Implementation of Evidenced-Based Practices to Improve Follow-up Care Following Inpatient Mental Health Hospitalizations. Jacqlyne W Bowman, Dr. Judy Rice, Dr. Beth Schreiner, Dr. Ernie Maupin, College of Nursing, East Tennessee State University Persons hospitalized for mental health conditions are frequently lost to follow up after discharge. The aim of this quality improvement project is to increase the rate of attendance at follow up appointments after hospital discharge back to the community. The focus of this project is the development and implementation of a discharge questionnaire for both clients and case management to better understand the needs of the clients during the discharge process. Behavioral health technicians employed by the agency are including the discharge questionnaire in the admission packet for a 12-week trial period. This discharge questionnaire asks clients their preferred location for follow up appointments, if they are active in their care, if transportation is needed for follow up appointments and verifies the patient’s phone number. Clients complete the discharge questionnaire and return it to the behavioral health technicians with their admission packet. The discharge questionnaire is then given to case managers to assess and address concerns outlined on the questionnaire. Data will be gathered over 12-weeks to determine if the rate of non-attendance decreases with the integration of the questionnaire. The project is in the implementation phase. The anticipated outcome is there will be an increase in the rate of attendance at follow-up appointments post discharge with the use of the discharge questionnaire. By utilizing the discharge questionnaire, case managers will be better able to determine barriers that lead to non-attendance to follow up appointments. With the barriers identified and addressed, individuals will be more likely to attend their follow-up appointments and medication compliance and rates of re-hospitalizations will improve.

Magister Public Health - MPH / Background: HIV/AIDS remains a major public health issue that is affecting all population groups and communities in Zambia. Among the most affected groups are key populations (KPs) such as female sex workers. KPs are considered at high risk of contracting HIV but have limited access to HIV services and retention in care due to internalized stigma, discrimination, criminalization, and negative attitudes towards HIV treatment. Under the USAID Open Doors project in Zambia, KPs access comprehensive HIV prevention, care and treatment services. The test and treat strategy is implemented by the project in support of the UNAIDS 90-90-90 targets by 2020 to diagnose 90% of people living with HIV, put 90% of them on treatment, and for 90% of them to have suppressed viral load. Aim: This study aimed to determine retention in care among female sex workers (FSWs) in the first six months after ART initiation using the HIV care cascade. Methodology: A retrospective cohort study was conducted of all new HIV positive female sex workers (FSWs) initiated on ART between October 2018 and June 2019 (9 months period) based on the electronic records. Data were extracted from SmartCare, an electronic health record system used by the ART clinic. Microsoft Excel and Epi-Info 7 software were used for data entry and analysis. Kaplan–Meier survival analysis was conducted to examine differences in retention rates. Results: A total of 205 FSWs were initiated on ART, out of which 180 were active on ART (36 youths and 144 adults) and 25 were lost to follow-up (four youths and 21 adults) during the 9 months study period. Of the 180 FSWs active on ART, 36 were FSWs aged 18 – 24 years (youths) representing 90% retained in care while 144 were FSWs aged 25 – 42 years (adults) with 87% being retained on ART treatment. Retention in ART care was not significantly different in the survival curves between the age groups of FSW youths and FSW adults during the study period (p-value = 0.637). Retention in ART care was not statistically significant for education (p-value = 0.481), marital status (p-value = 0.545), and occupation (p-value = 0.169). Conclusion: Retention in ART care among FSWs was 88%. However, there were no significant differences by age group identified in this study. While this study shows 88% retention rate among FSWs, it will be used as a baseline in meeting the UNAIDS 90-90-90 goals.

The objective of employability of graduates is one of the main comerstones of the Bologna process and hig quality education is a key to achieving employability. The main purpose of this study was to investigate and analyze what kind of occupation sport sciences students had after they completed their studies at Umeå University. Furthermore, the intension was to study the alumnus understandings and experiences concerning employability. This was investigated through a web-based survey and the study was based on 54 surveys. The result indicated that more than half of the alumnus currently has an employment that corresponds with their higher education. There were a big variation in employers and job titles. The main reason to why alumnus at the moment didn't have an employment that corresponded with their education was the lack of jobs. In addition the result indicated that 75% of the alumnus had experienced that their education in sport sciences had increased their employability.

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

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

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.

No description available.

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.

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.

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.