scholarly journals Evaluation of Undescended Testes in Newborns: It Is Really Simple, Just Not Easy

2021 ◽  
pp. 1-5
Author(s):  
Martin Promm ◽  
Annika Dittrich ◽  
Susanne Brandstetter ◽  
Sara Fill-Malfertheiner ◽  
Michael Melter ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Undescended Testis ◽  
Birth Cohort Study ◽  
Care Providers ◽  
Undescended Testes ◽  
Timely Initiation ◽  
Pediatric Urologist ◽  
Initiation Of Therapy ◽  
Lost To Follow Up

<b><i>Introduction:</i></b> The evaluation of the testicular position in newborns is important to ensure timely initiation of therapy. The aim of our study was to assess the reliability of a routinely performed screening examination. <b><i>Patients and Methods:</i></b> Newborns were examined by a pediatrician between 48 and 72 h after birth. Boys with suspected cryptorchidism were double-checked by a pediatric urologist within 24 h. <b><i>Results:</i></b> 1,181/2,353 children included in the study between June 2015 and December 2017 were male. Eight hundred sixty-one boys could be included in this analysis; 5.8% (<i>n</i> = 50) were diagnosed with undescended testis (UDT) by the pediatrician. 30/50 boys were double-checked at the Department of Pediatric Urology. Forty percent (20/50) were lost to follow-up. In 43% (13/30), the diagnosis could be confirmed. Three former studies had shown a relevant discrepancy in the results of the diagnosis of UDT made by health care providers and urologists/pediatric surgeons. To our knowledge, this is the first study evaluating the testicular position in male newborns in such a large prospective birth cohort study by physicians with ranging expertise within 1 day. <b><i>Conclusion:</i></b> Further treatment for UDT is based on clinical examination. Ours and previous studies can clearly show the various findings in boys suspected having UDT. Therefore, it is essential that the diagnosis is confirmed by a specialist before a therapy is initiated.

scholarly journals Acceptability, continuation and satisfaction of postpartum intrauterine contraceptive device (PPIUCD) and delayed insertion: a comparative study

2017 ◽  
Vol 6 (8) ◽  
pp. 3540
Author(s):  
Neha Jain ◽  
Nishat Akhtar
Keyword(s):  
Health Care Providers ◽  
Obstetrics And Gynecology ◽  
Contraceptive Device ◽  
Care Providers ◽  
Group I ◽  
Intrauterine Contraceptive ◽  
Group Ii ◽  
A Prospective Study ◽  
Lost To Follow Up

Background: Postpartum period is an ideal time to counsel and begin contraception as women are strongly motivated at this time, also being convenient for both patients and health-care providers. Copper T 380A is a safe, highly effective method of contraception and has become the method of choice of many women for attaining their reproductive goals.Methods: It was a prospective study conducted from February 2012 and November 2013 in the Department of Obstetrics and Gynecology, JNMCH, AMU, Aligarh, U.P.Results: 386 clients were counseled for immediate postpartum IUCD insertion (GROUP-I), out of which 34.2% clients accepted for insertion but 24.3% actually got it inserted. 337 clients were counseled for extended IUCD insertion (GROUP-II) out of these 61.1% clients accepted but only 16.5% actually got it inserted. 10.63%, 6.02% and 5.19% clients in GROUP-I and 16.22%, 13.11%, 11.54% GROUP-II went lost to follow up at 6 weeks, 3 months and 6 months respectively. Continuation rates in GROUP-I after 6 months was 73.4% in GROUP-I and 59.5% in GROUP-II. Among the clients who continued, 92.7% were satisfied in GROUP-I and 81.8% in GROUP-II.Conclusions: Immediate postpartum IUCD has better acceptability, continuation and satisfaction profile when compared to extended insertion. 

scholarly journals Client satisfaction with existing postnatal care and associated factors: A study among mothers in Awi Zone, Amhara region, Ethiopia

2020 ◽  
Vol 16 ◽  
pp. 174550652097601
Author(s):  
Daniel Adane ◽  
Biresaw Wassihun
Keyword(s):  
Antenatal Care ◽  
Health Care Providers ◽  
Postnatal Care ◽  
Associated Factors ◽  
Client Satisfaction ◽  
Post Partum ◽  
Care Providers ◽  
Amhara Region ◽  
Awi Zone

Background: The majority of maternal and neonatal adverse events take place during the postnatal period. However, it is the most neglected period for the provision of quality care. Objective: The aim of this study among mothers in the Awi Zone, Amhara region, Ethiopia, was to assess client satisfaction with existing postnatal care and associated factors. Methods: An institution-based cross-sectional study was conducted in Awi Zone hospitals from 1 to 30 April 2018. A total of 422 post-partum mothers were selected by systematic sampling. The data were collected using a pre-tested structured questionnaire via a face-to-face interview. Data entry and analysis were completed using EpiData version 3.1 and SPSS version 22, respectively. The data were summarized with frequency and cross-tabulation. Both binary and multiple logistic regressions were used to identify predictor variables using odds ratios and 95% confidence intervals. Result: The prevalence of postnatal care satisfaction was 63%. Being from urban area (AOR = 2.1, 95% CI = (1.11–3.99)), having a history of antenatal care follow up (AOR = 1.62, 95% CI = (1.23–1.64)), spontaneous vaginal birth (AOR = 3.14, 95% CI = (1.77–3.28)), and those who did not face any complications during birth (AOR = 2.90, 95% CI = (1.47–1.69)) were some of the factors associated with client satisfaction. Conclusion: According to the results of this study, the majority of mothers were satisfied with post-partum care services. The study findings indicate that maternal satisfaction on post-partum care is mainly affected by residency, antenatal care follow up, mode of delivery, and complications during birth. Therefore, health care providers and other concerned bodies should give special attention to those mothers who are from rural areas, who face complications during birth or who have instrumental-assisted or cesarean section birth. Also, every pregnant mother should be supported to have at least four regular antenatal care visits.

scholarly journals A Patient-Held Medical Record Integrating Depression Care into Diabetes Care

2016 ◽  
Vol 7 ◽  
pp. JCM.S39766 ◽  
Author(s):  
Noriko Satoh-Asahara ◽  
Hiroto Ito ◽  
Tomoyuki Akashi ◽  
Hajime Yamakage ◽  
Kazuhiko Kotani ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Diabetes Care ◽  
Clinical Pathways ◽  
Coping Resources ◽  
Care Providers ◽  
Depression Care ◽  
Patients With Diabetes ◽  
And Coping ◽  
Levels Of Integration

Purpose Depression is frequently observed in people with diabetes. The purpose of this study is to develop a tool for individuals with diabetes and depression to communicate their comorbid conditions to health-care providers. Method We searched the Internet to review patient-held medical records (PHRs) of patients with diabetes and examine current levels of integration of diabetes and depression care in Japan. Results Eight sets of PHRs were found for people with diabetes. All PHRs included clinical follow-up of diabetes and multidisciplinary clinical pathways for diabetes care. No PHRs included depression monitoring and/or treatment. In terms of an integrated PHR for a patient comorbid with diabetes and depression, necessary components include hopes/preferences, educational information on diabetes complications and treatment, medical history, stress and coping, resources, and monitoring diabetes and depression. Conclusion A new PHR may be suitable for comorbid patients with diabetes and depression.

TELE-MONITORING SYSTEM OF RISK IN RESPIRATORY PATIENTS

2021 ◽  
pp. 2150041
Author(s):  
Awad Al-Zaben ◽  
Lina M.K. Al-Ebbini ◽  
Badr Qatashah
Keyword(s):  
Health Care ◽  
Signal Processing ◽  
Health Care Providers ◽  
Mobile Phones ◽  
Model Parameters ◽  
Care Providers ◽  
Server Side ◽  
Respiration Signal ◽  
At Home

In many situations, health care professionals need to evaluate the respiration rate (RR) for home patients. Moreover, when cases are more than health care providers’ capacity, it is important to follow up cases at home. In this paper, we present a complete system that enables healthcare providers to follow up with patients with respiratory-related diseases at home. The aim is to evaluate the use of a mobile phone’s accelerometer to capture respiration waveform from different patients using mobile phones. Whereas measurements are performed by patients themselves from home, and not by professional health care personnel, the signals captured by mobile phones are subjected to many unknowns. Therefore, the validity of the signals has to be evaluated first and before any processing. Proper signal processing algorithms can be used to prepare the captured waveform for RR computations. A validity check is considered at different stages using statistical measures and pathophysiological limitations. In this paper, a mobile application is developed to capture the accelerometer signals and send the data to a server at the health care facility. The server has a database of each patient’s signals considering patient privacy and security of information. All the validations and signal processing are performed on the server side. The patient’s condition can be followed up over a few days and an alarm system may be implemented at the server-side in case of respiration deterioration or when there is a risk of a patient’s need for hospitalization. The risk is determined based on respiration signal features extracted from the received respiration signal including RR, and Autoregressive (AR) moving average (ARMA) model parameters of the signal. Results showed that the presented method can be used at a larger scale enabling health care providers to monitor a large number of patients.

Using ePROMs for follow-up after palliative radiotherapy: an exploratory study with patients and health care providers.

2021 ◽  
Author(s):  
Eva Oldenburger ◽  
Inge Neyens ◽  
Annemarie Coolbrandt ◽  
Sofie Isebaert ◽  
Aline Sevenants ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Exploratory Study ◽  
Palliative Radiotherapy ◽  
Care Providers

scholarly journals Cannabis and breastfeeding

2020 ◽  
Vol 25 (Supplement_1) ◽  
pp. S26-S28 ◽  
Author(s):  
Lisa Graves
Keyword(s):  
Health Care Providers ◽  
Small Sample ◽  
Adverse Outcomes ◽  
Care Providers ◽  
High Quality ◽  
High Quality Evidence ◽  
Small Sample Sizes ◽  
The Impact ◽  
Quality Evidence

Abstract Cannabis is one of the most commonly used substances in Canada with 15% of Canadians reporting use in 2019. There is emerging evidence that cannabis is linked to an impact on the developing brain in utero and adverse outcomes in infants, children, and adolescents. The impact of cannabis during breastfeeding has been limited by studies with small sample sizes, follow-up limited to 1 year and the challenge of separating prenatal exposure from that during breastfeeding. In the absence of high-quality evidence, health care providers need to continue to engage women in conversation about the potential concerns related to breastfeeding and cannabis use.

scholarly journals Person-Centered Maternity Care During Childbirth and Associated Factors at Selected Public Hospitals in Addis Ababa, Ethiopia, 2021: A Cross-Sectional Study

2021 ◽  
Author(s):  
Azezew Ambachew Tarekegne ◽  
Berhanu Wordofa Giru ◽  
Bazie Mekonnen
Keyword(s):  
Health Care Providers ◽  
Maternity Care ◽  
Associated Factors ◽  
Addis Ababa ◽  
Cross Sectional Study ◽  
Public Hospitals ◽  
Care Providers ◽  
Sectional Study ◽  
Cross Sectional

Abstract Background: Person-centered maternity care is respectful and responsive care to individual women’s preferences, needs, and values and ensuring that their values guide all clinical decisions during childbirth. It is recognized as a key dimension of the quality of maternity care that increases client satisfaction and institutional delivery. However, little research has been conducted about person-centered maternity care in Ethiopia. Objective: The aim of this study was to assess the status of person-centered maternity care and associated factors among mothers who gave birth at selected public hospitals in Addis Ababa city, Addis Ababa, Ethiopia, 2021.Method: A facility-based cross-sectional study was conducted at selected public hospitals in Addis Ababa city. A semi-structured questionnaire was used to collect data from post-natal mothers selected by systematic random sampling. The data was coded and entered using Epi-data version 4.6 and analyzed using SPSS version 25. Bivariate and multivariable linear regression analysis was used to identify factors associated with person-centered maternity care. The strength of association between independent and dependent variables was reported by using unstandardized β at 95% CI and p-value < 0.05 were considered statistically significant.Results: In this study 384 mothers were participated with a response rate of 99.2%. The overall prevalence of person-centered maternity care was 65.8%. Respondents who had no ANC follow-up (β= -5.39, 95% CI: -10.52, -0.26), <4 ANC follow up (β= -3.99, 95% CI: -6.63, -1.36), night time delivery (β= -3.95, 95% CI: -5.91, -1.98) and complications during delivery (β= -3.18, 95% CI: -6.01, -0.35) were factors significantly associated with person-centered maternity care.Conclusion and Recommendations: The finding of this study showed that the proportion of person-centered maternity care among mothers who gave birth in public hospitals of Addis Ababa was high as compared to previous studies. The factors affecting person-centered maternity care are manageable to interventions. Therefore, Health care providers need to provide person-centered maternity care for all mothers.

scholarly journals Teleassistance for Patients With Type 1 Diabetes During the COVID-19 Pandemic: Results of a Pilot Study (Preprint)

2020 ◽  
Author(s):  
Martina Parise ◽  
Linda Tartaglione ◽  
Antonio Cutruzzolà ◽  
Maria Ida Maiorino ◽  
Katherine Esposito ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Disease Management ◽  
Health Care Providers ◽  
Glucose Monitoring ◽  
Glycemic Variability ◽  
Care Providers ◽  
Virtual Visits

BACKGROUND Telemedicine use in chronic disease management has markedly increased during health emergencies due to COVID-19. Diabetes and technologies supporting diabetes care, including glucose monitoring devices, software analyzing glucose data, and insulin delivering systems, would facilitate remote and structured disease management. Indeed, most of the currently available technologies to store and transfer web-based data to be shared with health care providers. OBJECTIVE During the COVID-19 pandemic, we provided our patients the opportunity to manage their diabetes remotely by implementing technology. Therefore, this study aimed to evaluate the effectiveness of 2 virtual visits on glycemic control parameters among patients with type 1 diabetes (T1D) during the lockdown period. METHODS This prospective observational study included T1D patients who completed 2 virtual visits during the lockdown period. The glucose outcomes that reflected the benefits of the virtual consultation were time in range (TIR), time above range, time below range, mean daily glucose, glucose management indicator (GMI), and glycemic variability. This metric was generated using specific computer programs that automatically upload data from the devices used to monitor blood or interstitial glucose levels. If needed, we changed the ongoing treatment at the first virtual visit. RESULTS Among 209 eligible patients with T1D, 166 completed 2 virtual visits, 35 failed to download glucose data, and 8 declined the visit. Among the patients not included in the study, we observed a significantly lower proportion of continuous glucose monitoring (CGM) and continuous subcutaneous insulin infusion (CSII) users (n=7/43, 16% vs n=155/166, 93.4% and n=9/43, 21% vs n=128/166, 77.1%, respectively; <i>P</i>&lt;.001) compared to patients who completed the study. TIR significantly increased from the first (62%, SD 18%) to the second (65%, SD 16%) virtual visit (<i>P</i>=.02); this increase was more marked among patients using the traditional meter (n=11; baseline TIR=55%, SD 17% and follow-up TIR=66%, SD 13%; <i>P</i>=.01) than among those using CGM, and in those with a baseline GMI of ≥7.5% (n=46; baseline TIR=45%, SD 15% and follow-up TIR=53%, SD 18%; <i>P</i>&lt;.001) than in those with a GMI of &lt;7.5% (n=120; baseline TIR=68%, SD 15% and follow-up TIR=69%, SD 15%; <i>P</i>=.98). The only variable independently associated with TIR was the change of ongoing therapy. The unstandardized beta coefficient (B) and 95% CI were 5 (95% CI 0.7-8.0) (<i>P</i>=.02). The type of glucose monitoring device and insulin delivery systems did not influence glucometric parameters. CONCLUSIONS These findings indicate that the structured virtual visits help maintain and improve glycemic control in situations where in-person visits are not feasible.

scholarly journals Establishment of Outcome-Related Analytic Performance Goals

2010 ◽  
Vol 56 (5) ◽  
pp. 714-722 ◽  
Author(s):  
George G Klee
Keyword(s):  
Health Care Providers ◽  
Performance Standards ◽  
Performance Criteria ◽  
Medical Decision ◽  
Performance Goals ◽  
Care Providers ◽  
Performance Limits ◽  
Medical Decisions ◽  
External Assessment

Abstract Background: Accrediting organizations require laboratories to establish analytic performance criteria that ensure their tests provide results of the high quality required for patient care. However, the procedures for instituting performance criteria that are directly linked to the needs of medical practice are not well established, and therefore alternative strategies often are used to create and implement surrogate performance standards. Content: We reviewed 6 approaches for establishing outcome-related analytic performance goals: (a) limits defined by regulations and external assessment programs, (b) limits based on biologic variation, (c) limits based on surveys of clinicians about their needs, (d) limits based on effects on guideline driven medical decisions, (e) limits based on analysis of patterns for ordering follow-up clinical tests, and (f) limits based on formal medical decision models. Performance criteria were tabulated for 12 common chemistry analytes and 4 routine hematology tests. Conclusions: There is no consensus currently about the preferred methods for establishing medically necessary analytic performance limits. The various methods reviewed give considerably different performance limits. The analytic performance limits claimed by a laboratory should correspond to those limits that can be reliably maintained based on validated QC monitoring systems. These limits generally are larger than the observed CVs and bias parameters collected for assay validation. There is a major need for increased communication among laboratorians and clinicians on this topic, especially when the analytic performance limits that can be consistently maintained by a laboratory are inconsistent with the expectations of health care providers.

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