (KOA) scheduled for KA. Pre-operatively, patients provided socio-demographic data and completed the Hospital for Special Surgery Knee Replacement Expectations Survey (HSS-KRES) for baseline pre-operative expectations and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for baseline pain and function. Telephone interviews were conducted at 6- and 12-months post-operatively to collect the WOMAC, satisfaction with KA, and the extent to which pre-operative expectations had been fulfilled. We included 1136 patients (mean age 65.9 years, 69.9% female), of which 1103 and 1089 completed the telephone interviews at 6- and 12-months post-KA respectively. In the multivariable models, expectation fulfilment was consistently associated with improvements in WOMAC pain and function at 6- and 12-months post-operatively, but not the baseline expectations. In the sensitivity analyses, expectation fulfilment was also found to be significantly associated with the achievement of minimal clinically important difference (MCID) for WOMAC pain and function at both 6- and 12-months. Expectation fulfilment was associated with patient satisfaction in the adjustment models at both 6- and 12-months after KA. The fulfilment of expectations, rather than pre-operative expectations, is associated with improvements in WOMAC pain, function and overall satisfaction at 6- and 12-months after KA.

Recovery Trajectories After Lumbar Fusion Stratified by Baseline Patient-Reported Outcomes Measurement Information System Physical Function Disability Levels.

Previous studies have identified patient and surgical factors associated with patient-reported outcomes measurement information system (PROMIS)-physical function (PF) minimal clinically important difference (MCID) rates after lumbar fusion, but investigation into the timing of MCID achievement remains limited. This study aimed to assess whether time to MCID achievement differed across patients presenting with mild, moderate, or severe disability as measured using the PROMIS-PF instrument. A retrospective review of 144 patients undergoing 1- to 3-level lumbar fusion from 2020 to 2023 was performed. All patients completed PROMIS-PF surveys at baseline and 1 year postoperatively. Patients were classified as mild (PROMIS-PF > 40), moderate (30-40), or severe (<30) disability based on baseline PROMIS-PF T-scores. MCID achievement rates and time to MCID were compared across groups using univariate and multivariate analyses. Multivariate Cox proportional hazard models were used to assess the relationship between baseline disability and MCID achievement rates over time. Twenty (13.9%) patients presented with mild disability, 92 (63.9%) with moderate disability, and 32 (22.2%) with severe disability. The overall rate of 1-year postoperative MCID achievement was 59%. After adjusting for American Society of Anesthesiologists scores and Charlson Comorbidity Index, severe baseline disability was associated with increased odds of early MCID achievement (<90 days; OR = 2.95, P = 0.015) and shorter days to MCID achievement. In the adjusted Cox models, patients with severe baseline disability demonstrated increased MCID achievement at any time over the 1-year postoperative period when compared with the mild disability (HR = 3.52, P = 0.005) and moderate disability (HR = 1.85, P = 0.020) groups. Patients presenting with severe disability were more likely to achieve clinically significant improvements in function across time points during the 1-year postoperative period. Furthermore, these patients demonstrated higher rates of early MCID achievement and less time to MCID than those with moderate or mild baseline disability. Utilization of PROMIS-PF may assist with preoperative patient selection and expectation setting. In the clinical setting, establishing realistic recovery expectations is a critical aspect of the surgeon-patient relationship. The data presented in the current study may be used in preoperative consultations to provide patients with a depiction of their potential improvement in physical function over time based on their baseline level of function. Postoperatively, the data may serve as a benchmark for assessing an individual's recovery trajectory compared to historically similar patients.

Optimizing supply chain efficiency in healthcare using predictive modeling and data analytics

The increasing complexity of healthcare delivery systems, combined with rising patient expectations and global supply chain vulnerabilities, has amplified the urgency to optimize healthcare supply chain management (SCM). Predictive analytics, with its ability to anticipate demand, manage uncertainties, and inform strategic decisions, presents a transformative opportunity for healthcare logistics. This paper explores the foundational concepts of predictive modeling in healthcare SCM, reviews current applications and case studies from global contexts, and identifies key limitations such as data fragmentation, lack of real-time interoperability, and ethical concerns. To address these gaps, a novel Predictive Analytics-Driven Healthcare Supply Chain Optimization (PAD-HSCO) model is proposed, integrating machine learning, real-time data processing, and decision support systems into a cohesive framework. The model is designed to enhance forecasting accuracy, procurement efficiency, and system resilience, particularly in crisis-prone and resource-constrained environments. The study concludes with a discussion on implementation challenges, ethical considerations, and future research directions, underscoring the need for interdisciplinary collaboration to harness predictive analytics in building more sustainable, adaptive, and patient-centric healthcare supply chains.

"How long until I am seen, doc?" Modelling paediatric emergency department waiting times to make personalised predictions.

ED patient wait times have been progressively increasing leading to patient dissatisfaction in ED. Managing patient expectations towards wait times in ED may be more effective at decreasing dissatisfaction than shortening actual wait times. Models for predicting wait times have been made for general EDs but not for solely paediatric departments. We aimed to create a model that could predict the personalised wait time of a child presenting to paediatric ED after triage. This was a single-centre retrospective study analysing all ED attendances to the Bristol Royal Hospital for Children between 1 January 2022 and 31 December 2022. From anonymised routinely collected administrative data, we created a multiple linear regression model to predict wait times. We developed the model by randomly assigning 80% of the data to a training set and used the remaining 20% as a validation set to assess the accuracy of our model. CIs were calculated using 500 bootstrap iterations sampled from the validation set. Understanding that patients are satisfied being seen sooner than their predicted wait time, we considered the result to be unsuccessful if their actual wait time was 30 min over their predicted wait time. From 40 828 ED presentations, the median patient wait time was 65 min (IQR 34-122). Our model was able to predict wait times for 84.2% (95% CI 83.42% to 84.91%) of attendances successfully. Triage category, number of patients waiting, number of patients in the department, time of presentation, length of wait of last patient and day of week all had a significant impact on prediction of wait times (all p<0.001). Tailored models created using routine data can be used to give individualised predictions for wait times in paediatric ED, which could be given to patients with the aim of managing expectations and improving patient satisfaction.

Shortened Dental Arch Concept and Its Effect on Oral Health-Related Quality of Life

&amp;lt;i&amp;gt;Purpose: &amp;lt;/i&amp;gt;This review aimed to synthesize knowledge from the dental literature regarding the effects of the shortened dental arch (SDA) concept on patients&amp;apos; oral health-related quality of life (OHRQoL). &amp;lt;i&amp;gt;Materials and Methods: &amp;lt;/i&amp;gt;A comprehensive search of English-language, peer-reviewed literature on the SDA was conducted using the Medline (PubMed), Embase (OVID), Scopus, and Google Scholar databases. Studies that evaluated oral health-related quality of life as an outcome were critically appraised.&amp;lt;i&amp;gt;Results: &amp;lt;/i&amp;gt;The literature reviewed indicates that patients with SDAs do not exhibit a statistically significant difference in overall OHRQoL scores compared to other study groups. &amp;lt;i&amp;gt;Conclusion: &amp;lt;/i&amp;gt;When determining the most appropriate prosthodontic treatment for partially edentulous patients, it is essential to consider patient expectations and preferences. A fully rehabilitated dental arch does not always guarantee a successful outcome. Modern treatment approaches should prioritize function, patient satisfaction, and overall well-being rather than solely focusing on complete dentition restoration. The SDA concept offers significant advantages and may serve as a viable alternative to reduce the need for extensive restorative treatment in the posterior regions of the mouth.