scholarly journals The impact of ear growth on identification rates using an ear biometric system in young infants

2021 ◽  
Vol 5 ◽  
pp. 179
Author(s):  
Alinani Simukanga ◽  
Misaki Kobayashi ◽  
Lauren Etter ◽  
Wenda Qin ◽  
Rachel Pieciak ◽  
...  
Keyword(s):  
Feasible Solution ◽  
Biometric System ◽  
Patient Identification ◽  
Matching Accuracy ◽  
Young Infants ◽  
Left And Right ◽  
The Impact ◽  
Improve Patient ◽  
Urban Clinic

Background Accurate patient identification is essential for delivering longitudinal care. Our team developed an ear biometric system (SEARCH) to improve patient identification. To address how ear growth affects matching rates longitudinally, we constructed an infant cohort, obtaining ear image sets monthly to map a 9-month span of observations. This analysis had three main objectives: 1) map trajectory of ear growth during the first 9 months of life; 2) determine the impact of ear growth on matching accuracy; and 3) explore computer vision techniques to counter a loss of accuracy.   Methodology Infants were enrolled from an urban clinic in Lusaka, Zambia. Roughly half were enrolled at their first vaccination visit and ~half at their last vaccination. Follow-up visits for each patient occurred monthly for 6 months. At each visit, we collected four images of the infant’s ears, and the child’s weight. We analyze ear area versus age and change in ear area versus age. We conduct pair-wise comparisons for all age intervals. Results From 227 enrolled infants we acquired age-specific datasets for 6 days through 9 months. Maximal ear growth occurred between 6 days and 14 weeks. Growth was significant until 6 months of age, after which further growth appeared minimal. Examining look-back performance to the 6-month visit, baseline pair-wise comparisons yielded identification rates that ranged 46.9–75%. Concatenating left and right ears per participant improved identification rates to 61.5–100%. Concatenating images captured on adjacent visits further improved identification rates to 90.3–100%. Lastly, combining these two approaches improved identification to 100%. All matching strategies showed the weakest matching rates during periods of maximal growth (i.e., <6 months). Conclusion By quantifying the effect that ear growth has on performance of the SEARCH platform, we show that ear identification is a feasible solution for patient identification in an infant population 6 months and above.

scholarly journals Patient Satisfaction With Extended International Normalized Ratio Follow-up Intervals in a Veteran Population

2019 ◽  
Vol 54 (5) ◽  
pp. 442-449
Author(s):  
Rebecca R. Schoen ◽  
Michael W. Nagy ◽  
Andrea L. Porter ◽  
Amanda R. Margolis
Keyword(s):  
Patient Satisfaction ◽  
Focus Group ◽  
International Normalized Ratio ◽  
Limited Data ◽  
Participant Satisfaction ◽  
Small Effect Size ◽  
The Mean ◽  
The Impact ◽  
Improve Patient

Background: For highly stable warfarin patients, limited data exists regarding patient satisfaction on extended international normalized ratio (INR) follow-up intervals and how this population compares with patients on a direct oral anticoagulant (DOAC). Objective: To assess the impact on patient satisfaction of extending INR follow-up intervals. Methods: Veterans on stable warfarin doses had extended INR follow-up intervals up to 12 weeks in a single-arm prospective cohort study for 2 years. This analysis included participants who completed at least 2 Duke Anticoagulation Satisfaction Scales (DASS). The primary outcome was the change in the DASS. A focus group described participant experiences. Participant satisfaction was compared to patients on a DOAC. Results: Of the 51 participants, 48 were included in the warfarin extended INR follow-up group. Compared with baseline, the mean DASS score (42.9 ± 12.08) was worse at 24 months (46.82 ± 15.2, P = 0.0266), with a small effect size (Cohen’s d = 0.29). The 8 participants in the focus group were satisfied with the extended INR follow-up interval but would be uncomfortable extending follow-up past 2 to 3 months. The extended INR follow-up interval study had similar DASS scores as the 33 participants included on DOAC therapy (46.8 ± 15.1, P = 0.9970) but may be limited by differing populations using DOACs. Conclusion and Relevance: For patients currently stable on warfarin therapy, extending the INR follow-up interval up to 12 weeks or changing to a DOAC does not appear to improve patient satisfaction.

75 Community Dnacpr Forms: Opening A Can of Worms

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
J Odone ◽  
R Schiff
Keyword(s):  
Pilot Study ◽  
Phone Call ◽  
Post Intervention ◽  
Patient Understanding ◽  
Cardio Pulmonary Resuscitation ◽  
Pdsa Cycle ◽  
National Guidance ◽  
The Impact ◽  
Improve Patient

Abstract Background There is no national guidance for the transfer of Do Not Attempt Cardio-Pulmonary Resuscitation (DNACPR) decisions between care settings. This issue has been highlighted within our Integrated Care Trust. We reviewed our local process, to improve the transfer of DNACPR decisions between care settings. Method A third PDSA cycle was completed to evaluate intervention. Intervention Frequently asked questions were added to the reverse side of the DNACPR form to improve patient understanding. All patients discharged home were given this updated form during a pilot study. The impact of the intervention was analysed with a follow-up phone call (n = 30) and discussed at a staff focus group. Results No improvement in patient understanding was shown post-intervention, however the intervention was overwhelmingly supported by staff. 60% of patients reported receiving a DNACPR form on discharge and 12% recalled being informed that they would be discharged home with a form. Conclusion Further work is required on the DNACPR pathway across primary and secondary care. The next cycle will involve ensuring that the community form is highlighted in hospital discussions regarding DNACPR decisions.

Study on the Factory Prefabrication Technology of Large-Span Bridges Pier

2014 ◽  
Vol 501-504 ◽  
pp. 1413-1417 ◽  
Author(s):  
Qi He Wu ◽  
Zheng Zhong Qiu ◽  
Zhao Niu
Keyword(s):  
Accuracy Control ◽  
Bridge Construction ◽  
Matching Accuracy ◽  
Technical Problems ◽  
Large Span ◽  
Advantages And Disadvantages ◽  
Pile Caps ◽  
Design Idea ◽  
The Impact

The sea-crossing bridge construction takes orders the design idea of maximization, the factorization, the standardization and the assembly, which pile caps and pier shafts of the non-navigable span are prefabricated at the focus of prefabricated. In the paper, the precast solutions are put forward to pile caps and pier shafts of the non-navigable span, and the key technical problems of all kinds of precast solutions are analyzed. On this basis, the optimal pier factory prefabrication is proposed by the comparison of various schemes, which is carried out about advantages and disadvantages of prefabricated matching accuracy control, factory prefabrication, concrete placing, transport in the precast yard, transport style and the impact on follow-up construction.

scholarly journals 861. Impact of COVID-19 Mitigation Measures on PrEP Care at a Safety Net Health System in Atlanta

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S522-S522
Author(s):  
Valeria D Cantos ◽  
Kate Ferencsik ◽  
Jennifer Prevot ◽  
Kelly Reyna ◽  
Gabriela Georgial ◽  
...  
Keyword(s):  
Health System ◽  
Laboratory Testing ◽  
Safety Net ◽  
Mitigation Measures ◽  
Future Research ◽  
Cross Sectional ◽  
Convenience Sample ◽  
The Impact ◽  
Urban Clinic

Abstract Background The Grady Health System pre-exposure prophylaxis (PrEP) program modified its care practices to accommodate COVID-19 mitigation measures. Changes enacted included: transition to telemedicine visits, medication mail delivery, and flexible timing of quarterly laboratory testing. These were implemented in March 2020 and remain in place presently. This study aimed to evaluate patients’ long-term acceptability of these modifications and to assess their impact on PrEP care. Methods This was a cross-sectional study in a convenience sample of PrEP patients, ages 18 and older, at an urban clinic in Atlanta. They were invited to complete a survey between December 2020 and April 2021. The survey assessed the impact of mitigation measures on overall PrEP care, follow up visits, medication access, and ability to complete laboratory testing. It also evaluated the usability, quality, satisfaction, and concerns with telemedicine. Data were examined using median and interquartile ranges, and proportions. Results Of 145 patients contacted, 61 completed the survey (median age 33 years, 72% Black, 75% cisgender men, 15% transgender women). Most participants did not report interruptions in their PrEP care (72%) or follow up visits (74%). Most found it easy to access medications (82%), as participants’ report of medication mail delivery usage increased from 57% (pre-pandemic) to 73% (in-pandemic period). Interruptions in completing quarterly labs were more frequently reported, as only 62% found this to be easy. Overall, 89% reported using telemedicine; telephone call was the most used method (78%). Telemedicine users’ ratings for quality, usability, and satisfaction of telemedicine was high (median score: 6/7) and nearly all users (97%) reported no concerns about its continued use for PrEP care. A few participants (5%) raised concerns about loss of telephone services due to financial issues, impacting their ability to complete telemedicine visits. Conclusion PrEP care at an urban clinic was well- maintained despite COVID-19 mitigation measures. Telemedicine was found to be acceptable and usable by surveyed participants. Future research on widescale implementation of telemedicine for PrEP care is needed Disclosures All Authors: No reported disclosures

Sound Production Treatment for Acquired Apraxia of Speech: An Examination of Dosage in Relation to Probe Performance

2020 ◽  
pp. 1-16
Author(s):  
Julie L. Wambaugh ◽  
Lydia Kallhoff ◽  
Christina Nessler
Keyword(s):  
Retrospective Analysis ◽  
Sound Production ◽  
Apraxia Of Speech ◽  
Practice Schedule ◽  
Practice Schedules ◽  
Baseline Performance ◽  
The Mean ◽  
Number Of Treatment ◽  
The Impact

Purpose This study was designed to examine the association of dosage and effects of Sound Production Treatment (SPT) for acquired apraxia of speech. Method Treatment logs and probe data from 20 speakers with apraxia of speech and aphasia were submitted to a retrospective analysis. The number of treatment sessions and teaching episodes was examined relative to (a) change in articulation accuracy above baseline performance, (b) mastery of production, and (c) maintenance. The impact of practice schedule (SPT-Blocked vs. SPT-Random) was also examined. Results The average number of treatment sessions conducted prior to change was 5.4 for SPT-Blocked and 3.9 for SPT-Random. The mean number of teaching episodes preceding change was 334 for SPT-Blocked and 179 for SPT-Random. Mastery occurred within an average of 13.7 sessions (1,252 teaching episodes) and 12.4 sessions (1,082 teaching episodes) for SPT-Blocked and SPT-Random, respectively. Comparisons of dosage metric values across practice schedules did not reveal substantial differences. Significant negative correlations were found between follow-up probe performance and the dosage metrics. Conclusions Only a few treatment sessions were needed to achieve initial positive changes in articulation, with mastery occurring within 12–14 sessions for the majority of participants. Earlier occurrence of change or mastery was associated with better follow-up performance. Supplemental Material https://doi.org/10.23641/asha.12592190

Research Participation Experiences of Informants of Suicide and Control Cases

Crisis ◽  
2010 ◽  
Vol 31 (5) ◽  
pp. 238-246 ◽  
Author(s):  
Paul W. C. Wong ◽  
Wincy S. C. Chan ◽  
Philip S. L. Beh ◽  
Fiona W. S. Yau ◽  
Paul S. F. Yip ◽  
...  
Keyword(s):  
Ethical Issues ◽  
Research Participation ◽  
Self Report ◽  
Initial Contact ◽  
Psychological Autopsy ◽  
Autopsy Study ◽  
The People ◽  
And Control ◽  
The Impact

Background: Ethical issues have been raised about using the psychological autopsy approach in the study of suicide. The impact on informants of control cases who participated in case-control psychological autopsy studies has not been investigated. Aims: (1) To investigate whether informants of suicide cases recruited by two approaches (coroners’ court and public mortuaries) respond differently to the initial contact by the research team. (2) To explore the reactions, reasons for participation, and comments of both the informants of suicide and control cases to psychological autopsy interviews. (3) To investigate the impact of the interviews on informants of suicide cases about a month after the interviews. Methods: A self-report questionnaire was used for the informants of both suicide and control cases. Telephone follow-up interviews were conducted with the informants of suicide cases. Results: The majority of the informants of suicide cases, regardless of the initial route of contact, as well as the control cases were positive about being approached to take part in the study. A minority of informants of suicide and control cases found the experience of talking about their family member to be more upsetting than expected. The telephone follow-up interviews showed that none of the informants of suicide cases reported being distressed by the psychological autopsy interviews. Limitations: The acceptance rate for our original psychological autopsy study was modest. Conclusions: The findings of this study are useful for future participants and researchers in measuring the potential benefits and risks of participating in similar sensitive research. Psychological autopsy interviews may be utilized as an active engagement approach to reach out to the people bereaved by suicide, especially in places where the postvention work is underdeveloped.

Coexistent Osteoarthritis and Parkinson’s Disease: Data from the Parkinson’s Foundation Outcomes Project

2020 ◽  
Vol 10 (4) ◽  
pp. 1601-1610
Author(s):  
Jaimie A. Roper ◽  
Abigail C. Schmitt ◽  
Hanzhi Gao ◽  
Ying He ◽  
Samuel Wu ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Study Data ◽  
Functional Mobility ◽  
Quality Improvement Initiative ◽  
Timed Up And Go ◽  
Mobility Performance ◽  
Risk Of Mortality ◽  
The Impact

Background: The impact of concurrent osteoarthritis on mobility and mortality in individuals with Parkinson’s disease is unknown. Objective: We sought to understand to what extent osteoarthritis severity influenced mobility across time and how osteoarthritis severity could affect mortality in individuals with Parkinson’s disease. Methods: In a retrospective observational longitudinal study, data from the Parkinson’s Foundation Quality Improvement Initiative was analyzed. We included 2,274 persons with Parkinson’s disease. The main outcomes were the effects of osteoarthritis severity on functional mobility and mortality. The Timed Up and Go test measured functional mobility performance. Mortality was measured as the osteoarthritis group effect on survival time in years. Results: More individuals with symptomatic osteoarthritis reported at least monthly falls compared to the other groups (14.5% vs. 7.2% without reported osteoarthritis and 8.4% asymptomatic/minimal osteoarthritis, p = 0.0004). The symptomatic group contained significantly more individuals with low functional mobility (TUG≥12 seconds) at baseline (51.5% vs. 29.0% and 36.1%, p < 0.0001). The odds of having low functional mobility for individuals with symptomatic osteoarthritis was 1.63 times compared to those without reported osteoarthritis (p < 0.0004); and was 1.57 times compared to those with asymptomatic/minimal osteoarthritis (p = 0.0026) after controlling pre-specified covariates. Similar results hold at the time of follow-up while changes in functional mobility were not significant across groups, suggesting that osteoarthritis likely does not accelerate the changes in functional mobility across time. Coexisting symptomatic osteoarthritis and Parkinson’s disease seem to additively increase the risk of mortality (p = 0.007). Conclusion: Our results highlight the impact and potential additive effects of symptomatic osteoarthritis in persons with Parkinson’s disease.

Pediatrics’ Total Parenteral Nutrition: Initiative and implementation of standardized formulation in Saudi Arabia

2018 ◽  
Vol 4 (3) ◽  
pp. 492-496
Author(s):  
Yousef Ahmed Alomi ◽  
Hussam Saad Almalki ◽  
Aisha Omar Fallatah ◽  
Awatif Faraj Alshammari ◽  
Nesreen Al-Shubbar
Keyword(s):  
Saudi Arabia ◽  
Clinical Outcome ◽  
Parenteral Nutrition ◽  
Drug Related Problems ◽  
Kingdom Of Saudi Arabia ◽  
Parental Nutrition ◽  
Management Project ◽  
Improve Patient ◽  
New System

The national total parental nutrition program with an emphasis on pediatrics started before several ago at Ministry of health hospitals In Kingdom of Saudi Arabia. The program covered several regions and consisted from the foundation of Intravenous Admixture and preparation of pediatric parenteral nutrition to administration and follow up of patients outcomes. In addition to the prior system, the new initiative project with the standardized formulation of pediatric’s parenteral nutrition is the complementary project of the parental nutrition for pediatrics. The project initiated to prevent drug-related problems of parental nutrition, improve patient clinical outcome and reduce the unnecessary economic burden on the healthcare system. It is the new system in the Middle East and Gulf counties in additional to Saudi Arabia. The initiatives are the systemic implementation of standardized pediatrics formulation using management project tools of starting new idea until finding in the ground.

Assessment of parental knowledge, attitude and practice towards antibiotic use in children

2020 ◽  
Vol 10 (2) ◽  
pp. 25-41
Author(s):  
Thejaswini Karanth ◽  
Someswar Deb ◽  
Lal Ruatpuii Zadeng ◽  
Rajeswari Ramasamy ◽  
Teena Nazeem ◽  
...  
Keyword(s):  
Parental Knowledge ◽  
Antibiotic Use ◽  
Case Report Form ◽  
Standard Case ◽  
Attitude And Practice ◽  
Validated Questionnaire ◽  
Antibiotics Use ◽  
The Impact ◽  
Knowledge Attitude And Practice

Objective to assess the impact of pharmacist assisted counselling in improving Parental Knowledge, Attitude and Practice [KAP] towards antibiotic use in children. A Prospective, Educational Interventional Study was conducted in 200 subjects, from the randomly chosen communities in Bangalore. The investigators did door to door visit. The primary demographics data of parents and their children were collected using standard Case Report Form (CRF), and the baseline towards antibiotic use in Children was obtained from parents using validated Questionnaire. In the presence of both parents, only one was supposed to answer the Questionnaire. Pharmacist assisted parent centred interventional counselling was provided with the help of Patient Information Leaflet1s (PIL). Follow-up and post interventional KAP assessment were done after two months from the baseline measurement. The changes in parental KAP towards antibiotics use in children were being assessed by comparing the Pretest and Posttest responses using statistical analysis. The knowledge of parents towards antibiotic use in children was medium to good in the baseline KAP assessment; however, in the majority of the participating parents it was not satisfactory in attitude and practice domains. A statistically significant improvement was seen in the KAP of parents towards antibiotic use in children after the pharmacist assisted interventional counselling. Thus, Investigators could bring excellent changes in the knowledge part; whereas the result for changes in the Attitude and Practice was good to medium respectively.

The impact of statin therapy after surgical or endovascular treatment of cerebral aneurysms

2020 ◽  
Vol 133 (1) ◽  
pp. 182-189
Author(s):  
Tae-Jin Song ◽  
Seung-Hun Oh ◽  
Jinkwon Kim
Keyword(s):  
Statin Therapy ◽  
Coil Embolization ◽  
Primary Outcome ◽  
Cox Regression ◽  
Cerebral Aneurysms ◽  
Time Dependent ◽  
Lipid Lowering ◽  
Surgical Clipping ◽  
The Impact

OBJECTIVECerebral aneurysms represent the most common cause of spontaneous subarachnoid hemorrhage. Statins are lipid-lowering agents that may expert multiple pleiotropic vascular protective effects. The authors hypothesized that statin therapy after coil embolization or surgical clipping of cerebral aneurysms might improve clinical outcomes.METHODSThis was a retrospective cohort study using the National Health Insurance Service–National Sample Cohort Database in Korea. Patients who underwent coil embolization or surgical clipping for cerebral aneurysm between 2002 and 2013 were included. Based on prescription claims, the authors calculated the proportion of days covered (PDC) by statins during follow-up as a marker of statin therapy. The primary outcome was a composite of the development of stroke, myocardial infarction, and all-cause death. Multivariate time-dependent Cox regression analyses were performed.RESULTSA total of 1381 patients who underwent coil embolization (n = 542) or surgical clipping (n = 839) of cerebral aneurysms were included in this study. During the mean (± SD) follow-up period of 3.83 ± 3.35 years, 335 (24.3%) patients experienced the primary outcome. Adjustments were performed for sex, age (as a continuous variable), treatment modality, aneurysm rupture status (ruptured or unruptured aneurysm), hypertension, diabetes mellitus, household income level, and prior history of ischemic stroke or intracerebral hemorrhage as time-independent variables and statin therapy during follow-up as a time-dependent variable. Consistent statin therapy (PDC > 80%) was significantly associated with a lower risk of the primary outcome (adjusted hazard ratio 0.34, 95% CI 0.14–0.85).CONCLUSIONSConsistent statin therapy was significantly associated with better prognosis after coil embolization or surgical clipping of cerebral aneurysms.

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