scholarly journals The Association of Neighborhood Medical Facilities with Aging in Place and Risk of Incident Myocardial Infarction

2020 ◽  
pp. 089826432097522
Author(s):  
Janene R. Brown ◽  
Jana A. Hirsch ◽  
Suzanne E. Judd ◽  
Philip M. Hurvitz ◽  
Virginia J. Howard ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Clinical Care ◽  
Aging In Place ◽  
Self Care ◽  
Medical Facility ◽  
Residential Stability ◽  
Community Factors ◽  
Medical Facilities ◽  
Care Facilities

Objectives: Aging in place (residential stability) is a desirable means of aging where adults remain in their homes, even when facing challenges that impair their capacity for self-care. Residential stability, especially following acute health challenges, depends on individual and community factors, possibly including proximity to medical facilities. Methods: We explored the association between the density of medical facilities around homes with risk of incident myocardial infarction (MI) and with aging in place following incident MI. Results: Densities of neighborhood pharmacies were not associated with aging in place or time to MI. High densities of neighborhood clinical care facilities were significantly associated with decreased residential stability. Discussion: The lack of significant associations between medical facility exposures and MI-related outcomes, coupled with prior findings, casts doubt on their salience and may indicate that other neighborhood features are more strongly associated with these outcomes.

Diabetes Self-Care Behaviors and Barriers to Clinical Care During COVID-19 Pandemic for Marshallese Adults

2022 ◽  
pp. 263501062110653
Author(s):  
Rachel S. Purvis ◽  
Ramey A. Moore ◽  
Britni L. Ayers ◽  
Holly C. Felix ◽  
Sheldon Riklon ◽  
...  
Keyword(s):  
Health Care ◽  
Social Media ◽  
Health Education ◽  
Health Care Provider ◽  
Care Provider ◽  
Clinical Care ◽  
A Priori ◽  
Self Care ◽  
Qualitative Descriptive ◽  
Insight Into

Purpose: The purpose of the study was to explore experiences of Marshallese adults related to diabetes self-care behaviors during the COVID-19 pandemic. Methods: A qualitative descriptive design was utilized to understand participants’ diabetes self-care behaviors during the pandemic. Nine focus groups with 53 participants were held via videoconference and conducted in English, Marshallese, or a mixture of both languages. A priori codes based on diabetes self-care behaviors provided a framework for analyzing and summarizing participant experiences. Results: Both increases and decreases in healthy eating and exercise were described, with improvements in health behaviors attributed to health education messaging via social media. Participants reported increased stress and difficulty monitoring and managing glucose. Difficulty obtaining medication and difficulty seeing their health care provider regularly was reported and attributed to health care provider availability and lack of insurance due to job loss. Conclusions: The study provides significant insight into the reach of health education campaigns via social media and provides important information about the reasons for delays in care, which extend beyond fear of contracting COVID-19 to structural issues.

NCOG-18. RELATIONSHIP BETWEEN RANO-PRO WORKING GROUP STANDARDIZED PRIORITY CONSTRUCTS AND DISEASE PROGRESSION AMONG MALIGNANT GLIOMA PATIENTS AS MEASURED THROUGH CLINICAL OUTCOMES ASSESSMENTS

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi155-vi156
Author(s):  
Elizabeth Vera ◽  
Tito Mendoza ◽  
Alvina Acquaye ◽  
Nicole Briceno ◽  
Anna Choi ◽  
...  
Keyword(s):  
Malignant Glioma ◽  
Disease Progression ◽  
Clinical Outcomes ◽  
Stable Disease ◽  
Working Group ◽  
Karnofsky Performance Status ◽  
Clinical Care ◽  
Self Care ◽  
Work Activity ◽  
Core Symptoms

Abstract Recognizing the importance of clinical outcomes assessments (COA), the RANO-PRO Working Group recommends inclusion of core symptoms/functions in clinical care/research for malignant glioma patients. This study evaluated the association between the recommended symptoms (pain, perceived cognition, seizures, aphasia, treatment-specific symptoms) and functions (physical: weakness, walking; and role/social: work, usual activities) and disease progression in these patients. MDASI-Brain Tumor and EQ-5D-3L scores, Karnofsky Performance Status (KPS), and Neurologic Function Score (NFS) were evaluated in relation to disease progression by chi-square tests, independent- and paired-samples t-tests, adjusted for multiple comparisons. Our sample included 336 patients with malignant glioma; 82% white, 64% male, median age=52 (21-79). Imaging study revealed disease progression for 46% of patients. All symptoms except seizures and difficulty concentrating were worse in the group whose imaging showed disease progression versus stable disease, as well as the functions of walking, work, activity, and self-care (0.8 < difference < 1.8). Patients with disease progression were 4 times more likely to have a poor KPS (≤ 80) and worse NFS. Among patients with disease progression (n=112), all symptoms, except seizures, worsened from first assessment to time of progression. Up to 22% of patients reported worsening mobility, self-care, and usual activity; 46% and 35% had worsened KPS and NFS, respectively. Seven symptoms and functions were each individually reported by at least 10% of patients as having worsened the most. Worsening of symptoms and functions was not observed among patients with stable disease, except in difficulty understanding. Identified core symptoms/functions worsen at the time of progression demonstrating the relationship between priority constructs and a traditional tumor response measure while highlighting the importance of longitudinal collection of COA. The pattern of worsening was observed via both patient- and clinician-reported outcomes, emphasizing the utility of COA in clinical care and clinical trials.

scholarly journals Use of copeptin for rapid rule-out of acute myocardial infarction

2017 ◽  
Vol 7 (6) ◽  
pp. 570-576 ◽  
Author(s):  
Christian Mueller ◽  
Martin Möckel ◽  
Evangelos Giannitsis ◽  
Kurt Huber ◽  
Johannes Mair ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Diagnostic Accuracy ◽  
Cardiac Troponin ◽  
Clinical Care ◽  
High Sensitivity ◽  
Cardiac Care ◽  
Routine Clinical Care ◽  
Incremental Value ◽  
Rule Out

Copeptin is currently understood as a quantitative marker of endogenous stress. It rises rapidly in multiple acute disorders including acute myocardial infarction. As a single variable, it has only modest diagnostic accuracy for acute myocardial infarction. However, the use of copeptin within a dual-marker strategy together with conventional cardiac troponin increases the diagnostic accuracy and particularly the negative predictive value of cardiac troponin alone for acute myocardial infarction. The rapid rule-out of acute myocardial infarction is the only application in acute cardiac care mature enough to merit consideration for routine clinical care. However, the dual-marker approach seems to provide only very small incremental value when used in combination with sensitive or high-sensitivity cardiac troponin assays. This review aims to update and educate regarding the potential and the procedural details, as well as the caveats and challenges of using copeptin in clinical practice.

scholarly journals Depressive Symptoms Effect on Self Care Behavior During the First Month After Myocardial Infarction

2015 ◽  
Vol 7 (4) ◽  
Author(s):  
Maryam Niakan ◽  
Ezzat Paryad ◽  
Ehsan Kazemnezhad Leili ◽  
Farzane Sheikholeslami
Keyword(s):  
Myocardial Infarction ◽  
Depressive Symptoms ◽  
Self Care ◽  
Care Behavior

scholarly journals Keeping people with epilepsy safe during the COVID-19 pandemic

Neurology ◽  
2020 ◽  
Vol 94 (23) ◽  
pp. 1032-1037 ◽  
Author(s):  
Jacqueline A. French ◽  
Martin J. Brodie ◽  
Roberto Caraballo ◽  
Orrin Devinsky ◽  
Ding Ding ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Care Pathway ◽  
Clinical Care ◽  
Health Care Facilities ◽  
Urgent Care ◽  
Consensus Recommendations ◽  
Consensus Statements ◽  
Care Facilities ◽  
Strongly Agree

ObjectivesTo provide information on the effect of the coronavirus disease of 2019 (COVID-19) pandemic on people with epilepsy and provide consensus recommendations on how to provide the best possible care for people with epilepsy while avoiding visits to urgent care facilities and hospitalizations during the novel coronavirus pandemic.MethodsThe authors developed consensus statements in 2 sections. The first was “How should we/clinicians modify our clinical care pathway for people with epilepsy during the COVID-19 pandemic?” The second was “What general advice should we give to people with epilepsy during this crisis? The authors individually scored statements on a scale of −10 (strongly disagree) to +10 (strongly agree). Five of 11 recommendations for physicians and 3/5 recommendations for individuals/families were rated by all the authors as 7 or above (strongly agree) on the first round of rating. Subsequently, a teleconference was held where statements for which there was a lack of strong consensus were revised.ResultsAfter revision, all consensus recommendations received a score of 7 or above. The recommendations focus on administration of as much care as possible at home to keep people with epilepsy out of health care facilities, where they are likely to encounter COVID-19 (including strategies for rescue therapy), as well as minimization of risk of seizure exacerbation through adherence, and through ensuring a regular supply of medication. We also provide helpful links to additional helpful information for people with epilepsy and health providers.ConclusionThese recommendations may help health care professionals provide optimal care to people with epilepsy during the coronavirus pandemic.

The role of peer support education model on the quality of life and self-care behaviors of patients with myocardial infarction

2021 ◽  
Vol 104 (1) ◽  
pp. 130-135
Author(s):  
Hossein Ebrahimi ◽  
Ali Abbasi ◽  
Hossein Bagheri ◽  
Mohammad Hasan Basirinezhad ◽  
Sara Shakeri ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Myocardial Infarction ◽  
Peer Support ◽  
Self Care ◽  
Education Model

scholarly journals Evolution of the Output–Workforce Relationship in Primary Care Facilities in China from 2009 to 2017

2020 ◽  
Vol 17 (9) ◽  
pp. 3043 ◽  
Author(s):  
Shan Lu ◽  
Liang Zhang ◽  
Niek Klazinga ◽  
Dionne Kringos
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Latent Class ◽  
Clinical Care ◽  
Public Health Services ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Care Facilities ◽  
Facility Level ◽  
Latent Class Growth

This study evaluates trends in workforce supply compared with those in the volume of service delivery (output) for basic clinical care (CC) and public health (PH) services from 2009 to 2017 in China. A cross-sectional survey (2018) was combined with retrospective data (2009–2017) from 785 primary care (PC) facilities in six provinces. Measures for the output of clinical care and of public health services were aggregated into a single (weighted) index for both service profiles. The output–workforce relationship was measured by its ratio. Latent class growth analysis and logistic regression analysis were applied to classify trajectories and determine associations with facility-level, geographic, and economic characteristics. From 2009 to 2017, the proportion of PC to overall healthcare workforce decreased from 24.25% to 18.57%; the proportion of PH to PC providers at PC facilities increased from 23.6% to 29.5%, while the proportion of PH output increased from 44.3% to 65.9%. Four trajectories of the output–workforce relationship were identified for CC, and five trajectories for PH services of which 85.3% of the facilities showed initially increasing and then slightly decreasing trends. Geographic characteristics impacted different trajectories. The PC workforce falls behind hospital workforce. The expansion in workload of PH services is unbalanced with that of workforce.

Home alone: Does child self-care constitute a problem?

2000 ◽  
Vol 25 (4) ◽  
pp. 26-31
Author(s):  
Penny Sih ◽  
Rosalyn Shute
Keyword(s):  
Family Relationships ◽  
Self Care ◽  
Well Being ◽  
School Age Children ◽  
Care Experience ◽  
Positive Effects ◽  
Adult Supervision ◽  
Care Facilities ◽  
Sibling Care ◽  
Out Of School

Self-care in primary school age children (the ‘latchkeyphenomenon’) is often regarded as problematic, threatening children’s psychological and physical well-being, although suggestions that it is beneficial are also sometimes made. It is likely that more Australian children are being expected to look after themselves with reducing formal out-of-school hours care facilities. This paper reviews the available evidence on the effects of self-care. It concludes that it is not possible to state categorically that self-care has either negative or positive effects on children’s psychological well-being, as a range of factors influences outcome, for example, the children’s age, family relationships and whether sibling care is involved. Although under-researched, the physical safety of children without adult supervision remains a concern. It is concluded that, while many children will emerge well from the self-care experience, others will not, and that it is therefore important that affordable out-of-school hours care facilities continue to be made available to families.

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