Preferred Delivery Method Research Articles

Enhancing Reliability of Report Delivery through IT and Process Improvement

For JDMI partner hospitals (UHN, SHS, WCH), all diagnostic imaging reports are electronically transmitted to the organization’s Hospital Information System (HIS), which each affiliated physician has access to. Prior to April 2017, imaging reports were also delivered according to the physician’s preferred delivery method, either by FAX or MAIL. JDMI encountered numerous privacy and patient care incidents as a result of various issues related to faxing reports to physicians. To prevent future incidents from occurring with faxing, JDMI stopped its faxing service to internal physicians.

Changing rates of the modes of delivery over the decades (1976, 1986, 1996, 2006, and 2016) based on the Robson-10 group classification system in a single tertiary health care center

Aim To identify the underlying factors that may affect the changing rates of modes of delivery over the decades based on Robson-10 group classification system (TGCS) in a single tertiary health care center. Materials and methods This study included data from 10,458 deliveries in 1976, 1986, 1996, 2006, and 2016 with fetuses more than or equal to 500 g at the Department of Obstetrics and Gynecology at Hacettepe University Hospital. Patient characteristics and the mode of delivery were evaluated according to the TGCS. Results The cesarean section (CS) rates were 11.4% (304/2668), 19.2% (459/2393), 44.7% (783/1751), 69.3% (1213/1751), and 77.9% (1477/1895) in 1976, 1986, 1996, 2006, and 2016, respectively. CS has become the preferred method of delivery for multiple pregnancies and breech presentations over the years. TGCS Group 5 was the greatest contributor to increased CS ratios. Relative contributions of TGCS Groups 1 and 3 were decreased and relative contributions of Groups 2 and 4 were increased. Operative vaginal deliveries decreased over the years. Conclusion In conclusion, effective management of labor induction, choosing vaginal delivery for appropriate breech presentations and multifetal pregnancies, proper education of obstetricians for operative vaginal delivery and objective evaluation of labor dystocia might be key points in CS rate debates.

Needs assessment for cooperative extension dairy programs in California

The present study aimed to identify dairy producer needs and how best to direct and deliver cooperative extension (CE) programming. In March 2017, we mailed a needs assessment survey to grade A dairy producers in California (n = 1,080). The response rate was 15.4% (n = 166) and herd size averaged 1,405 milking cows (range 83-5,500). The geographic distribution of survey responses was representative of the distribution of dairies throughout the state. Producers were asked to indicate the level of concern for a predetermined list of 11 issues. Rank of concern had 3 numeric levels: (1) very concerned, (2) somewhat concerned, or (3) not concerned. Mean and percentage of responses in each rank for each issue topic were calculated. The top 5 concerns/obstacles indicated were (1) milk price, (2) labor availability/quality, (3) environmental issues/regulations, (4) labor costs, and (5) water quality/availability. Surveyed respondents were also asked to determine the level of priority of a predetermined list of 13 CE research and educational opportunities. Producers ranked topics as low, medium, or high priority. The 5 highest priority research topics were (1) herd health, (2) environmental issues, (3) reproduction, (4) milk quality, and (5) water quality. The 5 highest priority educational topics were (1) herd health, (2) milk quality, (3) reproduction, (4) environmental issues, and (5) calf and heifer management. Producers were then asked to identify the target audience for CE information delivery and preferred information delivery method. Most respondents indicated that the target audience should be dairy owners (93%) or managers (66%). Fewer producers indicated a target audience of dairy employees (27%) or allied industry (23%). Preferable information delivery methods were newsletter or magazine articles (81%), half-day/short meetings (47%), and on-farm training/meetings (39%). Webinars and 2- or 3-d destination meetings were the least preferable methods (27 and 9%, respectively). Survey results will serve to develop future dairy cooperative extension programs in California.

The Interdependence of Motor and Social Skill Development: Influence on Participation.

Participation is a major outcome area for physical therapists serving young children with disabilities. Contemporary models of disability such as the International Classification of Function, developmental theories such as the system perspective, and evidence-based early childhood practices recognize the interdependence of developmental domains, and suggest that change in 1 area of development influences change in another. Physical therapy provided in naturally occurring activities and routines, considered the preferred service delivery method, promotes participation of young children with disabilities. Research indicates that: (1) children develop skills, become independent, and form relationships through participation; and (2) with developing skills, children can increasingly participate. The purpose of this Perspective article is to synthesize the literature examining the relationship between motor skill development and the social interaction dimension of participation in young children. Current research examining the influence of motor skill development on social interactions in children with autism spectrum disorder will be discussed, exemplifying the interdependence of developmental domains. Implications for physical therapist practice and recommendations for future research are provided.

Real Time Sonography as an anatomy teaching aid in undergraduate radiography institutions in Northern Nigeria.

Real-time ultrasound scanning is increasing in popularity as a teaching tool for human anatomy because it is non-invasive, offers real-time 3-D anatomy and is cheaper than dissections. To assess real-time ultrasound scanning as a teaching method of human anatomy, and to determine what teaching methods radiography students consider effective for understanding human anatomy. One hundred and ten self-administered, structured and pre-tested questionnaires were distributed to Clinical Radiography students (Third, fourth and fifth year)in Northern Nigeria featuring University of Maiduguri and Bayero University Kano. The questionnaire consists of two sections;Demographics and preferred methods of delivery of anatomical information. Participation was voluntary. Comparisons among teaching methods were made using repeated measures ANOVA. A significant difference among the eight delivery methods with 3-D Radiology imaging being as the most preferred method overall (48.17, p<0.0001) and ultrasound the least (32.48, p<0.0001). With Duncan's multiple Range test, it is clearly shown that 3-D Radiology imaging differ with mean value(5.2522) followed by Computer programs(5.1292), Anatomic models( 4.7593), Laboratory videos(4.5815), textbooks(4.5358), animal dissection(4.2568), lectures(3.2568) and finally ultrasound scan (3.6087), (P<0.0001). 3-D Radiology imaging is the most preferred method of delivering anatomical information and ultrasound scanning is the least preferred method.

Knowledge of Legal Protections and Employment-Related Resources Among Young Adults with Cancer.

Purpose: Young adults (aged 18-39 years) who have received a cancer diagnosis can encounter significant barriers in their transition to employment. American young adults' familiarity with federal legislation and resources related to employment is unclear. The study questions included: (1) To what extent do young adults who have had a cancer diagnosis know about legal and programmatic supports that may help to address their employment-related needs and (2) What modes of receiving information about resources to address their employment-related concerns do young adults who have had a cancer diagnosis prefer? Methods: A cross-sectional online survey was conducted with a convenience sample composed of 203 young adults living in the United States, had a cancer diagnosis other than nonmelanoma skin cancer, and were between 18 and 39 years of age. Over half (57.6%) of respondents received a cancer diagnosis at age 24 years or older. The mean age at participation was 30.4. Results: More than half of the sample (57.0%) was familiar with the Americans with Disabilities Act yet many did not know that cancer was a covered condition. Almost 80% of the respondents were not familiar with other federal initiatives with employment protections for people with cancer. Participants preferred in-person trainings and resource fact sheets as the presentation channels, although sociodemographic factors such as employment status were related to preferred delivery methods. Conclusion: These young adults would benefit from additional outreach around federal guidelines concerning employment-related rights and services and programs applicable to young adult cancer survivors.

THE RELATIONSHIP OF DELIVERY METHOD, BIRTH WEIGHT AND RACE ON INFANT MORTALITY [Kennesaw State University

Infant mortality is defined as the number of deaths per 1000 births. The U.S. infant mortality rate in 2014 was reported as 5.8 which is very high compared to other countries such as Japan where the rate 2.1. It is known that infant mortality is a huge problem, but the challenge right now is finding ways to solve this issue. My research aims to see what factors influence infant mortality to see how it can be reduced. I also wanted to learn about which groups are most vulnerable to experiencing high infant death rates. The purpose of this research is to find out how factors such as delivery method, birth weight, and race affect infant mortality to determine how these factors lead to the reduction of mortality rates. I wanted to see if there is a preferred delivery method for small infants compared to larger infants. To evaluate this, I analyzed 2007-2016 U.S. infant mortality data from the CDC and created bar charts relating race, birth weight, and delivery method to the death rate. I found out that the vaginal delivery method has the lower death rate compared to the C-section delivery method, that American Indians who were born through C-sections have the highest death rate out of all the other races and delivery methods, that the death rate is lower for small infants when they are delivered through the C-section method and that it is preferable to deliver larger infants through the vaginal method since the death rate would be lower. These results can serve as then beginning of a more comprehensive look into infant mortality.

Education provision for patients following a spinal cord injury.

approximately 40 000 people in the UK live with spinal cord injury. to explore the views of patients and healthcare staff relating to the specialist education and information provided following a spinal cord injury. a service evaluation consisting of questionnaire surveys distributed to patients and staff at the London Spinal Cord Injury Centre. of the healthcare staff who responded, 98% found giving education an enjoyable part of their role with most agreeing (45/48) that it is the responsibility of all healthcare staff. The formal education programme was valued by patients. Sessions were graded to inform the development of future programmes. Face to face was the preferred delivery method for 80% of inpatients and 40% of outpatients, with the second most preferred method being an app/e-learning for both patient groups. findings support the continued need for both formal and informal sessions, provided by all members of the healthcare team, with particular emphasis on issues such as bladder and bowel management and sexual function following discharge.

Undergraduate radiology education: foundation doctors' experiences and preferences

To assess foundation doctors' experiences of undergraduate radiology teaching within the UK and preferences for radiology teaching delivery. This was a retrospective multicentre study of foundation doctors. A questionnaire, designed using the Royal College of Radiologists Undergraduate Radiology Curriculum, was completed to determine how prepared foundation doctors felt in image interpretation by their undergraduate teaching. For this, agreement with statements was graded using a five-point Likert scale. Open and closed questions were used to assess preferences for teaching delivery. The study involved 150 foundation doctors from 29 medical schools. The majority "strongly agreed" or "agreed" that undergraduate training gave them confidence in interpreting most basic chest and abdominal radiographs. Confidence was less for skeletal radiographs and trauma computed tomography (CT). Seventy-seven percent wished they had had more radiology teaching. The three most important topics to be included in teaching were chest radiograph, CT, and abdominal radiograph interpretation. Small group teaching and integration into clinical teaching received the highest number of votes for preferred teaching delivery method. Ninety-two percent felt radiologists were best suited to deliver teaching. In general, foundation doctors felt undergraduate teaching prepared them well for chest and abdominal radiograph interpretation, but less so for skeletal radiography and CT. The majority felt more undergraduate radiology teaching would be beneficial, and that this should be delivered by radiologists in either small group sessions or integrated into clinical teaching.

Exodus From the Classroom: Student Perceptions, Lecture Capture Technology, and the Inception of On-Demand Preclinical Medical Education.

Some medical educators have noted a decline in classroom attendance. Understanding student preferences for content delivery and the relationship between student attendance and learning outcomes may enhance curricular design and best practices for technology-supported learning. To measure the attendance of first-year osteopathic medical students, evaluate the relationship between classroom attendance and aggregate mean course grades, and characterize factors that influence attendance decisions when recorded lectures are available. In nonmandatory class sessions during the 2015-2016 academic year, student attendance data were collected using audience response technology and were linked to course grades. Pearson product moment and partial correlations, controlling for Medical College Admissions Test scores, were calculated to quantify the relationship between classroom attendance and aggregate mean course grades. Students were surveyed to characterize factors influencing attendance decisions and compare the perceived convenience, efficiency, and effectiveness of classroom attendance vs lecture capture technology. The preferred modality for receiving didactic content was assessed, and open-ended questions were included about the advantages or disadvantages of lecture capture, classroom attendance, and podcasts. Responses were analyzed using open and axial coding. A 78% reduction in first-year student classroom attendance was measured from the beginning to the end of the academic year (P<.001). The correlation between classroom attendance and aggregate mean course grades (r=0.17; P=.29) and the partial correlation between them after controlling for admission test scores (r=0.18; P=.08) were not significant, except in the Neuromusculoskeletal A course (r=0.22; P=.027). Students regarded lecture capture recordings as more convenient, efficient, and effective than classroom attendance, and podcasting was the preferred method of content delivery. Major themes associated with the open-ended questions were effective or ineffective time management, enhanced interaction, learning advantages or challenges, and positive or negative content characteristics. First-year classroom attendance decreased significantly during the academic year, but the authors found no significant relationship between attendance and aggregate mean course grades. Students regarded lecture capture recordings as a practical alternative to attending class; however, podcasts were the preferred modality for receiving didactic content. These findings may help in developing learning-centered curricula at colleges of osteopathic medicine.

The preferences of physiotherapy clinical educators on a learning package for teaching musculoskeletal clinical prediction rules – A qualitative study

BackgroundThere is a growing number of clinical prediction rules (CPRs) relevant to physiotherapy, particularly in the musculoskeletal area, but many students are not learning about them due to lack of awareness or understanding by clinical educators. An educational package specifically designed for physiotherapy clinical educators would aid their understanding of CPRs and ability to utilise them clinically, and also to be able to teach them to students. ObjectivesTo determine the desired content and preferred methods of delivery of an educational package for clinical educators on musculoskeletal CPRs. DesignA qualitative descriptive approach using semi-structured group and individual interviews with clinical educators. MethodEducators working in the clinical area of musculoskeletal physiotherapy who had an awareness of or interest in CPRs were recruited and interviewed on their views regarding the content and delivery of an educational package on musculoskeletal CPRs. Audio files were transcribed and analysed using framework analysis to explore and develop themes and subthemes. FindingsContent of an educational package should include general information on CPRs to improve familiarity and understanding, including a brief description, purpose, stages of development, application, limitations, and Information to dispel common myths and misunderstandings, as well as some specific examples of commonly-used CPRs. The package should be available in multiple formats to allow for different learning styles, both online via video, webinars, and podcasts, and face-to-face in practical sessions. ConclusionsClinical educators would find an educational package useful in assisting them to learn about musculoskeletal CPRs and to teach them to students.

Start-to-Finish Techniques Regarding the Practicalities of Producing Purposeful and Impactful Webinars

Webinar production has steadily increased as a preferred method of information delivery for Extension professionals. Our objective with this article is to offer practical guidance from Utah State University (USU) Forestry Extension and the eXtension Foundation that can help others generate impactful webinar programs. From January 2016 to August 2018, USU and eXtension were involved in the production of a combined total of over 300 webinars. We used the resulting knowledge to create a set of practical guidelines to assist other professionals interested in producing and delivering effective webinars.

Hispanic Students' Perceptions About HIV/STI Testing and Prevention: A Mixed-Methods Study in a Hispanic-Serving University.

Hispanic young adults in the United States are disproportionately affected by HIV and should be considered a priority for prevention efforts. The purpose of this study was to explore perceptions and beliefs of English-speaking students (aged 18-24 years) at a Hispanic-serving university about HIV/sexually transmitted infection (STI) testing and prevention to increase acceptance and adoption of services. Four major themes emerged from four qualitative focus groups (n = 30 students) and were corroborated by an optional anonymous survey (n = 24 surveys): (a) preferences for HIV/STI testing services, (b) essential HIV/STI testing information, (c) preferred delivery method of HIV/STI testing information, and (d) culturally appropriate message design with Hispanic young adults. Findings suggest that Hispanic young adults perceive accessible testing to be important to their community and view normalization of these services as a necessary component of successful adoption and adherence. Although flyers were reported as a practical means for distributing on-campus testing and service information, social media was endorsed as one of the most effective ways to reach young adults. Among participants, there was less consensus regarding the need for cultural tailoring. Results provide practical insights into the development and application of health promotion strategies with an ethnic minority group and demonstrate how a mixed-methods approach can be employed to inform health promotional efforts.

Prenatal care and labor in patients with mesenchimal dysplasias (Marfan syndrome, Ehlers–Danlos syndrome, hereditary hemorrhagic telangiectasia)

Background: Mesenchymal dysplasias or inherited connective tissue diseases are the group of diseases with deficiency of various components of connective tissue. Connective tissue disorders can affect different organs: skeleton, sight organ, skin, lungs, heart. But the most dangerous is vascular wall insufficiency leading to high risk of hemorrhage, especially during pregnancy and delivery due to hemodynamic and hormonal effects on the walls of the modified vessels.Aim: To evaluate the risk of complications during the pregnancy and delivery in patients with mesenchymal dysplasias.Study design: Fifty-six pregnancies in patients with mesenchymal dysplasias, including subclinical forms of diseases: 23 with Marfan syndrome (I group), 22 with Ehlers–Danlos syndrome (II group), and 11 with Osler–Weber–Rendu syndrome (hereditary hemorrhagic telangiectasia) (III group) of the age from 18 to 36. The study included retrospective analysis (for the period from 1993 to 2005) and prospective study. Results of study showed high risk of life-threatening complications during pregnancy and delivery, especially the risk of hemorrhage and cardiovascular complications. In all the patients, we observed the progression of bleeding or development of bleeding in new localizations (epistaxis in 27 patients, easy brushing in 22, skin and mucosa telangiectasia in 20, gastrointestinal bleedings in 4, hemoptysis in 4, hematomas for minor traumas in 14, conjunctivas hemorrhages in 5).Conclusion: The pathogenesis of bleeding in such patients has mixed pattern: besides vascular wall pathology coagulation deficiency plays some role. The preferred delivery method for such patients is caesarean section. Deep vaginal ruptures and serious hemorrhage accompany vaginal delivery.

Clinical research coordinators' instructional preferences for competency content delivery.

A lack of standardized clinical research coordinator (CRC) training programs requires determining appropriate approaches for content delivery. The purpose of this study was to assess CRCs preferred training delivery methods related to the 8 designated Joint Task Force Clinical Trial Competency domains. Repeated measures analysis of variance and split-plot analysis of variance were adopted to compare the group means among 5 training delivery methods by 8 competency content domains and to examine whether demographic variables caused different preference patterns on the training delivery methods. Participants reported a preference for online video; mentoring/coaching was the least preferred. Significant training delivery method preferences were reported for 3 content domains: participant safety considerations, medicines development and regulation, and clinical trials operations. Observed statistical differences in the training delivery methods by the content domains provides guidance for program development. Ensuring that standardized educational training is aligned with the needs of adult learners may help ensure that CRCs are appropriately prepared for the workforce.

Mobile applications in government services (mG-App) from user's perspectives: A predictive modelling approach

Mobile applications are becoming a preferred delivery method for the government sector and contributing to more convenient and timely services to citizens. This study examines the intention to use mobile applications for the government services (mG-App) in Oman. This study extended the Unified Theory of Acceptance and Use of Technology (UTAUT) model by including two constructs namely trust and information quality. Data were collected from 513 mobile application users across Oman. The research model was analysed in two stages. First, structural equation modelling (SEM) was employed to determine significant determinants affecting users' acceptance of mG-App. In the second stage, a neural network model was used to validate SEM results and determine the relative importance of determinants of acceptance of mG-App. The findings revealed that trust and performance expectancy are the strongest determinants influencing the acceptance of mG-App. The findings of this research have provided theoretical contributions to the existing research on mG-App and practical implications to decision-makers involved in the development and implementation of mG-App in in Oman.

A spoonful of sugar helps the medicine go down? A review of strategies for making pills easier to swallow.

Solid oral dosage forms such as tablets and capsules are generally the preferred method of drug delivery due to their convenience, cost, and acceptability. However, for many people, it can be a challenge to swallow solid oral medications, even those with healthy swallowing function. This review describes current strategies available to facilitate medication administration to otherwise healthy people with pill-swallowing difficulties. In general, restoring and maintaining the ability to swallow pills whole should ideally be the first choice in managing people with pill-swallowing difficulties. A number of strategies can potentially make it easier to swallow pills whole. These include postural adjustments, using pill-swallowing aids, and teaching pill-swallowing techniques. Where these are not successful or appropriate, then other approaches have to be considered using alternative formulations/routes of administration or deprescribing. If there is no other option, and it is not directly contraindicated for each specific medication dosage form, pills may be modified and mixed in foods and drinks to aid swallowing. In conclusion, people with pill-swallowing difficulties can benefit from a number of strategies designed to facilitate swallowing medications. However, these strategies should be further evaluated with regard to the evidence relating to both their efficacy and safety.

Multidisciplinary teams and ICT: a qualitative study exploring the use of technology and its impact on multidisciplinary team meetings

BackgroundMultidisciplinary teams (MDTs) are an integral component in the delivery of health care. This is particularly evident in the delivery of cancer care, where multidisciplinary teams are internationally recognized as the preferred method for service delivery. The use of health information systems and technology are key enabling factors for building the capacity of MDTs to engage in improvement and implementation projects but there is scant research on how MDTs make use of technology and information systems or the kinds of systems needed for them to undertake improvement and implementation research. This paper reports findings on how seven MDTs in cancer care utilized technological and information systems and the barriers and enabling factors that impacted on their uptake.MethodsSeven multidisciplinary teams from two large metropolitan hospitals participated in the study. Qualitative methods including structured observations and semi structured interviews that explored how teams engaged in research and improvement activities were utilized. Participants were also observed and interviewed in relation to their use of data and health information systems. Findings were subject to content analysis and key themes were identified. Interviews were transcribed and de-identified and key themes were subsequently discussed with participants to allow for member checking and further clarification of findings.ResultsA total of 43 MDT meetings across seven tumor streams were observed. Of these, observation notes from 13 meetings contained direct references to emerging technologies and health information systems. Findings from 15 semi-structured interviews were also analyzed in relation to how MDTs used technology in weekly meetings, and the perceived impact of technology. Three broad themes emerged: (1) methods for data collection and use by MDTs, (2) the impact of technology on the MDT meeting environment, and (3) the impact of technology and information systems on clinical decision making.ConclusionThe study demonstrates that real time data collection and imaging may improve patient centered care coordination. However, ICTs can be used sub-optimally by teams. We therefore urge additional research to identify the enabling factors that support better collection and use of outcome data from ICT.

A Preliminary Examination of Concussion Knowledge by Collegiate Athletes and Non-Athletes

Concussions affect various populations, including collegiate athletes and non-athletes. The purpose of this study was to compare collegiate varsity athletes, recreational athletes, and non-athletes' knowledge of concussion definition, symptoms, and support services available following injury. Preferred method of concussion education delivery was also examined. We surveyed 306 current college students using an online survey system. The survey included free recall and forced-choice question formats. Quantitative analyses were used to analyze results and compare responses among groups. Collegiate athletes and non-athletes demonstrate incomplete knowledge of concussion definition, related symptoms, and professionals involved in postinjury management. Varsity athletes rated self-knowledge of concussion parameters significantly higher than the other groups (p < .001), though few significant differences in actual knowledge levels were observed. Overall, respondents reported having the highest preference for concussion education delivered by medical professionals. Knowledge concerning concussion is incomplete in the collegiate population. Varsity athletes' exposure to formal education did not result in higher knowledge levels compared with other groups. Further examination of concussion educational delivery models' effect on change in concussion-related behavior in this population is warranted.

Psychosocial distress and the preferred method of delivery of mind-body interventions among patients with head-and-neck cancer.

ObjectiveTo describe the psychosocial distress of head-and-neck cancer patients at the completion of therapy and the interest in and the preferred method of delivery of mind–body interventions (MBIs) among head-and-neck cancer patients.Materials and methodsA descriptive, cross-sectional design was used to measure sleep disturbance, depression, anxiety, and the interest in and the preference for MBIs using anonymous, self-report questionnaires among a convenience sample of 30 males at their 3-month follow-up. Questionnaires included the Pittsburgh Sleep Quality Index, Hospital Anxiety and Depression Scale, and the self-created Survey for Preferred Methods of MBI. Frequency distributions and descriptive statistics were used to describe the sample demographic and clinical characteristics.ResultsThe mean age of the sample was 59 years. Oral cancer (63%) was the most common type of cancer. Nineteen participants (63%, 90% CI 47%–78%) had some interest in MBIs. Of interested participants, 8 (42%) preferred participating in MBIs alone, 10 (53%) preferred participating in MBIs at homes, 10 (53%) preferred participating in MBIs using a computer or mobile device, and 8 (42%) preferred participating in MBIs after the diagnosis, but before treatment started. Mean depression, anxiety, and sleep disturbance scores were 8.25 (SD 2.93), 5.41 (SD 3.52), and 6.3 (SD 3.86), respectively. Results from the independent-samples t-test and Mann–Whitney U tests revealed no significant differences in anxiety, depression, and sleep disturbance by MBI interest.ConclusionAsking about depression, anxiety, and sleep disturbances may help to identify head-and-neck cancer patients at risk for psychosocial distress. These findings suggest an interest in MBIs, but further research is warranted.