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Developmental screening : predictors of follow-up adherence in primary health careSchoeman, Joanne Christine January 2016 (has links)
Background: Early identification and intervention for infants and young children with
developmental delays may negate or minimise the negative effect of a disability on a
child's development. Poor follow-up on early detection referrals, however,
undermines the effectiveness of early intervention programmes. Objectives: To
identify factors, including text message reminders, that influence follow-up
adherence for early intervention after developmental screening in primary health
care. A secondary objective surveyed reasons for follow-up default. Methods: The
PEDS Tools was used to screen 247 high-risk children. A risk assessment
questionnaire was completed with caregivers whose children were referred for
speech-language and/or occupational therapy (n=106, 43%). A quasi-experimental
study was employed to identify risk factors for defaulting on appointments. A
thematic analysis of telephonic interviews was also employed to determine reasons
for follow-up defaults. Results: Follow-up adherence was 17%. Participants who
were divorced, widowed or never married were 2.88 times more likely to attend a
follow-up appointment than those who were married or living together (95%, CI 0.97-
8.63). Text message reminders did not significantly improve follow-up. More than
half (58%) of participants who defaulted on appointments could be reached for
telephonic interviews. During the telephonic interviews 87% of participants did not
report concern about their child's development. Reasons for defaulting were
employment, logistical issues, other responsibilities and forgetfulness.
Conclusions: Detecting possible developmental delays did not lead to acceptable
follow-up adherence for early intervention services at primary health care levels.
Increased awareness and education regarding the importance of development for
educational success is needed. / Dissertation (M Communication Pathology)--University of Pretoria, 2016. / Speech-Language Pathology and Audiology / MCommunication Pathology / Unrestricted
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Langzeitverlauf bei ST-Strecken-Hebungsinfarkt und später Vorstellung nach Symptombeginn mit und ohne ThrombusaspirationSchock, Sandra 04 January 2022 (has links)
Ziel der Arbeit war es, den Langzeitverlauf von Patienten mit STEMI bei Vorstellung nach 12 bis 48 Stunden nach Symptombeginn in Abhängigkeit der Revaskularisierung mit oder ohne TA zu beurteilen.
Es wurden hierfür insgesamt 144 Patienten mit Symptombeginn nach 12 bis 48 Stunden in einer 1:1 Randomisierung auf die zwei zu vergleichenden Gruppen PCI mit oder ohne TA verteilt. Der durch die MRT ermittelte primäre Endpunkt MVO konnte durch die TA nicht verringert werden. Der klinische Langzeitverlauf wurde vier Jahre nach Randomisierung des letzten Patienten erhoben. Hierbei wurde ein strukturiertes, telefonisches Interview durchgeführt. Dies umfasste die klinischen Ereignisse Tod, rezidivierender Herzinfarkt, erneute koronare Revaskularisierung, Stentthrombose und Schlaganfall. Anhand des EuroQol-5D-3L Fragebogens wurde die Lebensqualität bewertet.
Die Gesamtmortalität betrug nach vier Jahren 18%. Es stellte sich kein signifikanter Unterschied zwischen beiden Gruppen für die Mortalität heraus. Selbiges gilt für MACE, zusammengesetzt aus Tod, myokardialer Reinfarkt und Zielgefäßrevaskularisierung.
Mit Hilfe einer multivariaten Cox-Regressions-Analyse konnten die GFR nach Aufnahme, LVEF per MRT und kardiogener Schock als unabhängige Prädiktoren für die Langzeitmortalität ermittelt werden.
Zusammenfassend ergibt sich daraus, dass die TA im Vergleich zur Standard-PCI bei STEMI-Patienten, welche sich spät nach Auftreten der Symptome vorstellten, keinen signifikanten Unterschied in Bezug auf langfristige klinische Ereignisse hervorruft.:I. BIBLIOGRAFISCHE BESCHREIBUNG
II. ABKÜRZUNGSVERZEICHNIS
III. TABELLENVERZEICHNIS
IV. ABBILDUNGSVERZEICHNIS
1 EINFÜHRUNG
1.1 Epidemiologie
1.2 Definitionen und Pathophysiologie
1.3 Klinik und Diagnostik des ST-Strecken-Hebungsinfarktes
1.4 Reperfusionstherapie
1.4.1 Perkutane Koronarintervention
1.4.2 Manuelle Thrombusaspiration
1.5 Klinische Studien zu Thrombusaspiration bei subakutem STEMI
2 AUFGABENSTELLUNG
3 METHODEN
3.1 Studiendesign
3.2 Definition klinischer Ereignisse
3.3 Follow-Up
3.4 Statistische Analyse
4 ERGEBNISSE
4.1 Basischarakteristika
4.2 Angiografische und prozedurale Merkmale
4.3 Klinische Ereignisse im Langzeitverlauf
4.4 Lebensqualität nach subakutem ST-Strecken-Hebungsinfarkt
4.5 Prädiktoren der Langzeitmortalität
5 DISKUSSION
5.1 Langzeitverlauf bei subakutem Herzinfarkt
5.1.1 Einfluss der Zeitdauer zwischen Symptombeginn und Reperfusion auf die Infarktgröße und die myokardiale Rettung
5.1.2 Einfluss der Zeitdauer zwischen Symptombeginn und Reperfusion auf die Mortalität und klinischen Ereignisse im Langzeitverlauf
5.2 Die Rolle der Thrombusaspiration bei subakutem Myokardinfarkt
5.3 Grenzen der Arbeit
5.4 Schlussfolgerung und Ausblick
6 ZUSAMMENFASSUNG DER ARBEIT
7 LITERATUR
8 ERKLÄRUNG ÜBER DIE EIGENSTÄNDIGE ABFASSUNG DER ARBEIT
9 LEBENSLAUF
10 DANKSAGUNG
11 ANHANG
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Mitigating Hypothetical Bias: An Application to Willingness to Pay for Beach Conditions InformationQuainoo, Ruth 10 August 2018 (has links)
Hypothetical bias continues to be a challenge for practitioners of the contingent valuation method (CVM). This study compared the effect of three hypothetical bias mitigation techniques in a CVM survey focused on estimating maximum willingness to pay for a beach conditions monitoring service among U.S. Gulf Coast beachgoers. Beach conditions information is known to affect beach patronage but no valuation study has yet estimated its value. The two techniques tested are: budget and substitutes cheap talk treatments and certainty follow-up. We presented a theoretically consistent model of budget-constrained utility maximization which accounts for the respondents’ subjective probability of a good beach trip with and without the beach conditions information. Interval regression was used to estimate respondents WTP for beach conditions monitoring service. Both mitigation treatments were unable to mitigate HB. The mean WTP was $3.39 and the net benefit for the program was between $188,531,063 and $391,474,452.
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The incidence and prevalence of hypertension in the Province of Quebec /Vallée, Michel. January 2008 (has links)
No description available.
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Hospital Readmission and the Timing of Postdischarge Outpatient Follow-upKashiwagi, Deanne Tomie 09 March 2011 (has links)
Indiana University-Purdue University Indianapolis (IUPUI) / Postdischarge follow-up appointments are widely thought to improve the safety of transition for patients moving from the hospital to home. They provide an opportunity for outpatient primary care providers to detect problems or failures of postdischarge care. Readmissions can be used to reflect the quality of postdischarge or transitional care.
This study evaluated whether patients with an outpatient follow-up appointment scheduled with their primary care provider within five calendar days of discharge had fewer 30-day readmissions than those patients who had appointments scheduled six days or longer from discharge. No difference in readmission rate was detected between the two groups.
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Recurrence detection in oropharyngeal cancer –a retrospective cohortstudyLind, Mimmi January 2021 (has links)
Introduction: Oropharyngeal cancer (OPC) is a highly prevalent malignancy worldwideaffecting the tonsils, the soft palette and the base of the tongue. OPC has a high risk ofrecurrence. Patients are offered a 5-year follow-up program in order to discover earlyrecurrences. However, there exists some controversy regarding the benefit of this follow-up indetecting early recurrences. Objective: The primary aim of this study was to investigate whether recurrences of OPC weredetected in patient-initiated appointments or during routine follow-up. The secondary aim wasto compare the survival between these groups. Method and materials: This study is a retrospective cohort study regarding recurrencedetection among patients diagnosed with OPC. The Örebro Head- and neck cancer registerwas used to identify patients with recurrence of OPC. Additional data was collected frommedical records. Results: A total of 75 patients were included. Routine follow-up detected 50.7% ofrecurrences while patient-initiated visits detected 42.7% of recurrences. No statisticallysignificant difference was found in survival between these groups Conclusion: In contradiction to our hypothesis most of the recurrences were detected atroutine follow-up. There was no statistically significant difference in survival between thetwo ways of detection. These results indicate that our current follow-up program has animportance in detecting early recurrences and should not be altered.
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Marte meo i daglig verksamhet - En studie i hur Marte meo tillämpas inom daglig verksamhetGreen, Filip January 2014 (has links)
This report is the result of several interviews of employees within the field of pedagogy. The background behind this report is my period as a trainee in one of the daily activities in Malmo. In daily activities the employers gets training, education and guidance in Marte meo, which is funded by public finances. The method, which this study focuses upon is called Marte meo. It is a method of communicating and developing the means for the participants to evolve their skills in communicating and increase self esteem. In my time as a trainee I noticed that there was no follow up and no feedback to the educators. Nobody knew if the method was, in any way practiced. This study confirms that it in fact is practiced, but in several different ways, which leads to the conclusion that the qualities in the method is many and different from each other . The focus of this report lies completely on the employers in the daily activities. They have been given the opportunity to freely describe in detail how Marte meo is practiced, the pro's and con's of Marte meo and in which way the relations with the participants effect the professional pedagogy.
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Merlin.net Automation of External Reports Verification ProcessWettlaufer, Gabriel John 01 January 2010 (has links) (PDF)
Merlin.net Patient Care Network is a St. Jude Medical product that is used for remote patient management. The basic concept of Merlin.net is to allow the physician to view patient device follow-up information as well as general patient and device information on a web application. The Merlin.net system also interfaces with the patient and will send them notification if they miss a follow-up. All device information will be collected automatically while the patient is sleeping. This information is sent through a telephone line to a Merlin.net server to process a report package and display the collected information on the Merlin.net web application. The Merlin.net verification team ensures that all reports generated by the Merlin.net servers are processed and outputted correctly. There are currently 296 device parameters supported by Merlin.net, and the manual extraction and comparison of the expected parameter values takes several hours for each patient follow-up session. Currently there are 250 patient follow-up sessions used for verification testing. Each new release will continue to create additional patient follow-up sessions. Merlin.net releases are approximately 6 months apart, and each new release adds approximately 30-50 new patient follow-up records to support the new devices. In order to meet aggressive project deadlines, while ensuring that the Merlin.net system is processing and outputting patient follow-up data correctly, it is necessary to come up with an automated process to verify the contents of the processed data is correct. This will save a tremendous amount of time as well as improve on the quality of the verification process by eliminating human error and rework. It is critical for patient safety that the patient device follow-up information is processed and outputted correctly.
In this thesis an automated process was developed to verify the correct content of the Merlin.net server generated reports for each patient follow-up session. This process leveraged different tools and scripting languages to achieve automation. TDE (Test Development Environment) tool was used to extract the device parameters from the patient follow-up sessions. The TDE script was written to extracts the desired parameter values from the patient follow-up session and automatically populates parameters in a device parameters spreadsheet. Once all the device parameter values are extracted in the spreadsheet, they are passed through a set of mapping rules, which form the expected values. The mapping rules were implemented as VBA (Visual Basic for Application) macros, one macro for each report. The VBA macros write the expected values back to the spreadsheet to form an “expected values spreadsheet”. The patient follow-up session is then sent to the Merlin.net server to process, which generates a processed patient follow-up session that contains a reports package in .zip format. A perl script was then written to compare the parameter values in the Merlinet.net generated reports with the corresponding expected values from the expected values spreadsheet. The perl script generates a comparison report displaying the discrepancies between the actual and the expected values.
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Assistive technology recommendations: measuring device use, discontinuance, and client satisfaction in rehabilitation settingsPrimeau, Casey A. 29 September 2019 (has links)
INTRODUCTION: Device discontinuance is a widespread problem with assistive technology (AT) and durable medical equipment (DME), affecting approximately one third of people with disabilities who successfully acquire equipment. Consumers’ dissatisfaction with service and device-related factors can directly lead to AT device non-use. Roger’s Diffusion of Innovation Theory provides a foundation for understanding how to address device discontinuance, potentially through follow-up services.
OBJECTIVE: The aim of this doctoral capstone is to discuss the piloting and feasibility of using follow-up outcome measures in an outpatient occupational therapy rehabilitation setting in order to identify and address challenges with equipment discontinuance.
METHODS: A sample of 69 clients receiving equipment recommendations from a specialty AT clinic were contacted. The COPM, ATUFS, and QUEST 2.0 were piloted to measure device use and satisfaction. The feasibility of using these measures within a follow-up protocol for this outpatient practice was then evaluated.
RESULTS: A total of 63% of the sample (N=69) was successfully contacted. The site-specific protocol successfully determined whether these clients had acquired and used their devices, subsequently allowing AT practitioners to provide additional supports for clients who had experienced discontinuance or non-acquisition.
CONCLUSION: Using standardized outcome measures to follow-up with clients in this setting was deemed not feasible secondary to time constraints and difficulty contacting clients. Recommendations for improving follow-up with and without use of standardized measures is discussed. Follow-up encouraged clients to schedule additional appointments, utilize recommended funding resources, or seek out referrals.
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Follow-up routines for occlusal appliances in public dental practice in Västerbotten, SwedenDaniel, Terblanche, Mikael, Trinh January 2022 (has links)
Background: Occlusal appliances for treatment of different temporomandibular disorders (TMD) have shown to have good effect. Patients treated with an occlusal appliance should return for follow-ups and they have a right for free follow-ups within 3 months. Despite this, there are patients that are not receiving their follow-ups. Aim: To evaluate follow-up routines after treatment with an occlusal appliance in public dental practice in Västerbotten, Sweden. To evaluate the most common indications for treatment with an occlusal appliance. To evaluate if the dentists register the outcome of the treatment with their occlusal appliance or not. Methods: Onehundred randomly selected dental records were analysed from patients treated with an occlusal appliance during 2019 in public dental practice in Västerbotten county. The analysis was conducted using a Microsoft Excel document that had prior to analysis been created. The results were processed using IBM SPSS Statistics and Microsoft Excel. Results: Forty-eight of the 97 accessible patients had a scheduled follow-up. Out of these, 38 received their follow-ups. Seventy-three patients had bruxism as an indication for treatment, 40 had myalgia, 33 had tooth wear and 33 had replacement of an old appliance. Sixty-four out of 97 patients had no information about evaluation of treatment, 17 had improved symptoms. Conclusions: The study showed an approximately 50% rate of scheduled follow-ups of occlusal appliances and the most common indication for that treatment was bruxism. The dentists did not evaluate the treatment outcome of patients’ symptoms. It is recommended to adhere to the decision-making model.
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