Clinical Study of the Effectiveness of Constant Therapy in the Treatment of Clients With Dementia: Implications for Telepractice

2021 ◽  
pp. 1-13
Author(s):  
Debra L. Edgar ◽  
Peggy L. Bargmann
Keyword(s):  
Treatment Plan ◽  
Substantial Improvement ◽  
Individualized Treatment ◽  
Exploratory Research ◽  
Percent Correct ◽  
Department Of Health ◽  
Brain Fitness ◽  
Institutional Review ◽  
Florida Department ◽  
Individualized Services

Purpose The purpose of this clinical focus article was to advance interventions for person living with dementia by exploring the implications of integrating technology through telepractice to strengthen memory in clients with dementia. This study focused on individualized treatment plans using the software Constant Therapy (CT) for clients with dementia. Method This study utilizes an exploratory research design with nonprobability sampling of existing data analyzing the frequency, duration, and percent correct of CT exercises completed from two case studies of persons living with dementia. This study received exempt status for institutional review board approval from the Florida Department of Health, since it is secondary research. One participant had been diagnosed with Alzheimer's disease, and the other participant had vascular dementia. Both clients utilized CT as part of the clinical services provided by the University of Central Florida's Communication Sciences and Disorders Clinic at Brain Fitness Academy. Results The results of this exploratory research study indicate that both participants demonstrated an increase in percentage correct on CT exercises from baseline to current (Participant 1, 70%, and Participant 2, 50%). A substantial disparity of exercises completed confirms the necessity of an individualized treatment plan based on a specific type of dementia. Both participants demonstrated a 631% and 632% increase respectively in exercises completed at home versus in the clinic. This finding is especially significant as it relates to telepractice. Conclusion This study adds to the literature that clients with dementia demonstrate substantial improvement in global cognitive function when speech-language pathologists provide skilled individualized services using the digital software CT, whether in traditional or remote clinic settings.

The Florida Department of Health and the Florida Association of County Health Department Business Administrators

2004 ◽  
Vol 10 (5) ◽  
pp. 413-420 ◽  
Author(s):  
Michael J. Napier ◽  
Phillip Street ◽  
Robin Wright ◽  
James Michael Kouba ◽  
Christina Ciereck ◽  
...  
Keyword(s):  
Health Department ◽  
Department Of Health ◽  
Florida Department ◽  
Business Administrators ◽  
County Health Department

scholarly journals Examining the Relationship Between Low Birth Weight Occurrence and Passive Measures of Environmental Arsenic by Census Tract in Escambia and Santa Rosa Counties, Florida

2020 ◽  
Vol 14 ◽  
pp. 117863022091305
Author(s):  
Maya Scott-Richardson ◽  
Marilyn O’Hara Ruiz ◽  
Rebecca L Smith
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Census Tract ◽  
Linear Models ◽  
Arsenic Concentration ◽  
Vital Statistics ◽  
Health Concern ◽  
Department Of Health ◽  
Florida Department ◽  
Contaminated Drinking Water

Arsenic is a public health concern because of its widespread distribution and high toxicity, even when doses are small. Low birth weight (LBW) occurrence, birth weights less than 2500 g, may be associated with prenatal exposure of arsenic from environmental factors and consuming contaminated drinking water and food. The objective of this study was to examine whether mothers living in areas of Escambia and Santa Rosa counties with varying levels of background arsenic in surface soil and water were associated with the occurrence of LBW. Inverse distance weight in ArcGIS was used to interpolate arsenic concentrations from environmental samples and estimate arsenic concentrations by census tracts in the two counties. After excluding multiple births and displaced geocoding addresses, birth data were obtained for the years of 2005 (n = 5845), 2010 (n = 5569), and 2015 (n = 5770) from the Bureau of Vital Statistics at the Florida Department of Health to assess temporal differences. Generalized linear models were used to analyze and compare the association between child and maternal demographic information, socioeconomic characteristics, and the environmental estimates of arsenic with LBW. No significant association was found between environmental arsenic concentration and LBW, suggesting that environmental contamination of the pregnant mother’s census tract may not be a useful proxy in assessing risk for LBW.

scholarly journals Florida Department of Health Workers’ Response to 2004 Hurricanes: A Qualitative Analysis

2013 ◽  
Vol 7 (2) ◽  
pp. 153-159 ◽  
Author(s):  
Holly B. Herberman Mash ◽  
Carol S. Fullerton ◽  
Kathleen Kowalski-Trakofler ◽  
Dori B. Reissman ◽  
Ted Scharf ◽  
...  
Keyword(s):  
Public Health ◽  
Qualitative Analysis ◽  
Emergency Care ◽  
Work Performance ◽  
Health Workers ◽  
Self Report ◽  
Public Health Preparedness ◽  
Department Of Health ◽  
Florida Department ◽  
Public Health Workers

AbstractObjectiveExaminations of the demands on public health workers after disaster exposure have been limited. Workers provide emergency care while simultaneously risking injury, damage to personal property, and threats to their own and their family's safety. We examined the disaster management experiences of 4323 Florida Department of Health workers 9 months after their response to 4 hurricanes and 1 tropical storm during a 7-week period in August and September of 2004.MethodsParticipants completed a self-report questionnaire focused on work performance, mental and physical health, daily functioning, sleep disturbance, physiological arousal, and injury and work demand at the time of the hurricanes, and answered open-ended questions that described their experiences in more detail.ResultsA qualitative analysis conducted from the write-in data yielded 4 domains: (1) work/life balance; (2) training for disaster response role; (3) workplace support; and (4) recovery.ConclusionsStudy findings highlighted a number of concerns that are important to public health workers who provide emergency care after a disaster and, in particular, multiple disasters such as during the 2004 hurricane season. The findings also yielded important recommendations for emergency public health preparedness. (Disaster Med Public Health Preparedness. 2013;0:1–7)

ATRA Based (Iraqi) Protocol for Children with Acute Promyelocytic Leukemia (APL) in Baghdad: Results in the First 8 Patients.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 4529-4529
Author(s):  
Anna Maria Testi ◽  
Maria Luisa Moleti ◽  
Salma Abbas Nal-Hadad ◽  
Mazin Faisal Farhan Al-Jadiry ◽  
Franco Mandelli ◽  
...  
Keyword(s):  
High Risk ◽  
Teaching Hospital ◽  
Acute Myelogenous Leukaemia ◽  
Treatment Plan ◽  
Substantial Improvement ◽  
The Other ◽  
Induction Treatment ◽  
Wbc Count ◽  
Oncology Unit ◽  
Very High

Abstract At the Oncology Unit/Al Mansour Teaching Hospital for Pediatrics in Baghdad, Iraq, between January 2002 and January 2003, a total of 11 children (age < 15 years) out of 32 acute myelogenous leukaemia (AML), were morphologically diagnosed as APL. This represents an overall very high incidence (35%) of childhood AML referred to a single institution. Molecular and cytogenetic studies were not feasible. ATRA was not available and most children received combination cytarabine and daunorubicin induction treatment that resulted in more than 50% early fatalities mainly due to hemorrhagic events and in less than 10% survivors. As a consequence of a collaborative project between the Oncology Unit/Al Mansour Teaching Hospital for Pediatrics in Baghdad and the Pediatric Hematology Unit of our Institute at “La Sapienza” University of Rome, a specific ATRA based protocol was designed according to the modern strategies for the management of APL and adapted to the severe local difficulties in Iraq. ATRA was supplied by Roche. The treatment plan consisted of oral induction ATRA (25 mg/m2/day) for 30 days associated to Daunorubicin (DNR 25 mg/m2/day for 2 consecutive days) only if the WBC count was > 10 x 109/L at diagnosis or increased during treatment. Consolidation included three chemotherapy cycles (DNR; DNR+ARA-C; DNR); ATRA was associated to each cycle for patients with a WBC count at diagnosis > 10 x 109/L and/or for those requiring the addition of DNR during ATRA therapy (high-risk). Standard 6-MP and MTX maintenance with 14 days ATRA, every 3 months was administered to all patients in complete remission (CR) for 2 years. Intrathecal MTX prophylaxis (total 3 doses) was given at each consolidation course, for high-risk patients. Since December 2003, 8 consecutive children with APL (5 male and 3 female; median age: 12 years, range 3–16) were enrolled in the protocol. Seven were defined as high-risk and one as low-risk. Morphological diagnosis was that of classic M3 in 7 children and of M3 variant in 1. The M3v child had a very high WBC count and died the same day of referral due to a massive bleeding, while the other 7 children achieved a CR. One of the 7 responders was lost to follow-up in CR; the other 6 patients are alive and well in CR, on consolidation (1 case) and on maintenance treatment (5 cases). These preliminary but highly encouraging results represent a substantial improvement over the earlier experience in childhood APL in the main Pediatric Center in Baghdad and demonstrate that modern therapeutic strategies, adapted to the local reality, are a necessity and can be effectively implemented through international collaborative efforts even in countries with limited resources and severe difficulties.

11C-choline PET scanning is more accurate than biopsy in assessment of localized prostate cancer planned for radical prostatectomy.

2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 182-182
Author(s):  
Ian D. Davis ◽  
Sze Ting Lee ◽  
Lekshmy Shanker ◽  
David Clouston ◽  
Damien M Bolton ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Treatment Plan ◽  
Curative Intent ◽  
Trus Biopsy ◽  
Department Of Health ◽  
Imaging Results ◽  
Mri Scans ◽  
Treat Prostate Cancer ◽  
Ct And Mri

182 Background: A decision to treat prostate cancer (PC) with radical prostatectomy (RP) with curative intent requires confidence that the PC is confined to the prostate. PC outcomes will improve with better selection of surgical candidates. Current imaging modalities include CT and MRI but have limited accuracy. We assessed 18F-FDG (FDG) and 11C-choline (CHOL) PET in men planned for RP to determine the accuracy of PET, effects of PET on decision making by surgeons, and correlation with PSA. Methods: Written informed consent was obtained from eligible participants (pts) planned for RP. All men underwent TRUS-guided prostatic biopsies, CT and MRI scans, PSA and standard tests of organ function. The urologist then documented the treatment plan based on these results. Pts then underwent FDG and CHOL PET and the urologist then determined whether this information altered the treatment plan. After surgery the RP specimen was reconstructed, examined histologically and correlated with TRUS and imaging results on a sextant-based analysis (apex/mid/base on both sides). Results: 30 pts entered and completed the trial. Outcomes are shown in the table. Neither PET modality significantly affected decisions about surgery. Preoperative PSA did not correlate with degree of involvement. FDG PET was unhelpful. Conclusions: CHOL PET was the most sensitive and most accurate modality with highest congruity with pathology and had excellent positive predictive value, but was least specific. CHOL PET was superior to both TRUS biopsy and MRI. Supported by grant 487916 through Cancer Australia, Prostate Cancer Foundation Australia, Australian Government Department of Health and Aging. [Table: see text]

An Assessment of the Impact of a Multipronged Approach to Reducing Problematic Pain Clinics in Florida

2016 ◽  
Vol 47 (2) ◽  
pp. 185-204 ◽  
Author(s):  
Jacinta M. Gau ◽  
Erika J. Brooke
Keyword(s):  
Law Enforcement ◽  
Criminal Law ◽  
Law Enforcement Officers ◽  
Department Of Health ◽  
Florida Department ◽  
Pain Clinics ◽  
Opioid Diversion ◽  
The Impact ◽  
Depth Interviews ◽  
Combat Problems

The present research evaluates recent changes to Florida law and policy to reduce problematic pain clinics (pill mills) and criminal diversion of prescription opioids. These changes entailed a multipronged effort linking regulatory and criminal-law approaches. Quantitative data from the Florida Department of Health and qualitative data from in-depth interviews with law-enforcement officers assigned to pill-mill taskforces reveal steep declines in pain clinics and pill mills. Respondents credit some regulatory enhancements for the reduction, although they describe some interagency cooperation problems and emphasize that despite success, many troublesome establishments continue to operate. The results suggest that Florida’s effort to reduce opioid diversion by tightening regulatory restrictions and law-enforcement scrutiny illustrates a multiagency approach to a problem spanning public health and criminal justice. This could be an example for other states seeking to combat problems that cannot be effectively addressed using regulatory or criminal law alone.

scholarly journals Differential Diagnosis and Management of Incomplete Locked-In Syndrome after Traumatic Brain Injury

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Lauren Surdyke ◽  
Jennifer Fernandez ◽  
Hannah Foster ◽  
Pamela Spigel
Keyword(s):  
Traumatic Brain Injury ◽  
Differential Diagnosis ◽  
Brain Injury ◽  
Treatment Plan ◽  
Inpatient Rehabilitation ◽  
Individualized Treatment ◽  
Rehabilitation Team ◽  
Lower Cranial Nerve ◽  
Nerve Paralysis ◽  
Comprehensive Therapy

Locked-in syndrome (LIS) is a rare diagnosis in which patients present with quadriplegia, lower cranial nerve paralysis, and mutism. It is clinically difficult to differentiate from other similarly presenting diagnoses with no standard approach for assessing such poorly responsive patients. The purpose of this case is to highlight the clinical differential diagnosis process and outcomes of a patient with LIS during acute inpatient rehabilitation. A 32-year-old female was admitted following traumatic brain injury. She presented with quadriplegia and mutism but was awake and aroused based on eye gaze communication. The rehabilitation team was able to diagnose incomplete LIS based on knowledge of neuroanatomy and clinical reasoning. Establishing this diagnosis allowed for an individualized treatment plan that focused on communication, coping, family training, and discharge planning. The patient was ultimately able to discharge home with a single caregiver, improving her quality of life. Continued evidence highlights the benefits of intensive comprehensive therapy for those with acquired brain injury such as LIS, but access is still limited for those with a seemingly poor prognosis. Access to a multidisciplinary, specialized team provides opportunity for continued assessment and individualized treatment as the patient attains more medical stability, improving long-term management.

scholarly journals CLRM-06. COMPARISON OF INDIVIDUALIZED ANTI-CANCER THERAPY REGIMENS RECOMMENDED BY A MULTIDISCIPLINARY MOLECULARLY-DRIVEN TUMOR BOARD IN A PEDIATRIC DIPG CLINICAL TRIAL (PNOC003) VERSUS THOSE SELECTED BY THE CNS-TAP TOOL

2021 ◽  
Vol 3 (Supplement_4) ◽  
pp. iv2-iv2
Author(s):  
Holly Roberts ◽  
Karthik Ravi ◽  
Allison Schepers ◽  
Bernard Marini ◽  
Cassie Kline ◽  
...  
Keyword(s):  
Anticancer Agents ◽  
Treatment Plan ◽  
Pilot Trial ◽  
Study Participant ◽  
Molecular Profiling ◽  
Individualized Treatment ◽  
Tumor Board ◽  
Treatment Recommendation ◽  
Patient Specific ◽  
Genomic Profiling

Abstract Genetic sequencing of diffuse intrinsic pontine gliomas (DIPG) has revealed genomic heterogeneity, fueling an interest in individualized targeted therapies. A feasibility study, PNOC003: Molecular Profiling for Individualized Treatment Plan for DIPG (NCT02274987), was completed within the Pacific Pediatric Neuro-Oncology Consortium in which a multidisciplinary tumor board reviewed molecular and genomic profiling of each participant’s tumor to make targeted therapy recommendations. Separately, our team developed the Central Nervous System Targeted Agent Prediction (CNS-TAP) tool, which combines pre-clinical, clinical, and CNS penetration data with patient-specific genomic information to derive numeric scores for anticancer agents to objectively evaluate these therapies for use in patients with CNS tumors. We hypothesized that agents highly-scored by CNS-TAP would overlap with agents recommended by the PNOC003 tumor board. For each study participant, we retrospectively utilized the genomic profiling report to identify actionable alterations and incorporated these data into CNS-TAP to find the highest-scoring agents. We compared these CNS-TAP-recommended agents with recommendations from the tumor board for each of the 28 PNOC003 participants. Overall, 93% of patients (26/28) had at least one agent recommended by both the tumor board and CNS-TAP. Additionally, 38% of all agents (36/95) chosen by the tumor board were also selected by CNS-TAP. When only molecularly targeted anticancer agents were included in a sub-analysis, 60% of agents (34/57) were recommended by both methods. At present, we are prospectively evaluating the CNS-TAP tool within PNOC008: A Pilot Trial Testing the Clinical Benefit of Using Molecular Profiling to Determine an Individualized Treatment Plan in Children and Young Adults with High-Grade Glioma (NCT03739372). The CNS-TAP tool recommendations are shared during the PNOC008 molecular tumor board meetings once a consensus treatment recommendation has been reached. Subsequent analyses will focus on any adjustments in therapy decisions within the tumor board that result from the CNS-TAP tool output.

OPRM1 influence on and effectiveness of an individualized treatment plan for prescription opioid use disorder patients

2018 ◽  
Vol 1425 (1) ◽  
pp. 82-93 ◽  
Author(s):  
Javier Muriel ◽  
César Margarit ◽  
Beatriz Planelles ◽  
María J. Serralta ◽  
Carmen Puga ◽  
...  
Keyword(s):  
Treatment Plan ◽  
Opioid Use Disorder ◽  
Individualized Treatment ◽  
Prescription Opioid ◽  
Opioid Use ◽  
Prescription Opioid Use
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