scholarly journals A preliminary evaluation of optometric management and referral protocols for pa-tients with diabetic retinopathy

2005 ◽  
Vol 64 (4) ◽  
Author(s):  
M. Mehta ◽  
A. Bhagwanjee ◽  
B. Kubheka ◽  
A. Penchaliah ◽  
R. Jadwat
Keyword(s):  
Pilot Study ◽  
Management Practices ◽  
Clinical Skills ◽  
Descriptive Analysis ◽  
Standardize Patient ◽  
Structured Interview ◽  
Self Report ◽  
Preliminary Evaluation ◽  
Management Options ◽  
Clinical Measures

Aim: The purpose of this pilot study was to investigate  the  assessment,  management  and referral practices of South African optometrists in  the  care  of  patients  with  diabetic  retinop-athy  (DR)  and  to  recommend  strategies  to improve  and  standardize  patient  management as required.  Methods:  The  study  design  incorporated quantitative,  qualitative  and  clinical  measures that were administered to fourteen experienced optometrists from the Durban area. The quan-titative measure, the questionnaire in appendix I, evaluated the optometrists’ management pro-tocols of patients with diabetes mellitus (DM).  These  included  the  optometrists’  referral  and co-management practices, their awareness and usage  of  appropriate  guidelines  in  the  man-agement  and  referral  of  these  patients,  their perceived levels of competence and confidence in their education, levels of service offered to the patients and finally the role of Continuous Professional  Development  (CPD).  This  self-report information was supplemented by a set of clinical measures where the study sample grad-ed levels of DR, chose appropriate management options  and  indicated  prognosis  for  disease progression based on a set of slides presented to  them.  Finally  the  fourteen  optometrists,  as well as two ophthalmologists, were interviewed using tailored, semi-structured interview sched-ules. These interviews were used to elaborate and corroborate information obtained from the other two research approaches.  Results:  Descriptive  analysis  was  used  to analyse  the  data  from  the  quantitative  and clinical  measures,  whilst  the  interviews  were analysed  thematically.  Although  86%  of  the sample routinely screened for ocular manifesta-tions of DM, there was no standardization in the criteria used by the fourteen optometrists. Only  15%  of  the  sample  reportedly  assessed their  patients  using  dilated  fundus  examina-tions  (DFE),  which  is  the  internationally  rec-ommended standard of care. The results of the clinical measures indicated that there was a lack of standardization in the management and refer-ral of patients with DR by the study sample, contrary  to  their  own  levels  of  confidence  in their  educational  competencies  regarding  DR and their perception of the level of service that they  offered  to  their  patients.  The  interviews with the optometrists provided crucial insights into this lack of standardised care of patients with DR, with the ophthalmologists confirming the  urgent  need  for  CPD  aimed  at  enhancing clinical  skills  and  ensuring  standardization  in the  management  and  referral  of  patients  with DR.  This finding was particularly relevant for co-management models.Conclusion: This  pilot  study  indicates  that the  performance  of  the  optometrists  (albeit  a relatively small group) in the assessment, man-agement and referral of patients with DR was inconsistent  and  not  in  keeping  with  interna-tionally recommended guidelines. It is recom-mended  that  CPD  programmes  focus  on  the improvement of clinical skills and on the imple-mentation of existing standardised management protocols  for  patients  with  DR.  This  should result in improved patient care, patient confi-dence and loyalty with regard to care received, efficient and effective models of management and  co-management  and  decreased  costs  to patients and the health care system.

An Innovative Approach to Clinical Communication in Schizophrenia: The Approaches to Schizophrenia Communication Checklists

CNS Spectrums ◽  
2001 ◽  
Vol 6 (4) ◽  
pp. 333-338 ◽  
Author(s):  
Sharon G. Dott ◽  
Peter Weiden ◽  
Penelope Hopwood ◽  
A. George Awad ◽  
Jonathan S.E. Hellewell ◽  
...  
Keyword(s):  
Pilot Study ◽  
Side Effects ◽  
Side Effect ◽  
Treatment Compliance ◽  
Structured Interview ◽  
Self Report ◽  
Antipsychotic Treatment ◽  
Healthcare Team ◽  
Preliminary Evaluation ◽  
Busy Clinical Setting

ABSTRACTSide effects from antipsychotic medications can have a profound effect on patients' lives and may adversely affect their willingness to comply with treatment. Identification of side effects through improved communication between psychiatrists, other members of the healthcare team, and their patients might increase treatment compliance. The Approaches to Schizophrenia Communication (ASC) Steering Group developed two simple, practical checklists for use in the busy clinical setting. The ASC–Self-Report (ASC-SR) checklist is completed by the patient and comprises a list of the more common or clinically important side effects of antipsychotic treatment. The ASC-Clinic (ASC-C) checklist is completed by both clinician and patient together, being used as the basis for a semi-structured interview. In a multicenter pilot study set up to evaluate the utility of checklists, 86% of patients responding considered the ASC-SR to be useful in communicating their problems to psychiatrists and other members of the healthcare team. All healthcare team respondents found both checklists to be helpful when discussing side effect problems with their patients. Moreover, 41% and 47% of healthcare team respondents reported that the ASC-SR and ASC-C, respectively, had assisted them in identifying side-effect problems not previously acknowledged. Preliminary evaluation of the ASC-SR and ASC-C in this multicenter pilot study suggests that both tools were user-friendly, encouraged communication between patients and healthcare professionals about antipsychotic drug side effects, and could readily integrated into everyday clinical practice.

scholarly journals Knowledge related to nutrition and hypertension management practices of adults in Ga-Rankuwa day clinics

Curationis ◽  
2010 ◽  
Vol 33 (2) ◽  
Author(s):  
N.G. Nkosi ◽  
S.C.D. Wright
Keyword(s):  
Management Practices ◽  
Research Question ◽  
Structured Interview ◽  
Left Ventricular ◽  
Self Report ◽  
Uncontrolled Hypertension ◽  
Hypertension Management ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Physical Measurements

Hypertension is a global, non-communicable chronic disease being asymptomatic and known as the silent killer with signs and symptoms only occurring when a target organ is damaged. Being a condition common in South Africa, hypertension is also a risk factor for cerebro-vascular incidents, myocardial infarction, left ventricular hypertrophy, renal disease and retinopathy. Black adults in an urban environment appear to be especially vulnerable to excessive increases in blood pressure. The research question explored was what was the knowledge of hypertensive adults attending day clinics in Ga-Rankuwa regarding nutrition and hypertension management practices. An exploratory strategy was used as no similar research had previously been conducted in Ga-Rankuwa. A cross sectional survey design was used to investigate hypertensive adults attending the three primary health clinics in Ga-Rankuwa. The sampling method was convenient and the sample size 101 participants. Two data gathering methods were used, these being physical measurements and self-report. For the self-report, a structured interview was conducted. The data were analysed using descriptive statistics. The results indicated a lack of knowledge regarding nutrition and management of hypertension. The proportion of participants with uncontrolled hypertension was high (58.6%) and non-compliance with medication occurred frequently (58.1%). A third (28.7%) of the sample lacked knowledge of the complications of hypertension (28.7%). A community-based intervention, based on the results of the study, is recommended.

The development and preliminary evaluation of a thinking skills programme for adults with learning disabilities at risk of offending

2014 ◽  
Vol 16 (1) ◽  
pp. 32-45 ◽  
Author(s):  
Julia Kelly
Keyword(s):  
At Risk ◽  
Learning Disabilities ◽  
Specific Treatment ◽  
Thinking Skills ◽  
Self Report ◽  
Preliminary Evaluation ◽  
Content Type ◽  
Adults With Learning Disabilities ◽  
Offending Behaviour ◽  
Clinical Measures

Purpose – The purpose of this paper is to outline and evaluate the development of a thinking skills programme for adults with learning disabilities at risk of offending. Design/methodology/approach – The programme was evaluated over three years using self-report clinical measures related to treatment targets and feedback from participants. Findings – Results showed a statistically significant improvement in general empathy (t=1.800, df=15, p=<0.05) and perspective taking (t=1.898, df=15, p=<0.05). Improvement in impulsivity and locus of control was not significant. Feedback from service users was positive. Practical implications – Findings suggest that thinking skills programmes can be of benefit to adults with learning disabilities at risk of offending. Originality/value – There is a need to provide opportunities for adults with learning disabilities to address generic deficits and factors supporting offending behaviour and to increase readiness for offence-specific treatment.

scholarly journals An investigation of risk management practices in electronic banking in Sultanate of Oman

2020 ◽  
Author(s):  
Amira Mohammed Musabah Nasser Al Siyabi ◽  
Sarah Muslem Mubarak Al Araimi ◽  
Jitendra Pandey
Keyword(s):  
Risk Management ◽  
Pilot Study ◽  
Financial Services ◽  
Management Practices ◽  
Structured Interview ◽  
Market Liquidity ◽  
Electronic Banking ◽  
Reputational Risk ◽  
Security Controls ◽  
Area Of Interest

The growth in Internet has led to expansion of e-banking, forming online services, like financial services, account opening and facilities (Kolodinsky et al, 2004). Banks manage risks in some areas like: strategy, credit, market, liquidity etc. (Gorgisco, 2006). However, the growth of e-banking become vulnerable to the challenges it faces. All organisations conducting their business on-line have to focus on controlling the associated risks; e-banking is no exception. Malisuwan (2006) categories these e-banking risks into three main areas to be managed: Board and Management Oversight, Security Controls and Legal and Reputational Risk Management based on the fourteen “risk management principles” identified by the Electronic Banking Group (EBG) of the BCBS. Georgescu (2006) suggests that the competitive pressure to launch new innovative products in very short time scales intensifies the management challenge to ensure that adequate strategic assessment, risk analysis and security reviews are undertaken. Over the past two decades, e-banking has become an increasingly important area of interest, with the risks associated with e-banks during this period of significant growth requiring effective risk management processes. Based on the results of our research, the security risks are clearly identified as the most important as banks are working hard to mitigate the risks and this is very encouraging and effective. The main objectives are to investigate the risks of e-banking services in Oman, and their impact on population. Initially a semi-structured interview is conducted as a pilot study with four knowledgeable and experienced staff from one of the leading banks in Oman, to study employee views on risk management issues in e-banking. After the pilot study, the questionnaire was developed and used in major banks in Oman to determine whether it operates in line with basic risk management principles.  

A Preliminary Evaluation of the Active Communication Education Program in a Sample of 87-Year-Old Hearing Impaired Individuals

2014 ◽  
Vol 25 (02) ◽  
pp. 219-228 ◽  
Author(s):  
Marie Öberg ◽  
Therese Bohn ◽  
Ulrika Larsson ◽  
Louise Hickson
Keyword(s):  
Older Adults ◽  
Pilot Study ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Communication Strategy ◽  
Self Report ◽  
Preliminary Evaluation ◽  
Communication Education ◽  
Hearing Aid Fitting ◽  
Active Communication

Background: Previous research suggests that audiological rehabilitation for older adults could include group communication programs in addition to hearing aid fitting or as an alternative to hearing aid fitting for those people who do not wish to proceed with hearing aids. This pilot study was a first attempt to evaluate a Swedish version of such a program, Active Communication Education (ACE), which had been developed and previously evaluated in Australia (Hickson et al, 2007a). Purpose: The aim of the study was to explore the use of the ACE program in an older-old population of people aged 87 yr in Sweden. Research Design: A within-subject intervention study. Study Sample: The participants were recruited from the Elderly in Linköping Screening Assessment (ELSA), a population-based study of the functional abilities of all inhabitants of the city of Linkoping aged 85 yr in 2007. Participants who responded to the hearing related items in the ELSA study were approached for this study; 29 people agreed to undertake ACE, and 23 (79%) completed three or more sessions. Intervention: The ACE program consists of five weekly 2 hr group sessions with six to ten participants per group. Data Collection and Analysis: Self-report measures of communication strategy use, activity and participation, health-related quality of life, and depression were obtained preprogram, 3 wk postprogram, and 6 mo postprogram. Within-group changes and effect sizes were calculated. In addition, outcomes were measured postprogram using the International Outcome Inventory—Alternative Interventions (IOI-AI; Noble, 2002) and a modified version of the Client Oriented Scale of Improvement (COSI; Dillon et al, 1997; Hickson et al, 2007b), and qualitative feedback was obtained. Results: The effect size of ACE was small (0.03–0.27), and, in the sample of 23 included in this pilot study, differences in pre- and postprogram assessments were not statistically significant. Results from the IOI-AI and the modified COSI indicated that these elderly participants found the program to be beneficial, and 90% stated that the course had increased their ability to deal with hearing loss and the problems it creates. Conclusions: This preliminary investigation indicates the potential benefits of ACE for older adults, and further research is needed with larger numbers of participants in different age groups to draw conclusions about the effectiveness of the ACE program for a general Swedish population.

scholarly journals Assessment of Oral Chemotherapy Nonadherence in Chronic Myeloid Leukemia Patients Using Brief Measures in Community Cancer Clinics: A Pilot Study

2021 ◽  
Vol 18 (21) ◽  
pp. 11045
Author(s):  
Terry C. Davis ◽  
Connie L. Arnold ◽  
Glenn Mills ◽  
Glenn J. Lesser ◽  
W. Mark Brown ◽  
...  
Keyword(s):  
Health Literacy ◽  
Pilot Study ◽  
Chronic Myeloid Leukemia ◽  
Anticancer Agents ◽  
Myeloid Leukemia ◽  
Structured Interview ◽  
Self Report ◽  
Literacy Assessment ◽  
Limited Health Literacy ◽  
Limited Health

The purpose of this pilot study was to assess Chronic Myeloid Leukemia (CML) patients’ adherence to, beliefs about, and barriers to oral anticancer agents (OAC) using brief self-report measures in community-based cancer clinics. Patients completed a structured interview including a health literacy assessment, a Brief Medication Questionnaire, two single-item self-report adherence questions, and the Medications Adherence Reasons Scale. Of the 86 participants, 88.4% were white; 55.8% male; mean age, 58.7 years; and 22.1% had limited health literacy. Nonadherence (missing at least one dose in the last week) was reported by 18.6% of participants and associated (p < 0.003) with less-than-excellent perceived ability to take CML medications (16.3%). Black participants reported more difficulty taking CML medications than white participants (28.6% vs. 8.3%, p = 0.053). Among all participants, 43.0% reported their CML medicine was ineffective and 24.4% that taking CML pills was somewhat to very hard. The most common reasons for missing a dose were simply missed it (24.4%) and side effects (18.6%). Most patients perceived their ability to take CML medication was good to excellent, yet nearly one in five reported missing at least one dose in the last week. Brief, no-cost self-report assessments to screen CML patients’ OAC adherence, barriers, and beliefs could facilitate counseling in busy community cancer clinics.

Application of the Non-adoption, Abandonment, Scale-up, Spread and, Sustainability (NASSS) Framework to evaluate the role of technology in the Pathways to Comorbidity Care (PCC) implementation project to improve management of comorbid substance use and mental disorders

2020 ◽  
Author(s):  
MariaGabriela Uribe Guajardo ◽  
Andrew James Baillie ◽  
Eva Louie ◽  
Vicki Giannopoulos ◽  
Katie Wood ◽  
...  
Keyword(s):  
Substance Use ◽  
Clinical Supervision ◽  
Mental Health Problems ◽  
Scale Up ◽  
Structured Interview ◽  
Barriers And Facilitators ◽  
Self Report ◽  
Evidence Based ◽  
Face To Face ◽  
Drug And Alcohol

Abstract (250 words)In substance use treatment settings, there is a high prevalence of comorbid mental health problems. Yet an integrated approach for managing comorbidity, implementation of evidence-based intervention in drug and alcohol settings remains problematic. Technology can help the adoption of evidence-based practice and successfully implement effective treatment health care pathways. This study sought to examine aspects of electronic resources utilisation (barriers and facilitators) by clinicians participating in the PCC training. MethodA self-report questionnaire and a semi-structured interview was designed to measure overall satisfaction with the PCC portal and e-resources available throughout the 9-month intervention for participating clinicians. An adapted version of the ‘Non-adoption, Abandonment, Scale-up, Spread and, Sustainability’ (NASSS) framework was used to facilitate discussion in regards to the study findings. ResultsA total of 20 clinicians from drug and alcohol services responded to all the measures. Facilitators of portal use included: i. clinician acceptance of the PCC portal; ii. guidance from the clinical supervisor or clinical champion that encouraged the use of e-resources. Some of the barriers included: i. complexity of the illness (condition), ii. clinicians’ preference (adopter system) for face-to-face resources and training modes (e.g. clinical supervision, clinical champion workshops), and iii. lack of face-to-face training on how to use the portal (technology and organisation).ConclusionBased on the NASSS framework, we were able to identify several barriers and facilitators including such as the complexity of the illness, lack of face-to-face training and clinician preference for training mediums. Recommendations include ongoing consultation of clinicians to assist in the development of tailored e-health resources and offering in-house training on how to operate and effectively utilise these resources.

Feasibility study of technology-enabled prevention intervention for children and families (Preprint)

2019 ◽  
Author(s):  
Nikki Theofanopoulou ◽  
Katherine Isbister ◽  
Julian Edbrooke-Childs ◽  
Petr Slovák
Keyword(s):  
Emotion Regulation ◽  
Pilot Study ◽  
Low Cost ◽  
Digital Camera ◽  
Well Being ◽  
Structured Interview ◽  
Object A ◽  
Intervention Delivery ◽  
Parents And Children

BACKGROUND A common challenge within psychiatry and prevention science more broadly is the lack of effective, engaging, and scale-able mechanisms to deliver psycho-social interventions for children, especially beyond in-person therapeutic or school-based contexts. Although digital technology has the potential to address these issues, existing research on technology-enabled interventions for families remains limited. OBJECTIVE The aim of this pilot study was to examine the feasibility of in-situ deployments of a low-cost, bespoke prototype, which has been designed to support children’s in-the-moment emotion regulation efforts. This prototype instantiates a novel intervention model that aims to address the existing limitations by delivering the intervention through an interactive object (a ‘smart toy’) sent home with the child, without any prior training necessary for either the child or their carer. This pilot study examined (i) engagement and acceptability of the device in the homes during 1 week deployments; and (ii) qualitative indicators of emotion regulation effects, as reported by parents and children. METHODS In this qualitative study, ten families (altogether 11 children aged 6-10 years) were recruited from three under-privileged communities in the UK. The RA visited participants in their homes to give children the ‘smart toy’ and conduct a semi-structured interview with at least one parent from each family. Children were given the prototype, a discovery book, and a simple digital camera to keep at home for 7-8 days, after which we interviewed each child and their parent about their experience. Thematic analysis guided the identification and organisation of common themes and patterns across the dataset. In addition, the prototypes automatically logged every interaction with the toy throughout the week-long deployments. RESULTS Across all 10 families, parents and children reported that the ‘smart toy’ was incorporated into children’s emotion regulation practices and engaged with naturally in moments children wanted to relax or calm down. Data suggests that children interacted with the toy throughout the duration of the deployment, found the experience enjoyable, and all requested to keep the toy longer. Child emotional connection to the toy—caring for its ‘well-being’—appears to have driven this strong engagement. Parents reported satisfaction with and acceptability of the toy. CONCLUSIONS This is the first known study investigation of the use of object-enabled intervention delivery to support emotion regulation in-situ. The strong engagement and qualitative indications of effects are promising – children were able to use the prototype without any training and incorporated it into their emotion regulation practices during daily challenges. Future work is needed to extend this indicative data with efficacy studies examining the psychological efficacy of the proposed intervention. More broadly, our findings suggest the potential of a technology-enabled shift in how prevention interventions are designed and delivered: empowering children and parents through ‘child-led, situated interventions’, where participants learn through actionable support directly within family life, as opposed to didactic in-person workshops and a subsequent skills application.

Family asthma management in urban children and its association with sleep outcomes

2021 ◽  
pp. 136749352110147
Author(s):  
Maria T Coutinho ◽  
Clara G Sears ◽  
Rebecca Noga ◽  
Elizabeth L McQuaid ◽  
Sheryl J Kopel ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Sleep Duration ◽  
Management Practices ◽  
Environmental Control ◽  
Asthma Management ◽  
Persistent Asthma ◽  
Structured Interview ◽  
Urban Children ◽  
Quality Data ◽  
Management Interventions

Asthma symptoms impact children’s sleep quality. However, it is unclear how families’ daily management of their child’s asthma is associated with sleep quality. We examine associations between family asthma management components and sleep duration and quality for urban children (ages 7–9 years). Additionally, we examine these associations by racial/ethnic group. Data were collected as part of a longitudinal study that examined the co-occurrence of asthma, allergic rhinitis, sleep quality, and academic functioning for urban children diagnosed with persistent asthma ( N = 196). A semi-structured interview assessed family asthma management practices. Sleep quality data were collected via actigraphy. Our visual depiction of sleep outcomes show that those with higher family asthma management ratings present with longer sleep duration and better sleep quality. Among specific family asthma management components, we found a significant association between children’s adherence to asthma medications and number of nighttime awakenings. For non-Latino Black (NLB) children, we found a significant association between environmental control and sleep duration. For urban children with asthma, clinical strategies to enhance overall family asthma management have the potential to support improved sleep quality. Additionally, for NLB children, asthma management interventions that provide environmental control practices may increase sleep duration.

Comparing Traumatic Brain Injury Symptoms Reported via Questionnaires Versus a Novel Structured Interview

2021 ◽  
pp. 1-11
Author(s):  
Natalie A. Emmert ◽  
Georgia Ristow ◽  
Michael A. McCrea ◽  
Terri A. deRoon-Cassini ◽  
Lindsay D. Nelson
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Response Bias ◽  
Minnesota Multiphasic Personality Inventory ◽  
Assessment Tool ◽  
Symptom Burden ◽  
Structured Interview ◽  
Self Report ◽  
Symptom Reporting ◽  
Clinical Interviews

Abstract Objective: Mild traumatic brain injury (mTBI) symptoms are typically assessed via questionnaires in research, yet questionnaires may be more prone to biases than direct clinical interviews. We compared mTBI symptoms reported on two widely used self-report inventories and the novel Structured Interview of TBI Symptoms (SITS). Second, we explored the association between acquiescence response bias and symptom reporting across modes of assessment. Method: Level 1 trauma center patients with mTBI (N = 73) were recruited within 2 weeks of injury, assessed at 3 months post-TBI, and produced nonacquiescent profiles. Assessments collected included the SITS (comprising open-ended and closed-ended questions), Rivermead Post Concussion Symptoms Questionnaire (RPQ), Sport Concussion Assessment Tool-3 (SCAT-3) symptom checklist, and Minnesota Multiphasic Personality Inventory-2 Restructured Form True Response Inconsistency (TRIN-r) scale. Results: Current mTBI symptom burden and individual symptom endorsement were highly concordant between SITS closed-ended questions, the RPQ, and the SCAT-3. Within the SITS, participants reported significantly fewer mTBI symptoms to open-ended as compared to later closed-ended questions, and this difference was weakly correlated with TRIN-r. Symptom scales were weakly associated with TRIN-r. Conclusions: mTBI symptom reporting varies primarily by whether questioning is open- vs. closed-ended but not by mode of assessment (interview, questionnaire). Acquiescence response bias appears to play a measurable but small role in mTBI symptom reporting overall and the degree to which participants report more symptoms to closed- than open-ended questioning. These findings have important implications for mTBI research and support the validity of widely used TBI symptom inventories.

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