scholarly journals Leadless atrio-ventricular synchronous pacing in an outpatient setting – early lessons learned on factors affecting atrio-ventricular synchrony

Heart Rhythm ◽  
2021 ◽  
Author(s):  
Felix Neugebauer ◽  
Fabian Noti ◽  
Stephan van Gool ◽  
Laurent Roten ◽  
Samuel H. Baldinger ◽  
...  
Author(s):  
Swastika Chandra ◽  
Masoud Mohammadnezhad

From a clinical perspective, effective and efficient communication is part of a strategy to ensure doctors are providing high-quality care to their patients. Despite the positive impact of effective doctor–patient communication on health outcomes, limited information is available on this in Fiji. This study was carried out to determine the current patients’ perception of doctors’ communication behaviour and identify factors affecting the doctor–patient communication in Fiji. This mixed-method study was conducted in the outpatient setting of three randomly selected health centres in the Suva Subdivision, Fiji. For the quantitative phase, systematic random sampling was used to select the 375 participants who completed the structured questionnaire; of those, 20 participants were selected for the qualitative interview. From the patients’ perception, 45.6% of them perceived doctors’ communication behaviour as good, 53.6% as fair, and 0.8% as poor communication behaviour. Qualitative findings highlight factors such as the attitude of the doctors, their approach, their interaction with the patients, and them providing an explanation as important factors during doctor–patient communication. In Fiji, the majority of patients perceived doctors’ communication behaviour as fair to good and the doctors’ skills were important for effective doctor–patient communication. This study highlighted the importance of doctor–patient communication and suggested that doctors might not be practicing patient-centred care and communication; thus, they need to upgrade their patient-centred communication skills.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 850-850
Author(s):  
Nicole Dawson ◽  
Heather Menne

Abstract The National Institute on Aging recognizes the importance of identifying promising non-pharmacological interventions (NPI) to promote health in individuals with Alzheimer’s disease and related dementias. Several systematic reviews have been completed investigating exercise in this population resulting in mixed evidence regarding efficacy across functional domains. It is critical to investigate the methodological factors from the original interventions for a true understanding of these findings as to not outright dismiss exercise as beneficial. One example is Ohio’s replication of Reducing Disability in Alzheimer’s Disease (n=508), which resulted in no significant improvements in physical performance for individuals with dementia ((gait speed (p=.81), balance (p=.82), functional reach (p=.58)). In this investigation, along with many others, researchers were not guided by key principles of exercise science leading to critical intervention design and methodological flaws. Thus, exercise interventions for individuals with dementia need to include interpretations of non-findings and report key factors affecting the outcomes.


2021 ◽  
Author(s):  
Helena A. Rempala ◽  
Justin A. Barterian

Abstract Background: Neurofeedback (NF) has been described as “probably efficacious” when used in conjunction with other interventions for substance use disorders, including the most recent studies in population of individuals with opioid use disorder. Despite these promising outcomes, the seriousness of the opioid epidemic, and the high rate of relapse even with the most effective medication-assisted maintenance treatments NF continues to be an under-researched treatment modality. This article explores factors that affected the feasibility of adding Alpha/Theta Neurofeedback to treatment as usual for opioid dependence in an outpatient urban treatment center. The study strived to replicate previous research completed in Iran that found benefits of NF for opioid dependence.Methods: Out of approximately two dozen patients eligible for Alpha/Theta NF, about 60% (n=15) agreed to participate; however, only 2 participants completed treatment. The rates of enrollment in response to active treatment were monitored. Results: The 4 factors affecting feasibility were: 1) the time commitment required of participants, 2) ineffectiveness of standard incentives to promote participation, 3) delayed effects of training, and 4) the length and number of treatments required.Conclusion: The findings indicate a large scale study examining the use of NF for the treatment of opioid use disorder in the United States will likely be difficult to accomplish without modification to the traditional randomized control study approach and suggests challenges to the implementation of this treatment in an outpatient setting.


2018 ◽  
Vol 54 (3) ◽  
pp. 225-234 ◽  
Author(s):  
Hailey Meaklim ◽  
Jo‐Anne M. Abbott ◽  
Gerard A. Kennedy ◽  
Greg Murray ◽  
Britt Klein ◽  
...  

2011 ◽  
Vol 12 (6_suppl_1) ◽  
pp. 63S-72S ◽  
Author(s):  
Marielena Lara ◽  
Tyra Bryant-Stephens ◽  
Maureen Damitz ◽  
Sally Findley ◽  
Jesús González Gavillán ◽  
...  

The Merck Childhood Asthma Network (MCAN) initiative selected five sites (New York City, Puerto Rico, Chicago, Los Angeles, and Philadelphia) to engage in translational research to adapt evidence-based interventions (EBIs) to improve childhood asthma outcomes. The authors summarize the sites’ experience by describing criteria defining the fidelity of translation, community contextual factors serving as barriers or enablers to fidelity, types of adaptation conducted, and strategies used to balance contextual factors and fidelity in developing a “best fit” for EBIs in the community. A conceptual model captures important structural and process-related factors and helps frame lessons learned. Site implementers and intervention developers reached consensus on qualitative rankings of the levels of fidelity of implementation for each of the EBI core components: low fidelity, adaptation (major vs. minor), or high fidelity. MCAN sites were successful in adapting core EBI components based on their understanding of structural and other contextual barriers and enhancers in their communities. Although the sites varied regarding both the EBI components they implemented and their respective levels of fidelity, all sites observed improvement in asthma outcomes. Our collective experiences of adapting and implementing asthma EBIs highlight many of the factors affecting translation of evidenced-based approaches to chronic disease management in real community settings.


Author(s):  
Georg Reichard ◽  
Suchismita Bhattacharjee

The authors present a comparative study on effectiveness of energy policies for the building sector that are presently implemented in selected countries in Europe versus selected states in the U.S. Socio-economic factors affecting energy consumption on both sides of the Atlantic are identified from a human behavior perspective. Various identified factors known to affect energy efficiency and consumption have been positioned in diagrams based on four primary directions: lifestyle, economy, environment, and technology. In a second step various programs and incentives are positioned in the same diagram to demonstrate how well these strategies address the factors identified before. This is done for selected countries and continents in sub-diagrams to allow a comparison of effectiveness and provide a tool for predicting the effectiveness of a possible policy or program transfer to other nations. The research conducted so far suggests that energy efficiency policies and measures implemented in the United States do not always target the factors that have been identified to most significantly influence energy consumption. The results indicate that there might be a significant gap between parameters that are guiding factors affecting energy consumption, and parameters targeting a proper implementation of energy efficient policies. The authors strive to provide a tool that will help policy makers and other decision makers to evaluate and compare their incentives and programs against those from other countries and benefit from lessons learned by mapping various policies towards specific efficiency parameters.


1997 ◽  
Vol 36 (03) ◽  
pp. 179-183 ◽  
Author(s):  
S. J. Frawley ◽  
S. M. Powsner ◽  
R. N. Shiftman ◽  
P. L. Miller ◽  
C. A. Brandt

IMM/Graph is a visual model designed to help knowledge-base developers understand and refine the guideline logic for childhood immunization. The IMM/Graph model is domain-specific and was developed to help build a knowledge-based system that makes patient-specific immunization recommendations. A “visual vocabulary” models issues specific to the immunization domain, such as (1) the age a child is first eligible for each vaccination dose, (2) recommended, “past due” and maximum ages, (3) minimum waiting periods between doses, (4) the vaccine brand or preparation to be given, and (5) the various factors affecting the time course of vaccination. Several lessons learned in the course of developing IMM/Graph include the following: (1) The intended use of the model may influence the choice of visual presentation; (2) There is a potentially interesting interplay between the use of visual and textual information in creating the visual model; (3) Visualization may help a development team better understand a complex clinical guideline and may also help highlight areas of incompleteness.


2020 ◽  
pp. 1-14
Author(s):  
Jessica D Rothstein ◽  
Rolf Klemm ◽  
Debora Niyeha ◽  
Erin Smith ◽  
Stella Nordhagen

Abstract Objective: This process evaluation aimed to understand factors affecting the implementation of a government-sponsored short message service (SMS) programme for delivering nutrition information to rural populations, including message access, acceptability and putting messages into action. Design: The study was nested within a larger randomised controlled trial. Cross-sectional data collection included structured surveys and in-depth interviews. Data were analysed for key trends and themes using Stata and ATLAS.ti software. Setting: The study took place in Tanzania’s Mtwara region. Participants: Surveys were conducted with 205 women and 93 men already enrolled in the randomised controlled trial. A sub-set of 30 women and 14 men participated in the in-depth interviews. Results: Among women relying on a spouse’s phone, sharing arrangements impeded regular SMS access; men were commonly away from home, forgot to share SMS or did not share them in women’s preferred way. Phone-owning women faced challenges related to charging their phones and defective handsets. Once SMS were delivered, most participants viewed them as trustworthy and comprehensible. However, economic conditions limited the feasibility of applying certain recommendations, such as feeding meat to toddlers. A sub-set of participants concurrently enrolled in an interpersonal counselling (IPC) intervention indicated that the SMS provided reminders of lessons learned during the IPC; yet, the SMS did not help participants contextualise information and overcome the challenges of putting that information into practice. Conclusions: The challenges to accessing and implementing SMS services highlighted here suggest that such platforms may work well as one component of a comprehensive nutrition intervention, yet not as an isolated effort.


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