Staff and volunteers' perceptions of a Communication Enhanced Environment model in an acute/slow stream rehabilitation and a rehabilitation hospital ward: a qualitative description study within a before-and-after pilot study

ABSTRACTBackground: Inpatient rehabilitation presents a unique opportunity for smoking interventions, given the typical lengths of stay, the relevance of smoking to the admission diagnosis of many patients, and the occurrence of nicotine withdrawal during the hospital stay.Objective: To evaluate the feasibility of implementing a pharmacist-led version of the Ottawa Model for Smoking Cessation (OMSC) program at a rehabilitation hospital, using the indicators of reach, effectiveness, adoption, and implementation.Methods: A before-and-after pilot study was conducted. Smoking cessation data were collected from 2 cohorts of eligible smokers identified during 4-month periods before (control) and after (intervention) implementation of the OMSC program. Control participants received usual care (i.e., no cessation intervention). Intervention participants received initial in-hospital smoking cessation support (counselling and nicotine replacement therapy), inpatient follow-up during the hospital stay, and 3 months of postdischarge follow-up calls, with all aspects led by hospital pharmacists.Results: Among all patients admitted to participating inpatient rehabilitation units during the 2 study periods, smoking prevalence was 7.8% (127/1626). After exclusions, deaths, and withdrawals, 111 patients were retained for analysis: 55 in the control group and 56 in the intervention group. The overall mean age of participants was 64.9 (standard deviation [SD] 14.3) years, with a mean smoking history of 35.0 (SD 24.8) pack-years. There were no significant differences between groups in terms of baseline characteristics. Self-reported abstinence rates (determined 3 months after discharge) were higher after compared with before implementation of the OMSC program: for continuous abstinence, 16/56 (28.6%) versus 9/55 (16.4%), _2 = 4.462, p = 0.035; for 7-day point prevalence abstinence, 21/56 (37.5%) versus 10/55 (18.2%), _2 = 6.807, p = 0.009.Conclusions: Implementation of the OMSC program at a large rehabilitation hospital was feasible and led to an increase in 3-month smoking abstinence. This study provides preliminary evidence to support inclusion of smoking interventions as part of inpatient rehabilitation care.RÉSUMÉContexte : La réadaptation des patients hospitalisés représente une occasion unique de procéder à des interventions de désaccoutumance du tabac, notamment en raison de la durée habituelle des séjours, du rapport entre le tabagisme et le diagnostic posé à l’admission, et de la survenue du syndrome de sevrage de la nicotine durant le séjour.Objectif : Étudier la possibilité de mettre en oeuvre une version dirigée par des pharmaciens du programme Modèle d’Ottawa pour l’abandon du tabac (MOAT) dans un centre de réadaptation en employant les indicateurs pour la portée, l’efficacité, l’adoption et la mise en oeuvre.Méthodes : Une étude pilote avant-après a été menée. Des données sur la désaccoutumance ont été recueillies auprès de deux cohortes de fumeurs admissibles qui ont été repérés pendant des périodes de quatre mois avant (groupe témoin) et après (groupe expérimental) la mise en oeuvre du programme du MOAT. Les participants du groupe témoin ont reçu les soins habituels (c.-à-d. sans intervention de désaccoutumance). Les participants du groupe expérimental ont reçu un soutien initial à l’hôpital pour la désaccoutumance du tabac (des conseils et un traitement de remplacement de la nicotine), un suivi pendant le séjour à l’hôpital, et des appels de suivi pendant les trois mois suivant le congé, le tout sous la direction de pharmaciens d’hôpitaux.Résultats : Parmi l’ensemble des patients admis dans les unités de réadaptation participantes au cours des deux périodes de l’étude, la prévalence du tabagisme était de 7,8 % (127/1626). Mis à part les exclusions, les décès et les abandons, 111 patients ont été retenus pour l’analyse : 55 dans le groupe témoin et 56 dans le groupe expérimental. L’âge moyen des participants était de 64,9 (écart-type de 14,3) ans et leur antécédent de tabagisme moyen était de 35,0 (écart-type de 24,8) paquets-années. Aucune différence significative n’a été relevée entre les groupes en ce qui touche aux caractéristiques de base. Les taux d’abstinence autodéclarée (déterminée 3 mois après le congé) étaient plus élevés après la mise en oeuvre du programme du MOAT : pour une abstinence continue, 16/56 (28,6 %) contre 9/55 (16,4 %), _2 = 4,462, p = 0,035; pour une abstinence ponctuelle de sept jours consécutifs, 21/56 (37,5 %) contre 10/55 (18,2 %), _2 = 6,807, p = 0,009.Conclusions : La mise en oeuvre du programme du MOAT dans un important centre de réadaptation a été possible et a mené à une amélioration de l’abstinence du tabac à trois mois. Cette étude donne des résultats préliminaires en appui à l’inclusion d’interventions de désaccoutumance du tabac aux soins de réadaptation de patients hospitalisés.

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Investigation of the implementation of a Communication Enhanced Environment model on an acute/slow stream rehabilitation and a rehabilitation ward: A before-and-after pilot study

Clinical Rehabilitation ◽

10.1177/02692155211032655 ◽

2021 ◽

pp. 026921552110326

Author(s):

Sarah D’Souza ◽

Erin Godecke ◽

Natalie Ciccone ◽

Deborah Hersh ◽

Elizabeth Armstrong ◽

...

Keyword(s):

Pilot Study ◽

Intervention Group ◽

Observation Time ◽

Hospital Environment ◽

Future Research ◽

Control Group ◽

Time Points ◽

Environment Model ◽

Before And After ◽

Rehabilitation Ward

Objectives: Develop and implement a Communication Enhanced Environment model and explore its effect on language activities for patients early after stroke. Method and design: Before-and-after pilot study. Setting: An acute/slow stream rehabilitation and a rehabilitation ward in a private hospital in Perth, Western Australia. Participants: Fourteen patients recruited within 21 days of stroke. Seven recruited during the before-phase (control group: patients with aphasia = 3, patients without aphasia = 4) and seven recruited in the after-phase (intervention group: patients with aphasia = 4, patients without aphasia = 3). Intervention: The intervention group exposed to a Communication Enhanced Environment model had access to equipment, resources, planned social activities and trained communication partners. Both groups received usual stroke care. Data collection: Hospital site champions monitored the availability of the intervention. Behavioural mapping completed during the first minute of each 5-minute interval over 12 hours (between 7 am and 7 pm) determined patient engagement in language activities. Results: Seventy-one percent of the Communication Enhanced Environment model was available to the intervention group who engaged in higher, but not significant (95% CI), levels of language activities (600 of 816 observation time points, 73%) than the control group (551 of 835 observation time points, 66%). Unforeseen reorganisation of the acute ward occurred during the study. Conclusions: Implementation of a Communication Enhanced Environment model was feasible in this specific setting and may potentially influence patients’ engagement in language activities. The unforeseen contextual challenges that occurred during the study period demonstrate the challenging nature of the hospital environment and will be useful in future research planning.

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ANALISIS PENGARUH PEMBANGUNAN JALAN LAYANG JANTI TERHADAP PERKEMBANGAN TATA RUANG KAWASAN JANTI STUDI KASUS : KAWASAN JANTI, DESA CATURTUNGGAL, KABUPATEN SLEMAN, D. I. YOGYAKARTA

Jurnal Arsitektur KOMPOSISI ◽

10.24002/jars.v10i4.1089 ◽

2017 ◽

Vol 11 (3) ◽

pp. 255

Author(s):

Jeky El Boru

Keyword(s):

Road Network ◽

Open Space ◽

Qualitative Description ◽

Analysis Method ◽

Open Spaces ◽

The Road ◽

Before And After ◽

Linkage Method ◽

The Impact ◽

Parking Place

Abstract: This research aims to analyze the impact of Janti Flyover Construction toward the growth of layout at Janti Urban Area, including structured space, open space, and linkage. Method used for data collecting are observation, air photograph monitoring, and interview, whereas the analysis method is qualitative description, which is the superimposed method of two layers, that are the layout condition before and after flyover construction. The result shows that the impact of Janti Flyover construction can be seen on building mass (solid), the increasing number of open spaces, including the road network, parking place, and park, whereas the relation between spaces, visually and structurally, can be seen on the growth of buildings which have new shapes and styles, therefore the performance of the overall building does not have a proportional shape. Considering Janti Street at the collective relation, its role is getting stronger as the main frame road network.Keywords: Flyover construction, layout changing, Janti AreaAbstrak: Penelitian ini bertujuan untuk menganalisis pengaruh pembangunan Jalan Layang Janti terhadap perkembangan tata ruang Kawasan Janti, meliputi ruang terbangun, ruang terbuka, serta hubungan antar ruang (“linkage”). Metode pengumpulan data dilakukan melalui observasi, pengamatan foto udara, dan wawancara; sedangkan metode analisis melalui deskripsi secara kualitatif yang berupa “superimposed method” dari dua lapisan kondisi lahan, yakni kondisi tata ruang sebelum dan sesudah pembangunan jalan layang. Hasil penelitian menunjukkan bahwa pengaruh pembangunan Jalan Layang Janti terdapat pada massa bangunan (“solid”), pertambahan ruang terbuka yang berupa jaringan jalan, parkir, dan taman; sedangkan pada hubungan antar ruang ̶ secara visual dan struktural ̶ yakni tumbuhnya bangunan dengan bentuk dan gaya baru, sehingga bentuk tampilan bangunan secara keseluruhan tidak proporsional. Pada hubungan kolektif, Jalan Janti semakin kuat perannya sebagai kerangka utama jaringan jalan.Kata kunci : Pembangunan jalan layang, tata ruang, Kawasan Janti

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A pilot study on the effect of ulipristal acetate on myoma angiogenesis, measured by 2D ultrasound and VEGF serum levels

10.36811/ojgor.2020.110015 ◽

2020 ◽

pp. 19-29

Author(s):

Patricia Diaz Ortega ◽

Manuel García Manero

Keyword(s):

Pilot Study ◽

Power Doppler ◽

Uterine Fibroids ◽

Premenopausal Women ◽

Serum Levels ◽

Ulipristal Acetate ◽

Before And After ◽

Angiogenesis Process ◽

2D Ultrasound ◽

Average Size

Introduction: Symptomatic uterine fibroids can cause symptoms that can be disabling. There are many treatments, including ulipristal acetate, whose role in reducing symptoms and decreasing the size of the fibroid is well known. With this preliminary study, we also try to evaluate the correlation between myoma vascularization measured by ultrasound (Power Doppler 2D) and serum VEGF levels, before and after treatment with ulipristal acetate; in patients diagnosed with symptomatic uterine fibroids. Materials and Methods: A preliminary, prospective observational pilot study was designed. Twenty-four premenopausal women, diagnosed with symptomatic uterine fibroids, were included and all of them completed the study. Four cycles of ulipristal acetate were administered according to the dose and indications specified in the data sheet. In order to assess the influence of this treatment on the angiogenesis process of the fibroids, measurements of VEGF serum levels were made and their vascularization was assessed by means of 2D power doppler ultrasound; at the beginning and the end of treatment. In addition, several determinations of the same parameters were made throughout the successive visits. Endpoints were defined as the decrease in VEGF levels from previous levels, the decrease in myoma vascularization on ultrasound, and the reduction in myoma size. Result: 24 patients who met the inclusion criteria were enrolled (n=24). The average size of myomas was reduced from 45,08 ? 24,02mm to 29?16,96mm after treatment. The average VEGF serum level significantly decreased after the first treatment cycle (from 147,17 ? 153,51 pg/ml to 102,04 ? 186,08pg/ml). Vascularization of myomas after treatment with ulipristal acetate was analyzed, and a significantly decrease was achieved in 83,3% of cases. Conclusion: There is a correlation between myoma vascularization and treatment with Ulipristal acetate. SPRMs may provide effective treatment for women with symptomatic fibroids by two ways: supports selective progesterone receptor modulators and reduced angiogenesis. Keywords: Angiogenesis; Ulipristal Acetate; Uterine fibroids; VEGF

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THU0642-HPR EVOLUTION OF THE PERCEPTIONS OF RA PATIENTS AFTER EDUCATION PATIENT SESSION TEACHING METHOTREXATE SELF-INJECTION A PROSPECTIVE PILOT STUDY

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.5505 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 566.1-566

Author(s):

S. Afilal ◽

H. Rkain ◽

B. Berchane ◽

J. Moulay Berkchi ◽

S. Fellous ◽

...

Keyword(s):

Pilot Study ◽

Patient Education ◽

Median Duration ◽

Large Scale ◽

Education Session ◽

Prospective Pilot Study ◽

Mean Delay ◽

Lack Of Information ◽

Level Of Satisfaction ◽

Before And After

Background:Methotrexate is a gold standard for treatment of RA. In our context, RA patients prefer to be injected by paramedics rather than self-injecting. This can be explained by patients’ bad perceptions of self-injection or lack of information. Appropriate self-injection education can therefore be an important element in overcoming these obstacles and improving disease self-management.Objectives:Compare the RA patients’ perceptions on methotrexate self-injection before and after a patient education session.Methods:Prospective pilot study that included 27 consecutive patients (81.5% female, mean age 44.4 years, illiteracy rate 40.7%) with RA (median duration of progression of 4 years, mean delay in referral for specialist of 6 months, median duration of methotrexate use of 1 year). The patients benefited from an individual patient education session to learn how to self-inject with methotrexate subcutaneously. The patient education session was supervised by a nurse and a rheumatologist with a control a week later. Perceptions of the reluctance to self-inject and the difficulties encountered by patients were assessed before the patient education session, after the 1st and 2nd self-injection of methotrexate using a 10 mm visual analog scale. Patients also reported their level of satisfaction (10 mm VAS) after the 1st and 2nd self-injection.Results:The mean duration of patient education session is 13 min.Table I compares the evolution of the degrees of reluctance to self-injection, the difficulties encountered, and the satisfaction experienced by the patients.Table 1.Evolution of RA patients’ perceptions on the methotrexate self-injection. (N = 27)BeforeAfter the 1stself-injectionAfter the 2end self-injectionpVAS reluctance (0-10mm)6,5 ± 3,62,2 ± 2,91,0 ± 2,3<0,0001VAS difficulty (0-10mm)7,5 ± 2,62,5 ± 2,71,0 ± 1,9<0,0001VAS satisfaction (0-10mm)-8,9 ± 1,89,5 ± 1,50,002Conclusion:This study suggests the effectiveness of a methotrexate self-injection patient education session in RA patients. It also highlights the value of patient education in rheumatologic care. A large-scale study is necessary to better interpret and complete these preliminary results from this pilot study.Disclosure of Interests:None declared

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Plasma Exosomal miRNA Levels after Radiotherapy Are Associated with Early Progression and Metastasis of Cervical Cancer: A Pilot Study

Journal of Clinical Medicine ◽

10.3390/jcm10102110 ◽

2021 ◽

Vol 10 (10) ◽

pp. 2110

Author(s):

Oyeon Cho ◽

Do-Wan Kim ◽

Jae-Youn Cheong

Keyword(s):

Cervical Cancer ◽

Pilot Study ◽

Biological Functions ◽

Patients With Cancer ◽

Initial Stage ◽

Exosomal Mirnas ◽

Early Progression ◽

Before And After ◽

Microenvironmental Factors ◽

Exosomal Mirna

Plasma exosomal miRNAs are key regulators of cell-cell interactions associated with several biological functions in patients with cancer. This pilot study aimed to investigate the log2 fold change (log2FC) of the expression of exosomal miRNAs and related mRNAs in the blood of patients with cervical cancer to identify prognostic markers better than those currently available. We sequenced plasma exosomal RNA from 56 blood samples collected from 28 patients with cervical cancer, who had been treated with concurrent chemoradiotherapy (CCRT). Changes in the expression of miRNAs and mRNAs before and after CCRT were represented as log2FC. Their biological functions were studied by miRNA-mRNA network analysis, using ingenuity pathway analysis, after the selection of two groups of miRNAs, each associated with early progression (EP) and metastasis, also described as initial stage. Seven patients experienced EP, three of whom died within four months after progression. Reduced levels of miR-1228-5p, miR-33a-5p, miR-3200-3p, and miR-6815-5p and increased levels of miR-146a-3p in patients with EP revealed unresolved inflammation, with accompanying increased expression of PCK1 and decreased expression of FCGR1A. Increased levels of miR-605-5p, miR-6791-5p, miR-6780a-5p, and miR-6826-5p and decreased levels of miR-16-1-3p (or 15a-3p) were associated with the degree of metastasis and led to the systemic activation of myeloid, endothelial, and epithelial cells, as well as neurons, phagocytes, and platelets. Log2FCs in the expression of miRNAs and mRNAs from plasma exosomes after CCRT are associated with EP and metastasis, reflecting unresolved inflammation and systemic microenvironmental factors, respectively. However, this study, supported by preliminary data insufficient to reach clear conclusions, should be verified in larger prospective cohorts.

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Implementation of Person-Centered Care: A Feasibility Study Using the WE-CARE Roadmap

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18052205 ◽

2021 ◽

Vol 18 (5) ◽

pp. 2205

Author(s):

Roman A. Lewandowski ◽

Jędrzej B. Lewandowski ◽

Inger Ekman ◽

Karl Swedberg ◽

Jan Törnell ◽

...

Keyword(s):

Pilot Study ◽

Feasibility Study ◽

Health Care Professionals ◽

Quality Care ◽

Structured Interviews ◽

Rehabilitation Hospital ◽

Person Centered Care ◽

Centered Care ◽

Multi Disciplinary Team

Background: Person-Centered Care (PCC) is a promising approach towards improved quality of care and cost containment within health systems. It has been evaluated in Sweden and England. This feasibility study examines initial PCC implementation in a rehabilitation hospital for children in Poland. Methods: The WE-CARE Roadmap of enablers was used to guide implementation of PCC for patients with moderate scoliosis. A multi-disciplinary team of professionals were trained in the PCC approach and the hospital Information Technology (IT) system was modified to enhance PCC data capture. Semi-structured interviews were conducted with the nine health care professionals involved in the pilot study and three patients/parents receiving care. Transcribed data were analyzed via content analysis. Results: 51 patients and their families were treated via a PCC approach. High proportions of new PCC data fields were completed by the professionals. The professionals were able to implement the three core PCC routines and perceived benefits using the PCC approach. Patients and their families also perceived improved quality care. The WE-CARE framework enablers facilitated PCC implementation in this setting. Conclusions: This feasibility pilot study indicates that the Gothenburg PCC approach can be successfully transferred to a rehabilitation hospital in Poland with favorable perceptions of implementation by both professionals and patients/their families.

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Gamma entrainment frequency affects mood, memory and cognition: an exploratory pilot study

Brain Informatics ◽

10.1186/s40708-020-00119-9 ◽

2020 ◽

Vol 7 (1) ◽

Author(s):

Ryan L. S. Sharpe ◽

Mufti Mahmud ◽

M. Shamim Kaiser ◽

Jianhui Chen

Keyword(s):

Pilot Study ◽

Correlation Analysis ◽

Negative Correlation ◽

Cognitive Abilities ◽

Statistical Significance ◽

Assessment Scores ◽

Frequency Group ◽

Before And After ◽

Mood Score ◽

40 Hz

AbstractHere we provide evidence with an exploratory pilot study that through the use of a Gamma 40 Hz entrainment frequency, mood, memory and cognition can be improved with respect to a 9-participant cohort. Participants constituted towards three binaural entrainment frequency groups: the 40 Hz, 25 Hz and 100 Hz. Participants attended a total of eight entrainment frequency sessions twice over the duration of a 4-week period. Additionally, participants were assessed based on their cognitive abilities, mood as well as memory, where the cognitive and memory assessments occurred before and after a 5-min binaural beat stimulation. The mood assessment scores were collected from sessions 1, 4 and 8, respectively. With respect to the Gamma 40 Hz entrainment frequency population, we observed a mean improvement in cognitive scores, elevating from 75% average to 85% average upon conclusion of the experimentation at weak statistical significance ($$\alpha$$ α = 0.10, p = 0.076). Similarly, memory score improvements at a greater significance ($$\alpha$$ α = 0.05, p = 0.0027) were noted, elevating from an average of 87% to 95%. In pertinence to the mood scores, a negative correlation across all populations were noted, inferring an overall increase in mood due to lower scores correlating with elevated mood. Finally, correlation analysis revealed a stronger R$$^2$$ 2 value (0.9838) within the 40 Hz group between sessions as well as mood score when compared across the entire frequency group cohort.

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Serum testosterone and testicular hemodynamics before and after infection with SARS-COV-2 (pilot study)

Urologiia ◽

10.18565/urology.2021.5.5-9 ◽

2021 ◽

Vol 5_2021 ◽

pp. 5-9

Author(s):

Kh.S. Ibishev Ibishev ◽

E.A. Mamedov Mamedov ◽

Z.R. Gusova Gusova ◽

A.I. Palenyy Palenyy ◽

Y.O. Prokop Prokop ◽

...

Keyword(s):

Pilot Study ◽

Serum Testosterone ◽

Before And After

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Sleep Quality and Levodopa Intestinal Gel Infusion in Parkinson’s Disease: A Pilot Study

Parkinson s Disease ◽

10.1155/2018/8691495 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6

Author(s):

Oriol De Fabregues ◽

Alex Ferré ◽

Odile Romero ◽

Manuel Quintana ◽

José Álvarez-Sabin

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Pilot Study ◽

Sleep Quality ◽

Rem Sleep ◽

Rating Scale ◽

Sleep Problems ◽

Periodic Leg Movements ◽

Before And After ◽

Hamilton Anxiety Rating Scale

Background. Sleep problems in patients with advanced Parkinson’s disease (PD) have a deleterious impact on quality of life. Objective. To assess the effect of levodopa-carbidopa intestinal gel (LCIG) infusion on sleep quality in advanced PD patients. Methods. Seven patients participated in a prospective pilot study. Before and after 6 months of LCIG infusion, an overnight polysomnography was performed and the Epworth Sleepiness Scale, fatigue scale, Pittsburgh Sleep Quality Index, Beck Depression Inventory, and the Hamilton Anxiety Rating Scale were administered. Results. PSG showed low sleep efficiency. REM sleep without atony was found in 5 patients. After 6 months of LCIG infusion, the percentage of REM sleep decreased as well as the number of arousals especially due to reduction of spontaneous arousals and periodic leg movements during REM sleep, but differences were not statistically significant. Also, scores of all study questionnaires showed a tendency to improve. Conclusion. The results show a trend toward an improvement of sleep quality after 6 months of LCIG infusion, although differences as compared to pretreatment values were not statistically significant. The sleep architecture was not modified by LCIG. Further studies with larger study samples are needed to confirm these preliminary findings.

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