Thesis (M.S.)--University of Michigan, 19977 / Includes bibliographical references.

Thesis submitted in fulfilment of the requirements for the degree Master of Technology: Design in the Faculty of Informatics and Design at the Cape Peninsula University of Technology 2014 / If a patient arrives at a general practice whether with a scheduled appointment or at random during office hours, the general practitioner should be able to assist the patient’s with direct access to the patient folder which is stored at the office. What this research study focuses on is the accessing of patient information when the general practitioner is not at the office (usually after working hours). The research study takes place within the Durbanville suburb of Cape Town, South Africa. Interaction design is used as a framework to develop a solution by using smartphone technology.

(1) Were among the antihypertensive drugs with the lowest likelihood of discontinuation implying a potentially superior tolerability profile (2) Had similar odds of short and long term rates of add-on pharmacotherapy implying a similar efficacy with other drug classes (3) Were associated with statistically similar all cause and CVS mortality (4) Had similar odds of presenting with impaired fasting glucose in the short-term. (5) Had higher odds of presenting with hypercholesterolemia in the short-term but the absolute increase in cholesterol was minimal (in the magnitude of 0.14 mmol/1). > (6) Had similar odds of presenting with hyponatremia and hypokalemia in the short-term. / Due to the large sample size these studies are likely to be representative and are new findings among ethnic Chinese patients presenting with uncomplicated hypertension. These results point towards thiazide diuretics as a favorable first-line antihypertensive agent in the management of uncomplicated hypertension in Hong Kong primary practice, in addition to favorable public health considerations including affordability. These studies are in support of guidelines from international authorities recommending thaizide diuretics as the best choice of first-line antihypertensive agent, and suggest that such international guidelines may be generalizable to patients of Chinese race. (Abstract shortened by UMI.) / In these studies we have characterized the major antihypertensive drug classes in terms of their prescription patterns, efficacy, tolerability and association with adverse clinical as well as biochemical outcomes. The completeness of CDARS and e-CMS of the Hospital Authority allows retrieval and comparison of these clinical outcomes of the commonly used antihypertensive agents. The present studies showed that prescription of CCB and BB were high compared with international trends and that of thiazide particularly low and showed a declining trend. Yet when compared with other drug classes, thiazide diuretics: / Wong Chi Sang. / Adviser: Stewart William Mercer. / Source: Dissertation Abstracts International, Volume: 70-09, Section: B, page: . / Thesis submitted in: September, 2008. / Thesis (M.D.)--Chinese University of Hong Kong, 2009. / Includes bibliographical references (leaves 223-260). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / School code: 1307.

Chronic Diseases are the major cause of mortality around the world, accounting for 7 out of 10 deaths each year in the United States. Because of its adverse effect on the quality of life, it has become a major problem globally. Health care costs involved in managing these diseases are also very high. In this thesis, we will focus on two major chronic diseases Asthma and Diabetes, which are among the leading causes of mortality around the globe. It involves design and development of a predictive analytics based decision support system which uses five supervised machine learning algorithm to predict the occurrence of Asthma and Diabetes. This system helps in controlling the disease well in advance by selecting its best indicators and providing necessary feedback. / Includes bibliography. / Thesis (M.S.)--Florida Atlantic University, 2015. / FAU Electronic Theses and Dissertations Collection

The need to expand access to and availability of quality and comprehensive sexual and reproductive health care (SRH) to help close the gaps in existing health disparities and health inequities in the United States is a pressing public health concern. The emergence of alternative primary care settings (i.e., retail-based clinics [RBCs]) has recently proven to be an effective model for the delivery of acute care in lieu of more traditional medical services. Indeed, RBCs could be an agent for greater SRH care access with the integration of more services; however, barriers exist that inhibit this maximization of care. Providers play a central role in the utilization of SRH in RBCs, whether through their intent to recommend or biases about RBCs. Provider recommendation is a strong indicator for patient compliance. However, little is known about how providers’ attitudes and beliefs influence the uptake of SRH in RBCs. This cross-sectional study collected survey data from a large sample of 341 advanced practice clinicians (APC) to (1) understand the benefits and barriers of SRH integration in RBCs; and (2) identify the relationship between the attitudes of APCs regarding RBCs and their influence on barriers and benefits of SRH integration into RBCs. Items were adapted from existing valid and reliable measures. Survey data were analyzed primarily using descriptive statistics. Comparative analysis between demographic factors and identifier variables that led to several themes: a majority of APCs believe the integration of SRH into RBCs would expand access to and availability of quality and comprehensive SRH care for prevention and intervention; hesitancy to recommend SRH services is chiefly founded in lack of confidence in quality assurance, professional training and quality of services offered; overall APCs had a generally positive attitude towards the integration of SRH in RBCs but attitudes differed among the types of SRH services offered at RBCs. These findings provide insight for the identification of barriers and benefits in the integration of SRH in RBCs. This may create opportunities to address barriers for the expansion of prevention and intervention services among women while capitalizing on benefits to advance awareness, education and access to care.

With passage of the Patient Protection and Affordable Care Act (PPACA) and the publication of the Institute of Medicine’s report on the future of nursing, nurses are slated to take on an expanded role in primary healthcare delivery in the near future. Nurse practitioners, in particular, will be instrumental in filling the gap in primary care availability engendered by the increasing specialization of physician practice and increased access to healthcare made possible by the provisions of the PPACA. The need for this study was identified through gaps in the literature related to nurse practitioner practice; specifically, the paucity of quantitative research regarding patients’ perspectives of core holistic nursing values in nurse practitioner care, and, since nursing care is by definition and tradition holistic in nature, this inquiry attempted to quantify the degree to which nurse practitioner care upholds and preserves core holistic nursing values. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2014. / FAU Electronic Theses and Dissertations Collection

Chronic and complex conditions are a significant concern within contemporary health care systems. The ageing population and improvements in survival from acute cardiac illness have seen an increasing incidence of heart failure (HF). Heart failure represents a significant burden on both the individual and the wider community. Despite effective pharmacotherapy and established evidence-based management guidelines, the overall prognosis from HR is poor. The complexity of the disease process and the highly developed evidence-base makes HR an excellent exemplar for the management of a range of chronic conditions. Studies undertaken as part of the ‘Carving a niche for Australian practice nurses’ project have led to the development of a model of care that integrates the role of the practice nurse with those of other health care providers to improve outcomes for people with chronic and complex conditions. Whilst the model of care developed from these studies requires empirical testing to validate its utility, it is currently being incorporated in clinical planning and ongoing pragmatic research. The systematic, sequential derivation of data from this ‘Carving a niche for Australian practice nurses’ project will inform the development of primary care and provide a conceptual framework for future intervention studies in Australian general practice. / Doctor of Philosophy (PhD)

Introduction - Eighty five per cent of Australians visit a GP each year, but do not receive all of the preventive care which is indicated for them. There have been no controlled trials of the effects of on-screen preventive care reminders in Australian general practice, and there is little published research examining characteristics of patients, doctors and consultations associated with the performance of preventive services in general practice. This study aimed to measure the effects of opportunistic reminders and to explore previously unexamined patient, GP and consultation factors associated with performance of preventive activities. The hypotheses were : a ) that general practitioners who were using a computer medical record system would take at least fifteen per cent more of opportunities to perform preventive care activities if they were reminded ; b ) that this would occur without any significant increase in the number of consultations or in patient billings ; and c ) that every characteristic of patients, GPs, consultations and preventive opportunities would be significantly associated with the performance of the preventive activities. Method - All patients who attended a ten GP fully computerised practice during one year were enrolled and randomised either to an intervention group, for whom the GPs received opportunistic on-screen reminders about eleven preventive activities, or to a 'usual care' control group. Performance by the GPs of the preventive activities was recorded automatically and correlated with routinely-collected demographic and clinical information about the patients and billing data. Results - For the intervention group compared to the control group, the GPs took thirty two per cent more of the preventive opportunities without any increase in numbers of services or in patient billings. Every characteristic of patients, GPs, consultations and preventive opportunities was independently associated with the performance of at least two of the preventive activities. Discussion - This trial has shown that a low cost minimally-intrusive intervention in the form of automated opportunistic reminder messages can significantly improve GPs' performance of preventive care activities. The findings of this trial may help to improve the design and effectiveness of opportunistic reminders in clinical software, and provide direction about possible changes to the health system which may foster increased provision of preventive care. / Thesis (Ph.D.)--University of Adelaide, School of Population Health and Clinical Practice, Discipline of General Practice, 2006.

Source: Masters Abstracts International, Volume: 47-06, page: 3553. Advisers: Michael L. Parchman; Jimmy L. Perkins. Includes bibliographical references.

Source: Masters Abstracts International, Volume: 46-05, page: 2648. Adviser: Stephanie McFall. Includes bibliographical references.