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PubMed2026

Access Block and Ambulance Ramping: The Canaries of the Healthcare System.

OBJECTIVE: To identify evidence-based factors leading to the global challenge of hospital access block and inform strategies to improve emergency access performance. METHODS: A mixed methods approach was followed comprising an umbrella review of published systematic reviews, qualitative analysis of the perspectives of patients and healthcare workers, and quantitative analysis of contextual factors and 6 years of ambulance, emergency inpatient and ward movement records for the 25 largest public hospitals in Queensland, Australia. RESULTS: A key set of findings and recommendations were identified to improve emergency access that are practical and actionable. These comprise the introduction of inpatient discharge metrics and monitoring to shift focus from the front door of hospitals to the 'back door'; increasing support for primary care, community care, aged care, NDIS and vulnerable groups; maintaining demand-side strategies such as increasing inpatient-equivalent care alternatives (e.g., hospital in the home, acute care within nursing home services); investment in prehospital flow; improving hospital processes such as extended-hour discharge lounges; improving workforce; and revising funding policies. CONCLUSIONS: The study findings fill a gap in the evidence regarding challenges and recommendations for improving patient flow within hospital emergency departments and across the broader health system. Focussing efforts at the 'back end' of the inpatient journey is a critical step to improve emergency care outcomes.

Humans↗

PubMed2004

Socio-cultural influences on Chinese women's attendance for cervical screening.

BACKGROUND: Compared with other countries, Hong Kong has a relatively high rate of cervical cancer. Much of this morbidity should be avoidable with cervical screening, but uptake rates for screening in Hong Kong are low. In programmes to promote cervical screening attendance, it is essential that aspects of the socio-cultural system be taken into account to provide appropriate preventive health strategies. AIM: This paper outlines an investigation of the cultural and social factors contributing to Chinese women's attendance for cervical screening. METHOD: A mixed methods design was employed, combining and comparing two data sets. The initial data set was drawn from 10 focus groups involving both screened and unscreened Chinese women (n = 54). The second data set was drawn from a total population of Hong Kong doctors, and involved face-to-face semi-structured interviews (n = 28). RESULTS: Thematic analysis of the data from women indicated that the social factors of cost, educational base, knowledge of risk, the social value of early detection and cultural issues such as modesty and embarrassment contributed to screening attendance. The doctors perceived a cultural tendency towards fatalism, as well as seeing the gender, interpersonal and interprofessional skills of the practitioner to be important in influencing levels of Chinese women's shyness and discomfort, and hence affecting attendance. The lay and practitioner data sets varied in the perceptions of women's pain, embarrassment and risk factors. CONCLUSION: Programmes providing services for Chinese women need to ensure that the philosophy of the staff and the approach and materials used are culturally relevant. Recommendations are that nurses equipped with relevant social and cultural knowledge of population groups should have a central role in health promotion and screening services.

Adult↗

PubMed2005

The impact of research governance in healthcare and higher education organizations.

AIM: This paper reports a study exploring the impact and implementation of research governance in the North West region of England. BACKGROUND: In 2001, the UK Government launched a framework to ensure the governance of research within the National Health Service. Whilst this framework was undoubtedly geared towards improving the standards and practice of research, concerns have been raised in the academic literature about the potentially negative impact on future research. METHODS: A mixed method approach, using questionnaires (n = 350), semi-structured interviews and focus groups with a volunteer sample, was used to explore research staff perspectives about research governance. Survey data were analysed using Microsoft Excel, and a thematic analysis was used to elicit themes from the semi-structured interviews. The study lasted for 12 months and used a range of study sites, giving insight into potentially different experiences or approaches to implementing the research governance framework. FINDINGS: Questionnaire data revealed a good level of awareness about the Research Governance Framework. However, a range of concerns was also raised, such as the increased workload associated with the research governance application process and lack of transparency about the process. Five themes emerged from the focus groups: control, epistemology, organizational issues, impact on teaching and learning, and ambiguity in the definitions of research and audit. CONCLUSIONS: Recommendations emerging from the study include the promotion of transparent research governance guidelines for practitioners, and the need for staff education about governance processes and greater parity between organizations in research governance processes.

England↗

PubMed1992

[Synthesis, analgesic activity and structure-activity relationship of 4-N-propionyl analogs of cis-3-methyl fentanyl].

The synthesis of some 4-N-propionyl analogs of cis-3-methyl fentanyl by acyl chloride method. anhydride method, mixed anhydride method and DCC method is reported. The ethyl group in 4-N-propionyl portion of cis-3-methyl fentanyl was substituted by some groups with different electronic property. In mouse hot plate test, all compounds showed typical morphine-like action with analgesic potency corresponding to 49-1963 times that of morphine. Compound 3 was found to exhibit higher analgesic activity than cis-3-methyl fentanyl. Semiempirical INDO calculations have been undertaken for 4 typical compounds and it was found that as a result of introduction of chlorovinyl, compound 3 exhibited characteristics of electronic structure different from that of cis-3-methyl fentanyl. The relationships between analgesic activity and the electronic structure of these compounds were discussed.

Analgesics, Opioid↗

PubMed2005

Understanding relationships between diabetes mellitus and health-related quality of life in a rural community.

INTRODUCTION: There is a lack of information on health-related quality of life (HRQOL) for Aboriginal diabetic people. OBJECTIVE: To investigate HRQOL among aboriginal diabetics living in an isolated, rural Canadian community. METHODS DESIGN: Mixed methods: (1) A mailed health-related survey; and (2) a population based retrospective chart review. STUDY POPULATION: People aged 17 years and older living in the Bella Coola Valley, British Columbia, Canada, and having a chart at the Bella Coola Medical Clinic as of September 2001 were asked to complete a detailed HRQOL survey during the period August to December 2001. MAIN OUTCOME MEASURES: Demographics (age, sex, ethnicity). Health-related quality of life was measured using the MOS 36-item Short Form Health Survey (SF-36), and the US Centers for Disease Control healthy day's items. RESULTS: Relatively greater percentages of diabetic people (n = 72 [57%]) completed the survey than did non-diabetics (n = 675 [37%]). Mean scores for Aboriginal people were lower/poorer than mean scores for non-Aboriginal people in all the quality of life questions. Mean scores for diabetic people were lower than mean scores for non-diabetics in all the quality of life questions. Aboriginal diabetics reported the worst scores on almost all of our quality of life questions. CONCLUSION: Rural diabetics experience significant impairment in their health-related quality of life. Among rural diabetics, Aboriginals report the worst HRQOL scores. Compared with other people, Aboriginals fare worse in HRQOL, which may explain the difference.

Adult↗

PubMed2006

Impact of chronic disease on quality of life in the Bella Coola Valley.

INTRODUCTION: North American rural residents have higher rates of chronic disease and they report being ill more frequently compared to their urban counterparts. We recently studied health-related quality in residents living in the isolated, rural community of Bella Coola, Canada. OBJECTIVE: To assess health-related quality of life parameters in adults suffering from chronic disease and living in the rural, remote community of Bella Coola. METHODS: Design, mixed methods: (1) mailed health-related survey; (2) retrospective chart review. STUDY POPULATION: people aged 17 years and older living in the Bella Coola Valley and having a chart at the Bella Coola Medical Clinic as of September 2001 were asked to complete a detailed health-related quality of life survey during the period August to December 2001. MAIN OUTCOME MEASURES: demographics (age, sex, weight [BMI], ethnicity). Health-related quality of life was measured using the MOS 36-item Short Form Health Survey (SF-36), and the US Centers for Disease Control healthy day's items. Chronic diseases studied included diabetes mellitus, hypertension, chronic obstructive lung disease, coronary artery disease, hyperlipidemia, depression/anxiety, cancer, osteoarthritis, inflammatory arthritis and chronic back/neck pain. RESULTS: Response rate to the survey was 38% (675/1770). Compared to total clinic population relatively more female (57% vs 49%), non-Aboriginal (63% vs 57%) and older people (48.9 vs 43.5 years) answered the survey. The most prevalent chronic diseases among the survey respondents were hypertension (17%), depression/anxiety (13%), hyperlipidemia (11%), chronic back/neck pain (11%), and osteoarthritis (9%). Linear regression analysis was performed for each of the SF-36 domains and CDC healthy day items. The presence of chronic disease is associated with significant differences in HRQOL item scores and the greater the number chronic diseases present the worse the HRQOL item scores. CONCLUSION: People living in the rural remote community of Bella Coola who have chronic disease experience significant impairment in their health-related quality of life. The greater the number of coexisting chronic diseases a person has, the more likely that poor HRQOL scores will be reported.

Adolescent↗

PubMed2006

[Research advance in slurry sample introduction for plasma emission spectrometry/mass spectrometry].

The present review is focused on the advances and applications of slurry introduction for plasma spectrometry/mass spectrometry. Preparation and characterization of the suspensions are described, including the methods for decreasing the particle size such as the bottle and bead method, mixing mill method, vibration mill method, and supersonic mill method. Dispersion of the particles can be controlled via adding dispersant and pH adjustment. Some methods for particle size measurement, namely, sedimentation, optical microscopy, photosedimentometry, laser diffraction, scanning electron microscopy and transmission electron microscopy, are also described. Effects of suspension concentration and calibration techniques, including calibration by simple aqueous standard, internal standard, correction by empirical correction factors, standard additions, intrinsic internal standardization, and standard slurries, are discussed. Fundamental study of slurry introduction and its applications to plasma spectrometry/mass spectrometry are reviewed.

English Abstract↗

PubMed1978

Migration inhibition of sensitized mouse spleen cells by cell-associated transplantation antigens: effect of method of antigen presentation.

The migration of specifically sensitized mouse spleen cells following exposure to allogeneic cells (antigen) in vitro was studied. The migration inhibition recorded when sensitized cells were admixed with allogeneic cells in capillary tubes (mix method) was compared to the inhibition observed when allogeneic cells were suspended in the culture chamber media (non-mix method). Specificity as well as a higher degree of migration inhibition were obtained using the mix method, suggesting that this method is superior to the nom-mix method.

Animals↗

PubMed2004

A quantitative analysis of qualitative studies in clinical journals for the 2000 publishing year.

BACKGROUND: Quantitative studies are becoming more recognized as important to understanding health care with all of its richness and complexities. The purpose of this descriptive survey was to provide a quantitative evaluation of the qualitative studies published in 170 core clinical journals for 2000. METHODS: All identified studies that used qualitative methods were reviewed to ascertain which clinical journals publish qualitative studies and to extract research methods, content (persons and health care issues studied), and whether mixed methods (quantitative and qualitative methods) were used. RESULTS: 60 330 articles were reviewed. 355 reports of original qualitative studies and 12 systematic review articles were identified in 48 journals. Most of the journals were in the discipline of nursing. Only 4 of the most highly cited health care journals, based on ISI Science Citation Index (SCI) Impact Factors, published qualitative studies. 37 of the 355 original reports used both qualitative and quantitative (mixed) methods. Patients and non-health care settings were the most common groups of people studied. Diseases and conditions were cancer, mental health, pregnancy and childbirth, and cerebrovascular disease with many other diseases and conditions represented. Phenomenology and grounded theory were commonly used; substantial ethnography was also present. No substantial differences were noted for content or methods when articles published in all disciplines were compared with articles published in nursing titles or when studies with mixed methods were compared with studies that included only qualitative methods. CONCLUSIONS: The clinical literature includes many qualitative studies although they are often published in nursing journals or journals with low SCI Impact Factor journals. Many qualitative studies incorporate both qualitative and quantitative methods.

Bibliometrics↗

PubMedDate not supplied

Synthesis of vasoactive intestinal peptide (VIP) via the mixed anhydride method.

Porcine VIP was synthesized from three segments. The segments, VIP(1-6), VIP(7-13), and VIP(14-28), were synthesized via the Repetitive Excess Mixed Anhydride (REMA) method. The low solubility of the C-terminal segment was greatly improved by a temporary substitution of Asn28 by a beta-t-butyl aspartic acid ester. The segments VIP(1-6) and VIP(7-13) were purified by HPLC and coupled via the mixed anhydride method. The product was purified by gel filtration. VIP was synthesized from VIP(1-13) and VIP(14-28) by the same procedure. After deprotection, Met17-sulfoxide reduction, and purification by ion-exchange chromatography, the product was found to have the expected amino acid composition and biological potency. A HPLC purified sample was compared with several commercial preparations of varying purity.

Amino Acid Sequence↗

PubMed2006

Is verbatim transcription of interview data always necessary?

Verbatim transcription of interview data has become a common data management strategy in nursing research and is widely considered to be integral to the analysis and interpretation of verbal data. As the benefits of verbal data are becoming more widely embraced in health care research, interviews are being increasingly used to collect information for a wide range of purposes. In addition to purely qualitative investigations, there has been a significant increase in the conduct of mixed-method inquiries. This article examines the issues surrounding the conduct of interviews in mixed-method research, with particular emphasis on the transcription and data analysis phases of data management. It also debates on the necessity to transcribe all audiorecorded interview data verbatim, particularly in relation to mixed-method investigations. Finally, it provides an alternative method to verbatim transcription of managing audiorecorded interview data.

Humans↗

PubMed2001

A mixed model method to predict QTL-cluster effects using trait and marker information in a multi-group population.

In this study, a mixed model method using trait phenotype and marker information was developed for genetic evaluation of animals in a crossbred population originated from several founder genetic groups. The situation in which a cluster of QTLs is located in a particular chromosome region and is marked by two flanking markers is considered. With this method, the conditional expectation of the identity-by-descent proportion for the QTL-cluster marked and the genetic variances and covariances, given genetic group and marker information, are properly taken into account. The structure of segregation variance used in this method is different from that in the case of a single QTL marked. The current method provides best linear unbiased estimation of the relevant fixed effects and best linear unbiased prediction of the additive effects for the QTL-cluster marked and of the additive effects of the remaining polygenes. A small numerical example is given to illustrate the current prediction procedure.

Genetic Markers↗

PubMedDate not supplied

A method of mixed dentition analysis in the mandible.

We developed a method of space analysis based on the fact that the measurement between the distal surfaces of the mandibular permanent lateral incisors was approximately equal to that of the combined widths of the mandibular permanent canine and premolars. This method is referred to as Interlateral Incisor Width (I.L.I.W.) Analysis. One hundred and nineteen Japanese children, without malocclusion, were selected for the study. Various measurements of teeth were taken in their mouths with a modified, fine-tipped, electrical, digital caliper and recorded in a Handheld Computer by connecting it to the caliper. Statistical analyses were conducted to compare the accuracy of the I.L.I.W., Ono, Moyers, and Ballard and Wylie analyses in the mandibular arch. The summary of the results were: Correlation coefficients for the sum of the actual mesiodistal dimensions of the canine and premolars with their predicted values obtained by each of the four analyses revealed r = 0.63 for I.L.I.W., r = 0.55 for Ono, r = 0.57 for Moyers, and r - 0.55 for Ballard and Wylie. Our I.L.I.W. method presented the best correlation of the four analyses, although each indicated a relatively low correlation. This method does appear to be clinically valid, since it is simple enough to enable the practitioner to estimate the combined dimension of the unerupted canine and premolars by measurement, in the mouth, of the distance between the distal surfaces of both mandibular permanent lateral incisors, instead of on study casts. It is recommended that a radiographic method be used in conjunction with our method to obtain a more accurate estimate.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed2001

Static quadrupole moment of the five-quasiparticle k = 35/2 isomer in (179)w studied with the level-mixing spectroscopy method.

The spectroscopic quadrupole moment of the high-spin, high- K five-quasiparticle isomer (K(pi) = 35/2(-), T(1/2) = 750(80) ns, E(i) = 3349 keV) in (179)W has been determined using the level mixing spectroscopy method. A value Q(s) = 4.00(+0.83-1.06)e b was derived, which corresponds to an intrinsic quadrupole moment Q0 = 4.73(+0.98-1.25)e b and to a quadrupole deformation beta(2) = 0.185(+0.038-0.049). These values differ significantly from the deduced ground-state quadrupole moments and are in disagreement with the current theoretical predictions in this mass region.

Journal Article↗

PubMed2026

Acceptability of capillary point-of-care testing: a systematic review.

OBJECTIVE: To identify and synthesise evidence on the acceptability and perceived experience of finger-prick point-of-care testing (POCT) among patients and clinicians across healthcare settings. DESIGN: Systematic review conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines. DATA SOURCES: Medline, Embase, PsycInfo, CINAHL, Cochrane and Web of Science were searched from inception to January 2024 and re-run in July 2025, supplemented by citation tracking of relevant studies. ELIGIBILITY CRITERIA: Studies reporting patient and clinicians' experiences, perceptions, satisfaction or acceptability relating to finger-prick POCT for any health condition or blood parameter were eligible. Quantitative, qualitative and mixed-methods designs were included. DATA EXTRACTION AND SYNTHESIS: Data were extracted independently by two reviewers and synthesised using thematic analysis and narrative synthesis. Methodological quality was appraised using the Mixed-Methods Appraisal Tool. RESULTS: 21 studies met the inclusion criteria, encompassing 9128 participants (17 quantitative, 3 qualitative, 1 mixed methods). Across diverse clinical contexts, finger-prick POCT was reported as generally acceptable, less distressing and perceived as a convenient alternative to venous sampling in comparative studies. Thematic synthesis identified two major themes: (1) enhancing the patient-clinician relationship through improved engagement, communication and understanding of care and (2) clinical implications of finger-prick POCT on clinicians' workflow, confidence and skill acquisition. Finger-prick POCT was perceived to promote personalised consultations, enable immediate discussion of results and streamline decision-making. Clinicians highlighted its potential to expand task sharing, improve efficiency and strengthen continuity of care, although concerns regarding training, reliability and quality assurance were identified. CONCLUSIONS: Finger-prick POCT is generally acceptable to patients and clinicians, improving comfort, convenience, engagement and perceived efficiency. Implementation should prioritise training, infrastructure and quality assurance frameworks to maximise clinical and experiential benefits. PROSPERO REGISTRATION NUMBER: CRD42024512130.

Humans↗

PubMedDate not supplied

Use of the method of mixed substrates to study the specificity of tRNA methylases.

The absence of summation of the rate of methylation of positionally analogous cytidine residues in tRNA1Val, tRNAPhe, and tRNAMet in the case of simultaneous presence of two substrates in the incubation mixture was demonstrated by the method of mixed substrates. The same result was also obtained in the methylation of A19 (counting from the 3' end of the molecule) in tRNA1Val, tRNAPhe, tRNAfMet, tRNASer, and tRNAGlu individually and in the case of their mixing in pairs. These data are evidence that positionally analogous nucleotides in different RNAs are attacked by the same enzyme. Yeast tRNASer, already possessing a methyl group at the cytidine residue studied, proved to be an effective inhibitor of methylase, forming m5C with valine and phenylalanine tRNAs. The results obtained are evidence that differences in the primary and secondary structures at the site of methylation are not the deciding factors in the interaction of tRNA with methylases.

Base Sequence↗

PubMed1981

Suppression of reaginic antibodies with modified allergens. III. Preparation of tolerogenic conjugates of common allergens with monomethoxypolyethylene glycols of different molecular weights by the mixed anhydride method.

Our previous findings that antigens, such as ovalbumin (OA) and the extract of ragweed pollen (RAG), could be rendered nonantigenic, nonallergenic and tolerogenic by conjugation with polyethylene glycol (PEG) have been extended in the present study to the synthesis of conjugates of a variety of antigens with monofunctional monomethoxy-PEGs (mPEGS) of different molecular weights by the use of the mixed anhydride method. Thus, mPEGs with molecular weights of 2,000, 5,000, 10,000 and 20,000 were coupled to proteins such as dog serum albumin (DA), bovine pancreatic ribonuclease, OA and the constituents of pollen, helminth and bacterial allergens (RAG, Timothy grass pollen, Ascaris suum and Micropolyspora faeni). All these mPEG conjugates depressed markedly the ongoing IgE antibody formation in sensitized animals, in spite of additional injections of the sensitizing dose of the appropriate antigen. Moreover, the allergenicity of the proteins was either totally abolished or markedly reduced after coupling to mPEGs. Conjugates of DA and OA of varying degree of substitution (i.e. number of mPEG molecules attached per protein molecule) were prepared with mPEGs of different molecular weights and their immunological properties were assessed. It appears that, for a series of tolerogenic conjugates of the same antigen, there exists some inverse relationship between the degree of substitution and the molecular weight of mPEG, i.e. a high level of tolerogenicity with a concomitant reduction or total loss of allergenicity was achieved with a lower degree of substitution utilizing mPEGs of increasing molecular weights. On the basis of these results, it is concluded that a variety of allergens may be converted by conjugation with mPEGs to tolerogenic products with a potential for use in the therapy of patients allergic to a wide spectrum of common allergens.

Albumins↗

PubMed2006

HIV/AIDS prevalence and behaviour in drug users and pregnant women in Kashgar Prefecture: case report.

Second Generation sub-population HIV Surveillance was undertaken in Kashgar City and Shache County, Xinjiang, Peoples Republic of China between December 2003 and January 2004, targeting injecting and mixed method drug users and pregnant and postnatal women. The study aimed to determine the extent to which the epidemic is shifting from a concentrated stage to a more generalised epidemic. One hundred and forty two (142) exclusively injecting drug users (66) and mixed method drug users (injecting and non-injecting-76) participated in this survey. Eight hundred and two (802) pregnant and postnatal women participated in the survey. In Kashgar City and Shache County the serum prevalence of HIV amongst injecting drug users was 56.06%, for mixed method drug users 48.68% and 0.38% in pregnant women. In Shache County HIV infection rates were significantly lower in drug user groups and amongst pregnant and post-natal women, at 2.22% and 0% respectively. The behavioral survey indicated that 15% of injecting drug users have shared needles (however sero prevalence and knowledge in relation to access to clean needles and syringes suggests that this may not reflect the actual situation). Knowledge of prevention of transmission strategies (not sharing needles and condom utilisation) is similar between both groups at 60-70%. However it appears that this knowledge has not significantly impacted on behavior such as needle sharing and condom utilisation. In Kashgar City and Shache County there have been very few interventions to support HIV/AIDS prevention, care and control. The results from this survey will inform future directions and the development and implementation of targeted interventions including targeted information dissemination and harm reduction strategies. This survey was funded by the Xinjiang HIV/AIDS Prevention and Care Project, a bilateral project jointly implemented by the Government of the People's Republic of China and the Government of Australia.

Journal Article↗