scholarly journals Reducing prolonged chemoradiation treatment times for cervical cancer

2019 ◽  
Vol 8 (3) ◽  
pp. e000516 ◽  
Author(s):  
Lucas Vitzthum ◽  
Jianling Yuan ◽  
Daniel Jones ◽  
Anne Boldt ◽  
Kathryn Dusenbery
Keyword(s):  
Cervical Cancer ◽  
Positive Impact ◽  
Prolonged Treatment ◽  
Quality Improvement Initiative ◽  
Process Mapping ◽  
Post Intervention ◽  
Treatment Delays ◽  
Intervention Treatment ◽  
Total Treatment ◽  
Education And Care

Prolonged total treatment times (TTTs) beyond 56 days are associated with worse outcomes for cervical cancer treated with radiation therapy. We reviewed treatment times in a cohort of 24 consecutive patients treated with definitive chemoradiation (CRT) at our institution and found that only 14 patients (58.3%) completed treatment in less than or equal to 56 days. The primary objectives of this institutional quality improvement initiative were to identify sources for delays in treatment completion and to implement effective measures in an effort to minimise prolonged TTT. Pareto plot and process mapping were used to identify and resolve root causes of prolonged treatment. The Plan-Do-Study-Act method was then implemented to reduce treatment duration. Post-intervention treatment times were prospectively evaluated in 81 subsequent patients treated with definitive CRT. Process mapping identified inefficiencies with scheduling, staggered treatments and inadequate patient and staff education. Institutional changes were implemented, heavily utilising oncology nurses’ skill set in staff re-education and care coordination. Our workflow was redesigned to reduce/eliminate treatment delays. These interventions led to a significant improvement in the percentage of patients meeting the goal TTT compared with the pre-intervention cohort (85.2% vs 58.3%, p<0.01), and results were sustainable in additional 47 patients prospectively followed subsequently, potentially making a positive impact on their treatment outcomes.

Impact of targeted bundles to reduce the nebulization time gap from prescription to administration among red triaged patients in emergency department: An quality improvement initiative

2021 ◽  
Author(s):  
Seema Sachdeva seema sachdeva ◽  
Akshay Kumar Akshay Kumar ◽  
Parveen Aggarwal Parveen Aggarwal
Keyword(s):  
Emergency Department ◽  
Tertiary Care ◽  
Signs And Symptoms ◽  
Fish Bone ◽  
Quality Improvement Initiative ◽  
Care Hospital ◽  
Analysis Model ◽  
Post Intervention ◽  
Targeted Interventions ◽  
Administration Time

Abstract BackgroundSevere exacerbation of asthma are potentially life-threatening and therefore require prompt care and frequent management. Important elements of early treatment includes recognition of early signs and symptoms of breathing difficulty and timely prescription and administration of therapeutic agents. A subsequent delay in receiving nebulization during an acute exacerbation of asthma can leads to cardiac arrest and even death. AimTo reduce the gap in administration of nebulization from its prescription time among red triaged patients by 50% from its baseline. Setting and designThis interventional study was conducted among red triaged patients in emergency department of tertiary care hospital, India . Material and MethodsBaseline information was collected during first 4 weeks to find gap in administration of nebulization from its prescription time. Fish bone analysis and process map were laid down to analyse the situation. The intervention using targeted bundles was done via 3 PDSA (PDSA1: indenting the nebulizers, PDSA 2: training of doctors and nurses, PDSA 3; introducing equipment checklist) to reduce the gap . A run chart using time series analysis model was used to compare the pre and post intervention nebulization gap. ResultsTotal 74 patients (30 in pre- intervention, 44 in post intervention) admitted in red triaged area were observed for nebulization gap from prescription to administration. Median time for nebulization gap before intervention was 46.5 minutes which reduced to 15 minutes in post intervention phase. ConclusionThis bundles of targeted interventions was successful to reduce the nebulization gap. Key words: nebulization gap, prescription time, administration time

scholarly journals Dose: Comparison of 6 and 12 Nutrition and Physical Activity Sessions Targeting Middle School Adolescents

2009 ◽  
Vol 4 (4) ◽  
pp. 48-58
Author(s):  
Mical Kay Shilts ◽  
Anna C. Martin ◽  
Marilyn S. Townsend
Keyword(s):  
Physical Activity ◽  
Ethnically Diverse ◽  
Nutrition Intervention ◽  
Time Constraints ◽  
Post Intervention ◽  
Dose Comparison ◽  
Optimal Intervention ◽  
Intervention Treatment ◽  
8Th Grade ◽  
Behavioral Impact

Determining optimal intervention dose to meet time constraints of the teacher while maximizing behavioral impact for students has proven challenging. This study investigated the influence of intervention dose on 7th & 8th grade participants’ dietary and physical activity (PA) behaviors. Participants were assigned randomly to a: 1) 6 week-12 session nutrition intervention [treatment#1], or 2) 3 week-6 session nutrition intervention [treatment#2] with data collected pre/post intervention. Using ANCOVA, measures assessed dietary and PA self-efficacy and behaviors. Ethnically diverse participants (n=107) were included in the analyses (46% male). All students set two goals: one dietary and one PA regardless of dose. Treatment#1 resulted in similar outcomes compared to treatment#2 with no significant differences between groups. As a result, we recommend that teachers using the 12 week intervention give students the option of setting new goals after the 6th lesson to maintain motivation.

scholarly journals Menstrual and reproductive function repair in patients with polycystic ovary syndrome and obesity by correcting of glucose intolerance

2008 ◽  
Vol 5 (2) ◽  
pp. 38-41 ◽  
Author(s):  
O I Lineva ◽  
M V Glukhova
Keyword(s):  
Reproductive System ◽  
Negative Impact ◽  
Positive Impact ◽  
Polycystic Ovary ◽  
Reproductive Function ◽  
Endocrine Function ◽  
Anthropometric Parameters ◽  
Ovary Syndrome ◽  
High Incidence ◽  
Total Treatment

The aim of the study was to investigate the effect of sibutramine on metabolic and hormonal parameters in women with PCOS and obesity. Materials and methods. The study included 53 women aged 18 to 35 years (mean age 31,3 ± 1,1 years) with PCOS and obesity. All patients received therapy with sibutramine. The total treatment duration was 6 months. The treatment was evaluated monthly nature of the menstrual cycle, anthropometric parameters (body weight, BMI, ON, ON, ON / OF). The Results. The studies found that after 3 months of treatment with weight loss was 8,1 ± 0,31 kg, after 6 months - 13,1 ± 0,78 kg (p 0,05). Results of the survey of women included in this study strongly support the negative impact of obesity on the functional state of the reproductive system, evidenced by the high incidence of anovulation, rhythm disturbances of menstruation (amenorrhea up to), infertility. Conclusions. The obtained results once again confirm the high efficacy and safety of sibutramine to reduce body mass, suggest correction of metabolic, hormonal disorders and positive impact on women's reproductive health. This allows us to consider the use of sibutramine in women with PCOS and obesity as a way to restore the endocrine function of the reproductive system.

scholarly journals Impact of low vision services on the quality of life of low vision patients in Ghana

2016 ◽  
Vol 75 (1) ◽  
Author(s):  
Godwin O. Ovenseri-Ogbomo ◽  
Harriette Osafo-Agyei ◽  
Ralph E.U. Akpalaba ◽  
James Addy ◽  
Elizabeth O. Ovenseri
Keyword(s):  
Quality Of Life ◽  
Visual Acuity ◽  
Positive Impact ◽  
Low Vision ◽  
Care Quality ◽  
Eastern Region ◽  
Post Intervention ◽  
Low Vision Clinic ◽  
The Impact

Patients’ perspectives on the impact of clinical interventions have been recognised as critical elements in patient care. Quality-of-life instruments are designed to measure these perspectives. We used the National Eye Institute’s 25-item Visual Function Questionnaire (NEI VFQ) to measure the impact of optical low vision devices on the quality of life of 22 low vision patients who obtained and were using low vision devices from a secondary low vision clinic in the Eastern Region, Ghana. The study employed a pre- and post-intervention technique. We found statistically significant improvements in measured visual acuity and NEI VFQ scores in 8 of the 10 domains evaluated. We conclude that optical low vision devices have a positive impact on the quality of life of low vision patients in Ghana.Keywords: low vision; quality of life; visual acuity; visual impairment; Ghana

I see you’re in pain – The effects of partner validation on emotions in people with chronic pain

2015 ◽  
Vol 6 (1) ◽  
pp. 16-21 ◽  
Author(s):  
Sara M. Edlund ◽  
Maria L. Carlsson ◽  
Steven J. Linton ◽  
Alan E. Fruzzetti ◽  
Maria Tillfors
Keyword(s):  
Chronic Pain ◽  
Negative Affect ◽  
Negative Impact ◽  
Positive Impact ◽  
Training Session ◽  
The Other ◽  
Pain Level ◽  
Interpersonal Interactions ◽  
Post Intervention ◽  
Promising Tool

AbstractBackground and aimsChronic pain not only affects the person in pain, but can also have a negative impact on relationships with loved ones. Research shows that chronic pain is associated with difficulties in marital relationships, which in turn is related to a variety of negative outcomes such as psychological distress and conflict within the family. This suggests that couples where chronic physical pain is present also struggle with emotional pain and relationship problems, and thus targeting relationship skills and interpersonal functioning might be helpful for these couples. Although studies in this area are promising, their numbers are few. In the present study, validation as a way of communicating is suggested for handling emotional expression in interpersonal interactions. Validation communicates understanding and acceptance of the other person’s experience, and it has been shown to have a down-regulating effect on negative emotions. It has previously been demonstrated to be important for these couples. However, the feasibility and effects of increasing partner validation in these couples are unknown. Therefore, the aim of the present study was to investigate if a brief training session in validation for spouses would result in more validating and fewer invalidating responses towards their partners with pain, and to investigate if changes in these behavioural responses were associated with changes in emotion and pain level in the partner with pain.MethodsParticipants were 20 couples where at least one partner reported chronic pain. The study employed a within-groups design in which spouses of people with pain received validation training (without their partner’s knowledge), and their validating and invalidating responses were rated pre- and post-intervention using a reliable observational scale. Also, positive and negative affect and subjective pain level in the persons with pain were rated pre- and post-intervention.ResultsResults showed that the validation training was associated with increased validating and decreased invalidating responses in the partners. Their spouses with chronic pain reported a decrease in negative affect from pre- to post-training.ConclusionsOur results indicate that the partner or closest family member, after brief validation training, increased validating responses and decreased invalidating responses towards the person with pain, which had an immediate positive impact on emotions in the other person.ImplicationsThis study suggests that using validation in interpersonal interactions is a promising tool for couples where chronic pain is present.

A quality improvement project to reduce restrictive interventions in a mental health service

2021 ◽  
pp. 1-12
Author(s):  
Darren Savarimuthu ◽  
Katja Jung
Keyword(s):  
Mental Health ◽  
Quality Improvement ◽  
Positive Impact ◽  
Essential Elements ◽  
Quality Improvement Project ◽  
Psychiatric Ward ◽  
Quality Improvement Initiative ◽  
Successful Implementation ◽  
Evidence Based ◽  
Improvement Project

Background/aims This article describes a quality improvement project that aimed to reduce restrictive interventions on an acute psychiatric ward. In light of a service level agreement and based on a trust-wide target, the purpose of the project was to reduce restrictive interventions by 20% within a period of 6 months. It was also anticipated that a least restrictive environment could have a positive impact on patient experience. Methods Three evidence-based interventions were introduced to the ward during the quality improvement project. These included positive behaviour support, the Safewards model and the productive ward initiative. Results There was a 63% reduction in restrictive interventions over a 6-month period through the successful implementation of a series of evidence-based interventions to manage behaviours that challenge on the mental health ward. Conclusions The project identified collaborative team working, staff training and adequate resources as essential elements in the success of the quality improvement initiative. However, co-production was found to be crucially significant in bringing sustainable changes in ward environment and in addressing restrictive practices.

Evaluating the Elklan Talking Matters Programme: Exploring the impact of a training programme for early years professionals on pre-school children’s language development

2020 ◽  
Vol 36 (2) ◽  
pp. 108-125
Author(s):  
Judy Clegg ◽  
Carla Rohde ◽  
Henrietta McLachlan ◽  
Liz Elks ◽  
Alex Hall
Keyword(s):  
Language Development ◽  
Positive Impact ◽  
Training Programme ◽  
Early Years ◽  
Post Intervention ◽  
Main Effect ◽  
Tentative Evidence ◽  
Effectiveness Of Training ◽  
And Control ◽  
The Impact

Training early years practitioners to facilitate the language development of young children is a widely used intervention. Evidence to support the effectiveness of training in terms of the impact of children’s language development is limited. The Elklan Talking Matters programme is an accredited training programme for early years practitioners. Practitioners train to be Lead Communication Practitioners (LCPs) who cascade training across early years settings or Key Communication Practitioners (KCPs) who are embedded into these settings. The aim of this study was to identify if the Talking Matters Programme is effective in facilitating the language development of pre-school children. One hundred and twenty-six children from 13 early years settings were recruited (mean age 27.81 months; SD 4.90). Thirteen settings participated in the Talking Matters Programme (five LCP+KCP settings, four LCP settings and four control settings). At time 1, prior to practitioners participating in the programme, children completed the Pre-School Language Scales 5th Edition (PLS-5), a standardized assessment of receptive and expressive language. At time 1, 126 children completed the baseline assessment ( n = 43 in the LCP+KCP settings, n = 43 in the LCP settings and n = 40 in the control settings). Children then completed the post intervention (time 2) assessment approximately six months later. Children in the intervention groups (LCP+KCP settings and LCP settings) made more progress in their language development from time 1 to time 2 compared to the control. The children in the LCP+KCP settings made more gains than the children in the LCP settings. A significant main effect of groups and time was found but not an interaction of group scores with time, meaning the increases in scores were not statistically significant between the intervention and control groups. The study provides tentative evidence that the Talking Matters programme has a positive impact on pre-school children’s language development.

scholarly journals Educational intervention on knowledge of cervical cancer and uptake of Pap smear test among market women in Niger State, Nigeria

2017 ◽  
Author(s):  
Godwin Jiya Gana ◽  
Mansur O. Oche ◽  
Jessica Timane Ango ◽  
Aminu Umar Kaoje ◽  
Kehinde Joseph Awosan ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Educational Intervention ◽  
Pap Smear ◽  
Female Genital Tract ◽  
Intervention Group ◽  
Control Group ◽  
Post Intervention ◽  
Pap Smear Test ◽  
Smear Test ◽  
Market Women

Cervical cancer is the most common female genital tract carcinoma worldwide. It is increasingly becoming the leading carcinoma seen among women in the developing world. The aim of our study was to showcase the effect of educational intervention on the knowledge of cervical cancer and subsequently the uptake of Pap smear test amongst market women in Niger state, Nigeria. The state has a rich network of markets in all the local government areas because of the fishing activities, bountiful agricultural produce yearly and its situation to the North of the national capital, Abuja. This was a quasi-experimental study conducted in two groups with pre and post intervention data collection. Sample size was determined based on a previous similar study done in Nigeria. Multi stage sampling technique was used for recruiting the study participants. SPSS statistical software was used for data entry, editing and analysis. Respondents’ knowledge of cervical cancer were comparable at pre-intervention but were statistically significantly better (P<0.0001) at post-intervention in the intervention group compared to the control group for every variable measured. However, there was only a (Fisher’s exact, P=0.621) compared to the control group. This study showed an increase in knowledge about cervical cancer and Pap smear test however the uptake of Pap smear test remained low even after intervention. This underscores the need for sustained intervention programs to eventually translate knowledge acquired to habitual practice.

scholarly journals THE IMPACT OF PILATES EXERCISES ON THE POSTURAL ALIGNMENT OF HEALTHY ADULTS

2016 ◽  
Vol 22 (6) ◽  
pp. 485-490
Author(s):  
Bruna Krawczky ◽  
Míriam Raquel Meira Mainenti ◽  
Antonio Guilherme Fonseca Pacheco
Keyword(s):  
Sagittal Plane ◽  
Positive Impact ◽  
Healthy Adults ◽  
The Body ◽  
Exercise Session ◽  
Post Intervention ◽  
Horizontal Alignment ◽  
Postural Alignment ◽  
Pilates Method ◽  
The Impact

ABSTRACT Introduction: Exercises of Pilates method have been widely used to improve postural alignment. There is strong evidence favoring their use in improving flexibility and balance, as well as some evidence of improvement in muscle strength. However, the benefits related to posture are not well established. Objective: To investigate in healthy adults, the impact of the Pilates method in the postural alignment through some angles in the sagittal plane and the occurrence of pain before and after an exercise session, and after the completion of a 16-session program. Methods: This is a quasi-experimental study of pre and post-intervention type. Healthy adults (n = 37) interested in starting Pilates were evaluated for acute effects on posture after a Pilates session (n = 37) and after a 16-session program, for a period of 10 weeks (n = 13). Using the postural assessment software (SAPO), six angles were analyzed: head horizontal alignment (HHA), pelvis horizontal alignment (PHA), hip angle (HA), vertical alignment of the body (VAB), thoracic kyphosis (TK), and lumbar lordosis (LL). The occurrence of pain was investigated to control adverse effects. Results: Statistically significant (p<0.05) differences found after one session include increased HHA (left view), decreased VAB (left view) and TK (both side views). After 16 sessions, we observed an increase of HHA, and a decrease of TK, LL (both side views) and HA (right view). All the differences point to an improvement of postural alignment. A significant reduction of prevalence of pain was verified after the first session (40.5% vs. 13.5%; p=0.004) and after the full program (30.8% vs. 15.3%; p=0.02). Conclusions: Our results suggest that the Pilates method has a positive impact on postural alignment in healthy adults, besides being a safe exercise.

Sign in / Sign up

Export Citation Format

Share Document