Patient anxiety and experiences associated with an outpatient "one-stop" "see and treat" hysteroscopy clinic

BACKGROUND: "One-stop" outpatient hysteroscopy clinics have become well established for the investigation and treatment of women with abnormal uterine bleeding. However, the advantages of these clinics may be offset by patient factors such as anxiety, pain, and dissatisfaction. This study aimed to establish patients' views and experiences of outpatient service delivery in the context of a one-stop diagnostic and therapeutic hysteroscopy clinic, to determine the amount of anxiety experienced by these women and compare this with other settings, and to determine any predictors for patient preferences. METHODS: The 20-item State-Trait Anxiety Inventory was given to 240 women attending a one-stop hysteroscopy clinic: to 73 consecutive women before their appointment in a general gynecology clinic and to 36 consecutive women attending a chronic pelvic pain clinic. The results were compared with published data for the normal female population, for women awaiting major surgery, and for women awaiting a colposcopy clinic appointment. In addition, a questionnaire designed to ascertain patients' views and experiences was used. Logistic regression analysis was used to delineate the predictive values of diagnostic or therapeutic hysteroscopy, and to determine their effect on the preference of patients to have the procedure performed under general anesthesia in the future. RESULTS: Women attending the hysteroscopy clinic in this study reported significantly higher levels of anxiety than those attending the general gynecology clinic (median, 45 vs 39; p = 0.004), but the levels of anxiety were comparable with those of women attending the chronic pelvic pain clinic (median, 45 vs 46; p = 0.8). As compared with the data from the normal female population (mean, 35.7) and those reported for women awaiting major surgery (mean, 41.2), the levels of anxiety experienced before outpatient hysteroscopy clinic treatment were found to be higher (mean, 45.7). Only women awaiting colposcopy (6-item mean score, 51.1 +/- 13.3) experienced significantly higher anxiety scores than the women awaiting outpatient hysteroscopy (6-item mean score, 47.3 +/- 13.9; p = 0.002). Despite their anxiety, most women are satisfied with the outpatient hysteroscopy "see and treat" service. High levels of anxiety, particularly concerning pain but not operative intervention, were significant predictors of patients desiring a future procedure to be performed under general anesthesia. CONCLUSIONS: Outpatient hysteroscopy is associated with significant anxiety, which increases the likelihood of intolerance for the outpatient procedure. However, among those undergoing operative therapeutic procedures, dissatisfaction was not associated with the outpatient setting.

Financial consequences of one-stop dispensing at Birmingham Children's Hospital

Poster session - Costs for one stop dispensing and the use of patients’ own drugs (PODs) were compared with traditional dispensing costs - It was found that operating a one-stop dispensing scheme, with the use of PODs where applicable, could save an average of £4.35 per patient per day on ward A and £5.19 per patient per day on ward B - These saving would equate to annual savings of £24,000 on ward A and £34,000 on ward B - Additional savings can be made to the secondary care budget as no in-patient drugs would be wasted upon patient discharge - These additional savings are an average £25.19 per patient on ward A and £13.42 per patient on ward B

Kormányzati koordináció Magyarországon. Esettanulmány az egyablakos ügyfélszolgálati reformról (Governmental coordination in Hungary: Case study on the one-stopgovernment service reform)

A tanulmány a központi kormányzat koordinációs politikájának jellemző mintázatait vizsgálja. A vizsgálat fókuszában a magyar kormányzati szférában újonnan bevezetett koordinációs eszköz, a kormányablak, mint egyablakos ügyfélszolgálati modell tanulmányozása áll. A kutatás empirikus bázisát a kormányzati és közigazgatási kulcsszereplőkkel készített kvalitatív interjúkból és a dokumentumelemzésből származó adatok analitikus vizsgálata adja. A szerző a tanulmányban szemügyre veszi a kormányzati koordináció gyakorlatát Magyarországon, elemzi, hogy ez mennyire tér el más országokétól. ____ The paper examines, on the basis of qualitative interviews and documentary analysis, the emerging patterns of government policy coordination in Hungary. The focus of the paper is on a recent case of innovative policy coordination measure introduced by the Hungarian government: the newly established “Government Windows”, the one-stop-government initiative. The paper investigates such questions as what the main characteristics of the coordination traditions in Hungary are, what are the specific structural features of the newly established governmental coordination instruments, and how do they differ from of other countries’ similar experiences.

Improving usefulness of eHealth systems through Information Accountability

With the implementation of the Personally Controlled eHealth Records system (PCEHR) in Australia, shared Electronic Health Records (EHR) are now a reality. However, the characteristic implicit in the PCEHR that puts the consumer (i.e. patient) in control of managing his or her health information within the PCEHR prevents healthcare professionals (HCPs) from utilising it as a one-stop-shop for information at point of care decision making as they cannot trust that a complete record of the consumer's health history is available to them through it. As a result, whilst reaching a major milestone in Australia's eHealth journey, the PCEHR does not reap the full benefits that such a shared EHR system can offer.

Are we there yet?

The political and bureaucratic discourse surrounding non-profit sector reform is centred on streamlining the regulatory framework. Phrases such as 'one-stop shop','reducing red tape' and 'duplicative, burdensome and unclear requirements' fill press releases, government reports and discussion papers. In this chapter, I examine quantitative measures of the current regulatory compliance burden facing non-profit organisations in Australia as a benchmark for measuring progress over the coming years. I focus on regulatory compliance estimates for four key stages of non-profit enterprise activity non-profit enterprise start-up and registrations; fundraising;grant paperwork; and regulation proportionate to the size of the non-profit enterprise.

An exploration of the extent, use and success in the application of Building Information Modelling (BIM) in the UK construction industry

Building Information Modelling (BIM) has been regarded as a one stop shop capable of addressing the ills of the construction industry. Yet, while some firms have accepted BIM as a new way to work and gone on to record success, others (which have not so done) have raised such questions as: ‘How is BIM defined? Is it a tool or a process? Which kinds and sizes of organisations stand to benefit from BIM?’ These questions form the basis of this research. Hence, having explored the relevant body of literature, this research investigates three organisations within the UK – described as the earliest adopters of BIM – and considers how they have fared in terms of project performance in the years since adopting BIM; focusing on project cost, delivery time and quality achievement. This investigation also probed two of the leading voices in BIM in the UK in search of the much needed answers. The findings of the research show that successful projects executed in the organisations that have used BIM is predicated on its adoption as a process, rather than as a tool of technology; a process that changes the way work in the construction industry is typically done. Moreover, the successes recorded in the firms researched give credence to project success consequent upon adopting BIM. Nevertheless, the findings of this research show that the cornerstone of this success is leadership-driven innovation.

Universal Access-NY User’s Guide

What is Universal Access-NY? Universal Access-NY is a complete online planning toolkit, www.UniversalAccessNY.org, where a One-Stop Delivery System can assess its practices, and develop work plans to improve physical and programmatic accessibility for all One-Stop customers. This web site and manual was developed by Cornell University’s Employment and Disability Institute, through the support and guidance of the New York State Department of Labor, with funding from two U.S. Department of Labor Work Incentive Grants (WIG 1 and 2). This web site was designed for use in a collaborative manner, bringing together One-Stop personnel, agency partners, business leaders and customers with disabilities. Universal Access-NY supports continuous improvement, with features that encourage multiple uses and incremental systems change.

Controlled pollination methods for creating Corymbia hybrids.

Inter-specific Corymbia hybrids are of increasing interest to plantation forestry, yet there is little knowledge of the most suitable controlled pollination methods for this genus. Inter-specific crosses were made between C. torelliana [CT(maternal parent)] and C. citriodora subsp. variegata (CCV), C. henryi (CH) and C. citriodora subsp. citriodora (CCC) using conventional pollination, one-stop pollination (OSP) and artificially-induced protogyny on yellow buds (AIP Y) pollination methods. Additional treatments included AIP on green buds (AIP G) and the use of exclusion bags for the OSP and AIP methods. Inter-specific hybrids (CT x CCV, CT x CH and CT x CCC) were successfully created using all three pollination methods. The AIP Y treatment provided the highest seed yields and achieved time savings of >41% over the conventional and OSP methods, resulting in up to five-fold increases in operator productivity. However, the AIP Y treatment also had the highest C. torelliana contamination levels (9.3–13.2%). The use of exclusion bags with the AIP method had minimal effect on contamination rates, indicating a high proportion of selfpollen contamination. Contamination rates varied between maternal parents, suggesting variation in selfcompatibility for C. torelliana individuals. AIP using semi-ripe green buds was not effective at reducing selfing and had low operator productivity. The AIP method is suitable for use in a large-scale hybrid breeding program for C. torelliana. When self-pollination effects are managed, it could greatly reduce the costs associated with the production of seed of elite family crosses for commercial forestry deployment.

Improving information for the macadamia industry via an information "bank"

Macadamia growers are under increasing pressure to remain viable in an increasingly competitive global market. A key need is quick access to high quality information. Current industry information is poorly integrated, poorly updated, and because it is largely in hard-copy, is difficult to access efficiently. With the dramatic growth in the use of the internet by growers, as evidenced in a recent industry communications survey, an opportunity exists to address this problem through the development of a high quality, internet-based information “bank”. The bank would bring together the macadamia information resources and collective knowledge of R&D and other relevant agencies into a one-stop information shop, aligned more effectively with grower needs.

Pollination methods, stigma receptivity and pollen tube growth in Eucalyptus argophloia

Eucalyptus argophloia Blakely (Western white gum) has shown potential as a commercial forestry timber species in marginal environments of north-eastern Australia. We measured early pollination success in Eucalyptus argophloia to compare pollination methods, determine the timing of stigma receptivity and compare fresh and stored pollen. Early pollination success was measured by counting pollen tubes in the style of E. argophloia 12 days after pollination. We compared the early pollination success of 1) Artificially Induced Protogyny (AIP), one-stop and three-stop methods of pollination; 2) flowers pollinated at 2 day intervals between 2 days before and 6 days after anthesis and 3) fresh pollen and pollen that had been stored for 9 months. Our results show significantly more pollen tubes from unpollinated AIP and AIP treatments than either the one-stop pollination or three-stop pollination treatments. This indicates that self-pollination occurs in the unpollinated AIP treatment. There was very little pollen tube growth in the one-stop method indicating that the three-stop method is the most suitable for this species. Stigma receptivity in E. argophloia commenced six days after anthesis and no pollen tube growth was observed prior to this. Fresh pollen resulted in pollen tube growth in the style whereas the stored pollen resulted in a total absence of pollen tube growth. We recommend that breeding programs incorporating E. argophloia as a female parent use the three-stop pollination method, and controlled pollination be carried out at least six days after anthesis using fresh pollen.

Encouraging them to come to us: changing the way that information is made available to farmers

Recommendations for changes to service provision and fisheries policy in support of poverty alleviation emerged recently in India from a process know as facilitated advocacy (see Case Study SI 2) that helped to negotiate and support a role for poor people and their service providers, to contribute to changes in services and policies. Two of the key recommendations to emerge from farmers and fishers, which were prioritized by Fisheries Departments, were to change the way that information is made available and to simplify procedures for accessing government schemes and bank loans. This case which identifies the origin of these recommendations to change the way that information is made available, shows how different models of the concept have emerged, and follows the development of the One-stop Aqua Shops (OAS) in the eastern Indian states of Jharkhand, Orissa and West Bengal, that represent a new and vital tier in communications in aquaculture. (12 p.)

Helping ourselves: the role of self-help groups in poverty alleviation through aquaculture

Self-help groups (SHGs) are ways for farmers and fishers, especially those who are poor, to come together and work together. They can be a useful entry point for outsiders, promote a supportive local environment, strengthen voices in decision-making and in negotiations with more powerful forces, increase the effectiveness of local actions, and provide easier access to micro-credit and other resources and services. This case study describes a rural aquaculture development context, in India, the development of SHGs and the concept of a ‘one-stop aqua shop’, set up and run by a federation of self-help groups in Kaipara village, West Bengal (a pilot state along with Jharkhand and Orissa). It outlines testing new ways to share information, as part of a series of revised procedures and institutional arrangements for service delivery recommended by farmers and fishers and prioritized by government, with support from the Department of International Development, London (DFID) Natural Resources Support Programme (NRSP) and the Network of Aquaculture Centres in Asia-Pacific (NACA) to the Support to Regional Aquatic Resources Management (STREAM) Initiative (10 p.)

STREAM Journal, Vol. 4, No. 3, pp 1-19. July-September 2005

CONTENTS: One-stop Aqua Shops: an emerging phenomenon in Eastern India, by Graham Haylor, Rubu Mukerjee and S.D. Tripathi. Ranchi One-stop Aqua Shop, by Ashish Kumar. Kaipara One-stop Aqua Shop, by Kuddus Ansary. Bilenjore One-stop Aqua Shop, by Bhawani Sankar Panda. Patnagarh One-stop Aqua Shop, by Dipti Behera and Lingraj Otta. Using bar-coding in a One-stop Aqua Shop, by Christopher Keating.

STREAM Journal, Vol. 5, No. 1, pp 1-18. January-March 2006

CONTENTS: Policy development as a theme and policy briefs as a genre, by Graham Haylor and William Savage. Decriminalizing Cambodian family-scale fishers through a livelihoods approach to law reform, by Nao Thuok and Chun Sopha. Longer pond leases in Orissa, by Reshmee Guha and Rubu Mukherjee. One-stop aqua shop: a “one-window delivery” service center for aqua-farmers and fishers, by S.D. Tripathi, Rubu Mukherjee and Kuddus Ansary. Fisheries and aquaculture policy formulation process in Pakistan, by Muhammad Junaid Wattoo and Dr. Muhammad Hayat. Improving the international marine ornamental fish trade to sustain and improve the livelihoods of poor people involved in the trade, by Aniza Suspita, Michael J. Phillips and Samliok Ndobe.

STREAM Journal, Vol. 5, No. 2, pp 1-17. April-June 2006

CONTENTS: First one-stop aqua shop in Pakistan, by Syed Nadeem Sharib and Muhammad Junaid Wattoo. Dad Karim: a fisherman of Gwadar, by Abdul Rahim. Learning to fish in the deep sea of Sindh Province, by Muhammad Alam. Freshwater prawn fishery of Pakistan, by Muhammad Yaqoob. Cephalopod fishery: a local technique to catch cuttlefish in the coastal waters of Pakistan, by Shabir Ali Amir. Grouper culture in Pakistan, by S. Makhdoom Hussain and Zakia Khatoon.