scholarly journals Digital Support to Multimodal Community-Based Prehabilitation: Looking for Optimization of Health Value Generation

2021 ◽  
Vol 11 ◽  
Author(s):  
Anael Barberan-Garcia ◽  
Isaac Cano ◽  
Bart C. Bongers ◽  
Steffen Seyfried ◽  
Thomas Ganslandt ◽  
...  
Keyword(s):  
Large Scale ◽  
Patient Adherence ◽  
Hospital Setting ◽  
Service Selection ◽  
Chronic Patients ◽  
Community Based ◽  
Patient Reported ◽  
Integrated Care Pathways ◽  
Drop Outs

Prehabilitation has shown its potential for most intra-cavity surgery patients on enhancing preoperative functional capacity and postoperative outcomes. However, its large-scale implementation is limited by several constrictions, such as: i) unsolved practicalities of the service workflow, ii) challenges associated to change management in collaborative care; iii) insufficient access to prehabilitation; iv) relevant percentage of program drop-outs; v) need for program personalization; and, vi) economical sustainability. Transferability of prehabilitation programs from the hospital setting to the community would potentially provide a new scenario with greater accessibility, as well as offer an opportunity to effectively address the aforementioned issues and, thus, optimize healthcare value generation. A core aspect to take into account for an optimal management of prehabilitation programs is to use proper technological tools enabling: i) customizable and interoperable integrated care pathways facilitating personalization of the service and effective engagement among stakeholders; ii) remote monitoring (i.e. physical activity, physiological signs and patient-reported outcomes and experience measures) to support patient adherence to the program and empowerment for self-management; and, iii) use of health risk assessment supporting decision making for personalized service selection. The current manuscript details a proposal to bring digital innovation to community-based prehabilitation programs. Moreover, this approach has the potential to be adopted by programs supporting long-term management of cancer patients, chronic patients and prevention of multimorbidity in subjects at risk.

scholarly journals Why do participants drop-out: findings from a prospective pediatric cohort for fever surveillance established at Vellore, southern India

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Kulandaipalayam Natarajan Sindhu ◽  
Manikandan Srinivasan ◽  
Sathyapriya Subramaniam ◽  
Anita Shirley David ◽  
Venkata Raghava Mohan ◽  
...  
Keyword(s):  
Cohort Studies ◽  
Large Scale ◽  
Economic Status ◽  
Field Research ◽  
Drop Out ◽  
Background Characteristics ◽  
Group Discussions ◽  
Community Based ◽  
Drop Out Rate ◽  
Drop Outs

Abstract Background Cohort studies are pivotal in understanding the natural history, and to thereby determine the incidence of a disease. The conduct of large-scale community-based cohort studies is challenging with reference to money, manpower and time. Further, attrition inherent to cohort studies can affect the power, and thereby the study’s validity. Our objective was to estimate the percentage of participant withdrawal and to subsequently understand reasons for the same in the Vellore Typhoid Surveillance (VTS) cohort. Methods VTS study, a prospective community-based pediatric cohort, was established in a semi-urban settlement of Vellore to estimate the incidence rate of typhoid fever. An active weekly surveillance identified children with fever, and blood cultures were performed for fevers of ≥3 days. Reasons for participant drop-out in the cohort were documented. Nine focus group discussions (FGD), each with 5 to 7 parents/primary caregivers of former as well current participants were conducted separately, to understand reasons for consent withdrawal as well as the good aspects of the study that the current participants perceived. A descriptive, as well as an interpretative account of the themes that emerged from the FGDs were done. Results Of the 5639 children in the VTS cohort, 404 (7.2%) withdrew consent during the 12-month surveillance. Of these, 50% dropped out due to migration from study area; 18.1% as their parents were unhappy with the blood draws for blood culture; and 14.4% did not clearly put forth the reason for consent withdrawal. Being from an orthodox background, high socio-economic status and joint family were associated with a decision to drop-out. Frequent and voluminous blood draws, male field research assistants (FRA) making weekly home-visits, the perception that inquiring about fever made their child fall sick, and that the study clinic did not initiate antibiotics immediately, were the important themes that emerged from the FGDs conducted among drop-outs. Conclusion Our study showed that specific beliefs and behaviours within the community influenced the drop-out rate of the VTS cohort. Background characteristics and perceptions that exist, along with attrition data from previous cohort studies in the specific community are important to be considered while implementing large-scale cohort studies.

scholarly journals Access to community-based mental healthcare and psychosocial support within a disaster context

2015 ◽  
Vol 12 (2) ◽  
pp. 44-47 ◽  
Author(s):  
Katherine P O'Hanlon ◽  
Boris Budosan
Keyword(s):  
Mental Health ◽  
Large Scale ◽  
Psychosocial Support ◽  
Mental Healthcare ◽  
Community Services ◽  
Community Based ◽  
Clear Vision ◽  
Mental Health Interventions ◽  
Mental Health Effects

After a large-scale humanitarian disaster, 30–50% of victims develop moderate or severe psychological distress. Rates of mild and moderate mental disorders increase by 5–10% and severe disorders by 1–2%. Those with such disorders need access to mental healthcare. Primary care clinics are appropriate due to their easy accessibility and the non-stigmatising environment. There is a consensus among experts that the mental health effects of disaster are best addressed by existing services, that is, through capacity building rather than by establishing parallel systems. Mental health interventions in emergencies should begin with a clear vision for the long-term advancement of community services.

scholarly journals THE PORCHLIGHT PROJECT: PARTNERING WITH VOLUNTEERS TO ENHANCE COMMUNITY-BASED DEMENTIA CARE AND OUTREACH

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S795-S795
Author(s):  
Joseph E Gaugler ◽  
Christina Rosebush ◽  
Gabriela Bustamante ◽  
Jeri Schoonover ◽  
Roxanne Jenkins ◽  
...  
Keyword(s):  
Older Persons ◽  
Large Scale ◽  
Dementia Care ◽  
Negative Effects ◽  
Community Based ◽  
Care And Support ◽  
Training Approach ◽  
Potential Success ◽  
Services And Supports

Abstract Families often remain unaware of long-term services and supports (LTSS) that could help to mitigate the negative effects of Alzheimer’s disease and related dementias (ADRDs). Approaches that: a) identify community-residing older persons with potential memory impairment; b) assist their families in navigating the healthcare system; and c) facilitate the identification of appropriate community-based LTSS could result in more effective management of ADRD. The Porchlight Project is a multicomponent training approach for lay volunteers in Minnesota (i.e., Senior Companions) that enhances their capability to deliver dementia care and support to underserved older persons in need. Mixed methods analysis of qualitative and quantitative data among 20 Senior Companions and up to 25 persons with ADRD and their family caregivers suggest the potential success of the Porchlight Project, as well as areas to refine and enhance prior to large-scale evaluation throughout Minnesota.

Building Community Capacity for Disaster Resilience in Taiwan

2010 ◽  
Vol 5 (2) ◽  
pp. 138-146 ◽  
Author(s):  
Liang-Chun Chen ◽  
◽  
Yi-Wen Wang ◽  
Keyword(s):  
Large Scale ◽  
Central Government ◽  
Community Resilience ◽  
Disaster Resilience ◽  
Community Based ◽  
The Face ◽  
Building Community ◽  
Practical Experiences ◽  
Community Disaster Resilience

In the face of large-scale, high intensity, and continuously occurring disasters, the concept of community resilience in disaster management has gradually developed and drawn significant attention. This paper focuses on how to build community disaster resilience, based on practical experiences of disaster recovery in Taiwan, for the purpose of increasing community resilience. In order to build community disaster resilience, the Taiwanese central government has designed a community-based process for disaster adaptation. Since 2004, the process has been applied to more than one hundred communities in Taiwan, not only by our research team but also by the Taiwanese government. Two successful cases are used to illustrate our framework for community disaster resilience, which should include the two major components of emergency adjustment and long-term adaptive capacity. Significant factors for making the process operational are clarified so as to form a long-term framework for building community disaster resilience.

73 Objective Measurement of Adherence with Splint Use After Burn Injury

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S47-S48
Author(s):  
Ingrid Parry ◽  
Silvia Bastea ◽  
Michelle James ◽  
David G Greenhalgh
Keyword(s):  
Pediatric Patients ◽  
Burn Injury ◽  
Patient Adherence ◽  
Skin Grafting ◽  
Temperature Sensors ◽  
Burn Center ◽  
Patient Reported ◽  
High Level ◽  
One Way Anova

Abstract Introduction The prescription of splints (orthoses) to help protect vulnerable structures and maintain range of motion after skin grafting is an integral and important part of burn recovery. The degree to which a patient adheres to wearing a prescribed orthosis is believed to play a major role in outcome. However, orthoses may be uncomfortable or undesirable to wear, affecting a patient’s adherence. At our burn center, orthosis application and wear is heavily dependent on staff when patients are in the ICU. As patients move to the acute ward, the responsibility for orthotic use is shared by family and staff and as outpatients, caregivers are primarily responsible. The purpose of our study was to use temperature sensors implanted in the orthoses to objectively determine compliance rates with splint wear during these three different stages of burn recovery. Methods Pediatric patients with skin grafting to the hands who were prescribed a hand splint had a temperature sensing device implanted into their orthosis when it was fabricated and prescribed for wear. The sensors detected higher temperatures when the orthosis was on the patient and lower temperatures when it was not, providing an objective means to determine frequency and duration of wear. The data collected for each patient was compared to the prescribed time as noted in the medical record by the treating therapist. Data was analyzed using descriptive statistics and one-way ANOVA. Results Data were recorded for an average of 50 days for 12 patients using 17 splints during three continuous phases of care: ICU, acute ward, outpatient. Patients in ICU wore their splints 10.4 hours per 24 hour period, resulting in a 102% hourly compliance based on the prescribed wear time. During acute ward care, patients wore their splints for 7.6 hours (89% hourly compliance). As outpatients, subjects wore their splints an average of 6.7 hours (82% hourly compliance). There was no statistical difference in orthotic adherence between the phases of care. Daily compliance (days worn/ days prescribed) showed a similar trend: ICU=100%, ward=90%, OP=88%. Patients or their caregivers were asked to rate their own adherence with splinting at 8 weeks after injury using a 1–4 Likert scale. All but one patient reported the highest level of compliance and described use “as instructed by therapist” (92%). Conclusions This is the first study to objectively measure patient adherence with wearing orthoses over the course of burn recovery. Results show high level of adherence in ICU but demonstrate declining adherence as the patient and caregiver assume more responsibility. This study highlights potential areas for improvement in patient education during transition of care from inpatient, and highlights the need for better understanding of the barriers that exist for long-term orthotic use after hospitalization. Applicability of Research to Practice Prevention of contracture with splints.

Long-term rehabilitation after stroke: where do we go from here?

2010 ◽  
Vol 20 (3) ◽  
pp. 239-245 ◽  
Author(s):  
NA Aziz
Keyword(s):  
Sample Size ◽  
Hospital Setting ◽  
Stroke Care ◽  
Stroke Survivors ◽  
Stroke Management ◽  
Stroke Patients ◽  
Community Based ◽  
Rehabilitation Intervention ◽  
Current Guidelines

SummaryCurrent guidelines in stroke management are divided on the issue of providing further rehabilitation to stroke patients who have had stroke six months ago and longer. Whilst consensus considers that long-term rehabilitation is neither practical nor beneficial, rehabilitation remains vital in the complex management of longer-term stroke care, as it provides continuity from the formal rehabilitation intervention in the hospital setting. Longer-term rehabilitation is principally a community-based intervention, as it aims to assist the survivors to become more independent through social and leisure-based interventions. Available evidence is limited, with available studies heterogeneous and small in sample size. This review aims to look into the existing evidence, and discusses the feasibility and challenges in providing longer-term rehabilitation to stroke survivors.

scholarly journals Evaluation of Three Postal Invitational Strategies to Increase Survey Response Rates in a Combat-Injured U.S. Military Population: Findings From the Wounded Warrior Recovery Project

2019 ◽  
Vol 184 (Supplement_1) ◽  
pp. 521-528
Author(s):  
Daniel I Sack ◽  
Susan I Woodruff ◽  
Cameron T McCabe ◽  
Michael R Galarneau ◽  
Peggy P Han
Keyword(s):  
Patient Reported Outcomes ◽  
Large Scale ◽  
Response Rates ◽  
Life Outcomes ◽  
Military Population ◽  
Patient Reported ◽  
Military Populations ◽  
Wounded Warrior

Abstract The survival rate of those injured in combat in overseas contingency operations is higher than in previous conflicts. There is a need to assess the long-term psychosocial and quality of life outcomes of those injured in combat, yet surveying this population presents inherent challenges. As part of a large-scale, longitudinal examination of patient-reported outcomes of service members injured on deployment, the present manuscript evaluated the effectiveness of three postal strategies on response rates: (1) mailing a study prenotification postcard, (2) mailing the survey invitation in a larger envelope, and (3) including a small cash preincentive ($2). Evaluation of these strategies yielded mixed results in this population. Neither the prenotification postcard nor inclusion of a $2 cash preincentive significantly increased response rates. However, use of a larger envelope to mail the survey invitation significantly increased the response rate by 53.1%. Researchers interested in collecting patient-reported outcomes among military populations, including those with combat-related injuries, may find that increasing the visibility of recruitment materials is more effective for improving response rates than attempting to cognitively prime or offer prospective participants preincentives.

Evolution of Large-Scale Coronal Structures

1994 ◽  
Vol 144 ◽  
pp. 29-33
Author(s):  
P. Ambrož
Keyword(s):  
Magnetic Field ◽  
Field Line ◽  
Large Scale ◽  
Coronal Magnetic Field ◽  
Source Surface ◽  
Solar Cycles ◽  
Characteristic Relationship ◽  
The Magnetic Field ◽  
Coronal Structures

AbstractThe large-scale coronal structures observed during the sporadically visible solar eclipses were compared with the numerically extrapolated field-line structures of coronal magnetic field. A characteristic relationship between the observed structures of coronal plasma and the magnetic field line configurations was determined. The long-term evolution of large scale coronal structures inferred from photospheric magnetic observations in the course of 11- and 22-year solar cycles is described.Some known parameters, such as the source surface radius, or coronal rotation rate are discussed and actually interpreted. A relation between the large-scale photospheric magnetic field evolution and the coronal structure rearrangement is demonstrated.

Maximizing Outcomes in Group Treatment of Aphasia: Lessons Learned From a Community-Based Center

2014 ◽  
Vol 24 (3) ◽  
pp. 100-105 ◽  
Author(s):  
Darlene Williamson
Keyword(s):  
Group Treatment ◽  
Treatment Protocol ◽  
Lessons Learned ◽  
Group Program ◽  
Community Based ◽  
Multiple Treatment ◽  
Use Of Technology ◽  
Communication Impairments ◽  
Treatment Settings

Given the potential of long term intervention to positively influence speech/language and psychosocial domains, a treatment protocol was developed at the Stroke Comeback Center which addresses communication impairments arising from chronic aphasia. This article presents the details of this program including the group purposes and principles, the use of technology in groups, and the applicability of a group program across multiple treatment settings.

From Volunteering to Academic Programming: A Case Example

2016 ◽  
Vol 1 (17) ◽  
pp. 7-11 ◽  
Author(s):  
Cindy Gill ◽  
Sneha Bharadwaj ◽  
Nancy Quick ◽  
Sarah Wainscott ◽  
Paula Chance
Keyword(s):  
Special Needs ◽  
Cultural Relevance ◽  
Master's Program ◽  
Speech Language Pathology ◽  
Community Based ◽  
Charitable Organization ◽  
Language Pathology ◽  
The University

A speech-language pathology master's program that grew out of a partnership between the University of Zambia and a U.S.-based charitable organization, Connective Link Among Special needs Programs (CLASP) International, has just been completed in Zambia. The review of this program is outlined according to the suggested principles for community-based partnerships, a framework which may help evaluate cultural relevance and sustainability in long-term volunteer efforts (Israel, Schulz, Parker, & Becker, 1998).

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