scholarly journals Decrease in (Major) Amputations in Diabetics: A Secondary Data Analysis by AOK Rheinland/Hamburg

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Melanie May ◽  
Sebastian Hahn ◽  
Claudia Tonn ◽  
Gerald Engels ◽  
Dirk Hochlenert
Keyword(s):  
Health Care Providers ◽  
Secondary Data ◽  
Management Program ◽  
Medical Community ◽  
Insurance Company ◽  
Care Providers ◽  
Integrate Health Care ◽  
Before And After ◽  
Specialized Care ◽  
Log Linear

Aim. In two German regions with 11.1 million inhabitants, 6 networks for specialized treatment of DFS were implemented until 2008. Data provided for accounting purposes was analysed in order to determine changes in the rate of diabetics requiring amputations in the years before and after the implementation.Method. Data covering 2.9 million people insured by the largest insurance company between 2007 and 2013 was analysed by the use of log-linear Poisson regression adjusted for age, gender and region.Results. The rate of diabetics needing major amputations fell significantly by 9.5% per year (p<0.0001) from 217 to 126 of 100,000 patients per year. The rate of diabetics needing amputations of any kind fell from 504 to 419 of 100,000 patients per year (p=0.0038).Discussion. The networks integrate health care providers in an organised system of shared care. They educate members of the medical community and the general public. At the same time, a more general disease management program for people with diabetes was implemented, which may also have contributed to this decrease. At the end of the observation period, the rate of diabetics requiring amputations was still high. For this reason, further expansion of organised specialized care is urgently needed.

Genetic Predispositions, Prophylactic Treatments and Private Health Insurance: Nothing is Better Than a Good Pair of Genes

1997 ◽  
Vol 23 (1) ◽  
pp. 45-68 ◽  
Author(s):  
Alexandra K. Glazier
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Genetic Predisposition ◽  
Genetic Linkage ◽  
Dna Analysis ◽  
Care Delivery ◽  
Medical Community ◽  
Care Providers ◽  
Linkage Studies ◽  
Prophylactic Measures

Discovering the genetic basis of a particular disease is not only of great interest to the medical community; private health insurers are also anxiously awaiting the results of genetic linkage studies. Apart from the scientific value of DNA studies, the results of genetic linkage research are relevant to health care delivery in two principal ways. First, identifying the genetic origin of a disease may allow doctors to detect the disease earlier. If doctors know that an individual is genetically predisposed to a particular disease, then health care providers can increase screening efforts and watch for early symptoms. Second, if an individual has a genetic predisposition to a particular disease, health care providers may employ preventive or “prophylactic" measures to reduce or eliminate the risk of developing the disease or condition to which the individual is genetically predisposed. Genetic linkage studies will soon allow more individuals to learn of their own genetic predispositions to certain diseases. Currently genetic predisposition tests (both pedigrees of family history and DNA analysis) can indicate that an individual is at high risk for developing a disease.

scholarly journals Caregiver Burden: Caregiving Workshops Have a Positive Impact on Those Caring for Individuals With Dementia in Arkansas

2021 ◽  
Vol 8 ◽  
pp. 237437352110180
Author(s):  
Robin E. McAtee ◽  
Laura Spradley ◽  
Leah Tobey ◽  
Whitney Thomasson ◽  
Gohar Azhar ◽  
...  
Keyword(s):  
Caregiver Burden ◽  
Health Care Providers ◽  
Positive Impact ◽  
Educational Programs ◽  
Vital Role ◽  
Complex Care ◽  
Care Providers ◽  
Dementia Caregivers ◽  
Before And After ◽  
Burden Scale

Millions of Americans live with dementia. Caregivers of this population provide countless hours of multifaceted, complex care that frequently cause unrelenting stress which can result in immense burden. However, it is not fully understood what efforts can be made to reduce the stress among caregivers of persons with dementia (PWD). Therefore, the aim of this pretest–posttest designed study was to evaluate changes in caregiver burden after providing an educational intervention to those caring for PWD in Arkansas. Forty-one participants completed the Zarit Caregiver Burden Scale before and after attending a 4-hour dementia-focused caregiving workshop. The analysis of the means, standard deviations, and paired t tests showed that there was an increase in the confidence and competence in caring for PWD 30 to 45 days after attending the workshop. Health care providers need to understand both the vital role caregivers provide in managing a PWD and the importance of the caregiver receiving education about their role as a caregiver. Utilizing caregiver educational programs is a first step.

scholarly journals Knowledge of Health Care Providers on HPV Related Issues in Cervical Cancer

2012 ◽  
Vol 29 (4) ◽  
pp. 213-218
Author(s):  
F Hussain ◽  
MS Flora ◽  
K Nahar ◽  
M Khan
Keyword(s):  
Health Care ◽  
Cervical Cancer ◽  
Cancer Prevention ◽  
Health Care Providers ◽  
Hpv Vaccination ◽  
Cervical Cancer Prevention ◽  
Care Providers ◽  
Before And After ◽  
Post Test ◽  
Cancer Prevention Program

Background: The field of cervical cancer prevention is  rapidly evolving because of identification of Human  Papilloma Virus (HPV) as the necessary cause of disease.  HPV vaccines are now in the market. For successful  triggering of cervical cancer prevention program, HPV  informations should be communicated to health care  providers whose understanding about HPV has lagged  behind the scientific and technical advances.Objective: The objective of this intervention study was to  identify gap and educate health care providers delivering  services to women and adolescents in Medical Colleges on  HPV related issues and vaccination.Methods: The study was done from July 2007 to June 2008  where 3 advocacy workshops were conducted. The  knowledge level of 106 participants were assessed before  and after intervention. Updated informations about HPV  and vaccine was given to participants as intervention.Results: Wide knowledge gap was identified among  participants on HPV related insues, but significant  improvement was observed following intervention. The  pretest and post test score of knowledge was 28.09 and 38.60  respectively showing an average increase of 10 after  intervention.Conclusions: HPV education should be extensively  disseminated to health care providers to obtain public health  benefits of HPV vaccination program. DOI: http://dx.doi.org/10.3329/jbcps.v29i4.11329 J Bangladesh Coll Phys Surg 2011; 29: 213-218

scholarly journals Community-Based Intervention to Increase Usage of Medication Disposal Bins

2019 ◽  
Author(s):  
Sanjhavi Agarwal ◽  
Jordan Burr ◽  
Charis Darnell ◽  
Brett Ellison ◽  
Amir El-Khalili ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Healthcare Providers ◽  
Health Centers ◽  
P Value ◽  
Care Providers ◽  
Community Based ◽  
Before And After ◽  
Provider Knowledge ◽  
Informational Intervention ◽  
Medication Disposal

Despite the existence of medical waste disposal sites, many patients do not know how to discard their unused and expired medications. The goal of this project is to assess health care providers’ knowledge regarding proper medication disposal (PMD) and to measure the effectiveness of a brief provider informational intervention regarding PMD. Changes in knowledge were evaluated using paper pre and post surveys. The surveys were administered anonymously before and after the presentation. Principal findings: A total of 55 healthcare providers (Clinic A n = 25, Clinic B n = 28) received the PMD presentation. 52 (95%) completed the pre and post surveys. Pre-intervention knowledge of PMD was higher in Clinic B where there was an existing medication disposal box (92% accuracy) compared to Clinic B which did not have a medical disposal bin (52% accuracy). Surveys results showed improvement in 36% of Clinic A participants and 14.3% of Clinic B participants (p value = 0.0086). Based on these findings, we can conclude that the presence of a medication disposal bin is positively correlated with provider knowledge regarding PMD. This may be used to encourage the institution of medication disposal bins in more health centers and an increase in medical staff knowledge of the practice.

scholarly journals P023: Code Resus - using a quality improvement approach to improve health care provider response during resuscitations

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S86-S86
Author(s):  
L.B. Chartier ◽  
S. Hansen ◽  
D. Lim ◽  
S. Yi ◽  
B. McGovern ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Health Care Providers ◽  
Rating Scale ◽  
Tertiary Care ◽  
Care Hospital ◽  
Care Providers ◽  
Change Initiatives ◽  
Chi Square ◽  
Before And After

Introduction: In order to achieve the best possible outcomes for patients requiring resuscitation (PRRs) in the emergency department (ED), health care providers (HCPs) must provide an efficient, multi-disciplinary and coordinated response. A quality improvement (QI) project was undertaken to improve HCP response to PRRs at two tertiary care hospital EDs in Toronto. Methods: We conducted a before-and-after mixed-method survey to evaluate the perception of the adequacy of HCP response and clarity of HCP role when responding to PRRs. The results were compared using the Chi-square test. Qualitative responses to the first survey were also used to inform the development of the QI project. Through interviews of key stakeholders and with continuous input from front-line ED HCPs, a multi-disciplinary team modified the ED resuscitation protocol. This included standardized pre-hospital communication form with paramedics, ED-wide overhead announcement of ‘Code Resus’, dedicated HCPs assigned to respond to PRRs, and specific duties assigned to each responder. Change initiatives were reinforced through education and posters in the ED. Six months after implementation, a second survey was conducted to evaluate the sustained effects of the intervention. Results: Baseline measures indicated that 16 of 52 (30.8%) nurses surveyed believed their role was often or always apparent to themselves and others when they attended to a PRR (on a 5-point rating scale). This proportion increased to 35 of 55 (63.6%) nurses in the post-implementation survey (p < 0.001). Regarding adequacy of the number of HCPs responding to PRRs, 17 of 39 (43.6%) physicians and 23 of 53 (43.4%) nurses surveyed thought the appropriate number of HCPs responded to PRRs; the remainder thought that there were too few or too many HCPs. In the post-implementation survey, 34 of 41 (82.9%) physicians (p < 0.001) and 36 of 56 (64.3%) nurses (p = 0.029) surveyed felt that the appropriate number of HCPs attended to PRRs. Conclusion: Using a quality improvement approach, we identified and quantified perceived deficiencies in HCP response to PRRs in the ED. Through feedback-based modifications of the ED resuscitation protocol and by engaging HCP stakeholders, change initiatives were implemented to improve HCP response. As a result, this project achieved significant and sustained improvements in HCPs’ perceived response to PRRs.

scholarly journals An evaluation of Acute Care of at-Risk Newborns (ACoRN), a Canadian education program, in Chinese neonatal nurseries

2019 ◽  
Vol 25 (6) ◽  
pp. 351-357
Author(s):  
Khalid Aziz ◽  
Xiaolu Ma ◽  
Jocelyn Lockyer ◽  
Douglas McMillan ◽  
Xiang Y Ye ◽  
...  
Keyword(s):  
At Risk ◽  
Acute Care ◽  
Health Care Providers ◽  
Care Providers ◽  
Clinical Practices ◽  
Canadian Education ◽  
Before And After ◽  
Evaluation Decision ◽  
Hospital Births ◽  
Before And After Study

Abstract Background The Acute Care of at-Risk Newborns (ACoRN) program was developed in Canada to train health care providers in the identification and management of newborns who are at-risk and/or become unwell after birth. The ACoRN process follows a stepwise framework that enables evaluation, decision, and action irrespective of caregiver experience. This study examined the hypothesis that the ACoRN educational program improved clinical practices and outcomes in China. Methods In a before-and-after study, ACoRN training was provided to physicians, neonatal nurses, and administrators in 16 county hospitals in Zhejiang, PRC. Demographic and clinical data were collected on babies admitted to neonatal units before (May 1, 2008 to March 31, 2009) and after (June 1, 2010 to April 30, 2012) training. Results A total of 4,310 babies (1,865 pre- and 2,445 post-training) from 14 sites were included. There were more in-hospital births (97.8% versus 95.6%, P&lt;0.01) in the post-training epoch, fewer babies needing resuscitation (12.7% versus 16.0%, P=0.02), and more babies finishing their care in hospital (67.4% versus 53.1%, P&lt;0.0001). After training, significantly more babies were evaluated as having respiratory distress at admission (14.2% versus 9.4%, P&lt;0.0001); more babies had saturation, glucose and temperature measured on admission and at discharge; and more babies received intravenous fluids (86.3% versus 72.8%, P&lt;0.0001). No significant improvements were noted in mortality (0.49% [post] versus 0.8% [pre], P=0.19 and adjusted odds ratio 0.54, 95% confidence interval: 0.23 to 1.29). Conclusions ACoRN training significantly increased patient evaluations and changed clinical practices. However, we were unable to ascertain improvement in morbidity or mortality.

scholarly journals Mammographic Screening in Older Women: When Is It Time to Stop?

2020 ◽  
Vol 2 (2) ◽  
pp. 92-100
Author(s):  
Reni Butler ◽  
Liane Philpotts
Keyword(s):  
Older Women ◽  
Health Care Providers ◽  
Performance Metrics ◽  
Breast Cancer Mortality ◽  
Age Groups ◽  
Mammographic Screening ◽  
Screening Mammography ◽  
Medical Community ◽  
Individual Risk ◽  
Care Providers

Abstract Mammographic screening guidelines in women aged 75 and older are inconsistent due to a lack of data from prospective randomized controlled trials, such as those that exist for women between 40–74 years of age. In addition, older women are perceived as less likely to benefit from early detection due to increased comorbidities and a greater proportion of biologically favorable cancers. With increasing life expectancy and quality of life in the elderly, the question of when to stop mammographic screening merits renewed discussion. Observational data support a survival benefit from regular screening in older women with no severe comorbidities. In addition, screening mammography in this age group has been shown to perform better than in younger age groups, tipping the balance toward greater benefits than harms. Early studies of digital breast tomosynthesis (DBT) in older women suggest that performance metrics are further improved with DBT screening. While a biennial schedule in older women preserves some of the benefit of screening, annual mammography achieves the greatest reductions in breast cancer mortality and morbidity. As the medical community strives to offer personalized care for all age groups, health care providers are well positioned to offer shared decision-making based on existing data and tailored to each woman’s individual risk profile, comorbid conditions, and personal values.

The use of telehealth (text messaging and video communications) in patients with cystic fibrosis: A pilot study

2016 ◽  
Vol 23 (4) ◽  
pp. 489-493 ◽  
Author(s):  
Michal Gur ◽  
Vered Nir ◽  
Anna Teleshov ◽  
Ronen Bar-Yoseph ◽  
Eynav Manor ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Pilot Study ◽  
Health Care Providers ◽  
Text Messaging ◽  
Descriptive Analysis ◽  
Intervention Group ◽  
Control Group ◽  
Care Providers ◽  
Multi Centre Study ◽  
Before And After

Background Poor communications between cystic fibrosis (CF) patients and health-care providers may result in gaps in knowledge and misconceptions about medication usage, and can lead to poor adherence. We aimed to assess the feasibility of using WhatsApp and Skype to improve communications. Methods This single-centre pilot study included CF patients who were older than eight years of age assigned to two groups: one without intervention (control group), and one with intervention. Each patient from the intervention group received Skype-based online video chats and WhatsApp messages from members of the multidisciplinary CF team. CF questionnaires, revised (CFQ-R) scores, knowledge and adherence based on CF My Way and patients satisfaction were evaluated before and after three months. Feasibility was assessed by session attendance, acceptability and satisfaction survey. Descriptive analysis and paired and non-paired t-tests were used as applicable. Results Eighteen patients were recruited to this feasibility study (nine in each group). Each intervention group participant had between four and six Skype video chats and received 22–45 WhatsApp messages. In this small study, CFQ-R scores, knowledge, adherence and patient satisfaction were similar in both groups before and after the three-month intervention. Conclusions A telehealth-based approach, using Skype video chats and WhatsApp messages, was feasible and acceptable in this pilot study. A larger and longer multi-centre study is warranted to examine the efficacy of these interventions to improve knowledge, adherence and communication.

Evaluation of Glove Liners with Objective, Subjective and Performance Measures

1998 ◽  
Vol 42 (12) ◽  
pp. 846-850 ◽  
Author(s):  
S. C. Chen ◽  
I. Tarawneh ◽  
B. Goodwin ◽  
R. R. Bishu
Keyword(s):  
Performance Measures ◽  
Health Care Providers ◽  
Performance Tests ◽  
Care Providers ◽  
Before And After ◽  
Two Temperatures ◽  
And Performance ◽  
Subjective Discomfort ◽  
Skin Moisture ◽  
Skin Sensitizer

The objective of this study was to evaluate a number of inner glove liners used to protect the skin from latex proteins and chemical skin sensitizer found in gloves. A battery of performance tests were used for evaluating the inner gloves. Besides these, objective measurements such as skin temperature, skin conductance, and skin moisture content were measured. A series of subjective discomfort/comfort measures were also taken. Seventeen health care providers participated in this experiment where four liner conditions were evaluated at two temperatures. Some of the measures were recorded before and after the tests, while some other measures were recorded every fifteen minutes. Thus each subject participated in eight trials (4 liners X 2 temperatures). The tests were of two hours duration. Sweat, pegboard test, and discomfort measures were the best discriminators of liners, while the other subjective and objective measures were not.

scholarly journals Trustworthy Augmented Intelligence in Health Care

2022 ◽  
Vol 46 (2) ◽  
Author(s):  
Elliott Crigger ◽  
Karen Reinbold ◽  
Chelsea Hanson ◽  
Audiey Kao ◽  
Kathleen Blake ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Clinical Care ◽  
Medical Community ◽  
Care Providers ◽  
Innovative Technologies ◽  
Quadruple Aim ◽  
Regulatory Systems ◽  
Starting Point ◽  
Reducing Costs

AbstractAugmented Intelligence (AI) systems have the power to transform health care and bring us closer to the quadruple aim: enhancing patient experience, improving population health, reducing costs, and improving the work life of health care providers. Earning physicians' trust is critical for accelerating adoption of AI into patient care. As technology evolves, the medical community will need to develop standards for these innovative technologies and re-visit current regulatory systems that physicians and patients rely on to ensure that health care AI is responsible, evidence-based, free from bias, and designed and deployed to promote equity. To develop actionable guidance for trustworthy AI in health care, the AMA reviewed literature on the challenges health care AI poses and reflected on existing guidance as a starting point for addressing those challenges (including models for regulating the introduction of innovative technologies into clinical care).

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