A Response to Excessive Screening Questions

2021 ◽  
Author(s):  
Mitchell H. Katz
Keyword(s):  
Screening Questions

Tuberculosis: Diagnostic Challenges in Rural Africa

Praxis ◽  
2019 ◽  
Vol 108 (15) ◽  
pp. 991-996
Author(s):  
Ngisi Masawa ◽  
Farida Bani ◽  
Robert Ndege
Keyword(s):  
Extrapulmonary Tuberculosis ◽  
X Ray ◽  
Molecular Tests ◽  
Rural Settings ◽  
Chest X Ray ◽  
Screening Questions ◽  
Rural Africa ◽  
Tb Diagnostics ◽  
Strip Test ◽  
Urine Strip

Abstract. Tuberculosis (TB) remains among the top 10 infectious diseases with highest mortality globally since the 1990s despite effective chemotherapy. Among 10 million patients that fell ill with tuberculosis in the year 2017, 36 % were undiagnosed or detected and not reported; the number goes as high as 55 % in Tanzania, showing that the diagnosis of TB is a big challenge in the developing countries. There have been great advancements in TB diagnostics with introduction of the molecular tests such as Xpert MTB/RIF, loop-mediated isothermal amplification, lipoarabinomannan urine strip test, and molecular line-probe assays. However, most of the hospitals in Tanzania still rely on the TB score chart in children, the WHO screening questions in adults, acid-fast bacilli and chest x-ray for the diagnosis of TB. Xpert MTB/RIF has been rolled-out but remains a challenge in settings where the samples for testing must be transported over many kilometers. Imaging by sonography – nowadays widely available even in rural settings of Tanzania – has been shown to be a useful tool in the diagnosis of extrapulmonary tuberculosis. Despite all the efforts and new diagnostics, 30–50 % of patients in high-burden TB countries are still empirically treated for tuberculosis. More efforts need to be placed if we are to reduce the death toll by 90 % until 2030.

scholarly journals O19 Easy-BILAG: a new tool for simplified recording of SLE disease activity using BILAG-2004

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Lucy M Carter ◽  
Caroline Gordon ◽  
Chee-Seng Yee ◽  
Ian Bruce ◽  
David A Isenberg ◽  
...  
Keyword(s):  
Clinical Care ◽  
Coding System ◽  
Scoring Method ◽  
Highly Active ◽  
Main Page ◽  
Logical Sequence ◽  
Case Vignettes ◽  
Screening Questions ◽  
Frequent Items ◽  
Final Score

Abstract Background/Aims  BILAG-2004 index is required to prescribe and monitor biologics in SLE. It is more comprehensive and responsive than the SLEDAI and widely used in clinical trials. However, it may be time-consuming and does require training for accurate use. The original format requires a separate index form, glossary and scoring algorithm. Further, the eventual scores from A (highly active) to E (no disease involvement) which are required to make treatment decisions, can be difficult to calculate during in routine clinical practice.The Easy-BILAG project aimed to develop and validate a simplified tool to score the original BILAG-2004 index more rapidly and with fewer errors, for use in routine clinical care. Methods  The BILAG group identified four areas to address: (i) many items must be scored, but most are rare; (ii) glossary definitions are not always followed; (iii) the final score is not easily calculated at the time of assessment; (iv) training is time-consuming. Data from the BILAG-Biologics Registry were used to measure the frequency of each of 97 BILAG-2004 items in an active SLE population. These data and a series of prototypes were used to design a new tool for simplified scoring of the BILAG-2004 index - the “Easy-BILAG”. This instrument content was tested using exemplar paper cases. A validation study was then designed to test the Easy-BILAG compared to the standard BILAG-2004 scoring method for completion time and accuracy. Results  2395 assessments from the BILAG-BR were analysed. There was marked variation in item frequency. The 7 most frequent items were each present in more than 20% of records: arthralgia (72%), mild skin eruption (47%), moderate arthritis (38%), mild mucosal ulceration (34%), mild alopecia (34%), pleurisy / pericarditis (22%). 16 more items were scored in 5-20% of assessments; 36 items in 1-5% of assessments, and 25 items in < 1% of assessments. The Easy-BILAG was designed to capture items scoring >5% in a rapid single-page assessment. Items are arranged in a logical sequence of clinical assessment. An abridged glossary definition is cited immediately adjacent to each item. A new colour-coding system directs clinicians instantly to the overall A-E score for each domain (colour-blindness compatible). This single page assessment covered 68% of all assessments of biologic-treated patients. The remaining items are scored on a back page only in cases where necessary, as indicated by screening questions on the main page. The overall accuracy and usability of the Easy-BILAG template is now undergoing a validation against test series of standardized case vignettes by a sample of consultants and specialty trainees with a range of experience across England and Wales. Conclusion  Easy-BILAG allows rapid scoring of BILAG-2004 in routine clinical practice. Following completion of validation, it will be made widely available to clinicians. Disclosure  L.M. Carter: None. C. Gordon: None. C. Yee: None. I. Bruce: None. D.A. Isenberg: None. S. Skeoch: None. E.M. Vital: None.

scholarly journals Atypical cutaneous and musculoskeletal manifestation of SARS-CoV-2: ‘COVID-19 toes’ and spasticity in a 48-year-old woman

2021 ◽  
Vol 14 (3) ◽  
pp. e241410
Author(s):  
Avery Kopacz ◽  
Cameron Ludwig ◽  
Michelle Tarbox
Keyword(s):  
Nervous System ◽  
Adult Patient ◽  
Early Identification ◽  
Lower Limbs ◽  
Rare Occurrence ◽  
Cutaneous Manifestations ◽  
Crucial Component ◽  
History Of ◽  
Screening Questions ◽  
Insight Into

Establishing accurate symptomatology associated with novel diseases such as COVID-19 is a crucial component of early identification and screening. This case report identifies an adult patient with a history of clotting dysfunction presenting with rare cutaneous manifestations of COVID-19, known as ‘COVID-19 toes’', previously described predominantly in children. Additionally, this patient presented with possible COVID-associated muscle spasticity of the lower limbs, as well as a prolonged and atypical timeline of COVID-19 infection. The rare occurrence of ‘COVID-19 toes’' in this adult patient suggests that her medical history could have predisposed her to this symptom. This supports the coagulopathic hypothesis of this manifestation of COVID-19 and provides possible screening questions for patients with a similar history who might be exposed to the virus. Additionally, nervous system complaints associated with this disease are rare and understudied, so this novel symptom may also provide insight into this aspect of SARS-CoV-2.

scholarly journals Perception of nursing students about couples' violence: knowledge, beliefs and professional role

2015 ◽  
Vol 23 (3) ◽  
pp. 527-534 ◽  
Author(s):  
Assumpció Rigol-Cuadra ◽  
Paola Galbany-Estragué ◽  
Concepció Fuentes-Pumarola ◽  
Maria Dolors Burjales-Martí ◽  
Dolors Rodríguez-Martín ◽  
...  
Keyword(s):  
Nursing Students ◽  
Violence Against Women ◽  
Mentally Ill ◽  
Ecological Model ◽  
Professional Role ◽  
Specific Situation ◽  
Specific Intervention ◽  
Screening Questions ◽  
Nursing Courses ◽  
Demand Patterns

OBJECTIVES: to analyse the knowledge, beliefs and perception of the professional role that nursing students have, about exerted violence against women in relationships.METHOD: a descriptive qualitative study following the ecological model through 16 focus groups realized with 112 students from four nursing courses of four Spanish universities.RESULTS: the analytical categories were: knowledge, professional role, and beliefs about ones behaviour before the victim and the abuser. Students are unfamiliar with the characteristics of abuse, guidelines, protocols and screening questions and demand patterns for specific intervention. They do not identify their own professional role, be it delegated or specialized. Beliefs regarding their behaviour with the victim, not guided by professional criteria, perceive violence as a specific situation and disassociate the prevention of health care. They perceive the abuser as mentally ill, justifying the tolerance or delegation of performances.CONCLUSIONS: students define preconceived ideas about couples' violence. Speeches reproduce and reinforce stereotypical myths, values indicative of inadequate training for nursing studies which raises the need to fortify the competencies in relation to intimate couples' violence in the curriculum.

Burnout in Pediatric Residents: Comparing Brief Screening Questions to the Maslach Burnout Inventory

2019 ◽  
Vol 19 (3) ◽  
pp. 251-255 ◽  
Author(s):  
Kathi J. Kemper ◽  
Paria M. Wilson ◽  
Alan Schwartz ◽  
John D. Mahan ◽  
Maneesh Batra ◽  
...  
Keyword(s):  
Maslach Burnout Inventory ◽  
Pediatric Residents ◽  
Screening Questions ◽  
Brief Screening

scholarly journals Association between endometriosis, headache, and migraine

2019 ◽  
Vol 11 (1) ◽  
pp. 19-24 ◽  
Author(s):  
Burcin Karamustafaoglu Balci ◽  
Zehra Kabakci ◽  
Damla Y Guzey ◽  
Bartu Avci ◽  
Murathan Guler ◽  
...  
Keyword(s):  
Nervous System ◽  
Autonomic Nervous System ◽  
Medical Records ◽  
Cross Sectional Study ◽  
Control Group ◽  
Cross Sectional ◽  
Autonomic Nervous ◽  
Screening Questions ◽  
The Mean ◽  
Id Migraine

Introduction: Available data suggest that there is an association between endometriosis and a group of disorders including autonomic nervous system irregularities. A deeper understanding of relationship between endometriosis and autonomic nervous system is needed as it may lead to novel discoveries on the causes or consequences of endometriosis. In this study, we analyzed the prevalence of migraine in patients with endometriosis. Methods: In this cross-sectional study, medical records of women were reviewed through January 2013 to December 2017. Women with laparoscopically proven endometriosis (n = 185) were compared with those without endometriosis (n = 168). The 3-item screening questions (ID Migraine™) test was used to screen migraine. Data were analyzed using SPSS v25 (IBM Corporation). The χ2 test was used for analyzing the nominal parameters and group comparisons. Pearson χ2 was used to study the association between endometriosis and migraine. Results: The mean age was 31.86 ± 4.49 years of the endometriosis group and 28.95 ± 5.11 years of the controls (p = 0.408). The two pre-screening questions of ID Migraine test were answered positively by 86 patients of the endometriosis group (75.4%) and by 53 patients of the control group (54.6%) (p = 0.001). Of these patients, 51 (44.7% of endometriosis group) and 26 (26.8% of control group) were diagnosed as having migraine using 3-item Migraine questionnaire (p = 0.007). Conclusion: This study showed that the prevalence of migraine was significantly higher in patients with endometriosis. Because there is a strong correlation, patients with endometriosis should be screened for headache and migraine to increase the benefits of care.

scholarly journals Challenges of Diabetes Self-Management in Adults Affected by Food Insecurity in a Large Urban Centre of Ontario, Canada

2021 ◽  
Author(s):  
Justine Chan ◽  
Margaret De Melo ◽  
Jacqui Gingras ◽  
Enza Gucciardi
Keyword(s):  
Food Insecurity ◽  
Low Income ◽  
Local Community ◽  
Diabetes Education ◽  
Self Management ◽  
Semistructured Interview ◽  
Management Support ◽  
Urban Centre ◽  
Education Centre ◽  
Screening Questions

Objective. To explore how food insecurity affects individuals’ ability to manage their diabetes, as narrated by participants living in a large, culturally diverse urban centre. Design. Qualitative study comprising of in-depth interviews, using a semistructured interview guide. Setting. Participants were recruited from the local community, three community health centres, and a community-based diabetes education centre servicing a low-income population in Toronto, Ontario, Canada. Participants. Twenty-one English-speaking adults with a diagnosis of diabetes and having experienced food insecurity in the past year (based on three screening questions). Method. Using six phases of analysis, we used qualitative, deductive thematic analysis to transcribe, code, and analyze participant interviews. Main Findings. Three themes emerged from our analysis of participants’ experiences of living with food insecurity and diabetes: (1) barriers to accessing and preparing food, (2) social isolation, and (3) enhancing agency and resilience. Conclusion. Food insecurity appears to negatively impact diabetes self-management. Healthcare professionals need to be cognizant of resources, skills, and supports appropriate for people with diabetes affected by food insecurity. Study findings suggest foci for enhancing diabetes self-management support.

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