Effects of call reminders,short message services (SMS) reminders,and SMS immunization facts on childhood routine vaccination timing and completion in Ilorin,Nigeria

BackgroundReminders via mobile devices deployed as short message services (SMS) or calls have been identified to be a useful strategy in improving routine immunization uptake in several countries.ObjectiveTo identify the timeliness of appointments with reminders (calls or SMS), SMS health education and the routine care, and the vaccination completion rates in Ilorin, Nigeria.MethodMother-infant pairs presenting for the first vaccination appointment were randomized into four (three interventions, one control) groups, each consisting of 140 participants. Intervention groups were reminders via calls (A), SMS reminders (B), immunization fact SMS messages (C) and controls on usual care (D). Reminders were made a day before the appointment while SMS immunization facts were sent at five weeks, nine weeks and eight months. Appropriate timing was defined as the scheduled visit ±3 days.ResultsThe immunization completion rates after the nine months'' visit were 99.2%, 99.3%, 97% and 90.4% for Groups A, B, C and D respectively. Compared with controls, Group A had the highest odds [AOR 8.78 (6.10, 12.63)] of presenting at an appropriate time, followed by Group B [AOR 2.56 (1.96, 3.35)], then Group C [AOR 2.44 (1.87, 3.18)].ConclusionReminders/SMS immunization facts improve vaccination completion rates.     

Therapeutic strategies in the management of endocrine GEP tumours

Abstract. The therapeutic principles in the management of endocrine gastroenteropancreatic (GEP) tumours include surgical extirpation of the primary tumour in the absence of metastases and medical control of symptoms in the preoperative phase. In the presence of metastases only palliative procedures are available. Tumour growth might be controlled by surgical procedures as debulking of tumour masses, medically by chemotherapy and more recently by new developments as a long-acting somatostatin analogue (SMS 201–995) and α-interferon. Their efficacy is currently evaluated in prospective studies. In contrast to inhibition of growth symptoms derived from excessive hormone production by GEP tumours can be well controlled. SMS 201–995 effectively prevents or at least improves flush and diarrhoea in the carcinoid syndrome, disabling diarrhoea in the Verner-Morrison syndrome and migratory erythema in the glucago-noma syndrome. SMS acts by inhibition of hormone release from the tumour and by a direct mechanism at the site of the target cell via SMS receptors present on tumour and target cells. For control of acid hypersec-retion in gastrinoma patients omeprazole is superior to all former and present alternatives and replaced total gastrectomy completely. A similarly effective drug to prevent hypoglycaemia due to uncontrolled insulin release from insulinomas is not available since neither SMS nor diazoxide are effective in every insulinoma patient.     

Octreotide,a long-acting somatostatin analog,in the management of postoperative dumping syndrome

Summary Severe long-term complaints of dumping occur in a small number of patients after gastric surgery. Dietary modification, fiber preparations, and medical therapy are often ineffective. In these severely affected patients administration of the somatostatin analog octreotide before meals appears to be a promising new strategy. The effects of octreotide on both gastrointestinal transit time and hormonal changes appear to contribute to the benefits seen in dumping syndrome. However, as the majority of studies conducted have employed only a single dose of octreotide, careful long-term assessment of the nutritional and metabolic effects will be required. Recent results suggest that octreotide may be administered up to 2 hr before a meal and therefore has a sufficiently long duration of action to be of practical long-term use. Moreover, general improvements in life-style, as well as beneficial effects on symptoms, have been reported with long-term treatment, although the potential development of diarrhea will require careful monitoring. The development of an oral or nasal formulation should further improve the practical application of octreotide as a treatment for dumping syndrome.     

Needs analysis and development of a tailored mobile message program linked with electronic health records for weight reduction

ObjectiveWe developed and pilot-tested a personalized text messaging service program based on data from electronic health records (EHRs) and lifestyle questionnaires for weight control.MethodsIn the health promotion center of a hospital, 340 participants with a body mass index (BMI) greater than 25 were recruited and surveyed for the development of a text messaging program. After developing the interface linking the EHRs with personalized text messages for weight loss, we pilot-tested this program in 102 participants for its feasibility, acceptability and satisfaction.ResultsAccording to the needs analysis, the participants desired additional information about personalized nutrition and exercise. We selected many variables from the EHRs and questionnaires to create text messages with a more personalized program. After a 1-month trial of the text messaging program, the participants’ satisfaction score was 7.9 ± 1.5 and recommendation score was 7.5 ± 1.8.ConclusionsA personalized short message service (SMS) linked with EHRs was feasible, and the pilot test showed high satisfaction and recommendation scores. Further evaluation using a well-designed trial will be needed.     

Development and psychometric properties of a self report measure to assess clinicians' practices in self management support for patients with long term conditions

Objective

This paper presents a process of developing practices in self management support (PSMS) - a measure assessing clinicians’ self reported use of self management support practices in clinical consultations for patients with long term conditions (LTCs).

Methods

The development process comprised the following steps: literature review to define what skills clinicians need to effectively support patients to self manage, review of existing measures of SMS practices, construction of an initial pool of items, E Delphi study pilot survey to select items for final measure, data collection to confirm the factor structure and internal consistency of the final measure.

Results

The PSMS comprises three subscales: Clinical SMS (14 items), Patient Centeredness (4 items) and Organizational SMS (7 items). All subscales have very good internal reliability (Cronbach α: 0.94, 0.78 and 0.85; all item-total correlations above 0.50).

Conclusions and practice implications

We believe PSMS measure is suitable for both research and programme evaluation in UK clinical settings. To complete the process of measure development we are now planning to conduct further analyses to establish the validity of PSMS measure in UK and non UK healthcare settings and test the validity of PSMS measure on a wider range of other LTC groups.     

新型客户服务平台——“医患通”平台的研究与应用

目的：“医患通”服务平台建立的目的在于利用数字化手段在医院与患者之间搭起沟通的桥梁，创新医院客户服务方式。方法：该平台基于电子病历系统和医疗消息系统，将医院内部的医疗信息网络与社会通讯平台（手机、小灵通、互联网等）之间交互医疗信息，完成医患之间的沟通与交流。结果：可以轻松实现面对客户的人工、短信、语音、电子邮件等即时交互功能和群体管理功能。结论：该平台的建立实现了医院客户服务模式和客户关系管理模式的创新．推广应用前景广阔。