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Patients’experiences with‘sludge’(administrative burden)in the cancer screening process and its relationship with screening completion,experience and health system distrust

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Family Medicine and Community Health 2024年第S2期12卷 8-17页

作者： Michelle S Rockwell Brianna Chang Vivian Zagarese jamie k turner Ally Southworth YingXing Wu Paul Yeaton Li Li Jeffrey S Stein Sarah H Parker John W Epling Department of Family and Community Medicine Virginia Tech Carilion School of MedicineRoanokeVirginiaUSA Department of Family and Community Medicine Carilion ClinicRoanokeVirginiaUSA Virginia Tech Carilion School of Medicine RoanokeVirginiaUSA Department of Health Systems and Implementation Science Virginia Tech Carilion School of MedicineRoanokeVirginiaUSA Graduate Program in Translational Biology Medicineand HealthVirginia TechRoanokeVirginiaUSA Health Analytics Research Team Carilion ClinicRoanokeVirginiaUSA Division of Gastroenterology Department of Internal MedicineCarilion ClinicRoanokeVirginiaUSA Department of Family Medicine University of Virginia School of MedicineCharlottesvilleVirginiaUSA Center for Health Behaviors Research Fralin Biomedical Research Institute at VTCRoanokeVirginiaUSA

Objective‘Sludge’refers to administrative burdens or frictions that preclude people from getting what they want or need(eg,duplicative forms,complicated instructions,long waiting times).This mixed methods study evaluated patients’perceptions of sludge in the colorectal cancer(CRC)screening process and some impacts of this *** We employed an exploratory sequential mixed methods study design that comprised patient interviews and a patient *** interviews informed final survey revisions and captured contextual data about patients’experiences with *** transcripts were inductively and deductively analysed to identify overarching *** survey quantified sludge,delayed or forgone screenings,screening experience(Net Promoter Score)and health system distrust(Health System Distrust Scale).We usedχ2 or t-tests for univariable comparisons and logistic or linear regressions to evaluate the association between cumulative sludge score and delayed or forgone screenings,screening experience and health system *** were integrated for *** Southeastern United *** Patients who were 45–75 years of age,at average risk for CRC and had either completed or been referred for CRC screening(colonoscopy or stool-based test)within the previous 12 *** 22 interview participants and 255 survey participants completed the study.38(15%)survey participants rated their screening experience as poor(Net Promoter Score=0–7 out of 10).The mean(SD)Health System Distrust Scale score was 22.4(6.3)out of 45 possible points(higher score=greater distrust).Perceptions of sludge in the CRC screening process varied,with long waiting times and burdensome communication being the most common sources(58%and 35%of participants,respectively).Sludge was positively associated with delayed or forgone screenings(OR=1.42,95%CI 1.28,1.57,p<0.001),poor screening experience(OR=1.15,95%CI 1.04,1.28,p=0.009)and health system distrust(β=0.47,p

关键词： sludge screening burden

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Predicting an Athlete’s Physiological and Haematological Response to Live High-Train High Altitude Training Using a Hypoxic Sensitivity Test

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Journal of Science in Sport and Exercise 2022年第4期4卷 371-385页

作者： Gareth turner kate L.Spilsbury David J.Green Barry W.Fudge jamie S.M.Pringle Alan J.Richardson Neil S.Maxwell Environmental Extreme Laboratory University of BrightonEastbourneUK English Institute of Sport Bisham AbbeyUK Queensland Academy of Sport BrisbaneAustralia English Institute of Sport LoughboroughUK Aspire Academy DohaQatar University of Birmingham BirminghamUK

Purpose Elite endurance runners frequently utilise live high-train high(LHTH)altitude training to improve endurance per-formance at sea level(SL).Individual variability in response to the hypoxic exposure have resulted in contradictory *** the present case study,changes in total haemoglobin mass(tHbmass)and physiological capacity,in response to 4-weeks of LHTH were *** tested if a hypoxic sensitivity test(HST)could predict altitude-induced adaptations to *** Fifteen elite athletes were selected to complete 4-weeks of LHTH(~2400 m).Athletes visited the laboratory for preliminary testing(PRE),to determine lactate threshold(LT),lactate turn point(LTP),maximal oxygen uptake VO_(2max)and *** LHTH,athletes completed daily physiological measures[arterial oxygen saturation(SpO2)and body mass]and subjective wellbeing *** was repeated,for those who completed the full camp,post-LHTH(POST).Additionally,athletes completed the HST prior to *** A difference(Pks *** revealed a decrease in oxygen saturation at rest(ΔSp_(r))and higher hypoxic ventilatory response at rest(HVRr)predicted individual changes *** hypoxic cardiac response at rest(HCRr)and higher HVRr predicted individual changes VO_(2max).Conclusion Four weeks of LHTH at~2400 m increased tHbmass and enhanced physiological capacity in elite endurance *** was no observed relationship between these changes and baseline characteristics,pre-LHTH serum ferritin levels,or reported incidents of musculoskeletal injury or *** HST did however,estimate changes in tHbmass and VO_(2max).HST prior to LHTH could allow coaches and practitioners to better inform the acclimatisation strategies and train-ing load application of endurance runners at altitude.

关键词： Altitude training Runners Endurance Haemoglobin mass Performance Hypoxic sensitivity

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玩赚社会化媒体

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作者： (美)杰米·特纳(jamie turner) (美)列什吗·沙阿(Reshma Shah)

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孟菲斯式的美国梦

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世界建筑导报 2012年第6期 29-29页

作者： jamie Harmon

美国田纳西州孟菲斯市是摇滚音乐的神奇诞生地,其真实起源是又贫困又性感的美国南部白种人,开始爱上并演唱更贫困也更肉感的黑人音乐。***,James Cotton与Howlin’Wolf等著名蓝调音乐家都曾在该城市录制音乐。出过第一张摇滚唱片《火箭8... 详细信息

美国田纳西州孟菲斯市是摇滚音乐的神奇诞生地,其真实起源是又贫困又性感的美国南部白种人,开始爱上并演唱更贫困也更肉感的黑人音乐。***,James Cotton与Howlin’Wolf等著名蓝调音乐家都曾在该城市录制音乐。出过第一张摇滚唱片《火箭88》的Ike turner乐队也在孟菲斯录制音乐。1954年,Sam Phillips制作猫王的第一首歌,就是Arthur Crudup的原创蓝调歌《That’sAllRight》。

关键词：孟菲斯美国美利坚合众国北美洲蓝调音乐家

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