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The purpose of this study is to identify best practices for innovative primary care models and to describe a potential future primary care (PC) model for Texas to address the burden of chronic disease in a population-based approach.

A systematic literature review was conducted and identified 1,880 published records through PubMed using 26 search terms. After abstract and full-text review, 70 articles remained as potential models.

Although there is already a severe shortage of physicians in Texas, emerging practice patterns and choices among physicians are likely to erode access to primary care services in the state. Health-care leaders are encouraged to consider models such as complex adaptive systems for team-based care, pharmacist hypertension care management program and combined nurse-led care management with group visit structure.

As with any study, this research has its limitations; for example, models that might work in one state, or under a unique state-funded academic medical center, might not be “do-able” in another state within the nuances of a different funding mechanism.

Results of this research provide a model for implementing IPCM for the state of Texas first and will guide IPCM planning and implementation in other states.

This study is “land grant-centric” and focused on carrying out the mission of a major, top-tier research university with an emerging college of medicine at an academic medical center.

Recently, there has been a renewed interest in medical students’ mental health. The purpose of this paper is to determine factors associated with psychological distress in medical students and to assess the correlation between major lifestyle behaviours and mental health.

The authors conducted a cross-sectional questionnaire survey among 530 medical students randomized from a faculty of medicine in 2017. The authors used the 12-item General Health Questionnaire (GHQ-12) and the Simple Lifestyle Indicator Questionnaire (SLIQ) to assess mental health and lifestyle, respectively.

The mean value of GHQ-12 and SLIQ were 4.1±2.8 and 6.2±1.4, respectively. Bivariate correlation analysis showed that SLIQ was significantly correlated to GHQ-12 (r=−0.26; p<0.001). The prevalence of psychological distress (GHQ-12=4) was 50.1%. The authors found that low/middle financial situation of the family (OR=1.5; CI 95%=[1.1–2.3]), internship level, (OR=1.8; CI 95%=[1.1–3.3]), medium/poor perceived academic performance (OR=2.2; CI 95%=[1.5–3.2]) and medium/poor perceived health status (OR=2.3; CI 95%=[1.5–3.6]) were significantly associated with psychological distress. Multivariate analysis performing logistic regression showed that average and unhealthy lifestyle were independently associated with psychological distress, with an adjusted OR of 3.7 (CI 95%=[1.7–7.7]) and 5.8 (CI 95%=[2.4–14.8]), respectively.

The study highlighted the magnitude and the risk factors of psychological distress in medical students. Unhealthy lifestyle was a potential predictive of mental disorders. These findings provide fundamental information for future researches.

This study examined the impact of resonance expressed by the positive emotional attractor (PEA) and dissonance represented by the negative emotional attractor (NEA) created by medical students during diagnostic encounters with standardized patients (SPs) (laypeople) from the clinical skills exam (CSE). Secondary data were collected from 116 videotaped CSE encounters between SPs and medical students. Associations among the PEA and NEA states, and medical student effectiveness measured by SP, faculty, and differential diagnosis scores using moderated multiple regression analysis were determined. Results suggest that the PEA and NEA are powerful conditions for determining medical student effectiveness in clinical encounters.

The purpose of this paper is to investigate the results obtained from a study on cooperation, collaboration and partnerships between academic libraries in Romania.

The study is limited to the answers received from interviews with 11 of the 15 invited directors/heads of academic libraries from Romanian universities, but the findings can be extrapolated to assess the overall situation in this country.

The results’ analysis indicates that 73 percent of the participants (8 participants) consider cooperation in the activities of Romanian academic libraries as being at a low to medium level. National cooperation can be found only in relation to access to electronic information resources. Collaboration between libraries and other departments and services within universities exists, but collaboration with students and the teaching staff is less developed. Despite the small number of partnerships and collaborative projects in which Romanian academic libraries are involved, there is a desire to further develop such activities.

The study is the first of its kind undertaken in Romania and paves the way for further research on this issue.

Despite technological advancements to enhance patient health, the risks of not discovering the correct interactions and trends in digital health are high. Hence, a careful policy is required for health coverage tailored to needs and capacity. Therefore, this study aims to explore the adoption of a cognitive computing decision support system (CCDSS) in the assessment of health-care policymaking and validates it by extending the unified theory of acceptance and use of technology model.

A survey was conducted to collect data from different stakeholders, referred to as the 4Ps, namely, patients, providers, payors and policymakers. Structural equation modelling and one-way ANOVA were used to analyse the data.

The result reveals that the behavioural insight of policymakers towards the assessment of health-care policymaking is based on automatic and reflective systems. Investments in CCDSS for policymaking assessment have the potential to produce rational outcomes. CCDSS, built with quality procedures, can validate whether breastfeeding-supporting policies are mother-friendly.

Health-care policies are used by lawmakers to safeguard and improve public health, but it has always been a challenge. With the adoption of CCDSS, the overall goal of health-care policymaking can achieve better quality standards and improve the design of policymaking.

This study drew attention to how CCDSS as a technology enabler can drive health-care policymaking assessment for each stage and how the technology enabler can help the 4Ps of health-care gain insight into the benefits and potential value of CCDSS by demonstrating the breastfeeding supporting policy.

This study aims to explore the perspectives of psychiatrists with lived experiences and what their considerations are upon integrating the personal into the professional realm.

As part of a qualitative participatory research approach, participant observations during two years in peer supervision sessions (15 sessions with 8 psychiatrists with lived experiences), additional interviews as part of member feedback and a focus group were thematically analysed.

Although the decision to become a psychiatrist was often related to personal experiences with mental distress and some feel the need to integrate the personal into the professional, the actual use of lived experiences appears still in its early stages of development. Findings reveal three main considerations related to the personal (3.1), professionality (3.2) and clinical relevance (3.3) comprising 11 facilitators and 9 barriers to harness lived experiences.

This study was conducted locally and there are no similar comparable studies known. It was small in its size due to its qualitative nature and with a homogeneous group and therefore may lack generalisability.

Future directions to further overcome shame and stigma and discover the potential of lived experiences are directed to practice, education and research.

Psychiatrists with lived experiences valued the integration of experiential knowledge into the professional realm, even though being still under development. The peer supervision setting in this study was experienced as a safe space to share personal experiences with vulnerability and suffering rather than a technical disclosure. It re-sensitised participants to their personal narratives, unleashing its demystifying, destigmatising and humanising potential.

Anecdotally, many hospitals experience shortfalls in anaesthetic consultant staffing. This paper aims to investigate whether these subjective experiences are confirmed objectively.

The paper hypothesises that a simple model that estimated service delivery capability using consultant entitlements to annual and other types of leave would not (null hypothesis) accurately predict the magnitude of any shortfall that existed. It also hypothesises that excessive leave‐taking was an important cause of any shortfall. A comparison is made between the model predictions for total leave taken and service delivery with results from a real data set from a large university teaching hospital's department of anaesthetics.

The model prediction for leave (median total 45 days absence in a year per consultant, range (30‐59)) closely matched the reality (median 41 days (tenth‐ninetieth deciles 30‐69)). Consequently, both model predictions and the real data for annual elective service delivery agreed: median 228 sessions (193‐266) vs 232 (183‐266) per consultant respectively. Taking into account likely service delivery by trainees (2,304‐4,140 elective sessions in total annually) the predicted shortfall of 2,220 sessions was very close to the true elective service shortfall of 2,148 sessions for the department as a whole over the year.

Rejecting the null hypothesis, it is concluded that a simple model that estimates elective service delivery using leave entitlements as the main factor can accurately predict actual service capability for a department. There is no evidence that excessive leave‐taking occurs.

The paper computes an estimate that 2.2‐2.6 consultants per functional operating theatre are necessary to ensure that staffing matches the elective workload.

This paper sets out to investigate whether demand for gynaecological theatre time could be described in terms of the time required to undertake elective operations booked for surgery, and so help match the capacity to this.

A questionnaire assessed the estimates for total operation time for seven common operations, sent to surgeons, anaesthetists and nursing staff in one tertiary referral and one district general hospital (total 49 staff; response rate 58 per cent), and estimates were obtained from theatre computer logs. Average timings for each operation were then applied to cases added from clinics to the waiting list at the district general, to yield the mean demand for elective surgery, and were also applied to emergencies to estimate emergency workload. Finally these demand estimates were compared with the theatre capacity available.

The paper found no difference between the estimates of the three staff groups or between these and the theatre logs (p=0.669), nor did it find that estimates differed between the two centers (p=0.628). Including emergencies, the mean (95 per cent confidence intervals) demand at the district general was 2,438 (1,952‐2,924) min/week.

Although the paper modelled the variation in demand using the relevant variation in operation times, any additional variation caused by differences in booking rates from clinics over time was not nodelled. The minimum period over which data should be collected was not established.

The paper finds that the existing capacity of 1,680 min/week did not match these needs and, unless it was increased, a rise in waiting lists was predictable.

The paper concludes that time estimates for scheduled operations can be better used to assess the need for surgical operating capacity than current measures of demand or capacity.

The purpose of this paper is to provide a selected bibliography of recent resources on library instruction and information literacy.

The paper introduces and annotates periodical articles, monographs, and audiovisual material examining library instruction and information literacy.

The paper provides information about each source, discusses the characteristics of current scholarship, and describes sources that contain unique scholarly contributions and quality reproductions.

The information may be used by librarians and interested parties as a quick reference to literature on library instruction and information literacy.

This paper aims to present recently published resources on library instruction and information literacy providing an introductory overview and a selected annotated bibliography of publications covering all library types.

This paper introduces and annotates English-language periodical articles, monographs, dissertations, reports and other materials on library instruction and information literacy published in 2018.

The paper provides a brief description of all 422 sources, and highlights sources that contain unique or significant scholarly contributions.

The information may be used by librarians and anyone interested as a quick reference to literature on library instruction and information literacy.