Plos One
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Diabetic retinopathy (DR) can lead to visual impairment and blindness if not detected and treated in time. Knowing the barriers/enablers in advance in contrasting different country income settings may accelerate development of a successful DR screening (DRS) program. This would be especially applicable in the low-income settings with the rising prevalence of DR. ⋯ Knowing the barriers to access DRS is a pre-requisite in development of a successful screening program. The awareness, knowledge and attitude of the consumers, availability of skilled human resources and infrastructure emerged as the major barriers to access to DRS in any income setting.
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Observational Study
Evaluation of blood culture epidemiology and efficiency in a large European teaching hospital.
Blood cultures remain the gold standard for detecting bacteremia despite their limitations. The current practice of blood culture collection is still inefficient with low yields. Limited focus has been given to the association between timing of specimen collection at different time points during admission and their yield. ⋯ This study showed that blood cultures are inefficient in detecting bacteremia. Cultures collected during 24 hours after admission yielded more positive results than those collected later. Significant variations in blood culture epidemiology and efficiency per specialty suggest that guidelines should be reevaluated. Future studies should aim at improving blood culture yield, implementing educational programs to reduce contamination and cost-effective application of modern molecular diagnostic technologies.
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Observational Study
Unscheduled hospital contacts after inpatient discharge: A national observational study of COPD and heart failure patients in England.
Readmissions are a recognised challenge for providers of healthcare and incur financial penalties in a growing number of countries. However, the scale of unscheduled hospital contacts including attendances at emergency departments that do not result in admission is not well known. In addition, little is known about the route to readmission for patients recently discharged from an emergency hospital stay. ⋯ While the majority of patients did not have unscheduled contact with secondary care in the 30 days after index discharge, many patients attended the ED, often multiple times, and many were admitted to hospital, not always via the ED. More frail patients were more likely to be admitted through the ED, suggesting a possible area of focus as discharge bundles are developed.
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The aims of this study were to 1) evaluate the impact of eight common chronic conditions and multimorbidity on preference-based health-related quality of life (HRQoL), and 2) estimate the minimally important difference (MID) in the general population of Hong Kong (HK). ⋯ The findings suggest that having more chronic conditions is strongly associated with a lower HRQoL. Healthcare reforms to address foreseeable challenges arising as more patients live with chronic conditions and multimorbidity could improve the HRQoL of HK citizens.
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Oculometric measures have been proven to be useful markers of mind-wandering during visual tasks such as reading. However, little is known about ocular activity during mindfulness meditation, a mental practice naturally involving mind-wandering episodes. In order to explore this issue, we extracted closed-eyes ocular movement measurements via a covert technique (EEG recordings) from expert meditators during two repetitions of a 7-minute mindfulness meditation session, focusing on the breath, and two repetitions of a 7-minute instructed mind-wandering task. ⋯ The results show a significantly smaller average amplitude of eye movements in the delta band (1-4 Hz) during mindfulness meditation than instructed mind-wandering. Moreover, participants' meditation expertise correlated significantly with this average amplitude during both tasks, with more experienced meditators generally moving their eyes less than less experienced meditators. These findings suggest the potential use of this measure to detect mind-wandering episodes during mindfulness meditation and to assess meditation performance.