WorldWideScience

Sample records for florida patient acceptance

  1. Monitoring device acceptance in implantable cardioverter defibrillator patients using the Florida Patient Acceptance Survey

    DEFF Research Database (Denmark)

    Versteeg, Henneke; Starrenburg, Annemieke; Denollet, Johan

    2012-01-01

    Patient device acceptance might be essential in identifying patients at risk for adverse patient-reported outcomes following implantation of an implantable cardioverter defibrillator (ICD). We examined the validity and reliability of the Florida Patient Acceptance Scale (FPAS) and identified corr...

  2. Patient acceptance of awake craniotomy.

    Science.gov (United States)

    Wrede, Karsten H; Stieglitz, Lennart H; Fiferna, Antje; Karst, Matthias; Gerganov, Venelin M; Samii, Madjid; von Gösseln, Hans-Henning; Lüdemann, Wolf O

    2011-12-01

    The aim of this study was to objectively assess the patients' acceptance for awake craniotomy in a group of neurosurgical patients, who underwent this procedure for removal of lesions in or close to eloquent brain areas. Patients acceptance for awake craniotomy under local anesthesia and conscious sedation was assessed by a formal questionnaire (PPP33), initially developed for general surgery patients. The results are compared to a group of patients who had brain surgery under general anesthesia and to previously published data. The awake craniotomy (AC) group consisted of 37 male and 9 female patients (48 craniotomies) with age ranging from 18 to 71 years. The general anesthesia (GA) group consisted of 26 male and 15 female patients (43 craniotomies) with age ranging from 26 to 83 years. All patients in the study were included in the questionnaire analysis. In comparison to GA the overall PPP33 score for AC was higher (p=0.07), suggesting better overall acceptance for AC. The subscale scores for AC were also significantly better compared to GA for the two subscales "postoperative pain" (p=0.02) and "physical disorders" (p=0.01) and equal for the other 6 subscales. The results of the overall mean score and the scores for the subscales of the PPP33 questionnaire verify good patients' acceptance for AC. Previous studies have shown good patients' acceptance for awake craniotomy, but only a few times using formal approaches. By utilizing a formal questionnaire we could verify good patient acceptance for awake craniotomy for the treatment of brain tumors in or close to eloquent areas. This is a novel approach that substantiates previously published experiences. Copyright © 2011 Elsevier B.V. All rights reserved.

  3. determinants of tuberculosis services acceptance among patients

    African Journals Online (AJOL)

    J MUGUMBATE

    stigmatization on acceptance of tuberculosis services in government hospitals in Oyo State, ... tuberculosis. It usually attacks the lungs but can also affect other parts of the .... out that, stigma among Mexican immigrants in Califonia significantly ...

  4. Are medical students accepted by patients in teaching hospitals?

    Directory of Open Access Journals (Sweden)

    Yousef Marwan

    2012-04-01

    Full Text Available Background: Worldwide, patients are the cornerstone of bedside teaching of medical students. In this study, the authors aimed to assess patients’ acceptability toward medical students in teaching hospitals of the Faculty of Medicine of Kuwait University. Methods: Ninehundred and ninety five patients were approached in 14 teaching hospitals; 932 patients agreed to participate (refusal rate is 6.3%. A self-administered questionnaire was used to collect data. Results: In general, higher acceptance of students by patients was found when there is no direct contact between the patient and the student (e.g., reading patients’ files, presenting in outpatient clinic, observing doctors performing examination or procedures compared to other situations (e.g., performing physical examination or procedures. Pediatrics patients showed higher acceptance of students compared to patients in other specialties, while Obstetrics/Gynecology patients showed the highest refusal of students. Gender of patients (especially females and students appeared to affect the degree of acceptance of medical students by patients. Majority of the patients (436; 46.8% believed that the presence of medical students in hospitals improves the quality of health care. Conclusion: Patients are an important factor of bedside teaching. Clinical tutors must take advantage of patients who accept medical students. Clinical tutors and medical students should master essential communication skills to convince patients in accepting students, thus improving bedside teaching. Also, using simulation and standardization should be considered to address scenarios that most patients are unwilling to allow students to participate.

  5. Modeling patients' acceptance of provider-delivered e-health.

    Science.gov (United States)

    Wilson, E Vance; Lankton, Nancy K

    2004-01-01

    Health care providers are beginning to deliver a range of Internet-based services to patients; however, it is not clear which of these e-health services patients need or desire. The authors propose that patients' acceptance of provider-delivered e-health can be modeled in advance of application development by measuring the effects of several key antecedents to e-health use and applying models of acceptance developed in the information technology (IT) field. This study tested three theoretical models of IT acceptance among patients who had recently registered for access to provider-delivered e-health. An online questionnaire administered items measuring perceptual constructs from the IT acceptance models (intrinsic motivation, perceived ease of use, perceived usefulness/extrinsic motivation, and behavioral intention to use e-health) and five hypothesized antecedents (satisfaction with medical care, health care knowledge, Internet dependence, information-seeking preference, and health care need). Responses were collected and stored in a central database. All tested IT acceptance models performed well in predicting patients' behavioral intention to use e-health. Antecedent factors of satisfaction with provider, information-seeking preference, and Internet dependence uniquely predicted constructs in the models. Information technology acceptance models provide a means to understand which aspects of e-health are valued by patients and how this may affect future use. In addition, antecedents to the models can be used to predict e-health acceptance in advance of system development.

  6. Efficiency of patients with carcinoma and acceptance of the disease

    Directory of Open Access Journals (Sweden)

    Marzena Kamińska

    2014-04-01

    Full Text Available Introduction: Human functioning is based on physical, psychological, social and spiritual areas. The emergence of cancer and all types of problems affect these areas. Adapting to cancer is very important for the process of therapy, and acceptance of the disease is its determinant. Aim of the research study : To determine the relationship between oncological patients physical fitness and their acceptance of the disease. Material and methods: The following research techniques and tools have been used: a questionnaire survey, the Repta operation scale for assessing the functionality of patients in the course of the disease, a modified Pain Assessment Worksheet for evaluating the intensity of pain and its impact on daily activities and the AIS scale to assess the degree of acceptance of the disease. Results: Most of the respondents were fully efficient in the field of the activities of daily living. The vast majority of respondents did not feel pain, or felt pain that could be taken lightly. Pain that made daily functioning difficult, particularly in mobility and locomotion, concerned only persons over 60 years old. In the study group there was dominantly an average degree of acceptance of the disease; a small group was marked by a high level, and only a few people showed a lack of acceptance of the disease. Independent people and people in need of assistance accepted the illness at a medium level, and vulnerable patients showed the lowest level of acceptance. Conclusions : The efficiency of patients with cancer affects the level of acceptance of the disease. Cancer for the majority of respondents is not an obstacle in performing basic activities. Most respondents accept the disease, a small part selects a high level, and only a few people show a lack of acceptance of the disease.

  7. Social acceptance among tuberculosis patients at Puskesmas Amplas Medan, Indonesia

    Science.gov (United States)

    Eyanoer, P. C.

    2018-03-01

    Social acceptance is a confession, compilation, and appreciation for an individual which come from other individual or social groups in their entirety which makes individual feels safe, comfortable, and their existence is appreciated. A cross-sectional study consisted of 42 pulmonary TB patients registered at Puskesmas Amplas was done to analyze their social acceptance in the society. Data was collected by direct interview using structured questionnaire. The result showed that majority had either high and very high social acceptance with 45.20% and 31.0% respectively with high family support and high self-confidence (73.8%). Bivariate analysis showed a significant association between family support and self confidence with social acceptance (p value<0.05). The correlation coefficient (r) of self confidenceis 0.629 while family support were is 0.455 (p-value<0.05). This study concludes that both family support and self-confidence have a significant correlation with social acceptance.

  8. [The self-acceptance and the acceptance of the parents by patients with anorexia nervosa].

    Science.gov (United States)

    Pawłowska, Beata; Chuchra, Maria

    2004-01-01

    The aim of this work is to describe the relationship between self-esteem and characteristics of self image and acceptance of parents and the characteristics of their images in the perception of patients with anorexia nervosa. The test group consisted of 30 patients diagnosed with anorexia nervosa undergoing a treatment in the Department of Psychiatry of the Medical Academy in Lublin. The average age of the examined patients was 20 years. All patients had secondary education. In my work the ACL Gough and Heilbrun Adjectival Test was used which was completed by the examined women three times following the instruction: "I am", "my mother is", "my father is". As a result the actual images of the patients as well as of their mothers and fathers were obtained. The esteem rates were calculated by comparing the number of positive adjectives to the number of negative adjectives used by the patients to evaluate individual persons. The interdependencies between esteem rates and the characteristics of the actual images of these persons were determined based on the r-Pearson correlation. The results obtained indicated the existence of crucial statistic dependencies between the variables analysed and constituted the basis for the formulation of the following conclusions: 1. Patients are characterised by a low self-esteem and a low acceptance level of their parents. They accept their fathers in the smallest degree, compared to that their self-esteem is higher and the acceptance of their mothers is the highest. 2. Self-esteem is related in a significant way to the characteristics of self image such as: sense of responsibility, autonomy, ability to accomplish life objectives and establishing close relationships with other people. 3. The acceptance of their mothers is related to the characteristics typical of them such as: protectiveness, ability to establish and maintain positive interpersonal relationships, empathy and understanding the motives of their own behaviour and those of

  9. Treatments for irritable bowel syndrome: patients' attitudes and acceptability

    Directory of Open Access Journals (Sweden)

    Roberts Lesley

    2008-12-01

    Full Text Available Abstract Background Irritable Bowel Syndrome, a highly prevalent chronic disorder, places significant burden on the health service and the individual. Symptomatic distress and reduced quality of life are compounded by few efficacious treatments available. As researchers continue to demonstrate the clinical efficacy of alternative therapies, it would be useful to gain a patient-perspective of treatment acceptability and identify patient's attitudes towards those modalities considered not acceptable. Methods Six hundred and forty-five participants identified from an earlier IBS-prevalence study received a postal questionnaire to evaluate preferences and acceptability of nine forms of treatment. Proportions accepting each form of treatment were calculated and thematic analysis of qualitative data undertaken. Results A total of 256 (39.7% of 645 potential respondents completed the questionnaire (mean age 55.9 years, 73% female. Tablets were most acceptable (84%, followed by lifestyle changes (diet (82%, yoga (77%. Acupuncture (59% and suppositories (57% were less acceptable. When explaining lack of acceptability, patient views fell into four broad categories: dislike treatment modality, do not perceive benefit, general barriers and insufficient knowledge. Scepticism, lack of scientific rationale and fear of CAM were mentioned, although others expressed a dislike of conventional medical treatments. Past experiences, age and health concerns, and need for proof of efficacy were reported. Conclusion Most patients were willing to accept various forms of treatment. However, the reservations expressed by this patient-population must be recognised with particular focus directed towards allaying fears and misconceptions, seeking further evidence base for certain therapies and incorporating physician support and advice.

  10. Patients' reasons for accepting a free community pharmacy asthma service

    DEFF Research Database (Denmark)

    Kaae, Susanne; Sporrong, Sofia Kälvemark

    2015-01-01

    few studies have been conducted so far to explore why patients accept or decline offers of cognitive services at the pharmacy counter. Objective To explore patients’ reasons for accepting a particular cognitive service (the Inhaler Technique Assessment Service) a service intended to detect inhalation...... with 24 patients suffering mainly from asthma and COPD. Researchers from Copenhagen University conducted 11 long interviews and pharmacy internship students from Copenhagen University carried out 13 short interviews. The interviews were analyzed using descriptive analysis. Main outcome measure Patients......’ perceived needs of an inhalation counseling service as well as their motivation for accepting the service, including their accounts of how the service was orally offered by staff. Results The majority of participants were used to using inhaler devices. The participants felt, for several reasons, little need...

  11. Human Factors Affecting the Patient's Acceptance of Wireless Biomedical Sensors

    Science.gov (United States)

    Fensli, Rune; Boisen, Egil

    In monitoring arrhythmia, the quality of medical data from the ECG sensors may be enhanced by being based on everyday life situations. Hence, the development of wireless biomedical sensors is of growing interest, both to diagnose the heart patient, as well as to adjust the regimen. However, human factors such as emotional barriers and stigmatization, may affect the patient's behavior while wearing the equipment, which in turn may influence quality of data. The study of human factors and patient acceptance is important both in relation to the development of such equipment, as well as in evaluating the quality of data gathered from the individual patient. In this paper, we highlight some important aspects in patient acceptance by comparing results from a preliminary clinical trial with patients using a wireless ECG sensor for three days out-of-hospital service, to available published results from telehomecare projects, and discuss important aspects to be taken into account in future investigations.

  12. Correlates of Length of Stay and Boarding in Florida Emergency Departments for Patients With Psychiatric Diagnoses.

    Science.gov (United States)

    Smith, Joseph L; De Nadai, Alessandro S; Storch, Eric A; Langland-Orban, Barbara; Pracht, Etienne; Petrila, John

    2016-11-01

    Length of stay (LOS) and boarding in the emergency department (ED) for psychiatric patients have been the subject of concern, given the problems with crowding and excessive wait times in EDs. This investigation examined correlates of LOS and boarding in Florida EDs for patients presenting with psychiatric complaints from 2010 to 2013. Utilizing the Florida ED discharge database, the authors examined the association of LOS and boarding with hospital and encounter factors for adult patients presenting with a primary psychiatric diagnosis (N=597,541). The mean LOS was 7.77 hours. Anxiety disorders were the most frequent psychiatric complaint and were associated with the lowest mean LOS compared with other diagnoses (pboarding (a stay of more than six or more hours in the ED). Extended LOS was endemic for psychiatric patients in Florida EDs.

  13. Risk acceptance in multiple sclerosis patients on natalizumab treatment.

    Directory of Open Access Journals (Sweden)

    Carmen Tur

    Full Text Available OBJECTIVE: We aimed to investigate the ability of natalizumab (NTZ-treated patients to assume treatment-associated risks and the factors involved in such risk acceptance. METHODS: From a total of 185 patients, 114 patients on NTZ as of July 2011 carried out a comprehensive survey. We obtained disease severity perception scores, personality traits' scores, and risk-acceptance scores (RAS so that higher RAS indicated higher risk acceptance. We recorded JC virus status (JCV+/-, prior immunosuppression, NTZ treatment duration, and clinical characteristics. NTZ patients were split into subgroups (A-E, depending on their individual PML risk. Some 22 MS patients on first-line drugs (DMD acted as controls. RESULTS: No differences between treatment groups were observed in disease severity perception and personality traits. RAS were higher in NTZ than in DMD patients (p<0.01. Perception of the own disease as a more severe condition tended to predict higher RAS (p=0.07. Higher neuroticism scores predicted higher RAS in the NTZ group as a whole (p=0.04, and in high PML-risk subgroups (A-B (p=0.02. In low PML-risk subgroups (C-E, higher RAS were associated with a JCV+ status (p=0.01. Neither disability scores nor pre-treatment relapse rate predicted RAS in either group. CONCLUSIONS: Risk acceptance is a multifactorial phenomenon, which might be partly explained by an adaptive process, in light of the higher risk acceptance amongst NTZ-treated patients and, especially, amongst those who are JCV seropositive but still have low PML risk, but which seems also intimately related to personality traits.

  14. Should patient groups accept money from drug companies? No

    OpenAIRE

    Mintzes, Barbara

    2007-01-01

    Patient groups provide valuable support and advocacy for vulnerable people but funding the work can be difficult. Alastair Kent argues that not accepting industry money will unnecessarily limit the groups' effectiveness, but Barbara Mintzes believes that the money undermines their independence

  15. Should patient groups accept money from drug companies? Yes

    OpenAIRE

    Kent, Alastair

    2007-01-01

    Patient groups provide valuable support and advocacy for vulnerable people but funding the work can be difficult. Alastair Kent argues that not accepting industry money will unnecessarily limit the groups' effectiveness, but Barbara Mintzes believes that the money undermines their independence

  16. Acceptance of Smartphone in Enhancing Patient-Caregivers Relationship

    Directory of Open Access Journals (Sweden)

    Wan Khairuzzaman Wan Ismail

    2012-09-01

    Full Text Available Patients may take more initiative to give more attention to their health as well as foster closer relationship with the caregivers and this has been made possible through smartphone. This paper investigates the perceived usefulness of smartphone among healthcare personnel in a private hospital setting. The study has identified elements which have had impact on individual decision to use smartphones using Technology Acceptance Model (TAM. Questionnaires were distributed to 57 respondents including medical doctors, nurses and head of department of a hospital. The analysis shows that the younger generations were more ‘trendy’ in owning a Smartphone. The study indicates that females reported better acceptance of smartphone use in their works. Healthcare industry will be more patient-centric instead of doctor-centric, hence, it is important for healthcare providers to provide services in line with the customers’ requirement without jeopardizing patient safety and lives.

  17. Acceptance and perception of Nigerian patients to medical photography.

    Science.gov (United States)

    Adeyemo, W L; Mofikoya, B O; Akadiri, O A; James, O; Fashina, A A

    2013-12-01

    The aim of the study was to determine the acceptance and perception of Nigerian patients to medical photography. A self-administered questionnaire was distributed among Nigerian patients attending oral and maxillofacial surgery and plastic surgery clinics of 3 tertiary health institutions. Information requested included patients' opinion about consent process, capturing equipment, distribution and accessibility of medical photographs. The use of non-identifiable medical photographs was more acceptable than identifiable to respondents for all purposes (P = 0.003). Most respondents were favourably disposed to photographs being taken for inclusion in the case note, but opposed to identifiable photographs being used for other purposes most especially in medical websites and medical journals. Female respondents preferred non-identifiable medical photographs to identifiable ones (P = 0.001). Most respondents (78%) indicated that their consent be sought for each of the outline needs for medical photography. Half of the respondents indicated that identifiable photographs may have a negative effect on their persons; and the most commonly mentioned effects were social stigmatization, bad publicity and emotional/psychological effects. Most of the respondents preferred the use of hospital-owned camera to personal camera/personal camera-phone for their medical photographs. Most respondents (67.8%) indicated that they would like to be informed about the use of their photographs on every occasion, and 74% indicated that they would like to be informed of the specific journal in which their medical photographs are to be published. In conclusion, non-identifiable rather than identifiable medical photography is acceptable to most patients in the studied Nigerian environment. The use of personal camera/personal camera-phone should be discouraged as its acceptance by respondents is very low. Judicious use of medical photography is therefore advocated to avoid breach of principle of

  18. Impact of an Acceptance Facilitating Intervention on Patients' Acceptance of Internet-based Pain Interventions: A Randomized Controlled Trial.

    Science.gov (United States)

    Baumeister, Harald; Seifferth, Holger; Lin, Jiaxi; Nowoczin, Lisa; Lüking, Marianne; Ebert, David

    2015-06-01

    Results from clinical trials indicate that Internet-based psychological pain interventions are effective in treating chronic pain. However, little is known about patients' acceptance of these programs and how to positively influence patients' intention to engage in them. Therefore, the present study aimed (1) to assess patients' acceptance of Internet-based interventions, and (2) to examine whether patients' acceptance can be increased by an acceptance facilitating intervention. A total of 104 patients with chronic pain from 2 pain units were randomly allocated to an intervention group (IG) and a no-intervention control group (CG). The IG was shown a short informational video about Internet-based psychological pain interventions before receiving a questionnaire on patients' acceptance of Internet-based psychological pain interventions and predictors of acceptance (performance expectancy, effort expectancy, social influence, facilitating conditions, Internet usage, and Internet anxiety). The CG filled out the questionnaire immediately. Patients' acceptance was measured with a 4-item scale (sum score ranging from 4 to 20). Baseline acceptance of Internet-based interventions was reported as low (sum-score:4-9) by 53.8%, moderate (10 to 15) by 42.3%, and high (16 to 20) by 3.9% of the patients with chronic pain in the CG. The IG showed a significantly higher acceptance (M = 12.17, SD = 4.22) than the CG (M = 8.94, SD = 3.71) with a standardized mean difference of d = 0.81 (95% CI, 0.41, 1.21). All predictor variables were significantly improved in the IG compared with the CG, except for Internet usage. Patients with chronic pain display a relatively low acceptance of Internet-based psychological pain interventions, which can be substantially increased by a short informational video.

  19. Are web-based questionnaires accepted in patients attending rehabilitation?

    Science.gov (United States)

    Engan, Harald K; Hilmarsen, Christina; Sittlinger, Sverre; Sandmæl, Jon Arne; Skanke, Frode; Oldervoll, Line M

    2016-12-01

    The aim of the present paper was to study preferences for web based self-administered questionnaires (web SAQs) vs. paper-based self-administered questionnaires (paper SAQs) and to evaluate the feasibility of using web SAQs in patients referred to cardiac, lung, occupational and cancer rehabilitation programs. The patients were approached by mail and given the choice to answer the compulsory SAQs either on paper or on a web-based platform. Hundred and twenty seven out of 183 eligible patients (69.3%) were willing to participate and 126 completed the study. Web SAQs were preferred by 77.7%, and these patients were significantly younger, more often cohabiting and tended to have higher level of education than paper SAQ users. Mean number of data missing per patient was less among the web SAQ users than the paper SAQ users (0.55 vs. 2.15, p questionnaires on internet platforms when internet access is common and available. Implications for Rehabilitation The high acceptability of web-based self-administered questionnaires among rehabilitation patients suggests that internet platforms are suitable tools to collect patient information for rehabilitation units. Web-based modes of patient data collection demonstrate low number of missing data and can therefore improve the quality of data collection from rehabilitation patients. Use of web-based questionnaires considerably reduces administrative costs of data collection in rehabilitation settings compared to traditional pen and paper methods.

  20. Electrothermal debracketing: patient acceptance and effects on the dental pulp.

    Science.gov (United States)

    Dovgan, J S; Walton, R E; Bishara, S E

    1995-09-01

    Adhesives bond ceramic brackets so effectively that their removal by mechanical forces can fracture the brackets and may damage the tooth surface. Electrothermal debracketers have been developed to facilitate removal; whether the heat generated will damage the underlying pulp is unclear. In our experiment, a prototype device with a high heat tip was used to remove brackets from premolars in patients. The following parameters were evaluated: (1) time required for removal, (2) patient acceptance, and (3) histologic effect on the pulp. Forty-eight experimental teeth planned for orthodontic extraction were bonded by a filled Bis-GMA composite resin and a monocrystalline sapphire bracket. After the chemically cured composite set, debracketing was performed according to the manufacturer's recommendations. Seventeen premolars were not etched or bracketed and served as controls. The interval between heat application and removal of the bracket was timed. Patients were questioned as to sensations during debracketing. Teeth were extracted at 5 to 7 or 28 to 32 days and histologically prepared. Pulps were evaluated for alterations. Brackets were removed in an average of 2.1 seconds, usually at the bracket/composite interface. Patient acceptance was generally positive. Pulpal necrosis was not observed but, in a number of specimens, slight inflammation and odontoblastic disruption occurred at both observation periods.

  1. Efficacy, safety, and patient acceptability of the Essure™ procedure

    Directory of Open Access Journals (Sweden)

    Hopkins MR

    2011-04-01

    Full Text Available Collette R Lessard, Matthew R HopkinsDepartment of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USAAbstract: The Essure™ system for permanent contraception was developed as a less invasive method of female sterilization. Placement of the Essure™ coil involves a hysteroscopic transcervical technique. This procedure can be done in a variety of settings and with a range of anesthetic options. More than eight years have passed since the US Food and Drug Administration approval of Essure™. Much research has been done to evaluate placement success, adverse outcomes, satisfaction, pain, and the contraceptive efficacy of the Essure™. The purpose of this review is to summarize the available literature regarding the efficacy, safety, and patient satisfaction with this new sterilization technique.Keywords: hysteroscopic sterilization, Essure™, safety, efficacy, acceptability

  2. Enteral feeding pumps: efficacy, safety, and patient acceptability

    Directory of Open Access Journals (Sweden)

    White H

    2014-08-01

    Full Text Available Helen White, Linsey King Nutrition and Dietetic Group, School of Health and Wellbeing, Faculty Health and Social Science, Leeds Metropolitan University, Leeds, United Kingdom Abstract: Enteral feeding is a long established practice across pediatric and adult populations, to enhance nutritional intake and prevent malnutrition. Despite recognition of the importance of nutrition within the modern health agenda, evaluation of the efficacy of how such feeds are delivered is more limited. The accuracy, safety, and consistency with which enteral feed pump systems dispense nutritional formulae are important determinants of their use and acceptability. Enteral feed pump safety has received increased interest in recent years as enteral pumps are used across hospital and home settings. Four areas of enteral feed pump safety have emerged: the consistent and accurate delivery of formula; the minimization of errors associated with tube misconnection; the impact of continuous feed delivery itself (via an enteral feed pump; and the chemical composition of the casing used in enteral feed pump manufacture. The daily use of pumps in delivery of enteral feeds in a home setting predominantly falls to the hands of parents and caregivers. Their understanding of the use and function of their pump is necessary to ensure appropriate, safe, and accurate delivery of enteral nutrition; their experience with this is important in informing clinicians and manufacturers of the emerging needs and requirements of this diverse patient population. The review highlights current practice and areas of concern and establishes our current knowledge in this field. Keywords: nutrition, perceptions, experience

  3. Transvaginal retropubic sling systems: efficacy and patient acceptability

    Directory of Open Access Journals (Sweden)

    Moldovan CP

    2015-02-01

    Full Text Available Christina P Moldovan,1 Michelle E Marinone,2 Andrea Staack3 1Department of Psychology, Loma Linda University, Loma Linda, California, United States of America; 2School of Medicine, Loma Linda University, Loma Linda, California, United States of America; 3Department of Urology, Loma Linda University Medical Center, Loma Linda, California, United States of America Abstract: Stress urinary incontinence is a common, disabling, and costly medical problem that affects approximately 50% of women with urinary incontinence. Suburethral retropubic slings have been developed as a minimally invasive and effective surgical option, and they have been used as a first-line treatment for stress urinary incontinence since 1995. However, complications including vaginal extrusion, erosion, pain, bleeding, infections, lower urinary tract symptoms, urinary retention, and incontinence have been reported with use of the slings. Several companies manufacture sling kits, and the sling kits vary with regard to the composition of the mesh and introducer needle. The aim of this review was to determine which sling kit was most effective for patients, had minimal reported side effects, and was best accepted by patients and surgeons. In a review of the literature, it was found that a total of 38 studies were published between 1995 and 2014 that reported on eight tension-free retropubic sling kits: SPARC, RetroArc, Align, Advantage, Lynx, Desara, Supris, and Gynecare TVT. The Gynecare TVT was the most cited sling kit; the second most cited was the SPARC. This review provides a summary of the studies that have examined positive and negative outcomes of the retropubic tension-free suburethral sling procedure using various sling kits. Overall, the results of the literature review indicated that data from comparisons of the available sling kits are insufficient to make an evidenced-based recommendation. Therefore, the decision regarding which sling kit is appropriate to use in

  4. Hurricane Elena and Pinellas County, Florida: Some Lessons Learned from the Largest Evacuation of Nursing Home Patients in History.

    Science.gov (United States)

    Mangum, Wiley P.; And Others

    1989-01-01

    Studied prior planning for and problems associated with evacuation of 1,860 nursing home patients in Pinellas County, Florida, due to Hurricane Elena in 1985 through questionnaires administered to nursing home administrators and public documents. Found most serious problems to be transporting patients to shelters in timely fashion, delayed passage…

  5. Patient acceptability and practical implications of pharmacokinetic studies in patients with advanced cancer.

    Science.gov (United States)

    Dobbs, N A; Twelves, C J; Ramirez, A J; Towlson, K E; Gregory, W M; Richards, M A

    1993-01-01

    We have studied the practical implications and acceptability to patients of pharmacokinetic studies in 34 women receiving anthracyclines for advanced breast cancer. The following parameters were recorded: age, ECOG performance status, psychological state (Rotterdam Symptom Checklist), cytotoxic drug and dose, number of venepunctures for treatment and sampling, and time when the sampling cannula was removed. Immediately after finishing pharmacokinetic sampling, patients completed a questionnaire which revealed that (i) all patients understood sampling was for research, (ii) 35% of patients experienced problems with sampling, (iii) benefits from participation were perceived by 56% of patients. Of 20 patients later questioned after completion of their treatment course, 40% recalled difficulties with blood sampling. Factors identifying in advance those patients who tolerate pharmacokinetic studies poorly were not identified but the number of venepunctures should be minimised. Patients may also perceive benefits from 'non-therapeutic' research.

  6. HIV vaccine acceptability in seronaive patients in a resource limited ...

    African Journals Online (AJOL)

    Background: Current lifetime antiretroviral regimes are associated with clinically important toxicities, and have several limitations (eg. cost, development of resistance, complications). There is need for an alternative regime that must be acceptable, easy to administer and permanent for the eradication of HIV/AIDS.

  7. Scandiatransplant acceptable mismatch program (STAMP) a bridge to transplanting highly immunized patients

    DEFF Research Database (Denmark)

    Koefoed-Nielsen, Pernille; Weinreich, I; Bengtsson, M

    2017-01-01

    BACKGROUND: Highly immunized patients are a challenge for organ transplantation programs. One way of increasing the likelihood of transplantation in this group of patients is to expand the possible donations by defining acceptable HLA mismatches. In the Scandiatransplant Acceptable Mismatch Program...

  8. SU-E-T-502: Biometrically Accepted Patient Records

    International Nuclear Information System (INIS)

    Basavatia, A; Kalnicki, S; Garg, M; Lukaj, A; Hong, L; Fret, J; Yaparpalvi, R; Tome, W

    2014-01-01

    Purpose: To implement a clinically useful palm vein pattern recognition biometric system to treat the correct treatment plan to the correct patient each and every time and to check-in the patient into the department to access the correct medical record. Methods: A commercially available hand vein scanning system was paired to Aria and utilized an ADT interface from the hospital electronic health system. Integration at two points in Aria, version 11 MR2, first at the appointment tracker screen for the front desk medical record access and second at the queue screen on the 4D treatment console took place for patient daily time-out. A test patient was utilized to check accuracy of identification as well as to check that no unintended interactions take place between the 4D treatment console and the hand vein scanning system. This system has been in clinical use since December 2013. Results: Since implementation, 445 patients have been enrolled into our biometric system. 95% of patients learn the correct methodology of hand placement on the scanner in the first try. We have had two instances of patient not found because of a bad initial scan. We simply erased the scanned metric and the patient enrolled again in those cases. The accuracy of the match is 100% for each patient, we have not had one patient misidentified. We can state this because we still use patient photo and date of birth as identifiers. A QA test patient is run monthly to check the integrity of the system. Conclusion: By utilizing palm vein scans along with the date of birth and patient photo, another means of patient identification now exits. This work indicates the successful implementation of technology in the area of patient safety by closing the gap of treating the wrong plan to a patient in radiation oncology. FOJP Service Corporation covered some of the costs of the hardware and software of the palm vein pattern recognition biometric system

  9. SU-E-T-502: Biometrically Accepted Patient Records

    Energy Technology Data Exchange (ETDEWEB)

    Basavatia, A; Kalnicki, S; Garg, M; Lukaj, A; Hong, L [Montefiore Medical Center, Bronx, NY (United States); Fret, J [Montefiore Information Technology, Yonkers, NY (United States); Yaparpalvi, R [Montefiore Medical Center, Bronx, NY (United States); Montefiore Medical Center, Bronx, NY (United States); Tome, W [Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY (United States)

    2014-06-01

    Purpose: To implement a clinically useful palm vein pattern recognition biometric system to treat the correct treatment plan to the correct patient each and every time and to check-in the patient into the department to access the correct medical record. Methods: A commercially available hand vein scanning system was paired to Aria and utilized an ADT interface from the hospital electronic health system. Integration at two points in Aria, version 11 MR2, first at the appointment tracker screen for the front desk medical record access and second at the queue screen on the 4D treatment console took place for patient daily time-out. A test patient was utilized to check accuracy of identification as well as to check that no unintended interactions take place between the 4D treatment console and the hand vein scanning system. This system has been in clinical use since December 2013. Results: Since implementation, 445 patients have been enrolled into our biometric system. 95% of patients learn the correct methodology of hand placement on the scanner in the first try. We have had two instances of patient not found because of a bad initial scan. We simply erased the scanned metric and the patient enrolled again in those cases. The accuracy of the match is 100% for each patient, we have not had one patient misidentified. We can state this because we still use patient photo and date of birth as identifiers. A QA test patient is run monthly to check the integrity of the system. Conclusion: By utilizing palm vein scans along with the date of birth and patient photo, another means of patient identification now exits. This work indicates the successful implementation of technology in the area of patient safety by closing the gap of treating the wrong plan to a patient in radiation oncology. FOJP Service Corporation covered some of the costs of the hardware and software of the palm vein pattern recognition biometric system.

  10. Florida Sleeve Procedure Is Durable and Improves Aortic Valve Function in Marfan Syndrome Patients.

    Science.gov (United States)

    Aalaei-Andabili, Seyed Hossein; Martin, Tomas; Hess, Philip; Klodell, Charles; Karimi, Ashkan; Arnaoutakis, George; Lee, Teng; Beaver, Thomas

    2017-09-01

    The Florida sleeve (FS) procedure was developed as a simplified approach for repair of functional type I aortic insufficiency secondary to aortic root aneurysm. We evaluated postoperative aortic valve function, long-term survival, and freedom from reoperation in Marfan syndrome patients who underwent the FS procedure at our center. All Marfan syndrome patients undergoing FS procedure from May 2002 to December 2014 were included. Echocardiography assessment included left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), ejection fraction, and degree of aortic insufficiency (none = 0, minimal = 1, mild = 2, moderate = 3, severe = 4). Social Security Death Index and primary care physicians' report were used for long-term follow-up. Thirty-seven Marfan syndrome patients, 21 (56.8%) men and 16 (43%) women with mean age of 35.08 ± 13.45 years underwent FL repair at our center. There was no in-hospital or 30-day death or stroke. Two patients required reoperation due to bleeding. Patients' survival rate was 94% at 1 to 8 years. Freedom from reoperation was 100% at 8 years. Twenty-five patients had postoperative follow-up echocardiography at 1 week. Aortic insufficiency grade significantly decreased after the procedure (preoperative mean ± SD: 1.76 ± 1.2 versus 1-week postoperative mean ± SD: 0.48 ± 0.71, p Marfan syndrome patients with immediate improvement in aortic valve function. Long-term survival and freedom from reoperation rates are encouraging. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  11. Individual- and neighborhood-level predictors of mortality in Florida colorectal cancer patients.

    Directory of Open Access Journals (Sweden)

    Stacey L Tannenbaum

    Full Text Available We examined individual-level and neighborhood-level predictors of mortality in CRC patients diagnosed in Florida to identify high-risk groups for targeted interventions.Demographic and clinical data from the Florida Cancer Data System registry (2007-2011 were linked with Agency for Health Care Administration and US Census data (n = 47,872. Cox hazard regression models were fitted with candidate predictors of CRC survival and stratified by age group (18-49, 50-64, 65+.Stratified by age group, higher mortality risk per comorbidity was found among youngest (21%, followed by middle (19%, and then oldest (14% age groups. The two younger age groups had higher mortality risk with proximal compared to those with distal cancer. Compared with private insurance, those in the middle age group were at higher death risk if not insured (HR = 1.35, or received healthcare through Medicare (HR = 1.44, Medicaid (HR = 1.53, or the Veteran's Administration (HR = 1.26. Only Medicaid in the youngest (52% higher risk and those not insured in the oldest group (24% lower risk were significantly different from their privately insured counterparts. Among 18-49 and 50-64 age groups there was a higher mortality risk among the lowest SES (1.17- and 1.23-fold higher in the middle age and 1.12- and 1.17-fold higher in the older age group, respectively compared to highest SES. Married patients were significantly better off than divorced/separated (HR = 1.22, single (HR = 1.29, or widowed (HR = 1.19 patients.Factors associated with increased risk for mortality among individuals with CRC included being older, uninsured, unmarried, more comorbidities, living in lower SES neighborhoods, and diagnosed at later disease stage. Higher risk among younger patients was attributed to proximal cancer site, Medicaid, and distant disease; however, lower SES and being unmarried were not risk factors in this age group. Targeted interventions to improve

  12. Emotional and rational disease acceptance in patients with depression and alcohol addiction

    OpenAIRE

    Matthiessen Peter F; Büssing Arndt; Mundle Götz

    2008-01-01

    Abstract Background The concept of a rational respectively emotional acceptance of disease is highly valued in the treatment of patients with depression or addiction. Due to the importance of this concept for the long-term course of disease, there is a strong interest to develop a tool to identify the levels and factors of acceptance. We thus intended to test an instrument designed to assess the level of positive psychological wellbeing and coping, particularly emotional disease acceptance an...

  13. Surgical Patients\\' Knowledge and Acceptance of Autologous Blood ...

    African Journals Online (AJOL)

    Background: Homologous blood transfusion carries a well-documented array of risks especially in an HIV endemic environment like Nigeria. It is therefore imperative to consider other forms of restoring blood volume in surgical patients. Autologous blood transfusion (ABT) is one of the ways the problem of HIV transmission ...

  14. Social acceptance and quality of life of leprosy patient

    Science.gov (United States)

    Eyanoer, P. C.

    2018-03-01

    Some of the leprosy patients facing problems in many aspects such as social, economic, cultural and national security. Both the debilitating effects and disfigurements of leprosy, the society tends to stigmatize negatively those suffering from leprosy. The impact of negative stigma on society causes depression and problems in workplace cause difficulty in patient’s daily life. Neuropathic pain disturbs the quality of life of leprosy patients which could become so severe and significant. The neuropathic pain will lower their productivity which later caused difficulties in finding a job. This study was an analytical observational study to identify the correlation between neuropathic pain and quality of life in Leprosy Hospital of Scanning in Medan Belawan. The result showed that there is a correlation between neuropathic pain and disruption of quality of life (p=0.017). In conclusion, the milder the neuropathic pain experienced by persons with leprosy, the less the quality of life will be disturbed.

  15. Safety, efficacy, and patient acceptability of rifaximin for hepatic encephalopathy

    DEFF Research Database (Denmark)

    Kimer, Nina; Krag, Aleksander; Gluud, Lise L

    2014-01-01

    Hepatic encephalopathy is a complex disease entity ranging from mild cognitive dysfunction to deep coma. Traditionally, treatment has focused on a reduction of ammonia through a reduced production, absorption, or clearance. Rifaximin is a nonabsorbable antibiotic, which reduces the production of ...... and safety of long-term treatment with rifaximin and evaluate effects of combination therapy with lactulose and branched-chain amino acids for patients with liver cirrhosis and hepatic encephalopathy.......Hepatic encephalopathy is a complex disease entity ranging from mild cognitive dysfunction to deep coma. Traditionally, treatment has focused on a reduction of ammonia through a reduced production, absorption, or clearance. Rifaximin is a nonabsorbable antibiotic, which reduces the production...... of ammonia by gut bacteria and, to some extent, other toxic derivatives from the gut. Clinical trials show that these effects improve episodes of hepatic encephalopathy. A large randomized trial found that rifaximin prevents recurrent episodes of hepatic encephalopathy. Most patients were treated...

  16. Evaluation of communication and acceptance of the patients by medical personnel

    Science.gov (United States)

    Włoszczak-Szubzda, Anna; Jarosz, Mirosław J; Goniewicz, Mariusz; Goniewicz, Krzysztof

    The low level of patient satisfaction recorded in many studies and, at the same time, the level of frustration and burnout, disclosed by medics in the perception of the patient as a ‘problem’, incline to look for the causes of inadequate relationship between physician and patient. The aim of this study was to evaluate the level of acceptance of the patient by the medical personnel. The research problem was the acceptance level which was within the range of the communication skills of the nurses and doctors. Another aim was to discover the factors determining this level of acceptance. Two methods were used in the research process: 1) a diagnostic survey regarding the medical, professional communication skills; 2) testing of professional self-esteem from the medical aspect. The study population consisted of a total of 1,244 respondents divided into the following groups: registered nurses and doctors (729), students of nursing and medical faculties (515). The results of the research showed that in most cases the acceptance of the patient by the medical staff was ‘conditional’, which translated into the level of frustration or lack of satisfaction with their profession, and ultimately into the level of burnout. The level of patient acceptance by medical staff (unconditional acceptance), depended primarily on age, followed by their profession. However, the relationship between this acceptance and gender and work experience was statistically insignificant. As the method to improve this situation, the expansion of education in the field of interpersonal communication is proposed, adding issues related with both the conditional and unconditional acceptance of the patient, as well as issues regarding how to deal with the patient from the aspect of disease and the psycho-socio-spiritual area.

  17. A systematic review of patient acceptance of consumer health information technology.

    Science.gov (United States)

    Or, Calvin K L; Karsh, Ben-Tzion

    2009-01-01

    A systematic literature review was performed to identify variables promoting consumer health information technology (CHIT) acceptance among patients. The electronic bibliographic databases Web of Science, Business Source Elite, CINAHL, Communication and Mass Media Complete, MEDLINE, PsycArticles, and PsycInfo were searched. A cited reference search of articles meeting the inclusion criteria was also conducted to reduce misses. Fifty-two articles met the selection criteria. Among them, 94 different variables were tested for associations with acceptance. Most of those tested (71%) were patient factors, including sociodemographic characteristics, health- and treatment-related variables, and prior experience or exposure to computer/health technology. Only ten variables were related to human-technology interaction; 16 were organizational factors; and one was related to the environment. In total, 62 (66%) were found to predict acceptance in at least one study. Existing literature focused largely on patient-related factors. No studies examined the impact of social and task factors on acceptance, and few tested the effects of organizational or environmental factors on acceptance. Future research guided by technology acceptance theories should fill those gaps to improve our understanding of patient CHIT acceptance, which in turn could lead to better CHIT design and implementation.

  18. Patients' Acceptance of Smartphone Health Technology for Chronic Disease Management: A Theoretical Model and Empirical Test.

    Science.gov (United States)

    Dou, Kaili; Yu, Ping; Deng, Ning; Liu, Fang; Guan, YingPing; Li, Zhenye; Ji, Yumeng; Du, Ningkai; Lu, Xudong; Duan, Huilong

    2017-12-06

    Chronic disease patients often face multiple challenges from difficult comorbidities. Smartphone health technology can be used to help them manage their conditions only if they accept and use the technology. The aim of this study was to develop and test a theoretical model to predict and explain the factors influencing patients' acceptance of smartphone health technology for chronic disease management. Multiple theories and factors that may influence patients' acceptance of smartphone health technology have been reviewed. A hybrid theoretical model was built based on the technology acceptance model, dual-factor model, health belief model, and the factors identified from interviews that might influence patients' acceptance of smartphone health technology for chronic disease management. Data were collected from patient questionnaire surveys and computer log records about 157 hypertensive patients' actual use of a smartphone health app. The partial least square method was used to test the theoretical model. The model accounted for .412 of the variance in patients' intention to adopt the smartphone health technology. Intention to use accounted for .111 of the variance in actual use and had a significant weak relationship with the latter. Perceived ease of use was affected by patients' smartphone usage experience, relationship with doctor, and self-efficacy. Although without a significant effect on intention to use, perceived ease of use had a significant positive influence on perceived usefulness. Relationship with doctor and perceived health threat had significant positive effects on perceived usefulness, countering the negative influence of resistance to change. Perceived usefulness, perceived health threat, and resistance to change significantly predicted patients' intentions to use the technology. Age and gender had no significant influence on patients' acceptance of smartphone technology. The study also confirmed the positive relationship between intention to use

  19. Phenylketonuria patients' and their parents' acceptance of the disease: multi-centre study.

    Science.gov (United States)

    Witalis, Ewa; Mikoluc, Bożena; Motkowski, Radoslaw; Szyszko, Justyna; Chrobot, Agnieszka; Didycz, Bozena; Lange, Agata; Mozrzymas, Renata; Milanowski, Andrzej; Nowacka, Maria; Piotrowska-Depta, Mariola; Romanowska, Hanna; Starostecka, Ewa; Wierzba, Jolanta; Skorniewska, Magdalena; Wojcicka-Bartlomiejczyk, Barbara Iwona; Gizewska, Maria

    2016-11-01

    Phenylketonuria (PKU) still poses a therapeutic challenge for patients and medical professionals. The aim of the study was to assess both patients' and their parents' acceptance of the disease. The study included 218 PKU patients and 178 parents of PKU children who were enrolled in the study on the basis of questionnaire data. Regarding attitude towards the disease, our study demonstrated that 63 (28.9 %) PKU patients did not accept the disease. Patients who found accepting the disease difficult, more frequently perceived themselves as inferior/different in comparison with their peers. In total, 36 % of patients did not want their friends to be aware of their condition, while only 18 % of parents believed that their children's peers should not know about their disease. In total, 42 % of parents wanted to talk to other parents of PKU children and only 13 % to a doctor. Only 20 % of patients saw the need to discuss their condition with a doctor. In total, 8 % of children, regardless of age, and 14 % of parents preferred to talk to a psychologist. Our data demonstrated that disease acceptance played an essential role in patients' social integration. The study also indicated the need to overcome communication barriers between patients and their healthy peers and for patients to find the courage to be open about the disease. The importance of support groups for PKU families and the significance of strict cooperation between patients and their families with PKU treatment teams were also revealed.

  20. Impact of an acceptance facilitating intervention on diabetes patients' acceptance of Internet-based interventions for depression: a randomized controlled trial.

    Science.gov (United States)

    Baumeister, H; Nowoczin, L; Lin, J; Seifferth, H; Seufert, J; Laubner, K; Ebert, D D

    2014-07-01

    To (1) determine diabetes patients' acceptance of Internet-based interventions (IBIs) for depression, to (2) examine the effectiveness of an acceptance facilitating intervention (AFI) and to (3) explore subgroup specific effects. 141 diabetes patients from two inpatient rehabilitation units and one outpatient clinic in Germany were randomly allocated to an intervention (IG) and a no-intervention control group (CG). The IG received an AFI consisting of a personal information session before filling-out a questionnaire on patients' acceptance of IBIs, predictors of acceptance (performance expectancy, effort expectancy, social influence, facilitating conditions, and Internet anxiety) as well as sociodemographic, depression-related and diabetes-related variables. The CG filled out the questionnaire immediately. Patients' acceptance of IBIs was measured with a four-item scale (sum-score ranging from 4 to 20). The CG showed a low (50.7%) to medium (40.8%) acceptance with only 8.5% of all diabetes patients reporting a high acceptance of IBIs for depression. The AFI had no significant effect on acceptance (IG: M=10.55, SD=4.69, n=70; KG: M=9.65, SD=4.27, n=71; d=0.20 [95%-CI: -0.13;0.53]) and the predictors of acceptance. Yet, subgroup analyses yielded a trend for depressed, diabetes-related distressed, female and younger (Internet to profit from the AFI. Diabetes patients show a rather low acceptance toward IBIs for depression. Findings indicate that the AFI is likely to be effective in the subgroup of depressed, diabetes-related distressed, female or younger diabetes patients, but not in the whole target population. Hence, AFIs might need to be tailored to the specific needs of subpopulations. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  1. The acceptability of waiting times for elective general surgery and the appropriateness of prioritising patients

    Directory of Open Access Journals (Sweden)

    Knol Dirk L

    2007-02-01

    Full Text Available Abstract Background Problematic waiting lists in public health care threaten the equity and timeliness of care provision in several countries. This study assesses different stakeholders' views on the acceptability of waiting lists in health care, their preferences for priority care of patients, and their judgements on acceptable waiting times for surgical patients. Methods A questionnaire survey was conducted among 257 former patients (82 with varicose veins, 86 with inguinal hernia, and 89 with gallstones, 101 surgeons, 95 occupational physicians, and 65 GPs. Judgements on acceptable waiting times were assessed using vignettes of patients with varicose veins, inguinal hernia, and gallstones. Results Participants endorsed the prioritisation of patients based on clinical need, but not on ability to benefit. The groups had significantly different opinions (p Acceptable waiting times ranged between 2 and 25 weeks depending on the type of disorder (p Conclusion The explicit prioritisation of patients seems an accepted means for reducing the overall burden from waiting lists. The disagreement about appropriate prioritisation criteria and the need for uniformity, however, raises concern about equity when implementing prioritisation in daily practice. Single factor waiting time thresholds seem insufficient for securing timely care provision in the presence of long waiting lists as they do not account for the different consequences of waiting between patients.

  2. Conventional Vs Digital Impressions: Acceptability, Treatment Comfort and Stress Among Young Orthodontic Patients.

    Science.gov (United States)

    Mangano, Alessandro; Beretta, Matteo; Luongo, Giuseppe; Mangano, Carlo; Mangano, Francesco

    2018-01-01

    The objective of the present study was to compare patients' acceptability, comfort and stress with conventional and digital impressions. Thirty young orthodontic patients (15 males and 15 females) who had no previous experience of impressions were enrolled in this study. Conventional impressions for orthodontic study models of the dental arches were taken using an alginate impression material (Hydrogum ® , Zhermack Spa, Badia Polesine, Rovigo, Italy). Fifteen days later, digital impressions of both arches were acquired using an intraoral scanner (CS3600 ® , Carestream Dental, Rochester, NY, USA). Immediately after impression taking, patients' acceptability, comfort and stress were measured using two questionnaires and the State anxiety scale. Data showed no difference in terms of anxiety and stress; however, patients preferred the use of digital impressions systems instead of conventional impression techniques. Alginate impressions resulted as fast as digital impressions. Digital impressions resulted the most accepted and comfortable impression technique in young orthodontic patients, when compared to conventional techniques.

  3. Accepting or declining non-invasive ventilation or gastrostomy in amyotrophic lateral sclerosis: patients' perspectives.

    Science.gov (United States)

    Greenaway, L P; Martin, N H; Lawrence, V; Janssen, A; Al-Chalabi, A; Leigh, P N; Goldstein, L H

    2015-01-01

    The objective was to identify factors associated with decisions made by patients with amyotrophic lateral sclerosis (ALS) to accept or decline non-invasive ventilation (NIV) and/or gastrostomy in a prospective population-based study. Twenty-one people with ALS, recruited from the South-East ALS Register who made an intervention decision during the study timeframe underwent a face-to-face in-depth interview, with or without their informal caregiver present. Sixteen had accepted an intervention (11 accepted gastrostomy, four accepted NIV and one accepted both interventions). Five patients had declined gastrostomy. Thematic analysis revealed three main themes: (1) patient-centric factors (including perceptions of control, acceptance and need, and aspects of fear); (2) external factors (including roles played by healthcare professionals, family, and information provision); and (3) the concept of time (including living in the moment and the notion of 'right thing, right time'). Many aspects of these factors were inter-related. Decision-making processes for the patients were found to be complex and multifaceted and reinforce arguments for individualised (rather than 'algorithm-based') approaches to facilitating decision-making by people with ALS who require palliative interventions.

  4. Time perception and illness acceptance among remitting-relapsing multiple sclerosis patients under treatment.

    Science.gov (United States)

    Król, Joanna; Szcześniak, Małgorzata; Koziarska, Dorota; Rzepa, Teresa

    2015-01-01

    The aim of the study was to determine temporal orientation in patients diagnosed with RR-MS as compared with that of healthy individuals; to analyse self-evaluated acceptance levels in terms of physical and psychological condition and self-reliance; an attempt to identify factors of illness acceptance in patients with RR-MS including temporal perspective. Acceptance of Illness Scale (AIS, adapted into Polish by Z. Juczyński), Zimbardo Time Perspective Inventory (ZTPI, adapted into Polish by M. Mażewski), and original interview aimed to assess socio-demographic data and self-evaluated physical as well as psychological condition and self-reliance of patients with MS (referred to the neurological testing according to the EDSS). Patients with RR-MS focus on fatalistic and hedonistic present more than healthy individuals. They also tend to reflect on their negative past experience. Acceptance of illness correlated positively with subjective assessment of physical and psychological condition as well as self-reliance, and negatively with objective disability score (measured with the use of EDSS) and a factor considering time of disease duration. Avoiding contemplation of negative past and concentrating on hedonistic future constitute significant predictors of illness acceptance. These results may be of importance in terms of holistic approach to treatment of RR-MS patients. In the initial stage of the disease progression, patients might benefit from psychological support due to change in temporal orientation.

  5. Emotional and rational disease acceptance in patients with depression and alcohol addiction

    Directory of Open Access Journals (Sweden)

    Matthiessen Peter F

    2008-01-01

    Full Text Available Abstract Background The concept of a rational respectively emotional acceptance of disease is highly valued in the treatment of patients with depression or addiction. Due to the importance of this concept for the long-term course of disease, there is a strong interest to develop a tool to identify the levels and factors of acceptance. We thus intended to test an instrument designed to assess the level of positive psychological wellbeing and coping, particularly emotional disease acceptance and life satisfaction Methods In an anonymous cross-sectional survey enrolling 115 patients (51% female, 49% male; mean age 47.6 ± 10.0 years with depression and/or alcohol addiction, the ERDA questionnaire was tested. Results Factor analysis of the 29-item construct (Cronbach's alpha = 0.933 revealed a 4-factor solution, which explained 59.4% of variance: (1 Positive Life Construction, Contentedness and Well-Being; (2 Conscious Dealing with Illness; (3 Rejection of an Irrational Dealing with Disease; (4 Disease Acceptance. Two factors could be ascribed to a rational, and two to an emotional acceptance. All factors correlated negatively with Depression and Escape, while several aspects of Life Satisfaction" (i.e. myself, overall life, where I live, and future prospects correlated positively. The highest factor scores were found for the rational acceptance styles (i.e. Conscious Dealing with Illness; Disease Acceptance. Emotional acceptance styles were not valued in a state of depression. Escape from illness was the strongest predictor for several acceptance aspects, while life satisfaction was the most relevant predictor for "Positive Life Construction, Contentedness and Well-Being". Conclusion The ERDA questionnaire was found to be a reliable and valid assessment of disease acceptance strategies in patients with depressive disorders and drug abuses. The results indicate the preferential use of rational acceptance styles even in depression. Disease acceptance

  6. Emotional and rational disease acceptance in patients with depression and alcohol addiction.

    Science.gov (United States)

    Büssing, Arndt; Matthiessen, Peter F; Mundle, Götz

    2008-01-21

    The concept of a rational respectively emotional acceptance of disease is highly valued in the treatment of patients with depression or addiction. Due to the importance of this concept for the long-term course of disease, there is a strong interest to develop a tool to identify the levels and factors of acceptance. We thus intended to test an instrument designed to assess the level of positive psychological wellbeing and coping, particularly emotional disease acceptance and life satisfaction In an anonymous cross-sectional survey enrolling 115 patients (51% female, 49% male; mean age 47.6 +/- 10.0 years) with depression and/or alcohol addiction, the ERDA questionnaire was tested. Factor analysis of the 29-item construct (Cronbach's alpha = 0.933) revealed a 4-factor solution, which explained 59.4% of variance: (1) Positive Life Construction, Contentedness and Well-Being; (2) Conscious Dealing with Illness; (3) Rejection of an Irrational Dealing with Disease; (4) Disease Acceptance. Two factors could be ascribed to a rational, and two to an emotional acceptance. All factors correlated negatively with Depression and Escape, while several aspects of Life Satisfaction" (i.e. myself, overall life, where I live, and future prospects) correlated positively. The highest factor scores were found for the rational acceptance styles (i.e. Conscious Dealing with Illness; Disease Acceptance). Emotional acceptance styles were not valued in a state of depression. Escape from illness was the strongest predictor for several acceptance aspects, while life satisfaction was the most relevant predictor for "Positive Life Construction, Contentedness and Well-Being". The ERDA questionnaire was found to be a reliable and valid assessment of disease acceptance strategies in patients with depressive disorders and drug abuses. The results indicate the preferential use of rational acceptance styles even in depression. Disease acceptance should not be regarded as a coping style with an attitude

  7. Acceptability Study of "Ascenso": An Online Program for Monitoring and Supporting Patients with Depression in Chile.

    Science.gov (United States)

    Espinosa, H Daniel; Carrasco, Álvaro; Moessner, Markus; Cáceres, Cristian; Gloger, Sergio; Rojas, Graciela; Perez, J Carola; Vanegas, Jorge; Bauer, Stephanie; Krause, Mariane

    2016-07-01

    Major depression is a highly prevalent and severe mental disease. Despite the effective treatment options available, the risk of relapse is high. Interventions based on information and communication technologies generate innovative opportunities to provide support to patients after they completed treatment for depression. This acceptability study evaluated the Internet-based program Apoyo, Seguimiento y Cuidado de Enfermedades a partir de Sistemas Operativos (ASCENSO) in terms of its feasibility and acceptability in a sample of 35 patients in Chile. The study reveals high rates of acceptance and satisfaction among patients who actively used the program. As obstacles, patients mentioned technical problems, a lack of contact with other participants, and an insufficient connection between the program and the health service professionals. ASCENSO appears to be a promising complement to regular care for depression. Following improvements of the program based on participants' feedback, future research should evaluate its efficacy and cost-effectiveness.

  8. Understanding patient acceptance and refusal of HIV testing in the emergency department

    Directory of Open Access Journals (Sweden)

    Christopoulos Katerina A

    2012-01-01

    Full Text Available ABSTRACT Background Despite high rates of patient satisfaction with emergency department (ED HIV testing, acceptance varies widely. It is thought that patients who decline may be at higher risk for HIV infection, thus we sought to better understand patient acceptance and refusal of ED HIV testing. Methods In-depth interviews with fifty ED patients (28 accepters and 22 decliners of HIV testing in three ED HIV testing programs that serve vulnerable urban populations in northern California. Results Many factors influenced the decision to accept ED HIV testing, including curiosity, reassurance of negative status, convenience, and opportunity. Similarly, a number of factors influenced the decision to decline HIV testing, including having been tested recently, the perception of being at low risk for HIV infection due to monogamy, abstinence or condom use, and wanting to focus on the medical reason for the ED visit. Both accepters and decliners viewed ED HIV testing favorably and nearly all participants felt comfortable with the testing experience, including the absence of counseling. While many participants who declined an ED HIV test had logical reasons, some participants also made clear that they would prefer not to know their HIV status rather than face psychosocial consequences such as loss of trust in a relationship or disclosure of status in hospital or public health records. Conclusions Testing for HIV in the ED as for any other health problem reduces barriers to testing for some but not all patients. Patients who decline ED HIV testing may have rational reasons, but there are some patients who avoid HIV testing because of psychosocial ramifications. While ED HIV testing is generally acceptable, more targeted approaches to testing are necessary for this subgroup.

  9. Identifying barriers to patient acceptance of active surveillance: content analysis of online patient communications.

    Science.gov (United States)

    Mishra, Mark V; Bennett, Michele; Vincent, Armon; Lee, Olivia T; Lallas, Costas D; Trabulsi, Edouard J; Gomella, Leonard G; Dicker, Adam P; Showalter, Timothy N

    2013-01-01

    Qualitative research aimed at identifying patient acceptance of active surveillance (AS) has been identified as a public health research priority. The primary objective of this study was to determine if analysis of a large-sample of anonymous internet conversations (ICs) could be utilized to identify unmet public needs regarding AS. English-language ICs regarding prostate cancer (PC) treatment with AS from 2002-12 were identified using a novel internet search methodology. Web spiders were developed to mine, aggregate, and analyze content from the world-wide-web for ICs centered on AS. Collection of ICs was not restricted to any specific geographic region of origin. NLP was used to evaluate content and perform a sentiment analysis. Conversations were scored as positive, negative, or neutral. A sentiment index (SI) was subsequently calculated according to the following formula to compare temporal trends in public sentiment towards AS: [(# Positive IC/#Total IC)-(#Negative IC/#Total IC) x 100]. A total of 464 ICs were identified. Sentiment increased from -13 to +2 over the study period. The increase sentiment has been driven by increased patient emphasis on quality-of-life factors and endorsement of AS by national medical organizations. Unmet needs identified in these ICs include: a gap between quantitative data regarding long-term outcomes with AS vs. conventional treatments, desire for treatment information from an unbiased specialist, and absence of public role models managed with AS. This study demonstrates the potential utility of online patient communications to provide insight into patient preferences and decision-making. Based on our findings, we recommend that multidisciplinary clinics consider including an unbiased specialist to present treatment options and that future decision tools for AS include quantitative data regarding outcomes after AS.

  10. Pain acceptance and opiate use disorders in addiction treatment patients with comorbid pain.

    Science.gov (United States)

    Lin, Lewei Allison; Bohnert, Amy S B; Price, Amanda M; Jannausch, Mary; Bonar, Erin E; Ilgen, Mark A

    2015-12-01

    Studies from pain treatment settings indicate that poor acceptance of pain may be an important and modifiable risk factor for higher severity of opioid use. However, the degree to which pain acceptance relates to opioid use severity in the addiction treatment population is unknown. In this study of addiction treatment patients with co-morbid pain, we examined correlates of severity of opiate (heroin and prescription opioid) use, with a particular focus on the role of pain acceptance. Patients in residential addiction treatment with comorbid pain (N=501) were stratified into low, moderate and high severity of opiate use. Demographic and clinical characteristics were compared across opiate severity categories. 72% (N=360) of the participants had symptoms that were consistent with an opiate use disorder. Younger age, Caucasian race, female gender, cocaine use and lower pain acceptance were associated with higher severity of opiate use, whereas pain intensity was not. Controlling for demographic and other risk factors, such as substance use and pain intensity, higher pain acceptance was associated with lower odds of severe prescription opioid (AOR 0.50, 95% CI 0.38-0.68 for a one SD increase in pain acceptance) and heroin use (AOR 0.57, 95% CI 0.44-0.75 for a one SD increase in pain acceptance). Problematic opiate use is common in addictions treatment patients with chronic pain. Lower pain acceptance is related to greater opiate use severity, and may be an important modifiable target for interventions to successfully treat both pain and opiate use disorders. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  11. Financial incentive increases CPAP acceptance in patients from low socioeconomic background.

    Science.gov (United States)

    Tarasiuk, Ariel; Reznor, Gally; Greenberg-Dotan, Sari; Reuveni, Haim

    2012-01-01

    We explored whether financial incentives have a role in patients' decisions to accept (purchase) a continuous positive airway pressure (CPAP) device in a healthcare system that requires cost sharing. Longitudinal interventional study. The group receiving financial incentive (n = 137, 50.8±10.6 years, apnea/hypopnea index (AHI) 38.7±19.9 events/hr) and the control group (n = 121, 50.9±10.3 years, AHI 39.9±22) underwent attendant titration and a two-week adaptation to CPAP. Patients in the control group had a co-payment of $330-660; the financial incentive group paid a subsidized price of $55. CPAP acceptance was 43% greater (p = 0.02) in the financial incentive group. CPAP acceptance among the low socioeconomic strata (n = 113) (adjusting for age, gender, BMI, tobacco smoking) was enhanced by financial incentive (OR, 95% CI) (3.43, 1.09-10.85), age (1.1, 1.03-1.17), AHI (>30 vs. acceptance was affected by AHI (>30 vs. 30 vs. acceptance among low socioeconomic status patients. Thus, financial incentive should be applied as a policy to encourage CPAP treatment, especially among low socioeconomic strata patients.

  12. Patient acceptance of MR colonography with improved fecal tagging versus conventional colonoscopy

    International Nuclear Information System (INIS)

    Achiam, M.P.; Logager, V.; Chabanova, E.; Thomsen, H.S.; Rosenberg, J.

    2010-01-01

    Objective: Conventional colonoscopy (CC) is the gold standard for colonic examinations. However, patient acceptance is not high. Patient acceptance is influenced by several factors, notably anticipation and experience. This has led to the assumption that patient acceptance would be higher in non-invasive examinations such as MR/CT colonography (MRC/CTC) and perhaps even higher without bowel preparation. The purpose of this study was to evaluate patient acceptance of MRC with fecal tagging versus CC. Materials and methods: In a 14-month period, all patients first-time referred to our department for CC were asked to participate in the study. Two days prior to MRC, patients ingested an oral contrast mixture (barium/ferumoxsil) together with four meals each day. Standard bowel purgation was performed before CC. Before and after MRC and CC a number of questions were addressed. Results: Sixty-four (34 men, 30 women) patients referred for CC participated in the study. 27% had some discomfort ingesting the contrast mixture, and 49% had some discomfort with the bowel purgation. As a future colonic examination preference, 71% preferred MRC, 13% preferred CC and 15% had no preference. If MRC was to be performed with bowel purgation, 75% would prefer MRC, 12% would prefer CC and 12% had no preference. Conclusion: This study shows that there is a potential gain in patient acceptance by using MRC for colonic examination, since MRC is considered less painful and less unpleasant than CC. In addition, the results indicate that patients in this study prefer fecal tagging instead of bowel purgation.

  13. Acceptance of illness and satisfaction with life among malaria patients in rivers state, Nigeria.

    Science.gov (United States)

    Van Damme-Ostapowicz, Katarzyna; Krajewska-Kułak, Elżbieta; Nwosu, Paul J C; Kułak, Wojciech; Sobolewski, Marek; Olszański, Romuald

    2014-05-03

    Health condition is one of the basic factors affecting satisfaction with life, and the level of illness acceptance. The purpose of the study was to analyse the level of illness acceptance, the level of satisfaction with life among malaria patients, and the level of trust placed in the physician and the nurse. The study employs the method of diagnostic survey based on standardised AIS and SWLS scales, as well as Anderson and Dedrick's PPTS and PNTS scales. The average AIS level was 12 points, while the average level of SwL at the SWLS scale was 16.5 points. The average level of trust in the physician and the nurse amounted to 50.6 points and 51.4 points, respectively. The correlation between the level of illness acceptance and self-evaluated satisfaction with life was statistically significant, with R = 0.56. The marital status influenced the level of illness acceptance with p satisfaction with life with p employment status affected the level of satisfaction with life with p satisfaction with life was low. The majority of respondents trusted their physician and nurse. There is a statistically significant correlation between the level of illness acceptance and the self-evaluated satisfaction with life. The marital status had a statistically significant effect on the acceptance of illness and the satisfaction with life. The individuals who had a job demonstrated higher levels of quality of life and illness acceptance.

  14. Electronic adherence monitoring device performance and patient acceptability: a randomized control trial.

    Science.gov (United States)

    Chan, Amy Hai Yan; Stewart, Alistair William; Harrison, Jeff; Black, Peter Nigel; Mitchell, Edwin Arthur; Foster, Juliet Michelle

    2017-05-01

    To investigate the performance and patient acceptability of an inhaler electronic monitoring device in a real-world childhood asthma population. Children 6 to 15 years presenting with asthma to the hospital emergency department and prescribed inhaled corticosteroids were included. Participants were randomized to receive a device with reminder features enabled or disabled for use with their preventer. Device quality control tests were conducted. Questionnaires on device acceptability, utility and ergonomics were completed at six months. A total of 1306 quality control tests were conducted; 84% passed pre-issue and 87% return testing. The most common failure reason was actuation under-recording. Acceptability scores were high, with higher scores in the reminder than non-reminder group (median, 5 th -95 th percentile: 4.1, 3.1-5.0 versus 3.7, 2.3-4.8; p 90%) rated the device easy to use. Feedback was positive across five themes: device acceptability, ringtone acceptability, suggestions for improvement, effect on medication use, and effect on asthma control. This study investigates electronic monitoring device performance and acceptability in children using quantitative and qualitative measures. Results indicate satisfactory reliability, although failure rates of 13-16% indicate the importance of quality control. Favorable acceptability ratings support the use of these devices in children.

  15. Acceptability and confidence in antiretroviral generics of physicians and HIV-infected patients in France.

    Science.gov (United States)

    Allavena, Clotilde; Jacomet, Christine; Pereira, Bruno; Morand-Joubert, Laurence; Bagheri, Haleh; Cotte, Laurent; Garaffo, Rodolphe; Gerbaud, Laurent; Dellamonica, Pierre

    2014-01-01

    Switching brand name medications to generics is recommended in France in the interest of cost effectiveness but patients and physicians are sometimes not convinced that switching is appropriate. Some antiretroviral (ARV) generics (ZDV, 3TC, NVP) have been marketed in France since 2013. A multicentric cross-sectional survey was performed in September 2013 to evaluate the perception of generics overall and ARV generics in physicians and HIV-infected patients and factors associated to their acceptability. Adult HIV outpatients were asked to complete a self-questionnaire on their perception of generics. Physicians completed a questionnaire on the acceptability of generics and ARV generics. Socio-demographic data, medical history and HIV history were collected. 116 physicians in 33 clinics (68% in University Hospital) included 556 patients (France-native 77%, active employment 59%, covered by social Insurance 100%, homosexual/bisexual contamination 47%, median HIV duration 13 years, hepatitis coinfection 16%, on ARV therapy 95%). Overall, patients accepted and had confidence in generics in 76% and 55% of the cases, respectively. Switching ARVs for generics was accepted by 44% of the patients but only by 17% if the pill burden was going to increase. 75% of the physicians would prescribe generics, but this decreased to only 26% if the combo had to be broken. The main reasons for non-prescription of generics were previous brand name ARV-induced side effects (35%), refusal of generics overall (37%), lack of understanding of generics (26%), risk of non-observance of treatment (44%), anxiety (47%) and depressive symptoms (25%). In multivariate analysis, factors associated with the acceptability of ARV generics in patients were the use of generics overall (p<0.001) and in physicians, the absence of concern regarding the drug efficacy (p<0.001) and being aware that the patient would accept generics overall (p=0.03) and ARV generics (p=0.04). No factors related to

  16. A Randomized Controlled Trial of a Mindfulness and Acceptance Group Therapy for Residential Substance Use Patients.

    Science.gov (United States)

    Shorey, Ryan C; Elmquist, Joanna; Gawrysiak, Michael J; Strauss, Catherine; Haynes, Ellen; Anderson, Scott; Stuart, Gregory L

    2017-09-19

    Substance use disorders are understood as a chronically relapsing condition that is difficult to treat. However, in recent years there have been promising developments in the treatment of substance use disorders, specifically with interventions based on mindfulness and acceptance and commitment therapy. Little research has examined whether these types of interventions may positively impact residential substance use treatment outcomes. Thus, in the current study we developed and examined, in a randomized controlled trial, a 4-week, eight-session, adjunctive mindfulness and acceptance group therapy for patients in residential substance use treatment. Our primary outcomes were substance use cravings, psychological flexibility, and dispositional mindfulness at treatment discharge. Patients (N = 117) from a private residential substance use facility were randomized to receive the adjunctive mindfulness and acceptance group or treatment-as-usual. Patients were assessed at treatment intake and at discharge from a 28-30-day residential program. Although treatment groups did not statistically differ at discharge on any primary outcome, small effect sizes favored the mindfulness and acceptance group on cravings and psychological flexibility. Conclusions/Importance: Continued research is needed to determine whether the addition of mindfulness and acceptance-based interventions improve outcomes long term following residential substance use treatment.

  17. Financial incentive increases CPAP acceptance in patients from low socioeconomic background.

    Directory of Open Access Journals (Sweden)

    Ariel Tarasiuk

    Full Text Available OBJECTIVE: We explored whether financial incentives have a role in patients' decisions to accept (purchase a continuous positive airway pressure (CPAP device in a healthcare system that requires cost sharing. DESIGN: Longitudinal interventional study. PATIENTS: The group receiving financial incentive (n = 137, 50.8±10.6 years, apnea/hypopnea index (AHI 38.7±19.9 events/hr and the control group (n = 121, 50.9±10.3 years, AHI 39.9±22 underwent attendant titration and a two-week adaptation to CPAP. Patients in the control group had a co-payment of $330-660; the financial incentive group paid a subsidized price of $55. RESULTS: CPAP acceptance was 43% greater (p = 0.02 in the financial incentive group. CPAP acceptance among the low socioeconomic strata (n = 113 (adjusting for age, gender, BMI, tobacco smoking was enhanced by financial incentive (OR, 95% CI (3.43, 1.09-10.85, age (1.1, 1.03-1.17, AHI (>30 vs. 30 vs. 30 vs. <30 (5.25, 1.34-18.5. CONCLUSIONS: Minimizing cost sharing reduces a barrier for CPAP acceptance among low socioeconomic status patients. Thus, financial incentive should be applied as a policy to encourage CPAP treatment, especially among low socioeconomic strata patients.

  18. Analysis of the factors motivating HCV-infected patients to accept interferon therapy

    Directory of Open Access Journals (Sweden)

    Nagao Yumiko

    2012-08-01

    Full Text Available Abstract Background The aims of this study were to analyze factors motivating the acceptance of interferon (IFN therapy and to clarify the prevalence of oral mucosal diseases in hepatitis C virus (HCV-infected Japanese patients treated with IFN. Findings A total of 94 HCV-infected patients who were admitted to our hospital for IFN therapy were asked questions regarding their motivation to accept IFN therapy and were investigated for the presence of oral lichen planus (OLP before and during IFN treatment. Recommendation and encouragement from other people were the most common factors motivating the acceptance of IFN therapy (49/94, 52.13%. The other motivators were independent decision (30.85%, economic reasons (5.32%, and others. According to multivariate analysis, three factors – sex (male, retreatment after previous IFN therapy, and independent decision to accept IFN therapy - were associated with patients after curative treatment of hepatocellular carcinoma (HCC. The adjusted odds ratios for these three factors were 26.06, 14.17, and 8.72, respectively. The most common oral mucosal lesions included OLP in 11 cases (11.70%. One patient with OLP had postoperative squamous cell carcinoma of the tongue. The rate of sustained virological response (SVR was 45.45% in cases with OLP and 54.55% in cases without OLP. There were no patients who discontinued IFN therapy because of side effects such as oral mucosal diseases. Conclusions We should give full explanation and recommend a course of treatment for a patient to accept IFN therapy. The system to support liver disease as well as oral diseases is also necessary for patient treated for IFN therapy.

  19. Characteristics of patients with diabetes who accept referrals for care management services

    Directory of Open Access Journals (Sweden)

    Bree Holtz

    2016-01-01

    Full Text Available Introduction: Patients with chronic conditions can improve their health through participation in self-care programs. However, awareness of and enrollment in these programs are generally low. Objective: We sought to identify factors influencing patients’ receptiveness to a referral for programs and services supporting chronic disease management. Methods: We analyzed data from 541 high-risk diabetic patients who completed an assessment between 2010 and 2013 from a computer-based, nurse-led Navigator referral program within a large primary care clinic. We compared patients who accepted a referral to those who declined. Results: A total of 318 patients (75% accepted 583 referrals, of which 52% were for self-care programs. Patients who accepted a referral had more primary care visits in the previous year, were more likely to be enrolled in another program, expressed more interest in using the phone and family or friends for support, and were more likely to report recent pain than those who declined a referral. Discussion: Understanding what factors influence patients’ decisions to consider and participate in self-care programs has important implications for program design and development of strategies to connect patients to programs. This work informs outreach efforts to identify and engage patients who are likely to benefit from self-care activities.

  20. Automated Remote Monitoring of Depression: Acceptance Among Low-Income Patients in Diabetes Disease Management.

    Science.gov (United States)

    Ramirez, Magaly; Wu, Shinyi; Jin, Haomiao; Ell, Kathleen; Gross-Schulman, Sandra; Myerchin Sklaroff, Laura; Guterman, Jeffrey

    2016-01-25

    Remote patient monitoring is increasingly integrated into health care delivery to expand access and increase effectiveness. Automation can add efficiency to remote monitoring, but patient acceptance of automated tools is critical for success. From 2010 to 2013, the Diabetes-Depression Care-management Adoption Trial (DCAT)-a quasi-experimental comparative effectiveness research trial aimed at accelerating the adoption of collaborative depression care in a safety-net health care system-tested a fully automated telephonic assessment (ATA) depression monitoring system serving low-income patients with diabetes. The aim of this study was to determine patient acceptance of ATA calls over time, and to identify factors predicting long-term patient acceptance of ATA calls. We conducted two analyses using data from the DCAT technology-facilitated care arm, in which for 12 months the ATA system periodically assessed depression symptoms, monitored treatment adherence, prompted self-care behaviors, and inquired about patients' needs for provider contact. Patients received assessments at 6, 12, and 18 months using Likert-scale measures of willingness to use ATA calls, preferred mode of reach, perceived ease of use, usefulness, nonintrusiveness, privacy/security, and long-term usefulness. For the first analysis (patient acceptance over time), we computed descriptive statistics of these measures. In the second analysis (predictive factors), we collapsed patients into two groups: those reporting "high" versus "low" willingness to use ATA calls. To compare them, we used independent t tests for continuous variables and Pearson chi-square tests for categorical variables. Next, we jointly entered independent factors found to be significantly associated with 18-month willingness to use ATA calls at the univariate level into a logistic regression model with backward selection to identify predictive factors. We performed a final logistic regression model with the identified significant

  1. Acceptance of disease and the quality of life in patients with enteric stoma.

    Science.gov (United States)

    Szpilewska, Katarzyna; Juzwiszyn, Jan; Bolanowska, Zofia; Bolanowska, Zofia; Milan, Magdalena; Chabowski, Mariusz; Janczak, Dariusz

    2018-02-28

    The main reason of the emergence of enteric stoma is colorectal cancer. Enteric stoma is a serious health, as well as life problem. In Poland, there are about 6,000 stoma surgeries yearly. It changes the functioning of patients, restricts their daily activity and influences their quality of life significantly. Therefore, in the modern treatment process, all spheres of human life and its surroundings are considered. The evaluation of the quality of life and the level of acceptance of the disease enables us to identify the regions in which patients require attention and help, as well as places to which health promotion among patients with a stoma should be directed. The aim of the study was the evaluation of the acceptance of the disease and the quality of life in patients with colostomy. The study conducted between February 2015 and February 2016 included101 patients with enteric stoma of the Provincial Specialist Hospital in Wrocław at Kamieńskiego St. in the departments of General Surgery with the Subdivision of Traumatology and Orthopedic Surgery, Subdivision of Metabolic Surgery, Subdivision of Endocrine Surgery and Oncological Surgery . Two anonymous questionnaires, i.e., health-related quality of life (HRQoL) and acceptance of illness scale (AIS), were used. 60% (61 people) were women, and 40% (40 people) were men. The mean age was 48; the youngest respondent was 20 years old, and the oldest was 79 years old. 17% of the respondents had primary education, 25% - vocational, 33% - secondary and 26% - university-level. The most common reason for the emergence of a stoma among the respondents was colon cancer (44%), followed by: mechanical bowel onstruction (26%), intestinal damage following injuries (25%), inflammatory bowel disease (6%). The quality of life of patients with colostomy was evaluated in view of their health condition, postoperative recovery, everyday limitations, and self-evaluation. The majority of participants pointed to the deterioration of

  2. Patient satisfaction and acceptability: a journey through an ambulatory gynaecology clinic in the West of Ireland

    LENUS (Irish Health Repository)

    Uzochukwu, I

    2016-06-01

    Ambulatory Gynaecology allows a “see-and-treat” approach to managing gynaecological conditions, providing a more streamlined, integrated care pathway than the traditional gynaecology clinic and inpatient care model. This study was designed to assess patient satisfaction and acceptability of Ambulatory Gynaecology services in Mayo University Hospital, Castlebar, Ireland. It also provided for feedback from patients as to how the service might be improved. \\r\

  3. Automated Remote Monitoring of Depression: Acceptance Among Low-Income Patients in Diabetes Disease Management

    OpenAIRE

    Ramirez, Magaly; Wu, Shinyi; Jin, Haomiao; Ell, Kathleen; Gross-Schulman, Sandra; Myerchin Sklaroff, Laura; Guterman, Jeffrey

    2016-01-01

    Background Remote patient monitoring is increasingly integrated into health care delivery to expand access and increase effectiveness. Automation can add efficiency to remote monitoring, but patient acceptance of automated tools is critical for success. From 2010 to 2013, the Diabetes-Depression Care-management Adoption Trial (DCAT)?a quasi-experimental comparative effectiveness research trial aimed at accelerating the adoption of collaborative depression care in a safety-net health care syst...

  4. The influence of tinnitus acceptance on the quality of life and psychological distress in patients with chronic tinnitus

    Directory of Open Access Journals (Sweden)

    David Riedl

    2015-01-01

    Full Text Available Recent findings show the importance of acceptance in the treatment of chronic tinnitus. So far, very limited research investigating the different levels of tinnitus acceptance has been conducted. The aim of this study was to investigate the quality of life (QoL and psychological distress in patients with chronic tinnitus who reported different levels of tinnitus acceptance. The sample consisted of outpatients taking part in a tinnitus coping group (n = 97. Correlations between tinnitus acceptance, psychological distress, and QoL were calculated. Receiver operating characteristic (ROC curves were used to calculate a cutoff score for the German "Tinnitus Acceptance Questionnaire" (CTAQ-G and to evaluate the screening abilities of the CTAQ-G. Independent sample t-tests were conducted to compare QoL and psychological distress in patients with low tinnitus acceptance and high tinnitus acceptance. A cutoff point for CTAQ-G of 62.5 was defined, differentiating between patients with "low-to-mild tinnitus acceptance" and "moderate-to-high tinnitus acceptance." Patients with higher levels of tinnitus acceptance reported a significantly higher QoL and lower psychological distress. Tinnitus acceptance plays an important role for patients with chronic tinnitus. Increased levels of acceptance are related to better QoL and less psychological distress.

  5. Use and acceptance of electronic communication by patients with multiple sclerosis: a multicenter questionnaire study.

    Science.gov (United States)

    Haase, Rocco; Schultheiss, Thorsten; Kempcke, Raimar; Thomas, Katja; Ziemssen, Tjalf

    2012-10-15

    The number of multiple sclerosis (MS) information websites, online communities, and Web-based health education programs has been increasing. However, MS patients' willingness to use new ways of communication, such as websites, mobile phone application, short message service, or email with their physician, remains unknown. We designed a questionnaire to evaluate the a priori use of electronic communication methods by MS patients and to assess their acceptance of such tools for communication with their health care providers. We received complete data from 586 MS patients aged between 17 and 73 years. Respondents were surveyed in outpatient clinics across Germany using a novel paper-and-pencil questionnaire. In addition to demographics, the survey items queried frequency of use of, familiarity with, and comfort with using computers, websites, email, and mobile phones. About 90% of all MS patients used a personal computer (534/586) and the Internet (527/586) at least once a week, 87.0% (510/586) communicated by email, and 85.6% (488/570) communicated by mobile phone. When asked about their comfort with using electronic communication methods for communication with health care providers, 20.5% (120/586) accepted communication by mobile Internet application or short message service via mobile phone, 41.0% (240/586) by websites, 54.3% (318/586) by email service, and 67.8% (397/586) by at least one type of electronic communication. The level of a priori use was the best predictor for the acceptance of electronic communication with health care providers. Patients who reported already searching online for health information (odds ratio 2.4, P higher acceptance for Web-based communication. Patients who already scheduled appointments with their mobile phones (odds ratio 2.1, P = .002) were more likely to accept the use of mobile phone applications or short message service for communicating with their physician. The majority of MS patients seen at specialist centers already use

  6. Financial Incentive Increases CPAP Acceptance in Patients from Low Socioeconomic Background

    Science.gov (United States)

    Tarasiuk, Ariel; Reznor, Gally; Greenberg-Dotan, Sari; Reuveni, Haim

    2012-01-01

    Objective We explored whether financial incentives have a role in patients′ decisions to accept (purchase) a continuous positive airway pressure (CPAP) device in a healthcare system that requires cost sharing. Design Longitudinal interventional study. Patients The group receiving financial incentive (n = 137, 50.8±10.6 years, apnea/hypopnea index (AHI) 38.7±19.9 events/hr) and the control group (n = 121, 50.9±10.3 years, AHI 39.9±22) underwent attendant titration and a two-week adaptation to CPAP. Patients in the control group had a co-payment of $330–660; the financial incentive group paid a subsidized price of $55. Results CPAP acceptance was 43% greater (p = 0.02) in the financial incentive group. CPAP acceptance among the low socioeconomic strata (n = 113) (adjusting for age, gender, BMI, tobacco smoking) was enhanced by financial incentive (OR, 95% CI) (3.43, 1.09–10.85), age (1.1, 1.03–1.17), AHI (>30 vs. CPAP (4.29, 1.05–17.51). Among average/high-income patients (n = 145) CPAP acceptance was affected by AHI (>30 vs. CPAP adherence was similar in the financial incentive and control groups, 35% and 39%, respectively (p = 0.82). Adherence rate was sensitive to education (+yr) (1.28, 1.06–1.55) and AHI (>30 vs. CPAP acceptance among low socioeconomic status patients. Thus, financial incentive should be applied as a policy to encourage CPAP treatment, especially among low socioeconomic strata patients. PMID:22479368

  7. Impact of Florida's prescription drug monitoring program and pill mill law on high-risk patients: A comparative interrupted time series analysis.

    Science.gov (United States)

    Chang, Hsien-Yen; Murimi, Irene; Faul, Mark; Rutkow, Lainie; Alexander, G Caleb

    2018-04-01

    We quantified the effects of Florida's prescription drug monitoring program and pill mill law on high-risk patients. We used QuintilesIMS LRx Lifelink data to identify patients receiving prescription opioids in Florida (intervention state, N: 1.13 million) and Georgia (control state, N: 0.54 million). The preintervention, intervention, and postintervention periods were July 2010 to June 2011, July 2011 to September 2011, and October 2011 to September 2012. We identified 3 types of high-risk patients: (1) concomitant users: patients with concomitant use of benzodiazepines and opioids; (2) chronic users: long-term, high-dose, opioid users; and (3) opioid shoppers: patients receiving opioids from multiple sources. We compared changes in opioid prescriptions between Florida and Georgia before and after policy implementation among high-risk/low-risk patients. Our monthly measures included (1) average morphine milligram equivalent per transaction, (2) total opioid volume across all prescriptions, (3) average days supplied per transaction, and (4) total number of opioid prescriptions dispensed. Among opioid-receiving individuals in Florida, 6.62% were concomitant users, 1.96% were chronic users, and 0.46% were opioid shoppers. Following policy implementation, Florida's high-risk patients experienced relative reductions in morphine milligram equivalent (opioid shoppers: -1.08 mg/month, 95% confidence interval [CI] -1.62 to -0.54), total opioid volume (chronic users: -4.58 kg/month, CI -5.41 to -3.76), and number of dispensed opioid prescriptions (concomitant users: -640 prescriptions/month, CI -950 to -340). Low-risk patients generally did not experience statistically significantly relative reductions. Compared with Georgia, Florida's prescription drug monitoring program and pill mill law were associated with large relative reductions in prescription opioid utilization among high-risk patients. Copyright © 2018 John Wiley & Sons, Ltd.

  8. Problems, acceptance and social inequality: a study of the deformed leprosy patients and their families.

    Science.gov (United States)

    Kopparty, S N

    1995-09-01

    Though the impact of social inequality on health conditions is widely known, its impact on the chronic and stigmatized disease, leprosy, has received little attention. Deformity sometimes leads to disabilities and to handicaps causing problems to the patient and his family. In this paper an attempt has been made to understand the impact of social inequality, prevalent in the form of the caste system in India on the deformed leprosy patients and on their families. This impact was examined in terms of the problems faced by the patients. A sample of 150 deformed patients and their families, drawn from two districts in Tamil Nadu, was selected for the study. About 57% of the deformed patients experienced their deformity as a handicap which caused social and economic problems while the rest did not. Of the three caste groups, the Lower Caste group experienced more severe economic problems while the Upper Caste group faced more social problems. The extent of acceptance of deformed patients in their family varied significantly among those facing and not facing problems due to their deformity. The deformed patients without any handicap were accepted in a large majority of their families (82%) regardless of their caste status. In contrast the deformed but handicapped patients were accepted differentially among the three caste groups with the Upper group accepting them in most of their families (80%) while in the Lower group much less number of families (54%) did. All the families of the deformed but not handicapped patients desired to keep their patients till their death irrespective of their caste status. On the contrary, while all the families in the Upper Caste group expressed their willingness to keep their handicapped patients in the family till their death, 10% in the Middle and 22% in the Lower Caste groups did not want to do so. This suggests the gradual marginalization, rejection and dehabilitation of the affected. Thus, one's caste status can be a broad indicator

  9. Psoriasis patients' willingness to accept side-effect risks for improved treatment efficacy.

    Science.gov (United States)

    Kauf, Teresa L; Yang, Jui-Chen; Kimball, Alexa B; Sundaram, Murali; Bao, Yanjun; Okun, Martin; Mulani, Parvez; Hauber, A Brett; Johnson, F Reed

    2015-01-01

    Previous studies suggest that efficacy is more important than side-effect risks to psoriasis patients. However, those studies did not consider potentially fatal risks of biologic treatments. To quantify the risks patients are willing to accept for improvements in psoriasis symptoms. Adults with a self-reported physician diagnosis of psoriasis were recruited through the National Psoriasis Foundation. Using a discrete-choice experiment, patients completed a series of nine choice questions, each including a pair of hypothetical treatments. Treatments were defined by severity of plaques, body surface area (BSA), and 10-year risks of tuberculosis, serious infection and lymphoma. For complete clearance of 25% BSA with mild plaques, respondents (n = 1608) were willing to accept a 20% (95% confidence interval: 9-26%) risk of serious infection, 10% (5-15%) risk of tuberculosis and 2% (1-3%) risk of lymphoma. For complete clearance of 25% BSA with severe plaques, respondents were willing to accept a 54% (48-62%) risk of serious infection, 36% (28-49%) risk of tuberculosis and 8% (7-9%) risk of lymphoma. Respondents were asked to evaluate hypothetical scenarios. Actual treatment choices may differ. Respondents were willing to accept risks above likely clinical exposures for improvements in psoriasis symptoms. Individual risk tolerances may vary.

  10. 42 CFR 484.18 - Condition of participation: Acceptance of patients, plan of care, and medical supervision.

    Science.gov (United States)

    2010-10-01

    ..., and medical supervision. Patients are accepted for treatment on the basis of a reasonable expectation that the patient's medical, nursing, and social needs can be met adequately by the agency in the... 42 Public Health 5 2010-10-01 2010-10-01 false Condition of participation: Acceptance of patients...

  11. Computer-facilitated rapid HIV testing in emergency care settings: provider and patient usability and acceptability.

    Science.gov (United States)

    Spielberg, Freya; Kurth, Ann E; Severynen, Anneleen; Hsieh, Yu-Hsiang; Moring-Parris, Daniel; Mackenzie, Sara; Rothman, Richard

    2011-06-01

    Providers in emergency care settings (ECSs) often face barriers to expanded HIV testing. We undertook formative research to understand the potential utility of a computer tool, "CARE," to facilitate rapid HIV testing in ECSs. Computer tool usability and acceptability were assessed among 35 adult patients, and provider focus groups were held, in two ECSs in Washington State and Maryland. The computer tool was usable by patients of varying computer literacy. Patients appreciated the tool's privacy and lack of judgment and their ability to reflect on HIV risks and create risk reduction plans. Staff voiced concerns regarding ECS-based HIV testing generally, including resources for follow-up of newly diagnosed people. Computer-delivered HIV testing support was acceptable and usable among low-literacy populations in two ECSs. Such tools may help circumvent some practical barriers associated with routine HIV testing in busy settings though linkages to care will still be needed.

  12. Acceptance of NCPAP in a sample of patients admitted for geriatric rehabilitation

    Directory of Open Access Journals (Sweden)

    Frohnhofen H

    2009-12-01

    Full Text Available Abstract Objective Sleep apnea syndrome (SAS is common in older people. Nasal continuous airway pressure (NCPAP therapy is the treatment of choice for sleep apnea, but is not always accepted by patients. The rate of successful initiation of NCPAP is unknown in geriatric patients. Methods All patients admitted for geriatric rehabilitation were considered for sleep studies. Sleep apnea was assessed using an Edentrace (Nellcor, Hayward, CA multi-channel recording system. SAS was defined as an apnea-hypopnea-index (AHI of more than five events per hour plus excessive daytime sleepiness, or an AHI of more than fifteen events per hour regardless of reported sleepiness. Disability was assessed using the Barthel Index of Activities of Daily Living. Results Two hundred sixty nine of 322 consecutive patients (84% had adequate sleep studies and gave informed consent. SAS was found in 169 subjects (68%. There was no gender difference in the prevalence of SAS. Six subjects (4% accepted NCPAP therapy. Individuals who accepted NCPAP were younger and less disabled (p Conclusion NCPAP should not be withheld in the elderly. However, initiation of treatment for SAS remains to be a great challenge in those patients. Geriatric assessment procedures may help better manage older subjects with sleep apnea syndrome.

  13. Patient satisfaction and acceptance of spherical equivalent spectacles correction wear in rural India.

    Science.gov (United States)

    Reddy, B Sandeep; Das, Taraprasad; Mirdha, Ghansyam S; Reddy, Nagavardhan

    2017-08-01

    The aim of this study was to explore the possibilities of acceptance of a ready-to-dispense spherical equivalent (SE) of spherocylindrical (SC) correction spectacles in rural India. Snellen visual acuity with SE power of refracted SC lenses was prospectively collected from all individuals visiting vision centers in Phase 1 (vision correction accuracy) of the study conducted in two South Indian districts. The satisfaction level was recorded by asking one standard question. The SE spectacles were dispensed in vision centers of one district in Phase 2 (SE acceptance) with a suggestion to return, if unsatisfied, for free exchange of spectacles within a month of dispensing. In Phase 1, 929 of 3529 patients were refracted and it was found that 320 patients and one eye of one patient (641 eyes) had astigmatism. The average age was 41 (±16; range: 7-84) years. There was no reduction of visual acuity in SE of 0.25 Dcyl (100% satisfaction) and progressive decrease in satisfaction to 43%, 26%, and 19% with SE correction of 0.50, 0.75, and 1.00 Dcyl, respectively. In Phase 2, 988 of 6168 patients needed refraction and 240 had astigmatism. A total of 103 patients (206 eyes) accepted SE equivalent spectacles. No client returned for the free exchange of spectacles. Dispensing SE power up to 1 Dcyl in ready - made spectacles could be considered in remote rural populations in resource-poor economic conditions.

  14. Association of ventricular arrhythmia and in-hospital mortality in stroke patients in Florida: A nonconcurrent prospective study.

    Science.gov (United States)

    Dahlin, Arielle A; Parsons, Chase C; Barengo, Noël C; Ruiz, Juan Gabriel; Ward-Peterson, Melissa; Zevallos, Juan Carlos

    2017-07-01

    Stroke remains one of the leading causes of death in the United States. Current evidence identified electrocardiographic abnormalities and cardiac arrhythmias in 50% of patients with an acute stroke. The purpose of this study was to assess whether the presence of ventricular arrhythmia (VA) in adult patients hospitalized in Florida with acute stroke increased the risk of in-hospital mortality.Secondary data analysis of 215,150 patients with ischemic and hemorrhagic stroke hospitalized in the state of Florida collected by the Florida Agency for Healthcare Administration from 2008 to 2012. The main outcome for this study was in-hospital mortality. The main exposure of this study was defined as the presence of VA. VA included the ICD-9 CM codes: paroxysmal ventricular tachycardia (427.1), ventricular fibrillation (427.41), ventricular flutter (427.42), ventricular fibrillation and flutter (427.4), and other - includes premature ventricular beats, contractions, or systoles (427.69). Differences in demographic and clinical characteristics and hospital outcomes were assessed between patients who developed versus did not develop VA during hospitalization (χ and t tests). Binary logistic regression was used to estimate unadjusted and adjusted odds ratios and 95% confidence intervals (CIs) between VA and in-hospital mortality.VA was associated with an increased risk of in-hospital mortality after adjusting for all covariates (odds ratio [OR]: 1.75; 95% CI: 1.6-1.2). There was an increased in-hospital mortality in women compared to men (OR: 1.1; 95% CI: 1.1-1.14), age greater than 85 years (OR: 3.9, 95% CI: 3.5-4.3), African Americans compared to Whites (OR: 1.1; 95% CI: 1.04-1.2), diagnosis of congestive heart failure (OR: 2.1; 95% CI: 2.0-2.3), and atrial arrhythmias (OR: 2.1, 95% CI: 2.0-2.2). Patients with hemorrhagic stroke had increased odds of in-hospital mortality (OR: 9.0; 95% CI: 8.6-9.4) compared to ischemic stroke.Identifying VAs in stroke patients may help in

  15. On the Moral Acceptability of Physician-Assisted Dying for Non-Autonomous Psychiatric Patients.

    Science.gov (United States)

    Varelius, Jukka

    2016-05-01

    Several authors have recently suggested that the suffering caused by mental illness could provide moral grounds for physician-assisted dying. Yet they typically require that psychiatric-assisted dying could come to question in the cases of autonomous, or rational, psychiatric patients only. Given that also non-autonomous psychiatric patients can sometimes suffer unbearably, this limitation appears questionable. In this article, I maintain that restricting psychiatric-assisted dying to autonomous, or rational, psychiatric patients would not be compatible with endorsing certain end-of-life practices commonly accepted in current medical ethics and law, practices often referred to as 'passive euthanasia'. © 2015 John Wiley & Sons Ltd.

  16. Acceptability of Bibliotherapy for Patients With Cancer: A Qualitative, Descriptive Study.

    Science.gov (United States)

    Roberts, Nicole; Lee, Virginia; Ananng, Bethsheba; Körner, Annett

    2016-09-01

    To determine the acceptability of a self-help workbook, Mastering the Art of Coping in Good Times and Bad, for patients with cancer.
. Descriptive, qualitative.
. Participants were recruited from the psychosocial support cancer centers of two tertiary care teaching hospitals in Montreal, Quebec, Canada.
. 18 individuals diagnosed with cancer.
. A semistructured interview guide with open-ended questions was used to gather feedback from participants about the workbook. 
. 18 participants completed the interviews from which the data emerged. Two main categories were identified from the respondents' interviews regarding the acceptability of the workbook. The first category focuses on content, whereas the other focuses on recommendations. Interviewees specified the following content as most helpful. Bibliotherapy gives patients access to knowledge to help them cope and engage in their own self-management. The workbook Mastering the Art of Coping in Good Times and Bad may be an acceptable means of helping them manage their stress. 
. Bibliotherapy is not only cost-effective and easy to administer but also an acceptable minimal intervention.

  17. Impact of educational messages on patient acceptance of male medical students in OB-GYN encounters.

    Science.gov (United States)

    Buck, Katherine; Littleton, Heather

    2016-09-01

    Although training in obstetrics and gynecology is a key part of medical education, male students receive less extensive experience, due in part to patient refusals. However, there is limited work seeking to reduce patient refusal rates of male students. The current study examined the efficacy of two messages at increasing male medical student acceptance into a well-woman visit. A total of 656 college women participated in a simulation study where they viewed a video of a nurse asking for permission to have a male medical student participate in their well-woman visit. The 30.5% of women who refused student participation (n = 181) were randomly assigned to view a video of the nurse either describing students' medical knowledge and technical skills training (e.g. training in performing pelvic exams) or empathic skills training (e.g. training in communication about sensitive issues). They were again asked if they would be willing to have the student participate. Both messages similarly increased student acceptance with 44.8% of those receiving the empathic skills training message and 48.9% of those who received the medical/technical skills training message accepting student participation, χ(2) (1, N = 181) = 0.3, p = 0.58. Educational messages about medical student training delivered in an engaging fashion by a credible source are a potentially effective tool to increase male student acceptance into sensitive patient encounters. Future work should test these messages in real-world settings as part of a focus on patient education to increase comfort with student participation.

  18. A Systematic Review of Patient Acceptance of Consumer Health Information Technology

    OpenAIRE

    Karsh, BT; Or, CKL

    2009-01-01

    A systematic literature review was performed to identify variables promoting consumer health information technology (CHIT) acceptance among patients. The electronic bibliographic databases Web of Science, Business Source Elite, CINAHL, Communication and Mass Media Complete, MEDLINE, PsycArticles, and PsycInfo were searched. A cited reference search of articles meeting the inclusion criteria was also conducted to reduce misses. Fifty-two articles met the selection criteria. Among them, 94 diff...

  19. A personalized snack-based intervention for hip fracture patients: development, feasibility and acceptability.

    Science.gov (United States)

    Price, Rosemary J G; McMurdo, Marion E T; Anderson, Annie S

    2006-04-01

    Undernutrition is common in older people admitted to hospital with hip fracture. Oral supplementation with sip feeds may be provided but compliance is a major problem. To develop a personalized snack-based intervention for practical implementation in hip fracture patients and to assess feasibility, adherence, acceptability and cost. Twenty-three older hip fracture patients with a mean age (SD) 84.1 (6.3) were provided with three between-meal snacks daily for 4 weeks following surgery. Dietary counselling, assessment of acceptability and feasibility were undertaken and costs of intervention calculated. Sixteen of the 23 participants recruited completed the study. Mean estimated energy derived from the snacks provided 26% of daily energy requirements. Monitoring adherence proved problematic and stocktakes highlighted discrepancies. Although several participants reported that they did not usually eat between meals, overall the intervention was acceptable to participants. The cost of implementation was 21.29 UK pounds per participant per week. Although it proved feasible, practical difficulties were encountered with implementation and adherence due to timing. A more appropriate time to deliver such an intervention may be after the acute phase is over and patients are back home. The costs compared favourably with the alternative of providing sip feeds.

  20. Conventional Vs Digital Impressions: Acceptability, Treatment Comfort and Stress Among Young Orthodontic Patients

    Science.gov (United States)

    Mangano, Alessandro; Beretta, Matteo; Luongo, Giuseppe; Mangano, Carlo; Mangano, Francesco

    2018-01-01

    Objective: The objective of the present study was to compare patients’ acceptability, comfort and stress with conventional and digital impressions. Materials and Methods: Thirty young orthodontic patients (15 males and 15 females) who had no previous experience of impressions were enrolled in this study. Conventional impressions for orthodontic study models of the dental arches were taken using an alginate impression material (Hydrogum®, Zhermack Spa, Badia Polesine, Rovigo, Italy). Fifteen days later, digital impressions of both arches were acquired using an intraoral scanner (CS3600®, Carestream Dental, Rochester, NY, USA). Immediately after impression taking, patients’ acceptability, comfort and stress were measured using two questionnaires and the State anxiety scale. Results: Data showed no difference in terms of anxiety and stress; however, patients preferred the use of digital impressions systems instead of conventional impression techniques. Alginate impressions resulted as fast as digital impressions. Conclusions: Digital impressions resulted the most accepted and comfortable impression technique in young orthodontic patients, when compared to conventional techniques. PMID:29492177

  1. Recruitment of patients into head and neck clinical trials: acceptability of studies to patients from perspective of the research team.

    Science.gov (United States)

    Ho, M W; Pick, A S; Sutton, D N; Dyker, K; Cardale, K; Gilbert, K; Johnson, J; Quantrill, J; McCaul, J A

    2018-05-01

    We reviewed longitudinal recruitment data to assess recruitment into head and neck cancer trials, and to identify factors that could influence this and affect their acceptability to patients. We retrieved data from the prospective computerised database (2009-2016) to measure acceptability to patients using the recruitment:screening ratio, and compared observational with interventional studies, single specialty (or site) with multispecialty (or site) studies, and "step-up" randomisation with "non-inferiority" randomisation designs. A total of 1283 patients were screened and 583 recruited. The recruitment:screening ratio for all National Institute for Health Research (NIHR) portfolio studies combined was 0.47 (486/1133). Studies that involved treatment by several specialties or at several sites had a significantly adverse impact on acceptability (p=0.01). Recruitment into non-inferiority randomised controlled studies was lower than that into step-up randomised studies (p=0.06). The complexity of a study's design did not compromise recruitment. Treatment across several specialties or several sites and perceived non-inferiority designs, reduced the acceptability of some trials. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

  2. Reducing the oral contrast dose in CT colonography: evaluation of faecal tagging quality and patient acceptance

    International Nuclear Information System (INIS)

    Liedenbaum, M.H.; Denters, M.J.; Zijta, F.M.; Ravesteijn, V.F. van; Bipat, S.; Vos, F.M.; Dekker, E.; Stoker, J.

    2011-01-01

    Aim: To evaluate the minimal iodine contrast medium load necessary for an optimal computed tomography colonography tagging quality. Materials and Methods: Faecal occult blood test positive patients were randomly selected for one of three iodine bowel preparations: (1) 3 x 50 ml meglumine ioxithalamate (45 g iodine), (2) 4 x 25 ml meglumine ioxithalamate (30 g iodine); or (3) 3 x 25 ml (22.5 g iodine) meglumine ioxithalamate. Two experienced readers assessed the tagging quality per colonic segment on a five-point scale and the presence of adherent stool. Also semi-automatic homogeneity measurements were performed. Patient acceptance was assessed with questionnaires. Results: Of 70 eligible patients, 45 patients participated (25 males, mean age 62 years). Each preparation group contained 15 patients. The quality of tagging was insufficient (score 1-2) in 0% of segments in group 1; 4% in group 2 (p < 0.01 versus group 1); and 5% in group 3 (p = 0.06 versus group 1). In group 1 in 11% of the segments adherent stool was present compared with 49% in group 2 and 41% in group 3 (p < 0.01, group 2 and 3 versus group 1). Homogeneity was 85, 102 (p < 0.01), and 91 SD HU (p = 0.26) in groups 1, 2, and 3, respectively. In group 1 two patients experienced no burden after contrast agent ingestion compared to one patient in group 2 and nine patients in group 3 (p = 0.017). Conclusion: A dose of 3 x 50 ml meglumine ioxithalamate is advisable for an optimal tagging quality despite beneficial effects on the patient acceptance in patients receiving a lower dose.

  3. Patients after colostomy: relationship between quality of life and acceptance of disability and social support.

    Science.gov (United States)

    Zhang, Tie-Ling; Hu, Ai-Ling; Xu, Hong-Lian; Zheng, Mei-Chun; Liang, Ming-Juan

    2013-11-01

    The aim of this research was to explore quality of life (QOL) and acceptance of disability and social support of colostomy patients as well as the relationship between these factors. A descriptive, correlational study was conducted using four scales: the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and European Organization for Research and Treatment of Cancer Colorectal Cancer-Specific Quality of Life Questionnaire (EORTC QLQ-CR38) scales, the Acceptance of Disability Scale (ADS), and the Social Relational Quality Scale (SRQS). A convenience sample of 111 colostomy patients from four hospitals in Guangzhou who underwent colostomy operation at least one month prior to the study and who visited the stoma clinic or association from August 2011 to February 2012 was evaluated for inclusion in the study. All statistical analyses were performed using SPSS 17.0 software (SPSS Inc., Chicago, IL, USA). The patients' general health status was better than the reference level recommended by European Organization for Research and Treatment of Cancer, and the overall ADS score was average. The SRQS score was similar to that found in a Hong Kong study. The general health status and dimensions of QOL were significantly correlated with ADS and all of its dimensions (P colostomy patients were closely related. Our results emphasize that patients should work to form rational values and close bonds with families and friends to achieve a better QOL.

  4. Patients' Acceptance of the Use of Serious Games in Physical Rehabilitation in Morocco.

    Science.gov (United States)

    Bonnechère, Bruno; Van Vooren, Mélissa; Jansen, Bart; Van Sint, Jan S; Rahmoun, Mohamed; Fourtassi, Maryam

    2017-10-01

    The aim of this study was to determine whether serious games especially customized for physical rehabilitation could be used in daily clinics with patients who are not familiar with informatics and/or new technologies and whether such a clinical approach would be culturally acceptable within a North African population to plan further clinical distribution if the hypothesis appears to be positive. Twenty-one patients participated in this study. Experiments were performed in the University Hospital Mohammed VI Oujda in Morocco. Patients were asked to perform physical rehabilitation exercises with dedicated serious games after their conventional therapy session. A questionnaire was used to evaluate patients' habits to rehabilitation exercises and satisfaction and expectation about the use of serious games for physical rehabilitation. The same problem of low participation in at-home exercises was found in Morocco compared to Europe and the United States: 60 (30)% of the exercises was performed by the patients in Morocco and 48 (28)% in Europe and the United States. Results of this study show that serious games are well accepted by the patients (100%) and that it can help during rehabilitation (90%). Most of the patients prefer exercises with games than conventional rehabilitation exercises. Even in a context of low education (participants in this study attended school until the age of 10 years old), and low access and knowledge about new technology and informatics, rehabilitation exercises within serious games seem to be an interesting option to motivate patients during rehabilitation with a physiotherapist. Such a system could be installed also at home to increase patient's participation.

  5. Association of physicians' illness perception of fibromyalgia with frustration and resistance to accepting patients: a cross-sectional study.

    Science.gov (United States)

    Homma, Mieko; Ishikawa, Hirono; Kiuchi, Takahiro

    2016-04-01

    The aim of this study was to elucidate whether physicians' illness perceptions correlate with their frustration or resistance to accepting patients with fibromyalgia (FM). In this cross-sectional postal survey, questionnaires were sent to member physicians of the Japan College of Rheumatology and Japan Rheumatism Foundation. Measures collected included the Brief Illness Perception Questionnaire with Causal Attribution, the Illness Invalidation Inventory, and the Difficult Doctor-Patient Relationship Questionnaire (DDPRQ-10). Multiple logistic regression was performed to examine associations between the DDPRQ-10 and resistance to accepting patients with FM for treatment. We analyzed data from 233 physicians who had experience in consulting with patients with FM. Only 44.2 % answered that they wanted to accept additional patients with FM. Physicians' frustration was associated with difficulty controlling symptoms, patients' emotional responses, and causal attribution of FM to patient internal factors. Conversely, lower levels of frustration were associated with causal attributions to biological factors and uncontrollable external factors. However, the "difficult patient" perception did not correlate with resistance to accepting patients with FM. Difficulty controlling symptoms with treatment was the one factor common to both physicians' frustration and resistance to accepting patients with FM. Physicians may hesitate to accept patients with FM not because of the stigmatic image of the "difficult patient," but instead because of the difficulty in controlling the symptoms of FM. Thus, to improve the quality of consultation, physicians must continuously receive new information about the treatments and causes of FM.

  6. Patient-led training on patient safety: a pilot study to test the feasibility and acceptability of an educational intervention.

    Science.gov (United States)

    Jha, V; Winterbottom, A; Symons, J; Thompson, Z; Quinton, N; Corrado, O J; Melville, C; Watt, I; Torgerson, D; Wright, J

    2013-09-01

    Training in patient safety is an important element of medical education. Most educational interventions on patient safety training adopt a 'health-professional lens' with limited consideration on the impact of safety lapses on the patient and their families and little or no involvement of patients in the design or delivery of the training. This paper describes a pilot study to test the feasibility and acceptability of implementing a patient-led educational intervention to facilitate safety training amongst newly qualified doctors. Patients and/or carers who had experienced harm during their care shared narratives of their stories with trainees; this was followed by a focused discussion on patient safety issues exploring the causes and consequences of safety incidents and lessons to be learned from these. The intervention, which will be further tested in an NIHR-funded randomised controlled trial (RCT), was successfully implemented into an existing training programme and found acceptance amongst the patients and trainees. The pilot study proved to be a useful step in refining the intervention for the RCT including identifying appropriate outcome measures and highlighting organisational issues.

  7. The future of patient safety: Surgical trainees accept virtual reality as a new training tool

    Directory of Open Access Journals (Sweden)

    Vogelbach Peter

    2008-06-01

    Full Text Available Abstract Background The use of virtual reality (VR has gained increasing interest to acquire laparoscopic skills outside the operating theatre and thus increasing patients' safety. The aim of this study was to evaluate trainees' acceptance of VR for assessment and training during a skills course and at their institution. Methods All 735 surgical trainees of the International Gastrointestinal Surgery Workshop 2006–2008, held in Davos, Switzerland, were given a minimum of 45 minutes for VR training during the course. Participants' opinion on VR was analyzed with a standardized questionnaire. Results Fivehundred-twenty-seven participants (72% from 28 countries attended the VR sessions and answered the questionnaires. The possibility of using VR at the course was estimated as excellent or good in 68%, useful in 21%, reasonable in 9% and unsuitable or useless in 2%. If such VR simulators were available at their institution, most course participants would train at least one hour per week (46%, two or more hours (42% and only 12% wouldn't use VR. Similarly, 63% of the participants would accept to operate on patients only after VR training and 55% to have VR as part of their assessment. Conclusion Residents accept and appreciate VR simulation for surgical assessment and training. The majority of the trainees are motivated to regularly spend time for VR training if accessible.

  8. Scandiatransplant acceptable mismatch program (STAMP) a bridge to transplanting highly immunized patients.

    Science.gov (United States)

    Koefoed-Nielsen, P; Weinreich, I; Bengtsson, M; Lauronen, J; Naper, C; Gäbel, M; Sørensen, S S; Wennberg, L; Reisaeter, A V; Møller, B K

    2017-07-01

    Highly immunized patients are a challenge for organ transplantation programs. One way of increasing the likelihood of transplantation in this group of patients is to expand the possible donations by defining acceptable HLA mismatches. In the Scandiatransplant Acceptable Mismatch Program (STAMP), a de-centralized approach has been implemented in 2009. The program has been improved during the years from utilizing HLA-A, -B, -DR matching only to include typing of all deceased donors for HLA-A, -B, -C, -DRB1 and -DQB1. The calculation of a transplantability score (TS) has been introduced in order to take both HLA and AB0 into consideration resulting in a more realistic picture of the transplantability chance. Patients were selected for eligibility and results of immunisation status were prepared in each of the 9 tissue typing laboratories, while access to the program is finally governed by a common steering group of immunologists and clinicians. In the period from March 2009 until February 2015, 96 patients were transplanted within this program. The mean recipient age was 49 years and 57% were females, 30% of the patients were first transplants and of these 93% were females. The majority of the patients had 2-5 HLA-A, -B. -DR mismatches. The allograft survival at 60 months was 79.1%. Applying the TS to the cohort confirmed that patients with a low TS score had longer waiting times. The program has matured during the years and now proves to be a valid approach for transplanting highly immunized patients. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. Acceptance factors of mobile apps for diabetes by patients aged 50 or older: a qualitative study.

    Science.gov (United States)

    Scheibe, Madlen; Reichelt, Julius; Bellmann, Maike; Kirch, Wilhelm

    2015-03-02

    Mobile apps for people with diabetes offer great potential to support therapy management, increase therapy adherence, and reduce the probability of the occurrence of accompanying and secondary diseases. However, they are rarely used by elderly patients due to a lack of acceptance. We investigated the question "Which factors influence the acceptance of diabetes apps among patients aged 50 or older?" Particular emphasis was placed on the current use of mobile devices/apps, acceptance-promoting/-inhibiting factors, features of a helpful diabetes app, and contact persons for technical questions. This qualitative study was the third of three substudies investigating factors influencing acceptance of diabetes apps among patients aged 50 or older. Guided interviews were chosen in order to get a comprehensive insight into the subjective perspective of elderly diabetes patients. At the end of each interview, the patients tested two existing diabetes apps to reveal obstacles in (first) use. Altogether, 32 patients with diabetes were interviewed. The mean age was 68.8 years (SD 8.2). Of 32 participants, 15 (47%) knew apps, however only 2 (6%) had already used a diabetes app within their therapy. The reasons reported for being against the use of apps were a lack of additional benefits (4/8, 50%) compared to current therapy management, a lack of interoperability with other devices/apps (1/8, 12%), and no joy of use (1/8, 12%). The app test revealed the following main difficulties in use: nonintuitive understanding of the functionality of the apps (26/29, 90%), nonintuitive understanding of the menu navigation/labeling (19/29, 66%), font sizes and representations that were too small (14/29, 48%), and difficulties in recognizing and pressing touch-sensitive areas (14/29, 48%). Furthermore, the patients felt the apps lacked individually important functions (11/29, 38%), or felt the functions that were offered were unnecessary for their own therapy needs (10/29, 34%). The most

  10. Assessment of Patients' Perception of Telemedicine Services Using the Service User Technology Acceptability Questionnaire.

    Science.gov (United States)

    Dario, Claudio; Luisotto, Elena; Dal Pozzo, Enrico; Mancin, Silvia; Aletras, Vassilis; Newman, Stanton; Gubian, Lorenzo; Saccavini, Claudio

    2016-06-01

    The purpose of this paper is to assess if similar telemedicine services integrated in the management of different chronic diseases are acceptable and well perceived by patients or if there are any negative perceptions. Participants suffering from different chronic diseases were enrolled in Veneto Region and gathered into clusters. Each cluster received a similar telemedicine service equipped with different disease-specific measuring devices. Participants were patients with diabetes (n = 163), chronic obstructive pulmonary disease (n = 180), congestive heart failure (n = 140) and Cardiac Implantable Electronic Devices (n = 1635). The Service User Technology Acceptability Questionnaire (SUTAQ) was initially translated, culturally adapted and pretested and subsequently used to assess patients' perception of telemedicine. Data were collected after 3 months and after 12 months from the beginning of the intervention. Data for patients with implantable devices was collected only at 12 months. Results at 12 months for all clusters are similar and assessed a positive perception of telemedicine. The SUTAQ results for clusters 2 (diabetes), 5 (COPD) and 7 (CHF) after 3 months of intervention were confirmed after 12 months. Telemedicine was perceived as a viable addition to usual care. A positive perception for telemedicine services isn't a transitory effect, but extends over the course of time.

  11. Cultural acceptance of robotic telestroke medicine among patients and healthcare providers in Saudi Arabia

    Science.gov (United States)

    Al-Khathaami, Ali M.; Alshahrani, Saeed M.; Kojan, Suleiman M.; Al-Jumah, Mohammed A.; Alamry, Ahmed A.; El-Metwally, Ashraf A.

    2015-01-01

    Objectives: To determine the degree of satisfaction and acceptance of stroke patients, their relatives, and healthcare providers toward using telestroke technology in Saudi Arabia. Methods: A cross-sectional study was conducted between October and December 2012 at King Abdulaziz Medical City, Ministry of National Guard Affairs, Riyadh, Saudi Arabia. The Remote Presence Robot (RPR), the RP-7i® (FDA- cleared) provided by InTouch Health was used in the study. Patients and their relatives were informed that the physician would appear through a screen on top of a robotic device, as part of their clinical care. Stroke patients admitted through the emergency department, and their relatives, as well as healthcare providers completed a self-administered satisfaction questionnaire following the telestroke consultation sessions. Results: Fifty participants completed the questionnaire. Most subjects agreed that the remote consultant interview was useful and that the audiovisual component of the intervention was of high quality; 98% agreed that they did not feel shy or embarrassed during the remote interview, were able to understand the instruction of the consultant, and recommended its use in stroke management. Furthermore, 92% agreed or strongly agreed that the use of this technology can efficiently replace the physical presence of a neurologist. Conclusion: Results suggest that the use of telestroke medicine is culturally acceptable among stroke patients and their families in Saudi Arabia and favorably received by healthcare providers. PMID:25630777

  12. Post-operative telephone review is cost-effective and acceptable to patients.

    LENUS (Irish Health Repository)

    Gray, R T

    2012-02-01

    INTRODUCTION: Patients undergoing selective minor emergency and elective procedures are followed up by a nurse-led structured telephone review six weeks post-operatively in our hospital. Our study objectives were to review patients\\' satisfaction, assess cost-effectiveness and compare our practice with other surgical units in Northern Ireland (NI). PATIENTS AND METHODS: Completed telephone follow-up forms were reviewed retrospectively for a three-year period and cost savings calculated. Fifty patients were contacted prospectively by telephone using a questionnaire to assess satisfaction of this follow-up. A postal questionnaire was sent to 68 general and vascular surgeons in NI, assessing individual preferences for patient follow-up. RESULTS: A total of 1378 patients received a telephone review from September 2005 to September 2008. One thousand one hundred and seventy-seven (85.4%) were successfully contacted, while 201 (14.6%) did not respond despite multiple attempts. One hundred and forty-seven respondents (10.7%) required further outpatient follow-up, thereby saving 1231 outpatient reviews, equivalent to pound41,509 per annum. Thirty-nine (78%) patients expected post-operative follow-up, with 29 (58%) expecting this in the outpatient department. However, all patients were satisfied with the nurse-led telephone review. Fifty-three (78%) consultants responded. Those who always, or occasionally, review patients post-operatively varies according to the operation performed, ranging from 2.2% appendicectomy patients to 40.0% for varicose vein surgery. CONCLUSION: Current practice in NI varies, but a significant proportion of patients are not routinely reviewed. This study confirmed that patients expect post-operative follow-up. A nurse-led telephone review service is acceptable to patients, cost-effective and reduces the number of unnecessary outpatient reviews.

  13. [Acceptance of generic prescribing in general practice: effect of patient education and reference prices].

    Science.gov (United States)

    Vallès, J A; Barreiro, M; Cereza, G; Ferro, J J; Martínez, M J; Cucurull, E; Barceló, E

    2002-01-01

    To assess patient acceptance of the substitution of brand-name drugs for generic equivalents in the context of repeat prescriptions for chronic diseases. A prospective multicenter study of drug use was performed. Of the 31 centers included in the study, 8 were randomized to the intervention group and 23 to the control group. For 1 year, patients in the intervention group who visited the center to collect repeat prescriptions received verbal and written information on the advantages and disadvantages of generic and brand name drugs. Data on the number of patients taking brand-name drugs for which generic equivalents were available, as well as the reasons and variables related to refusal of generic drugs (age, gender, education, primary care centre, general practitioner, type of drug and total number of repeat prescriptions) were collected. The percentage of generic drugs among the total number of drugs prescribed was calculated at 2-monthly intervals. A total of 98.9% of the 4620 patients in the intervention group agreed to change to a generic formulation. The percentage of patients accepting generic drugs was significantly associated with the primary care centre, the class of drug, doctors' influence, and patient satisfaction with the drug. Generic prescriptions represented 5.9% in the intervention practices compared with 2.8% in controls. After the intervention, and before the application of reference prices, the percentages were 6.7% and 3.9%, respectively. Immediately after application of the reference prices, the percentages were 8.6% and 6.3%, respectively. Direct patient education is an effective strategy in increasing the prescription of generic equivalents. General practitioners' motivation and knowledge of generic drugs influenced their use. The application of reference prices increased the use of generic equivalents.

  14. A review of cost communication in oncology: Patient attitude, provider acceptance, and outcome assessment.

    Science.gov (United States)

    Shih, Ya-Chen Tina; Chien, Chun-Ru

    2017-05-15

    The American Society of Clinical Oncology released its first guidance statement on the cost of cancer care in August 2009, affirming that patient-physician cost communication is a critical component of high-quality care. This forward-thinking recommendation has grown increasingly important in oncology practice today as the high costs of cancer care impose tremendous financial burden to patients, their families, and the health care system. For the current review, a literature search was conducted using the PubMed and Web of Science databases to identify articles that covered 3 topics related to patient-physician cost communication: patient attitude, physician acceptance, and the associated outcomes; and 15 articles from 12 distinct studies were identified. Although most articles that addressed patient attitude suggested that cost communication is desired by >50% of patients in the respective study cohorts, only communication. When asked about whether cost communication actually took place in their practice, percentages reported by physicians varied widely from 60%. The data suggested that cost communication was associated with improved patient satisfaction, lower out-of-pocket expenses, and a higher likelihood of medication nonadherence; none of the studies established causality. Both patients and physicians expressed a strong need for accurate, accessible, and transparent information about the cost of cancer care. Cancer 2017;123:928-39. © 2016 American Cancer Society. © 2016 American Cancer Society.

  15. A clinical study of patient acceptance and satisfaction of Varilux Plus and Varilux Infinity lenses.

    Science.gov (United States)

    Cho, M H; Barnette, C B; Aiken, B; Shipp, M

    1991-06-01

    An independent study was conducted at the UAB School of Optometry to determine the clinical success with Varilux Plus (Varilux 2) and Varilux Infinity progressive addition lenses (PAL). Two hundred eighty patients (280) were fit between June 1988 and May 1989. The acceptance rate of 97.5 percent was based on the number of lenses ordered versus the number of lenses returned. Patients were contacted by telephone and asked to rate their level of satisfaction with their PALs. A chi-square (non-parametric) test revealed no statistically significant differences in levels of satisfaction with respect to gender, PAL type, or degree of presbyopia. Also, neither refractive error nor previous lens history had a measurable impact on patient satisfaction.

  16. Utilization and acceptance of virtual patients in veterinary basic sciences - the vetVIP-project.

    Science.gov (United States)

    Kleinsorgen, Christin; Kankofer, Marta; Gradzki, Zbigniew; Mandoki, Mira; Bartha, Tibor; von Köckritz-Blickwede, Maren; Naim, Hassan Y; Beyerbach, Martin; Tipold, Andrea; Ehlers, Jan P

    2017-01-01

    Context: In medical and veterinary medical education the use of problem-based and cased-based learning has steadily increased over time. At veterinary faculties, this development has mainly been evident in the clinical phase of the veterinary education. Therefore, a consortium of teachers of biochemistry and physiology together with technical and didactical experts launched the EU-funded project "vetVIP", to create and implement veterinary virtual patients and problems for basic science instruction. In this study the implementation and utilization of virtual patients occurred at the veterinary faculties in Budapest, Hannover and Lublin. Methods: This report describes the investigation of the utilization and acceptance of students studying veterinary basic sciences using optional online learning material concurrently to regular biochemistry and physiology didactic instruction. The reaction of students towards this offer of clinical case-based learning in basic sciences was analysed using quantitative and qualitative data. Quantitative data were collected automatically within the chosen software-system CASUS as user-log-files. Responses regarding the quality of the virtual patients were obtained using an online questionnaire. Furthermore, subjective evaluation by authors was performed using a focus group discussion and an online questionnaire. Results: Implementation as well as usage and acceptance varied between the three participating locations. High approval was documented in Hannover and Lublin based upon the high proportion of voluntary students (>70%) using optional virtual patients. However, in Budapest the participation rate was below 1%. Due to utilization, students seem to prefer virtual patients and problems created in their native language and developed at their own university. In addition, the statement that assessment drives learning was supported by the observation that peak utilization was just prior to summative examinations. Conclusion: Veterinary

  17. Utilization and acceptance of virtual patients in veterinary basic sciences – the vetVIP-project

    Directory of Open Access Journals (Sweden)

    Kleinsorgen, Christin

    2017-05-01

    Full Text Available Context: In medical and veterinary medical education the use of problem-based and cased-based learning has steadily increased over time. At veterinary faculties, this development has mainly been evident in the clinical phase of the veterinary education. Therefore, a consortium of teachers of biochemistry and physiology together with technical and didactical experts launched the EU-funded project “vetVIP”, to create and implement veterinary virtual patients and problems for basic science instruction. In this study the implementation and utilization of virtual patients occurred at the veterinary faculties in Budapest, Hannover and Lublin.Methods: This report describes the investigation of the utilization and acceptance of students studying veterinary basic sciences using optional online learning material concurrently to regular biochemistry and physiology didactic instruction. The reaction of students towards this offer of clinical case-based learning in basic sciences was analysed using quantitative and qualitative data. Quantitative data were collected automatically within the chosen software-system CASUS as user-log-files. Responses regarding the quality of the virtual patients were obtained using an online questionnaire. Furthermore, subjective evaluation by authors was performed using a focus group discussion and an online questionnaire.Results: Implementation as well as usage and acceptance varied between the three participating locations. High approval was documented in Hannover and Lublin based upon the high proportion of voluntary students (>70% using optional virtual patients. However, in Budapest the participation rate was below 1%. Due to utilization, students seem to prefer virtual patients and problems created in their native language and developed at their own university. In addition, the statement that assessment drives learning was supported by the observation that peak utilization was just prior to summative examinations

  18. Profile of vildagliptin in type 2 diabetes: efficacy, safety, and patient acceptability

    Directory of Open Access Journals (Sweden)

    Pan CY

    2013-05-01

    Full Text Available CY Pan,1 XL Wang21Chinese PLA General Hospital, Beijing, People's Republic of China; 2Medical Affairs Department, Beijing Novartis Pharma Co, Ltd, Beijing, People's Republic of ChinaAbstract: Vildagliptin is a selective and potent dipeptidyl peptidase-4 inhibitor that improves glycemic control by inhibiting the degradation of both endogenous glucagon-like peptide-1 and glucose-dependent insulinotropic peptide. This article is a comprehensive review of the safety and efficacy of vildagliptin in patients with type 2 diabetes. Clinical evidence has proven that it effectively decreases hemoglobin A1c with a low risk of hypoglycemia and is weight neutral. The addition of vildagliptin to metformin improves glucose control and significantly reduces gastrointestinal adverse events, particularly in patients inadequately controlled with metformin monotherapy. Its long-term advantages include preservation of β-cell function, reduction in total cholesterol, decrease in fasting lipolysis in adipose tissue, and triglyceride storage in non-fat tissues. Vildagliptin is well tolerated with a low incidence of AEs, and it does not increase the risk of cardiovascular/cerebrovascular (CCV events. It can be taken before or after meals, and has little drug interaction, thus it will be well accepted.Keywords: dipeptidyl peptidase-4, incretin hormones, vildagliptin, efficacy, safety, patient acceptability

  19. Design simplicity influences patient portal use: the role of aesthetic evaluations for technology acceptance.

    Science.gov (United States)

    Lazard, Allison J; Watkins, Ivan; Mackert, Michael S; Xie, Bo; Stephens, Keri K; Shalev, Heidi

    2016-04-01

    This study focused on patient portal use and investigated whether aesthetic evaluations of patient portals function are antecedent variables to variables in the Technology Acceptance Model. A cross-sectional survey of current patient portals users (N = 333) was conducted online. Participants completed the Visual Aesthetics of Website Inventory, along with items measuring perceived ease of use (PEU), perceived usefulness (PU), and behavioral intentions (BIs) to use the patient portal. The hypothesized model accounted for 29% of the variance in BIs to use the portal, 46% of the variance in the PU of the portal, and 29% of the variance in the portal's PEU. Additionally, one dimension of the aesthetic evaluations functions as a predictor in the model - simplicity evaluations had a significant positive effect on PEU. This study provides evidence that aesthetic evaluations - specifically regarding simplicity - function as a significant antecedent variable to patients' use of patient portals and should influence patient portal design strategies. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  20. To Accept or Refuse Patient's Gift in Money? and How? - Case Report with Review.

    Science.gov (United States)

    Kos, Vesna

    2016-11-01

    This report describes a (rare) situation when a patient's first gift to a young doctor was in money. This happened in very specific circumstances - in a refugee camp during the War in Croatia. The data are taken from a large study on gifts, conducted on a representative sample of Croatian general practitioners (GPs), N = 265, from 2358 in total. Pro and contra factors are discussed, considering tradition and customs, but also a lack of knowledge of young doctors in handling gifts in general. The intention of this report is primarily educative, with review of (scarce) literature, and recommendations, where the generally accepted rules might have exceptions.

  1. Acceptability and outcomes of the Percutaneous Endoscopic Gastrostomy (PEG tube placement- patients' and care givers' perspectives

    Directory of Open Access Journals (Sweden)

    Shah Hasnain A

    2006-11-01

    Full Text Available Abstract Background Percutaneous endoscopic gastrostomy tube has now become a preferred option for the long-term nutritional support device for patients with dysphagia. There is a considerable debate about the health issues related to the quality of life of these patients. Our aim of the study was to assess the outcome and perspectives of patients/care givers, about the acceptability of percutaneous endoscopic gastrostomy tube placement. Methods This descriptive analytic study conducted in patients, who have undergone percutaneous endoscopic gastrostomy tube placement during January 1998 till December 2004. Medical records of these patients were evaluated for their demographic characteristics, underlying diagnosis, indications and complications. Telephonic interviews were conducted till March 2005, on a pre-tested questionnaire to address psychological, social and physical performance status, of the health related quality of life issues. Results A total of 191 patients' medical records were reviewed, 120 (63% were males, and mean age was 63 years. Early complication was infection at PEG tube site in 6 (3% patients. In follow up over 365 ± 149 days, late complications (occurring 72 hours later were infection at PEG tube site in 29 (15 % patient and dislodgment/blockage of the tube in 26 (13.6%. Interviews were possible with 126 patients/caretakers. Karnofsky Performance Score of 0, 1, 2, 3 and 4 was found in 13(10%, 18(14%, 21(17%, 29(23% and 45(36% with p-value Conclusion PEG-tube placement was found to be relatively free from serious immediate and long- term complications. Majority of caregivers and patient felt that PEG-tube helped in feeding and prolonging the survival. Studies are needed to assess the real benefit in terms of actual nutritional gain and quality of life in such patients.

  2. Acceptance of Serious Games in Psychotherapy: An Inquiry into the Stance of Therapists and Patients.

    Science.gov (United States)

    Eichenberg, Christiane; Grabmayer, Gloria; Green, Nikos

    2016-11-01

    Serious games are computer or video games that contain elements that are specifically designed for the purpose of education or training. Serious games are increasingly being used within healthcare, but their introduction into and application in psychotherapeutic settings as an e-mental health treatment modality raises questions for both patients and therapists. Current research demonstrates the potential role and effectiveness of serious games within a psychotherapeutic context. However, a limited understanding of patients' and therapists' existing knowledge and experience of serious games, as well as of their readiness to utilize and apply them for the treatment of psychological conditions, requires further investigation. Acceptance, experience, and requirements for the utilization of serious games in therapeutic contexts were assessed through online surveys with German-speaking patients (n = 260) and psychotherapists (n = 234). Respondents' answers were analyzed by a combination of descriptive and inferential statistics by using SPSS. Current knowledge regarding serious games was very limited, with only 10.4% of patients and 11.5% of therapists reporting existing knowledge. However, a general openness toward the concept was observed: 88% of patients and 90% of therapists could envisage a therapeutic use. Patients (rs = 0.169, p = 0.006) who self-rated their level of computer and video game expertise as high were more likely to consider use within psychotherapy, compared with patients who self-rated their expertise as low. Therapists who currently play computer and video games perceive fewer disadvantages of serious game application in a psychotherapeutic context (p = 0.097). Consideration of serious game use was differentiated by the therapeutic approach (p = 0.003), specific mental disorders (highest rated relevant cases: anxiety disorders, affective disorders, disorders regarding impulse control, and adjustment disorders), and patient

  3. Is it acceptable to approach colorectal cancer patients at diagnosis to discuss genetic testing? A pilot study

    OpenAIRE

    Porteous, M; Dunckley, M; Appleton, S; Catt, S; Dunlop, M; Campbell, H; Cull, A

    2003-01-01

    In this pilot study, the acceptability of approaching 111 newly diagnosed colorectal cancer patients with the offer of genetic testing for hereditary nonpolyposis colorectal cancer (HNPCC) was assessed. A total of 78% of participants found it highly acceptable to have the information about HNPCC brought to their attention at that time.

  4. Investigation into the acceptability of door locking to staff, patients, and visitors on acute psychiatric wards.

    Science.gov (United States)

    Muir-Cochrane, Eimear; van der Merwe, Marie; Nijman, Henk; Haglund, Kristina; Simpson, Alan; Bowers, Len

    2012-02-01

    There is disagreement among psychiatric professionals about whether the doors of acute psychiatric wards should be kept locked to prevent patients from leaving and harming themselves or others. This study explored patient, staff, and visitor perceptions about the acceptability of locking the ward door on acute psychiatric inpatient wards. Interviews were conducted with 14 registered nurses, 15 patients, and six visitors from three different acute wards. Findings revealed commonalities across all groups, with general agreement that locking the door reduced absconding. Staff expressed feelings of guilt, embarrassment, and fear of being blamed when a patient absconded. Staff also reported that open wards created anxious vigilance to prevent an abscond and increased workload in allocating staff to watch the door, whereas staff on partially-locked doors also perceived an increased workload in letting people in and out of the ward. Patients had mixed feelings about the status of the door, expressing depression, a sense of stigma, and low self-esteem when the door was locked. The issue of balancing safety and security on acute psychiatric wards against the autonomy of patients is not easily resolved, and requires focused research to develop innovative nursing practices. © 2011 The Authors. International Journal of Mental Health Nursing © 2011 Australian College of Mental Health Nurses Inc.

  5. Design simplicity influences patient portal use: the role of aesthetic evaluations for technology acceptance

    Science.gov (United States)

    Watkins, Ivan; Mackert, Michael S; Xie, Bo; Stephens, Keri K; Shalev, Heidi

    2016-01-01

    Objective This study focused on patient portal use and investigated whether aesthetic evaluations of patient portals function are antecedent variables to variables in the Technology Acceptance Model. Methods A cross-sectional survey of current patient portals users (N = 333) was conducted online. Participants completed the Visual Aesthetics of Website Inventory, along with items measuring perceived ease of use (PEU), perceived usefulness (PU), and behavioral intentions (BIs) to use the patient portal. Results The hypothesized model accounted for 29% of the variance in BIs to use the portal, 46% of the variance in the PU of the portal, and 29% of the variance in the portal’s PEU. Additionally, one dimension of the aesthetic evaluations functions as a predictor in the model – simplicity evaluations had a significant positive effect on PEU. Conclusion This study provides evidence that aesthetic evaluations – specifically regarding simplicity – function as a significant antecedent variable to patients’ use of patient portals and should influence patient portal design strategies. PMID:26635314

  6. Safety, Efficacy, and Patient Acceptability of Everolimus in the Treatment of Breast Cancer.

    Science.gov (United States)

    Lousberg, Laurence; Jerusalem, Guy

    2016-01-01

    Everolimus combined with exemestane is an important treatment option for patients suffering from estrogen receptor-positive, human epidermal growth factor receptor 2-negative, advanced breast cancer (ABC) who have been previously treated with a nonsteroidal aromatase inhibitor (NSAI). After presentation of phase III registration trial BOLERO-2, several phase IIIb trials have been started to evaluate this regimen in a more real-world setting. Here, we review the efficacy and safety data published or presented at selected international meetings. These studies confirmed the outcome observed in the BOLERO-2 trial. Patient acceptance rate is also discussed by focusing on the permanent everolimus discontinuation rate in these trials. Factors influencing the safety profile are also reported, including the impact of age. The optimal sequence of combined therapy approaches associating targeted and endocrine therapy (ET) has yet to be determined as new treatment options such as cyclin-dependent kinase inhibitors become available. However, everolimus-exemestane remains an important treatment option with a major impact on progression-free survival (PFS) and an acceptable safety profile.

  7. Comprehension and acceptability of a patient information leaflet (pil for antiretroviral therapy

    Directory of Open Access Journals (Sweden)

    Betty Mwingira

    2006-11-01

    Full Text Available The patient information leaflet (PIL is recognised as playing a key role in informing patients about their medicines. The objectives of this research were to evaluate the readability and understanding of a PIL for the first-line ARV (antiretroviral regimen available in the South African public health sector, and investigate its acceptability in the target Xhosa population. Opsomming Daar word algemeen aanvaar dat die pasiëntinligtingsblaadjie (PIB ‘n sleutelrol speel in die oordra van inligting ten opsigte van medikasie aan pasiënte. Die doelwitte van hierdie navorsing was om die leesbaarheid en begrip van ‘n PIB vir die eerste-linie antiretrovirale (ARV regimen wat in die Suid-Afrikaanse openbare gesondheidsektor beskikbaar is, te evalueer, en om die aanvaarbaarheid daarvan in ‘n teiken-Xhosabevolking te ondersoek. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.

  8. Patients' acceptance of medical photography in a French adult and paediatric dermatology department: a questionnaire survey.

    Science.gov (United States)

    Hacard, F; Maruani, A; Delaplace, M; Caille, A; Machet, L; Lorette, G; Samimi, M

    2013-08-01

    Despite the increasing use of medical photography by dermatologists, no study on patients' perceptions of photography in dermatology has been performed to date. Firstly, to evaluate patients' perceptions of medical photography. Secondly, to assess whether perceptions differed between patients in our adult department and parents accompanying a child in our paediatric department. An opinion survey was conducted at the Hospital of Tours (France) among adult patients (adult department) and accompanying parents (paediatric department) by completion of a questionnaire after any medical photography had been performed. We collected 272 questionnaires regarding 158 adults and 114 children. A camera used only in the department, and storage of the images in the department's records were the most accepted modalities (> 90%), especially in the paediatric survey. Respondents agreed with the sharing of the images with other practitioners and in medical meetings (> 85%) rather than distribution via publications (58·3%), e-mails (45·5%), health magazines (44·3%) and websites (32·0%). Most (78·8%) considered that the consent form should list all the possible uses of the images. Need for renewed consent for each use of the images was significantly more often expressed in the paediatric than the adult survey (44·5% vs. 24·5%, P = 0·001). More than 95% of respondents considered medical photography to be useful for improving diagnosis, monitoring of skin disease and aiding teaching. These findings could be used to improve practice, to increase the acceptability of medical photography and for devising a standardized consent form for medical practitioners performing medical photography. © 2013 The Authors BJD © 2013 British Association of Dermatologists.

  9. Patient knowledge, perceptions, and acceptance of generic medicines: a comprehensive review of the current literature

    Directory of Open Access Journals (Sweden)

    Alrasheedy AA

    2014-04-01

    Full Text Available Alian A Alrasheedy,1 Mohamed Azmi Hassali,1 Kay Stewart,2 David CM Kong,2 Hisham Aljadhey,3 Mohamed Izham Mohamed Ibrahim,4 Saleh Karamah Al-Tamimi1 1Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia; 2Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia; 3Medication Safety Research Chair, Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia; 4College of Pharmacy, Qatar University, Doha, Qatar Background: Generic medicines have the same quality, safety, and efficacy as their counterpart original brand medicines. Generic medicines provide the same therapeutic outcomes but at a much cheaper cost, so are promoted in many countries to contain pharmaceutical expenditure and sustain the health care system. Thus, the perspective of patients and medicine consumers as end users of these medicines is an important factor to enhance the use and utilization of generic medicines. The objective of this paper is to review patients’ and consumers’ knowledge, perceptions, acceptance, and views of generic medicines in the current literature. Methods: An extensive literature search was performed in several databases, namely Scopus, PubMed, ISI Web of Knowledge, Proquest, and the Wiley online library, to identify relevant studies published in the English literature for the period 1990–2013. Results: A total of 53 studies were included in the review, comprising 24 studies from Europe, ten from North America, six from Asia, five from Australia and New Zealand, five from the Middle East, one from Africa, one from Latin America, and one from the Caribbean region. A large body of literature has reported misconceptions and negative perceptions about generic medicines on the part of patients and medicine consumers. Moreover, although it is reported in almost all countries, the percentage of consumers who had

  10. Acceptability of short term neo-adjuvant androgen deprivation in patients with locally advanced prostate cancer

    International Nuclear Information System (INIS)

    Lamb, David S.; Denham, James W.; Mameghan, Hedy; Joseph, David; Turner, Sandra; Matthews, John; Franklin, Ian; Atkinson, Chris; North, John; Poulsen, Michael; Kovacev, Olga; Robertson, Randall; Francis, Lynne; Christie, David; Spry, Nigel A.; Tai, K.-H.; Wynne, Chris; Duchesne, Gillian

    2003-01-01

    Purpose: To determine the acceptability of short term neo-adjuvant maximal androgen deprivation (MAD) to patients treated with external beam radiation for locally advanced prostate cancer. Methods: Between 1996 and 2000, 818 patients with locally advanced, but non-metastatic, prostate cancer were entered into a randomised clinical trial (TROG 96.01), which compared radiation treatment alone with the same radiation treatment and 3 or 6 months neo-adjuvant MAD with goserelin and flutamide. Relevant symptoms, and how troublesome they were to the patient, were scored using a self-assessment questionnaire. This was completed by the patient at registration, and at specified times during and after treatment. Patients taking flutamide had liver function tests checked at regular intervals. Results: All patients have completed at least 12 months follow-up after treatment. Nearly all patients completed planned treatment with goserelin, but 27% of patients in the 6-month MAD treatment arm, and 20% in the 3-month arm, had to stop flutamide early. This was mainly due to altered liver function (up to 17% patients) and bowel side effects (up to 8% patients). However, although flutamide resulted in more bowel symptoms for patients on MAD, there was significant reduction in some urinary symptoms on this treatment. Acute bowel and urinary side effects at the end of radiation treatment were similar in all treatment arms. Side effect severity was unrelated to radiation target volume size, which was reduced by MAD, but symptomatology prior to any treatment was a powerful predictor. Of the 36% of patients who were sexually active before any treatment, the majority became inactive whilst on MAD. However, sexual activity at 12 months after radiation treatment was similar in all treatment arms, indicating that the effects of short term MAD on sexual function are reversible. Conclusion: Despite temporary effects on sexual activity, and compliance difficulties with flutamide, short-term neo

  11. The Bandung neurosurgery patient outcomes project, Indonesia (Part II): Patient pathways and feasibility and acceptability of telephone follow-up.

    Science.gov (United States)

    Sutiono, Agung Budi; Faried, Ahmad; McAllister, Susan; Ganefianty, Amelia; Sarjono, Kalih; Arifin, Muhammad Zafrullah; Derrett, Sarah

    2018-01-01

    Support of neurosurgery patients following discharge from hospital is important. Currently, little is known about patients' in low- and middle-income countries before and after their hospital treatment. This companion paper reports patients' pathways before and after hospital admission and the feasibility of following up this ill-patient population by telephone. Eligible patients were aged ≥18 years admitted to the Neurosurgery Department in Dr. Hasan Sadikin Hospital-a regional referral hospital in Bandung City, Indonesia. Clinical data were collected on admission by clinicians. In-person interviews were undertaken with a clinical research nurse 1 to 2 days pre-discharge, and telephone follow-up interviews at 1, 2, and 3 months post-discharge. Information was also collected on pathways prior to admission and following discharge. The number of contact attempts for each patient interview was documented, as was the overall acceptability of undertaking a telephone interview. Of 178 patients discharged from hospital, 12 later died. Of the remaining 166 patients, 95% were able to be followed up to 3 months. Two-thirds of patients had been referred from another hospital. Patients came from, and were discharged to, locations throughout the West Java region. At the 1-month interview, 84% participants reported that they had had a follow-up consultation with a health professional-mostly with a neurosurgeon. This study has shown that, with a neurosurgery nurse delegated to the role, it is feasible to conduct follow-up telephone interviews with patients after discharge from a neurosurgery ward and that in fact such follow-up was appreciated by patients. Copyright © 2017 John Wiley & Sons, Ltd.

  12. Body-Worn Sensors in Parkinson's Disease: Evaluating Their Acceptability to Patients.

    Science.gov (United States)

    Fisher, James M; Hammerla, Nils Y; Rochester, Lynn; Andras, Peter; Walker, Richard W

    2016-01-01

    Remote monitoring of symptoms in Parkinson's disease (PD) using body-worn sensors would assist treatment decisions and evaluation of new treatments. To date, a rigorous, systematic evaluation of the acceptability of body-worn sensors in PD has not been undertaken. Thirty-four participants wore bilateral wrist-worn sensors for 4 h in a research facility and then for 1 week at home. Participants' experiences of wearing the sensors were evaluated using a Likert-style questionnaire after each phase. Qualitative data were collected through free-text responses. Differences in responses between phases were assessed by using the Wilcoxon rank-sum test. Content analysis of qualitative data was undertaken. "Non-wear time" was estimated via analysis of accelerometer data for periods when sensors were stationary. After prolonged wearing there was a negative shift in participants' views on the comfort of the sensor; problems with the sensor's strap were highlighted. However, accelerometer data demonstrated high patient concordance with wearing of the sensors. There was no evidence that participants were less likely to wear the sensors in public. Most participants preferred wearing the sensors to completing symptom diaries. The finding that participants were not less likely to wear the sensors in public provides reassurance regarding the ecological validity of the data captured. The validity of our findings was strengthened by "triangulation" of data sources, enabling patients to express their agenda and repeated assessment after prolonged wearing. Long-term monitoring with wrist-worn sensors is acceptable to this cohort of PD patients. Evaluation of the wearer's experience is critical to the development of remote monitoring technology.

  13. Excimer laser for the treatment of psoriasis: safety, efficacy, and patient acceptability

    Directory of Open Access Journals (Sweden)

    Abrouk M

    2016-12-01

    Full Text Available Michael Abrouk,1 Ethan Levin,2 Merrick Brodsky,1 Jessica R Gandy,1 Mio Nakamura,2 Tian Hao Zhu,3 Benjamin Farahnik,4 John Koo,2 Tina Bhutani2 1Irvine School of Medicine, Irvine, 2Department of Dermatology, Psoriasis and Skin Treatment Center, University of California, San Francisco, 3Department of Dermatology, University of Southern California Keck School of Medicine, Los Angeles, CA, 4Department of Dermatology, University of Vermont College of Medicine, Burlington, VT, USA Introduction: The 308 nm excimer laser is a widely used device throughout the field of dermatology for many diseases including psoriasis. Although the laser has demonstrated clinical efficacy, there is a lack of literature outlining the safety, efficacy, and patient acceptability of the excimer laser. Methods: A literature search on PubMed was used with combinations of the terms “excimer”, “excimer laser”, “308 nm”, “psoriasis”, “protocol”, “safety”, “efficacy”, acceptability”, “side effects”, and “dose”. The search results were included if they contained information pertaining to excimer laser and psoriasis treatment and description of the safety, efficacy, and patient acceptability of the treatment. Results: The 308 nm excimer laser is generally safe and well tolerated with minimal side effects including erythema, blistering, and pigmentary changes. It has a range of efficacies depending on the protocol used with several different treatment protocols, including the induration protocol, the minimal erythema dose protocol, and the newer minimal blistering dose protocol. Conclusion: Although the excimer laser is not a first-line treatment, it remains an excellent treatment option for psoriasis patients and has been demonstrated to be an effective treatment with little to no side effects. Keywords: excimer, laser, 308 nm, psoriasis, safety, efficacy

  14. Toward optimizing patient-specific IMRT QA techniques in the accurate detection of dosimetrically acceptable and unacceptable patient plans.

    Science.gov (United States)

    McKenzie, Elizabeth M; Balter, Peter A; Stingo, Francesco C; Jones, Jimmy; Followill, David S; Kry, Stephen F

    2014-12-01

    The authors investigated the performance of several patient-specific intensity-modulated radiation therapy (IMRT) quality assurance (QA) dosimeters in terms of their ability to correctly identify dosimetrically acceptable and unacceptable IMRT patient plans, as determined by an in-house-designed multiple ion chamber phantom used as the gold standard. A further goal was to examine optimal threshold criteria that were consistent and based on the same criteria among the various dosimeters. The authors used receiver operating characteristic (ROC) curves to determine the sensitivity and specificity of (1) a 2D diode array undergoing anterior irradiation with field-by-field evaluation, (2) a 2D diode array undergoing anterior irradiation with composite evaluation, (3) a 2D diode array using planned irradiation angles with composite evaluation, (4) a helical diode array, (5) radiographic film, and (6) an ion chamber. This was done with a variety of evaluation criteria for a set of 15 dosimetrically unacceptable and 9 acceptable clinical IMRT patient plans, where acceptability was defined on the basis of multiple ion chamber measurements using independent ion chambers and a phantom. The area under the curve (AUC) on the ROC curves was used to compare dosimeter performance across all thresholds. Optimal threshold values were obtained from the ROC curves while incorporating considerations for cost and prevalence of unacceptable plans. Using common clinical acceptance thresholds, most devices performed very poorly in terms of identifying unacceptable plans. Grouping the detector performance based on AUC showed two significantly different groups. The ion chamber, radiographic film, helical diode array, and anterior-delivered composite 2D diode array were in the better-performing group, whereas the anterior-delivered field-by-field and planned gantry angle delivery using the 2D diode array performed less well. Additionally, based on the AUCs, there was no significant difference

  15. Development of a marmalade for patients with type 2 diabetes: Sensory characteristics and acceptability.

    Science.gov (United States)

    Zhilinskaya, Nataliya V; Sarkisyan, Varuzhan A; Vorobieva, Valentina M; Vorobieva, Irina S; Kochetkova, Alla A; Smirnova, Elena A; Glazkova, Irina V

    2018-01-01

    Type 2 diabetes is one of the most common noncommunicable diseases worldwide. The quality of life of people with this metabolic disorder is highly related to nutrition, given that products for glycemic control are of great importance for them. In this study, we have developed marmalades for glycemic control with the aims to investigate the most important sensory characteristics, to study the impact of the sensory properties on the acceptability of these marmalades, and to evaluate a difference in the acceptability of the marmalade samples between healthy people and people with type 2 diabetes. The main objects of the investigation were agar-, gelatin-, and pectin-based marmalades with maltitol, dried fruits, and berries for glycemic control. By means of descriptive sensory analysis, we have shown that major factors of the sensory differentiation of marmalade samples are the type of gelling agent and presence of nonsoluble components such as apple puree, which influencing the perception of "off-flavor," "gumminess," and "springiness" sensory attributes. Results of this research show that even with significant differences in sensory attributes it is possible to develop marmalade for glycemic control that will have no differences in the total liking score for the perception of both healthy people and patients with type 2 diabetes.

  16. Fasting during Ramadan: efficacy, safety, and patient acceptability of vildagliptin in diabetic patients

    Directory of Open Access Journals (Sweden)

    Aziz KMA

    2015-04-01

    Full Text Available Kamran MA Aziz Aseer Diabetes Center, Aseer Central Hospital, Ministry of Health, Abha, Saudi Arabia Abstract: Diabetes management during Ramadan fasting is challenging to the physician in terms of minimizing the risk of hypoglycemia. As compared to oral hypoglycemic agents (OHAs and sulfonylureas (SUs, which carry a higher and significant risk of hypoglycemia, newer antidiabetic agents such as dipeptidyl peptidase-4 (DPP-4 inhibitors have demonstrated lower risk of hypoglycemia during Ramadan fasting, with better patient compliance. In addition to diabetes education and pre-Ramadan assessments, the physician should also consider use of DPP-4 inhibitors (such as vildagliptin during Ramadan fasting to minimize the risk of hypoglycemia in type 2 diabetic subjects. Severe episodes of hypoglycemia have been demonstrated in recent research and clinical trials with OHAs/SUs. Conversely, these research observations have also demonstrated comparative safety and efficacy with lower risk of hypoglycemia associated with vildagliptin. Current research review has collected evidence-based clinical trials and observations for the drug vildagliptin to minimize the risk of hypoglycemia during Ramadan fasting, while at the same time focusing the role of diabetes self-management education (DSME, pre-Ramadan assessments, and patient care. Keywords: hypoglycemia, DPP4-inhibitors, oral hypoglycemic agents, Ramadan fasting, type 2 diabetes, vildagliptin

  17. Mobile technologies: expectancy, usage, and acceptance of clinical staff and patients at a university medical center.

    Science.gov (United States)

    Illiger, Kristin; Hupka, Markus; von Jan, Ute; Wichelhaus, Daniel; Albrecht, Urs-Vito

    2014-10-21

    Despite their increasing popularity, little is known about how users perceive mobile devices such as smartphones and tablet PCs in medical contexts. Available studies are often restricted to evaluating the success of specific interventions and do not adequately cover the users' basic attitudes, for example, their expectations or concerns toward using mobile devices in medical settings. The objective of the study was to obtain a comprehensive picture, both from the perspective of the patients, as well as the doctors, regarding the use and acceptance of mobile devices within medical contexts in general well as the perceived challenges when introducing the technology. Doctors working at Hannover Medical School (206/1151, response 17.90%), as well as patients being admitted to this facility (213/279, utilization 76.3%) were surveyed about their acceptance and use of mobile devices in medical settings. Regarding demographics, both samples were representative of the respective study population. GNU R (version 3.1.1) was used for statistical testing. Fisher's exact test, two-sided, alpha=.05 with Monte Carlo approximation, 2000 replicates, was applied to determine dependencies between two variables. The majority of participants already own mobile devices (doctors, 168/206, 81.6%; patients, 110/213, 51.6%). For doctors, use in a professional context does not depend on age (P=.66), professional experience (P=.80), or function (P=.34); gender was a factor (P=.009), and use was more common among male (61/135, 45.2%) than female doctors (17/67, 25%). A correlation between use of mobile devices and age (P=.001) as well as education (P=.002) was seen for patients. Minor differences regarding how mobile devices are perceived in sensitive medical contexts mostly relate to data security, patients are more critical of the devices being used for storing and processing patient data; every fifth patient opposed this, but nevertheless, 4.8% of doctors (10/206) use their devices for this

  18. Willingness to pay and willingness to accept in a patient-centered blood pressure control study.

    Science.gov (United States)

    Gleason-Comstock, Julie; Streater, Alicia; Goodman, Allen; Janisse, James; Brody, Aaron; Mango, LynnMarie; Dawood, Rachelle; Levy, Phillip

    2017-08-07

    Elevated blood pressure is a major risk factor for cardiovascular disease and stroke but patients often discount recommended behavioral changes and prescribed medications. While effective interventions to promote adherence have been developed, cost-effectiveness from the patient's perspective, has not been well studied. The valuation of patient time and out of pocket expenses should be included while performing cost effectiveness evaluation. The Achieve BP study uses the contingent valuation method to assess willingness to accept (WTA) and willingness to pay (WTP) among patients with a history of uncontrolled blood pressure discharged from an urban emergency department and enrolled in a larger randomized controlled trial. WTA and WTP were assessed by asking patients a series of questions about time and travel costs and time value related to their study participation. A survey was conducted during the final study visit with patients to investigate the effectiveness of a kiosk-based educational intervention on blood pressure control. All study patients, regardless of study arm, received the same clinical protocol of commonly prescribed antihypertensive medication and met with research clinicians four times as part of the study procedures. Thirty-eight patients were offered the opportunity to participate in the cost-effectiveness study and all completed the survey. Statistical comparisons revealed these 38 patients were similar in representation to the entire RCT study population. All 38 (100.0%) were African-American, with an average age of 49.1 years; 55.3% were male, 21.1% were married, 78.9% had a high school or higher education, and 44.7% were working. 55.9% did not have a primary care provider and 50.0% did not have health insurance. Time price linear regression analysis was performed to estimate predictors of WTA and WTP. WTP and WTA may generate different results, and the elasticities were proportional to the estimated coefficients, with WTP about twice as

  19. Health locus of control in patients with graves-basedow disease and hashimoto disease and their acceptance of illness.

    Science.gov (United States)

    Basinska, Malgorzata Anna; Andruszkiewicz, Anna

    2012-01-01

    Adaptation to a chronic somatic disease depends on a variety of factors, including belief in health locus of control. Correlation between health locus of control and illness acceptance in patients with Graves-Basedow and Hashimoto diseases as well as correlation between health locus of control, illness acceptance, sex, and age. THREE METHODS WERE APPLIED: Multidimensional Health Locus of Control Scale by K.A. Wallston, B.S. Wallston and R. DeVellis; the Acceptance of Illness Scale by B.J. Felton, T.A. Revenson, and G.A. Hinrichsena; and a personal questionnaire. Two groups were subject to the research: 68 patients with Graves-Basedow disease and 54 patients with Hashimoto disease. Patients with Graves-Basedow disease, women above all, have their health locus of control in other persons (P = 0,001) and are less inclined to accept their illness (P = 0,005) when compared to patients with Hashimoto disease. A statistically significant correlation occurred between the age of patients and external (i.e., in other persons) health locus of control. Beliefs in health locus of control and type of illness in female patient group are predictors of illness acceptance (P = 0,0009).

  20. The influence of frailty syndrome on acceptance of illness in elderly patients with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Uchmanowicz I

    2016-09-01

    Full Text Available Izabella Uchmanowicz,1 Beata Jankowska-Polanska,1 Mariusz Chabowski,2 Bartosz Uchmanowicz,1 Andrzej M Fal3 1Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, 2Division of Nursing in Surgical Procedures, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, 3Department of Healthcare Organisation and Economics, National Institute of Public Health, National Institute of Hygiene, Warsaw, Poland Abstract: COPD is one of the most debilitating diseases. Frailty syndrome and advanced age may decrease the acceptance of illness, quality of life, and worsen health conditions in these patients, as well as lead to an increase in health care expenses. The aim of the study was to assess how the level of frailty affects the acceptance of illness in elderly patients with COPD. We also aimed to evaluate the associations between sociodemographic and clinical factors and the level of acceptance of illness, anxiety, and frailty in this group of patients. The study included 102 COPD patients with a mean age of 63.2 (standard deviation =6.5 years and grades I (3%, II (37%, III (52%, and IV (8% by Global Initiative for Chronic Obstructive Lung Disease. The Polish versions of the Acceptance of Illness Scale and Tilburg frailty indicator were used. Frailty syndrome was found in 77 (75.5% patients, with an average score of 7.42 (standard deviation =2.24. Coexisting diseases such as hypertension (46.07%, coronary artery disease (32.35%, heart failure (28.43%, diabetes (18.63%, and heart arrhythmia (9.8% were found among the subjects. The overall level of acceptance of illness was 20.6 (standard deviation =7.62. A lower level of acceptance of illness was associated with a higher level of frailty, especially in the physical and social domain. Elderly patients with severe COPD are more prone to frailty and decreased acceptance of their disease in comparison to patients with other chronic diseases

  1. Acceptability and efficacy of an emollient containing ceramide-precursor lipids and moisturizing factors for atopic dermatitis in pediatric patients.

    Science.gov (United States)

    Hon, Kam Lun; Pong, Nga Hin; Wang, Shuxin Susan; Lee, Vivian W; Luk, Nai Ming; Leung, Ting Fan

    2013-03-01

    Atopic eczema or dermatitis (AD) is associated with atopy and is characterized by reduced skin hydration and an impaired skin barrier in the epidermis. We investigated the patient acceptability and efficacy of an emollient containing ceramide-precursor lipids and moisturizing factors (LMF) in AD. Consecutive AD patients were recruited. Swabs and cultures were obtained from the right antecubital fossa and the worst-affected eczematous area, and disease severity [according to the SCORing Atopic Dermatitis (SCORAD) Index], skin hydration, and transepidermal water loss (TEWL) were measured prior to and after 2 weeks' use of the LMF moisturizer. The general acceptability of treatment was documented as being 'very good', 'good', 'fair', or 'poor'. Twenty-four AD patients [mean age 13.8 (standard deviation 5.7) years] were recruited. Two thirds of the patients reported very good or good acceptability of the LMF moisturizer, whereas one third reported fair or poor acceptability. There were no inter-group differences in the pre-use clinical parameters of age, objective SCORAD score, pruritus score, sleep disturbance score, skin hydration, TEWL, topical corticosteroid use, oral antihistamine use, or acceptability of previously used proprietary emollients. However, patients in the fair/poor acceptability group were more likely to have Staphylococcus aureus colonization and to be female (odds ratio 13, 95 % confidence interval 1.7-99.4; p = 0.021). Following use of the LMF moisturizer, the objective SCORAD score, pruritus score, and sleep disturbance score were lower in the very good/good acceptability group than in the fair/poor acceptability group. The mean objective SCORAD score improved (from 31.5 to 25.7; p = 0.039) and skin hydration improved [from 30.7 arbitrary units (a.u.) to 36.0 a.u.; p = 0.021] in the very good/good acceptability group. When the data were analyzed for the strength of the agreement of the rating of acceptability, the κ values were 0.338 (fair) for

  2. Feasibility and Acceptability of a Positive Psychological Intervention for Patients With Type 2 Diabetes.

    Science.gov (United States)

    DuBois, Christina M; Millstein, Rachel A; Celano, Christopher M; Wexler, Deborah J; Huffman, Jeff C

    2016-01-01

    Positive psychological attributes (eg, optimism) have been associated with a healthier lifestyle and superior medical outcomes in patients with type 2 diabetes; however, there has been minimal study of behavioral interventions that target positive psychological constructs in this population. Accordingly, we developed a novel, telephone-based, 12-week positive psychology intervention and assessed its feasibility and short-term impact in adults with type 2 diabetes and suboptimal health behavior adherence. This was a pilot and feasibility study in adult inpatients and outpatients at an urban academic medical center recruited between December 2013 and December 2014. Adult patients with (1) type 2 diabetes (meeting American Diabetes Association criteria, eg, glycated hemoglobin A 1c [HbA 1c ] > 6.5% or fasting glucose > 126 mg/dL) and (2) suboptimal adherence (score psychology manual, completed exercises (eg, writing a gratitude letter, performing acts of kindness), and reviewed these activities by phone with a study trainer over the 12-week study period. Feasibility and acceptability were assessed via exercise completion rates and postexercise ratings of ease/utility on 0-10 Likert scales. Longer-term efficacy was explored by examining changes in psychological states and health behaviors from baseline to 12 weeks using random-effects regression models and estimates of effect size. A total of 15 participants enrolled; 12 participants provided complete baseline and follow-up data and were included in the analyses. Over 90% of these participants completed at least 2 exercises, and 75% completed a majority of the exercises. Participants rated the exercises as helpful (mean = 7.8/10) and easy to complete (mean = 7.1/10), and they reported improvements in optimism, gratitude, depression, anxiety, physical function, self-care, and health behaviors (Cohen d = 0.28-1.00). A positive psychology intervention for suboptimally adherent patients with type 2 diabetes was feasible

  3. Image quality and patient acceptance of four regimens with different amounts of mild laxatives for CT colonography

    NARCIS (Netherlands)

    Jensch, Sebastiaan; de Vries, Ayso H.; Pot, Dennis; Peringa, Jan; Bipat, Shandra; Florie, Jasper; van Gelder, Rogier E.; Stoker, Jaap

    2008-01-01

    OBJECTIVE: The purpose of our study was to prospectively evaluate image quality and patient acceptance of CT colonography (CTC) with fecal tagging using different levels of catharsis. SUBJECTS AND METHODS: Forty consecutive increased-risk patients were randomized. Group 1 received orally 20 mg of

  4. Use, perceptions, and acceptability of a ready-to-use supplementary food among adult HIV patients initiating antiretroviral treatment

    DEFF Research Database (Denmark)

    Olsen, Mette Frahm; Tesfaye, Markos; Kæstel, Pernille

    2013-01-01

    Ready-to-use supplementary foods (RUSF) are used increasingly in human immunodeficiency virus (HIV) programs, but little is known about how it is used and viewed by patients. We used qualitative methods to explore the use, perceptions, and acceptability of RUSF among adult HIV patients in Jimma...

  5. Safety, efficacy and patient acceptability of the combined estrogen and progestin transdermal contraceptive patch: a review

    Directory of Open Access Journals (Sweden)

    Alessandra Graziottin

    2008-11-01

    Full Text Available Alessandra GraziottinCenter of Gynecology and Medical Sexology, H San Raffaele Resnati, Via Santa Croce 10/a, 20123 Milano, ItalyAbstract: The worldwide introduction of the first, unique patch for hormonal contraception (ethinyl estradiol/norelgestromin, EE/NGMN patch was widely recognized as a significant event in the development of drug delivery systems. This innovation offers a number of advantages over the oral route, and extensive clinical trials have proved its safety, efficacy, effectiveness, and tolerability. The weekly administration and ease of use/simplicity of the EE/NGMN patch contribute to its acceptability, and help to resolve the two main problems of non-adherence, namely early discontinuation and inconsistent use. The patch offers additional benefits to adolescents (improvement of dysmenorrhea and acne, adults (improvement in emotional and physical well-being, premenstrual syndrome, and menstrual irregularities, and perimenopausal women (correction of hormonal imbalance, modulation of premenopausal symptoms, thus providing high satisfaction rates (in nearly 90% of users. Since its introduction, the transdermal contraceptive patch has proved to be a useful choice for women who seek a convenient formulation which is easy to use, with additional, non-contraceptive tailored benefits for all the ages.Keywords: transdermal, hormonal contraceptive, patient satisfaction, patient adherence

  6. Hip Arthroscopy Outcomes With Respect to Patient Acceptable Symptomatic State and Minimal Clinically Important Difference.

    Science.gov (United States)

    Levy, David M; Kuhns, Benjamin D; Chahal, Jaskarndip; Philippon, Marc J; Kelly, Bryan T; Nho, Shane J

    2016-09-01

    To determine whether the hip arthroscopy literature to date has shown outcomes consistent with published patient acceptable symptomatic state (PASS) and minimal clinically important difference (MCID) estimates. All clinical investigations of hip arthroscopy using modified Harris Hip Score (mHHS) and/or Hip Outcome Score (HOS) outcomes with at least 1 year of follow-up were reviewed. Ninety-one studies (9,746 hips) were included for review. Eighty-one studies (9,317 hips) contained only primary hip arthroscopies and were the primary focus of this review. The remaining studies (429 hips) did not exclude patients with prior surgical history and were thus considered separately. Mean mHHS, HOS-ADL (Activities of Daily Living) and HOS-SS (Sports-Specific) scores were compared with previously published PASS and MCID values. After 31 ± 20 months, 5.8% of study populations required revision arthroscopy and 5.5% total hip arthroplasty. A total of 88%, 25%, and 30% of study populations met PASS for mHHS, HOS-ADL, and HOS-SS, respectively, and 97%, 90%, and 93% met MCID. On bivariate analysis, increasing age was associated with significantly worse postoperative mHHS (P arthroscopy, we have found that more than 90% of study populations meet MCID standards for the most commonly used patient-reported outcomes measures in hip arthroscopy literature, mHHS and HOS. Eighty-eight percent meet PASS standards for the mHHS, but PASS standards are far more difficult to achieve for HOS-ADL (25%) and HOS-SS (30%) subscales. Differences in psychometric properties of the mHHS and HOS likely account for the discrepancies in PASS. Level IV, systematic review of Level I to IV studies. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  7. Characteristics of Patients Accepting and Declining Participation in a Transition of Care Service Provided by a Community Pharmacy

    Directory of Open Access Journals (Sweden)

    Julianne M Kowalski, PharmD

    2017-02-01

    Full Text Available Objectives: To identify characteristics of patients who accepted or declined an appointment for a transition of care service provided by an independent community pharmacist and identify the most common reasons patients declined the service. Methods: A transition of care service was offered by a community pharmacy to patients discharged to home from the cardiac unit of a local hospital. The community pharmacist approached patients prior to discharge for recruitment into the service. Outcomes included service acceptance rate, LACE score at discharge, readmission risk category, age, gender, geographic home location, and reason for refusing the service. Descriptive statistics and logistic regression were used to compare characteristics between those who accepted or declined the service. Reasons for decline were assessed using content analysis. Results: Of the 87 patients that were included in the analysis, 21 patients received the transitions of care service (24.1%. None of the characteristics were found to be statistically significant between patients who received or declined the service. Patients at a moderate risk for readmission seemed more likely to accept the pharmacist-run appointment than those at high risk (27.9% vs 15.3%; P = 0.29. Of the 66 patients who declined, 51 gave a reason (77.3%. Thirty-nine patients saw no benefit (76.5%, five patients had perceived barriers (10%, and seven patients gave reasons that fell into both categories (13.5%. Conclusions: This evaluation did not find a statistically significant difference in characteristics between those patients who accepted or declined participation in a pharmacist-run transition of care service. Patients may be less likely to accept pharmacist-run transition of care appointments primarily due to no perceived benefits. To increase participation, we need to understand the patient’s health beliefs, educate patients on pharmacy services, and implement changes to recruit potential

  8. Psychometric Properties of the Chinese Version of the Acceptance of Chronic Health Conditions (Stoma) Scale for Patients With Stoma.

    Science.gov (United States)

    Lim, Siew Hoon; He, Hong-Gu; Chan, Sally Wai Chi

    Formation of a stoma is a common outcome in surgical treatment of colorectal cancer. A higher acceptance of stoma was shown to improve quality of life of patients. No instrument in Chinese is available that can be used to measure the acceptance of stoma among patients with colorectal cancer. The aims of this study were to translate and test the psychometric properties of Chinese version of Acceptance of Chronic Health Conditions (ACHC) (Stoma) scale. A sample of 100 Chinese-speaking patients with stoma was recruited from a public tertiary care hospital in Singapore. The scale was translated into Chinese and reviewed by an expert panel for semantic equivalence and content validity testing. Convergent validity was established by exploring correlations between scores of the Chinese version of the ACHC (Stoma) scale and those of the 5-level version of European Quality of Life Questionnaire-5 Dimensions. Reliability was assessed by internal consistency and test-retest reliability. The newly translated scale had high content validity (content validity index = 94%) and acceptable internal consistency (Cronbach's α = .846). The test-retest reliability was satisfactory with an intraclass coefficient of 0.997. A positive correlation was found between both scores on ACHC (Stoma) scale and EQ-5D utility score (r = 0.63, P Stoma) scale demonstrated satisfactory content validity, good convergent validity, and adequate internal consistency and stability. This scale can be used as a convenient screening tool in clinical settings to assess the level of acceptance in Chinese-speaking patients with stoma.

  9. Assessing physician and patient acceptance of infliximab biosimilars in rheumatoid arthritis, ankylosing spondyloarthritis and psoriatic arthritis across Germany

    Directory of Open Access Journals (Sweden)

    Waller J

    2017-03-01

    Full Text Available John Waller,1 Emma Sullivan,1 James Piercy,1 Christopher M Black,2 Sumesh Kachroo2 1Adelphi Real World, Manchester, UK; 2Center for Observational and Real-World Evidence (CORE, Merck & Co., Inc., Kenilworth, NJ, USA Objectives: We examined rheumatologists’ motivation for prescribing biosimilars, assessed their treatment preferences in relation to prescribing behavior and explored patient attitudes to biosimilars. Methods: Data were taken from the Adelphi Real World Biosimilars Programme, a real-world, cross-sectional study undertaken with German rheumatologists and patients with rheumatoid arthritis, ankylosing spondyloarthritis or psoriatic arthritis in 2015–2016. Rheumatologists provided data on their prescribing behavior and attitudes toward biosimilars and invited the next eight eligible consecutive consulting patients to complete a questionnaire. Rheumatologists were split into “investigative”, “conservative” and “other” groups. Results: Overall, 50 rheumatologists and 261 patients participated. Biosimilars accounted for <10% of all biologic therapy prescriptions, and >95% of rheumatologists would prescribe a biooriginator rather than biosimilar as the first- or second-line therapy if unrestricted. Patients showed some reluctance to accept biosimilars, and a small proportion of patients were unhappy when switched from a biooriginator to a biosimilar. Satisfaction with treatment was highest in patients who started treatment with a biooriginator prior to biosimilar availability. Patient concerns when starting treatment with a biooriginator or a biosimilar included not knowing enough about the drug (25%–41%, potential side effects (26%–32% and potential long-term problems (19%–30%. Conclusion: Study results demonstrate that there is some reluctance from patients to accept biosimilars and the need to educate patients who are unsure to allow them to be involved in decision making, highlighting the importance of patient and

  10. Pain intensity in patients with juvenile idiopathic arthritis with respect to the level of their activity and disease acceptance

    Directory of Open Access Journals (Sweden)

    Grażyna Cepuch

    2014-11-01

    Full Text Available Objectives: Being diagnosed with a chronic disease, such as juvenile idiopathic arthritis (JIA, may adversely affect the activity of a young person. Additionally, the pain associated with the disease may cause difficulty accepting it. The aim was to assess the intensity of pain as well as the degree of activity and acceptance of the disease in young people aged 14–18 years with JIA. Material and methods : The study group consisted of youth of both genders suffering from JIA aged 14–18 years during remission of the disease. The study included 50 people and used the following: numerical rating scale (NRS 0–10, Cantril ladder, activity scale of own authorship (grouped items of the questionnaire form subscales of: tiredness, physical activity, social and intellectual activity and Acceptance of Illness Scale (AIS. Statistical analysis included the following tests: Mann-Whitney U test, Wilcoxon’s, χ2 test, Fisher’s, and Spearman rank correlation. The statistical significance level was set as p value below 0.05. Results : The majority of the respondents observed currently do not feel pain or feel pain of low intensity. The young people are physically, psychologically and socially active. The majority of patients accept their illness. The patients who suffer from pain on the NRS scale within 4–7 points do not adapt to living with the disease as do patients without pain or experiencing pain of low intensity. There was a strong correlation between acceptance of the disease at the time of the study determined by the Cantril ladder and AIS. Conclusions : 1. The pain suffered by patients with juvenile idiopathic arthritis (JIA has undoubtedly a negative impact on their activity and acceptance of the disease. 2. It seems to be crucial to recognize pain as a significant determinant of acceptance of the disease.

  11. Pain acceptance potentially mediates the relationship between pain catastrophizing and post-surgery outcomes among compensated lumbar fusion patients

    Directory of Open Access Journals (Sweden)

    Dance C

    2016-12-01

    Full Text Available Cassie Dance,1 M. Scott DeBerard,1 Jessica Gundy Cuneo2 1Department of Psychology, Utah State University, Logan, UT, 2Department of Psychiatry, University of California, San Diego, CA, USA Purpose: Chronic low back pain is highly prevalent and often treatment recalcitrant condition, particularly among workers’ compensation patients. There is a need to identify psychological factors that may predispose such patients to pain chronicity. The primary aim of this study was to examine whether pain acceptance potentially mediated the relationship between pain catastrophizing and post-surgical outcomes in a sample of compensated lumbar fusion patients.Patients and methods: Patients insured with the Workers Compensation Fund of Utah and who were at least 2 years post-lumbar fusion surgery completed an outcome survey. These data were obtained from a prior retrospective-cohort study that administered measures of pain catastrophizing, pain acceptance, mental and physical health, and disability.Results: Of the 101 patients who completed the outcome survey, 75.2% were male with a mean age of 42.42 years and predominantly identified as White (97.0%. The majority of the participants had a posterior lumbar interbody fusion surgery. Pain acceptance, including activity engagement and pain willingness, was significantly correlated with better physical health and mental health, and lower disability rates. Pain catastrophizing was inversely correlated with measures of pain acceptance (activity engagement r=–0.67, p<0.01, pain willingness r=–0.73, p<0.01 as well as the outcome measures: mental health, physical health, and disability. Pain acceptance significantly mediated the relationship between pain catastrophizing and both mental and physical health and also the relationship between pain catastrophizing and disability. Conclusion: This study demonstrated that the relationship between pain catastrophizing and negative patient outcomes was potentially mediated

  12. Internet Searches About Therapies Do Not Impact Willingness to Accept Prescribed Therapy in Inflammatory Bowel Disease Patients.

    Science.gov (United States)

    Feathers, Alexandra; Yen, Tommy; Yun, Laura; Strizich, Garrett; Swaminath, Arun

    2016-04-01

    A significant majority of patients with inflammatory bowel disease (IBD) search the Internet for information about their disease. While patients who search the Internet for disease or treatment information are believed to be more resistant to accepting medical therapy, no studies have tested this hypothesis. All IBD patients over a 3-month period across three gastroenterology practices were surveyed about their disease, treatments, websites visited, attitudes toward medications, and their willingness to accept prescribed therapies after disease-related Internet searches. Of 142 total patients, 91 % of respondents searched the Internet for IBD information. The vast majority (82 %) reported taking medication upon their doctor's recommendation and cited the desire to acquire additional information about their disease and prescribed therapies as their most important search motivator (77 %). Internet usage did not affect the willingness of 52 % of our cohort to accept prescribed medication. The majority of IBD patients who searched the Internet for disease and treatment-related information were not affected in their willingness to accept prescribed medical therapy.

  13. Trends in Readmission Rates, Hospital Charges, and Mortality for Patients With Chronic Obstructive Pulmonary Disease (COPD) in Florida From 2009 to 2014.

    Science.gov (United States)

    Jiang, Xinyi; Xiao, Hong; Segal, Richard; Mobley, William Cary; Park, Haesuk

    2018-04-01

    Chronic obstructive pulmonary disease (COPD) is a leading and costly cause of readmissions to the hospital, with one of the highest rates reported in Florida. From 2009 to 2014, strategies such as readmission reduction programs, as well as updated guidelines for COPD management, were instituted to reduce readmission rates for patients with COPD. Thus, the question has been raised whether COPD-related 30-day hospital readmission rates in Florida have decreased and whether COPD-related readmission costs during this period have changed. In addition, we examined trends in length of stay, hospital charges, and in-hospital mortality associated with COPD, as well as identified patient-level risk factors associated with 30-day readmissions. A retrospective analysis of adult patients (≥18 years of age) with COPD was conducted by using the Healthcare Cost and Utilization Project Florida State Inpatient Database, 2009 to 2014. Weighted least squares regression was used to assess trends in the COPD readmission rate on a yearly basis, as well as other outcomes of interest. A multivariable logistic regression was used to identify patient characteristics that were associated with 30-day COPD readmissions. Overall, 268,084 adults were identified as having COPD. Between 2009 and 2014, more than half of patients aged 65-84 years, most were white, 55% were female, and 73% had Medicare. The unadjusted rate for COPD-related 30-day readmissions did not change (8.04% to 7.85%; P = 0.434). However, the mean total charge for 30-day COPD-related readmissions was significantly higher in 2014 ($40,611) compared with that in 2009 ($36,714) (P = 0.011). The overall unadjusted in-hospital mortality of COPD-related hospitalizations significantly decreased from 1.83% in 2009 to 1.34% in 2014 (P COPD were 2% less likely to be readmitted to the hospital for each additional year (odds ratio [OR], 0.98 [95% confidence interval (CI), 0.97-0.99]). Factors associated with significantly higher odds of

  14. Efficacy, side-effects and patients' acceptance of different bleaching techniques (OTC, in-office, at-home).

    NARCIS (Netherlands)

    Auschill, T.M.; Hellwig, E.; Schmidale, S.; Sculean, A.; Arweiler, N.B.

    2005-01-01

    This clinical study compared the efficacy of three different bleaching techniques with respect to the bleaching times required in order to achieve six grades of whitening in human teeth. Any side effects that were noted and the patients' acceptance of the method were recorded by a visual analog

  15. Feasibility and acceptability of e-cigarettes as an aid to quitting smoking among lung cancer patients: a pilot study

    OpenAIRE

    Allison Ford; Lesley Sinclair; Jennifer Mckell; Stephen Harrow; Jennifer Macphee; Andy Morrison; Linda Bauld

    2018-01-01

    Background Many patients diagnosed with lung cancer continue to smoke even though this can make their treatment less effective and increase side effects. E-cigarettes form part of the UK's tobacco harm reduction policy landscape and are, by far, smokers' most popular quit attempt method. This pilot study explores feasibility and acceptability of e-cigarettes to aid smoking cessation among lung cancer patients undergoing chemotherapy. Methods 27 smokers with stage IV lung cancer we...

  16. [Feasibility and acceptance of computer-based assessment for the identification of psychosocially distressed patients in routine clinical care].

    Science.gov (United States)

    Sehlen, Susanne; Ott, Martin; Marten-Mittag, Birgitt; Haimerl, Wolfgang; Dinkel, Andreas; Duehmke, Eckhart; Klein, Christian; Schaefer, Christof; Herschbach, Peter

    2012-07-01

    This study investigated feasibility and acceptance of computer-based assessment for the identification of psychosocial distress in routine radiotherapy care. 155 cancer patients were assessed using QSC-R10, PO-Bado-SF and Mach-9. The congruence between computerized tablet PC and conventional paper assessment was analysed in 50 patients. The agreement between the 2 modes was high (ICC 0.869-0.980). Acceptance of computer-based assessment was very high (>95%). Sex, age, education, distress and Karnofsky performance status (KPS) did not influence acceptance. Computerized assessment was rated more difficult by older patients (p = 0.039) and patients with low KPS (p = 0.020). 75.5% of the respondents supported referral for psycho-social intervention for distressed patients. The prevalence of distress was 27.1% (QSC-R10). Computer-based assessment allows easy identification of distressed patients. Level of staff involvement is low, and the results are quickly available for care providers. © Georg Thieme Verlag KG Stuttgart · New York.

  17. Impacts of Initial Transformation to a Patient-Centered Medical Home on Diabetes Outcomes in Federally Qualified Health Centers in Florida.

    Science.gov (United States)

    Kinsell, Heidi S; Hall, Allyson G; Harman, Jeffrey S; Tewary, Sweta; Brickman, Andrew

    2017-10-01

    Federally qualified health centers (FQHCs) in Florida see large numbers of vulnerable patients with diabetes. Patient-centered medical home (PCMH) models can lead to improvements in health for patients with chronic conditions and cost savings for providers. Therefore, FQHCs are increasingly moving to PCMH models of care. The study objective was to examine the effects of initial transformation to a level 3 National Committee for Quality Assurance (NCQA) certified PCMH in 2011, on clinical diabetes outcomes among 27 clinic sites from a network of FQHCs in Florida. We used de-identified, longitudinal electronic health record (EHR) data from 2010-2012 and multivariate logistic regression to analyze the effects of initial transformation on the odds of having well-controlled HbA1c, body mass index (BMI), and blood pressure (BP) among vulnerable patients with diabetes. Models controlled for clustering by year, patient, and organizational characteristics. Overall, transformation to a PCMH was associated with 19% greater odds of having well-controlled HbA1c values with no statistically significant impact on BMI or BP. Subanalyses showed transformation had less of an effect on BP for African American patients and HbA1c control for Medicare enrollees but a greater effect on weight control for patients older than 35 years. Transformation to a PCMH in FQHCs appears to improve the health of vulnerable patients with diabetes, with less improvement for subsets of patients. Future research should seek to understand the heterogeneous effects of patient-centered transformation on various subgroups.

  18. Long term safety, efficacy, and patient acceptability of hyaluronic acid injection in patients with painful osteoarthritis of the knee

    Science.gov (United States)

    McArthur, Benjamin A; Dy, Christopher J; Fabricant, Peter D; Valle, Alejandro Gonzalez Della

    2012-01-01

    The increasing prevalence of painful knee osteoarthritis has created an additional demand for pharmacologic management to prevent or delay surgical management. Viscosupplementation, via intraarticular injection of hyaluronic acid (HA), aims to restore the favorable milieu present in the nonarthritic joint. The safety profile of intraarticular HA injections for painful knee osteoarthritis is well established, with the most common adverse effect being a self-limited reaction at the injection site. Although acceptance of the early literature has been limited by publication bias and poor study quality, more recent and rigorous meta-analysis suggests that intraarticular HA injection is superior to placebo injection for pain relief and matches, if not surpasses, the effect size of other nonoperative treatments, such as nonsteroidal anti-inflammatory medication. Intraarticular HA injection is effective in providing temporary pain relief in patients with painful knee osteoarthritis. Future investigations should focus on optimizing the composition and administration of HA agents to provide prolonged relief of painful osteoarthritis in the knee and other joints. PMID:23271899

  19. Feasibility and Acceptability of a Real-Time Adherence Device among HIV-Positive IDU Patients in China

    Directory of Open Access Journals (Sweden)

    Mary Bachman DeSilva

    2013-01-01

    Full Text Available We collected data on feasibility and acceptability of a real-time web-linked adherence monitoring container among HIV-positive injection drug users (IDU in China. “Wisepill” uses wireless technology to track on-time medication dosing. Ten patients on antiretroviral therapy (ART at the Guangxi CDC HIV clinic in Nanning, China, used Wisepill for one ART medication for one month. We monitored device use and adherence and explored acceptability of the device among patients. Mean adherence was 89.2% (SD 10.6%. Half of the subjects reported a positive overall experience with Wisepill. Seven said that it was inconvenient, supported by comments that it was large and conspicuous. Five worried about disclosure of HIV status due to the device; no disclosures were reported. Twelve signal lapses occurred (5.4% of prescribed doses, of which one was due to technical reasons, nine to behavioral reasons (both intentional and unintentional, and two to unclear reasons. Although the technical components must be monitored carefully, and acceptability to patients presents challenges which warrant further exploration, the Wisepill device has potential for adherence interventions that deliver rapid adherence-support behavioral feedback directly to patients, including IDU. The use of wireless technology appears uniquely promising for providing time-sensitive communication on patient behavior that can be harnessed to maximize the benefits of HIV treatment.

  20. The acceptability to patients of PhysioDirect telephone assessment and advice services; a qualitative interview study.

    Science.gov (United States)

    Pearson, Jennifer; Richardson, Jane; Calnan, Michael; Salisbury, Chris; Foster, Nadine E

    2016-03-28

    In response to long waiting lists and problems with access to primary care physiotherapy, several Primary Care Trusts (PCTs) (now Clinical Commissioning Groups CCGs) developed physiotherapy-led telephone assessment and treatment services. The Medical Research Council (MRC) funded PhysioDirect trial was a randomised control trial (RCT) in four PCTs, with a total of 2252 patients that compared this approach with usual physiotherapy care. This nested qualitative study aimed to explore the acceptability of the PhysioDirect telephone assessment and advice service to patients with musculoskeletal conditions. We conducted 57 semi-structured interviews with adults from 4 PCTs who were referred from general practice to physiotherapy with musculoskeletal conditions and were participating in the PhysioDirect trial. The Framework method was used to analyse the qualitative data. The PhysioDirect service was largely viewed as acceptable although some saw it as a first step to subsequent face-to-face physiotherapy. Most participants found accessing the PhysioDirect service straightforward and smooth, and they valued the faster access to physiotherapy advice offered by the telephone service. Participants generally viewed both the PhysioDirect service and the physiotherapists providing the service as helpful. Participants' preferences and priorities for treatment defined the acceptable features of PhysioDirect but the acceptable features were traded off against less acceptable features. Some participants felt that the PhysioDirect service was impersonal and impaired the development of a good relationship with their physiotherapist, which made the service feel remote and less valuable. The PhysioDirect service was broadly acceptable to participants since it provided faster access to physiotherapy advice for their musculoskeletal conditions. Participants felt that it is best placed as one method of accessing physiotherapy services, in addition to, rather than as a replacement for

  1. Relationships between dispositional mindfulness, self-acceptance, perceived stress, and psychological symptoms in advanced gastrointestinal cancer patients.

    Science.gov (United States)

    Xu, Wei; Zhou, Yuyang; Fu, Zhongfang; Rodriguez, Marcus

    2017-12-01

    Previous studies have shown that dispositional mindfulness is associated with less psychological symptoms in cancer patients. The present study investigated how dispositional mindfulness is related to psychological symptoms in advanced gastrointestinal cancer patients by considering the roles of self-acceptance and perceived stress. A total of 176 patients with advanced gastrointestinal cancer were recruited to complete a series of questionnaires including Mindfulness Attention Awareness Scale, Self-acceptance Questionnaire, Chinese Perceived Stress Scale, and General Health Questionnaire. Results showed that the proposed model fitted the data very well (χ 2  = 7.564, df = 7, P = .364, χ 2 /df = 1.094, Goodness of Fit Index (GFI) = 0.986, Comparative Fit Index (CFI) = 0.998, Tucker Lewis Index (TLI) = 0.995, Root Mean Square Error of Approximation (RMSEA) = 0.023). Further analyses revealed that, self-acceptance and perceived stress mediated the relation between dispositional mindfulness and psychological symptoms (indirect effect = -0.052, 95% confidence interval = -0.087 ~ -0.024), while self-acceptance also mediated the relation between dispositional mindfulness and perceived stress (indirect effect = -0.154, 95% confidence interval = -0.261 ~ -0.079). Self-acceptance and perceived stress played critical roles in the relation between dispositional mindfulness and psychological symptoms. Limitations, clinical implications, and directions for future research were discussed. Copyright © 2017 John Wiley & Sons, Ltd.

  2. Acceptance and Commitment Based Therapy on Disease Perception and Psychological Capital in Patients with Type II Diabetes

    Directory of Open Access Journals (Sweden)

    A. Baghban Baghestan

    2017-02-01

    Full Text Available Aims: As a prevalent metabolic disease, diabetes can be followed by severe mental outcomes leading to problems affecting the daily life. The aim of the study was to determine the effects of acceptance and commitment-based intervention on illness perception and psychological capital in persons with type II diabetes. Materials & Methods: In the controlled pretest-posttest semi-experimental study, 34 patients with type II diabetes were studied in the Diabetes Clinic of Chamran Hospital of Ferdows City in 2015. The subjects, selected via available sampling method, were randomly divided into two groups including control (n=17 persons and experimental (n=17 persons groups. Data was collected by short illness perception questionnaire (IPQ and Luthans’ psychological capital questionnaire (PCQ. Eight 60-minute acceptance and commitment-base intervention sessions were weekly conducted in experimental group. Data was analyzed by SPSS 18 software using descriptive statistics and covariance analysis test. Findings: The pretest score having been adjusted, the acceptance and commitment-based intervention significantly increases the scores of illness perception and its sub-scales (p=0.0001 except the personal control sub-scale. In addition, it significantly increases the scores of the psychological capital and its sub-scales (p=0.0001 in patients with type II diabetes. Conclusion: The acceptance and commitment-based intervention can considerably improve the illness perception and the psychological capital in persons with type II diabetes.

  3. Emotional control, styles of coping with stress and acceptance of illness among patients suffering from chronic somatic diseases.

    Science.gov (United States)

    Janowski, Konrad; Kurpas, Donata; Kusz, Joanna; Mroczek, Bożena; Jedynak, Tomasz

    2014-02-01

    The purpose of this study was to analyse the associations of emotional control with sociodemographic and clinical variables in a sample of patients with a range of chronic somatic diseases. The relationships between emotional control, coping styles and adjustment to the disease were investigated. The sample consisted of 300 patients with the mean age of 54.60 ± 17.57 years. Courtauld Emotional Control Scale was used to measure the patients' tendency to suppress negative emotions, Coping Inventory for Stressful Situations was used to measure coping styles and Acceptance of Illness Scale was applied to determine adjustment to the disease. Patients with neurological conditions showed significantly lower suppression of anger. Levels of emotional control were found to be related to gender, age and educational level but not to the place of residence. Task-oriented style of coping with stress correlated positively with suppression of depression and anxiety, whereas acceptance of illness correlated negatively with suppression of anger. Levels of emotional control are only weakly related to the type of diagnosis; however, some clinical samples may show lower suppression of anger. Suppression of negative emotions is weakly related to adjustment indicators such as certain coping styles and acceptance of illness. Copyright © 2013 John Wiley & Sons, Ltd.

  4. Young women's decisions to accept chlamydia screening: influences of stigma and doctor-patient interactions

    Directory of Open Access Journals (Sweden)

    O'Connell Emer

    2010-07-01

    Full Text Available Abstract Background An understanding of the factors that encourage young women to accept, and discourage them from accepting, STI (sexually transmitted infection testing is needed to underpin opportunistic screening programs for the STI Chlamydia trachomatis (opportunistic screening involves healthcare professionals offering chlamydia tests to people while they are attending health services for reasons that are usually unrelated to their sexual health. We conducted a qualitative study to identify and explore: how young women would feel about being offered opportunistic tests for chlamydia?; how young women would like to be offered screening, and who they wanted to be offered screening by?; and what factors would influence young women's partner notification preferences for chlamydia (who they would notify in the event of a positive diagnosis of chlamydia, how they would want to do this. Methods Semi-structured interviews with 35 young women between eighteen and twenty nine years of age. The study was conducted in the Dublin and Galway regions of the Republic of Ireland. Young adults were recruited from General Practice (GP practices, Third Level College health services, Family Planning clinics and specialist STI treatment services. Results Respondents were worried that their identities would become stigmatised if they accepted screening. Younger respondents and those from lower socio-economic backgrounds had the greatest stigma-related concerns. Most respondents indicated that they would accept screening if it was offered to them, however; accepting screening was seen as a correct, responsible action to engage in. Respondents wanted to be offered screening by younger female healthcare professionals. Respondents were willing to inform their current partners about positive chlamydia diagnoses, but were more ambivalent about informing their previous partners. Conclusions If an effort is not put into reducing young women's stigma-related concerns the

  5. Written advice can provide a safe and acceptable alternative to new patient assessment for selected referrals to haematologists.

    Science.gov (United States)

    Ganly, Peter S; Keeman, Helen; Spearing, Ruth L; Smith, Mark P; Patton, Nigel; Merriman, Eileen G; Gibbons, Steve S

    2008-01-07

    To measure the safety and acceptability of providing written advice (WA) for selected patients referred to a haematology service, as an alternative to inpatient or outpatient assessment. Review of the initial management and subsequent course of patients newly referred to a tertiary referral hospital in Christchurch, New Zealand, between 16 October 2003 and 8 June 2006. Structured questionnaires were sent to all referring doctors and patients recently managed with WA. Numbers and diagnoses of patients managed with WA, early assessment or delayed assessment; re-referral and treatment details; characteristics of WA letters; and opinions of referring doctors and their patients on the WA process. 26% of new referrals (714/2785) were managed with prompt WA, while 16% (455/2785) received the alternative of delayed assessment. After a median follow-up of 23 months (range, 8-40 months), 13% of those managed with WA (91/714) were re-referred back to the same haematologists; 7% (52/714) were assessed in hospital and 2% (15/714) eventually required treatment. There were no deaths due to haematological causes. Over 90% of responding referring doctors said the WA process was rapid and effective, and 77% of recently managed patients were pleased to be treated by their own doctors. Using WA to manage a substantial minority of patients referred to haematologists can be rapid and safe. It is widely accepted by referring doctors.

  6. How the definition of acceptable antigens and epitope analysis can facilitate transplantation of highly sensitized patients with excellent long-term graft survival.

    Science.gov (United States)

    Heidt, Sebastiaan; Haasnoot, Geert W; Claas, Frans H J

    2018-05-24

    Highly sensitized patients awaiting a renal transplant have a low chance of receiving an organ offer. Defining acceptable antigens and using this information for allocation purposes can vastly enhance transplantation of this subgroup of patients, which is the essence of the Eurotransplant Acceptable Mismatch program. Acceptable antigens can be determined by extensive laboratory testing, as well as on basis of human leukocyte antigen (HLA) epitope analyses. Within the Acceptable Mismatch program, there is no effect of HLA mismatches on long-term graft survival. Furthermore, patients transplanted through the Acceptable Mismatch program have similar long-term graft survival to nonsensitized patients transplanted through regular allocation. Although HLA epitope analysis is already being used for defining acceptable HLA antigens for highly sensitized patients in the Acceptable Mismatch program, increasing knowledge on HLA antibody - epitope interactions will pave the way toward the definition of acceptable epitopes for highly sensitized patients in the future. Allocation based on acceptable antigens can facilitate transplantation of highly sensitized patients with excellent long-term graft survival.

  7. Minimal clinically important improvement (MCII) and patient-acceptable symptom state (PASS) in total hip arthroplasty (THA) patients 1 year postoperatively

    DEFF Research Database (Denmark)

    Paulsen, Aksel; Roos, Ewa M.; Pedersen, Alma Becic

    2014-01-01

    -55% improvement from mean baseline PRO score and PASSs corresponded to absolute follow-up scores of 57-91% of the maximum score in THA patients 1 year after surgery. Interpretation - This study improves the interpretability of PRO scores. The different estimation approaches presented may serve as a guide......Background and purpose - The increased use of patient-reported outcomes (PROs) in orthopedics requires data on estimated minimal clinically important improvements (MCIIs) and patient-acceptable symptom states (PASSs). We wanted to find cut-points corresponding to minimal clinically important PRO...... change score and the acceptable postoperative PRO score, by estimating MCII and PASS 1 year after total hip arthroplasty (THA) for the Hip Dysfunction and Osteoarthritis Outcome Score (HOOS) and the EQ-5D. Patients and methods - THA patients from 16 different departments received 2 PROs and additional...

  8. Rehabilitation Engineering Service Evaluation: A Follow-Up Survey of Device Effectiveness and Patient Acceptance.

    Science.gov (United States)

    Caudrey, David J.; Seeger, Barry R.

    1983-01-01

    A study was undertaken to determine the extent to which a rehabilitation engineering service met the needs and expectations of 100 patients (or parents of child patients). The patients were interviewed an average of 16 weeks after a new piece of equipment was supplied. (Author)

  9. Neurophysiological mechanisms in acceptance and commitment therapy in opioid-addicted patients with chronic pain.

    Science.gov (United States)

    Smallwood, Rachel F; Potter, Jennifer S; Robin, Donald A

    2016-04-30

    Acceptance and Commitment Therapy (ACT) has been effectively utilized to treat both chronic pain and substance use disorder independently. Given these results and the vital need to treat the comorbidity of the two disorders, a pilot ACT treatment was implemented in individuals with comorbid chronic pain and opioid addiction. This pilot study supported using neurophysiology to characterize treatment effects and revealed that, following ACT, participants with this comorbidity exhibited reductions in brain activation due to painful stimulus and in connectivity at rest. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  10. Prejudices and perceptions: patient acceptance of mobile technology use in health care.

    Science.gov (United States)

    Alexander, S M; Nerminathan, A; Harrison, A; Phelps, M; Scott, K M

    2015-11-01

    mHealth is transforming health care, yet few studies have evaluated patient and carer perceptions of the use of smartphones at the patient bedside. In this study, 70 patients and carers answered a short survey on health professionals' use of mobile devices. Half the participants were tolerant of doctors using such devices if it was work-related; others believed it was a distraction and not beneficial to patient care. Changes in practice and patient education may be needed to enable effective use of mobile devices in health. © 2015 Royal Australasian College of Physicians.

  11. Pelvimetry and patient acceptability compared between open 0.5-T and closed 1.5-T MR systems

    International Nuclear Information System (INIS)

    Michel, Sven C.A.; Treiber, Karl; Marincek, Borut; Kubik-Huch, Rahel A.; Rake, Annett; Chaoui, Rabih; Keller, Thomas M.; Goetzmann, Lutz; Seifert, Burkhardt; Ferrazzini, Mattia

    2002-01-01

    Our objective was to compare maternal pelvimetry and patient acceptability between open low-field (0.5-T) and closed 1.5-T MR systems. Thirty women referred for pelvimetry (pregnant: n=15) were scanned twice in the supine position, once in the vertical open system and once in the closed system. Each patient completed a comfort and acceptability questionnaire. Pelvimetric and questionnaire data were compared between systems. Total scan time was double in the open system (7:52±1:47 vs 3:12±1:20 min). Poor image quality in the open system prevented assessment of interspinous and intertuberous diameters in one woman and all measurements in another, both pregnant, with abdominal circumferences >120 cm. The open system was much more acceptable in terms of claustrophobia and confinement (both p<0.01). Claustrophobia interrupted one closed examination. Thirty-three percent of pregnant women in both systems reported fear of fetal harm. Sixty percent of all women preferred the open system, 7% the closed system, and 33% had no preference. Limits of agreement of 3-5% from the mean for all diameters confirmed good pelvimetric reproducibility. Women's preference for open-system MR pelvimetry is feasible with abdominal circumferences ≤120 cm. (orig.)

  12. Pelvimetry and patient acceptability compared between open 0.5-T and closed 1.5-T MR systems

    Energy Technology Data Exchange (ETDEWEB)

    Michel, Sven C.A.; Treiber, Karl; Marincek, Borut; Kubik-Huch, Rahel A. [Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich (Switzerland); Rake, Annett; Chaoui, Rabih; Keller, Thomas M. [Department of Obstetrics, University Hospital Zurich, Raemistrasse 100, 8091 Zurich (Switzerland); Goetzmann, Lutz [Institute of Psychosocial Medicine, University Hospital Zurich, Raemistrasse 100, 8091 Zurich (Switzerland); Seifert, Burkhardt [Department of Biostatistics, University Hospital Zurich, Sumatrastrasse 30, 8006 Zurich (Switzerland); Department of Biostatistics, University Hospital Zurich, Sumatrastrasse 30, 8006 Zurich (Switzerland); Ferrazzini, Mattia [Department of Otorhinolaryngology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich (Switzerland)

    2002-12-01

    Our objective was to compare maternal pelvimetry and patient acceptability between open low-field (0.5-T) and closed 1.5-T MR systems. Thirty women referred for pelvimetry (pregnant: n=15) were scanned twice in the supine position, once in the vertical open system and once in the closed system. Each patient completed a comfort and acceptability questionnaire. Pelvimetric and questionnaire data were compared between systems. Total scan time was double in the open system (7:52{+-}1:47 vs 3:12{+-}1:20 min). Poor image quality in the open system prevented assessment of interspinous and intertuberous diameters in one woman and all measurements in another, both pregnant, with abdominal circumferences >120 cm. The open system was much more acceptable in terms of claustrophobia and confinement (both p<0.01). Claustrophobia interrupted one closed examination. Thirty-three percent of pregnant women in both systems reported fear of fetal harm. Sixty percent of all women preferred the open system, 7% the closed system, and 33% had no preference. Limits of agreement of 3-5% from the mean for all diameters confirmed good pelvimetric reproducibility. Women's preference for open-system MR pelvimetry is feasible with abdominal circumferences {<=}120 cm. (orig.)

  13. Initiation of CPAP therapy for OSA: does prophylactic humidification during CPAP pressure titration improve initial patient acceptance and comfort?

    Science.gov (United States)

    Wiest, G H; Harsch, I A; Fuchs, F S; Kitzbichler, S; Bogner, K; Brueckl, W M; Hahn, E G; Ficker, J H

    2002-01-01

    Heated humidifiers (HH) enable effective treatment of upper airway dryness during nasal continuous positive airway pressure (nCPAP) therapy for obstructive sleep apnoea (OSA), but the role of prophylactic use of HH during the initiation of nCPAP treatment has not been studied so far. The aim of the present study was to investigate whether prophylactic HH during the initiation of CPAP would result in improved initial patient comfort and acceptance. In 44 consecutive, previously untreated OSA patients with no history of upper airway dryness, CPAP titration with and without HH was performed on two consecutive nights in a randomised order. The patients were interviewed after each treatment night in order to establish the comfort of the treatment, and, after the second treatment, they were asked which of the two nights they considered more pleasant, and which treatment they would prefer for long-term use. Following CPAP titration with HH, 32 patients (73%) claimed to have had a better night's sleep than usual (i.e. without CPAP treatment) compared with 33 patients (75%) saying the same following CPAP treatment without HH. For 21 patients (47.7%) treatment with HH was more pleasant, 23 (52.3%) saw no difference or said that treatment without HH was more pleasant. Nineteen patients (43.2%) gave preference to treatment with HH for long-term use, while 25 patients (56.8%) had no preference or said they would prefer treatment without HH. The use of HH during the initiation phase of CPAP treatment was associated neither with an initial improvement in comfort nor with greater initial treatment acceptance. Copyright 2002 S. Karger AG, Basel

  14. Acceptance of a Mobile Application Supporting Nurses Workflow at Patient Bedside: Results from a Pilot Study.

    Science.gov (United States)

    Ehrler, Frederic; Ducloux, Pascal; Wu, Danny T Y; Lovis, Christian; Blondon, Katherine

    2018-01-01

    Supporting caregivers' workflow with mobile applications (apps) is a growing trend. At the bedside, apps can provide new ways to support the documentation process rather than using a desktop computer in a nursing office. Although these applications show potential, few existing reports have studied the real impact of such solutions. At the University Hospitals of Geneva, we developed BEDside Mobility, a mobile application supporting nurses' daily workflow. In a pilot study, the app was trialed in two wards for a period of one month. We collected data of the actual usage of the app and asked the users to complete a tailored technology acceptance model questionnaire at the end of the study period. Results show that participation remain stable with time with participants using in average the tool for almost 29 minutes per day. The technology acceptance questionnaires revealed a high usability of the app and good promotion from the institution although users did not perceive any increase in productivity. Overall, intent of use was divergent between promoters and antagonist. Furthermore, some participants considered the tool as an addition to their workload. This evaluation underlines the importance of helping all end users perceive the benefits of a new intervention since coworkers strong influence each other.

  15. Cultural acceptance of robotic telestroke medicine among patients and healthcare providers in Saudi Arabia. Results of a pilot study.

    Science.gov (United States)

    Al-Khathaami, Ali M; Alshahrani, Saeed M; Kojan, Suleiman M; Al-Jumah, Mohammed A; Alamry, Ahmed A; El-Metwally, Ashraf A

    2015-01-01

    To determine the degree of satisfaction and acceptance of stroke patients, their relatives, and healthcare providers toward using telestroke technology in Saudi Arabia. A cross-sectional study was conducted between October and December 2012 at King Abdulaziz Medical City, Ministry of National Guard Affairs, Riyadh, Saudi Arabia. The Remote Presence Robot (RPR), the RP-7i (FDA- cleared) provided by InTouch Health was used in the study. Patients and their relatives were informed that the physician would appear through a screen on top of a robotic device, as part of their clinical care. Stroke patients admitted through the emergency department, and their relatives, as well as healthcare providers completed a self-administered satisfaction questionnaire following the telestroke consultation sessions. Fifty participants completed the questionnaire. Most subjects agreed that the remote consultant interview was useful and that the audiovisual component of the intervention was of high quality; 98% agreed that they did not feel shy or embarrassed during the remote interview, were able to understand the instruction of the consultant, and recommended its use in stroke management. Furthermore, 92% agreed or strongly agreed that the use of this technology can efficiently replace the physical presence of a neurologist. Results suggest that the use of telestroke medicine is culturally acceptable among stroke patients and their families in Saudi Arabia and favorably received by healthcare providers.

  16. Quality of life and satisfaction with life of malaria patients in context of acceptance of the disease: quantitative studies.

    Science.gov (United States)

    Van Damme-Ostapowicz, Katarzyna; Krajewska-Kułak, Elżbieta; Rozwadowska, Emilia; Nahorski, Wacław L; Olszański, Romuald

    2012-06-29

    Health status is one of the basic factors of a high quality of life and the problem of the acceptance of illness is important for adaptation to the limitations imposed by it. The purpose of the study was the evaluation of the quality of life, satisfaction with life and the acceptance of illness by malaria patients, as well as the discovery of a relationship between studied parameters. The study was undertaken in August 2010, on 120 Nigerian patients with confirmed malaria. A method of diagnostic survey, based on standardized scales - Acceptance of Illness Scale, The Satisfaction With Life Scale and a standardized survey questionnaire World Health Organization Quality of Life/BREF - was used in this study. Descriptive statistics, variability range, 95% confidence interval, correlation analysis, Spearman's non-parametric correlation coefficient, Mann-Whitney test and Kruskal-Wallis test were applied and the, so called, test statistics was calculated, followed by the calculation of the test probability p. Results of analyses were presented in a box graph, and a graph of dispersion. A dominating share in the adjective scale of the AIS scale was the category of "no acceptance", given by 71.7% of respondents. The average level of a "somatic domain" was 41.7, and of a "social domain" was 62.8. The mean satisfaction of life evaluation in the SWLS scale was 18 points. The correlation between acceptance of the disease and quality of life for the psychological domain was 0.39***, and between acceptance of the disease and satisfaction with life was 0.40***. The correlation between satisfaction with life and quality of life for the psychological domain was 0.65***, and between satisfaction with life and quality of life for the environment domain was 0.60***. The mean level of AIS for the studied population of men was 16.5, and test probability: p = 0.0014**, and for the environment domain the level was 50, and the test probability: p = 0.0073**. For quality of life in

  17. Communicating the benefits of chronic preventive therapy: does the format of efficacy data determine patients' acceptance of treatment?

    Science.gov (United States)

    Hux, J E; Naylor, C D

    1995-01-01

    Patients' informed acceptance of chronic medical therapy hinges on communicating the potential benefits of drugs in quantitative terms. In a hypothetical scenario of treatment initiation, the authors assessed how three different formats of the same data affected the willingness of 100 outpatients to take what were implied to be three different lipid-lowering drugs. Side-effects were declared negligible and costs insured. Subjects make a "yes-no" decision about taking such a medication, and graded the decision on a certainty scale. Advised of a relative risk reduction--"34% reduction in heart attacks"--88% of the patients assented to therapy. All other formats elicited significantly more refusals (p benefits are presented. Multiple complementary formats may be most appropriate. The results imply that many patients may decline treatment if briefed on the likelihood or extent of benefit.

  18. Crisis model to assist the patient to establish self-management in accepting stoma

    OpenAIRE

    村田, 節子

    1995-01-01

    Patients with stoma are susceptible to psychological damage due to changes in both body image and bowel habituation Therefore, it is important to help those patients to be able to manage stoma care by themselves as well as to take care of postoperative recovery process. In gynecologic oncology field, almost all stoma ta are made for the patients who had metastatic tumor in the pelvis, or massive bleeding from rectum or fistula after radiation therapy. For the reason, there is a great risk of ...

  19. Integrating the patient portal into the health management work ecosystem: user acceptance of a novel prototype

    Science.gov (United States)

    Eschler, Jordan; Meas, Perry Lin; Lozano, Paula; McClure, Jennifer B.; Ralston, James D.; Pratt, Wanda

    2016-01-01

    People with a chronic illness must manage a myriad of tasks to support their health. Online patient portals can provide vital information and support in managing health tasks through notification and reminder features. However, little is known about the efficacy of these features in managing health tasks via the portal. To elicit feedback about reminder and notification features in patient portals, we employed a patient-centered approach to design new features for managing health tasks within an existing portal tool. We tested three iteratively designed prototypes with 19 patients and caregivers. Our findings provide insights into users’ attitudes, behavior, and motivations in portal use. Design implications based on these insights include: (1) building on positive aspects of clinician relationships to enhance engagement with the portal; (2) using face-to-face visits to promote clinician collaboration in portal use; and (3) allowing customization of portal modules to support tasks based on user roles. PMID:28269850

  20. Is the qualitative research interview an acceptable medium for research with palliative care patients and carers?

    OpenAIRE

    Shipman Cathy; Gysels Marjolein; Higginson Irene J

    2008-01-01

    Abstract Background Contradictory evidence exists about the emotional burden of participating in qualitative research for palliative care patients and carers and this raises questions about whether this type of research is ethically justified in a vulnerable population. This study aimed to investigate palliative care patients' and carers' perceptions of the benefits and problems associated with open interviews and to understand what causes distress and what is helpful about participation in a...

  1. Nomegestrol acetate/17-beta estradiol: a review of efficacy, safety, and patient acceptability

    Science.gov (United States)

    Akintomide, Hannat; Panicker, Sabeena

    2015-01-01

    Nomegestrol acetate (NOMAC) 2.5 mg with 17-beta estradiol (E2) 1.5 mg is a new combined oral contraceptive (COC) formulation and is the first monophasic E2 pill to be marketed, having been licensed for use in Europe in 2011. It is available to be taken daily in a regimen of 24 active pills followed by four placebo pills. NOMAC is a highly selective 19-nor progestogen derivative with specific binding to progesterone receptors, anti-estrogenic activity and no androgenic, mineralocorticoid nor glucocorticoid effects. E2 is an estrogen that is identical to endogenous estrogen. While it has been in use for only a short period of time, current evidence suggests that NOMAC/E2 is just as effective, safe, and acceptable as existing COC preparations. Two large Phase III trials conducted in the Americas and across Europe, Australia, and Asia showed lower cumulative pregnancy rates in the NOMAC/E2 groups compared to the drospirenone (DRSP) 3 mg in combination with ethinyl estradiol (EE) 30 µg (DRSP/EE) groups but this difference was not statistically significant. NOMAC/E2 exhibits a good safety profile and has less effects on cardiovascular risk, hemostatic, metabolic, and endocrine factors in comparison to COCs containing EE in combination with levonorgestrel (LNG) or DRSP. NOMAC/E2 has also been found to cause less breast cell proliferation when compared to E2 alone and has some anti-proliferative effect on human breast cancer cells. NOMAC/E2 is considered acceptable as its compliance, continuation rates, and bleeding patterns were similar to COCs containing DRSP/EE and LNG 150 µg combined with EE 30 µg or LNG 100 µg combined with EE 20 µg (LNG/EE). However, discontinuation was found to be slightly higher in the NOMAC/E2 groups in the two large Phase III trials comparing NOMAC/E2 use with DRSP/EE. As the scientific literature has limited information on NOMAC/E2, further experience with NOMAC/E2 is required. PMID:29386925

  2. Is the qualitative research interview an acceptable medium for research with palliative care patients and carers?

    Directory of Open Access Journals (Sweden)

    Shipman Cathy

    2008-04-01

    Full Text Available Abstract Background Contradictory evidence exists about the emotional burden of participating in qualitative research for palliative care patients and carers and this raises questions about whether this type of research is ethically justified in a vulnerable population. This study aimed to investigate palliative care patients' and carers' perceptions of the benefits and problems associated with open interviews and to understand what causes distress and what is helpful about participation in a research interview. Methods A descriptive qualitative study. The data were collected in the context of two studies exploring the experiences of care of palliative care patients and carers. The interviews ended with questions about patients' and carers' thoughts on participating in the studies and whether this had been a distressing or helpful event. We used a qualitative descriptive analysis strategy generated from the interviews and the observational and interactional data obtained in the course of the study. Results The interviews were considered helpful: sharing problems was therapeutic and being able to contribute to research was empowering. However, thinking about the future was reported to be the most challenging. Consent forms were sometimes read with apprehension and being physically unable to sign was experienced as upsetting. Interviewing patients and carers separately was sometimes difficult and not always possible. Conclusion The open interview enables the perspectives of patients and carers to be heard, unfettered from the structure of closed questions. It also enables those patients or carers to take part who would be unable to participate in other study designs. The context is at least as important as the format of the research interview taking into account the relational circumstances with carers and appropriate ways of obtaining informed consent. Retrospective consent could be a solution to enhancing participants control over the interview.

  3. Is the qualitative research interview an acceptable medium for research with palliative care patients and carers?

    Science.gov (United States)

    Gysels, Marjolein; Shipman, Cathy; Higginson, Irene J

    2008-04-24

    Contradictory evidence exists about the emotional burden of participating in qualitative research for palliative care patients and carers and this raises questions about whether this type of research is ethically justified in a vulnerable population. This study aimed to investigate palliative care patients' and carers' perceptions of the benefits and problems associated with open interviews and to understand what causes distress and what is helpful about participation in a research interview. A descriptive qualitative study. The data were collected in the context of two studies exploring the experiences of care of palliative care patients and carers. The interviews ended with questions about patients' and carers' thoughts on participating in the studies and whether this had been a distressing or helpful event. We used a qualitative descriptive analysis strategy generated from the interviews and the observational and interactional data obtained in the course of the study. The interviews were considered helpful: sharing problems was therapeutic and being able to contribute to research was empowering. However, thinking about the future was reported to be the most challenging. Consent forms were sometimes read with apprehension and being physically unable to sign was experienced as upsetting. Interviewing patients and carers separately was sometimes difficult and not always possible. The open interview enables the perspectives of patients and carers to be heard, unfettered from the structure of closed questions. It also enables those patients or carers to take part who would be unable to participate in other study designs. The context is at least as important as the format of the research interview taking into account the relational circumstances with carers and appropriate ways of obtaining informed consent. Retrospective consent could be a solution to enhancing participants control over the interview.

  4. Is the qualitative research interview an acceptable medium for research with palliative care patients and carers?

    Science.gov (United States)

    Gysels, Marjolein; Shipman, Cathy; Higginson, Irene J

    2008-01-01

    Background Contradictory evidence exists about the emotional burden of participating in qualitative research for palliative care patients and carers and this raises questions about whether this type of research is ethically justified in a vulnerable population. This study aimed to investigate palliative care patients' and carers' perceptions of the benefits and problems associated with open interviews and to understand what causes distress and what is helpful about participation in a research interview. Methods A descriptive qualitative study. The data were collected in the context of two studies exploring the experiences of care of palliative care patients and carers. The interviews ended with questions about patients' and carers' thoughts on participating in the studies and whether this had been a distressing or helpful event. We used a qualitative descriptive analysis strategy generated from the interviews and the observational and interactional data obtained in the course of the study. Results The interviews were considered helpful: sharing problems was therapeutic and being able to contribute to research was empowering. However, thinking about the future was reported to be the most challenging. Consent forms were sometimes read with apprehension and being physically unable to sign was experienced as upsetting. Interviewing patients and carers separately was sometimes difficult and not always possible. Conclusion The open interview enables the perspectives of patients and carers to be heard, unfettered from the structure of closed questions. It also enables those patients or carers to take part who would be unable to participate in other study designs. The context is at least as important as the format of the research interview taking into account the relational circumstances with carers and appropriate ways of obtaining informed consent. Retrospective consent could be a solution to enhancing participants control over the interview. PMID:18435846

  5. Knowledge, attitudes and acceptability to provider-initiated HIV testing and counseling: patients' perspectives in Moshi and Rombo Districts, Tanzania.

    Science.gov (United States)

    Manongi, Rachel; Mahande, Michael; Njau, Bernard

    2014-10-01

    Provider-initiated HIV testing and counseling (PITC) is referred to as routine testing in a clinical setting as part of a standard programme of medical services. PITC is initiated in order to avoid missed opportunities for people to get tested for HIV. While advocated as a strategy, there is dearth of information on patients' views on PITC in a number of districts in Tanzania. The objective of this study was to assess the knowledge, attitude and acceptability to PITC services among patients attending health care facilities in rural and urban settings in Kilimanjaro region A total of 12 focus group discussions (FGDs) were conducted with 99 (73 female and 26 male) patients enrolled into out-patient clinics in 8 (2 hospitals and 6 primary care centers) health facilities in Moshi Urban and Rombo districts in northern Tanzania. The study explored on knowledge, attitudes and acceptability of PITC, perceived benefits and barriers of PITC, and ethical issues related to PITC. Interviews were audio taped, transcribed, translated, and analyzed using Non-numerical Unstructured Data Indexing and Theorizing (NUDIST) software. Knowledge about PITC services was generally low. Compared to men, women had a more positive attitude towards PITC services, because of its ability to identify and treat undiagnosed HIV cases. HIV stigma was regarded as a major barrier to patients' uptake of PITC. Institutional factors such as lack of supplies and human resources were identified as barriers to successful provision of PITC. In conclusion, the findings highlight both opportunities and potential barriers in the successful uptake of PITC, and underscore the importance of informed consent, counseling and confidentiality and the need for specific strategies on advocacy for the service.

  6. Relocatable fixation systems in intracranial stereotactic radiotherapy. Accuracy of serial CT scans and patient acceptance in a randomized design.

    Science.gov (United States)

    Theelen, A; Martens, J; Bosmans, G; Houben, R; Jager, J J; Rutten, I; Lambin, P; Minken, A W; Baumert, B G

    2012-01-01

    The goal was to provide a quantitative evaluation of the accuracy of three different fixation systems for stereotactic radiotherapy and to evaluate patients' acceptance for all fixations. A total of 16 consecutive patients with brain tumours undergoing fractionated stereotactic radiotherapy (SCRT) were enrolled after informed consent (Clinical trials.gov: NCT00181350). Fixation systems evaluated were the BrainLAB® mask, with and without custom made bite-block (fixations S and A) and a homemade neck support with bite-block (fixation B) based on the BrainLAB® frame. The sequence of measurements was evaluated in a randomized manner with a cross-over design and patients' acceptance by a questionnaire. The mean three-dimensional (3D) displacement and standard deviations were 1.16 ± 0.68 mm for fixation S, 1.92 ± 1.28 and 1.70 ± 0.83 mm for fixations A and B, respectively. There was a significant improvement of the overall alignment (3D vector) when using the standard fixation instead of fixation A or B in the craniocaudal direction (p = 0.037). Rotational deviations were significantly less for the standard fixation S in relation to fixations A (p = 0.005) and B (p = 0.03). EPI imaging with off-line correction further improved reproducibility. Five out of 8 patients preferred the neck support with the bite-block. The mask fixation system in conjunction with a bite-block is the most accurate fixation for SCRT reducing craniocaudal and rotational movements. Patients favoured the more comfortable but less accurate neck support. To optimize the accuracy of SCRT, additional regular portal imaging is warranted.

  7. Relocatable fixation systems in intracranial stereotactic radiotherapy. Accuracy of serial CT scans and patient acceptance in a randomized design

    International Nuclear Information System (INIS)

    Theelen, A.; Martens, J.; Bosmans, G.; Houben, R.; Jager, J.J.; Rutten, I.; Lambin, P.; Baumert, B.G.; Minken, A.W.; Radiotherapeutic Inst. RISO, Deventer

    2012-01-01

    The goal was to provide a quantitative evaluation of the accuracy of three different fixation systems for stereotactic radiotherapy and to evaluate patients' acceptance for all fixations. Methods A total of 16 consecutive patients with brain tumours undergoing fractionated stereotactic radiotherapy (SCRT) were enrolled after informed consent (Clinical trials.gov: NCT00181350). Fixation systems evaluated were the BrainLAB registered mask, with and without custom made bite-block (fixations S and A) and a homemade neck support with bite-block (fixation B) based on the BrainLAB registered frame. The sequence of measurements was evaluated in a randomized manner with a cross-over design and patients' acceptance by a questionnaire. Results The mean three-dimensional (3D) displacement and standard deviations were 1.16 ± 0.68 mm for fixation S, 1.92 ± 1.28 and 1.70 ± 0.83 mm for fixations A and B, respectively. There was a significant improvement of the overall alignment (3D vector) when using the standard fixation instead of fixation A or B in the craniocaudal direction (p = 0.037). Rotational deviations were significantly less for the standard fixation S in relation to fixations A (p = 0.005) and B (p = 0.03). EPI imaging with off-line correction further improved reproducibility. Five out of 8 patients preferred the neck support with the bite-block. Conclusion The mask fixation system in conjunction with a bite-block is the most accurate fixation for SCRT reducing craniocaudal and rotational movements. Patients favoured the more comfortable but less accurate neck support. To optimize the accuracy of SCRT, additional regular portal imaging is warranted. (orig.)

  8. Increasing the acceptance of internet-based mental health interventions in primary care patients with depressive symptoms. A randomized controlled trial.

    Science.gov (United States)

    Ebert, D D; Berking, M; Cuijpers, P; Lehr, D; Pörtner, M; Baumeister, H

    2015-05-01

    Internet-based interventions (IBI) are effective in treating depression. However, uptake rates in routine care are still limited. Hence, this study aimed to (1) assess the acceptance of IBIs in primary care patients with depressive symptoms and to (2) examine the effects of a brief acceptance facilitating intervention in the form of an informational video on patients' acceptance of IBIs. Primary care patients (N=128) with Minor or Major Depression were randomly assigned to an intervention (IG) or control group (CG). Patients in the IG were shown a brief informational video about IBIs before receiving a questionnaire that assessed their acceptance of IBIs and other secondary outcomes. Patients of the CG filled out the questionnaire immediately. Baseline acceptance of IBIs in the CG was high for 6.3%, moderate for 53.1% and low for 40.6% of patients. Acceptance of IBIs was significantly higher in the IG when compared to the CG (d=.71, 95%-CI:.09-2.91). Except for social influence and the general attitude towards psychological treatment, all secondary outcomes were also significantly improved (e.g. effort- (d=.40) and performance-expectancy: d=.65; knowledge about Internet interventions d=.35). Depression of the participants was only assessed using a self-report measure (PHQ-9). Primary care patients' acceptance of IBIs for depressive symptoms was low but could be increased significantly using a brief acceptance facilitating intervention on the basis of an informational video. Future studies should further examine the potential of acceptance facilitating interventions for patients and health care providers to exploit the public health impact of IBIs. Copyright © 2015 Elsevier B.V. All rights reserved.

  9. Is billboard advertising beneficial for healthcare organizations? An investigation of efficacy and acceptability to patients.

    Science.gov (United States)

    Fortenberry, John L; McGoldrick, Peter J

    2010-01-01

    The healthcare industry is increasingly turning to billboard advertising to promote various medical services, yet little attention has been directed toward understanding the performance and policy implications of billboard advertising from the perspective of the patients targeted. To shed light on this, we initiated a field experiment investigating the impact of an urgent care center's billboard advertising campaign, collecting primary data over a 32-day period at the center's two clinics. Over the course of the billboard campaign, perspectives from 1,640 patients were collected via questionnaire. Institutionally supplied business metrics were also monitored. Our principal findings indicate that billboard advertisements are noticed by patients, favorably viewed by patients, and effective across the sequence of steps leading to patient patronage. Enhancement of awareness exerts the most powerful influence on patronage, but the capacity to inform consumers is also highly significant. These effects are not limited to new patients, as many returning clients were made more aware of the clinics and were influenced by the campaign. The study offers insights for creative billboard treatments and campaign planning. Although effects remained strong throughout the campaign, some degree of "wearout" was evident after three weeks, which suggests the need to rotate billboards frequently and to consider digital billboards. Corner tabs--small announcements sometimes placed in the corners of billboard advertisements--proved largely ineffective as a promotional device and may clutter the central messages. Given these findings, we believe healthcare institutions are justified in using billboards, as they perform effectively and appear relatively free of controversy. Careful planning of creative billboard treatments and appropriate scheduling patterns are essential to maximize their communications potential.

  10. Understanding why cancer patients accept or turn down psycho-oncological support: a prospective observational study including patients' and clinicians' perspectives on communication about distress.

    Science.gov (United States)

    Zwahlen, Diana; Tondorf, Theresa; Rothschild, Sacha; Koller, Michael T; Rochlitz, Christoph; Kiss, Alexander

    2017-05-30

    International standards prioritize introducing routine emotional distress screening in cancer care to accurately identify patients who most need psycho-oncological treatment, and ensure that patients can access appropriate supportive care. However, only a moderate proportion of distressed patients accepts referrals to or uses psycho-oncological support services. Predictors and barriers to psycho-oncological support service utilization are under-studied. We know little about how patients and oncologists perceive the discussions when oncologists assess psychosocial distress with a screening instrument. We aim to 1) assess the barriers and predictors of uptake of in-house psycho-oncological support along the distress screening pathway in cancer patients treated at a University Oncology Outpatient Clinic and, 2) determine how patients and clinicians perceive communication about psychosocial distress after screening with the Distress Thermometer. This is a quantitative prospective observational study with qualitative aspects. We will examine medical and demographic variables, cancer patient self-reports of various psychological measures, and aspects of the patient-clinician communication as variables that potentially predict uptake of psycho-oncological support service. We will also assess the patients' reasons for accepting or refusing psycho-oncological support services. We assess at three points in time, based on paper-and-pencil questionnaires and two patient interviews during the study period. We will monitor outcomes (psycho-oncology service uptake) four months after study entry. The study will improve our understanding of characteristics of patients who accept or refuse psycho-oncological support, and help us understand how patients' and oncologists perceive communication about psychosocial distress, and referral to a psycho-oncologist. We believe this is the first study to focus on factors that affect uptake or rejection of psycho-oncological support services

  11. An Acceptance-Based Psychoeducation Intervention to Reduce Expressed Emotion in Relatives of Bipolar Patients

    Science.gov (United States)

    Eisner, Lori R.; Johnson, Sheri L.

    2008-01-01

    Expressed emotion (EE) is a robust predictor of outcome in bipolar disorder. Despite decades of research, interventions to reduce EE levels have had only modest effects. This study used an expanded model of EE to develop an intervention. Research has demonstrated a strong link between attributions and EE in families of patients with psychiatric…

  12. Efficacy, safety, and patient acceptability of the combined chlormadinone acetate-ethinylestradiol oral contraceptive

    Directory of Open Access Journals (Sweden)

    Serena Ferrari

    2010-09-01

    Full Text Available Serena Ferrari, Marianna Cannoletta, Matteo Generali, Lucia Cazzato, Angelo CagnacciDepartment of Obstetrics, Gynecology, and Pediatrics, Azienda Ospedaliero, Universitaria di Modena, ItalyAbstract: Since their introduction in 1959, development of hormonal contraceptives has been ongoing, with the ultimate aim of creating not only an effective and safe contraceptive method, but also a drug able to meet the need for treatment of other conditions, such as acne, seborrhea, and hirsutism, with few or no side effects. With this objective, a new progestin, chlormadinone acetate (CMA, has been developed as a derivative of progesterone for ­contraception. This new molecule has been introduced in combination with ethinylestradiol (EE 30 µg as a safe ­contraceptive with antiandrogenic properties. Many clinical studies have investigated this new oral combination and found it to be safe, with a Pearl Index similar to that of other combined hormonal contraceptives. CMA, because of its antiandrogenic properties, has been also considered effective for resolution of acne, seborrhea, and hirsutism. The data show it to be a safe molecule in terms of glucose and lipid metabolism. No major weight changes have been linked with its use, and it seems to be the only progestin able to reduce fat mass during use. The CMA-EE combination is well tolerated and acceptable to women. Adverse events related to its use are similar to those reported with other third-generation ­contraceptives. We can conclude that CMA-EE is an effective, safe, and well tolerated ­antiandrogenic hormonal contraceptive.Keywords: chlormadinone acetate, acne, weight, metabolism, safety, hormonal contraceptive

  13. Feasibility, safety, acceptability, and preliminary efficacy of measurement-based care depression treatment for HIV patients in Bamenda, Cameroon.

    Science.gov (United States)

    Pence, Brian W; Gaynes, Bradley N; Atashili, Julius; O'Donnell, Julie K; Kats, Dmitry; Whetten, Kathryn; Njamnshi, Alfred K; Mbu, Tabenyang; Kefie, Charles; Asanji, Shantal; Ndumbe, Peter

    2014-06-01

    Depression affects 18-30 % of HIV-infected patients in Africa and is associated with greater stigma, lower antiretroviral adherence, and faster disease progression. However, the region's health system capacity to effectively identify and treat depression is limited. Task-shifting models may help address this large mental health treatment gap. Measurement-Based Care (MBC) is a task-shifting model in which a Depression Care Manager guides a non-psychiatric (e.g., HIV) provider in prescribing and managing antidepressant treatment. We adapted MBC for depressed HIV-infected patients in Cameroon and completed a pilot study to assess feasibility, safety, acceptability, and preliminary efficacy. We enrolled 55 participants; all started amitriptyline 25-50 mg daily at baseline. By 12 weeks, most remained at 50 mg daily (range 25-125 mg). Median (interquartile range) PHQ-9 depressive severity scores declined from 13 (12-16) (baseline) to 2 (0-3) (week 12); 87 % achieved depression remission (PHQ-9 feasibility, safety, acceptability, and preliminary efficacy in this uncontrolled pilot study. Further research should assess whether MBC could improve adherence and HIV outcomes in this setting.

  14. Florida sinkhole index

    OpenAIRE

    Spencer, Steven; Lane, Ed.

    1995-01-01

    The following data were compiled from the Florida Sinkhole Research Institute data base. That database, which contains approximately 1900 sinkholes, is available from the Florida Geological Survey upon request. The data are arranged alphabetically by county. The first two digits of the identification number represents the county. These numbers correspond to the Florida Department of Transportation county numbering system. Following the county number are three numbers which represe...

  15. Internet-enabled pulmonary rehabilitation and diabetes education in group settings at home: a preliminary study of patient acceptability.

    Science.gov (United States)

    Burkow, Tatjana M; Vognild, Lars K; Østengen, Geir; Johnsen, Elin; Risberg, Marijke Jongsma; Bratvold, Astrid; Hagen, Tord; Brattvoll, Morten; Krogstad, Trine; Hjalmarsen, Audhild

    2013-03-05

    The prevalence of major chronic illnesses, such as chronic obstructive pulmonary disease (COPD) and diabetes, is increasing. Pulmonary rehabilitation and diabetes self-management education are important in the management of COPD and diabetes respectively. However, not everyone can participate in the programmes offered at a hospital or other central locations, for reasons such as travel and transport. Internet-enabled home-based programmes have the potential to overcome these barriers.This study aims to assess patient acceptability of the delivery form and components of Internet-enabled programmes based on home groups for comprehensive pulmonary rehabilitation and for diabetes self-management education. We have developed Internet-enabled home programmes for comprehensive pulmonary rehabilitation and for diabetes self-management education that include group education, group exercising (COPD only), individual consultations, educational videos and a digital health diary. Our prototype technology platform makes use of each user's own TV at home, connected to a computer, and a remote control. We conducted a six-week home trial with 10 participants: one group with COPD and one with diabetes. The participants were interviewed using semi-structured interviews. Both home-based programmes were well accepted by the participants. The group setting at home made it possible to share experiences and to learn from questions raised by others, as in conventional group education. In the sessions, interaction and discussion worked well, despite the structure needed for turn taking. The thematic educational videos were well accepted although they were up to 40 minutes long and their quality was below TV broadcasting standards. Taking part in group exercising at home under the guidance of a physiotherapist was also well accepted by the participants. Participants in the COPD group appreciated the social aspect of group education sessions and of exercising together, each in their own home

  16. Patient acceptability of CT colonography compared with double contrast barium enema: results from a multicentre randomised controlled trial of symptomatic patients

    International Nuclear Information System (INIS)

    Wagner, Christian von; Smith, Samuel; Ghanouni, Alex; Power, Emily; Wardle, Jane; Halligan, Steve; Lilford, Richard J.; Morton, Dion; Dadswell, Edward; Atkin, Wendy

    2011-01-01

    To determine patient acceptability of barium enema (BE) or CT colonography (CTC). After ethical approval, 921 consenting patients with symptoms suggestive of colorectal cancer who had been randomly assigned and completed either BE (N = 606) or CTC (N = 315) received a questionnaire to assess experience of the clinical episode including bowel preparation, procedure and complications. Satisfaction, worry and physical discomfort were assessed using an adapted version of a validated acceptability scale. Non-parametric methods assessed differences between the randomised tests and the effect of patient characteristics. Patients undergoing BE were significantly less satisfied (median 61, interquartile range [IQR] 54-67 vs. median 64, IQR 56-69; p = 0.003) and experienced more physical discomfort (median 40, IQR 29-52 vs. median 35.5, IQR 25-47; p < 0.001) than those undergoing CTC. Post-test, BE patients were significantly more likely to experience 'abdominal pain/cramps' (68% vs. 57%; p = 0.007), 'soreness' (57% vs. 37%; p < 0.001), 'nausea/vomiting' (16% vs. 8%; p = 0.009), 'soiling' (31% vs. 23%; p = 0.034) and 'wind' (92% vs. 84%; p = 0.001) and in the case of 'wind' to also rate it as severe (27% vs. 15%; p < 0.001). CTC is associated with significant improvements in patient experience. These data support the case for CTC to replace BE. (orig.)

  17. Patient acceptability of CT colonography compared with double contrast barium enema: results from a multicentre randomised controlled trial of symptomatic patients

    Energy Technology Data Exchange (ETDEWEB)

    Wagner, Christian von; Smith, Samuel; Ghanouni, Alex; Power, Emily; Wardle, Jane [University College London, Department of Epidemiology and Public Health, London (United Kingdom); Halligan, Steve [University College London, Centre for Medical Imaging, London (United Kingdom); University College Hospital, Centre for Medical Imaging, London (United Kingdom); Lilford, Richard J. [Birmingham University, Department of Epidemiology, Birmingham (United Kingdom); Morton, Dion [Birmingham University, Department of Surgery, Birmingham (United Kingdom); Dadswell, Edward; Atkin, Wendy [Imperial College London, Department of Surgery and Cancer, London (United Kingdom)

    2011-10-15

    To determine patient acceptability of barium enema (BE) or CT colonography (CTC). After ethical approval, 921 consenting patients with symptoms suggestive of colorectal cancer who had been randomly assigned and completed either BE (N = 606) or CTC (N = 315) received a questionnaire to assess experience of the clinical episode including bowel preparation, procedure and complications. Satisfaction, worry and physical discomfort were assessed using an adapted version of a validated acceptability scale. Non-parametric methods assessed differences between the randomised tests and the effect of patient characteristics. Patients undergoing BE were significantly less satisfied (median 61, interquartile range [IQR] 54-67 vs. median 64, IQR 56-69; p = 0.003) and experienced more physical discomfort (median 40, IQR 29-52 vs. median 35.5, IQR 25-47; p < 0.001) than those undergoing CTC. Post-test, BE patients were significantly more likely to experience 'abdominal pain/cramps' (68% vs. 57%; p = 0.007), 'soreness' (57% vs. 37%; p < 0.001), 'nausea/vomiting' (16% vs. 8%; p = 0.009), 'soiling' (31% vs. 23%; p = 0.034) and 'wind' (92% vs. 84%; p = 0.001) and in the case of 'wind' to also rate it as severe (27% vs. 15%; p < 0.001). CTC is associated with significant improvements in patient experience. These data support the case for CTC to replace BE. (orig.)

  18. Patient acceptability of CT colonography compared with double contrast barium enema: results from a multicentre randomised controlled trial of symptomatic patients.

    Science.gov (United States)

    von Wagner, Christian; Smith, Samuel; Halligan, Steve; Ghanouni, Alex; Power, Emily; Lilford, Richard J; Morton, Dion; Dadswell, Edward; Atkin, Wendy; Wardle, Jane

    2011-10-01

    To determine patient acceptability of barium enema (BE) or CT colonography (CTC). After ethical approval, 921 consenting patients with symptoms suggestive of colorectal cancer who had been randomly assigned and completed either BE (N = 606) or CTC (N = 315) received a questionnaire to assess experience of the clinical episode including bowel preparation, procedure and complications. Satisfaction, worry and physical discomfort were assessed using an adapted version of a validated acceptability scale. Non-parametric methods assessed differences between the randomised tests and the effect of patient characteristics. Patients undergoing BE were significantly less satisfied (median 61, interquartile range [IQR] 54-67 vs. median 64, IQR 56-69; p = 0.003) and experienced more physical discomfort (median 40, IQR 29-52 vs. median 35.5, IQR 25-47; p < 0.001) than those undergoing CTC. Post-test, BE patients were significantly more likely to experience 'abdominal pain/cramps' (68% vs. 57%; p = 0.007), 'soreness' (57% vs. 37%; p < 0.001), 'nausea/vomiting' (16% vs. 8%; p = 0.009), 'soiling' (31% vs. 23%; p = 0.034) and 'wind' (92% vs. 84%; p = 0.001) and in the case of 'wind' to also rate it as severe (27% vs. 15%; p < 0.001). CTC is associated with significant improvements in patient experience. These data support the case for CTC to replace BE.

  19. A consumer register: an acceptable and cost-effective alternative for accessing patient populations

    Directory of Open Access Journals (Sweden)

    Jamie Bryant

    2016-10-01

    Full Text Available Abstract Background Population-based registries are increasingly used to recruit patient samples for research, however, they have several limitations including low consent and participation rates, and potential selection bias. To improve access to samples for research, the utility of a new model of recruitment termed the ‘Consumer Register’, that allows for direct patient recruitment from hospitals, was examined. This paper reports: (i consent rates onto the register; (ii preferred methods and frequency of contact; and (iii the feasibility of establishing the register, including: (a cost per person recruited to the register; (b the differential cost and consent rates of volunteer versus paid data collectors; and (c participant completion rates. Methods A cross-sectional survey was conducted in five outpatient clinics in Australia. Patients were approached by volunteers or paid data collectors and asked to complete a touch-screen electronic survey. Consenting individuals were asked to indicate their willingness and preferences for enrolment onto a research register. Descriptive statistics were used to examine patient preferences and linear regression used to model the success of volunteer versus paid data collectors. The opportunity and financial costs of establishing the register were calculated. Results A total of 1947 patients (80.6 % consented to complete the survey, of which, 1486 (76.3 % completed the questionnaire. Of the completers, the majority (69.4 %, or 1032 participants were willing to be listed on the register and preferred to be contacted by email (50.3 %. Almost 39 % of completers were willing to be contacted three or more times in a 12 month period. The annual opportunity cost of resources consumed by the register was valued at $37,187, giving an opportunity cost per person recruited to the register of $36. After amortising fixed costs, the annual financial outlay was $23,004 or $22 per person recruited to the

  20. Long-term safety, efficacy, and patient acceptability of teriparatide in the management of glucocorticoid-induced osteoporosis

    Directory of Open Access Journals (Sweden)

    Dore RK

    2013-05-01

    Full Text Available Robin K DoreDavid Geffen School of Medicine, University of California, Los Angeles, CA, USAAbstract: Glucocorticoids are commonly prescribed medications to treat multiple diseases across many medical specialties. One of the most common yet largely unappreciated side effect of glucocorticoid use is increased risk of fracture. Many different therapies are indicated to prevent and treat this condition; many guidelines exist that suggest appropriate use of both glucocorticoids and the medications approved to prevent this common side effect of glucocorticoid therapy. Nevertheless, 30%–50% of patients on long-term glucocorticoid therapy sustain a fracture. Teriparatide, recombinant human parathyroid hormone (1–34, is a daily self-injectable therapy for 24 months approved for use in patients taking long-term glucocorticoids. Teriparatide has been shown to increase bone mineral density and reduce vertebral fracture risk in glucocorticoid-treated patients. Glucocorticoids have many adverse effects on bone that teriparatide has been shown to prevent or negate. Given the fact that preventive therapy for glucocorticoid-induced osteoporosis is often not prescribed, one wonders whether a daily self-injectable therapy for this condition would be prescribed by physicians and accepted by patients. This article reviews the epidemiology, pathophysiology, treatment, guidelines, and persistence data (when available for patients with glucocorticoid-induced osteoporosis treated with teriparatide.Keywords: glucocorticoid-induced osteoporosis, teriparatide, anabolic, PTH, parathyroid hormone

  1. Florida Energy Assurance Plan

    Science.gov (United States)

    Turner, Niescja E.; Murtagh, William; Guthrie, Kevin; Nykyri, Katariina; Radasky, William A.; Senkowicz, Eric

    2012-08-01

    This spring, Florida held the nation's first statewide emergency preparedness training and exercises geared specifically to the aftermath of severe geomagnetic events. Funded by the State of Florida Division of Emergency Management (FDEM) via a Department of Energy grant and held in collaboration with Watch House International, Inquesta Corporation, and the Florida Institute of Technology, the 17-19 April 2012 workshop had 99 on-site attendees in an oceanfront hotel in Melbourne, Florida, as well as 16 over live Web streaming. The workshop was the capstone to a three-month season of 21 regional space weather training sessions and workshops serving 386 attendees in total.

  2. Feasibility and acceptability of patient partnership to improve access to primary care for the physical health of patients with severe mental illnesses: an interactive guide.

    Science.gov (United States)

    Pelletier, Jean-François; Lesage, Alain; Boisvert, Christine; Denis, Frédéric; Bonin, Jean-Pierre; Kisely, Steve

    2015-09-14

    Even in countries with universal healthcare systems, excess mortality rates due to physical chronic diseases in patients also suffering from serious mental illness like schizophrenia is such that their life expectancy could be lessened by up to 20 years. The possible explanations for this disparity include: unhealthy habits (i.e. smoking; lack of exercise); side-effects of psychotropic medication; delays in the detection or initial presentation leading to a more advanced disease at diagnosis; and inequity of access to services. The main objective of this paper is to explore the feasibility and acceptability of patient partnership for developing an interactive guide to improve access to primary care providers for chronic diseases management and health promotion among patients with severe mental illnesses. A participatory action research design was used to engage patients with mental illness as full research partners for a strategy for patient-oriented research in primary care for persons with schizophrenia who also have chronic physical illnesses. This strategy was also developed in partnership with a health and social services centre responsible for the health of the population of a territory with about 100,000 inhabitants in East-end Montreal, Canada. A new interactive guide was developed by patient research partners and used by 146 participating patients with serious mental illness who live on this territory, for them to be better prepared for their medical appointment with a General Practitioner by becoming more aware of their own physical condition. Patient research partners produced a series of 33 short videos depicting signs and symptoms of common chronic diseases and risk factors for the leading causes of mortality and study participants were able to complete the corresponding 33-item questionnaire on an electronic touch screen tablet. What proved to be most relevant in terms of interactivity was the dynamic that has developed among the study participants

  3. Silodosin for the treatment of clinical benign prostatic hyperplasia: safety, efficacy, and patient acceptability.

    Science.gov (United States)

    Cho, Hee Ju; Yoo, Tag Keun

    2014-01-01

    α1-Adrenergic receptor antagonists are commonly used to treat male lower urinary tract symptoms and benign prostatic hyperplasia (BPH). We performed a literature search using PubMed, Medline via Ovid, Embase, and the Cochrane Library databases to identify studies on the treatment of BPH by silodosin. Silodosin is a novel α1-adrenergic receptor antagonist whose affinity for the α1A-adrenergic receptor is greater than that for the α1B-adrenergic receptor. Therefore, silodosin does not increase the incidence of blood pressure-related side effects, which may result from the inhibition of the α1B-adrenergic receptor. Patients receiving silodosin at a daily dose of 8 mg showed a significant improvement in the International Prostate Symptom Score and maximum urinary flow rate compared with those receiving a placebo. Silodosin also improved both storage and voiding symptoms, indicating that silodosin is effective, even during early phases of BPH treatment. Follow-up extension studies performed in the United States, Europe, and Asia demonstrated its long-term safety and efficacy. In the European study, silodosin significantly reduced nocturia compared to the placebo. Although retrograde or abnormal ejaculation was the most commonly reported symptom in these studies, only a few patients discontinued treatment. The incidence of adverse cardiovascular events was also very low. Evidence showing solid efficacy and cardiovascular safety profiles of silodosin will provide a good solution for the treatment of lower urinary tract symptoms associated with BPH in an increasingly aging society.

  4. What is an acceptable outcome of treatment before it begins? Methodological considerations and implications for patients with chronic low back pain

    DEFF Research Database (Denmark)

    Lauridsen, Henrik; Manniche, Claus; Korsholm, Lars

    2009-01-01

    (LBP) patients' view of an acceptable change (MCID(pre)) before treatment begins. One-hundred and forty-seven patients with chronic LBP were recruited from an out-patient hospital back pain unit and followed over an 8-week period. Original and modified versions of the Oswestry disability index (ODI...

  5. Silodosin for the treatment of clinical benign prostatic hyperplasia: safety, efficacy, and patient acceptability

    Directory of Open Access Journals (Sweden)

    Cho HJ

    2014-09-01

    Full Text Available Hee Ju Cho, Tag Keun Yoo Department of Urology, Eulji Hospital, Eulji University School of Medicine, Seoul, KoreaAbstract: α1-Adrenergic receptor antagonists are commonly used to treat male lower urinary tract symptoms and benign prostatic hyperplasia (BPH. We performed a literature search using PubMed, Medline via Ovid, Embase, and the Cochrane Library databases to identify studies on the treatment of BPH by silodosin. Silodosin is a novel α1-adrenergic receptor antagonist whose affinity for the α1A-adrenergic receptor is greater than that for the α1B-adrenergic receptor. Therefore, silodosin does not increase the incidence of blood pressure-related side effects, which may result from the inhibition of the α1B-adrenergic receptor. Patients receiving silodosin at a daily dose of 8 mg showed a significant improvement in the International Prostate Symptom Score and maximum urinary flow rate compared with those receiving a placebo. Silodosin also improved both storage and voiding symptoms, indicating that silodosin is effective, even during early phases of BPH treatment. Follow-up extension studies performed in the United States, Europe, and Asia demonstrated its long-term safety and efficacy. In the European study, silodosin significantly reduced nocturia compared to the placebo. Although retrograde or abnormal ejaculation was the most commonly reported symptom in these studies, only a few patients discontinued treatment. The incidence of adverse cardiovascular events was also very low. Evidence showing solid efficacy and cardiovascular safety profiles of silodosin will provide a good solution for the treatment of lower urinary tract symptoms associated with BPH in an increasingly aging society. Keywords: α1A-adrenoceptor antagonist, silodosin, benign prostatic hyperplasia, lower urinary tract symptoms

  6. Combining biologic and phototherapy treatments for psoriasis: safety, efficacy, and patient acceptability

    Directory of Open Access Journals (Sweden)

    Farahnik B

    2016-07-01

    Full Text Available Benjamin Farahnik,1 Viraat Patel,2 Kourosh Beroukhim,3 Tian Hao Zhu,4 Michael Abrouk,2 Mio Nakamura,5 Rasnik Singh,3 Kristina Lee,5 Tina Bhutani,5 John Koo5 1University of Vermont College of Medicine, Burlington, VT; 2School of Medicine, University of California, Irvine, 3David Geffen School of Medicine, University of California, Los Angeles, 4University of Southern California Keck School of Medicine, Los Angeles, 5Department of Dermatology, Psoriasis and Skin Treatment Center, University of California, San Francisco, CA, USA Background: The efficacy and safety of biologic and phototherapy in treating moderate-to-severe psoriasis is well known. However, some patients may not respond well to biologic agents or phototherapy on their own and may require combination therapy. Skillfully combining a biologic agent and phototherapy may provide an additive improvement without much increase in risks.Objective: To summarize the current state of evidence for the efficacy and safety of combining biologics with phototherapy in the treatment of moderate-to-severe plaque psoriasis.Methods: We conducted an extensive search on Pubmed database for English language literature that evaluated the use of a combination of biologic and phototherapy for the treatment of moderate-to-severe psoriasis through January 2016. The search included the following keywords: psoriasis, etanercept, adalimumab, infliximab, ustekinumab, biologics, phototherapy, and combination therapy.Results: The primary literature included randomized controlled trials, a head-to-head study, open-label controlled and uncontrolled trials, case series, and case reports. Etanercept was used in over half of the reported cases, but other biologic agents used included ustekinumab, adalimumab, and infliximab. The vast majority of phototherapy was narrowband ultraviolet B (NBUVB radiation. Most cases reported enhanced improvement with combination therapy. Serious adverse events throughout the study duration

  7. Metacognitive therapy for body dysmorphic disorder patients in Iran: acceptability and proof of concept.

    Science.gov (United States)

    Rabiei, Mehdi; Mulkens, Sandra; Kalantari, Mehrdad; Molavi, Hossein; Bahrami, Fatemeh

    2012-06-01

    The purpose of the present study was to determine the effect of metacognitive therapy (MCT) on symptoms of body dysmorphic disorder (BDD) and on symptoms of thought-fusion, by means of a wait-list controlled clinical trial. Participants were referred from dermatology and cosmetic surgery clinics in the city of Isfahan, Iran, and 20 patients were selected on the basis of DSM-IV-TR diagnostic criteria for BDD. They were randomly assigned to either the experimental or the wait-list control group. The Yale-Brown Obsessive Compulsive Scale Modified for Body Dysmorphic Disorder (BDD-YBOCS) and the Thought-Fusion Inventory (TFI) were used as the outcome measures. The experimental group received 8 weekly metacognitive intervention sessions. The control group was in the waiting-list until the end of the follow-up. Measures were taken at pre-test, post-test (after 2 months) and follow-up (after 6-months). The results of analysis of variance showed that MCT significantly reduced the symptoms of BDD and of thought-fusion, compared to the wait-list. Effects on both outcome measures were maintained at 6-months follow-up. Copyright © 2011 Elsevier Ltd. All rights reserved.

  8. Diagnostic accuracy and patient acceptance of MRI in children with suspected appendicitis

    Energy Technology Data Exchange (ETDEWEB)

    Thieme, Mai E.; Valdehueza, Zaldy D.; Wiarda, Bart M. [Medical Centre Alkmaar, Department of Radiology, Alkmaar (Netherlands); Leeuwenburgh, Marjolein M.N. [Academic Medical Centre Amsterdam, Department of Radiology, Amsterdam (Netherlands); Academic Medical Centre Amsterdam, Department of Surgery, Amsterdam (Netherlands); Bouman, Donald E. [Medical Spectrum Twente, Department of Radiology, Enschede (Netherlands); Bruin, Ivar G.J.M. de; Schreurs, W.H.; Houdijk, Alexander P.J. [Medical Centre Alkmaar, Department of Surgery, Alkmaar (Netherlands); Stoker, Jaap [Academic Medical Centre Amsterdam, Department of Radiology, Amsterdam (Netherlands)

    2014-03-15

    To compare magnetic resonance imaging (MRI) and ultrasound in children with suspected appendicitis. In a single-centre diagnostic accuracy study, children with suspected appendicitis were prospectively identified at the emergency department. All underwent abdominal ultrasound and MRI within 2 h, with the reader blinded to other imaging findings. An expert panel established the final diagnosis after 3 months. We evaluated the diagnostic accuracy of three imaging strategies: ultrasound only, conditional MRI after negative or inconclusive ultrasound, and MRI only. Significance between sensitivity and specificity was calculated using McNemar's test statistic. Between April and December 2009 we included 104 consecutive children (47 male, mean age 12). According to the expert panel, 58 patients had appendicitis. The sensitivity of MRI only and conditional MRI was 100 % (95 % confidence interval 92-100), that of ultrasound was significantly lower (76 %; 63-85, P < 0.001). Specificity was comparable among the three investigated strategies; ultrasound only 89 % (77-95), conditional MRI 80 % (67-89), MRI only 89 % (77-95) (P values 0.13, 0.13 and 1.00). In children with suspected appendicitis, strategies with MRI (MRI only, conditional MRI) had a higher sensitivity for appendicitis compared with a strategy with ultrasound only, while specificity was comparable. (orig.)

  9. 'Florida Beauty' strawberry

    Science.gov (United States)

    Florida Beauty’ strawberry (Fragaria x ananassa) originated from a 2012 cross made by the Queensland breeding program between Queensland Australia selection 2010-119 (female parent) and ‘Florida Radiance’ (male parent). Selection 2010-119 was chosen as a parent for its excellent fruit shape and fl...

  10. Acceptance of New Medicaid Patients by Primary Care Physicians and Experiences with Physician Availability among Children on Medicaid or the Children's Health Insurance Program

    Science.gov (United States)

    Decker, Sandra L

    2015-01-01

    Objective To estimate the relationship between physicians' acceptance of new Medicaid patients and access to health care. Data Sources The National Ambulatory Medical Care Survey (NAMCS) Electronic Health Records Survey and the National Health Interview Survey (NHIS) 2011/2012. Study Design Linear probability models estimated the relationship between measures of experiences with physician availability among children on Medicaid or the Children's Health Insurance Program (CHIP) from the NHIS and state-level estimates of the percent of primary care physicians accepting new Medicaid patients from the NAMCS, controlling for other factors. Principal Findings Nearly 16 percent of children with a significant health condition or development delay had a doctor's office or clinic indicate that the child's health insurance was not accepted in states with less than 60 percent of physicians accepting new Medicaid patients, compared to less than 4 percent in states with at least 75 percent of physicians accepting new Medicaid patients. Adjusted estimates and estimates for other measures of access to care were similar. Conclusions Measures of experiences with physician availability for children on Medicaid/CHIP were generally good, though better in states where more primary care physicians accepted new Medicaid patients. PMID:25683869

  11. Efficacy, acceptability and tolerability of 8 atypical antipsychotics in Chinese patients with acute schizophrenia: A network meta-analysis.

    Science.gov (United States)

    Bai, Zhihua; Wang, Guoqiang; Cai, Shangli; Ding, Xindi; Liu, Weiwei; Huang, Depei; Shen, Weidi; Zhang, Juncheng; Chen, Kui; Yang, Yuqing; Zhang, Lili; Zhao, Xiaochen; Ouyang, Qiong; Zhao, Jingping; Lu, Huafei; Hao, Wei

    2017-07-01

    We aimed to create hierarchies of the efficacy, acceptability and tolerability of eight atypical antipsychotics in the treatment of Chinese patients with acute schizophrenia. We systematically searched for RCT articles published between January 1st 2005 and December 31st 2014 in electronic databases (Medline, Pubmed, Embase, the Cochrane Library and ClinicalTrial.gov for studies in English and the China National Knowledge Infrastructure, Wan Fang, and VIP Information/Chinese Scientific Journals Database for studies in Chinese). The primary outcome was efficacy, as measured by the change of PANSS total score. Pairwise comparisons were performed using random-effects model by the Dersimonian-Laird method and network meta-analyses were performed in a Bayesian set. Sixty high-quality RCTs with 6418 participants were included. A pattern of superiority from olanzapine, paliperidone and amisulpride was seen in the primary outcome. Only paliperidone was found better than aripiprazole (odds ratio, 0.49 [95% credible intervals, 0.25 to 0.99]), ziprasidone (0.42 [0.21 to 0.85]) and quetiapine (0.36 [0.13 to 0.93]) in terms of all-cause discontinuation. The best and worst drugs in terms of weight gain, EPS and somnolence were aripiprazole and olanzapine, clozapine and amisulpride, aripiprazole and clozapine, respectively. The rank of efficacy did not change substantially in sensitivity analyses or in meta-regressions. Our findings provided the hierarchies of eight antipsychotics in efficacy, acceptability and tolerability. These findings are expected to help Chinese clinicians to select the appropriate antipsychotic drug for their patients. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Assessing the acceptability and usability of an interactive serious game in aiding treatment decisions for patients with localized prostate cancer.

    Science.gov (United States)

    Reichlin, Lindsey; Mani, Nithya; McArthur, Kara; Harris, Amy M; Rajan, Nithin; Dacso, Clifford C

    2011-01-12

    Men diagnosed with localized prostate cancer face a potentially life-altering treatment decision that can be overwhelming. Enhancing patient knowledge through education can significantly reduce feelings of uncertainty while simultaneously increasing confidence in decision making. Serious games have been shown in other populations to increase health knowledge and assist with the health decision-making process. We developed an interactive serious game, Time After Time, which translates evidence-based treatment outcome data into an accessible and understandable format that men can utilize in their prostate cancer treatment decision-making process. The game specifically aims to raise men's awareness and understanding of the impact of health-related quality of life issues associated with the major treatment options and to enrich their conversations with their health care providers. This study determined the acceptability and usability of the alpha version of Time After Time, an interactive decision aid for men diagnosed with localized prostate cancer, in order to inform future iterations of the serious game. The study employed a mixed methods approach to assess the acceptability and usability of the Time After Time serious game using qualitative focus groups and a quantitative Likert scale survey. A total of 13 men who had already completed treatment for localized prostate cancer completed the survey and participated in focus group meetings. The majority of the study participants rated Time After Time as an appropriate decision tool for localized prostate cancer and verified that it meets its goals of increasing focus on side effects and generating questions for the patient's health care team. However, participants also expressed concerns about game usability and the diversity of information covered regarding treatment options and potential treatment outcomes. Serious games are a promising approach to health education and decision support for older men. Participants

  13. A prospective study of the feasibility and acceptability of a Web-based, electronic patient-reported outcome system in assessing patient recovery after major gynecologic cancer surgery.

    Science.gov (United States)

    Andikyan, Vaagn; Rezk, Youssef; Einstein, M Heather; Gualtiere, Gina; Leitao, Mario M; Sonoda, Yukio; Abu-Rustum, Nadeem R; Barakat, Richard R; Basch, Ethan M; Chi, Dennis S

    2012-11-01

    The purposes of this study are to evaluate the feasibility of capturing patient-reported outcomes (PROs) electronically and to identify the most common distressing symptoms in women recovering from major gynecologic cancer surgery. This was a prospective, single-arm pilot study. Eligible participants included those scheduled for a laparotomy for presumed or known gynecologic malignancy. Patients completed a Web-based "STAR" (Symptom Tracking and Reporting for Patients) questionnaire once preoperatively and weekly during the 6-week postoperative period. The questionnaire consisted of the patient adaptation of the NCI CTCAE 3.0 and EORTC QLQ-C30 3.0. When a patient submitted a response that was concerning, an automated email alert was sent to the clinician. The patient's assessment of STAR's usefulness was measured via an exit survey. Forty-nine patients completed the study. The procedures included the following: hysterectomy±staging (67%), resection of tumor (22%), salpingo-oophorectomy (6%), and other (4%). Most patients (82%) completed at least 4 sessions in STAR. The CTC generated 43 alerts. These alerts resulted in 25 telephone contacts with patients, 2 ER referrals, one new appointment, and one pharmaceutical prescription. The 3 most common patient-reported symptoms generating an alert were as follows: poor performance status (19%), nausea (18%), and fatigue (17%). Most patients found STAR useful (80%) and would recommend it to others (85%). Application of a Web-based, electronic STAR system is feasible in the postoperative period, highly accepted by patients, and warrants further study. Poor performance status, nausea, and fatigue were the most common distressing patient-reported symptoms. Copyright © 2012 Elsevier Inc. All rights reserved.

  14. Intra-individual comparison of patient acceptability of multidetector-row CT colonography and double-contrast barium enema

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, S.A. [Department of Intestinal Imaging, St Mark' s and Northwick Park Hospitals, London (United Kingdom)]. E-mail: csytaylor@yahoo.co.uk; Halligan, S. [Department of Intestinal Imaging, St Mark' s and Northwick Park Hospitals, London (United Kingdom); Burling, D. [Department of Intestinal Imaging, St Mark' s and Northwick Park Hospitals, London (United Kingdom); Bassett, P. [Department of Intestinal Imaging, St Mark' s and Northwick Park Hospitals, London (United Kingdom); Bartram, C.I. [Department of Intestinal Imaging, St Mark' s and Northwick Park Hospitals, London (United Kingdom)

    2005-02-01

    AIMS: To compare the subjective acceptability of CT colonography in comparison with barium enema in older symptomatic patients, and to ascertain preferences for future colonic investigation. MATERIALS AND METHODS: The study population comprised 78 persons aged 60 years or over with symptoms suggestive of colorectal neoplasia, who underwent CT colonography followed the same day by barium enema. A 25-point questionnaire was administered after each procedure and an additional follow-up questionnaire a week later. Responses were compared using Wilcoxon matched pairs testing, Mann-Whitney test statistics and binomial exact testing. RESULTS: Participants suffered less physical discomfort during CT colonography (p=0.03) and overall satisfaction was greater compared with barium enema (p=0.03). On follow-up, respondents reported significantly better tolerance of CT colonography (p=0.002), and were less prepared to undergo barium enema again (p<0.001). Of 52 subjects expressing an opinion, all preferred CT to barium enema. CONCLUSION: Patient satisfaction was higher with CT colonography than barium enema. CT colonography caused significantly less physical discomfort and was overwhelmingly preferred by patients.

  15. Intra-individual comparison of patient acceptability of multidetector-row CT colonography and double-contrast barium enema

    International Nuclear Information System (INIS)

    Taylor, S.A.; Halligan, S.; Burling, D.; Bassett, P.; Bartram, C.I.

    2005-01-01

    AIMS: To compare the subjective acceptability of CT colonography in comparison with barium enema in older symptomatic patients, and to ascertain preferences for future colonic investigation. MATERIALS AND METHODS: The study population comprised 78 persons aged 60 years or over with symptoms suggestive of colorectal neoplasia, who underwent CT colonography followed the same day by barium enema. A 25-point questionnaire was administered after each procedure and an additional follow-up questionnaire a week later. Responses were compared using Wilcoxon matched pairs testing, Mann-Whitney test statistics and binomial exact testing. RESULTS: Participants suffered less physical discomfort during CT colonography (p=0.03) and overall satisfaction was greater compared with barium enema (p=0.03). On follow-up, respondents reported significantly better tolerance of CT colonography (p=0.002), and were less prepared to undergo barium enema again (p<0.001). Of 52 subjects expressing an opinion, all preferred CT to barium enema. CONCLUSION: Patient satisfaction was higher with CT colonography than barium enema. CT colonography caused significantly less physical discomfort and was overwhelmingly preferred by patients

  16. Three in one: safety, efficacy, and patient acceptability of triple fixed-dose combination medicine in the management of hypertension

    Directory of Open Access Journals (Sweden)

    Taylor AA

    2012-08-01

    Full Text Available Addison A Taylor, Shawn RagbirDepartment of Medicine, Baylor College of Medicine, Houston, TX, USAAbstract: Hypertensive patients whose blood pressures are more than 20 mmHg above their goal will often require three or more medications. Careful selection of medications whose actions are complementary or have an improved adverse effect profile when combined can affect not only the blood pressure but also patient acceptance, thus improving persistence in taking the medications as prescribed. This review will highlight the three single-pill three-drug combinations currently available in the US and will address their efficacy, safety, and tolerability. All three include the dihydropyridine calcium-channel blocker, amlodipine, and the thiazide diuretic, hydrochlorothiazide. They each contain a different renin–angiotensin system blocker. One includes the angiotensin-receptor blocker, olmesartan, while another contains valsartan. The third combination includes the direct renin inhibitor, aliskiren. All three fixed-dose combinations (FDC at maximum doses of each component lowers the blood pressure of patients with stage II hypertension by 37 to 40 mmHg systolic and 21 to 25 mmHg diastolic, which is superior to any two of the components that comprise the three-drug FDC. These drugs are effective in males and females, the elderly, diabetics, minority populations, and patients with metabolic syndrome. Triple-drug FDCs are well tolerated with a low incidence of adverse effects, the most common being peripheral edema related to amlodipine. Extrapolation of data from two-drug FDC suggests that medication compliance (adherence and persistence should be better with these FDCs than with the individual components taken as separate medications, although additional studies are necessary to confirm this.Keywords: calcium-channel blockers, hypertension, patient tolerability, renin–angiotensin system antagonists, safety, triple-drug combinations

  17. Factors associated with the difficulty in hospital acceptance among elderly emergency patients: A population-based study in Osaka City, Japan.

    Science.gov (United States)

    Matsuyama, Tasuku; Kitamura, Tetsuhisa; Katayama, Yusuke; Kiyohara, Kosuke; Hayashida, Sumito; Kawamura, Takashi; Iwami, Taku; Ohta, Bon

    2017-12-01

    We aimed to investigate prehospital factors associated with difficulty in hospital acceptance among elderly emergency patients. We reviewed ambulance records in Osaka City from January 2013 through December 2014, and enrolled all elderly emergency patients aged ≥65 years who were transported by on-scene emergency medical service personnel to a hospital that the personnel had selected. The definition of difficulty in hospital acceptance was to the requirement for ≥4 phone calls to hospitals by emergency medical service personnel before receiving a decision from the destination hospitals. Prehospital factors associated with difficulty in hospital acceptance were examined through logistic regression analysis. During the study period, 72 105 elderly patients were included, and 13 332 patients (18.5%) experienced difficulty in hospital acceptance. In the simple linear regression model, hospital selection time increased significantly with an increasing number of phone calls (R 2  = 0.774). In the multivariable analysis, older age (P for trend emergency-related symptoms and difficulty in hospital acceptance among elderly patients with symptoms of internal disease (AOR 1.71, 95% CI 1.53-1.91). In Japan, which has a rapidly aging population, a comprehensive strategy for elderly emergency patients, especially for advanced age groups or nursing home residents, is required. Geriatr Gerontol Int 2017; 17: 2441-2448. © 2017 Japan Geriatrics Society.

  18. Treatment acceptance and adherence in HIV disease: patient identity and the perceived impact of physician–patient communication

    Directory of Open Access Journals (Sweden)

    Laws MB

    2012-12-01

    Full Text Available M Barton Laws,1 Gary S Rose,2 Tanya Bezreh,1 Mary Catherine Beach,3 Tatiana Taubin,1 Laura Kogelman,4 Marcia Gethers,3 Ira B Wilson11Department of Health Services Policy and Practice, Brown University, Providence, RI, USA; 2Massachusetts School of Professional Psychology, Boston, MA, USA; 3Johns Hopkins University School of Medicine, Baltimore, MD, USA; 4Tufts Medical Center, Boston, MA, USAAbstract: Studies have found that physician–patient relationships and communication quality are related to medication adherence and outcomes in HIV care. Few qualitative studies exist of how people living with HIV experience clinical communication about their self-care behavior. Eight focus groups with people living with HIV in two US cities were conducted. Participants responded to a detailed discussion guide and to reenactments of actual physician–patient dialogue about antiretroviral adherence. The 82 participants were diverse in age, sex, and ethnicity. Most had been living with HIV for many years and had stable relationships with providers. They appreciated providers who knew and cared about their personal lives, who were clear and direct about instructions, and who were accessible. Most had struggled to overcome addiction, emotional turmoil, and/or denial before gaining control over their lives and becoming adherent to medications. They made little or no causal attribution for their transformation to any outside agency, including their providers. They generally saw medication adherence as a function of autonomous motivation. Successful coping with HIV with its prevalent behavioral comorbidities, stigma, and other challenges requires a transformation of identity and internalization of motivation to maintain health. Effective methods for clinicians to support such development are needed.Keywords: HIV, physician–patient communication, treatment adherence

  19. Using diffusion of innovation theory to understand the factors impacting patient acceptance and use of consumer e-health innovations: a case study in a primary care clinic

    NARCIS (Netherlands)

    Zhang, Xiaojun; Yu, Ping; Yan, Jun; Spil, Antonius A.M.

    2015-01-01

    Background Consumer e-Health is a potential solution to the problems of accessibility, quality and costs of delivering public healthcare services to patients. Although consumer e-Health has proliferated in recent years, it remains unclear if patients are willing and able to accept and use this new

  20. Evaluation of local hospital discharge for thyroid cancer patients treated with Iodine-131; comparison with internationally accepted release criteria

    International Nuclear Information System (INIS)

    Stylianou-Markidou, E.; Peraticou, A.; Constantinou, C.; Giannos, A.; Aritkan, A.V.; Dimitriadou, D.; Frangos, S.

    2007-01-01

    Full text: Aim: Patients with Thyroid Cancer treated with I-131 in our institution, stay in a shielded room for two days, or until they emit less than 40 μSv/hr at 1m, based on the Cyprus legislation for radiation protection. Other countries have different regulations and public dose limits, and their hospital discharge guidelines vary accordingly. The purpose of this study is to evaluate local hospital discharge regulations, make a comparison with other countries' accepted release criteria, and find where improvements can be made. Methods: 267 patients were treated with I-131 (activity 1.8-8.9GBq) from September 2001 to April 2007. The dose equivalent rate (DER) was measured within 30 min of the administration at a distance of 1 m from the patient. Measurements at 1m were also obtained before the release of the patient. For a group of these patients, measurements were also carried out a week after the treatment with I-131. The doses given to members of the public, from each of the above patients, were calculated using the Total Effective Dose Equivalent (TEDE) concept, which is based on the line source model. For 10% of these patients, measurements of the dose emitted to surroundings were taken, using two different methods. (a) Doses were measured with TLD dosimeters placed at specific points of the room during the two day restriction of the patient in the shielded room. These points were at bedside, at 1 m from the patient's bed, at 3m from the patient's bed, in the shower area, and at the side of the toilet. (b) On the day of release, personal dosimeters were given to a member of the immediate family (carer) of the patient for a minimum of five days. The skin dose and dose at approximately 10cm depth were measured by the National personnel monitoring for radiation protection authority of Cyprus. Results: Our calculation of the TEDE values indicated that, had the patients been released just after the administration of the radiopharmaceutical, members of the

  1. Feasibility and acceptability of e-cigarettes as an aid to quitting smoking among lung cancer patients: a pilot study

    Directory of Open Access Journals (Sweden)

    Allison Ford

    2018-03-01

    Full Text Available Background Many patients diagnosed with lung cancer continue to smoke even though this can make their treatment less effective and increase side effects. E-cigarettes form part of the UK's tobacco harm reduction policy landscape and are, by far, smokers' most popular quit attempt method. This pilot study explores feasibility and acceptability of e-cigarettes to aid smoking cessation among lung cancer patients undergoing chemotherapy. Methods 27 smokers with stage IV lung cancer were recruited from one NHS site in Scotland between May-16 and June-17. They were provided with a 2 nd generation e-cigarette kit at a baseline home visit conducted by a researcher and a volunteer who was an experienced e-cigarette user. Participants were followed-up weekly for four weeks and at 16 weeks. Participants´ response to, and use of, e-cigarettes was explored along with cessation outcomes (self-reported and CO verified. In-depth qualitative interviews were conducted with health professionals (n=8 engaged with lung cancer patients to obtain their views on the study. Results Overall, participants were motivated to stop smoking and took easily to using e-cigarettes. Minor issues arose around choice of flavour, and some side effects were noted, although participants reported difficulty in distinguishing these from treatment side effects. Seven participants were lost to follow-up. Preliminary findings show that at 4-week follow-up: average CO reading had reduced from 14 (range 3-37 to 8 (range 1-29, and 70% of participants reported daily e-cigarette use, however, use was dependent on individuals' day-to-day health. Health professionals interviewed were generally supportive of e-cigarettes as a tool for quitting, and suggested future efforts should concentrate on patients with curable cancer. Conclusions E-cigarettes have a potential role to play for lung cancer patients. Future smoking cessation research should take account of the impact of cancer treatment on

  2. Perceptions of adult trauma patients on the acceptability of text messaging as an aid to reduce harmful drinking behaviours

    Science.gov (United States)

    2014-01-01

    Background Brief interventions (BIs) have been shown to be effective in modifying hazardous drinking behaviours in a range of settings. However, they are underutilised in hospitals due to resource constraints. We explored the perspectives of admitted trauma patients about the appeal, acceptability and content of a Brief Intervention (BI) delivered via text messages. Methods Thirty mobile phone users (≥16 years old) admitted to Auckland City Hospital as a result of injury were recruited (December 2010 – January 2011). Participants were interviewed face-to-face during their hospital stay using a semi-structured interview guide that explored topics including perceptions of the proposed intervention to reduce hazardous drinking and related harm, and perceived acceptability of an m-health program. Where issues relating to content of messages were raised by participants these were also captured. In addition, a brief survey captured information on demographic information, mobile phone usage and type of phone, along with the frequency of alcohol use. Results 22 of the 30 participants were male, and almost half were aged 20 to 39 years. The majority of participants identified as New Zealand Europeans, six as Māori (New Zealand's indigenous population) and of the remainder two each identified as Pacific and of Asian ethnicity. Most (28/30) participants used a mobile phone daily. 18 participants were deemed to be drinking in a non-hazardous manner, seven were hazardous drinkers, and three were non-drinkers. Most participants (21/30) indicated that text messages could be effective in reducing hazardous drinking and related harms, with more than half (17/30) signalling they would sign-up. Factors identified that would increase receptiveness included: awareness that the intervention was evidence-based; participants readiness-to-change; informative messages that include the consequences of drinking and practical advice; non-judgemental messages; and ease-of-use. Areas of

  3. Effectiveness and Patient Acceptability of Stellate Ganglion Block (SGB) for Treatment of Posttraumatic Stress Disorder (PTSD) Symptoms among Active Duty Military Members

    Science.gov (United States)

    2017-03-01

    as well as active  engagement through social media channels. We also are exploring the placement of paid  advertisements  in local  newspapers , both...Page 1 of 2 AWARD NUMBER: W81XWH-15-2-0015 TITLE: Effectiveness and Patient Acceptability of Stellate Ganglion Block (SGB) for Treatment of...SUBTITLE 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-15-2-0015 Effectiveness and Patient Acceptability of Stellate Ganglion Block (SGB) for Treatment of

  4. Escitalopram for the management of major depressive disorder: a review of its efficacy, safety, and patient acceptability

    Directory of Open Access Journals (Sweden)

    Kirino E

    2012-12-01

    Full Text Available Eiji Kirino1,21Department of Psychiatry, Juntendo University Shizuoka Hospital, Shizuoka, Japan; 2Department of Psychiatry, Juntendo University School of Medicine, Tokyo, JapanAbstract: Escitalopram (escitalopram oxalate; Cipralex®, Lexapro® is a selective serotonin reuptake inhibitor (SSRI used for the treatment of major depressive disorder (MDD and anxiety disorder. This drug exerts a highly selective, potent, and dose-dependent inhibitory effect on the human serotonin transport. By inhibiting the reuptake of serotonin into presynaptic nerve endings, this drug enhances the activity of serotonin in the central nervous system. Escitalopram also has allosteric activity. Moreover, the possibility of interacting with other drugs is considered low. This review covers randomized, controlled studies that enrolled adult patients with MDD to evaluate the efficacy of escitalopram based on the Montgomery–Asberg Depression Rating Scale and the Hamilton Depression Rating Scale. The results showed that escitalopram was superior to placebo, and nearly equal or superior to other SSRIs (eg, citalopram, paroxetine, fluoxetine, sertraline and serotonin-noradrenaline reuptake inhibitors (eg, duloxetine, sustained-release venlafaxine. In addition, with long-term administration, escitalopram has shown a preventive effect on MDD relapse and recurrence. Escitalopram also showed favorable tolerability, and associated adverse events were generally mild and temporary. Discontinuation symptoms were milder with escitalopram than with paroxetine. In view of the patient acceptability of escitalopram, based on both a meta-analysis and a pooled analysis, this drug was more favorable than other new antidepressants. The findings indicate that escitalopram achieved high continuity in antidepressant drug therapy.Keywords: escitalopram, MDD, SSRI, allosteric action, discontinuation symptoms

  5. Feasibility and acceptability of a self-measurement using a portable bioelectrical impedance analysis, by the patient with chronic heart failure, in acute decompensated heart failure.

    Science.gov (United States)

    Huguel, Benjamin; Vaugrenard, Thibaud; Saby, Ludivine; Benhamou, Lionel; Arméro, Sébastien; Camilleri, Élise; Langar, Aida; Alitta, Quentin; Grino, Michel; Retornaz, Frédérique

    2018-06-01

    Chronic heart failure (CHF) is a major public health matter. Mainly affecting the elderly, it is responsible for a high rate of hospitalization due to the frequency of acute heart failure (ADHF). This represents a disabling pathology for the patient and very costly for the health care system. Our study is designed to assess a connected and portable bioelectrical impedance analysis (BIA) that could reduce these hospitalizations by preventing early ADHF. This prospective study included patients hospitalized in cardiology for ADHF. Patients achieved 3 self-measurements using the BIA during their hospitalization and answered a questionnaire evaluating the acceptability of this self-measurement. The results of these measures were compared with the clinical, biological and echocardiographic criteria of patients at the same time. Twenty-three patients were included, the self-measurement during the overall duration of the hospitalization was conducted autonomously by more than 80% of the patients. The acceptability (90%) for the use of the portable BIA was excellent. Some correlations were statistically significant, such as the total water difference to the weight difference (p=0.001). There were common trends between the variation of impedance analysis measures and other evaluation criteria. The feasibility and acceptability of a self-measurement of bioelectrical impedance analysis by the patient in AHF opens up major prospects in the management of monitoring patients in CHF. The interest of this tool is the prevention of ADHF leading to hospitalization or re-hospitalizations now requires to be presented by new studies.

  6. Acceptance and tolerability of an adjuvanted nH1N1 vaccine in HIV-infected patients in the cologne-bonn cohort

    Directory of Open Access Journals (Sweden)

    Steffens B

    2011-07-01

    Full Text Available Abstract Objective To evaluate the acceptance and tolerability of the nH1N1 2009 vaccine in HIV-positive individuals. Method 758 patients were included in this prospective study. Different study populations were formed: The Tolerability Study Group consists of HIV-infected patients who visited three outpatient clinics (Cologne, Bonn, Freiburg during a predefined time period. Patients were offered nH1N1 vaccination. Those accepting were administered a standard dose AS03 adjuvant nH1N1 vaccine. Questionnaires to report side effects occurring within 7 days after immunization were handed out. In a substudy conducted during the same time period, acceptance towards immunization was recorded. This Acceptance Study Group consists of all HIV-infected patients visiting the Cologne clinic. They were offered vaccination. In case of refusal, motivation was recorded. Results In the Tolerability Study Group, a total of 475 patient diaries returned in the three study centres could be evaluated, 119 of those (25% reported no side effects. Distribution of symptoms was as follows: Pain 285/475 patients (60%, swelling 96 (20%, redness 54 (11%, fever 48/475 (10%, muscle/joint ache 173 (36%, headache 127 (27%, and fatigue 210 (44%. Association of side effects with clinical data was calculated for patients in Cologne and Bonn. Incidence of side effects was significantly associated with CDC stages A, B compared to C, and with a detectable viral load (> 50 copies/mL. No correlation was noted for CD4 cell count, age, gender or ethnicity. In the Acceptance Study Group, 538 HIV-infected patients were offered vaccination, 402 (75% accepted, while 136 (25% rejected. Main reasons for rejection were: Negative media coverage (35%, indecisiveness with preference to wait until a later date (23%, influenza not seen as personal threat (19% and scepticism towards immunization in general (10%. Conclusion A total of 622 HIV-infected patients were vaccinated against nH1N1-influenza in

  7. Treatment acceptability and preferences for managing severe health anxiety: Perceptions of internet-delivered cognitive behaviour therapy among primary care patients.

    Science.gov (United States)

    Soucy, Joelle N; Hadjistavropoulos, Heather D

    2017-12-01

    While cognitive behaviour therapy (CBT) is an established treatment for health anxiety, there are barriers to service access. Internet-delivered cognitive behaviour therapy (ICBT) has demonstrated effectiveness and has the potential to improve access to treatment. Nevertheless, it is unknown how patients perceive ICBT relative to other interventions for health anxiety and what factors predict ICBT acceptability. This study investigated these questions. Primary care patients (N = 116) who reported elevated levels of health anxiety were presented three treatment vignettes that each described a different protocol for health anxiety (i.e., medication, CBT, ICBT). Acceptability and credibility of the treatments were assessed following the presentation of each vignette. Participants then ranked the three treatments and provided a rational for their preferences. The treatments were similarly rated as moderately acceptable. Relative to medication and ICBT, CBT was perceived as the most credible treatment for health anxiety. The highest preference ranks were for CBT and medication. Regression analyses indicated that lower computer anxiety, past medication use, and lower ratings of negative cognitions about difficulty coping with an illness significantly predicted greater ICBT acceptability. Health anxiety was not assessed with a diagnostic interview. Primary care patients were recruited through a Qualtrics panel. Patients did not have direct experience with treatment but learned about treatment options through vignettes. Medication and CBT are preferred over ICBT. If ICBT is to increase treatment access, methods of improving perceptions of this treatment option are needed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Proportion of Patients Reporting Acceptable Symptoms or Treatment Failure and Their Associated KOOS Values at 6 to 24 Months After Anterior Cruciate Ligament Reconstruction

    DEFF Research Database (Denmark)

    Ingelsrud, Lina Holm; Granan, Lars-Petter; Terwee, Caroline B

    2015-01-01

    -34) to 71 (95% CI, 65-76) for patients with treatment failure. For both categories, the worst subscale values were seen in the sport and recreation and quality of life subscales and the best in the activities of daily living subscale. CONCLUSION: Only half of the patients at 6 months and about two......-thirds at 1 to 2 years perceived their symptoms as acceptable after ACLR. For these patients, KOOS values reflected no problems to mild problems on average, while for patients reporting treatment failure, KOOS values reflected moderate to severe problems....

  9. A theory-based decision aid for patients with cancer: results of feasibility and acceptability testing of DecisionKEYS for cancer.

    Science.gov (United States)

    Hollen, Patricia J; Gralla, Richard J; Jones, Randy A; Thomas, Christopher Y; Brenin, David R; Weiss, Geoffrey R; Schroen, Anneke T; Petroni, Gina R

    2013-03-01

    Appropriate utilization of treatment is a goal for all patients undergoing cancer treatment. Proper treatment maximizes benefit and limits exposure to unnecessary measures. This report describes findings of the feasibility and acceptability of implementing a short, clinic-based decision aid and presents an in-depth clinical profile of the participants. This descriptive study used a prospective, quantitative approach to obtain the feasibility and acceptability of a decision aid (DecisionKEYS for Balancing Choices) for use in clinical settings. It combined results of trials of patients with three different common malignancies. All groups used the same decision aid series. Participants included 80 patients with solid tumors (22 with newly diagnosed breast cancer, 19 with advanced prostate cancer, and 39 with advanced lung cancer) and their 80 supporters as well as their physicians and nurses, for a total of 160 participants and 10 health professionals. The decision aid was highly acceptable to patient and supporter participants in all diagnostic groups. It was feasible for use in clinic settings; the overall value was rated highly. Of six physicians, all found the interactive format with the help of the nurse as feasible and acceptable. Nurses also rated the decision aid favorably. This intervention provides the opportunity to enhance decision making about cancer treatment and warrants further study including larger and more diverse groups. Strengths of the study included a theoretical grounding, feasibility testing of a practical clinic-based intervention, and summative evaluation of acceptability of the intervention by patient and supporter pairs. Further research also is needed to test the effectiveness of the decision aid in diverse clinical settings and to determine if this intervention can decrease overall costs.

  10. [Acceptability of the opportunistic search for human immunodeficiency virus infection by serology in patients recruited in Primary Care Centres in Spain].

    Science.gov (United States)

    Puentes Torres, Rafael Carlos; Aguado Taberné, Cristina; Pérula de Torres, Luis Angel; Espejo Espejo, José; Castro Fernández, Cristina; Fransi Galiana, Luís

    2016-01-01

    To assess the acceptability of opportunistic search for human immunodeficiency virus (HIV). Cross-sectional, observational study. Primary Care Centres (PCC) of the Spanish National Health Care System. patients aged 18 to 65 years who had never been tested for HIV, and were having a blood test for other reasons. RECORDED VARIABLES: age, gender, stable partner, educational level, tobacco/alcohol use, reason for blood testing, acceptability of taking the HIV test, reasons for refusing to take the HIV test, and reasons for not having taken an HIV test previously. A descriptive, bivariate, multivariate (logistic regression) statistical analysis was performed. A total of 208 general practitioners (GPs) from 150 health care centres recruited 3,314 patients. Most (93.1%) of patients agreed to take the HIV test (95%CI: 92.2-93.9). Of these patients, 56.9% reported never having had an HIV test before because they considered not to be at risk of infection, whereas 34.8% reported never having been tested for HIV because their doctor had never offered it to them. Of the 6.9% who refused to take the HIV test, 73.9% considered that they were not at risk. According to the logistic regression analysis, acceptability was positively associated to age (higher among between 26 and 35 year olds, OR=1.79; 95%CI: 1.10-2.91) and non-smokers (OR=1.39; 95%CI: 1.01-1.93). Those living in towns with between 10,000 and 50,000 inhabitants showed less acceptance to the test (OR=0.57; 95%CI: 0.40-0.80). The HIV prevalence detected was 0.24% Acceptability of HIV testing is very high among patients having a blood test in primary care settings in Spain. Opportunistic search is cost-effective. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  11. Behavior change, acceptance, and coping flexibility in highly distressed patients with rheumatic diseases: feasibility of a cognitive-behavioral therapy in multimodal rehabilitation.

    Science.gov (United States)

    Vriezekolk, Johanna E; Geenen, Rinie; van den Ende, Cornelia H M; Slot, Helma; van Lankveld, Wim G J M; van Helmond, Toon

    2012-05-01

    To describe the development and feasibility of the integration of a cognitive-behavioral therapy (CBT) within a multimodal rehabilitation program for highly distressed patients with rheumatic diseases. Development included the detailed specification of the theoretical and empirical-based underpinnings of the CBT and the comprehensive description of its design and content. Feasibility was assessed by percentage of eligible patients, attrition and attendance rates, and patient satisfaction. The developed CBT component seeks to decrease psychological distress and improve activities and participation across multiple life domains by accomplishing behavior change, acceptance, and coping flexibility. Motivational interviewing was applied to endorse patients' own reasons to change. Forty percent (35/87) of the eligible patients were admitted to the program. Attendance rate (>95%) was high. Patient satisfaction ranged from 6.8 to 8.0 (10-point scale). Integrating CBT within a multimodal rehabilitation program is feasible. An acceptable proportion of the intended patient sample is eligible and patient's attendance and satisfaction is high. Patients with impaired physical and psychosocial functioning despite adequate medical treatment pose a great challenge. Their treatment outcome may be improved by screening and selecting highly distressed patients and offering them a CBT embedded in multimodal rehabilitation program. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  12. Woodville Karst Plain, North Florida

    OpenAIRE

    2006-01-01

    Map showing the largest mapped underwater cave systems and conduit flow paths confirmed by tracer testing relative to surface streams, sinkholes and potentiometric surface of the Florida aquifer in the Woodville Karst Plain, Florida

  13. Acceptance of anti-retroviral therapy among patients infected with HIV and tuberculosis in rural Malawi is low and associated with cost of transport.

    Directory of Open Access Journals (Sweden)

    Rony Zachariah

    Full Text Available BACKGROUND: A study was conducted among newly registered HIV-positive tuberculosis (TB patients systematically offered anti-retroviral treatment (ART in a district hospital in rural Malawi in order to a determine the acceptance of ART b conduct a geographic mapping of those placed on ART and c examine the association between "cost of transport" and ART acceptance. METHODOLOGY/PRINCIPAL FINDINGS: A retrospective cross-sectional analysis was performed on routine program data for the period of February 2003 to July 2004. Standardized registers and patient cards were used to gather data. The place of residence was used to determine road distances to the Thyolo district hospital. Cost of transport from different parts of the district was based on the known cost for public transport to the road-stop closest to the patient's residence. Of 1,290 newly registered TB patients, 1,003(78% underwent HIV-testing of whom 770 (77% were HIV-positive. 742 of these individuals (pulmonary TB = 607; extra-pulmonary TB = 135 were considered eligible for ART of whom only 101(13.6% accepted ART. Cost of transport to the hospital ART site was significantly associated with ART acceptance and there was a linear trend in association between cost and ART acceptance (chi(2 for trend = 25.4, P<0.001. Individuals who had to pay 50 Malawi Kwacha (1 United States Dollar = 100 Malawi Kwacha, MW or less for a one-way trip to the Thyolo hospital were four times more likely to accept ART than those who had to pay over 100 MW (Adjusted Odds ratio = 4.0, 95% confidence interval: 2.0-8.1, P<0.001. CONCLUSIONS/SIGNIFICANCE: ART acceptance among TB patients in a rural district in Malawi is low and associated with cost of transport to the centralized hospital based ART site. Decentralizing the ART offer from the hospital to health centers that are closer to home communities would be an essential step towards reducing the overall cost and burden of travel.

  14. A randomized controlled pilot study of CBT-I Coach: Feasibility, acceptability, and potential impact of a mobile phone application for patients in cognitive behavioral therapy for insomnia.

    Science.gov (United States)

    Koffel, Erin; Kuhn, Eric; Petsoulis, Napoleon; Erbes, Christopher R; Anders, Samantha; Hoffman, Julia E; Ruzek, Josef I; Polusny, Melissa A

    2018-03-01

    There has been growing interest in utilizing mobile phone applications (apps) to enhance traditional psychotherapy. Previous research has suggested that apps may facilitate patients' completion of cognitive behavioral therapy for insomnia (CBT-I) tasks and potentially increase adherence. This randomized clinical trial pilot study ( n = 18) sought to examine the feasibility, acceptability, and potential impact on adherence and sleep outcomes related to CBT-I Coach use. All participants were engaged in CBT-I, with one group receiving the app as a supplement and one non-app group. We found that patients consistently used the app as intended, particularly the sleep diary and reminder functions. They reported that it was highly acceptable to use. Importantly, the app did not compromise or undermine benefits of cognitive behavioral therapy for insomnia and patients in both groups had significantly improved sleep outcomes following treatment.

  15. Certification of solar products - The Florida experience

    International Nuclear Information System (INIS)

    POST, HAROLD N.; ROLAND, JAMES D.; VENTRE, GERARD G.; HUGGINS, JAMES C.

    2000-01-01

    Florida legislation enacted in 1976 directed the Florida Solar Energy Center (FSEC) to develop standards for solar energy systems manufactured or sold in the state, establish criteria for testing the performance of solar energy systems, and provide a means to display compliance with approved performance tests for these systems. This mandate has been effectively implemented for both solar domestic water heating and solar pool heating systems. With growing interest and markets for photovoltaic systems, plans are presently being developed to expand the scope of the mandate to include photovoltaic technology. This paper discusses four complementary facets of a photovoltaic (PV) system certification program. They include PV module performance characterization and rating; PV system design review and approval; examination and authorization of photovoltaic system installers; and inspection and acceptance testing of PV system installation. The suggested photovoltaic system process builds on lessons learned from over 20 years of testing, certifying and labeling of solar thermal collectors, and the certification of solar thermal systems

  16. eHealth in Modern Patient-Caregiver Communication: High Rate of Acceptance Among Physicians for Additional Support of Breast Cancer Patients During Long-Term Therapy.

    Science.gov (United States)

    Kirkovits, Thomas; Schinkoethe, Timo; Drewes, Caroline; Gehring, Caroline; Bauerfeind, Ingo; Harbeck, Nadia; Wuerstlein, Rachel

    2016-09-19

    Lack of adherence and compliance with drug regimens among breast cancer patients represent substantial problems in oral therapies, leading to significant impacts on mortality. Where other systems have failed, electronic health (eHealth) could be a possible solution to improve medication intake, along with the doctor-patient relationship. Initial results from studies concerning new interventions for therapy support are promising, but reports suggest that general acceptance of new treatment support tools is needed among patients and physicians alike. The aim of this study was to investigate the actual use of the Internet and other modern media among physicians involved in breast cancer treatment. Using a standardized questionnaire, actual utilization of new media among physicians was analyzed. Internet-related behaviors in private, as well as in business life, were investigated. Attention was focused on physicians' opinions regarding modern eHealth tools and how patients could be best supported to enhance adherence. A total of 120 physicians, all participating in breast cancer care, completed the questionnaire (median age 41 years). Almost all participants (99.2%, 119/120) used the Internet for general purposes and 98.3% (118/120) used it for medical issues as well. Virtually all medical professionals (99.2%, 119/120) reported that they owned a computer, while more recently invented technologies such as tablets and smartphones were owned by 31.9% (38/119) and 73.1% (87/119), respectively. The Internet was favored by 66.4% (79/119) of the physicians in our survey as a source for patient support; 71.2% (84/118) would also favor modern media for side effect registration. Based on our analysis, the most frequent Internet-utilizing physicians were characterized by age <60, worked in a hospital, and were employed as a junior physician. This study demonstrated a high usage of Internet-related technologies among physicians, indicating that the use of eHealth for advanced and

  17. 1 Patient acceptability and feasibility of HIV testing in emergency departments in the UK - a systematic review and meta-analysis.

    Science.gov (United States)

    Lungu, Nicola

    2017-12-01

    NICE 2016 HIV testing guidelines now include the recommendation to offer HIV testing in Emergency Departments, in areas of high prevalence, 1 to everyone who is undergoing blood tests. 23% of England's local authorities are areas of high HIV prevalence (>2/1000) and are therefore eligible. 2 So far very few Emergency Departments have implemented routine HIV testing. This systematic review assesses evidence for two implementation considerations: patient acceptability (how likely a patient will accept an HIV test when offered in an Emergency Department), and feasibility, which incorporates staff training and willingness, and department capacity, (how likely Emergency Department staff will offer an HIV test to an eligible patient), both measured by surrogate quantitative markers. Three medical databases were systematically searched for reports of non-targeted HIV testing in UK Emergency Departments. A total of 1584 unique papers were found, 9 full text articles were critically appraised, and 7 studies included in meta-analysis. There is a combined patient sample of 1 01 975. The primary outcome, patient acceptability of HIV testing in Emergency Departments (number of patients accepting an HIV test, as a proportion of those offered) is 54.1% (CI 40.1, 68.2). Feasibility (number of tests offered, as a proportion of eligible patients) is 36.2% (CI 9.8, 62.4). For an Emergency Department considering introducing routine HIV testing, this review suggests an opt-out publicity-lead strategy. Utilising oral fluid and blood tests would lead to the greatest proportion of eligible patients accepting an HIV test. For individual staff who are consenting patients for HIV testing, it may be encouraging to know that there is >50% chance the patient will accept an offer of testing.emermed;34/12/A860-a/T1F1T1Table 1Summary table of data extracted from final 7 studies, with calculated acceptability and feasibility if appropriate, and GRADE score. Studies listed in chronological

  18. Florida's forests-2005 update

    Science.gov (United States)

    Mark J. Brown

    2007-01-01

    This bulletin highlights principal findings of an annual inventory of Florida's forests. Data summaries are based on measurements of 60 percent of the plots in the State. Additional data summaries and bulletins will be published as the remaining plots are measured.

  19. Conservation: saving Florida's manatees

    Science.gov (United States)

    Bonde, Robert K.

    2008-01-01

    Robert K. Bonde of the U.S. Geological Survey writes about the protected population of manatees in Crystal River, Florida, including information about the threats they face as they migrate in and out of protected waters. Photographer Carol Grant shares images of "Angel," a newborn manatee she photographed early one winter morning.

  20. Acceptability and preliminary feasibility of an internet/CD-ROM-based education and decision program for early-stage prostate cancer patients: randomized pilot study.

    Science.gov (United States)

    Diefenbach, Michael A; Mohamed, Nihal E; Butz, Brian P; Bar-Chama, Natan; Stock, Richard; Cesaretti, Jamie; Hassan, Waleed; Samadi, David; Hall, Simon J

    2012-01-13

    Prostate cancer is the most common cancer affecting men in the United States. Management options for localized disease exist, yet an evidence-based criterion standard for treatment still has to emerge. Although 5-year survival rates approach 98%, all treatment options carry the possibility for significant side effects, such as erectile dysfunction and urinary incontinence. It is therefore recommended that patients be actively involved in the treatment decision process. We have developed an Internet/CD-ROM-based multimedia Prostate Interactive Educational System (PIES) to enhance patients' treatment decision making. PIES virtually mirrors a health center to provide patients with information about prostate cancer and its treatment through an intuitive interface, using videos, animations, graphics, and texts. (1) To examine the acceptability and feasibility of the PIES intervention and to report preliminary outcomes of the program in a pilot trial among patients with a new prostate cancer diagnosis, and (2) to explore the potential impact of tailoring PIES treatment information to participants' information-seeking styles on study outcomes. Participants (n = 72) were patients with newly diagnosed localized prostate cancer who had not made a treatment decision. Patients were randomly assigned to 3 experimental conditions: (1) control condition (providing information through standard National Cancer Institute brochures; 26%), and PIES (2) with tailoring (43%) and (3) without tailoring to a patient's information-seeking style (31%). Questionnaires were administrated before (t1) and immediately after the intervention (t2). Measurements include evaluation and acceptability of the PIES intervention, monitoring/blunting information-seeking style, psychological distress, and decision-related variables (eg, decisional confidence, feeling informed about prostate cancer and treatment, and treatment preference). The PIES program was well accepted by patients and did not interfere

  1. The Effects of Increasing the Capacity of Admission in Emergency Ward in increasing the Rate of Patient Acceptance at the Time of Crisis

    Directory of Open Access Journals (Sweden)

    S Geravandi

    2016-03-01

    Full Text Available Background & Aim: The emergency ward at the time of a disaster is the most important ward for providing therapy service to the injured. The purpose of this research study was to study of the effects of increasing the capacity of admission in emergency ward in increasing the rate of patient acceptance at the time of crisis at Razi Educational Hospital, Ahvaz, Iran. Methods: The present interventional study was performed to determine role of the increase of capacity to emergency ward in increase rate of patient acceptance at the time of disaster. After one year a re-evaluation of the capacity of the emergency department was conducted. Data were analyzed using descriptive statistics. Results: The results of this study showed that the capacity to accept patients was 16 injured in time of disasters at the emergency ward before reform measures. After performing reforms, this capacity increased to 42 patients. The findings also showed that the implementation of appropriate capacity building increased 2.6 times, thus led to increasing the readiness and service delivery in times of crisis and emergency department of the disaster. Conclusion: Based on the findings, it could be concluded that planning and action to be carried out in hospital emergency departments by the crisis committee increased the admission capacity of the injured during the crisis.

  2. High acceptability for cell phone text messages to improve communication of laboratory results with HIV-infected patients in rural Uganda: a cross-sectional survey study.

    Science.gov (United States)

    Siedner, Mark J; Haberer, Jessica E; Bwana, Mwebesa Bosco; Ware, Norma C; Bangsberg, David R

    2012-06-21

    Patient-provider communication is a major challenge in resource-limited settings with large catchment areas. Though mobile phone usership increased 20-fold in Africa over the past decade, little is known about acceptability of, perceptions about disclosure and confidentiality, and preferences for cell phone communication of health information in the region. We performed structured interviews of fifty patients at the Immune Suppression Syndrome clinic in Mbarara, Uganda to assess four domains of health-related communication: a) cell phone use practices and literacy, b) preferences for laboratory results communication, c) privacy and confidentiality, and d) acceptability of and preferences for text messaging to notify patients of abnormal test results. Participants had a median of 38 years, were 56% female, and were residents of a large catchment area throughout southwestern Uganda. All participants expressed interest in a service to receive information about laboratory results by cell phone text message, stating benefits of increased awareness of their health and decreased transportation costs. Ninety percent reported that they would not be concerned for unintended disclosure. A minority additionally expressed concerns about difficulty interpreting messages, discouragement upon learning bad news, and technical issues. Though all respondents expressed interest in password protection of messages, there was also a strong desire for direct messages to limit misinterpretation of information. Cell phone text messaging for communication of abnormal laboratory results is highly acceptable in this cohort of HIV-infected patients in rural Uganda. The feasibility of text messaging, including an optimal balance between privacy and comprehension, should be further studied.

  3. Associations of prognostic awareness/acceptance with psychological distress, existential suffering, and quality of life in terminally ill cancer patients' last year of life.

    Science.gov (United States)

    Tang, Siew Tzuh; Chang, Wen-Cheng; Chen, Jen-Shi; Chou, Wen-Chi; Hsieh, Chia-Hsun; Chen, Chen H

    2016-04-01

    Whether prognostic awareness benefits terminally ill cancer patients' psychological-existential well-being and quality of life (QOL) is unclear because of lack of well-controlled longitudinal studies. This study longitudinally evaluated the associations of accurate prognostic awareness and prognostic acceptance with psychological distress, existential suffering, and QOL while comprehensively controlling for confounders in Taiwanese terminally ill cancer patients' last year of life. A convenience sample of 325 cancer patients was followed until death. Psychological distress and existential suffering were assessed by severe anxiety and depressive symptoms and high self-perceived sense of burden to others, respectively. Dichotomized and continuous (QOL) outcome variables were evaluated by multivariate logistic and linear regression modeling with the generalized estimating equation, respectively. Accurate prognostic awareness was not associated with the likelihood of severe anxiety or depressive symptoms but significantly increased the likelihood of high self-perceived sense of burden to others and was associated with poorer QOL in participants' last year of life. Participants who knew and highly accepted their prognosis were significantly less likely to experience severe anxiety symptoms than those who were unaware of or knew their prognosis but had difficulty accepting it. Knowing one's poor prognosis and confronting one's impending death without full acceptance and adequate professional psycho-spiritual support may harm more than benefit terminally ill cancer patients' psychological state, existential well-being, and QOL. These findings highlight the importance of tailoring psycho-spiritual support to cancer patients' psychological and existential needs when prognostic information is disclosed. Copyright © 2015 John Wiley & Sons, Ltd.

  4. Feasibility and Acceptability of Utilizing a Smartphone Based Application to Monitor Outpatient Discharge Instruction Compliance in Cardiac Disease Patients around Discharge from Hospitalization

    Directory of Open Access Journals (Sweden)

    Aimee M. Layton

    2014-01-01

    Full Text Available The purpose of this study was to determine the feasibility and acceptability of utilizing a smartphone based application to monitor compliance in patients with cardiac disease around discharge. For 60 days after discharge, patients’ medication compliance, physical activity, follow-up care, symptoms, and reading of education material were monitored daily with the application. 16 patients were enrolled in the study (12 males, 4 females, age 55 ± 18 years during their hospital stay. Five participants were rehospitalized during the study and did not use the application once discharged. Seven participants completed 1–30 days and four patients completed >31 days. For those 11 patients, medication reminders were utilized 37% (1–30-day group and 53% (>31-day group of the time, education material was read 44% (1–30 and 53% (>31 of the time, and physical activity was reported 25% (1–30 and 42% (>31 of the time. Findings demonstrated that patients with stable health utilized the application, even if only minimally. Patients with decreased breath sounds by physical exam and who reported their health as fair to poor on the day of discharge were less likely to utilize the application. Acceptability of the application to report health status varied among the stable patients.

  5. Florida Hydrogen Initiative

    Energy Technology Data Exchange (ETDEWEB)

    Block, David L

    2013-06-30

    The Florida Hydrogen Initiative (FHI) was a research, development and demonstration hydrogen and fuel cell program. The FHI program objectives were to develop Florida?s hydrogen and fuel cell infrastructure and to assist DOE in its hydrogen and fuel cell activities The FHI program funded 12 RD&D projects as follows: Hydrogen Refueling Infrastructure and Rental Car Strategies -- L. Lines, Rollins College This project analyzes strategies for Florida's early stage adaptation of hydrogen-powered public transportation. In particular, the report investigates urban and statewide network of refueling stations and the feasibility of establishing a hydrogen rental-car fleet based in Orlando. Methanol Fuel Cell Vehicle Charging Station at Florida Atlantic University ? M. Fuchs, EnerFuel, Inc. The project objectives were to design, and demonstrate a 10 kWnet proton exchange membrane fuel cell stationary power plant operating on methanol, to achieve an electrical energy efficiency of 32% and to demonstrate transient response time of less than 3 milliseconds. Assessment of Public Understanding of the Hydrogen Economy Through Science Center Exhibits, J. Newman, Orlando Science Center The project objective was to design and build an interactive Science Center exhibit called: ?H2Now: the Great Hydrogen Xchange?. On-site Reformation of Diesel Fuel for Hydrogen Fueling Station Applications ? A. Raissi, Florida Solar Energy Center This project developed an on-demand forecourt hydrogen production technology by catalytically converting high-sulfur hydrocarbon fuels to an essentially sulfur-free gas. The removal of sulfur from reformate is critical since most catalysts used for the steam reformation have limited sulfur tolerance. Chemochromic Hydrogen Leak Detectors for Safety Monitoring ? N. Mohajeri and N. Muradov, Florida Solar Energy Center This project developed and demonstrated a cost-effective and highly selective chemochromic (visual) hydrogen leak detector for safety

  6. Elaboration of an algorithm for preserving a projective skin flap above the tumor when planning subcutaneous mastectomy from an aesthetically acceptable area in patients with breast nodule cancer

    Directory of Open Access Journals (Sweden)

    A. R. Khamitov

    2016-01-01

    Full Text Available Indications for the conservation of the skin flap over the tumor for potential offset of the operational access in aesthetically acceptable zone in patients with primary nodular breast cancer are discussed in the article. The survey results of 203 patients (T1–2N0–3M0 are analyzed. The study revealed that the risk factors affecting the skin flap involvement are the presence of the skin flattening as well as topographic and anatomical characteristics: tumor < 3 cm, located at a depth of < 0.46 ± 0.2 cm, tumor ≥ 3 cm located at a depth of < 1.66 cm. Based on the data the algorithm for immediate breast reconstruction from aesthetically acceptable zone for surgical oncologist is compiled.

  7. Feasibility and Acceptability of Screening and Brief Interventions to Address Alcohol and Other Drug Use among Patients Presenting for Emergency Services in Cape Town, South Africa

    Directory of Open Access Journals (Sweden)

    Bronwyn Myers

    2012-01-01

    Full Text Available Despite evidence from high income countries, it is not known whether screening and brief interventions (SBI for alcohol and other drug (AOD use are feasible to implement in low and middle income countries. This paper describes the feasibility and acceptability of a peer-led SBI for AOD-using patients presenting with injuries at emergency services in Cape Town, South Africa. Data were extracted from program records on the number of eligible patients screened and the number of program refusals. A questionnaire examined preliminary responses to the intervention for 30 patients who had completed the program and 10 emergency personnel. Peer counselors were also interviewed to identify barriers to implementation. Of the 1458 patients screened, 21% (305 met inclusion criteria, of which 74% (225 were enrolled in the intervention. Of the 30 patients interviewed, most (83% found the program useful. Emergency personnel were supportive of the program but felt that visibility and reach could improve. Peer counselors identified the need for better integration of the program into emergency services and for additional training and support. In conclusion, with limited additional resources, peer-led SBIs for AOD use are feasible to conduct in South African emergency services and are acceptable to patients and emergency personnel.

  8. Health-related behavior, profile of health locus of control and acceptance of illness in patients suffering from chronic somatic diseases.

    Directory of Open Access Journals (Sweden)

    Konrad Janowski

    Full Text Available PURPOSE: The purpose of the study was to determine health-related behaviors, profile of health locus of control (HLC, and to assess the relationships between these constructs among patients suffering from chronic somatic diseases. MATERIAL AND METHODS: Three-hundred adult patients suffering from various chronic diseases participated in the study. The patients' mean age was 54.6 years (SD = 17.57. RESULTS: No statistically significant differences were found between the different clinical groups in health-related behavior, acceptance of illness, internal HLC or chance HLC. Patients with neurologic conditions showed slightly lower powerful others HLC than did some other clinical groups. Health-related behavior was significantly positively related to all three categories of HLC, with most prominent associations observed with powerful others HLC. Only one type of health-related behavior--preventive behavior--correlated significantly and negatively with acceptance of illness. Differences in the frequency of health-related behavior were also found due to gender (women showing more healthy nutritional habits than men, age (older subjects showing more frequent health-promoting behavior, education (higher education was associated with less frequent health-promoting behavior and marital status (widowed subjects reporting more frequent health-promoting behavior. CONCLUSIONS: Health-related behavior in patients with chronic diseases seems to be unrelated to a specific diagnosis; however it shows associations with both internal and external HLC. Sociodemographic factors are also crucial factors determining frequency of health-related behavior in such patients.

  9. Acceptability of a very‐low‐energy diet in Type 2 diabetes: patient experiences and behaviour regulation

    OpenAIRE

    Rehackova, L.; Araújo‐Soares, V.; Adamson, A. J.; Steven, S.; Taylor, R.; Sniehotta, F. F.

    2017-01-01

    Abstract Aims To evaluate the acceptability of an 8‐week very‐low‐energy diet for remission of Type 2 diabetes, and to identify barriers and facilitators of adherence and behaviour‐regulation strategies used by participants in the Counterbalance study. Methods Eighteen of 30 participants in the Counterbalance study (ISRCTN88634530) took part in semi‐structured interviews. Of these, 15 participants were interviewed before and after the 8‐week very‐low‐energy diet intervention. Thematic analysi...

  10. Florida statewide radiation study

    International Nuclear Information System (INIS)

    Nagda, N.L.; Koontz, M.D.; Fortmann, R.C.; Schoenborn, W.A.; Mehegan, L.L.

    1987-01-01

    Florida phosphate deposits contain higher levels of uranium than most other soils and rocks, thus exposing the population to higher-than-desirable levels of radon and its short-lived daughters. The Florida Legislature ordered a survey of significant land areas where an environmental radiation standard should be applied. Among other things, the study assessed indoor radon in 6,000 homes, soil radon at 3,000 residences, and all data existing prior to the study. The report explains the purpose of the study, how it was designed and conducted, and its results. It concludes with a discussion of radon/radon decay product equilibrium factor, correlation between indoor and soil radon, and preliminary attempts to develop a safe threshold for soil radon below which few elevated indoor levels would be anticipated

  11. m-RESIST, a complete m-Health solution for patients with treatmentresistant schizophrenia: a qualitative study of user needs and acceptability in the Barcelona metropolitan area.

    Science.gov (United States)

    Huerta-Ramos, Elena; Marcó-García, Silvia; Escobar-Villegas, Maria Soledad; Rubio-Abadal, Elena; Ochoa, Susana; Grasa Bello, Eva M; Alonso Solís, Anna; Rabella, Mireia; Berdun, Jesús; Hospedales, Margarita; M-Resist, Group; Corripio, Iluminada; Usall, Judith

    2017-11-01

    Despite the theoretical potential of m-health solutions in the treatment of patients with schizophrenia, there remains a lack of technological solutions in daily practice. The aim of this study was to measure the receptivity of patients, informal carers, and clinicians to an integral intervention model focused on patients with persistent positive symptoms: Mobile Therapeutic Attention for Patients with Treatment Resistant Schizophrenia (m-RESIST). A qualitative study of the needs and acceptability of outpatients with treatment-resistant schizophrenia was carried out in Parc Sanitari Sant Joan de Déu (Barcelona). We analyzed the opinions of patients, informal carers, and clinicians concerning the services initially thought to be part of the solution. Five focus groups and eight interviews were carried out, using discourse analysis as the analytical approach. A webpage and a virtual forum were perceived as suitable to get reliable information on both the disease and support. Data transmission service, online visits, and instant messages were evaluated as ways to improve contact with clinicians. Alerts were appreciated as reminders of daily tasks and medical appointments. Avoiding stressful situations for outpatients, promoting an active role in the management of the disease, and maintaining human contact with clinicians were the main suggestions for improving the effectiveness of the solution. Positive acceptance of m-RESIST services is related to its usefulness in meeting user needs, its capacity to empower them, and the possibility of maintaining human contact.

  12. Efficacy, acceptability and tolerability of Zelesse® for the treatment of non-specific vulvovaginitis in paediatric patients: The NINESSE Study.

    Science.gov (United States)

    García, Fátima; Rodríguez, Carmen-Amparo; Palomo, María-Lourdes; Català, Pere; Fernández, Santiago; Huerta, Ibone; Velasco, Syra; Nieto, Concepción

    2018-01-01

    Objective To evaluate the efficacy, tolerability and acceptability of Zelesse®, an intimate hygiene wash solution, in the relief of the symptoms and signs of non-specific vulvovaginitis in paediatric patients. Methods The NINESSE Study was a prospective, observational, multicentre study involving females aged 2-8 years who attended paediatric offices with symptoms suggestive of non-specific vulvovaginitis. They were administered Zelesse® as a single treatment for 15 ± 5 days. Pruritus, burning, dysuria, erythema, leucorrhoea and oedema were evaluated before and after treatment. Results A total of 71 paediatric patients were enrolled in the study (mean ± SD age, 4.5 ± 1.9 years). The most significant effects were observed for pruritus and burning, where 98.4% (62 of 63) and 96.9% (63 of 65) of the patients improved after treatment, respectively. Zelesse® demonstrated a beneficial effect on dysuria, erythema, leucorrhoea and oedema. The effects on the symptoms and signs were observed within the first week of treatment; although 44.9% (31 of 69) of patients experienced improvements after 2-3 days. Zelesse® was well accepted and tolerated by most patients. No serious adverse events were reported. Conclusions Zelesse® was very effective for the relief of the symptoms and signs of non-specific vulvovaginitis, in particular pruritus, burning and erythema, in females aged 2-8 years.

  13. Using diffusion of innovation theory to understand the factors impacting patient acceptance and use of consumer e-health innovations: a case study in a primary care clinic.

    Science.gov (United States)

    Zhang, Xiaojun; Yu, Ping; Yan, Jun; Ton A M Spil, Ir

    2015-02-21

    Consumer e-Health is a potential solution to the problems of accessibility, quality and costs of delivering public healthcare services to patients. Although consumer e-Health has proliferated in recent years, it remains unclear if patients are willing and able to accept and use this new and rapidly developing technology. Therefore, the aim of this research is to study the factors influencing patients' acceptance and usage of consumer e-health innovations. A simple but typical consumer e-health innovation--an e-appointment scheduling service--was developed and implemented in a primary health care clinic in a regional town in Australia. A longitudinal case study was undertaken for 29 months after system implementation. The major factors influencing patients' acceptance and use of the e-appointment service were examined through the theoretical lens of Rogers' innovation diffusion theory. Data were collected from the computer log records of 25,616 patients who visited the medical centre in the entire study period, and from in-depth interviews with 125 patients. The study results show that the overall adoption rate of the e-appointment service increased slowly from 1.5% at 3 months after implementation, to 4% at 29 months, which means only the 'innovators' had used this new service. The majority of patients did not adopt this innovation. The factors contributing to the low the adoption rate were: (1) insufficient communication about the e-appointment service to the patients, (2) lack of value of the e-appointment service for the majority of patients who could easily make phone call-based appointment, and limitation of the functionality of the e-appointment service, (3) incompatibility of the new service with the patients' preference for oral communication with receptionists, and (4) the limitation of the characteristics of the patients, including their low level of Internet literacy, lack of access to a computer or the Internet at home, and a lack of experience with

  14. Evaluation of the Directly Observed Treatment’s Acceptance by Tuberculosis Patients in the Republic of Macedonia

    Directory of Open Access Journals (Sweden)

    Biljana Ilievska-Poposka

    2018-05-01

    CONCLUSION: We can conclude that the DOT visits to TB patients are useful, contribute patients to complete the therapeutic regime without interruption, take care for every individual patient effectively, and protect the rest of society by preventing the development and spread of TB, including drug-resistant strains.

  15. Usability, acceptability, and adherence to an electronic self-monitoring system in patients with major depression discharged from inpatient wards

    DEFF Research Database (Denmark)

    Lauritsen, Lise; Andersen, Louise; Olsson, Emilia

    2017-01-01

    Background: Patients suffering from depression have a high risk of relapse and readmission in the weeks following discharge from inpatient wards. Electronic self-monitoring systems that offer patient-communication features are now available to offer daily support to patients, but the usability, a...

  16. Unexpected Acceptance? Patients with Social Anxiety Disorder Manifest their Social Expectancy in ERPs During Social Feedback Processing

    Science.gov (United States)

    Cao, Jianqin; Gu, Ruolei; Bi, Xuejing; Zhu, Xiangru; Wu, Haiyan

    2015-01-01

    Previous studies on social anxiety have demonstrated negative-expectancy bias in social contexts. In this study, we used a paradigm that employed self-relevant positive or negative social feedback, in order to test whether this negative expectancy manifests in event-related potentials (ERPs) during social evaluation among socially anxious individuals. Behavioral data revealed that individuals with social anxiety disorder (SAD) showed more negative expectancy of peer acceptance both in the experiment and in daily life than did the healthy control participants. Regarding ERP results, we found a overally larger P2 for positive social feedback and also a group main effect, such that the P2 was smaller in SAD group. SAD participants demonstrated a larger feedback-related negativity (FRN) to positive feedback than to negative feedback. In addition, SAD participants showed a more positive ΔFRN (ΔFRN = negative – positive). Furthermore, acceptance expectancy in daily life correlated negatively with ΔFRN amplitude, while the Interaction Anxiousness Scale (IAS) score correlated positively with the ΔFRN amplitude. Finally, the acceptance expectancy in daily life fully mediated the relationship between the IAS and ΔFRN. These results indicated that both groups could differentiate between positive and negative social feedback in the early stage of social feedback processing (reflected on the P2). However, the SAD group exhibited a larger FRN to positive social feedback than to negative social feedback, demonstrating their dysfunction in the late stage of social feedback processing. In our opinion, such dysfunction is due to their greater negative social feedback expectancy. PMID:26635659

  17. Unexpected Acceptance? Patients with Social Anxiety Disorder Manifest their Social Expectancy in ERPs During Social Feedback Processing.

    Science.gov (United States)

    Cao, Jianqin; Gu, Ruolei; Bi, Xuejing; Zhu, Xiangru; Wu, Haiyan

    2015-01-01

    Previous studies on social anxiety have demonstrated negative-expectancy bias in social contexts. In this study, we used a paradigm that employed self-relevant positive or negative social feedback, in order to test whether this negative expectancy manifests in event-related potentials (ERPs) during social evaluation among socially anxious individuals. Behavioral data revealed that individuals with social anxiety disorder (SAD) showed more negative expectancy of peer acceptance both in the experiment and in daily life than did the healthy control participants. Regarding ERP results, we found a overally larger P2 for positive social feedback and also a group main effect, such that the P2 was smaller in SAD group. SAD participants demonstrated a larger feedback-related negativity (FRN) to positive feedback than to negative feedback. In addition, SAD participants showed a more positive ΔFRN (ΔFRN = negative - positive). Furthermore, acceptance expectancy in daily life correlated negatively with ΔFRN amplitude, while the Interaction Anxiousness Scale (IAS) score correlated positively with the ΔFRN amplitude. Finally, the acceptance expectancy in daily life fully mediated the relationship between the IAS and ΔFRN. These results indicated that both groups could differentiate between positive and negative social feedback in the early stage of social feedback processing (reflected on the P2). However, the SAD group exhibited a larger FRN to positive social feedback than to negative social feedback, demonstrating their dysfunction in the late stage of social feedback processing. In our opinion, such dysfunction is due to their greater negative social feedback expectancy.

  18. Unexpected acceptance? Patients with social anxiety disorder manifest their social expectancy in ERPs during social feedback processing

    Directory of Open Access Journals (Sweden)

    Jianqin eCao

    2015-11-01

    Full Text Available Previous studies on social anxiety have demonstrated negative-expectancy bias in social contexts. In this study, we used a paradigm that employed self-relevant positive or negative social feedback, in order to test whether this negative expectancy manifests in event-related potentials (ERPs during social evaluation among socially anxious individuals. Behavioral data revealed that individuals with social anxiety disorder (SAD showed more negative expectancy of peer acceptance both in the experiment and in daily life than did the healthy control (HC participants. Regarding ERP results, we found a overally larger P2 for positive social feedback and also a group main effect, such that the P2 was smaller in SAD group. SAD participants demonstrated a larger FRN to positive feedback than to negative feedback. In addition, SAD participants showed a more positive △FRN (△FRN = negative - positive. Furthermore, acceptance expectancy in daily life correlated negatively with △FRN amplitude, while the Interaction Anxiousness Scale (IAS score correlated positively with the △FRN amplitude. Finally, the acceptance expectancy in daily life fully mediated the relationship between the IAS and △FRN. These results indicated that both groups could differentiate between positive and negative social feedback in the early stage of social feedback processing (reflected on the P2. However, the SAD group exhibited a larger FRN to positive social feedback than to negative social feedback, demonstrating their dysfunction in the late stage of social feedback processing. In our opinion, such dysfunction is due to their greater negative social feedback expectancy.

  19. [Acceptance of the Implementation of Standardised Patient Education Programmes by the Multidisciplinary Rehabilitation Team Using the Example of a Back School - A Qualitative Study].

    Science.gov (United States)

    Peters, S; Schultze, A; Pfeifer, K; Faller, H; Meng, K

    2016-03-01

    The transfer of standardised patient education programmes into practice is a complex process with a multitude of influencing factors. Determinants relate among others to the organisation and individuals (e. g., practitioner, patient). Knowledge about individual factors regarding the trainers of patient education programmes in the German rehabilitation system is scarce. The aim of this study is to explore the acceptance of trainers concerning the implementation of a standardised back school and to derive facilitators and barriers to the implementation of patient education programmes. Semi-structured guideline-based interviews were conducted in 10 rehabilitation clinics. The sample consisted of 46 trainers (25 women): 11 physicians, 11 psychologists, 21 physio-/exercise therapists and 3 occupational therapists with a mean age of 41. The opinions of the trainers regarding the central components of back schools in general, their opinions about the new curriculum, their expectations on its implementation, anticipated difficulties with implementation and requests to the project team were explored as indicators for acceptance. The data were analysed with a multi-step qualitative content analysis. 6 main categories comprising 136 subcategories were created and 729 quotations coded. Regarding the central components that should be covered by back schools, back-friendly behaviour was addressed most often. Opinions regarding the new curriculum were mostly positive. Trainers' approval of content and methods was highlighted and the similarity with existing offers in the clinics as well as the structure of the programme were rated positively. The trainers expected an increased patient orientation and personal development as well as a common, coherent language and interdisciplinarity. Difficulties were anticipated regarding time and personnel as well as therapy and appointment planning and also regarding the motivation/acceptance of patients. A wish for communication, education

  20. Acceptability, acceptance and decision making

    International Nuclear Information System (INIS)

    Ackerschott, H.

    2002-01-01

    There is a fundamental difference between the acceptability of a civilizatory or societal risk and the acceptability of the decision-making process that leads to a civilizatory or societal risk. The analysis of individual risk decisions - regarding who, executes when which indisputably hazardous, unhealthy or dangerous behaviour under which circumstances - is not helpful in finding solutions for the political decisions at hand in Germany concerning nuclear energy in particular or energy in general. The debt for implementation of any technology, in the sense of making the technology a success in terms of broad acceptance and general utilisation, lies with the particular industry involved. Regardless of the technology, innovation research identifies the implementation phase as most critical to the success of any innovation. In this sense, nuclear technology is at best still an innovation, because the implementation has not yet been completed. Fear and opposition to innovation are ubiquitous. Even the economy - which is often described as 'rational' - is full of this resistance. Innovation has an impact on the pivotal point between stability, the presupposition for the successful execution of decisions already taken and instability, which includes insecurity, but is also necessary for the success of further development. By definition, innovations are beyond our sphere of experience; not at the level of reliability and trust yet to come. Yet they are evaluated via the simplifying heuristics for making decisions proven not only to be necessary and useful, but also accurate in the familiar. The 'settlement of the debt of implementation', the accompanying communication, the decision-making procedures concerning the regulation of averse effects of the technology, but also the tailoring of the new technology or service itself must be directed to appropriate target groups. But the group often aimed at in the nuclear debate, the group, which largely determines political

  1. Safety and acceptability of transcranial direct current stimulation for the acute treatment of major depressive episodes: Analysis of individual patient data.

    Science.gov (United States)

    Moffa, Adriano H; Brunoni, André R; Fregni, Felipe; Palm, Ulrich; Padberg, Frank; Blumberger, Daniel M; Daskalakis, Zafiris J; Bennabi, Djamila; Haffen, Emmanuel; Alonzo, Angelo; Loo, Colleen K

    2017-10-15

    Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation modality that has been increasingly used for major depressive disorder (MDD) treatment. Although studies in healthy volunteers showed that the technique is well-tolerated, tDCS safety and acceptability have not been sufficiently explored in patients with MDD. We collected individual patient data from 6 randomized clinical trials that had been previously identified in a systematic review and meta-analysis. Primary outcomes were safety (rate of adverse events) and acceptability (rate of dropouts). Secondary outcomes were clinical, demographic and treatment predictors of the primary outcomes. Dropout rates between active (8.8%) and sham (12%) groups were not significantly different (OR= 0.7, p=0.38). Adverse event rates between active (73.5%) and sham (68.3%) groups were not significantly different (OR= 1.4, p= 0.23). Higher current densities were associated with lower adverse event rates. Dropout reasons were not systematically reported and adverse events were not collected using questionnaires standardized across studies. Active tDCS is as acceptable and safe as sham tDCS, as found in randomized clinical trials of MDD. Copyright © 2017. Published by Elsevier B.V.

  2. Ethical acceptability of offering financial incentives for taking antipsychotic depot medication: patients' and clinicians' perspectives after a 12-month randomized controlled trial.

    Science.gov (United States)

    Noordraven, Ernst L; Schermer, Maartje H N; Blanken, Peter; Mulder, Cornelis L; Wierdsma, André I

    2017-08-29

    A randomized controlled trial 'Money for Medication'(M4M) was conducted in which patients were offered financial incentives for taking antipsychotic depot medication. This study assessed the attitudes and ethical considerations of patients and clinicians who participated in this trial. Three mental healthcare institutions in secondary psychiatric care in the Netherlands participated in this study. Patients (n = 169), 18-65 years, diagnosed with schizophrenia, schizoaffective disorder or another psychotic disorder who had been prescribed antipsychotic depot medication, were randomly assigned to receive 12 months of either treatment as usual plus a financial reward for each depot of medication received (intervention group) or treatment as usual alone (control group). Structured questionnaires were administered after the 12-month intervention period. Data were available for 133 patients (69 control and 64 intervention) and for 97 clinicians. Patients (88%) and clinicians (81%) indicated that financial incentives were a good approach to improve medication adherence. Ethical concerns were categorized according to the four-principles approach (autonomy, beneficence, non-maleficence, and justice). Patients and clinicians alike mentioned various advantages of M4M in clinical practice, such as increased medication adherence and improved illness insight; but also disadvantages such as reduced intrinsic motivation, loss of autonomy and feelings of dependence. Overall, patients evaluated financial incentives as an effective method of improving medication adherence and were willing to accept this reward during clinical treatment. Clinicians were also positive about the use of this intervention in daily practice. Ethical concerns are discussed in terms of patient autonomy, beneficence, non-maleficence and justice. We conclude that this intervention is ethically acceptable under certain conditions, and that further research is necessary to clarify issues of benefit

  3. The Changes in Dentists' Perception and Patient's Acceptance on Amalgam Restoration in Kurdistan-Iraq: A Questionnaire-based Cross-Sectional Study.

    Science.gov (United States)

    Faraj, Bestoon Mohammad; Mohammad, Hawzhen Masoud; Mohammad, Kale Masoud

    2015-04-01

    There has been considerable controversy concerning the health risks and benefits of utilizing mercury-containing amalgam. Across the developing countries, a reduction in the use of dental amalgam in oral health care provision is expected. Assessment of dentists' and patient's attitude of dental amalgam regarding attractiveness, perceived health, and treatment preferences in Kurdistan, Iraq. A 4-page questionnaire comprised two parts, specific for dentist and patient were structured and delivered to each dentist oneself. Both open-ended and close-ended questions about the treatment needs of patients, uses of amalgam and its alternative, the properties and usefulness of different materials. Patient's acceptance was assessed by means of structured questionnaire prepared based on commonly asked questions from routinely daily practice. Questions on the type of filling material in their mouth, previous knowledge of mercury in dental amalgam and disappointment due to mercury hazard and toxicity. They were to indicate their acceptance with filling their cavities by dental amalgam with or without prior information about its mercury content. This part was also accomplished by the dentists participated in this survey. Out of 185 dentists shared, only 39 (21.1%) indicated that amalgam presents no harm for the dentists and patients. While majority of dentists 85 (45.9%) were uncertain about this issue. Amalgam was selected most often 107 (57.8%) as the material of choice for restoring posterior teeth. About 94(50.8%) and 85(45.9%) of the practitioners primarily used glass ionomer/resin-reinforced glass ionomer and composite, respectively. Among 1850 patients received treatment, only 450 (24.32%) claimed to have heard about adverse reactions to dental amalgams. Those who believed it to be safe were 200 (10.82%).Acceptance towards amalgam was 62%. While amalgam was the most common material used for posterior restorations, direct tooth-coloured restorative materials were also

  4. Realistic evaluation of tester exposure based on Florida testing experience

    International Nuclear Information System (INIS)

    Schreiber, R.A.

    1990-01-01

    This paper reports on a radon decay product exposure model for Florida Certified Radon Measurement Technicians that has been formulated based on the guidance of 10CFR20. This model was used to estimate the exposure of 44 Florida measurement technicians from January through November of 1989. Comparing estimated testing and home exposure shows that 100% of the technicians observed received more exposure in the home than during testing activities. Exposure during normal office hours also exceed testing exposure in 86% of the technicians observed. Health and safety exposure data for radon measurement technicians does not follow the standard concepts of occupational radiation exposure normally accepted in 10CFR20

  5. High acceptability for cell phone text messages to improve communication of laboratory results with HIV-infected patients in rural Uganda: a cross-sectional survey study

    Science.gov (United States)

    2012-01-01

    Background Patient-provider communication is a major challenge in resource-limited settings with large catchment areas. Though mobile phone usership increased 20-fold in Africa over the past decade, little is known about acceptability of, perceptions about disclosure and confidentiality, and preferences for cell phone communication of health information in the region. Methods We performed structured interviews of fifty patients at the Immune Suppression Syndrome clinic in Mbarara, Uganda to assess four domains of health-related communication: a) cell phone use practices and literacy, b) preferences for laboratory results communication, c) privacy and confidentiality, and d) acceptability of and preferences for text messaging to notify patients of abnormal test results. Results Participants had a median of 38 years, were 56% female, and were residents of a large catchment area throughout southwestern Uganda. All participants expressed interest in a service to receive information about laboratory results by cell phone text message, stating benefits of increased awareness of their health and decreased transportation costs. Ninety percent reported that they would not be concerned for unintended disclosure. A minority additionally expressed concerns about difficulty interpreting messages, discouragement upon learning bad news, and technical issues. Though all respondents expressed interest in password protection of messages, there was also a strong desire for direct messages to limit misinterpretation of information. Conclusions Cell phone text messaging for communication of abnormal laboratory results is highly acceptable in this cohort of HIV-infected patients in rural Uganda. The feasibility of text messaging, including an optimal balance between privacy and comprehension, should be further studied. PMID:22720901

  6. High acceptability for cell phone text messages to improve communication of laboratory results with HIV-infected patients in rural Uganda: a cross-sectional survey study

    Directory of Open Access Journals (Sweden)

    Siedner Mark J

    2012-06-01

    Full Text Available Abstract Background Patient-provider communication is a major challenge in resource-limited settings with large catchment areas. Though mobile phone usership increased 20-fold in Africa over the past decade, little is known about acceptability of, perceptions about disclosure and confidentiality, and preferences for cell phone communication of health information in the region. Methods We performed structured interviews of fifty patients at the Immune Suppression Syndrome clinic in Mbarara, Uganda to assess four domains of health-related communication: a cell phone use practices and literacy, b preferences for laboratory results communication, c privacy and confidentiality, and d acceptability of and preferences for text messaging to notify patients of abnormal test results. Results Participants had a median of 38 years, were 56% female, and were residents of a large catchment area throughout southwestern Uganda. All participants expressed interest in a service to receive information about laboratory results by cell phone text message, stating benefits of increased awareness of their health and decreased transportation costs. Ninety percent reported that they would not be concerned for unintended disclosure. A minority additionally expressed concerns about difficulty interpreting messages, discouragement upon learning bad news, and technical issues. Though all respondents expressed interest in password protection of messages, there was also a strong desire for direct messages to limit misinterpretation of information. Conclusions Cell phone text messaging for communication of abnormal laboratory results is highly acceptable in this cohort of HIV-infected patients in rural Uganda. The feasibility of text messaging, including an optimal balance between privacy and comprehension, should be further studied.

  7. Acceptance of shared decision making with reference to an electronic library of decision aids (arriba-lib) and its association to decision making in patients: an evaluation study.

    Science.gov (United States)

    Hirsch, Oliver; Keller, Heidemarie; Krones, Tanja; Donner-Banzhoff, Norbert

    2011-07-07

    Decision aids based on the philosophy of shared decision making are designed to help patients make informed choices among diagnostic or treatment options by delivering evidence-based information on options and outcomes. A patient decision aid can be regarded as a complex intervention because it consists of several presumably relevant components. Decision aids have rarely been field tested to assess patients' and physicians' attitudes towards them. It is also unclear what effect decision aids have on the adherence to chosen options. The electronic library of decision aids (arriba-lib) to be used within the clinical encounter has a modular structure and contains evidence-based decision aids for the following topics: cardiovascular prevention, atrial fibrillation, coronary heart disease, oral antidiabetics, conventional and intensified insulin therapy, and unipolar depression. We conducted an evaluation study in which 29 primary care physicians included 192 patients. After the consultation, patients filled in questionnaires and were interviewed via telephone two months later. We used generalised estimation equations to measure associations within patient variables and traditional crosstab analyses. Patients were highly satisfied with arriba-lib and the process of shared decision making. Two-thirds of patients reached in the telephone interview wanted to be counselled again with arriba-lib. There was a high congruence between preferred and perceived decision making. Of those patients reached in the telephone interview, 80.7% said that they implemented the decision, independent of gender and education. Elderly patients were more likely to say that they implemented the decision. Shared decision making with our multi-modular electronic library of decision aids (arriba-lib) was accepted by a high number of patients. It has positive associations to general aspects of decision making in patients. It can be used for patient groups with a wide range of individual

  8. Acceptability and perceived barriers and facilitators to creating a national research register to enable 'direct to patient' enrolment into research: the Scottish Health Research Register (SHARE).

    Science.gov (United States)

    Grant, Aileen; Ure, Jenny; Nicolson, Donald J; Hanley, Janet; Sheikh, Aziz; McKinstry, Brian; Sullivan, Frank

    2013-10-18

    Difficulties with recruitment pose a major, increasingly recognised challenge to the viability of research. We sought to explore whether a register of volunteers interested in research participation, with data linkage to electronic health records to identify suitable research participants, would prove acceptable to healthcare staff, patients and researchers. We undertook a qualitative study in which a maximum variation sampling approach was adopted. Focus groups and interviews were conducted with patients, general practitioners (GP), practice managers and health service researchers in two Scottish health boards. Analysis was primarily thematic to identify a range of issues and concerns for all stakeholder groups. The concept of a national research register was, in general, acceptable to all stakeholder groups and was widely regarded as beneficial for research and for society. Patients, however, highlighted a number of conditions which should be met in the design of a register to expedite confidence and facilitate recruitment. They also gave their perceptions on how a register should operate and be promoted, favouring a range of media. GPs and practice managers were primarily concerned with the security and confidentiality of patient data and the impact a register may have on their workload. Researchers were supportive of the initiative seeing advantages in more rapid access to a wider pool of patients. They did raise concerns that GPs may be able to block access to personal patient data held in general practice clinical systems and that the register may not be representative of the whole population. This work suggests that patients, healthcare staff and researchers have a favourable view of the potential benefits of a national register to identify people who are potentially eligible and willing to participate in health related research. It has highlighted a number of issues for the developers to incorporate in the design of research registers.

  9. Patient Acceptance of Sexual Orientation and Gender Identity Questions on Intake Forms in Outpatient Clinics: A Pragmatic Randomized Multisite Trial.

    Science.gov (United States)

    Rullo, Jordan E; Foxen, Jilian L; Griffin, Joan M; Geske, Jennifer R; Gonzalez, Cesar A; Faubion, Stephanie S; van Ryn, Michelle

    2018-03-09

    To (1) test whether patient attitudes toward intake forms at three Midwestern outpatient clinics are significantly more negative among those who are asked to complete SOGI questions versus those who are not; and (2) gain an in-depth understanding of patient concerns about SOGI questions. Data were collected between 6/29/2015 and 2/29/2016 from new patients (N = 491) who presented at three outpatient clinics in a large academic medical center. This study was originally a quality improvement project, and later, institutional review board approval was obtained for secondary data analysis. Two-stage mixed-methods study. (1) Experimental: New patients at three sites were randomly assigned to complete either routine intake forms (control) or routine intake forms with SOGI questions (experimental); and (2) qualitative: interviews with patients who responded negatively to SOGI questions. There were no significant differences in patient attitudes between experimental and control groups (p > .05). Of those who received SOGI questions, only 3 percent reported being distressed, upset, or offended by the SOGI questions. Collection of SOGI data as a part of the routine clinical patient intake process is not distressing to 97 percent of patients who are heterosexual, cisgender, and older than 50 years. © Health Research and Educational Trust.

  10. Low-Fiber Diet in Limited Bowel Preparation for CT Colonography: Influence on Image Quality and Patient Acceptance

    NARCIS (Netherlands)

    Liedenbaum, Marjolein H.; Denters, Maaike J.; de Vries, Ayso H.; van Ravesteijn, Vincent F.; Bipat, Shandra; Vos, Frans M.; Dekker, Evelien; Stoker, Jaap

    2010-01-01

    OBJECTIVE. The purpose of this study was to determine whether a low-fiber diet is necessary for optimal tagging-only bowel preparation for CT colonography. SUBJECTS AND METHODS. Fifty consecutively enrolled patients received an iodine bowel preparation: 25 patients used a low-fiber diet and 25 used

  11. Feasibility and acceptability of a nursing intervention with family caregiver on self-care among heart failure patients: a randomized pilot trial.

    Science.gov (United States)

    Cossette, Sylvie; Belaid, Hayet; Heppell, Sonia; Mailhot, Tanya; Guertin, Marie-Claude

    2016-01-01

    Self-care practices in heart failure (HF) contribute to quality of life, symptom stabilization, and extended life expectancy. However, adherence to practices such as liquid and salt restriction or symptom monitoring require high motivation on a daily basis. The aim was to assess the feasibility, acceptability, and potential effectiveness of a nursing intervention with family caregivers, aimed at improving self-care practice of HF patients. This pilot study involved 32 HF patient-caregiver dyads (16/group) randomized to an experimental (EG) or control group (CG). The intervention, based on the Self-Determination Theory, was designed to enhance patients' autonomy and motivation in self-care practices, by involving their caregivers' support. Five encounters were planned with the EG dyads-two face-to-face during hospitalization and three by telephone after discharge. The feasibility of delivering the protocol was evaluated as well as the acceptability of the intervention. The potential effectiveness of the intervention was assessed based on patient outcomes, including general self-care management and self-care specific to HF, perceived competence to manage HF, autonomous motivation (A-motivation, external extrinsic motivation, internal extrinsic motivation, and intrinsic motivation), and perceived support from the caregiver. Caregiver outcomes included level of support provided to the patient. Despite recruitment challenges, the intervention was feasible, with 12 of the 16 dyads receiving all 5 encounters delivered per protocol. The 4 other dyads received the two hospital encounters, but at least 1 of the 3 post-discharge planned telephone encounters was not feasible because the patients had been re-hospitalized or was deceased. Participant's satisfaction with the intervention was high. Outcomes favoring the EG include self-care specific to HF, internal extrinsic motivation, intrinsic motivation, and caregiver's feeling that they provide a higher level of support

  12. Feasibility and acceptability of electronic symptom surveillance with clinician feedback using the Patient-Reported Outcomes version of Common Terminology Criteria for Adverse Events (PRO-CTCAE) in Danish prostate cancer patients

    DEFF Research Database (Denmark)

    Baeksted, Christina; Pappot, Helle; Nissen, Aase

    2017-01-01

    Background: The aim was to examine the feasibility, acceptability and clinical utility of electronic symptom surveillance with clinician feedback using a subset of items drawn from the Patient-Reported Outcomes version of Common Terminology Criteria for Adverse Events (PRO-CTCAE) in a cancer...

  13. University of Florida Advanced Technologies Campus Testbed

    Science.gov (United States)

    2017-09-21

    The University of Florida (UF) and its Transportation Institute (UFTI), the Florida Department of Transportation (FDOT) and the City of Gainesville (CoG) are cooperating to develop a smart transportation testbed on the University of Florida (UF) main...

  14. Feasibility randomized-controlled trial of online Acceptance and Commitment Therapy for patients with complex chronic pain in the United Kingdom.

    Science.gov (United States)

    Scott, W; Chilcot, J; Guildford, B; Daly-Eichenhardt, A; McCracken, L M

    2018-04-28

    Acceptance and Commitment Therapy (ACT) has growing support for chronic pain. However, more accessible treatment delivery is needed. This study evaluated the feasibility of online ACT for patients with complex chronic pain in the United Kingdom to determine whether a larger trial is justified. Participants with chronic pain and clinically meaningful disability and distress were randomly assigned to ACT online plus specialty medical pain management, or specialty medical management alone. Participants completed questionnaires at baseline, and 3- and 9-month post-randomization. Primary feasibility outcomes included recruitment, retention and treatment completion rates. Secondary outcomes were between-groups effects on treatment outcomes and psychological flexibility. Of 139 potential participants, 63 were eligible and randomized (45% recruitment rate). Retention rates were 76-78% for follow-up assessments. Sixty-one per cent of ACT online participants completed treatment. ACT online was less often completed by employed (44%) compared to unemployed (80%) participants. Fifty-six per cent of ACT online participants rated themselves as 'much improved' or better on a global impression of change rating, compared to only 20 per cent of control participants. Three-month effects favouring ACT online were small for functioning, medication and healthcare use, committed action and decentring, medium for mood, and large for acceptance. Small-to-medium effects were maintained for functioning, healthcare use and committed action at 9 months. Online ACT for patients with chronic pain in the United Kingdom appears feasible to study in a larger efficacy trial. Some adjustments to treatment and trial procedures are warranted, particularly to enhance engagement among employed participants. This study supports the feasibility of online Acceptance and Commitment Therapy for chronic pain in the United Kingdom and a larger efficacy trial. Refinements to treatment delivery, particularly to

  15. Acceptability and Perceived Benefits and Risks of Public and Patient Involvement in Health Care Policy: A Delphi Survey in Belgian Stakeholders.

    Science.gov (United States)

    Cleemput, Irina; Christiaens, Wendy; Kohn, Laurence; Léonard, Christian; Daue, François; Denis, Alain

    2015-06-01

    In systems with public health insurance, coverage decisions should reflect social values. Deliberation among stakeholders could achieve this goal, but rarely involves patients and citizens directly. This study aimed at evaluating the acceptability, and the perceived benefits and risks, of public and patient involvement (PPI) in coverage decision making to Belgian stakeholders. A two-round Delphi survey was conducted among all stakeholder groups. The survey was constructed on the basis of interviews with 10 key stakeholders and a review of the literature on participation models. Consensus was defined as 65% or more of the respondents agreeing with a statement and less than 15% disagreeing. Eighty stakeholders participated in both rounds. They were defined as the Delphi panel. Belgian stakeholders are open toward PPI in coverage decision processes. Benefits are expected to exceed risks. The preferred model for involvement is to consult citizens or patients, within the existing decision-making structures and at specific milestones in the process. Consulting citizens and patients is a higher level of involvement than merely informing them and a lower level than letting them participate actively. Consultation involves asking nonbinding advice on (parts of) the decision problem. According to the Delphi panel, the benefits of PPI could be increasing awareness among members of the general public and patients about the challenges and costs of health care, and enriched decision processes with expertise by experience from patients. Potential risks include subjectivity, insufficient resources to participate and weigh on the process, difficulties in finding effective ways to express a collective opinion, the risk of manipulation, and lobbying or power games of other stakeholders. PPI in coverage decision-making processes is acceptable to Belgian stakeholders, be it in different ways for different types of decisions. Benefits are expected to outweigh risks. Copyright © 2015

  16. Do Ask, Do Tell: High Levels of Acceptability by Patients of Routine Collection of Sexual Orientation and Gender Identity Data in Four Diverse American Community Health Centers

    Science.gov (United States)

    Cahill, Sean; Singal, Robbie; Grasso, Chris; King, Dana; Mayer, Kenneth; Baker, Kellan; Makadon, Harvey

    2014-01-01

    Background The Institute of Medicine and The Joint Commission have recommended asking sexual orientation and gender identity (SOGI) questions in clinical settings and including such data in Electronic Health Records (EHRs). This is increasingly viewed as a critical step toward systematically documenting and addressing health disparities affecting lesbian, gay, bisexual, and transgender (LGBT) people. The U.S. government is currently considering whether to include SOGI data collection in the Stage 3 guidelines for the incentive program promoting meaningful use of EHR. However, some have questioned whether acceptable standard measures to collect SOGI data in clinical settings exist. Methods In order to better understand how a diverse group of patients would respond if SOGI questions were asked in primary care settings, 301 randomly selected patients receiving primary care at four health centers across the U.S. were asked SOGI questions and then asked follow-up questions. This sample was mainly heterosexual, racially diverse, and geographically and regionally broad. Results There was a strong consensus among patients surveyed about the importance of asking SOGI questions. Most of the LGBT respondents thought that the questions presented on the survey allowed them to accurately document their SOGI. Most respondents—heterosexual and LGBT—answered the questions, and said that they would answer such questions in the future. While there were some age-related differences, respondents of all ages overwhelmingly expressed support for asking SOGI questions and understood the importance of providers' knowing their patients' SOGI. Conclusions Given current deliberations within national health care regulatory bodies and the government's increased attention to LGBT health disparities, the finding that patients can and will answer SOGI questions has important implications for public policy. This study provides evidence that integrating SOGI data collection into the meaningful

  17. Feasibility and patient acceptability of a novel artificial intelligence-based screening model for diabetic retinopathy at endocrinology outpatient services: a pilot study.

    Science.gov (United States)

    Keel, Stuart; Lee, Pei Ying; Scheetz, Jane; Li, Zhixi; Kotowicz, Mark A; MacIsaac, Richard J; He, Mingguang

    2018-03-12

    The purpose of this study is to evaluate the feasibility and patient acceptability of a novel artificial intelligence (AI)-based diabetic retinopathy (DR) screening model within endocrinology outpatient settings. Adults with diabetes were recruited from two urban endocrinology outpatient clinics and single-field, non-mydriatic fundus photographs were taken and graded for referable DR ( ≥ pre-proliferative DR). Each participant underwent; (1) automated screening model; where a deep learning algorithm (DLA) provided real-time reporting of results; and (2) manual model where retinal images were transferred to a retinal grading centre and manual grading outcomes were distributed to the patient within 2 weeks of assessment. Participants completed a questionnaire on the day of examination and 1-month following assessment to determine overall satisfaction and the preferred model of care. In total, 96 participants were screened for DR and the mean assessment time for automated screening was 6.9 minutes. Ninety-six percent of participants reported that they were either satisfied or very satisfied with the automated screening model and 78% reported that they preferred the automated model over manual. The sensitivity and specificity of the DLA for correct referral was 92.3% and 93.7%, respectively. AI-based DR screening in endocrinology outpatient settings appears to be feasible and well accepted by patients.

  18. Supporting shared decision-making and people’s understanding of medicines: An exploration of the acceptability and comprehensibility of patient information

    Directory of Open Access Journals (Sweden)

    Gibson Smith K

    2017-12-01

    Full Text Available Background: Patient information may assist in promoting shared decision-making, however it is imperative that the information presented is comprehensible and acceptable to the target audience. Objective: This study sought to explore the acceptability and comprehensibility of the ‘Medicines in Scotland: What’s the right treatment for you?’ factsheet to the general public. Methods: Qualitative semi-structured telephone interviews were conducted with members of the public. An interview schedule was developed to explore the acceptability and comprehensibility of the factsheet. Participants were recruited by a researcher who distributed information packs to attendees (n=70 of four community pharmacies. Interviews, (12-24 minutes duration, were audio recorded, transcribed verbatim and analysed using a framework approach. Results: Nineteen participants returned a consent form (27.1%, twelve were interviewed. Six themes were identified: formatting of the factsheet and interpretation; prior health knowledge and the factsheet; information contained in the factsheet; impact of the factsheet on behaviour; uses for the factsheet; and revisions to the factsheet. Conclusions: The factsheet was generally perceived as helpful and comprehensive. It was highlighted that reading the leaflet may generate new knowledge and may have a positive impact on behaviour.

  19. The effectiveness, side effects and acceptability of locally available brand of Clopidogrel (Osvix as antiplatelet tablet in CABG patients

    Directory of Open Access Journals (Sweden)

    Behzad Imani

    2014-07-01

    Conclusion: This study showed the Iranian brand of Clopidogrel (Osvix is significantly different from the original brand (Plavix in terms of performance factors in preventing platelet aggregation in patients undergoing coronary artery bypass grafting.

  20. Perceptions on use of home telemonitoring in patients with long term conditions - concordance with the Health Information Technology Acceptance Model: a qualitative collective case study.

    Science.gov (United States)

    Middlemass, Jo B; Vos, Jolien; Siriwardena, A Niroshan

    2017-06-26

    Health information technology (HIT) may be used to improve care for increasing numbers of older people with long term conditions (LTCs) who make high demands on health and social care services. Despite its potential benefits for reducing disease exacerbations and hospitalisations, HIT home monitoring is not always accepted by patients. Using the Health Information Technology Acceptance Model (HITAM) this qualitative study examined the usefulness of the model for understanding acceptance of HIT in older people (≥60 years) participating in a RCT for older people with Chronic Obstructive Pulmonary Disease (COPD) and associated heart diseases (CHROMED). An instrumental, collective case study design was used with qualitative interviews of patients in the intervention arm of CHROMED. These were conducted at two time points, one shortly after installation of equipment and again at the end of (or withdrawal from) the study. We used Framework Analysis to examine how well the HITAM accounted for the data. Participants included 21 patients aged between 60-99 years and their partners or relatives where applicable. Additional concepts for the HITAM for older people included: concerns regarding health professional access and attachment; heightened illness anxiety and desire to avoid continuation of the 'sick-role'. In the technology zone, HIT self-efficacy was associated with good organisational processes and informal support; while ease of use was connected to equipment design being suitable for older people. HIT perceived usefulness was related to establishing trends in health status, detecting early signs of infection and potential to self-manage. Due to limited feedback to users opportunities to self-manage were reduced. HITAM helped understand the likelihood that older people with LTCs would use HIT, but did not explain how this might result in improved self-management. In order to increase HIT acceptance among older people, equipment design and organisational factors

  1. Tympanic ear thermometer assessment of body temperature among patients with cognitive disturbances. An acceptable and ethically desirable alternative?

    Science.gov (United States)

    Aadal, Lena; Fog, Lisbet; Pedersen, Asger Roer

    2016-12-01

    Investigation of a possible relation between body temperature measurements by the current generation of tympanic ear and rectal thermometers. In Denmark, a national guideline recommends the rectal measurement. Subsequently, the rectal thermometers and tympanic ear devices are the most frequently used and first choice in Danish hospital wards. Cognitive changes constitute challenges with cooperating in rectal temperature assessments. With regard to diagnosing, ethics, safety and the patients' dignity, the tympanic ear thermometer might comprise a desirable alternative to rectal noninvasive measurement of body temperature during in-hospital-based neurorehabilitation. A prospective, descriptive cohort study. Consecutive inclusion of 27 patients. Linear regression models were used to analyse 284 simultaneous temperature measurements. Ethical approval for this study was granted by the Danish Data Protection Agency, and the study was completed in accordance with the Helsinki Declaration 2008. About 284 simultaneous rectal and ear temperature measurements on 27 patients were analysed. The patient-wise variability of measured temperatures was significantly higher for the ear measurements. Patient-wise linear regressions for the 25 patients with at least three pairs of simultaneous ear and rectal temperature measurements showed large interpatient variability of the association. A linear relationship between the rectal body temperature assessment and the temperature assessment employing the tympanic thermometer is weak. Both measuring methods reflect variance in temperature, but ear measurements showed larger variation. © 2016 Nordic College of Caring Science.

  2. Can physicians’ judgments of futility be accepted by patients?: A comparative survey of Japanese physicians and laypeople

    Directory of Open Access Journals (Sweden)

    Kadooka Yasuhiro

    2012-04-01

    Full Text Available Abstract Back ground Empirical surveys about medical futility are scarce relative to its theoretical assumptions. We aimed to evaluate the difference of attitudes between laypeople and physicians towards the issue. Methods A questionnaire survey was designed. Japanese laypeople (via Internet and physicians with various specialties (via paper-and-pencil questionnaire were asked about whether they would provide potentially futile treatments for end-of-life patients in vignettes, important factors for judging a certain treatment futile, and threshold of quantitative futility which reflects the numerical probability that an act will produce the desired physiological effect. Also, the physicians were asked about their practical frequency and important reasons for futile treatments. Results 1134 laypeople and 401 (80% physicians responded. In all vignettes, the laypeople were more affirmative in providing treatments in question significantly. As the factors for judging futility, medical information and quality of life (QOL of the patient were rather stressed by the physicians. Treatment wish of the family of the patient and psychological impact on patient side due to the treatment were rather stressed by laypeople. There were wide variations in the threshold of judging quantitative futility in both groups. 88.3% of the physicians had practical experience of providing futile treatment. Important reasons for it were communication problem with patient side and lack of systems regarding futility or foregoing such treatment. Conclusion Laypeople are more supportive of providing potentially futile treatments than physicians. The difference is explained by the importance of medical information, the patient family’s influence to decision-making and QOL of the patient. The threshold of qualitative futility is suggested to be arbitrary.

  3. FLORIDA TOWER FOOTPRINT EXPERIMENTS

    Energy Technology Data Exchange (ETDEWEB)

    WATSON,T.B.; DIETZ, R.N.; WILKE, R.; HENDREY, G.; LEWIN, K.; NAGY, J.; LECLERC, M.

    2007-01-01

    The Florida Footprint experiments were a series of field programs in which perfluorocarbon tracers were released in different configurations centered on a flux tower to generate a data set that can be used to test transport and dispersion models. These models are used to determine the sources of the CO{sub 2} that cause the fluxes measured at eddy covariance towers. Experiments were conducted in a managed slash pine forest, 10 km northeast of Gainesville, Florida, in 2002, 2004, and 2006 and in atmospheric conditions that ranged from well mixed, to very stable, including the transition period between convective conditions at midday to stable conditions after sun set. There were a total of 15 experiments. The characteristics of the PFTs, details of sampling and analysis methods, quality control measures, and analytical statistics including confidence limits are presented. Details of the field programs including tracer release rates, tracer source configurations, and configuration of the samplers are discussed. The result of this experiment is a high quality, well documented tracer and meteorological data set that can be used to improve and validate canopy dispersion models.

  4. A case series investigating acceptance and commitment therapy as a treatment for previously treated, unremitted patients with anorexia nervosa.

    Science.gov (United States)

    Berman, M I; Boutelle, K N; Crow, S J

    2009-11-01

    The aim of the present study was to evaluate the effectiveness of Acceptance and Commitment Therapy (ACT) for treatment of anorexia nervosa (AN) using a case series methodology among participants with a history of prior treatment for AN. Three participants enrolled; all completed the study. All participants had a history of 1-20 years of intensive eating disorder treatment prior to enrollment. Participants were seen for 17-19 twice-weekly sessions of manualized ACT. Symptoms were assessed at baseline, post-treatment and 1-year follow-up. All participants experienced clinically significant improvement on at least some measures; no participants worsened or lost weight even at 1-year follow-up. Simulation modelling analysis (SMA) revealed for some participants an increase in weight gain and a decrease in eating disorder symptoms during the treatment phase as compared to a baseline assessment phase. These data, although preliminary, suggest that ACT could be a promising treatment for subthreshold or clinical cases of AN, even with chronic participants or those with medical complications.

  5. Survey and online discussion groups to develop a patient-rated outcome measure on acceptability of treatment response in vitiligo

    Science.gov (United States)

    2014-01-01

    Background Vitiligo is a chronic depigmenting skin disorder which affects around 0.5-1% of the world’s population. The outcome measures used most commonly in trials to judge treatment success focus on repigmentation. Patient-reported outcome measures of treatment success are rarely used, although recommendations have been made for their inclusion in vitiligo trials. This study aimed to evaluate the face validity of a new patient-reported outcome measure of treatment response, for use in future trials and clinical practice. Method An online survey to gather initial views on what constitutes treatment success for people with vitiligo or their parents/carers, followed by online discussion groups with patients to reach consensus on what constitutes treatment success for individuals with vitiligo, and how this can be assessed in the context of trials. Participants were recruited from an existing database of vitiligo patients and through posts on the social network sites Facebook and Twitter. Results A total of 202 survey responses were received, of which 37 were excluded and 165 analysed. Three main themes emerged as important in assessing treatment response: a) the match between vitiligo and normal skin (how well it blends in); b) how noticeable the vitiligo is and c) a reduction in the size of the white patches. The majority of respondents said they would consider 80% or more repigmentation to be a worthwhile treatment response after 9 months of treatment. Three online discussion groups involving 12 participants led to consensus that treatment success is best measured by asking patients how noticeable their vitiligo is after treatment. This was judged to be best answered using a 5-point Likert scale, on which a score of 4 or 5 represents treatment success. Conclusions This study represents the first step in developing a patient reported measure of treatment success in vitiligo trials. Further work is now needed to assess its construct validity and responsiveness to

  6. Investigating the Effectiveness, Acceptability and Impact on Healthcare Usage of Providing a Cognitive-Behavioural Based Psychological Therapy Service for Patients with Primary Antibody Deficiency.

    Science.gov (United States)

    Campbell, Mari; Clarke, Alex; Symes, Andrew; Workman, Sarita; Stauss, Hans; Webster, A David

    2018-02-01

    Patients with primary antibody deficiency report poorer quality of life and higher rates of anxiety and depression than the general population. Cognitive-behavioral therapy has been shown to be a valuable treatment for patients with other long-term physical health conditions, improving well-being and enabling them to manage their symptoms more effectively. The aim of this project was to establish the feasibility and effectiveness of providing cognitive-behavioral based therapy to patients with primary antibody deficiency. Forty-four patients completed a course of psychological therapy. Participants completed a series of self-report measures examining psychological and physical health, and service usage, prior to starting treatment and following their final session. They also provided feedback on their experience of treatment. Patients showed improvements in anxiety, depression, insomnia and fatigue. There was a high level of acceptability of the service and the potential for long-term cost savings to the NHS. Psychological therapy based on the cognitive-behavioral model of treatment appears to be a valuable treatment for patients with primary antibody deficiency and comorbid mental health difficulties.

  7. CT colonography with minimal bowel preparation: evaluation of tagging quality, patient acceptance and diagnostic accuracy in two iodine-based preparation schemes

    International Nuclear Information System (INIS)

    Liedenbaum, Marjolein H.; Vries, A.H. de; Bipat, S.; Stoker, J.; Gouw, C.I.B.F.; Rijn, A.F. van; Dekker, E.

    2010-01-01

    The aim of this study was to compare a 1-day with a 2-day iodine bowel preparation for CT colonography in a positive faecal occult blood test (FOBT) screening population. One hundred consecutive patients underwent CT colonography and colonoscopy with segmental unblinding. The first 50 patients (group 1) ingested 7*50 ml iodinated contrast starting 2 days before CT colonography. The latter 50 patients (group 2) ingested 4*50 ml iodinated contrast starting 1 day before CT colonography. Per colonic segment measurements of residual stool attenuation and homogeneity were performed, and a subjective evaluation of tagging quality (grade 1-5) was done. Independently, two reviewers performed polyp and carcinoma detection. The tagging density was 638 and 618 HU (p = 0.458) and homogeneity 91 and 86 HU for groups 1 and 2, respectively (p = 0.145). The tagging quality was graded 5 (excellent) in 90% of all segments in group 1 and 91% in group 2 (p = 0.749). Mean per-polyp sensitivity for lesions ≥10 mm was 86% in group 1 and 97% in group 2 (p = 0.355). Patient burden from diarrhoea significantly decreased for patients in group 2. One-day preparation with meglumine ioxithalamate results in an improved patient acceptability compared with 2-day preparation and has a comparable, excellent image quality and good diagnostic performance. (orig.)

  8. eHealth System for Collecting and Utilizing Patient Reported Outcome Measures for Personalized Treatment and Care (PROMPT-Care) Among Cancer Patients: Mixed Methods Approach to Evaluate Feasibility and Acceptability.

    Science.gov (United States)

    Girgis, Afaf; Durcinoska, Ivana; Levesque, Janelle V; Gerges, Martha; Sandell, Tiffany; Arnold, Anthony; Delaney, Geoff P

    2017-10-02

    Despite accumulating evidence indicating that collecting patient-reported outcomes (PROs) and transferring results to the treating health professional in real time has the potential to improve patient well-being and cancer outcomes, this practice is not widespread. The aim of this study was to test the feasibility and acceptability of PROMPT-Care (Patient Reported Outcome Measures for Personalized Treatment and Care), a newly developed electronic health (eHealth) system that facilitates PRO data capture from cancer patients, data linkage and retrieval to support clinical decisions and patient self-management, and data retrieval to support ongoing evaluation and innovative research. We developed an eHealth system in consultation with content-specific expert advisory groups and tested it with patients receiving treatment or follow-up care in two hospitals in New South Wales, Australia, over a 3-month period. Participants were recruited in clinic and completed self-report Web-based assessments either just before their upcoming clinical consultation or every 4 weeks if in follow-up care. A mixed methods approach was used to evaluate feasibility and acceptability of PROMPT-Care; data collected throughout the study informed the accuracy and completeness of data transfer procedures, and extent of missing data was determined from participants' assessments. Patients participated in cognitive interviews while completing their first assessment and completed evaluation surveys and interviews at study-end to assess system acceptability and usefulness of patient self-management resources, and oncology staff were interviewed at study-end to determine the acceptability and perceived usefulness of real-time PRO reporting. A total of 42 patients consented to the study; 7 patients were withdrawn before starting the intervention primarily because of changes in eligibility. Overall, 35 patients (13 on treatment and 22 in follow-up) completed 67 assessments during the study period. Mean

  9. DiAlert: a prevention program for overweight first degree relatives of type 2 diabetes patients: results of a pilot study to test feasibility and acceptability

    Directory of Open Access Journals (Sweden)

    Heideman Wieke H

    2012-09-01

    Full Text Available Abstract Background Prevalence of type 2 diabetes mellitus is increasing due to lifestyle changes, particularly affecting those genetically at risk. We developed DiAlert as a targeted group-based intervention aimed to promote intrinsic motivation and action planning for lifestyle changes and weight loss in first degree relatives of patients with type 2 diabetes mellitus. The main objective of the pilot of the DiAlert intervention was to assess fidelity, feasibility and acceptability prior to starting the randomized controlled trial. Methods Individuals with a family history of type 2 diabetes mellitus were self-identified and screened for eligibility. DiAlert consists of two group sessions. Feasibility, fidelity, acceptability and self-reported perceptions and behavioral determinants were evaluated in a pre-post study using questionnaires and observations. Determinants of behavior change were analyzed using paired-samples t tests and Wilcoxon signed rank tests. Results DiAlert was delivered to two groups of first degree relatives of patients with type 2 diabetes mellitus (N = 9 and N = 12. Feasibility and fidelity were confirmed. Overall, the DiAlert group sessions were positively evaluated (8.0 on a scale of 1 to 10 by participants. The intervention did not impact perceived susceptibility or worry about personal diabetes risk. Action planning with regard to changing diet and physical activity increased. Conclusions DiAlert proved feasible and was well-accepted by participants. Positive trends in action planning indicate increased likelihood of actual behavior change following DiAlert. Testing the effectiveness in a randomized controlled trial is imperative. Trial registration Netherlands National Trial Register (NTR: NTR2036

  10. Peer role-play and standardised patients in communication training: a comparative study on the student perspective on acceptability, realism, and perceived effect

    Directory of Open Access Journals (Sweden)

    Schultz Jobst H

    2010-03-01

    Full Text Available Abstract Background To assess the student perspective on acceptability, realism, and perceived effect of communication training with peer role play (RP and standardised patients (SP. Methods 69 prefinal year students from a large German medical faculty were randomly assigned to one of two groups receiving communication training with RP (N = 34 or SP (N = 35 in the course of their paediatric rotation. In both groups, training addressed major medical and communication problems encountered in the exploration and counselling of parents of sick children. Acceptability and realism of the training as well as perceived effects and applicability for future parent-physician encounters were assessed using six-point Likert scales. Results Both forms of training were highly accepted (RP 5.32 ± .41, SP 5.51 ± .44, n.s.; 6 = very good, 1 = very poor and perceived to be highly realistic (RP 5.60 ± .38, SP 5.53 ± .36, n.s.; 6 = highly realistic, 1 = unrealistic. Regarding perceived effects, participation was seen to be significantly more worthwhile in the SP group (RP 5.17 ± .37, SP 5.50 ± .43; p Conclusions RP and SP represent comparably valuable tools for the training of specific communication skills from the student perspective. Both provide highly realistic training scenarios and warrant inclusion in medical curricula. Given the expense of SP, deciding which method to employ should be carefully weighed up. From the perspective of the students in our study, SP were seen as a more useful and more applicable tool than RP. We discuss the potential of RP to foster a greater empathic appreciation of the patient perspective.

  11. A systematic review to investigate the effectiveness and acceptability of interventions for moist desquamation in radiotherapy patients

    International Nuclear Information System (INIS)

    Kedge, Elizabeth M.

    2009-01-01

    Aim: To systematically review the currently available high quality evidence evaluating treatments for moist desquamation in radiotherapy patients. Design: Systematic literature review. Methods: Electronic databases, websites, reference lists, key journals and conference proceedings were searched. Attempts were also made to uncover unpublished material. Relevant studies proceeded to data extraction and quality assessment. Results: Twenty studies were found; 10 were eligible for inclusion. Although many studies were small, none had unacceptably poor quality. No meta-analysis was undertaken as the studies were not homogenous in their interventions or methods. No convincing evidence for any intervention was found. Conclusion: Despite being recommended by many guidelines (College of Radiographers Summary of Intervention for Acute Radiotherapy Induced Skin Reactions in Cancer Patients (London, 2001); NHS Quality Improvement Scotland Best Practice Statement: Skincare of Patients Receiving Radiotherapy (Edinburgh, 2004)); there is mixed evidence concerning the use of hydrogels and hydrocolloid dressings. However, improved patient comfort was sometimes seen, which is arguably equally important. There was limited evidence to support other interventions. Further research is urgently needed.

  12. Acceptability of Extended-Release Naltrexone by Heroin-Dependent Patients and Addiction Treatment Providers in the Netherlands

    NARCIS (Netherlands)

    Zaaijer, Eline; Goudriaan, Anna E.; Koeter, Maarten W. J.; Booij, Jan; van den Brink, Wim

    2016-01-01

    Background: Extended-release naltrexone (XRNT) was developed to overcome poor treatment compliance with oral naltrexone in alcohol and opioid-dependent patients. XRNT injections are registered in the United States and Russia, but not in The Netherlands. However, XRNT can be obtained for individual

  13. Perampanel in the management of partial-onset seizures: a review of safety, efficacy, and patient acceptability

    Directory of Open Access Journals (Sweden)

    Schulze-Bonhage A

    2015-08-01

    Full Text Available Andreas Schulze-Bonhage, Mandy Hintz Epilepsy Center, University Medical Center Freiburg, Freiburg, Germany Abstract: Perampanel (PER is a novel antiepileptic drug recently introduced for the adjunctive treatment in epilepsy patients aged 12 years or older with partial-onset seizures with or without secondary generalization in the US and Europe. Its antiepileptic action is based on noncompetitive inhibition of postsynaptic AMPA receptors, decreasing excitatory synaptic transmission. Evaluation of efficacy in three placebo-controlled randomized Phase III studies showed that add-on therapy of PER decreased seizure frequencies significantly compared to placebo at daily doses between 4 mg/day and 12 mg/day. PER’s long half-life of 105 hours allows for once-daily dosing that is favorable for patient compliance with intake. Long-term extension studies showed a 62.5%–69.6% adherence of patients after 1 year of treatment, comparing favorably with other second-generation antiepileptic drugs. Whereas these trials demonstrated an overall favorable tolerability profile of PER, nonspecific central nervous system adverse effects like somnolence, dizziness, headache, and fatigue may occur. In addition, neuropsychiatric disturbances ranging from irritability to suicidality were reported in several case reports; both placebo-controlled and prospective long-term extension trials showed a low incidence of such behavioral and psychiatric complaints. For early recognition of neuropsychiatric symptoms like depression, anxiety, and aggression, slow titration and close monitoring during drug introduction are mandatory. This allows on the one hand to recognize patients particularly susceptible to adverse effects of the drug, and on the other hand to render the drug’s full potential of seizure control available for the vast majority of patient groups tolerating the drug well. Keywords: epilepsy, antiepileptic drugs, AMPA receptor, structural epilepsy, partial

  14. Perceptions and acceptability of short message services technology to improve treatment adherence amongst tuberculosis patients in Peru: a Focus Group Study.

    Directory of Open Access Journals (Sweden)

    Sandra Albino

    Full Text Available Tuberculosis (TB is global health concern and a leading infectious cause of mortality. Reversing TB incidence and disease-related mortality is a major global health priority. Infectious disease mortality is directly linked to failure to adhere to treatments. Using technology to send reminders by short message services have been shown to improve treatment adherence. However, few studies have examined tuberculosis patient perceptions and attitudes towards using SMS technology to increase treatment adherence. In this study, we sought to investigate perceptions related to feasibility and acceptability of using text messaging to improve treatment adherence among adults who were receiving treatment for TB in Callao, Peru.We conducted focus group qualitative interviews with current TB positive and non-contagious participants to understand the attitudes, perceptions, and feasibility of using short message service (SMS reminders to improve TB treatment adherence. Subjects receiving care through the National TB Program were recruited through public health centers in Ventanilla, Callao, Peru. In four focus groups, we interviewed 16 patients. All interviews were recorded and transcribed verbatim. Thematic network analysis and codebook techniques were used to analyze data.Three major themes emerged from the data: limits on health literacy and information posed challenges to successful TB treatment adherence, treatment motivation at times facilitated adherence to TB treatment, and acceptability of SMS including positive perceptions of SMS to improve TB treatment adherence. The majority of patients shared considerations about how to effectively and confidentially administer an SMS intervention with TB positive participants.The overall perceptions of the use of SMS were positive and indicated that SMS technology may be an efficient way to transmit motivational texts on treatment, health education information, and simple reminders to increase treatment adherence

  15. Perceptions and acceptability of short message services technology to improve treatment adherence amongst tuberculosis patients in Peru: a Focus Group Study.

    Science.gov (United States)

    Albino, Sandra; Tabb, Karen M; Requena, David; Egoavil, Miguel; Pineros-Leano, Maria F; Zunt, Joseph R; García, Patricia J

    2014-01-01

    Tuberculosis (TB) is global health concern and a leading infectious cause of mortality. Reversing TB incidence and disease-related mortality is a major global health priority. Infectious disease mortality is directly linked to failure to adhere to treatments. Using technology to send reminders by short message services have been shown to improve treatment adherence. However, few studies have examined tuberculosis patient perceptions and attitudes towards using SMS technology to increase treatment adherence. In this study, we sought to investigate perceptions related to feasibility and acceptability of using text messaging to improve treatment adherence among adults who were receiving treatment for TB in Callao, Peru. We conducted focus group qualitative interviews with current TB positive and non-contagious participants to understand the attitudes, perceptions, and feasibility of using short message service (SMS) reminders to improve TB treatment adherence. Subjects receiving care through the National TB Program were recruited through public health centers in Ventanilla, Callao, Peru. In four focus groups, we interviewed 16 patients. All interviews were recorded and transcribed verbatim. Thematic network analysis and codebook techniques were used to analyze data. Three major themes emerged from the data: limits on health literacy and information posed challenges to successful TB treatment adherence, treatment motivation at times facilitated adherence to TB treatment, and acceptability of SMS including positive perceptions of SMS to improve TB treatment adherence. The majority of patients shared considerations about how to effectively and confidentially administer an SMS intervention with TB positive participants. The overall perceptions of the use of SMS were positive and indicated that SMS technology may be an efficient way to transmit motivational texts on treatment, health education information, and simple reminders to increase treatment adherence for low

  16. Clinical study on the efficacy, acceptance, and safety of hearing aids in patients with mild to moderate presbyacusis.

    Science.gov (United States)

    Romanet, Phillipe; Guy, Martine; Allaert, Francois-André

    2018-04-17

    of the study: The primary objective of this trial was to demonstrate the effect of wearing a Hearing aid (HA) on improvement of hearing and comprehension in everyday life situations. This mono-centre phase IV open-label clinical trial was carried out on men or women 40 years old or more, presenting mild or moderate first-degree presbyacusis. Presbyacusis was diagnosed by performance of pure-tone audiometry in silence. The main criterion was the comparison of the Glasgow Hearing Aid Benefit Profile (GHABP) before wearing HA and after a month of use and the secondary one was audiometric parameters. 47 patients, 60.0 ± 6.9 years old were included in the study. After 4 weeks, when wearing HA, no significant difficulty remains in the patients when they watch television (GHABP situation 1) or when they have a conversation without background noise (GHABP situation 2). To have a conversation in a busy street or a shop GHABP (situation 3) 4.4% of patients still have great difficulty, as are 2.2% of them when participating in a group conversation (GHABP situation 4). The GHABP score of residual disability for the whole of the 4 situations of difficulty is 1.3 ± 0.5, translating into no or only slight residual disability, in very significant amelioration of 1.3 ± 0.7 points (p: <0.0001), or 46.4% compared to the initial value. Audiometric parameters were also significantly improved. This study has allowed us to highlight from a clinical as well as an audiometric perspective the safety, effectiveness, as well as the important benefit of Sonalto® pre-set hearing aids on the improvement of hearing in patients presenting incipient presbyacusis.

  17. An exploratory mixed methods study of the acceptability and effectiveness of mindfulness -based cognitive therapy for patients with active depression and anxiety in primary care

    Directory of Open Access Journals (Sweden)

    Mercer Stewart W

    2006-04-01

    Full Text Available Abstract Background Mindfulness Based Cognitive Therapy (MBCT is an 8-week course developed for patients with relapsing depression that integrates mindfulness meditation practices and cognitive theory. Previous studies have demonstrated that non-depressed participants with a history of relapsing depression are protected from relapse by participating in the course. This exploratory study examined the acceptability and effectiveness of MBCT for patients in primary care with active symptoms of depression and anxiety Methods 13 patients with recurrent depression or recurrent depression and anxiety were recruited to take part in the study. Semi-structured qualitative interviews were conducted three months after completing the MBCT programme. A framework approach was used to analyse the data. Beck depression inventories (BDI-II and Beck anxiety inventories (BAI provided quantitative data and were administered before and three months after the intervention. Results The qualitative data indicated that mindfulness training was both acceptable and beneficial to the majority of patients. For many of the participants, being in a group was an important normalising and validating experience. However most of the group believed the course was too short and thought that some form of follow up was essential. More than half the patients continued to apply mindfulness techniques three months after the course had ended. A minority of patients continued to experience significant levels of psychological distress, particularly anxiety. Statistically significant reductions in mean depression and anxiety scores were observed; the mean pre-course depression score was 35.7 and post-course score was 17.8 (p = 0.001. A similar reduction was noted for anxiety with a mean pre-course anxiety score of 32.0 and mean post course score of 20.5 (p = 0.039. Overall 8/11 (72% patients showed improvements in BDI and 7/11 (63% patients showed improvements in BAI. In general the results

  18. "They just come, pick and go." The Acceptability of Integrated Medication Adherence Clubs for HIV and Non Communicable Disease (NCD) Patients in Kibera, Kenya.

    Science.gov (United States)

    Venables, Emilie; Edwards, Jeffrey K; Baert, Saar; Etienne, William; Khabala, Kelly; Bygrave, Helen

    2016-01-01

    The number of people on antiretroviral therapy (ART) for the long-term management of HIV in low- and middle-income countries (LMICs) is continuing to increase, along with the prevalence of Non-Communicable Diseases (NCDs). The need to provide large volumes of HIV patients with ART has led to significant adaptations in how medication is delivered, but access to NCD care remains limited in many contexts. Medication Adherence Clubs (MACs) were established in Kibera, Kenya to address the large numbers of patients requiring chronic HIV and/or NCD care. Stable NCD and HIV patients can now collect their chronic medication every three months through a club, rather than through individual clinic appointments. We conducted a qualitative research study to assess patient and health-care worker perceptions and experiences of MACs in the urban informal settlement of Kibera, Kenya. A total of 106 patients (with HIV and/or other NCDs) and health-care workers were purposively sampled and included in the study. Ten focus groups and 19 in-depth interviews were conducted and 15 sessions of participant observation were carried out at the clinic where the MACs took place. Thematic data analysis was conducted using NVivo software, and coding focussed on people's experiences of MACs, the challenges they faced and their perceptions about models of care for chronic conditions. MACs were considered acceptable to patients and health-care workers because they saved time, prevented unnecessary queues in the clinic and provided people with health education and group support whilst they collected their medication. Some patients and health-care workers felt that MACs reduced stigma for HIV positive patients by treating HIV as any other chronic condition. Staff and patients reported challenges recruiting patients into MACs, including patients not fully understanding the eligibility criteria for the clubs. There were also some practical challenges during the implementation of the clubs, but MACs

  19. THE IMPROVEMENT OF FAMILY COPING IN TAKING CARE OF PATIENT MENTAL DISORDER WITH SPIRITUAL THERAPY; DIRECTION, OBEDIENCE AND ACCEPTANCE (DOA

    Directory of Open Access Journals (Sweden)

    Ah. Yusuf

    2017-04-01

    Full Text Available Introduction: Mental disorder remains a stigma in society, even until now. A family who have a member with mental disorder, will experience continues objective and subjective burden, experience serious stress for a lifetime, which may cause ineffective coping. Method: Design used in this study was experimental (pre post test control group design. The population was every family of patient with mental disorder in Menur Mental Hospital along the year of 2010, has been taking care there twice, in minimum, lived in Surabaya. The samples were chosen by allocation simple random. Samples were 13 persons in each treatment and control group. The intervention was given in 60–120 minute in 8 times meeting with average interval about 1 week. Data analysis was done using paired t-test and independent t-test. Result: Results in this study showed that there was significant change in total of family coping (p = 0.040, maintaining family integration, cooperation and an optimistic definition of the stuation (p = 0.009, maintaining social support, self esteem, and psychological stability (p = 0.230, understanding the medical situations through communication with other parents and concultation with medical staff (p = 0.025. Discussion: The provision of family therapy with spiritual approach (DOA can increase family coping in taking care of patient with mental disorder.

  20. A technology-enabled adherence enhancement system for people with bipolar disorder: results from a feasibility and patient acceptance analysis

    Directory of Open Access Journals (Sweden)

    Sajatovic M

    2015-06-01

    Full Text Available Martha Sajatovic,1 Michael S Davis,2 Kristin A Cassidy,3 Joseph Nestor,2 Johnny Sams,3 Edna Fuentes-Casiano3 1Department of Psychiatry and Neurological and Behavioral Outcomes Center, Case Western Reserve University School of Medicine and University Hospitals Case Medical Center, Cleveland, OH, USA; 2MedicaSafe, New York, NY, USA; 3Department of Psychiatry, Case Western Reserve University School of Medicine, University Hospitals Case Medical Center, Cleveland, OH, USA Objective: As poor medication adherence is common in bipolar disorder (BD, technology-assisted approaches may help to monitor and enhance adherence. This study evaluated preliminary feasibility, patient satisfaction and effects on adherence, BD knowledge, and BD symptoms associated with the use of a multicomponent technology-assisted adherence enhancement system. Methods: This prospective study tested the system in five BD patients over a 15-day period. System components included: 1 an automated pill cap with remote monitoring sensor; 2 a multimedia adherence enhancement program; and 3 a treatment incentive program. This study evaluated system usability, patient satisfaction and effects on adherence (Morisky scale, knowledge (treatment knowledge test [TKT], and symptoms (internal state scale [ISS]. Results: Mean age of the sample was 62 years, 4/5 (80% Caucasian, and 4/5 (80% single/divorced or widowed. Most participants (4/5, 80% were on a single BD medication. Participants had BD for an average of 21 years. Challenges included attaching the pill sensor to standard pharmacy bottles for individuals using very large pill containers or those with multiday pill boxes. Three of five (60% individuals completed the full 15-day period. Usability scores were high overall. Mean Morisky scores improved. Means on all four subscales of the ISS were all in the direction of improvement. On the TKT, there was a 40% increase in mean scores. Conclusion: A multicomponent technology-assisted BD

  1. Paediatric in-patient care in a conflict-torn region of Somalia: are hospital outcomes of acceptable quality?

    Science.gov (United States)

    Zachariah, R.; Hinderaker, S. G.; Khogali, M.; Manzi, M.; van Griensven, J.; Ayada, L.; Jemmy, J. P.; Maalim, A.; Amin, H.

    2013-01-01

    Setting: A district hospital in conflict-torn Somalia. Objective: To report on in-patient paediatric morbidity, case fatality and exit outcomes as indicators of quality of care. Design: Cross-sectional study. Results: Of 6211 children, lower respiratory tract infections (48%) and severe acute malnutrition (16%) were the leading reasons for admission. The highest case-fatality rate was for meningitis (20%). Adverse outcomes occurred in 378 (6%) children, including 205 (3.3%) deaths; 173 (2.8%) absconded. Conclusion: Hospital exit outcomes are good even in conflict-torn Somalia, and should boost efforts to ensure that such populations are not left out in the quest to achieve universal health coverage. PMID:26393014

  2. Acceptability of Mobile Phone Technology for Medication Adherence Interventions among HIV-Positive Patients at an Urban Clinic.

    Science.gov (United States)

    Miller, Christopher W T; Himelhoch, Seth

    2013-01-01

    Mobile phone technology is increasingly used to overcome traditional barriers limiting access to care. The goal of this study was to evaluate access and willingness to use smart and mobile phone technology for promoting adherence among people attending an urban HIV clinic. One hundred consecutive HIV-positive patients attending an urban HIV outpatient clinic were surveyed. The questionnaire evaluated access to and utilization of mobile phones and willingness to use them to enhance adherence to HIV medication. The survey also included the CASE adherence index as a measure of adherence. The average age was 46.4 (SD = 9.2). The majority of participants were males (63%), black (93%), and Hispanic (11.4%) and reported earning less than $10,000 per year (67.3%). Most identified themselves as being current smokers (57%). The vast majority reported currently taking HAART (83.5%). Approximately half of the participants reported some difficulty with adherence (CASE mobile phone. Among owners of mobile phones 47.4% reported currently owning more than one device. Over a quarter reported owning a smartphone. About 60% used their phones for texting and 1/3 used their phone to search the Internet. Nearly 70% reported that they would use a mobile device to help with HIV adherence. Those who reported being very likely or likely to use a mobile device to improve adherence were significantly more likely to use their phone daily (P = 0.03) and use their phone for text messages (P = 0.002). The vast majority of patients in an urban HIV clinic own mobile phones and would use them to enhance adherence interventions to HIV medication.

  3. [Validity, reliability, and acceptability of the brief version of the self-management knowledge, attitude, and behavior assessment scale for diabetes patients].

    Science.gov (United States)

    Wu, Y Z; Wang, W J; Feng, N P; Chen, B; Li, G C; Liu, J W; Liu, H L; Yang, Y Y

    2016-07-06

    To evaluate the validity, reliability, and acceptability of the brief version of the self-management knowledge, attitude, and behavior (KAB) assessment scale for diabetes patients. Diabetes patients who were managed at the Xinkaipu Community Health Service Center of Tianxin in Changsha, Hunan Province were selected for survey by cluster sampling. A total of 350 diabetes patients were surveyed using the brief scale to collect data on knowledge, attitudes, and behaviors of self-management. Content validity was evaluated by Pearson correlation coefficient between the brief scale and subscales of knowledge, attitude, and behavior. Structure validity was evaluated by factor analysis, and discrimination validity was evaluated by an independent sample t-test between the high-score and low-score groups. Reliability was tested by internal consistency reliability and split-half reliability. The evaluation indexes of internal consistency reliability were Cronbach's α coefficients, θ coefficient, and Ω coefficient. Acceptability was evaluated by valid response rate and completion time of the brief scale. A total of 346(98.9%) valid questionnaires were returned, with average survey time of (11.43±3.4) minutes. Average score of the brief scale was 78.85 ± 11.22; scores of the knowledge, attitude, and behavior subscales were 16.45 ± 4.42, 21.33 ± 2.03, and 41.07 ± 8.34, respectively. Pearson correlation coefficients between the brief scale and the knowledge, attitude, and behavior subscales were 0.92, 0.42, and 0.60, respectively; P-values were all less than 0.01, indicating that the face validity and content validity of the brief scale were achieved to a good level. The common factor cumulative variance contribution rate of the brief scale and three subscales was from 53.66% to 61.75%, which achieved more than 50% of the approved standard. There were 11 common factors; 41 of the total 42 items had factor loadings above 0.40 in their relevant common factor, indicating

  4. Efficacy, Tolerability, and Acceptability of Iron Hydroxide Polymaltose Complex versus Ferrous Sulfate: A Randomized Trial in Pediatric Patients with Iron Deficiency Anemia

    Directory of Open Access Journals (Sweden)

    Beril Yasa

    2011-01-01

    Full Text Available Iron polymaltose complex (IPC offers similar efficacy with superior tolerability to ferrous sulfate in adults, but randomized trials in children are rare. In a prospective, open-label, 4-month study, 103 children aged >6 months with iron deficiency anemia (IDA were randomized to IPC once daily or ferrous sulfate twice daily, (both 5 mg iron/kg/day. Mean increases in Hb to months 1 and 4 with IPC were 1.2±0.9 g/dL and 2.3±1.3 g/dL, respectively, (both P=0.001 versus baseline and 1.8±1.7 g/dL and 3.0±2.3 g/dL with ferrous sulfate (both P=0.001 versus baseline (n.s. between groups. Gastrointestinal adverse events occurred in 26.9% and 50.9% of IPC and ferrous sulfate patients, respectively (P=0.012. Mean acceptability score at month 4 was superior with IPC versus ferrous sulfate (1.63±0.56 versus 2.14±0.75, P=0.001. Efficacy was comparable with IPC and ferrous sulfate over a four-month period in children with IDA, but IPC was associated with fewer gastrointestinal adverse events and better treatment acceptability.

  5. Safety, efficacy and patient acceptability of drospirenone and estradiol in the treatment of menopausal vasomotor symptoms: a review

    Directory of Open Access Journals (Sweden)

    Sebastián Carranza-Lira

    2008-12-01

    Full Text Available Sebastián Carranza-LiraReproductive Medicine, UMAE Hospital de Ginecología y Obstetricia “Luis Castelazo Ayala” Instituto Mexicano del Seguro Social, MéxicoAbstract: During menopause vasomotor symptoms are one of the main complaints about which women seek medical advice. For symptom control, several therapies have been used, among which hormone therapy has produced good results. One of these is estrogen monotherapy, which unfortunately may induce endometrial hyperplasia in women with an intact uterus. A progestin must be added to avoid this risk. Progestins may induce several secondary effects such as breast tenderness, hirsutism, edema and unfavorable lipid profile modifications. Recently a new progestin called drospirenone has been synthesized and used in combination with estradiol for the treatment of postmenopausal women. This progestin is derived from spironolactone, and lacks estrogenic, androgenic and glucocorticoid activities. Several studies have evaluated safety, efficacy and patient tolerability, and have shown a good profile in all these parameters. All studies agree that the combination of estradiol 1 mg plus drospirenone 2 mg is a good choice for postmenopausal women with vasomotor symptoms.Keywords: estradiol, drospirenone, postmenopause, review

  6. Predictors of Sunburn Risk Among Florida Residents.

    Science.gov (United States)

    Arutyunyan, Sergey; Alfonso, Sarah V; Hernandez, Nilda; Favreau, Tracy; Fernández, M Isabel

    2017-03-01

    The incidence of skin cancer, the most common type of cancer in the United States, is increasing. Sunburn is a major modifiable risk factor for skin cancer, and its prevalence among the US population is high. To identify predictors of having had a red or painful sunburn in the past 12 months among people living in Florida. Florida residents were recruited from public places and online. They were asked to complete an anonymous cross-sectional survey that assessed demographic information, dermatologic history, as well as knowledge, attitude, and behavior factors associated with sunburn. A total of 437 participants whose data were complete for all variables were included in the multivariate analysis. In multivariate logistic regression, younger age (18-29 years) was the most significant predictor of sunburn (OR, 15.26; 95% CI, 5.97-38.98; PSunburn prevention programs that osteopathic physicians can readily implement in clinical practice are urgently needed, particularly for young adult patients. This study identified 7 predictors of sunburn in Florida residents. With additional research findings, promoting attitude change toward sun protection may be a viable strategy.

  7. Safety, efficacy, actions, and patient acceptability of drospirenone/ethinyl estradiol contraceptive pills in the treatment of premenstrual dysphoric disorder

    Directory of Open Access Journals (Sweden)

    Lesley L Breech

    2009-08-01

    Full Text Available Lesley L Breech, Paula K BravermanDivision of Adolescent Medicine, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USAAbstract: Premenstrual dysphoric disorder (PMDD is estimated to affect 3%–8% of reproductive age women. Multiple therapeutic modalities have been evaluated with varying efficacy for the associated somatic and mood symptoms. The majority of older studies had shown that oral contraceptive pills (OCs were most effective for the physical symptoms. However, newer OCs containing a novel progestin, drospirenone, have shown promise in alleviating both the somatic and affective/behavioral symptoms. This progestin, which is a derivative of spironolactone, has both antimineralocorticoid and antiandrogenic activity. A 24/4 formulation containing 20 µg of ethinyl estradiol has been found effective in randomized double-blind placebo-controlled trials utilizing established scales documenting symptoms associated with PMDD. Multiple studies have shown that drospirenone-containing OCs are safe without evidence of clinically adverse effects on carbohydrate metabolism, lipids, blood pressure, weight, serum potassium or increased thrombotic events compared to other low dose OCs. In addition, significant improvements have been demonstrated in acne, hirsutism, and fluid retention symptoms. Several open label studies demonstrated good patient compliance and reported satisfaction with the method. Because of the significant placebo effect demonstrated in the blinded placebo-controlled trials, additional large randomized placebo-controlled trials are needed to confirm the efficacy of the drospirenone OCs in the treatment of PMDD. However, this OC formulation appears to be a promising therapeutic modality.Keywords: drospirenone, premenstrual dysphoric disorder, premenstrual syndrome, oral contraceptive pill

  8. Spaceport Florida Authority: Business Plan

    Science.gov (United States)

    1996-01-01

    The Spaceport Florida Authority (SFA) was established under Florida Statute by the Governor and Legislature to assist the development of our nation's space transportation industry and to generate new space-related jobs, investment and opportunities statewide. Included in the Authorities' business plan is the statement of work and list of team members involved in creating the report, SFA's current operating concept, market analysis, assessment of accomplishments, a sample operating concept and a "roadmap to success".

  9. Peer role-play and standardised patients in communication training: a comparative study on the student perspective on acceptability, realism, and perceived effect

    Science.gov (United States)

    2010-01-01

    Background To assess the student perspective on acceptability, realism, and perceived effect of communication training with peer role play (RP) and standardised patients (SP). Methods 69 prefinal year students from a large German medical faculty were randomly assigned to one of two groups receiving communication training with RP (N = 34) or SP (N = 35) in the course of their paediatric rotation. In both groups, training addressed major medical and communication problems encountered in the exploration and counselling of parents of sick children. Acceptability and realism of the training as well as perceived effects and applicability for future parent-physician encounters were assessed using six-point Likert scales. Results Both forms of training were highly accepted (RP 5.32 ± .41, SP 5.51 ± .44, n.s.; 6 = very good, 1 = very poor) and perceived to be highly realistic (RP 5.60 ± .38, SP 5.53 ± .36, n.s.; 6 = highly realistic, 1 = unrealistic). Regarding perceived effects, participation was seen to be significantly more worthwhile in the SP group (RP 5.17 ± .37, SP 5.50 ± .43; p < .003; 6 = totally agree, 1 = don't agree at all). Both training methods were perceived as useful for training communication skills (RP 5.01 ± .68, SP 5.34 ± .47; 6 = totally agree; 1 = don't agree at all) and were considered to be moderately applicable for future parent-physician encounters (RP 4.29 ± 1.08, SP 5.00 ± .89; 6 = well prepared, 1 = unprepared), with usefulness and applicability both being rated higher in the SP group (p < .032 and p < .009). Conclusions RP and SP represent comparably valuable tools for the training of specific communication skills from the student perspective. Both provide highly realistic training scenarios and warrant inclusion in medical curricula. Given the expense of SP, deciding which method to employ should be carefully weighed up. From the perspective of the students in our study, SP were seen as a more useful and more applicable tool than RP

  10. Andrew spares Florida Coast

    Science.gov (United States)

    Bush, Susan

    When geologists heard of the intensity of Hurricane Andrew, which struck the Florida coast on August 25 and then moved on to southern Louisiana, they were expecting the same kinds of coastal damage that Hurricane Hugo brought to the Caribbean and Carolina shores in 1989. Both storms were category 4 hurricanes, having winds of 131-155 mph and surges of 13-18 feet. However, the coastal damage never materialized, leaving geologists to analyze the factors that lessened the impact of the storm. “For minimum coastal damage, you couldn't have designed a better storm,” said Orrin Pilkey, director of the Program for the Study of Developed Shorelines (PSDS) in Durham, N.C. This was due in part to the nature of the storm itself and where it hit land, and in part to the regional geology, said Rob Thieler of PSDS. Despite the huge amounts of damage to buildings, there was virtually no evidence of coastal process destruction, he said.

  11. Acceptability of the Distress Thermometer and Problem List to community-based telephone cancer helpline operators, and to cancer patients and carers

    Directory of Open Access Journals (Sweden)

    Sargeant Hilary

    2011-01-01

    Full Text Available Abstract Background Cancer can be a distressing experience for cancer patients and carers, impacting on psychological, social, physical and spiritual functioning. However, health professionals often fail to detect distress in their patients due to time constraints and a lack of experience. Also, with the focus on the patient, carer needs are often overlooked. This study investigated the acceptability of brief distress screening with the Distress Thermometer (DT and Problem List (PL to operators of a community-based telephone helpline, as well as to cancer patients and carers calling the service. Methods Operators (n = 18 monitored usage of the DT and PL with callers (cancer patients/carers, >18 years, and English-speaking from September-December 2006 (n = 666. The DT is a single item, 11-point scale to rate level of distress. The associated PL identifies the cause of distress. Results The DT and PL were used on 90% of eligible callers, most providing valid responses. Benefits included having an objective, structured and consistent means for distress screening and triage to supportive care services. Reported challenges included apparent inappropriateness of the tools due to the nature of the call or level of caller distress, the DT numeric scale, and the level of operator training. Conclusions We observed positive outcomes to using the DT and PL, although operators reported some challenges. Overcoming these challenges may improve distress screening particularly by less experienced clinicians, and further development of the PL items and DT scale may assist with administration. The DT and PL allow clinicians to direct/prioritise interventions or referrals, although ongoing training and support is critical in distress screening.

  12. At first glance, informal payments experience on track: why accept or refuse? Patients' perceive in cardiac surgery department of public hospitals, northeast of Iran 2013.

    Science.gov (United States)

    Vafaei Najar, Ali; Ebrahimipour, Hossein; Pourtaleb, Arefeh; Esmaily, Habibollah; Jafari, Mehdi; Nejatzadegan, Zohre; Taleghani, Yasamin Molavi

    2017-03-14

    Patient's Informal payments is among the main source of health care financing in some countries. This paper aimed at determining the patient informal payments and relative factors in Cardiac Surgery Departments (CSD) in hospitals affiliated to Mashhad University of Medical Sciences (MUMS) in 2013. In this cross-sectional study, 316 discharged patients were selected using multi-stage sampling. Data gathering tool was a questionnaire which was filled by structured telephone interviews. We used quantitative content analysis for open-ended questions besides descriptive statistics and nonparametric tests by SPSS 16 at 0.05 Sig level. Sixteen (5.93%) patients made voluntary informal payments. The purpose of payment was: "gratitude" (43.75%), satisfaction with health services provided" (31.25%) and (18.75%) for better quality of services. About 75% of the payments were occurred during receiving health care services. The main causes were "no request for informal payments" (98.14%), "not affording to pay for informal payments" (73.33%) and "paying the hospital expenses by taking out a loan" (55.91%). Responders said they would pay informally in demand situation (51.85%) just for patient's health priority, 40.71% would also "search for other alternative solutions" and 27.33% "accepted the demand as a kind of gratitude culture". Twenty four patients (8.9%) had experienced mandatory informal payments during the last 6 months. The minimum amount of payment was 62.5$ and the maximum was 3125$. There was a significant relationship between the way of referring to medical centers and informal patient's payment (P ≤0.05). Despite the widespread prevalent belief about informal payments in public hospitals -particularly to the well-known physicians - such judgment cannot be generalized. The main reasons for the low informal payments in the current study were the personality characteristics of the physicians and hospital staff, their moral conscience and commitment to professional

  13. Review of dutasteride/tamsulosin fixed-dose combination for the treatment of benign prostatic hyperplasia: efficacy, safety, and patient acceptability

    Directory of Open Access Journals (Sweden)

    Barkin J

    2011-10-01

    Full Text Available Jack BarkinHumber River Regional Hospital, Toronto, Canada and Department of Surgery, University of Toronto, Toronto, Ontario, CanadaAbstract: Lower urinary tract symptoms (LUTS caused by benign prostatic hyperplasia (BPH will usually affect older men, of whom 50% over the age 60 years and almost 90% in their nineties will be bothered enough by their symptoms that they request some type of treatment. However, symptomatic bother may also affect men in their forties with a prevalence rate of almost 18%. The International Prostate Symptom Score (IPSS has become the most widely used and best validated questionnaire to allow the patient to quantify the severity of his LUTS/BPH symptoms. This score has become the cornerstone in demonstrating the “rate of symptom response” for the patient who has been exposed to any type BPH management. Question 8 on the IPSS score is what is defined as the “Quality of Life” question or what is also termed the “Bothersome Index.” The score out of 6 as declared by the patient will reflect the degree of concern that the patient is feeling about his symptoms and the reduction of the score after treatment is a statement of their improved quality of life. There are 2 families of accepted medical therapy to treat the symptoms of BPH and potentially prevent the most worrisome long-term sequelae of progression of BPH: urinary retention or the need for surgery. When defining the impact of the main types of medical therapy, the alpha blockers have been termed the “openers” and the 5 alpha-reductase inhibitors are described as the “shrinkers.” Since they each offer a different mechanism of effect, the concept of combination therapy was raised and trialed many times over recent years. The final aspect of any medical therapy is the patient's satisfaction with the treatment and the side effects. In the CombAT (Combination of Avodart and Tamsulosin trial a new assessment was developed and tested called the Patient

  14. Keele Aches and Pains Study protocol: validity, acceptability, and feasibility of the Keele STarT MSK tool for subgrouping musculoskeletal patients in primary care

    Directory of Open Access Journals (Sweden)

    Campbell P

    2016-10-01

    Full Text Available Paul Campbell,1 Jonathan C Hill,1 Joanne Protheroe,1 Ebenezer K Afolabi,1 Martyn Lewis,1 Ruth Beardmore,1 Elaine M Hay,1 Christian D Mallen,1 Bernadette Bartlam,1 Benjamin Saunders,1 Danielle A van der Windt,1 Sue Jowett,2 Nadine E Foster,1 Kate M Dunn1 1Arthritis Research UK Primary Care Centre, Research Institute of Primary Care and Health Sciences, Keele University, Keele, 2Health Economics Unit, University of Birmingham, Birmingham, UK Abstract: Musculoskeletal conditions represent a considerable burden worldwide, and are predominantly managed in primary care. Evidence suggests that many musculoskeletal conditions share similar prognostic factors. Systematically assessing patient’s prognosis and matching treatments based on prognostic subgroups (stratified care has been shown to be both clinically effective and cost-effective. This study (Keele Aches and Pains Study aims to refine and examine the validity of a brief questionnaire (Keele STarT MSK tool designed to enable risk stratification of primary care patients with the five most common musculoskeletal pain presentations. We also describe the subgroups of patients, and explore the acceptability and feasibility of using the tool and how the tool is best implemented in clinical practice. The study design is mixed methods: a prospective, quantitative observational cohort study with a linked qualitative focus group and interview study. Patients who have consulted their GP or health care practitioner about a relevant musculoskeletal condition will be recruited from general practice. Participating patients will complete a baseline questionnaire (shortly after consultation, plus questionnaires 2 and 6 months later. A subsample of patients, along with participating GPs and health care practitioners, will be invited to take part in qualitative focus groups and interviews. The Keele STarT MSK tool will be refined based on face, discriminant, construct, and predictive validity at baseline and 2

  15. A comparison between two lingual orthodontic brackets in terms of speech performance and patients' acceptance in correcting Class II, Division 1 malocclusion: a randomized controlled trial.

    Science.gov (United States)

    Haj-Younis, Samiha; Khattab, Tarek Z; Hajeer, Mohammad Y; Farah, Hassan

    2016-01-01

    To compare speech performance and levels of oral impairment between two types of lingual brackets. A parallel-group randomized controlled trial was carried out on patients with Class II, Division 1 malocclusion treated at the University of Hama School of Dentistry in Hama, Syria. A total of 46 participants (mean age: 22.3 ± 2.3 years) with maxillary dentoalveolar protrusion were randomly distributed into two groups with 23 patients each (1:1 allocation ratio). Either STb (Ormco) or 7th Generation (Ormco) lingual brackets were applied. Fricative sound/s/ spectrograms were analyzed directly before intervention (T0), one week following premolar extraction prior to bracket placement (T1), within 24 hours of bracket bonding (T2), one month after (T3), and three months after (T4) bracket placement. Patients' acceptance was assessed by means of standardized questionnaires. After bracket placement, significant deterioration in articulation was recorded at all assessment times in the 7th Generation group, and up to T3 in the STb group. Significant intergroup differences were detected at T2 and T3. No statistically significant differences were found between the two groups in reported tongue irritation levels, whereas chewing difficulty was significantly higher in the 7th Generation group one month after bracket placement. 7th Generation brackets have more interaction with sound production than STb ones. Although patients in both groups complained of some degree of oral impairment, STb appliances appeared to be more comfortable than the 7th Generation ones, particularly within the first month of treatment.

  16. Inconsistent approaches of the G-BA regarding acceptance of primary study endpoints as being relevant to patients - an analysis of three disease areas: oncological, metabolic, and infectious diseases

    Directory of Open Access Journals (Sweden)

    Thomas Staab

    2016-11-01

    Full Text Available Abstract Background Previous evaluations of oncological medicines in the German early benefit assessment (EBA procedure have demonstrated inconsistent acceptance of endpoints by regulatory authorities and the Federal Joint Committee (G-BA. Accepted standard endpoints for regulatory purposes are frequently not considered as patient-relevant in the German EBA system. In this study the acceptance of clinically acknowledged primary endpoints (PEPs from regulatory trials in EBAs conducted by the G-BA was evaluated across three therapeutic areas. Methods Medicines for oncological, metabolic and infectious diseases with EBAs finalised before 25 January 2016 were evaluated. Respective manufacturer’s dossiers, regulatory assessments, G-BA appraisals and oral hearing minutes were reviewed, and PEPs were examined to determine whether they were considered relevant to patients by the G-BA. Furthermore, the acceptance of symptomatic vs asymptomatic PEPs was also analysed. Results A total of 65 EBAs were evaluated. Mortality PEPs were widely accepted as patient-relevant but were only used in a minority of EBAs and exclusively in oncological diseases. Morbidity PEPs constituted around 72 % of assessed PEPs, but were excluded from the EBA in over half of the corresponding assessments as they were not considered patient-relevant. Symptomatic endpoints were largely deemed patient-relevant, whereas acceptance of asymptomatic endpoints varied between therapeutic areas. Conclusions This evaluation identified inconsistencies in patient relevance of morbidity-related PEPs as well as in acceptance of asymptomatic endpoints by the G-BA in all three disease areas examined. Better harmonisation between the regulatory authorities and the G-BA is still required after 5 years of AMNOG health technology assessment in Germany.

  17. Test performance and acceptability of self- versus provider-collected swabs for high-risk HPV DNA testing in female-to-male trans masculine patients.

    Science.gov (United States)

    Reisner, Sari L; Deutsch, Madeline B; Peitzmeier, Sarah M; White Hughto, Jaclyn M; Cavanaugh, Timothy P; Pardee, Dana J; McLean, Sarah A; Panther, Lori A; Gelman, Marcy; Mimiaga, Matthew J; Potter, Jennifer E

    2018-01-01

    endorsed a preference for the self-collected vaginal swab over provider-collected cervical swab. Self-collected vaginal swabs are highly acceptable to TM as a means to test for hrHPV DNA. Test performance of this self-collection method for hrHPV detection in TM is consistent with previous studies in cisgender females. Self-collected vaginal swab testing for hrHPV DNA represents a reasonable and patient-centered strategy for primary cervical cancer screening in TM patients unwilling to undergo provider collection of specimens via speculum exam.

  18. Epidemiology of Ciguatera in Florida.

    Science.gov (United States)

    Radke, Elizabeth G; Reich, Andrew; Morris, John Glenn

    2015-08-01

    Ciguatera is the most commonly reported marine food-borne illness worldwide. Because there is a biological plausibility that ciguatera may be impacted by long-term climate variability and Florida is on the northern border of the geographic distribution of ciguatera, it is important to update our understanding of its epidemiology in Florida. We performed an analysis of 291 reports in Florida from 2000 to 2011 and an e-mail survey of 5,352 recreational fishers to estimate incidence and underreporting and identify high risk demographic groups, fish types, and catch locations. Incidence was 5.6 per 100,000 adjusted for underreporting. Hispanics had the highest incidence rate (relative risk [RR] = 3.4) and were more likely to eat barracuda than non-Hispanics. The most common catch locations for ciguatera-causing fish were the Bahamas and Florida Keys. Cases caused by fish from northern Florida were infrequent. These results indicate that ciguatera incidence is higher than estimated from public health reports alone. There is little evidence that incidence or geographic range has increased because of increased seawater temperatures since earlier studies. © The American Society of Tropical Medicine and Hygiene.

  19. A comparison between two lingual orthodontic brackets in terms of speech performance and patients' acceptance in correcting Class II, Division 1 malocclusion: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Samiha Haj-Younis

    Full Text Available ABSTRACT Objective: To compare speech performance and levels of oral impairment between two types of lingual brackets. Methods: A parallel-group randomized controlled trial was carried out on patients with Class II, Division 1 malocclusion treated at the University of Hama School of Dentistry in Hama, Syria. A total of 46 participants (mean age: 22.3 ± 2.3 years with maxillary dentoalveolar protrusion were randomly distributed into two groups with 23 patients each (1:1 allocation ratio. Either STb (Ormco or 7th Generation (Ormco lingual brackets were applied. Fricative sound/s/ spectrograms were analyzed directly before intervention (T0, one week following premolar extraction prior to bracket placement (T1, within 24 hours of bracket bonding (T2, one month after (T3, and three months after (T4 bracket placement. Patients′ acceptance was assessed by means of standardized questionnaires. Results: After bracket placement, significant deterioration in articulation was recorded at all assessment times in the 7th Generation group, and up to T3 in the STb group. Significant intergroup differences were detected at T2 and T3. No statistically significant differences were found between the two groups in reported tongue irritation levels, whereas chewing difficulty was significantly higher in the 7th Generation group one month after bracket placement. Conclusions: 7th Generation brackets have more interaction with sound production than STb ones. Although patients in both groups complained of some degree of oral impairment, STb appliances appeared to be more comfortable than the 7th Generation ones, particularly within the first month of treatment.

  20. A comparison between two lingual orthodontic brackets in terms of speech performance and patients' acceptance in correcting Class II, Division 1 malocclusion: a randomized controlled trial

    Science.gov (United States)

    Haj-Younis, Samiha; Khattab, Tarek Z.; Hajeer, Mohammad Y.; Farah, Hassan

    2016-01-01

    ABSTRACT Objective: To compare speech performance and levels of oral impairment between two types of lingual brackets. Methods: A parallel-group randomized controlled trial was carried out on patients with Class II, Division 1 malocclusion treated at the University of Hama School of Dentistry in Hama, Syria. A total of 46 participants (mean age: 22.3 ± 2.3 years) with maxillary dentoalveolar protrusion were randomly distributed into two groups with 23 patients each (1:1 allocation ratio). Either STb (Ormco) or 7th Generation (Ormco) lingual brackets were applied. Fricative sound/s/ spectrograms were analyzed directly before intervention (T0), one week following premolar extraction prior to bracket placement (T1), within 24 hours of bracket bonding (T2), one month after (T3), and three months after (T4) bracket placement. Patients′ acceptance was assessed by means of standardized questionnaires. Results: After bracket placement, significant deterioration in articulation was recorded at all assessment times in the 7th Generation group, and up to T3 in the STb group. Significant intergroup differences were detected at T2 and T3. No statistically significant differences were found between the two groups in reported tongue irritation levels, whereas chewing difficulty was significantly higher in the 7th Generation group one month after bracket placement. Conclusions: 7th Generation brackets have more interaction with sound production than STb ones. Although patients in both groups complained of some degree of oral impairment, STb appliances appeared to be more comfortable than the 7th Generation ones, particularly within the first month of treatment. PMID:27653268

  1. Feasibility and acceptability of electronic symptom surveillance with clinician feedback using the Patient-Reported Outcomes version of Common Terminology Criteria for Adverse Events (PRO-CTCAE) in Danish prostate cancer patients

    DEFF Research Database (Denmark)

    Bæksted, Christina; Pappot, Helle; Nissen, Aase

    2017-01-01

    -CTCAE questionnaire on tablet computers using AmbuFlex software at each treatment visit in the outpatient clinic. In total, 22 symptomatic toxicities (41 PRO-CTCAE items), corresponding to the symptomatic adverse-events profile associated with the regimens commonly used for prostate cancer treatment (Docetaxel......Background: The aim was to examine the feasibility, acceptability and clinical utility of electronic symptom surveillance with clinician feedback using a subset of items drawn from the Patient-Reported Outcomes version of Common Terminology Criteria for Adverse Events (PRO-CTCAE) in a cancer...

  2. Developing and assessing the acceptability of an epilepsy first aid training intervention for patients who visit UK emergency departments: A multi-method study of patients and professionals.

    Science.gov (United States)

    Snape, Darlene A; Morgan, Myfanwy; Ridsdale, Leone; Goodacre, Steve; Marson, Anthony G; Noble, Adam J

    2017-03-01

    Epilepsy affects around 1% of the UK population; 40% of whom experience two or more seizures annually. However, most Emergency Department (ED) visits by people with epilepsy (PWE) are clinically unnecessary. Evidence highlights that with correct training, seizures can be safely managed by patients and their families within the community. Arguably therefore, PWE who frequently visit the ED might benefit from a self-management intervention that improves their own and their families' confidence and ability in managing seizures. Currently, no such intervention is available for PWE attending the ED. A collaborative approach (patients, carers, health professionals) was adopted to develop a patient-focused, self-management intervention. An existing group-based seizure management course, offered by the Epilepsy Society, was adapted. Collaborative feedback was sought via a base-line document review, one-to-one semi-structured interviews, and focus group discussions. The applied framework provided a systematic approach from development through to implementation. Participant feedback overall was extremely positive. People with epilepsy who visit the ED reported a positive view of epilepsy seizure first aid training and associated educational materials. Their feedback was then used to develop the optimized intervention presented here. Strengths and perceived barriers to successful implementation and participation, as well as the practical and psychosocial benefits, were identified. We describe the developed intervention together with the process followed. This description, while being project-specific, provides a useful template to assist in the development of interventions more generally. Ongoing evaluation will determine the effects of the training intervention on participants' behavior. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Review of the safety, efficacy, costs and patient acceptability of recombinant follicle-stimulating hormone for injection in assisting ovulation induction in infertile women

    Directory of Open Access Journals (Sweden)

    Marleen Nahuis

    2009-11-01

    Full Text Available Marleen Nahuis1,2,3, Fulco van der Veen1, Jur Oosterhuis2, Ben Willem Mol1, Peter Hompes3, Madelon van Wely11Center for Reproductive Medicine, Department of Obstetrics and Gynaecology (H4-205, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; 2Department of Obstetrics and Gynaecology, Medisch Spectrum Twente, Enschede, The Netherlands; 3Department of Obstetrics and Gynaecology, Free Medical University, Amsterdam, The NetherlandsAbstract: Anovulation is a common cause of female subfertility. Treatment of anovulation is aimed at induction of ovulation. In women with clomiphene-citrate resistant WHO group II anovulation, one of the treatment options is ovulation induction with exogenous follicle-stimulating hormone (FSH or follitropin. FSH is derived from urine or is produced as recombinant FSH. Two forms of recombinant FSH are available – follitropin alpha and follitropin beta. To evaluate the efficacy, safety, costs and acceptability of recombinant FSH, we performed a review to compare recombinant FSH with urinary-derived FSH products. Follitropin alpha, beta and urinary FSH products appeared to be equally effective in terms of pregnancy rates. Patient safety was also found to be comparable, as the incidence of side effects including multiple pregnancies was similar for all FSH products. In practice follitropin alpha and beta may be more convenient to use due to the ease of self-administration, but they are also more expensive than the urinary products.Keywords: follitropin apha, follitropin beta, urinary gonadotropins, polycystic ovary syndrome

  4. Hydrology of Southeast Florida and Associated Topics.

    Science.gov (United States)

    Monsour, William, Comp.; Moyer, Maureen, Comp.

    This booklet deals with the hydrology of southeastern Florida. It is designed to provide the citizen, teacher, or student with hydrological information, to promote an understanding of water resources, and to initiate conservation practices within Florida communities. The collection of articles within the booklet deal with Florida water resources…

  5. Sick-listed persons' experiences with taking part in an in-patient occupational rehabilitation program based on Acceptance and Commitment Therapy: a qualitative focus group interview study.

    Science.gov (United States)

    Rise, Marit B; Gismervik, Sigmund Ø; Johnsen, Roar; Fimland, Marius S

    2015-11-27

    Occupational medicine has shifted emphasis from disease treatment to disability rehabilitation and management. Hence, newly developed occupational rehabilitation programs are often generic and multicomponent, aiming to influence the sick-listed persons' perception on return to work, and thereby support the return to work process. The aim of this study was to explore sick-listed persons' experiences with taking part in an in-patient occupational rehabilitation program based on Acceptance and Commitment Therapy. Twenty-nine adults on sickness benefit or work assessment allowance due to musculoskeletal and/or common mental health disorders participated in this study. They were interviewed in focus groups at the beginning and at the end of a 3.5 week inpatient group-based occupational rehabilitation program in Central Norway. Key elements in the program were Acceptance and Commitment Therapy (ACT), physical exercise and creating a work-participation plan. The program was mainly group-based including participants with different diagnoses. Data was analyzed according to a phenomenological approach. At the start of the program most participants expressed frustration regarding being sick-listed, external anticipations as well as hindrances towards returning to work, and described hope that the program would provide them with the skills and techniques necessary to cope with health problems and being able to return to work. At the end of the program the participants described that they had embarked upon a long process of increased awareness. This process encompassed four areas; an increased awareness of what was important in life, realizing the strain from external expectations and demands, a need to balance different aspects of life, and return to work as part of a long and complex process. The occupational rehabilitation program induced a perceived meaningful reorientation encompassing several aspects of life. However, the return to work process was described as diffuse

  6. Long-acting reversible contraceptive acceptability and unintended pregnancy among women presenting for short-acting methods: a randomized patient preference trial.

    Science.gov (United States)

    Hubacher, David; Spector, Hannah; Monteith, Charles; Chen, Pai-Lien; Hart, Catherine

    2017-02-01

    Measures of contraceptive effectiveness combine technology and user-related factors. Observational studies show higher effectiveness of long-acting reversible contraception compared with short-acting reversible contraception. Women who choose long-acting reversible contraception may differ in key ways from women who choose short-acting reversible contraception, and it may be these differences that are responsible for the high effectiveness of long-acting reversible contraception. Wider use of long-acting reversible contraception is recommended, but scientific evidence of acceptability and successful use is lacking in a population that typically opts for short-acting methods. The objective of the study was to reduce bias in measuring contraceptive effectiveness and better isolate the independent role that long-acting reversible contraception has in preventing unintended pregnancy relative to short-acting reversible contraception. We conducted a partially randomized patient preference trial and recruited women aged 18-29 years who were seeking a short-acting method (pills or injectable). Participants who agreed to randomization were assigned to 1 of 2 categories: long-acting reversible contraception or short-acting reversible contraception. Women who declined randomization but agreed to follow-up in the observational cohort chose their preferred method. Under randomization, participants chose a specific method in the category and received it for free, whereas participants in the preference cohort paid for the contraception in their usual fashion. Participants were followed up prospectively to measure primary outcomes of method continuation and unintended pregnancy at 12 months. Kaplan-Meier techniques were used to estimate method continuation probabilities. Intent-to-treat principles were applied after method initiation for comparing incidence of unintended pregnancy. We also measured acceptability in terms of level of happiness with the products. Of the 916

  7. Miami, Florida: The Magic City

    Science.gov (United States)

    McIntosh, Phyllis

    2008-01-01

    With its subtropical climate and intimate ties to Latin America, Miami is like no other city in the United States. More than 65 percent of its population is Hispanic, and Spanish is the most commonly heard language. Situated at the southern tip of the 500-mile-long Florida peninsula, Miami is the largest urban area in the southeastern United…

  8. Residential Energy Efficiency Potential: Florida

    Energy Technology Data Exchange (ETDEWEB)

    Wilson, Eric J [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

    2017-11-16

    Energy used by Florida single-family homes that can be saved through cost-effective improvements. Prepared by Eric Wilson and Noel Merket, NREL, and Erin Boyd, U.S. Department of Energy Office of Energy Policy and Systems Analysis.

  9. Responsible technology acceptance

    DEFF Research Database (Denmark)

    Toft, Madeleine Broman; Schuitema, Geertje; Thøgersen, John

    2014-01-01

    As a response to climate change and the desire to gain independence from imported fossil fuels, there is a pressure to increase the proportion of electricity from renewable sources which is one of the reasons why electricity grids are currently being turned into Smart Grids. In this paper, we focus...... on private consumers’ acceptance of having Smart Grid technology installed in their home. We analyse acceptance in a combined framework of the Technology Acceptance Model and the Norm Activation Model. We propose that individuals are only likely to accept Smart Grid technology if they assess usefulness...... in terms of a positive impact for society and the environment. Therefore, we expect that Smart Grid technology acceptance can be better explained when the well-known technology acceptance parameters included in the Technology Acceptance Model are supplemented by moral norms as suggested by the Norm...

  10. [3-dimensional computer animation--a new medium for supporting patient education before surgery. Acceptance and assessment of patients based on a prospective randomized study--picture versus text].

    Science.gov (United States)

    Hermann, M

    2002-05-01

    The rigorous implementation of clear preoperative information is mandatory for the patient's understanding, acceptance and written informed consent to all diagnostic and surgical procedures. In the present study, I evaluated whether new media are suitable for conveying basic information to patients; I analysed the merits of computerized animation to illustrate a difficult treatment process, i.e., the progressive steps of a thyroid operation, in comparison to the use of conventional flyers. 3D animation software was employed to illustrate the basic anatomy of the thyroid and the larnyx; the principle of thyroidectomy was explained by visualizing the surgical procedure step by step. Finally, the possible complications that may result from the intraoperative manipulations were also visually explained. Eighty patients entered a prospective randomisation: on the day before surgery, group 1 watched the computer animation, whereas group 2 was given the identical information in a written text (= standard flyer). The evaluation included a questionnaire with scores of 1-5, rating the patients' understanding, subjective and objective knowledge, emotional factors like anxiety and trust, and the willingness to undergo an operation. Understanding of and subjective knowledge about the surgical procedure and possible complications, the degree of trust in professional treatment, the reduction in anxiety and readiness for the operation were significantly better after watching the computer animation than after reading the text. However, active knowledge did not improve significantly. The interest in the preoperative information was high in both groups. The benefit of computer animation was enhanced in a second inquiry; patients who had only read the text had a significant improvement in parameters after an additional exposure to the video animation. Preoperative surgical information can be optimized by presenting the operative procedure via computer animation. Nowadays, several types

  11. Feasibility and acceptability to patients of a longitudinal system for evaluating cancer-related symptoms and quality of life: pilot study of an e/Tablet data-collection system in academic oncology.

    Science.gov (United States)

    Abernethy, Amy P; Herndon, James E; Wheeler, Jane L; Day, Jeannette M; Hood, Linda; Patwardhan, Meenal; Shaw, Heather; Lyerly, Herbert Kim

    2009-06-01

    Programmed, notebook-style, personal computers ("e/Tablets") can collect symptom and quality-of-life (QOL) data at the point of care. Patients use an e/Tablet in the clinic waiting area to complete electronic surveys. Information then travels wirelessly to a server, which generates a real-time report for use during the clinical visit. The objective of this study was to determine whether academic oncology patients find e/Tablets logistically acceptable and a satisfactory means of communicating symptoms to providers during repeated clinic visits. Sixty-six metastatic breast cancer patients at Duke Breast Cancer Clinic participated. E/Tablets were customized to electronically administer a satisfaction/acceptability survey, several validated questionnaires, and the Patient Care Monitor (PCM) review of symptoms survey. At each of the four visits within six months, participants completed the patient satisfaction/acceptability survey, which furnished data for the current analysis. Participant demographics were: mean age of 54 years, 77% Caucasian, and 47% with less than a college education. Participants reported that e/Tablets were easy to read (94%), easy to navigate (99%), and had a comfortable weight (90%); they found it easy to respond to questions using the e/Tablet (98%). Seventy-five percent initially indicated satisfaction with PCM for reporting symptoms; this proportion increased over time. By the last visit, 88% of participants indicated that they would recommend the PCM to other patients; 74% felt that the e/Tablet helped them remember symptoms to report to their clinician. E/Tablets offered a feasible and acceptable method for collecting longitudinal patient-reported symptom and QOL data within an academic, tertiary care, breast cancer clinic.

  12. Management of pest mole crickets in Florida and Puerto Rico with a nematode and parasitic wasp

    International Nuclear Information System (INIS)

    Leppla, N.C.; Frank, J.H.; Adjei, M.B.; Vicente, N.E.

    2007-01-01

    Non-indigenous invasive mole crickets, Scapteriscus vicinus Scudder (Orthoptera: Gryllotalpidae) in Florida and S. didactylus (Latreille) (the 'changa') in Puerto Rico, are being managed with an entomopathogenic nematode, Steinernema scapterisci (Nguyen and Smart) (Rhabditida: Steinernematidae), and a parasitic wasp, Larra bicolor L. (Hymenoptera: Sphecidae). Pest mole cricket populations have declined by 95% in north central Florida since these specialist natural enemies were released and established in the 1980s. Commercial production of the nematode was initiated, nearly 70 billion were applied in 34 Florida counties, and their establishment, spread, and impact on mole crickets were monitored. The infected mole crickets dispersed the nematode rapidly, so that within 6 months these parasites were present in most of the insects trapped in experimental pastures. Three years later, mole cricket populations were reduced to acceptable levels and the bahiagrass had recovered. The nematode was released for the first time in Puerto Rico during 2001 and has persisted; the wasp was introduced in the late 1930s. The geographical distribution of the wasp is being expanded in Florida and Puerto Rico by planting plots of Spermacoce verticillata (L.), a wildflower indigenous to Puerto Rico and widely distributed in southern Florida. Pastures, sod farms, golf courses, landscapes, and vegetable farms in Florida and Puerto Rico are benefiting from biological control of invasive mole crickets. (author) [es

  13. Treatment adherence with the easypod™ growth hormone electronic auto-injector and patient acceptance: survey results from 824 children and their parents

    Directory of Open Access Journals (Sweden)

    Larroque Sylvain

    2011-02-01

    Full Text Available Abstract Background Accurately monitoring adherence to treatment with recombinant human growth hormone (r-hGH enables appropriate intervention in cases of poor adherence. The electronic r-hGH auto-injector, easypod™, automatically records the patient's adherence to treatment. This study evaluated adherence to treatment of children who started using the auto-injector and assessed opinions about the device. Methods A multicentre, multinational, observational 3-month survey in which children received r-hGH as part of their normal care. Physicians reviewed the recorded dose history and children (with or without parental assistance completed a questionnaire-based survey. Children missing ≤2 injections per month (92% of injections given were considered adherent to treatment. Adherence was compared between GH treatment-naïve and treatment-experienced children. Results Of 834 recruited participants, 824 were evaluated. The median (range age was 11 (1-18 years. From the recorded dose history, 87.5% of children were adherent to treatment over the 3-month period. Recorded adherence was higher in treatment-naïve (89.7%, n = 445/496 than in treatment-experienced children (81.7%, n = 152/186 [Fisher's exact test FI(X = 7.577; p = 0.0062]. According to self-reported data, 90.2% (607/673 of children were adherent over 3 months; 51.5% (421/817 missed ≥1 injection over this period (mainly due to forgetfulness. Concordance between reported and recorded adherence was 84.3%, with a trend towards self-reported adherence being higher than recorded adherence. Most children liked the auto-injector: over 80% gave the top two responses from five options for ease of use (720/779, speed (684/805 and comfort (716/804. Although 38.5% (300/780 of children reported pain on injection, over half of children (210/363 considered the pain to be less or much less than expected. Given the choice, 91.8% (732/797 of children/parents would continue using the device. Conclusions

  14. Barriers to Medicaid Participation among Florida Dentists

    Science.gov (United States)

    Logan, Henrietta L.; Catalanotto, Frank; Guo, Yi; Marks, John; Dharamsi, Shafik

    2015-01-01

    Background Finding dentists who treat Medicaid-enrolled children is a struggle for many parents. The purpose of this study was to identify non-reimbursement factors that influence the decision by dentists about whether or not to participate in the Medicaid program in Florida. Methods Data from a mailed survey was analyzed using a logistic regression model to test the association of Medicaid participation with the Perceived Barriers and Social Responsibility variables. Results General and pediatric dentists (n=882) who identified themselves as either Medicaid (14%) or Non-Medicaid (86%) participants responded. Five items emerged as significant predictors of Medicaid participation, with a final concordance index of 0.905. Two previously unreported barriers to participation in Medicaid emerged: 1) dentists’ perception of social stigma from other dentists for participating in Medicaid, and 2) the lack of specialists to whom Medicaid patients can be referred. Conclusions This study provides new information about non-reimbursement barriers to Medicaid participation. PMID:25702734

  15. Evaluating Emergency Department Asthma Management Practices in Florida Hospitals.

    Science.gov (United States)

    Nowakowski, Alexandra C H; Carretta, Henry J; Dudley, Julie K; Forrest, Jamie R; Folsom, Abbey N

    2016-01-01

    To assess gaps in emergency department (ED) asthma management at Florida hospitals. Survey instrument with open- and closed-ended questions. Topics included availability of specific asthma management modalities, compliance with national guidelines, employment of specialized asthma care personnel, and efforts toward performance improvement. Emergency departments at 10 large hospitals in the state of Florida. Clinical care providers and health administrators from participating hospitals. Compliance with national asthma care guideline standards, provision of specific recommended treatment modalities and resources, employment of specialized asthma care personnel, and engagement in performance improvement efforts. Our results suggest inconsistency among sampled Florida hospitals' adherence to national standards for treatment of asthma in EDs. Several hospitals were refining their emergency care protocols to incorporate guideline recommendations. Despite a lack of formal ED protocols in some hospitals, adherence to national guidelines for emergency care nonetheless remained robust for patient education and medication prescribing, but it was weaker for formal care planning and medical follow-up. Identified deficiencies in emergency asthma care present a number of opportunities for strategic mitigation of identified gaps. We conclude with suggestions to help Florida hospitals achieve success with ED asthma care reform. Team-based learning activities may offer an optimal strategy for sharing and implementing best practices.

  16. Florida's salt-marsh management issues: 1991-98.

    Science.gov (United States)

    Carlson, D B; O'Bryan, P D; Rey, J R

    1999-06-01

    During the 1990s, Florida has continued to make important strides in managing salt marshes for both mosquito control and natural resource enhancement. The political mechanism for this progress continues to be interagency cooperation through the Florida Coordinating Council on Mosquito Control and its Subcommittee on Managed Marshes (SOMM). Continuing management experience and research has helped refine the most environmentally acceptable source reduction methods, which typically are Rotational Impoundment Management or Open Marsh Water Management. The development of regional marsh management plans for salt marshes within the Indian River Lagoon by the SOMM has helped direct the implementation of the best management practices for these marshes. Controversy occasionally occurs concerning what management technique is most appropriate for individual marshes. The most common disagreement is over the benefits of maintaining an impoundment in an "open" vs. "closed" condition, with the "closed" condition, allowing for summer mosquito control flooding or winter waterfowl management. New federal initiatives influencing salt-marsh management have included the Indian River Lagoon-National Estuary Program and the Pesticide Environmental Stewardship Program. A new Florida initiative is the Florida Department of Environmental Protection's Eco-system Management Program with continuing involvement by the Surface Water Improvement and Management program. A developing mitigation banking program has the potential to benefit marsh management but mosquito control interests may suffer if not handled properly. Larvicides remain as an important salt-marsh integrated pest management tool with the greatest acreage being treated with temephos, followed by Bacillus thuringiensis israelensis and methoprene. However, over the past 14 years, use of biorational larvicides has increased greatly.

  17. 78 FR 43881 - Florida Petroleum Reprocessors Site, Davie, Broward County, Florida; Notice of Settlement

    Science.gov (United States)

    2013-07-22

    ... ENVIRONMENTAL PROTECTION AGENCY [FRL9836-2; CERCLA-04-2013-3758] Florida Petroleum Reprocessors... entered into a settlement with Jap. Tech, Inc. concerning the Florida Petroleum Reprocessors Site located.... Painter. Submit your comments by Site name Florida Petroleum Reprocesssors Site by one of the following...

  18. Benthic Habitats of Estero Bay Area, Florida 1999 Geodatabase

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Data produced for the Florida Fish and Wildlife Conservation Commission's Florida Marine Research Institute (FMRI) in partnership with the South Florida Water...

  19. Benthic Habitats of Estero Bay Area, Florida 1999 Biotic

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Data produced for the Florida Fish and Wildlife Conservation Commission's Florida Marine Research Institute (FMRI) in partnership with the South Florida Water...

  20. Benthic Habitats of Estero Bay Area, Florida 1999 Geoform

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Data produced for the Florida Fish and Wildlife Conservation Commission's Florida Marine Research Institute (FMRI) in partnership with the South Florida Water...

  1. Acceptance procedures: Microfilm printer

    Science.gov (United States)

    Lockwood, H. E.

    1973-01-01

    Acceptance tests were made for a special order automatic additive color microfilm printer. Tests include film capacity, film transport, resolution, illumination uniformity, exposure range checks, and color cuing considerations.

  2. On risks and acceptability

    International Nuclear Information System (INIS)

    Watson, S.R.

    1981-01-01

    A very attractive notion is that it should be possible not only to determine how much risk is associated with any particular activity, but also to determine if that risk is acceptable. Stated boldly this seems an entirely unobjectionable and indeed a very acceptable notion. There is, however, underlying this idea, a mistaken view of risk which we might refer to as the ''phlogiston'' theory of risk. In this paper, presented at the SRP meeting on Ethical and Legal Aspects of Radiological Protection, the phlogiston theory of risk is described; secondly, it will be argued that it is too simple a theory to be realistic or useful; and thirdly, the management of risk will be placed in a wider decision framework. Acceptability, it will be argued is highly dependent on context, and it is not possible, therefore, to lay down generally applicable notions of acceptability. (author)

  3. Acceptable noise level

    DEFF Research Database (Denmark)

    Olsen, Steen Østergaard; Nielsen, Lars Holme; Lantz, Johannes

    2012-01-01

    The acceptable noise level (ANL) is used to quantify the amount of background noise that subjects can accept while listening to speech, and is suggested for prediction of individual hearing-aid use. The aim of this study was to assess the repeatability of the ANL measured in normal-hearing subjects...... using running Danish and non-semantic speech materials as stimuli and modulated speech-spectrum and multi-talker babble noises as competing stimuli....

  4. Operations Acceptance Management

    OpenAIRE

    Suchá, Ivana

    2010-01-01

    This paper examines the process of Operations Acceptance Management, whose main task is to control Operations Acceptance Tests (OAT). In the first part the author focuses on the theoretical ground for the problem in the context of ITSM best practices framework ITIL. Benefits, process pitfalls and possibilities for automation are discussed in this part. The second part contains a case study of DHL IT Services (Prague), where a solution optimizing the overall workflow was implemented using simp...

  5. Acceptable noise level

    DEFF Research Database (Denmark)

    Olsen, Steen Østergaard; Nielsen, Lars Holme; Lantz, Johannes

    2012-01-01

    The acceptable noise level (ANL) is used to quantify the amount of background noise that subjects can accept while listening to speech, and is suggested for prediction of individual hearing-aid use. The aim of this study was to assess the repeatability of the ANL measured in normal-hearing subjec...... using running Danish and non-semantic speech materials as stimuli and modulated speech-spectrum and multi-talker babble noises as competing stimuli....

  6. Is it acceptable to video-record palliative care consultations for research and training purposes? A qualitative interview study exploring the views of hospice patients, carers and clinical staff.

    Science.gov (United States)

    Pino, Marco; Parry, Ruth; Feathers, Luke; Faull, Christina

    2017-09-01

    Research using video recordings can advance understanding of healthcare communication and improve care, but making and using video recordings carries risks. To explore views of hospice patients, carers and clinical staff about whether videoing patient-doctor consultations is acceptable for research and training purposes. We used semi-structured group and individual interviews to gather hospice patients, carers and clinical staff views. We used Braun and Clark's thematic analysis. Interviews were conducted at one English hospice to inform the development of a larger video-based study. We invited patients with capacity to consent and whom the care team judged were neither acutely unwell nor severely distressed (11), carers of current or past patients (5), palliative medicine doctors (7), senior nurses (4) and communication skills educators (5). Participants viewed video-based research on communication as valuable because of its potential to improve communication, care and staff training. Video-based research raised concerns including its potential to affect the nature and content of the consultation and threats to confidentiality; however, these were not seen as sufficient grounds for rejecting video-based research. Video-based research was seen as acceptable and useful providing that measures are taken to reduce possible risks across the recruitment, recording and dissemination phases of the research process. Video-based research is an acceptable and worthwhile way of investigating communication in palliative medicine. Situated judgements should be made about when it is appropriate to involve individual patients and carers in video-based research on the basis of their level of vulnerability and ability to freely consent.

  7. Development of a Weight Loss Mobile App Linked With an Accelerometer for Use in the Clinic: Usability, Acceptability, and Early Testing of its Impact on the Patient-Doctor Relationship.

    Science.gov (United States)

    Choo, Seryung; Kim, Ju Young; Jung, Se Young; Kim, Sarah; Kim, Jeong Eun; Han, Jong Soo; Kim, Sohye; Kim, Jeong Hyun; Kim, Jeehye; Kim, Yongseok; Kim, Dongouk; Steinhubl, Steve

    2016-03-31

    Although complications of obesity are well acknowledged and managed by clinicians, management of obesity itself is often difficult, which leads to its underdiagnosis and undertreatment in hospital settings. However, tools that could improve the management of obesity, including self-monitoring, engagement with a social network, and open channels of communication between the patient and doctor, are limited in a clinic-based setting. The objective of our study was to evaluate the usability and acceptability of a newly developed mobile app linked with an accelerometer and its early effects on patient-doctor relationships. From September 2013 to February 2014, we developed a mobile app linked with an accelerometer as a supportive tool for a clinic-based weight loss program. The app used information from electronic health records and delivered tailored educational material. Personal goal setting, as well as monitoring of weight changes and physical activity combined with feedback, are key features of the app. We also incorporated an interactive message board for patients and doctors. During the period of March 2014 to May 2014, we tested our mobile app for 1 month in participants in a hospital clinic setting. We assessed the app's usability and acceptability, as well as the patient-doctor relationship, via questionnaires and analysis of app usage data. We recruited 30 individuals (18 male and 12 female) for the study. The median number of log-ins per day was 1.21, with the most frequently requested item being setting goals, followed by track physical activities and view personal health status. Scales of the depth of the patient-doctor relationship decreased from 27.6 (SD 4.8) to 25.1 (SD 4.5) by a Wilcoxon signed rank test (P=.02). A mobile phone app linked with an accelerometer for a clinic-based weight loss program is useful and acceptable for weight management but exhibited less favorable early effects on patient-doctor relationships.

  8. Saltwater intrusion monitoring in Florida

    Science.gov (United States)

    Prinos, Scott T.

    2016-01-01

    Florida's communities are largely dependent on freshwater from groundwater aquifers. Existing saltwater in the aquifers, or seawater that intrudes parts of the aquifers that were fresh, can make the water unusable without additional processing. The quality of Florida's saltwater intrusion monitoring networks varies. In Miami-Dade and Broward Counties, for example, there is a well-designed network with recently constructed short open-interval monitoring wells that bracket the saltwater interface in the Biscayne aquifer. Geochemical analyses of water samples from the network help scientists evaluate pathways of saltwater intrusion and movement of the saltwater interface. Geophysical measurements, collected in these counties, aid the mapping of the saltwater interface and the design of monitoring networks. In comparison, deficiencies in the Collier County monitoring network include the positioning of monitoring wells, reliance on wells with long open intervals that when sampled might provide questionable results, and the inability of existing analyses to differentiate between multiple pathways of saltwater intrusion. A state-wide saltwater intrusion monitoring network is being planned; the planned network could improve saltwater intrusion monitoring by adopting the applicable strategies of the networks of Miami-Dade and Broward Counties, and by addressing deficiencies such as those described for the Collier County network.

  9. Sexual Harassment Policies in Florida School Districts.

    Science.gov (United States)

    Rienzo, Barbara A.; Moore, Michele Johnson

    1998-01-01

    Investigated the extent to which Florida's school districts complied with the Florida Department of Education's (FDOE) recommendations for addressing sexual harassment in schools. Surveys of district equity coordinators and analysis of policies indicated that most districts approved sexual harassment policies incorporating many FDOE…

  10. A Clinical Experience of Dental Treatment under Ambulatory General Anesthesia for A Disabled Patient Who Accepts Only One Favorite Dental Chair

    OpenAIRE

    佐藤, 潤; 川合, 宏仁; 山崎, 信也; 相澤, 徳久; 島村, 和宏; 鈴木, 康生; サトウ, ジュン; カワイ, ヒロヨシ; ヤマザキ, シンヤ; アイザワ, ノリヒサ; シマムラ, カズヒロ; スズキ, ヤスオ; Jun, SATO; Hiroyoshi, KAWAAI; Shinya, YAMAZAKI

    2007-01-01

    In our hospital, we have many cases of ambulatory general anesthesia in the dental treatment of disabled patients. However, if the disability patients have strong refusal to enter the general anesthesia room due to strong phobia, we can not apply the general anesthesia induction. We experienced a dental treatment under ambulatory general anesthesia of a disabled patient who could not sit on any dental chair except for his favorite one. The patient was a 16-year-old boy. He was diagnosed Down ...

  11. A Web-based, educational, quality-of-life intervention for patients with a chronic skin disease: feasibility and acceptance in routine dermatological practice

    NARCIS (Netherlands)

    van Cranenburgh, Oda D.; Smets, Ellen M. A.; de Rie, Menno A.; Sprangers, Mirjam A. G.; de Korte, John

    2015-01-01

    Chronic skin diseases have a negative impact on patients' health-related quality of life (HRQoL). Patient education might contribute to HRQoL improvement. We developed a web-based, educational, HRQoL intervention for patients with a chronic skin disease. We aimed to assess 1) the feasibility of

  12. Improvements in Patient Acceptance by Hospitals Following the Introduction of a Smartphone App for the Emergency Medical Service System: A Population-Based Before-and-After Observational Study in Osaka City, Japan.

    Science.gov (United States)

    Katayama, Yusuke; Kitamura, Tetsuhisa; Kiyohara, Kosuke; Iwami, Taku; Kawamura, Takashi; Izawa, Junichi; Gibo, Koichiro; Komukai, Sho; Hayashida, Sumito; Kiguchi, Takeyuki; Ohnishi, Mitsuo; Ogura, Hiroshi; Shimazu, Takeshi

    2017-09-11

    Recently, the number of ambulance dispatches has been increasing in Japan, and it is therefore difficult for hospitals to accept emergency patients smoothly and appropriately because of the limited hospital capacity. To facilitate the process of requesting patient transport and hospital acceptance, an emergency information system using information technology (IT) has been built and introduced in various communities. However, its effectiveness has not been thoroughly revealed. We introduced a smartphone app system in 2013 that enables emergency medical service (EMS) personnel to share information among themselves regarding on-scene ambulances and the hospital situation. The aim of this study was to assess the effects of introducing this smartphone app on the EMS system in Osaka City, Japan. This retrospective study analyzed the population-based ambulance records of Osaka Municipal Fire Department. The study period was 6 years, from January 1, 2010 to December 31, 2015. We enrolled emergency patients for whom on-scene EMS personnel conducted hospital selection. The main endpoint was the difficulty experienced in gaining hospital acceptance at the scene. The definition of difficulty was making ≥5 phone calls by EMS personnel at the scene to hospitals until a decision to transport was determined. The smartphone app was introduced in January 2013, and we compared the patients treated from 2010 to 2012 (control group) with those treated from 2013 to 2015 (smartphone app group) using an interrupted time-series analysis to assess the effects of introducing this smartphone app. A total of 600,526 emergency patients for whom EMS personnel selected hospitals were eligible for our analysis. There were 300,131 emergency patients in the control group (50.00%, 300,313/600,526) from 2010 to 2012 and 300,395 emergency patients in the smartphone app group (50.00%, 300,395/600,526) from 2013 to 2015. The rate of difficulty in hospital acceptance was 14.19% (42,585/300,131) in the

  13. A 12-week pilot study of acceptance of a computer-based chronic disease self-monitoring system among patients with type 2 diabetes mellitus and/or hypertension.

    Science.gov (United States)

    Yan, Mian; Or, Calvin

    2017-08-01

    This study tested a structural model examining the effects of perceived usefulness, perceived ease of use, attitude, subjective norm, perceived behavioral control, health consciousness, and application-specific self-efficacy on the acceptance (i.e. behavioral intention and actual usage) of a computer-based chronic disease self-monitoring system among patients with type 2 diabetes mellitus and/or hypertension. The model was tested using partial least squares structural equation modeling, with 119 observations that were obtained by pooling data across three time points over a 12-week period. The results indicate that all of the seven constructs examined had a significant total effect on behavioral intention and explained 74 percent of the variance. Also, application-specific self-efficacy and behavioral intention had a significant total effect on actual usage and explained 17 percent of the variance. This study demonstrates that technology acceptance is determined by patient characteristics, technology attributes, and social influences. Applying the findings may increase the likelihood of acceptance.

  14. Impact of a "TED-Style" presentation on potential patients' willingness to accept dental implant therapy: a one-group, pre-test post-test study.

    Science.gov (United States)

    Ghanem, Henry; Afrashtehfar, Kelvin Ian; Abi-Nader, Samer; Tamimi, Faleh

    2015-12-01

    A survey was conducted to assess the impact of a TED-like educational session on participants' willingness to accept dental implant therapy. Volunteers interested in having information about dental implant therapies were recruited and asked to complete a two-part survey before and after an educational session. The initial survey elicited demographic information, self-perceived knowledge on dental implants and willingness to this kind of treatment. A "TED-style" presentation that provided information about dental implant treatments was conducted before asking the participants to complete a second set of questions assessing the impact of the session. The survey was completed by 104 individuals, 78.8% were women and the mean age was 66.5±10.8. Before the educational session, 76.0% of the participants refused dental implants mainly due to lack of knowledge. After the educational session, the rejection of dental implants decreased by almost four folds to 20.2%. This study proved that an educational intervention can significantly increase willingness to accept treatment with dental implants in a segment of the population who is interested in having information about dental implant therapy. Furthermore, educational interventions, such as TED-like talks, might be useful to increase popular awareness on dental implant therapy.

  15. Impact of a "TED-Style" presentation on potential patients' willingness to accept dental implant therapy: a one-group, pre-test post-test study

    Science.gov (United States)

    Ghanem, Henry; Abi-Nader, Samer

    2015-01-01

    PURPOSE A survey was conducted to assess the impact of a TED-like educational session on participants' willingness to accept dental implant therapy. MATERIALS AND METHODS Volunteers interested in having information about dental implant therapies were recruited and asked to complete a two-part survey before and after an educational session. The initial survey elicited demographic information, self-perceived knowledge on dental implants and willingness to this kind of treatment. A "TED-style" presentation that provided information about dental implant treatments was conducted before asking the participants to complete a second set of questions assessing the impact of the session. RESULTS The survey was completed by 104 individuals, 78.8% were women and the mean age was 66.5±10.8. Before the educational session, 76.0% of the participants refused dental implants mainly due to lack of knowledge. After the educational session, the rejection of dental implants decreased by almost four folds to 20.2%. CONCLUSION This study proved that an educational intervention can significantly increase willingness to accept treatment with dental implants in a segment of the population who is interested in having information about dental implant therapy. Furthermore, educational interventions, such as TED-like talks, might be useful to increase popular awareness on dental implant therapy. PMID:26816573

  16. 1991 Acceptance priority ranking

    International Nuclear Information System (INIS)

    1991-12-01

    The Standard Contract for Disposal of Spent Nuclear Fuel and/or High- Level Radioactive Waste (10 CFR Part 961) that the Department of Energy (DOE) has executed with the owners and generators of civilian spent nuclear fuel requires annual publication of the Acceptance Priority Ranking (APR). The 1991 APR details the order in which DOE will allocate Federal waste acceptance capacity. As required by the Standard Contract, the ranking is based on the age of permanently discharged spent nuclear fuel (SNF), with the owners of the oldest SNF, on an industry-wide basis, given the highest priority. the 1991 APR will be the basis for the annual allocation of waste acceptance capacity to the Purchasers in the 1991 Annual Capacity Report (ACR), to be issued later this year. This document is based on SNF discharges as of December 31, 1990, and reflects Purchaser comments and corrections, as appropriate, to the draft APR issued on May 15, 1991

  17. Does the use of Nintendo Wii Sports™ improve arm function and is it acceptable to patients after stroke? Publication of the Protocol of the Trial of Wii™ in Stroke - TWIST.

    Science.gov (United States)

    Adie, Katja; Schofield, Christine; Berrow, Margie; Wingham, Jennifer; Freeman, Janet; Humfryes, John; Pritchard, Colin

    2014-01-01

    Many stroke patients experience loss of arm function requiring rehabilitation, which is expensive, repetitive, and does not always translate into "real life." Nintendo Wii Sports™ (Wii™) may offer task-specific training that is repetitive and motivating. The Trial of Wii™ in Stroke (TWIST) is designed to investigate feasibility, efficacy, and acceptability using Wii™ to improve affected arm function for patients after stroke. This is a randomized controlled trial (RCT), incorporating a qualitative study and health economics analysis that compares playing Wii™ versus arm exercises in patients receiving standard rehabilitation in a home setting within 6 months of stroke with a motor deficit of less than 5 on the MRC (Medical Research Council) scale (arm). In this study, we expect to randomize 240 participants. Primary outcome is change in affected arm function at 6 weeks follow-up in intervention and control group using the Action Research Arm Test. Secondary outcomes include occupational performance using the Canadian Occupational Performance Measure, quality of life using the Stroke Impact Scale, cost effectiveness analysis, and a qualitative study investigating factors that influence use of Wii™ for patients and carers. TWIST is the first UK RCT assessing the feasibility, cost effectiveness, and acceptability of Wii™ in stroke rehabilitation. The trial has been registered with ISRCTN 06807619 and UK CRN 11030. Results of the study will be published after completion of study in August 2014.

  18. Enforced dismissal of Dutch patients who are not motivated to leave forensic psychiatric settings and treatment--is it ethically acceptable?

    Science.gov (United States)

    Martens, W H J

    2009-09-01

    The ethical issues surrounding enforced release of forensic psychiatric patients are discussed in this article. Some patients disagree with their discharge because they are convinced that they need the continued structure of the hospital setting and the social relationships with fellow patients and therapists. They fear that without this structure they will unable to cope with the challenges of life in society and the consequence could be relapse and recidivism. Suggestions for guidelines on a practical approach to this category of forensic patients are presented.

  19. Ethical acceptability of offering financial incentives for taking antipsychotic depot medication: Patients' and clinicians' perspectives after a 12-month randomized controlled trial

    NARCIS (Netherlands)

    E.L. Noordraven (Ernst); M.H.N. Schermer (Maartje); P. Blanken (Peter); C.L. Mulder (Niels); A.I. Wierdsma (André)

    2017-01-01

    textabstractBackground: A randomized controlled trial 'Money for Medication'(M4M) was conducted in which patients were offered financial incentives for taking antipsychotic depot medication. This study assessed the attitudes and ethical considerations of patients and clinicians who participated in

  20. A web-based self-help intervention for partners of cancer patients based on Acceptance and Commitment Therapy : a protocol of a randomized controlled trial

    NARCIS (Netherlands)

    Kohle, Nadine; Drossaert, Constance H. C.; Schreurs, Karlein M. G.; Hagedoorn, Mariet; Verdonck-de Leeuw, Irma M.; Bohlmeijer, Ernst T.

    2015-01-01

    Background: There is a growing recognition that cancer not only affects the lives of the patients, but also the lives of their partners. Partners of cancer patients are highly involved in the illness trajectory by providing informal care and they often experience distress. However, supporting

  1. Displacement compressors - acceptance tests

    CERN Document Server

    International Organization for Standardization. Geneva

    1996-01-01

    ISO 1217:2009 specifies methods for acceptance tests regarding volume rate of flow and power requirements of displacement compressors. It also specifies methods for testing liquid-ring type compressors and the operating and testing conditions which apply when a full performance test is specified.

  2. From motivation to acceptability

    DEFF Research Database (Denmark)

    Nordfalk, Francisca; Olejaz, Maria; Jensen, Anja M. B.

    2016-01-01

    Background: Over the past three decades, public attitudes to organ donation have been a subject of numerous studies focusing on donor motivation. Here, we present a fresh approach. We suggest focusing on public acceptability instead of motivation. The point is to understand public attitudes well...

  3. Approaches to acceptable risk

    International Nuclear Information System (INIS)

    Whipple, C.

    1997-01-01

    Several alternative approaches to address the question open-quotes How safe is safe enough?close quotes are reviewed and an attempt is made to apply the reasoning behind these approaches to the issue of acceptability of radiation exposures received in space. The approaches to the issue of the acceptability of technological risk described here are primarily analytical, and are drawn from examples in the management of environmental health risks. These include risk-based approaches, in which specific quantitative risk targets determine the acceptability of an activity, and cost-benefit and decision analysis, which generally focus on the estimation and evaluation of risks, benefits and costs, in a framework that balances these factors against each other. These analytical methods tend by their quantitative nature to emphasize the magnitude of risks, costs and alternatives, and to downplay other factors, especially those that are not easily expressed in quantitative terms, that affect acceptance or rejection of risk. Such other factors include the issues of risk perceptions and how and by whom risk decisions are made

  4. Does Accreditation Matter? School Readiness Rates for Accredited versus Nonaccredited Child Care Facilities in Florida's Voluntary Pre-Kindergarten Program

    Science.gov (United States)

    Winterbottom, Christian; Piasta, Shayne B.

    2015-01-01

    Accreditation is a widely accepted indicator of quality in early education and includes many of the components cited in broad conceptualizations of quality. The purpose of this study was to examine whether kindergarten readiness rates differed between Florida child care facilities that were and were not accredited by any relevant national…

  5. NASA Hydrogen Research at Florida Universities

    International Nuclear Information System (INIS)

    David L Block; Ali T-Raissi

    2006-01-01

    This paper presents a summary of the activities and results from 36 hydrogen research projects being conducted over a four-year period by Florida universities for the U. S. National Aeronautics and Space Administration (NASA). The program entitled 'NASA Hydrogen Research at Florida Universities' is managed by the Florida Solar Energy Center (FSEC). FSEC has 22 years of experience in conducting research in areas related to hydrogen technologies and fuel cells. The R and D activities under this program cover technology areas related to production, cryogenics, sensors, storage, separation processes, fuel cells, resource assessments and education. (authors)

  6. A Double-Blind, Randomised Study Comparing the Skin Hydration and Acceptability of Two Emollient Products in Atopic Eczema Patients with Dry Skin

    OpenAIRE

    Djokic-Gallagher, Jasmina; Rosher, Phil; Oliveira, Gabriela; Walker, Jennine

    2017-01-01

    Introduction Healthcare professionals tend to recommend emollients based primarily on patient/consumer preference and cost, with cheaper options assumed to be therapeutically equivalent. The aim of this study was therefore to compare the effects on skin hydration of two emollients prescribed in the UK, Doublebase Dayleve? gel (DELP) and a cheaper alternative, Zerobase Emollient? cream (ZBC). Methods This was a single-centre, randomised, double-blind, concurrent bi-lateral (within-patient) com...

  7. Relationship between the disability acceptance and personality trait in patients with traumatic brain injury%人格特质与脑外伤偏瘫患者残障接受度的相关性研究

    Institute of Scientific and Technical Information of China (English)

    王丽静; 颜敏素

    2015-01-01

    目的::了解脑外伤患者的人格特质和残障接受度现状,并探讨两者的相关性,为改善脑外伤患者残障接受度提供参考。方法:采用艾森克人格问卷简式量表(中国版)和残障接受度量表对209例脑外伤患者进行问卷调查,比较不同残障接受度患者人格特质的差别,并采用 Pearson 相关分析法探讨两者的相关性。结果:脑外伤患者残障接受度总分为(160.11±34.58)分,其中低接受度占29.19%,中接受度占54.07%,高接受度占16.74%。本研究209例脑外伤患者精神质、神经质、掩饰性评分显著高于中国常模(均 P <0.01),内外向评分显著低于中国常模(均 P <0.01)。不同接受度组的精神质、内外向、神经质和掩饰性评分比较,差异均有统计学意义(均 P <0.05)。脑外伤患者残障接受度总分及各维度得分与人格特质中的精神质、神经质和掩饰性均显著负相关(均 P <0.05);残障接受度总分及各维度得分与人格特质中的内外向显著正相关(均 P <0.05)。结论:脑外伤患者残障接受度处于中等偏下水平,人格特质与其残障接受度密切相关,可从人格特质入手改善脑外伤患者的残障接受度。%Objective:To investigate the disability acceptance and personality trait in patients with traumatic brain injury,and analyze the relationship between them,so as to provide a new perspective to improve the disability ac-ceptance.Methods:209 patients with traumatic brain injury were surveyed by the Acceptance of Disability Scale and the Eysenck Personality Questionnaire-revised-Short Scale for Chinese (EPQ-RSC).The levels of personality trait were compared among the groups with different levels of the disability acceptance,and the Pearson correlation anal-ysis was used to explore the relationship between the personality trait and the disability acceptance in patients with traumatic brain injury.Results:The total score of

  8. Allocation of healthcare dollars: analysis of nonneonatal circumcisions in Florida.

    Science.gov (United States)

    Gutwein, Luke G; Alvarez, Juan F; Gutwein, Jenny L; Kays, David W; Islam, Saleem

    2013-09-01

    Circumcision remains a controversial operation. Most procedures are performed in the neonatal period and avoid general anesthesia. Legislation driven by policy statements from the American Academy of Pediatrics led to significant changes in circumcisions in Florida with a shift to nonneonatal procedures as a result of costs. We sought to study the prevalence and financial implications of nonneonatal circumcisions in Florida. A retrospective population study was performed using the Florida Agency for Health Care Administration outpatient procedure database. We queried for patients 0 to 17 years of age undergoing circumcision between 2003 and 2008. Demographics, charges, and insurance status were analyzed. From 2003 to 2008, 31,741 outpatient circumcisions were performed. Publicly funded circumcisions accounted for 17,537 charging the state $6,263 on average for each circumcision at an expense of $111.8 million for the 5-year time period analyzed. Publicly funded circumcision procedures increased more than sixfold (P < 0.0001) than those covered by private insurance. Black circumcision procedures increased 77.3 per cent, whereas white circumcisions increased 28.7 per cent. There has been a significant increase in the number of nonneonatal circumcisions performed. This has resulted in an increase in economic health care. Public funding of neonatal circumcision could result in significant cost savings and avoid potential complications of general anesthesia.

  9. Flexible public transportation services in Florida.

    Science.gov (United States)

    2013-08-01

    This synthesis research provides an overview of the current use of flexible transportation services in Florida through administration of a survey and subsequent identification and examination of case study locations. The research included a literatur...

  10. Southwest Florida Shelf Ecosystems Analysis Study

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Southwest Florida Shelf Ecosystems Analysis Study produced grain size analyses in the historic 073 format for 299 sea floor samples collected from October 25,...

  11. 2006 Volusia County Florida LiDAR

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This dataset is the lidar data for Volusia County, Florida, approximately 1,432 square miles, acquired in early March of 2006. A total of 143 flight lines of Lidar...

  12. Biscayne Bay Florida Bottlenose Dolphin Studies

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — These data sets include a compilation of small vessel based studies of bottlenose dolphins that reside within Biscayne Bay, Florida, adjacent estuaries and nearshore...

  13. Florida Reef Fish Visual Census 1999 - Present

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data set of Excel files contain data from visual sampling of coral reef fish species in the National Marine Sanctuary along the Florida Keys. The dataset...

  14. Waste acceptance and logistics

    International Nuclear Information System (INIS)

    Carlson, James H.

    1992-01-01

    There are three major components which are normally highlighted when the Civilian Radioactive Waste Management Program is discussed - the repository, the monitored retrievable storage facility, and the transportation system. These are clearly the major physical system elements and they receive the greatest external attention. However, there will not be a successful, operative waste management system without fully operational waste acceptance plans and logistics arrangements. This paper will discuss the importance of developing, on a parallel basis to the normally considered waste management system elements, the waste acceptance and logistics arrangements to enable the timely transfer of spent nuclear fuel from more than one hundred and twenty waste generators to the Federal government. The paper will also describe the specific activities the Program has underway to make the necessary arrangements. (author)

  15. Human Trafficking of Minors and Childhood Adversity in Florida.

    Science.gov (United States)

    Reid, Joan A; Baglivio, Michael T; Piquero, Alex R; Greenwald, Mark A; Epps, Nathan

    2017-02-01

    To examine the link between human trafficking of minors and childhood adversity. We compared the prevalence of adverse childhood experiences (ACEs) and cumulative childhood adversity (ACE score) among a sample of 913 juvenile justice-involved boys and girls in Florida for whom the Florida child abuse hotline accepted human trafficking abuse reports between 2009 and 2015 with those of a matched sample. ACE composite scores were higher and 6 ACEs indicative of child maltreatment were more prevalent among youths who had human trafficking abuse reports. Sexual abuse was the strongest predictor of human trafficking: the odds of human trafficking was 2.52 times greater for girls who experienced sexual abuse, and there was a 8.21 times greater risk for boys who had histories of sexual abuse. Maltreated youths are more susceptible to exploitation in human trafficking. Sexual abuse in connection with high ACE scores may serve as a key predictor of exploitation in human trafficking for both boys and girls.

  16. Environment and public acceptance

    International Nuclear Information System (INIS)

    Gauvenet; Bresson; Braillard; Ertaud; Ladonchamps, de; Toureau

    1976-01-01

    The problems involved in the siting of nuclear power stations at a local level are of a political economic, social or ecological order. The acceptance of a nuclear station mostly depends on its interest for the local population. In order to avoid negative reactions, the men who are responsible must make the harmonious integration of the station within the existing economic and social context their first priority [fr

  17. Nuclear power and acceptation

    International Nuclear Information System (INIS)

    Speelman, J.E.

    1990-01-01

    In 1989 a workshop was held organized by the IAEA and the Argonne National Laboratory. The purpose was to investigate under which circumstances a large-scale extension of nuclear power can be accepted. Besides the important technical information, the care for the environment determined the atmosphere during the workshop. The opinion dominated that nuclear power can contribute in tackling the environment problems, but that the social and political climate this almost makes impossible. (author). 7 refs.; 1 fig.; 1 tab

  18. Plantation Houses of North Florida

    Directory of Open Access Journals (Sweden)

    Eduardo Robles

    2017-06-01

    Full Text Available The concept of Plantation conjures an image that identifies the North Florida / South Georgia region of the U. S. Leon County attracted many cotton planters from Georgia, Virginia, Maryland, North and South Carolina in the 1820’s to the 1850’s. Up to the beginning of the Civil War, Leon County was the 5th largest producer of cotton counting all counties from Florida and Georgia. The Civil War brought the plantation culture to a standstill. The plantations transformed the environment based on their need for open fields in which to cultivate different crops, or raise a variety of animals with the help of slaves. From the 1900’s many plantations abandoned their land to nature producing a deep change in the local landscape. Today plantations are not used as much for planting crops but more for hunting or as tree farms. The hunting plantations do not grow crops but provide good conditions for the hunting of animals and birds. Other plantations were torn apart, sold and now are part of the Tallahassee urban fabric. In other words, they disappeared. The transformation of the plantations has been slow and steady, and has become the image of the area, even the region. The paper shows five plantations that represent five different evolutions of these traditional landscapes. The landscapes have evolved to accommodate the very local but fluid definition of place. It is this transformation, this evolving identity which helped preserve some of the traditional landscapes and the traditional architecture on them. The most prominent feature of the plantation is the “Big House” or plantation house. The house embodies all aspects of the plantation life style. The construction materials and methods reflected the times, the technologies and the available resources. The research has been done mainly in the archives of the Tallahassee Trust for Historic Preservation. The results, still pending, explain the land typology as it evolved from the golden decades

  19. Correlation between disability acceptance and personality trait in patients with cerebral infarction%脑梗死患者残障接受度与人格特质的相关性分析

    Institute of Scientific and Technical Information of China (English)

    陈正君; 林敬; 程丹灵; 谢晶晶

    2015-01-01

    Objective To investigate the correlation between disability acceptance and personality trait in patients with cerebral infarction, so as to provide a new perspective to improve the disability acceptance. Methods A total of 205 patients with cerebral infarction were investigated by the Acceptance of Disability Scale and the Eysenck Personality Questionnaire-revised-Short Scale for Chinese( EPQ-RSC) . The level of personality trait in patients was compared with the norm, and the Pearson correlation analysis and hierarchical regression analysis were used to explore the effect of personality trait on the disability acceptance. Results The total score of disability acceptance was (128. 08 ± 28. 89) in patients, and 57. 07% of them (117/205) were in the low level, 27. 80% of them (57/205) were in the medium level, 15. 13% of them (31/205) were in the high level. The level of neuroticism, psychoticism and lie in personality trait were significantly higher than those of the norm (t=4. 143,12. 622, 6. 604, respectively;P<0. 01). The level of introvert or extrovert character in personality trait was significantly lower than that in the normal population (t= -9. 552,P<0. 01). Pearson correlation analysis showed that each factor of disability acceptance was significantly negatively correlated with the scores of neuroticism, psychoticism and dissimulation in personality trait (r= -0. 436 0. 025,P<0. 05), but significantly positively correlated with the score of introvert or extrovert character in personality trait ( P<0. 05). Hierarchical regression analysis showed that dissimulation, introvert or extrovert character and neuroticism in personality trait could explained 30. 50% of the total variance of disability acceptance in patients with cerebral infarction (P <0. 05). Conclusions The level of disability acceptance is in the low level in cerebral infarction patients, and personality trait is the influencing factor. Nursing staff can start from the personality trait to

  20. Age and Acceptance of Euthanasia.

    Science.gov (United States)

    Ward, Russell A.

    1980-01-01

    Study explores relationship between age (and sex and race) and acceptance of euthanasia. Women and non-Whites were less accepting because of religiosity. Among older people less acceptance was attributable to their lesser education and greater religiosity. Results suggest that quality of life in old age affects acceptability of euthanasia. (Author)

  1. Acceptable risk of contact allergy in the general population assessed by CE-DUR--a method to detect and categorize contact allergy epidemics based on patient data

    DEFF Research Database (Denmark)

    Thyssen, Jacob Pontoppidan; Menné, Torkil; Schnuch, Axel

    2009-01-01

    of persons eligible for patch testing each year based on patch test sales data. A reverse CE-DUR was performed to make delineations between the 10-year prevalence of contact allergy in the general population and the corresponding theoretical prevalences of contact allergy observed among patients...

  2. Development and Pilot Evaluation of an Online Relapse-Prevention Program Based on Acceptance and Commitment Therapy for Chronic Pain Patients

    NARCIS (Netherlands)

    Fledderus, M.; Schreurs, Karlein Maria Gertrudis; Bohlmeijer, Ernst Thomas; Vollenbroek-Hutten, Miriam Marie Rosé

    2015-01-01

    Background: A significant number of chronic pain patients experience a decline in therapeutic effects after rehabilitation. As face-to-face contacts with health care professionals are not always feasible after treatment, new, innovative, fully automated relapse-prevention programs are highly needed.

  3. Why don't they accept non-invasive ventilation?: insight into the interpersonal perspectives of patients with motor neurone disease.

    Science.gov (United States)

    Ando, Hikari; Williams, Carl; Angus, Robert M; Thornton, Everard W; Chakrabarti, Biswajit; Cousins, Rosanna; Piggin, Lucy H; Young, Carolyn A

    2015-05-01

    Although non-invasive ventilation (NIV) can benefit survival and quality of life, it is rejected by a substantial proportion of people with motor neurone disease (MND). The aim of this study was to understand why some MND patients decline or withdraw from NIV. Nine patients with MND (male = 7, mean age = 67 years) participated in this study. These patients, from a cohort of 35 patients who were offered NIV treatment to support respiratory muscle weakness, did not participate in NIV treatment when it was clinically appropriate. Semi-structured interviews and interpretative phenomenological analysis (IPA) were employed to explore these patient's experience of MND and their thoughts and understanding of NIV treatment. Using IPA, four themes were identified: preservation of the self, negative perceptions of NIV, negative experience with health care services, and not needing NIV. Further analysis identified the fundamental issue to be the maintenance of perceived self, which was interpreted to consist of the sense of autonomy, dignity, and quality of life. The findings indicate psychological reasons for disengagement with NIV. The threat to the self, the sense of loss of control, and negative views of NIV resulting from anxiety were more important to these patients than prolonging life in its current form. These findings suggest the importance of understanding the psychological dimension involved in decision-making regarding uptake of NIV and a need for sensitive holistic evaluation if NIV is declined. Statement of contribution What is already known on this subject? Non-invasive ventilation is widely used as an effective symptomatic therapy in MND, yet about a third of patients decline the treatment. Psychological disturbance generated by NIV use leads to negative experiences of the treatment. Decision-making about treatment potentials is complex and unique to each individual affected by perceived impact of disease. What does this study add? A decision concerning

  4. A prospective study of anxiety in ICD patients with a pilot randomized controlled trial of cognitive behavioral therapy for patients with moderate to severe anxiety

    DEFF Research Database (Denmark)

    Qintar, Mohammed; George, Jason J; Panko, Melanie

    2015-01-01

    , but higher anxiety was associated with recent and total number of shocks. The small pilot study suggested that a simple program of CBT might lower moderate-high anxiety with lasting effects to 1 year and supports the need for a larger trial to validate these results. CLINICAL TRIAL REGISTRATION: Clinical......PURPOSE: Stress and anxiety are potential consequences from arrhythmias and implantable cardioverter defibrillator (ICD) shocks that can contribute to substantial morbidity. We assessed anxiety associated with an ICD and whether cognitive behavioral therapy (CBT) reduces anxiety. METHODS: The study...... consisted of two parts: part 1 (N = 690) was a prospective cross-sectional observational study of consecutive ICD patients. Patients completed the Beck Anxiety Inventory (BAI), Generalized Anxiety Disorder Scale (GAD-7), Florida Shock Anxiety Scale (FSAS), and Florida Patient Acceptance Survey (FPAS...

  5. Accepting telemedicine in a circulatory medicine ward in major hospitals in South Korea: patients' and health professionals' perception of real-time electrocardiogram monitoring.

    Science.gov (United States)

    Lee, Seo-Joon; Jung, Tae-Young; Lee, Tae-Ro; Han, Jae-Hoon

    2018-04-20

    South Korean government is currently in progress of expanding the coverage of telemedicine projects as part of an attempt to vitalize service industry, but is facing fierce opposition from KMA. Practice of telemedicine requires sufficient discussions among related parties. Although the participation of medical specialists is important, agreement from the public is essential. Three main tertiary care centers in Seoul were selected for data collection. A total of 224 patients (patients n = 180, patient guardian n = 44) and medical professionals (n = 41) were selected using simple random sampling. Mixed method of quantitative survey and qualitative semi-interview was used. This study analyzed patients' and medical professionals' perception about the application of telemedicine in cardiology ward in tertiary care centers to provide baseline data when developing and applying telemedicine services. Results implied high need for encouraging telemedicine projects in order to appeal needs among population by providing experience (p < 0.001) and knowledge (p < 0.001). Other results showed that the need for electrocardiography monitoring was high among not only in remote areas but also in areas close to the capital. 64.52% of all participants thought that telemedicine was needed, and 73.21% of participants were willing to use telemedicine service if provided. Semi-interviews revealed that participants expected more cost and time saving services through remote treatment, by not having to visit long distance hospitals frequently. Research results oppose Korean Medical Association's opinion that the population is against enforcing telemedicine related laws. The findings in this study reflect an up-to-date perception of telemedicine among patients and medical professionals in a tertiary care centers' cardiology ward. Moreover, the study provides a baseline that is needed in order to overcome past failures and to successfully implement telemedicine in South

  6. Water withdrawals in Florida, 2012

    Science.gov (United States)

    Marella, Richard L.

    2015-09-01

    In 2012, the total amount of water withdrawn in Florida was estimated to be 14,237 million gallons per day (Mgal/d). Saline water accounted for 7,855 Mgal/d (55 percent), and freshwater accounted for 6,383 Mgal/d (45 percent). Groundwater accounted for 4,167 Mgal/d (65 percent) of freshwater withdrawals, and surface water accounted for the remaining 2,216 Mgal/d (35 percent). Surface water accounted for nearly all (99.9 percent) saline-water withdrawals. Freshwater withdrawals were greatest in Palm Beach County (682 Mgal/d), and saline-water withdrawals were greatest in Pasco County (1,822 Mgal/d). Fresh groundwater provided drinking water (through either public supply or private domestic wells) for 17.699 million residents (93 percent of Florida’s population), and fresh surface water provided drinking water for 1.375 million residents (7 percent). The statewide public-supply gross per capita water use for 2012 was estimated at 136 gallons per day.

  7. Grau de aceitação de mini-implantes por pacientes em tratamento ortodôntico: estudo preliminar The mini-implants acceptance rate by patients in orthodontic treatments: a preliminary study

    Directory of Open Access Journals (Sweden)

    Larissa Bustamante Capucho Brandão

    2008-10-01

    Full Text Available OBJETIVOS: os mini-implantes atualmente representam um grande avanço na Ortodontia, por proporcionarem máxima ancoragem com o mínimo de cooperação dos pacientes. No entanto, ainda existem algumas dúvidas quanto ao uso destes dispositivos temporários de ancoragem no que se refere, principalmente, aos aspectos psicológicos de aceitação pelos pacientes durante o tratamento ortodôntico. METODOLOGIA: dez pacientes adultos, portadores de má oclusão de Classe I, com biprotrusão, que foram submetidos a tratamento ortodôntico com a colocação de quatro mini-implantes nos arcos dentários, entre os primeiros molares e segundos pré-molares superiores e inferiores, responderam a um questionário, com o objetivo de avaliar as condições de aceitação dos mini-implantes. RESULTADOS: as respostas indicaram que a maioria dos pacientes aceitou prontamente o procedimento, estavam satisfeitos e recomendariam para outros pacientes (90%, enquanto 50% tiveram alguma preocupação com os procedimentos cirúrgicos e os outros 50% não relataram nenhum desconforto. O tempo médio de tolerância a partir da colocação foi de 3 dias e a maioria tolerou os implantes durante todo o tratamento ortodôntico. CONCLUSÕES: pôde-se concluir que os mini-implantes foram aceitos de forma positiva pela maioria dos pacientes submetidos ao tratamento ortodôntico.OBJECTIVE: Actually, mini-implants as anchorage resources have been spotlight in Orthodontics, providing maximum anchorage with minimum patient's cooperation. However, there are still some restrictions regarding the use of these temporary anchorage devices, and among these, the psychological aspects and the patient's acceptance, which still not properly evaluated. METHODS: Ten adults patients, with Class I biprotrusion malocclusion, that were submitted to orthodontic treatment with the implantation of four mini-implants, in the dental arches, among upper and lower first molar and second premolar teeth, in

  8. Children acceptance of laser dental treatment

    Science.gov (United States)

    Lazea, Andreea; Todea, Carmen

    2016-03-01

    Objectives: To evaluate the dental anxiety level and the degree of acceptance of laser assisted pedodontic treatments from the children part. Also, we want to underline the advantages of laser use in pediatric dentistry, to make this technology widely used in treating dental problems of our children patients. Methods: Thirty pediatric dental patients presented in the Department of Pedodontics, University of Medicine and Pharmacy "Victor Babeş", Timişoara were evaluated using the Wong-Baker pain rating scale, wich was administered postoperatory to all patients, to assess their level of laser therapy acceptance. Results: Wong-Baker faces pain rating scale (WBFPS) has good validity and high specificity; generally it's easy for children to use, easy to compare and has good feasibility. Laser treatment has been accepted and tolerated by pediatric patients for its ability to reduce or eliminate pain. Around 70% of the total sample showed an excellent acceptance of laser dental treatment. Conclusions: Laser technology is useful and effective in many clinical situations encountered in pediatric dentistry and a good level of pacient acceptance is reported during all laser procedures on hard and soft tissues.

  9. Does the use of Nintendo Wii Sports™ improve arm function and is it acceptable to patients after stroke? Publication of the Protocol of the Trial of Wii™ in Stroke – TWIST

    Directory of Open Access Journals (Sweden)

    Adie K

    2014-10-01

    Full Text Available Katja Adie,1 Christine Schofield,1 Margie Berrow,2 Jennifer Wingham,3 Janet Freeman,1 John Humfryes,1 Colin Pritchard3 1Royal Cornwall Hospital Trust, Cornwall, UK; 2Peninsula Clinical Trials Unit, Plymouth University Schools of Medicine and Dentistry, Plymouth, Devon, UK; 3Royal Cornwall Hospital, Truro, Cornwall, UKIntroduction: Many stroke patients experience loss of arm function requiring rehabilitation, which is expensive, repetitive, and does not always translate into “real life.” Nintendo Wii Sports™ (Wii™ may offer task-specific training that is repetitive and motivating. The Trial of Wii™ in Stroke (TWIST is designed to investigate feasibility, efficacy, and acceptability using Wii™ to improve affected arm function for patients after stroke.Method: This is a randomized controlled trial (RCT, incorporating a qualitative study and health economics analysis that compares playing Wii™ versus arm exercises in patients receiving standard rehabilitation in a home setting within 6 months of stroke with a motor deficit of less than 5 on the MRC (Medical Research Council scale (arm. In this study, we expect to randomize 240 participants.Outcome measures: Primary outcome is change in affected arm function at 6 weeks follow-up in intervention and control group using the Action Research Arm Test. Secondary outcomes include occupational performance using the Canadian Occupational Performance Measure, quality of life using the Stroke Impact Scale, cost effectiveness analysis, and a qualitative study investigating factors that influence use of Wii™ for patients and carers.Conclusion: TWIST is the first UK RCT assessing the feasibility, cost effectiveness, and acceptability of Wii™ in stroke rehabilitation. The trial has been registered with ISRCTN 06807619 and UK CRN 11030. Results of the study will be published after completion of study in August 2014.Keywords: virtual reality, rehabilitation

  10. Feasibility and acceptability of mobile phone short message service as a support for patients receiving antiretroviral therapy in rural Uganda: a cross-sectional study.

    Science.gov (United States)

    Kim, Jiho; Zhang, Wendy; Nyonyitono, Maureen; Lourenco, Lillian; Nanfuka, Mastula; Okoboi, Stephen; Birungi, Josephine; Lester, Richard T; Kaleebu, Pontiano; Munderi, Paula; Moore, David M

    2015-01-01

    Mobile phone technologies have been promoted to improve adherence to antiretroviral therapy (ART). We studied the receptiveness of patients in a rural Ugandan setting to the use of short messaging service (SMS) communication for such purposes. We performed a cross-sectional analysis measuring mobile phone ownership and literacy amongst patients of The AIDS Support Organisation (TASO) in Jinja, Uganda. We performed bivariate and multivariate logistic regression analyses to examine associations between explanatory variables and a composite outcome of being literate and having a mobile phone. From June 2012 to August 2013, we enrolled 895 participants, of whom 684 (76%) were female. The median age was 44 years. A total of 576 (63%) were both literate and mobile phone users. Of these, 91% (527/ 576) responded favourably to the potential use of SMS for health communication, while only 38.9% (124/319) of others were favourable to the idea (pmobile phone users reported optimal adherence to ART (86.4% vs. 90.6%; p=0.007). Male participants (AOR=2.81; 95% CI 1.83-4.30), sub-optimal adherence (AOR=1.76; 95% CI 1.12-2.77), those with waged or salaried employment (AOR=2.35; 95% CI 1.23-4.49), crafts/trade work (AOR=2.38; 95% CI 1.11-5.12), or involved in petty trade (AOR=1.85; 95% CI 1.09-3.13) (in comparison to those with no income) were more likely to report mobile phone ownership and literacy. In a rural Ugandan setting, we found that over 60% of patients could potentially benefit from a mobile phone-based ART adherence support. However, support for such an intervention was lower for other patients.

  11. User-experiences with a web-based self-help intervention for partners of cancer patients based on acceptance and commitment therapy and self-compassion: a qualitative study

    Directory of Open Access Journals (Sweden)

    Nadine Köhle

    2017-02-01

    Full Text Available Abstract Background Partners of cancer patients are the cornerstone of supportive cancer care. They assume different roles and responsibilities that optimally support the patient. Such support is highly demanding, and many partners report (mental health problems. However, many of them do not use professional supportive care themselves. Offering a Web-based self-help intervention based on Acceptance and Commitment Therapy (ACT and self-compassion could be an important resource to support this group. This qualitative study aimed to examine user-experiences with a Web-based self-help intervention based on ACT and self-compassion among partners of cancer patients. Methods Individual in-depth interviews, about partners’ appreciation of the intervention and lessons learned, were conducted with 14 partners of cancer patients who used the Web-based self-help intervention. Interviews were audio-recorded, transcribed verbatim and analyzed by three independent coders both deductively and inductively. Results In general, partners appreciated the intervention, however, they also expressed ambivalent feelings towards peer support, the content of the feedback of their counselor, and the ‘tunneled’ structure of the intervention. The majority of the partners reported being more self-compassionate accepting that they experienced negative thoughts and feelings, they reported that they learned to increase the distance between their thoughts and themselves, they indicated being more aware of their personal values, and they thought that they were better able to commit to those values. They also reported other (non-specific helpful processes such as insight and acknowledgement, positivity, the possibility to tell their story, time for themselves, and feeling closer and more connected with their partner (the patient. Conclusions Partners of cancer patients indicated to appreciate the Web-based self-help intervention based on ACT and self-compassion. They felt

  12. Den betingede accept

    DEFF Research Database (Denmark)

    Kolind, Torsten

    1999-01-01

    The article focus on aspects of identity and social order in relation to the interaction between ‘normals' and ex-prisoners, that is, ex-prisoners, who wants to live a normal life without criminality. It is argued, that this interaction and the normality that the ex-prisoner is granted often......, on the surface, can look rather unproblematic, but that it, none the less, is ruled by, what the author calls the conditioned accept. That is, the ex-prisoner should see himself as normal, at the same time that he withdraw from those situations, practices and attitude where the normals would have difficulties...

  13. Baby-Crying Acceptance

    Science.gov (United States)

    Martins, Tiago; de Magalhães, Sérgio Tenreiro

    The baby's crying is his most important mean of communication. The crying monitoring performed by devices that have been developed doesn't ensure the complete safety of the child. It is necessary to join, to these technological resources, means of communicating the results to the responsible, which would involve the digital processing of information available from crying. The survey carried out, enabled to understand the level of adoption, in the continental territory of Portugal, of a technology that will be able to do such a digital processing. It was used the TAM as the theoretical referential. The statistical analysis showed that there is a good probability of acceptance of such a system.

  14. Acceptance, Tolerance, Participation

    International Nuclear Information System (INIS)

    1993-01-01

    The problem of radioactive waste management from an ethical and societal viewpoint was treated in this seminar, which had participants from universities (social, theological, philosophical and science institutes), waste management industry, and regulatory and controlling authorities. After initial reviews on repository technology, policies and schedules, knowledge gaps, and ethical aspects on decision making under uncertainty, four subjects were treated in lectures and discussions: Democratic collective responsibility, Handling threats in democratic decision making, Waste management - a technological operation with a social dimension, Acceptance and legitimity. Lectures with comments and discussions are collected in this report

  15. Marketing for Acceptance

    Directory of Open Access Journals (Sweden)

    Tina L. Johnston, Ph.D.

    2009-11-01

    Full Text Available Becoming a researcher comes with the credentializing pressure to publish articles in peer-reviewed journals (Glaser, 1992; Glaser, 2007; Glaser, 2008. The work intensive process is exacerbated when the author’s research method is grounded theory. This study investigated the concerns of early and experienced grounded theorists to discover how they worked towards publishing research projects that applied grounded theory as a methodology. The result was a grounded theory of marketing for acceptance that provides the reader with insight into ways that classic grounded theorists have published their works. This is followed by a discussion of ideas for normalizing classic grounded theory research methods in our substantive fields.

  16. 78 FR 43197 - Duke Energy Florida, Inc.; Florida Power & Light Company; Tampa Electric Company; Orlando...

    Science.gov (United States)

    2013-07-19

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [ER13-1922-000; ER13-1929-000; ER13-1932-000; NJ13-11-000] Duke Energy Florida, Inc.; Florida Power & Light Company; Tampa Electric Company; Orlando Utilities Commission; Notice of Compliance Filings Take notice that on July 10, 2013, Duke Energy...

  17. 78 FR 29364 - Seminole Electric Cooperative, Inc., and Florida Municipal Power Agency v. Duke Energy Florida...

    Science.gov (United States)

    2013-05-20

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. EL13-63-000] Seminole Electric Cooperative, Inc., and Florida Municipal Power Agency v. Duke Energy Florida, Inc.; Notice of... of the Federal Energy Regulatory Commission (Commission), 18 CFR 385.206 and sections 206, 306, and...

  18. Florida State University superconducting linac

    International Nuclear Information System (INIS)

    Myers, E.G.; Fox, J.D.; Frawley, A.D.; Allen, P.; Faragasso, J.; Smith, D.; Wright, L.

    1988-01-01

    As early as the fall of 1977 it was decided that the future research needs of their nuclear structure laboratory required an increase in energy capability to at least 8 MeV per nucleon for the lighter ions, and that these needs could be met by the installation of a 17 MV tandem Van de Graaff accelerator. The chief problem with this proposal was the high cost. It became apparent that a far less expensive option was to construct a linear accelerator to boost the energy from their existing 9 MV tandem. The options open to them among linac boosters were well represented by the room temperature linac at Heidelberg and the superconducting Stony Brook and Argonne systems. By the Spring of 1979 it had been decided that both capital cost and electric power requirements favored a superconducting system. As regards the two superconducting resonator technologies - the Argonne niobium-copper or the Caltech-Stony Brook lead plated copper - the Argonne resonators, though more expensive to construct, had the advantages of more boost per resonator, greater durability of the superconducting surface and less stringent beam bunching requirements. In 1980 pilot funding from the State of Florida enabled the construction of a building addition to house the linac and a new target area, and the setting up of a small, three resonator, test booster. Major funding by the NSF for the laboratory upgrade started in 1984. With these funds they purchased their present helium liquefaction and transfer system and constructed three large cryostats, each housing four Argonne beta = 0.105 resonators and two superconducting solenoids. The last large cryostat was completed and installed on-line early this year and the linac was dedicated on March 20. Nuclear physics experiments using the whole linac began in early June. 4 references, 6 figures, 1 table

  19. A Double-Blind, Randomised Study Comparing the Skin Hydration and Acceptability of Two Emollient Products in Atopic Eczema Patients with Dry Skin.

    Science.gov (United States)

    Djokic-Gallagher, Jasmina; Rosher, Phil; Oliveira, Gabriela; Walker, Jennine

    2017-09-01

    Healthcare professionals tend to recommend emollients based primarily on patient/consumer preference and cost, with cheaper options assumed to be therapeutically equivalent. The aim of this study was therefore to compare the effects on skin hydration of two emollients prescribed in the UK, Doublebase Dayleve™ gel (DELP) and a cheaper alternative, Zerobase Emollient™ cream (ZBC). This was a single-centre, randomised, double-blind, concurrent bi-lateral (within-patient) comparison in 18 females with atopic eczema and dry skin on their lower legs. DELP gel and ZBC cream were each applied to one lower leg twice daily for 4 days and on the morning only on day 5. The efficacy of both products was assessed by hydration measurements using a Corneometer CM825 probe (Courage-Khazaka Electronic). The measurements were made three times daily on days 1 to 5. The primary efficacy variable was the area under the curve (AUC) of the change from baseline corneometer readings over the 5 days. Skin hydration using DELP gel was significantly higher than using ZBC cream (p skin hydration observed for DELP gel was substantial and long lasting. In contrast, for ZBC cream, there was no significant improvement of the cumulative skin hydration as measured by the AUC (p = 0.22). DELP gel achieved substantial, long-lasting and cumulative skin hydration, whilst ZBC cream achieved no measurable improvement in skin hydration compared to before treatment. Healthcare professionals should be aware that different emollients can perform differently. Dermal Laboratories Ltd. EudraCT number:2014-001026-16.

  20. Wpływ akceptacji choroby na zachowania zdrowotne pacjentów z marskością wątroby = The impact of the acceptance of the disease on the health behaviors of patients with liver cirrhosis

    Directory of Open Access Journals (Sweden)

    Ewa Krzyżanowska

    2017-02-01

    łowych zachowań zdrowotnych. Czas trwania choroby nie ma wpływu na zachowania zdrowotne pacjentów marskością wątroby, jednak najwyższe nasilenie zachowań zdrowotnych prezentują badani chorujący  najkrócej  a najniższe chorujący dłużej niż dwa lata.   Słowa kluczowe: akceptacja choroby, zachowania zdrowotne, marskość wątroby     Summary Aim of the study. The aim of the study was to determine the effect of the acceptance of the disease on the health behavior of patients with cirrhosis of the liver. Material and methods. The study involved a group of 100 patients diagnosed with cirrhosis of the liver. The study was conducted from April to June 2016. in the Department of Internal Gastroenterology in the Military Clinical Hospital and the Department of Gastroenterology of the Independent Public Clinical Hospital No. 4 in Lublin. The study used Acceptance of Illness Scale (AIS and the Behavioral Health Inventory Siegfried Juczyński (IZZ. Findings. Research shows that 69% of respondents presented average level of acceptance of the disease is characterized by high while only 12% ankietowanych.19% of respondents did not accept the disease. A greater level of acceptance of the disease occurred in women than men and in the group of respondents living in the city. However, the differences in rating were not statistically significant. The highest intensity of health behaviors was recorded in the category of prevention, the lowest in the category of normal eating habits. Differences in ratings were also not statistically significant. Conclusions. It was found that women more than men accept their illness. The duration of the disease affects its acceptance, the subjects with the shortest experience of illness easier to accept the disease than subjects who have developed more than 2-3 years. Health behaviors surveyed are not dependent on their place of residence, but a higher rate of health behaviors observed in subjects living in the city. In the group of education

  1. Florida Sinkholes and Grout Injection Stabilization

    Directory of Open Access Journals (Sweden)

    Charles Hunt Griffith II

    2014-09-01

    Full Text Available Florida has a major problem when it comes to sinkholes. These sinkholes can become very hazardous to people, homes, and to the landscape as a whole. Florida sits on a carbonate platform which is highly indicative of sinkholes. There are three main types of sinkholes which occur in Florida: dissolution, cover subsidence, and cover collapse. I will compare these types of sinkholes to the underlying formation beneath Florida to see if there is a connection between the types of sinkholes that occur. I will also create a 3D model of grout injection stabilization and calculate its volume to compare to the actual volume placed under the house. This information will help inform and bring attention to the problem in Florida and in turn, may help alleviate the problem if we can understand what causes these sinkholes. The 3D model may help engineering companies become more efficient in predicting the projected amount of volume to stabilize a house that may be in danger.

  2. Occurrence of Pasteuria spp. in Florida

    Science.gov (United States)

    Hewlett, T. E.; Cox, R.; Dickson, D. W.; Dunn, R. A.

    1994-01-01

    Two years of data collected from the Florida Nematode Assay Laboratory of the Florida Cooperative Extension Service and 4 years of data from the Florida Department of Agriculture and Consumer Services, Division of Plant Industry, were compiled to find out the distribution of Pasteuria spp. on nematodes in Florida soils. Information recorded came from 335 samples and included nematode genera with Pasteuria endospores attached, host plants associated with the samples, and the origins of the samples. Pasteuria spp. were detected on 14 different plant-parasitic nematode genera in 41 Florida counties and associated with over 39 different plant species and in seven fallow fields. Pasteuria-infected nematodes were associated with a wide range of plant hosts, although frequency of associations with these hosts reflected the sample bias of the laboratories involved. Meloidogyne and Hoplolaimus spp. were the two nematode genera most frequently associated with Pasteuria. Pasteuria spp. were observed attached to members of these two genera in 176 and 59 soil samples, respectively. PMID:19279936

  3. Barriers to Technological Acceptance in a Legal Environment: A Case Study of a Florida Law Firm

    Science.gov (United States)

    Owusu, Theophilus D.

    2010-01-01

    Technology is made available in the law firm to promote time efficient tasks and to provide resources that allows the accurate billing and storing of documents. This study examined the impact of three major technologies that are used by attorneys in a law firm. Quantitative procedures facilitated the identification of barriers to Personal Digital…

  4. Public acceptance of nuclear power

    International Nuclear Information System (INIS)

    Wildgruber, O.H.

    1990-01-01

    The lecture addresses the question why we need public acceptance work and provides some clues to it. It explains various human behaviour patterns which determine the basics for public acceptance. To some extent, the opposition to nuclear energy and the role the media play are described. Public acceptance efforts of industry are critically reviewed. Some hints on difficulties with polling are provided. The lecture concludes with recommendations for further public acceptance work. (author)

  5. Acceptance of low-sodium diets among patients with heart diseases in a tertiary hospital Aceitação de dietas com reduzido teor de sódio entre cardiopatas em um hospital terciário

    Directory of Open Access Journals (Sweden)

    Bruna Fraga dos Santos

    2012-08-01

    Full Text Available Objective: To evaluate the acceptance of low-sodium diets among patients with heart diseases in a tertiary hospital in Porto Alegre, RS. Materials and Methods: A cross-sectional study was performed in patients with medical prescription of sodium restricted diets, standardized by the hospital. We have evaluated wasted food from one meal (lunch or dinner by weighing it. Subjective Global Assessment (SGA was used for nutritional status assessment. Demographic data and reasons for no acceptance of the diet were recorded using a questionnaire. Results: Among the 173 patients assessed, mean age was 63±14.4 years. According to SGA, 84% of the individuals were classified as (A - well nourished and 16% suspicion/malnourished (SGA B. Seventy-one per cent of all individuals reported not to fully accept the meal provided by the hospital. Seventy-three per cent of the patients reported that usually restrict sodium chloride in their diet at home. Meat was the kind of food with greater acceptance, and rice had lower acceptance. On average, around 167 kcal were not consumed in a full meal, representing around 8% from the total daily energy that was supposed to be supplied by the diet prescribed. There was no difference in the acceptance between both low-sodium diets standardized (“Low-Sodium” and “Cardiopaty” and the salt reduction was the most cited reason from patients to justify the meal rejection. Conclusions: Reduction of sodium was the factor that most influenced the low acceptance of the meal among prescribed diets. The lack of energy value from the rejected food can negatively affect nutritional status.Objetivo: Avaliar a aceitação de dietas com restrição de sal por pacientes portadores de cardiopatias admitidos em um hospital terciário de Porto Alegre, RS. Materiais e Métodos: Estudo transversal entre pacientes com prescrição de dietas restritas em sódio, padronizadas pelo hospital. Foram verificados os restos de alimentos de uma

  6. Florida Progress Corporation 1991 annual report

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    Florida Progress Corporation is a utility holding company with assets of 5 billion dollars. Its principal subsidiary is the Florida Power Corporation; others are the Electric Fuels Corporation, the Mid-Continent Life Assurance Company, the Talquin Corporation, the Progress Credit Corporation and Advanced Separation Technologies Incorporated. The annual report describes achievements during the year. To meet growing energy demand Florida Power is building new peaking and base-load generating units, purchasing power from neighbouring utilities and cogenerators, and building more bulk power transmission line capacity in the state. Emphasis has been placed on meeting load growth by demand-site management. Attention is given to balancing energy needs with concerns for the environment, and there is an award-winning recycling program. The Electric Fuels Corporation major area of business is coal mining and transportation services. Advanced Separation Technologies has sold several of its patented ion separation machines. The report includes consolidated financial statements for the year ended 31 December 1991

  7. Development of the Future Physicists of Florida

    Science.gov (United States)

    Wade, A.; Weatherford, C.; Cottle, P.; Fannin, S.; Roberts, W.; Fauerbach, M.; Ponti, L.; Sear, J.

    2013-03-01

    We present the development of the ``Future Physicists of Florida'' (FPF) comprised of Florida university physics professors, middle and high school science teachers, and backed by the Florida Legislature. Our purpose is to address the lack of incoming college freshmen ready and willing to become physics majors. We will discuss the building of FPF and the development of a pipeline for middle and high school students predicted to produce the optimal number of bachelor's degrees in STEM. We will also discuss our use of community-building activities to educate the students, and their parents and teachers about the educational value of taking physics before going to college and potential careers in physics, to entertain them with fun physics related activities in order to peak their interest in physics, and to ultimately inspire the students to become physicists.

  8. A randomised controlled multicentre trial of treatments for adolescent anorexia nervosa including assessment of cost-effectiveness and patient acceptability - the TOuCAN trial.

    Science.gov (United States)

    Gowers, S G; Clark, A F; Roberts, C; Byford, S; Barrett, B; Griffiths, A; Edwards, V; Bryan, C; Smethurst, N; Rowlands, L; Roots, P

    2010-03-01

    To evaluate the clinical effectiveness and cost-effectiveness of inpatient compared with outpatient treatment and general (routine) treatment in Child and Adolescent Mental Health Services (CAMHS) against specialist treatment for young people with anorexia nervosa. In addition, to determine young people's and their carers' satisfaction with these treatments. A population-based, pragmatic randomised controlled trial (RCT) was carried out on young people age 12 to 18 presenting to community CAMHS with anorexia nervosa. Thirty-five English CAMHS in the north-west of England co-ordinated through specialist centres in Manchester and Liverpool. Two hundred and fifteen young people (199 female) were identified, of whom 167 (mean age 14 years 11 months) were randomised and 48 were followed up as a preference group. Randomised patients were allocated to either inpatient treatment in one of four units with considerable experience in the treatment of anorexia nervosa, a specialist outpatient programme delivered in one of two centres, or treatment as usual in general community CAMHS. The outpatient programmes spanned 6 months of treatment. The length of inpatient treatment was determined on a case-by-case basis on clinical need with outpatient follow-up to a minimum of 6 months. Follow-up assessments were carried out at 1, 2 and 5 years. The primary outcome measure was the Morgan-Russell Average Outcome Scale (MRAOS) and associated categorical outcomes. Secondary outcome measures included physical measures of weight, height, body mass index (BMI) and % weight for height. Research ratings included the Health of the National Outcome Scale for Children and Adolescents (HoNOSCA). Self report measures comprised the user version of HoNOSCA (HoNOSCA-SR), the Eating Disorder Inventory 2 (EDI-2), the Family Assessment Device (FAD) and the recent Mood and Feelings Questionnaire (MFQ). Information on resource use was collected in interview at 1, 2 and 5 years using the Child and

  9. Landscape Analysis of Adult Florida Panther Habitat.

    Directory of Open Access Journals (Sweden)

    Robert A Frakes

    Full Text Available Historically occurring throughout the southeastern United States, the Florida panther is now restricted to less than 5% of its historic range in one breeding population located in southern Florida. Using radio-telemetry data from 87 prime-aged (≥3 years old adult panthers (35 males and 52 females during the period 2004 through 2013 (28,720 radio-locations, we analyzed the characteristics of the occupied area and used those attributes in a random forest model to develop a predictive distribution map for resident breeding panthers in southern Florida. Using 10-fold cross validation, the model was 87.5 % accurate in predicting presence or absence of panthers in the 16,678 km2 study area. Analysis of variable importance indicated that the amount of forests and forest edge, hydrology, and human population density were the most important factors determining presence or absence of panthers. Sensitivity analysis showed that the presence of human populations, roads, and agriculture (other than pasture had strong negative effects on the probability of panther presence. Forest cover and forest edge had strong positive effects. The median model-predicted probability of presence for panther home ranges was 0.81 (0.82 for females and 0.74 for males. The model identified 5579 km2 of suitable breeding habitat remaining in southern Florida; 1399 km2 (25% of this habitat is in non-protected private ownership. Because there is less panther habitat remaining than previously thought, we recommend that all remaining breeding habitat in south Florida should be maintained, and the current panther range should be expanded into south-central Florida. This model should be useful for evaluating the impacts of future development projects, in prioritizing areas for panther conservation, and in evaluating the potential impacts of sea-level rise and changes in hydrology.

  10. Landscape Analysis of Adult Florida Panther Habitat.

    Science.gov (United States)

    Frakes, Robert A; Belden, Robert C; Wood, Barry E; James, Frederick E

    2015-01-01

    Historically occurring throughout the southeastern United States, the Florida panther is now restricted to less than 5% of its historic range in one breeding population located in southern Florida. Using radio-telemetry data from 87 prime-aged (≥3 years old) adult panthers (35 males and 52 females) during the period 2004 through 2013 (28,720 radio-locations), we analyzed the characteristics of the occupied area and used those attributes in a random forest model to develop a predictive distribution map for resident breeding panthers in southern Florida. Using 10-fold cross validation, the model was 87.5 % accurate in predicting presence or absence of panthers in the 16,678 km2 study area. Analysis of variable importance indicated that the amount of forests and forest edge, hydrology, and human population density were the most important factors determining presence or absence of panthers. Sensitivity analysis showed that the presence of human populations, roads, and agriculture (other than pasture) had strong negative effects on the probability of panther presence. Forest cover and forest edge had strong positive effects. The median model-predicted probability of presence for panther home ranges was 0.81 (0.82 for females and 0.74 for males). The model identified 5579 km2 of suitable breeding habitat remaining in southern Florida; 1399 km2 (25%) of this habitat is in non-protected private ownership. Because there is less panther habitat remaining than previously thought, we recommend that all remaining breeding habitat in south Florida should be maintained, and the current panther range should be expanded into south-central Florida. This model should be useful for evaluating the impacts of future development projects, in prioritizing areas for panther conservation, and in evaluating the potential impacts of sea-level rise and changes in hydrology.

  11. Biodiversity in a Florida Sandhill Ecosystem

    Directory of Open Access Journals (Sweden)

    Samantha Robertson

    2009-01-01

    Full Text Available This project compares two transects of land in the University of South Florida's Botanical Gardens for their biodiversity. The transects were chosen to represent a Florida sandhill ecosystem and the individual Longleaf Pine, Saw Palmetto, Turkey Oak, Laurel Oak and Live Oak specimens were counted. All other species above waist height were counted as "other"?. Once the individuals were counted, the Simpson's and Shannon-Wiener indices were calculated. Since the Shannon-Wiener index incorporates several diversity characteristics, it is typically more reliable than Simpson's. However, both biodiversity indices agreed that transect B was more diverse than transect A.

  12. Impacts of dialysis transportation on Florida's coordinated public transportation programs.

    Science.gov (United States)

    2014-04-01

    The National Center for Transit Research (NCTR) at the University of South Florida (USF) collected quantitative and qualitative data from Community Transportation Coordinators (CTCs) throughout Florida. An online survey and a series of personal inter...

  13. Florida public transportation anti-terrorism resource guide

    Science.gov (United States)

    2001-10-01

    The Center for Urban Transportation (CUTR) at the University of South Florida (USF) assembled this guide to provide public transit agencies in Florida with information on current resources available to assist them with improving system security and g...

  14. 2005 Southwest Florida Water Management District (SWFWMD) Lidar: Manatee District

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Light Detection and Ranging (LiDAR) LAS dataset is a survey of select areas within Southwest Florida. These data were produced for the Southwest Florida Water...

  15. Florida Model Task Force on Diabetic Retinopathy: Development of an Interagency Network.

    Science.gov (United States)

    Groff, G.; And Others

    1990-01-01

    This article describes the development of a mechanism to organize a network in Florida for individuals who are at risk for diabetic retinopathy. The task force comprised representatives from governmental, academic, professional, and voluntary organizations. It worked to educate professionals, patients, and the public through brochures, resource…

  16. HPS simulation and acceptance

    Energy Technology Data Exchange (ETDEWEB)

    Mundim, Luiz Martins [UERJ, Rio de Janeiro, RJ (Brazil); Pol, Maria Elena [CBPF, Rio de Janeiro, RJ (Brazil)

    2013-07-01

    Full text: The High Precision Spectrometer (HPS) is a proposal of sub-detector to be installed in the region of 200-240m from each side of CMS along the LHC beam-line to measure scattered protons from exclusive centrally produced processes, pp → p + X + p. In order to study the protons that reach the detectors, the beam-line of the LHC accelerator has to be taken into account, as the particles are deflected by dipoles and suffer the influence of quadrupoles and other beam devices. The LHC team provides a detailed description of these elements, currents, energies, magnetic fields, and all the information needed to study the propagation of the protons. The program HECTOR, developed at the University of Louvain, uses the information from LHC to calculate at any point along the beam-line the kinematic quantities that characterize the scattered protons. A simple minded program was initially developed for the preliminary studies of acceptances varying the position and size of the foreseen detectors. Also, it took into account vertex and position smearing, to simulate a realistic resolution of the tracking detectors. These studies were performed using a particle gun generator which shoot protons from the IP within reasonable ranges of possible t and ξ (the square of the four-momentum transfer and the fractional energy loss of the outgoing proton in a diffractive collision), and propagated them to the position of the tracking detectors. These kinematic quantities were reconstructed back at the IP using the transport equations from HECTOR. This simplified simulation was afterwards interfaced with the full software of CMS, CMSSW, in such a way that when a diffractive event was fully simulated and reconstructed in the central detector, the outgoing protons were treated by the HPS software and then the complete (CMS+HPS) event was output. The ExHuME generator was used to produce Monte Carlo simulations to study the mass acceptance of the HPS detector, and central and

  17. Rocky Mountain spotted fever acquired in Florida, 1973-83.

    Science.gov (United States)

    Sacks, J J; Janowski, H T

    1985-01-01

    From 1973 to 1983, 49 Florida residents were reported with confirmed Rocky Mountain spotted fever (RMSF), 25 of whom were considered to have had Florida-acquired disease. Although there was no history of tick exposure for six of these 25 persons, all had contact with dogs or outdoor activities during the incubation period. The tick vectors of RMSF are widely distributed throughout Florida. We conclude that RMSF, although rare in Florida, can be acquired in the state. PMID:4061716

  18. Bridging the Gap between Social Acceptance and Ethical Acceptability.

    Science.gov (United States)

    Taebi, Behnam

    2017-10-01

    New technology brings great benefits, but it can also create new and significant risks. When evaluating those risks in policymaking, there is a tendency to focus on social acceptance. By solely focusing on social acceptance, we could, however, overlook important ethical aspects of technological risk, particularly when we evaluate technologies with transnational and intergenerational risks. I argue that good governance of risky technology requires analyzing both social acceptance and ethical acceptability. Conceptually, these two notions are mostly complementary. Social acceptance studies are not capable of sufficiently capturing all the morally relevant features of risky technologies; ethical analyses do not typically include stakeholders' opinions, and they therefore lack the relevant empirical input for a thorough ethical evaluation. Only when carried out in conjunction are these two types of analysis relevant to national and international governance of risky technology. I discuss the Rawlsian wide reflective equilibrium as a method for marrying social acceptance and ethical acceptability. Although the rationale of my argument is broadly applicable, I will examine the case of multinational nuclear waste repositories in particular. This example will show how ethical issues may be overlooked if we focus only on social acceptance, and will provide a test case for demonstrating how the wide reflective equilibrium can help to bridge the proverbial acceptance-acceptability gap. © 2016 The Authors Risk Analysis published by Wiley Periodicals, Inc. on behalf of Society for Risk Analysis.

  19. Aquatic vegetation were photographed from aircraft from Florida Bay, Indian River (Florida), and the Coast of Massachusetts (NODC Accession 0000411)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Aerial photographs were taken of the aquatic vegetation of Florida Bay, Indian River (Florida), and the Coast of Massachusetts. Photographs were scanned and...

  20. Water Use in Florida, 2005 and Trends 1950-2005

    Science.gov (United States)

    Marella, Richard L.

    2008-01-01

    Water is among Florida's most valued resources. The State has more than 1,700 streams and rivers, 7,800 freshwater lakes, 700 springs, 11 million acres of wetlands, and underlying aquifers yielding quantities of freshwater necessary for both human and environmental needs (Fernald and Purdum, 1998). Although renewable, these water resources are finite, and continued growth in population, tourism, and agriculture will place increased demands on these water supplies. The permanent population of Florida in 2005 totaled 17.9 million, ranking fourth in the Nation (University of Florida, 2006); nearly 86 million tourists visited the State (Orlando Business Journal, 2006). In 2005, Florida harvested two-thirds of the total citrus production in the United States and ranked fifth in the Nation net farm income (Florida Department of Agriculture and Consumer Services, 2006). Freshwater is vital for sustaining Florida's population, economy, and agricultural production. Accurate estimates reflecting water use and trends in Florida are compiled in 5-year intervals by the U.S. Geological Survey (USGS) in cooperation with the Florida Department of Environmental Protection (FDEP) and the Northwest Florida, St. Johns River, South Florida, Southwest Florida, and Suwannee River Water Management Districts (Marella, 2004). This coordinated effort provides the necessary data and information for planning future water needs and resource management. The purpose of this fact sheet is to present the highlights of water use in Florida for 2005 along with some significant trends in withdrawals since 1950.

  1. Virginia Tech Wildlife Professor Helping To Save Florida Panther

    OpenAIRE

    Davis, Lynn

    2003-01-01

    With few Florida panthers now in existence, Mike Vaughan, Virginia Tech professor of wildlife and sciences in the College of Natural Resources, has been appointed to serve on the Florida Panther Scientific Review Team (SRT). Vaughan and other SRT members have made several trips to Naples, Fla., to interview state and federal biologists directly involved with the recovery of the Florida panther.

  2. 7 CFR 915.332 - Florida avocado maturity regulation.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Florida avocado maturity regulation. 915.332 Section... SERVICE (Marketing Agreements and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE AVOCADOS GROWN IN SOUTH FLORIDA Container and Pack Regulations § 915.332 Florida avocado maturity regulation. (a...

  3. 2007 Florida Division of Emergency Management (FDEM) Lidar Project: Southwest Florida

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This Light Detection and Ranging (LiDAR) LAS dataset is a topographic survey conducted for a coalition of GIS practitioners, including the Florida Division of...

  4. Multibeam Mapping of the West Florida Shelf-The Edges, Gulf of Mexico, Appalachicola, Florida.

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — XYZ ASCII format high-resolution bathymetry data generated from the 2010 multibeam sonar survey of the West Florida Shelf-The Edges, Gulf of Mexico, Appalachicola,...

  5. Richard Florida : loovsektor on majanduskasvu mootor / Richard Florida ; interv. Argo Ideon

    Index Scriptorium Estoniae

    Florida, Richard

    2008-01-01

    USA majandus- ja ühiskonnateadlane Richard Florida loovklassi teooriast, selle osast majanduskasvu tagamisel, seosest ühiskonna tolerantsuse ja ühiskonna majandusliku edukuse vahel, sotsiaalse sidususe takistavast rollist loovuse motiveerimisel

  6. Florida Teachers' Attitudes about Teaching Evolution

    Science.gov (United States)

    Fowler, Samantha R.; Meisels, Gerry G.

    2010-01-01

    A survey of Florida teachers reveals many differences in comfort level with teaching evolution according to the state's science teaching standards, general attitudes and beliefs about evolution, and the extent to which teachers are criticized, censured, disparaged, or reprehended for their beliefs about the teaching of evolution.

  7. Forest statistics for South Florida, 1970

    Science.gov (United States)

    Thomas R. Bellamy; Herbert A. Knight

    1970-01-01

    This report highlights the principal findings of the fourth Forest Survey of the timber resource in South Florida. The survey was started in February 1970 and completed in March 1970. Findings of the three previous surveys, completed in 1936, 1949, and 1959, provide the basis for measuring changes that have occurred and trends that have developed over the past 34...

  8. Wildfires and tourist behaviors in Florida

    Science.gov (United States)

    Brijesh Thapa; Ignatius Cahyanto; Stephen M. Holland; James D. Absher

    2013-01-01

    The impacts of wildfires on tourism have largely been examined with emphasis on economic losses and recovery strategies. Given the limited research from a demand perspective, this study examined tourist risk perceptions and reactionary behaviors toward wildfires in Florida. Data (N ¼ 771) was collected among a U.S. sample of non-resident overnight leisure travelers...

  9. South Florida embraces waste-to-energy

    International Nuclear Information System (INIS)

    Lueck, G.W.

    1991-01-01

    This paper reports that some regions have prepared for these days of disposal shortage with comprehensive waste plans that include a strong WTE presence. Witness Broward County, Florida's program, 12 years in planning by public and private entities, Broward is the second most populated county in the state, with 1.3 million residents and a heavy tourist population, which, together, produce 1.6 million tons of waste annually. The disposal program includes Waste Management, Inc.'s expansion of a 400-acre Central Disposal Sanitary Landfill, the county's new 588-acre landfill, composting, and curbside pickup for recyclables. And, this south Florida plan would not be complete without the two brand new combustion plants. Clean Air and Water Acts notwithstanding, the Florida Department of Environmental Regulation can induce standards stricter than the federal government's due to the sensitive South Florida ecology. Wheelabrator was prepared for all eventualities with its design which uses state-of-the-art scrubbers, bag houses, and monitoring to track and capture the trace amounts of lead, cadmium, and mercury, which end up in the ash. In fact, tests at other Wheelabrator facilities using similar technology showed that heavy metals in leachate from the residue showed up in concentrations as much as 200 times lower than the EPA criteria for toxicity

  10. The "Phantom Costs" of Florida's Citrus Industry

    OpenAIRE

    Muraro, Ronald P.; Roka, Fritz M.; Spreen, Thomas H.

    2006-01-01

    Regulatory compliance, the "phantom costs of production," is an increasingly "fact-of-life" for U.S. agriculture. A survey was developed and implemented to enumerate regulatory compliance costs for Florida's 748,500 acres citrus industry. Complying with 61 production related regulations, 643,757 hours were expended at a total annual cost of over $24.3 million.

  11. Sensation™ ‘Florida 127’ Strawberry

    Science.gov (United States)

    Florida127’ strawberry originated from a 2009 cross between Winterstar™ ‘FL 05-107’ (female parent) and unreleased selection FL 02-58 (male parent). It is a short-day genotype adapted to an annual plasticulture growing system. The plant is upright with open architecture, allowing air movement and e...

  12. Recensie "The Great Reset" : Richard Florida

    NARCIS (Netherlands)

    Roy van Dalm

    2010-01-01

    Like the Great Depression and the Long Depression before it, experts have viewed prolonged economic downturns as crises. In The Great Reset , bestselling author Richard Florida argues that we should instead see the recent recession as an opportunity to create entirely new ways of working and living

  13. AECT Convention, Orlando, Florida 2008 Report

    Science.gov (United States)

    Vega, Eddie

    2009-01-01

    This article presents several reports that highlight the events at the 2008 Association for Educational Communications and Technology (AECT) International Convention in Orlando, Florida. At the annual convention this year, the Multimedia Production Division goal was to continue to share information about the latest tools in multimedia production,…

  14. Northeast Florida Regional Sediment Management: Implementation Strategies and Recommendations for Nassau County and Duval County, Florida

    Science.gov (United States)

    2016-03-01

    management strategies and alternatives are actively coordinated. DISCLAIMER: The contents of this report are not to be used for advertising , publication... Strategies and Recommendations for Nassau County and Duval County, Florida Co as ta l a nd H yd ra ul ic s La bo ra to ry Kevin C. Hodgens, Michael...Sediment Management Implementation Strategies and Recommendations for Nassau County and Duval County, Florida Kevin C. Hodgens and Michael P

  15. acceptance rate recipients satisfaction

    OpenAIRE

    Soyka-Hundt, Benjamin

    2015-01-01

    The cancer-related loss of a testicle triggers in about one third of affected patients feelings of insecurity, shame and threat to masculinity. Amazingly, the operational-technical possibility of aesthetic testicles replacement using a silicone prosthesis is not mentioned in any of the current Testicular Cancer Guidelines. So far, there are very few medical opinions on the use of testicular prostheses. In particular, there is little information about how many times a prosthesis is desi...

  16. South African patient's acceptance of generic drugs

    African Journals Online (AJOL)

    mechanism in this regard for final consumers, insurance providers, and ... facilities are viewed as inferior, treated with sus- picion and ... to choose a generic drug if the decision was supported by their doctor ... The effect of brand to generic and ...

  17. American acceptance of nuclear power

    International Nuclear Information System (INIS)

    Barrett, W.

    1980-01-01

    The characteristic adventurous spirit that built American technology will eventually lead to American acceptance of nuclear power unless an overpowering loss of nerve causes us to reject both nuclear technology and world leadership. The acceptance of new technology by society has always been accompanied by activist opposition to industralization. To resolve the debate between environmental and exploitive extremists, we must accept with humility the basic premise that human accomplishment is a finite part of nature

  18. Tacit acceptance of the succession

    Directory of Open Access Journals (Sweden)

    Ioana NICOLAE

    2012-01-01

    Full Text Available This paper examines some essential and contradictory aspects regarding the issue of tacit acceptance of succession in terms of distinction between documents valuing tacit acceptance of succession and other acts that would not justify such a solution. The documents expressly indicated by the legislator as having tacit acceptance value as well as those which do not have such value are presented and their most important legal effects are examined and discussed.

  19. Acceptance of Swedish e-health services

    Directory of Open Access Journals (Sweden)

    Mary-Louise Jung

    2010-11-01

    Full Text Available Mary-Louise Jung1, Karla Loria11Division of Industrial Marketing, e-Commerce and Logistics, Lulea University of Technology, SwedenObjective: To investigate older people’s acceptance of e-health services, in order to identify determinants of, and barriers to, their intention to use e-health.Method: Based on one of the best-established models of technology acceptance, Technology Acceptance Model (TAM, in-depth exploratory interviews with twelve individuals over 45 years of age and of varying backgrounds are conducted.Results: This investigation could find support for the importance of usefulness and perceived ease of use of the e-health service offered as the main determinants of people’s intention to use the service. Additional factors critical to the acceptance of e-health are identified, such as the importance of the compatibility of the services with citizens’ needs and trust in the service provider. Most interviewees expressed positive attitudes towards using e-health and find these services useful, convenient, and easy to use.Conclusion: E-health services are perceived as a good complement to traditional health care service delivery, even among older people. These people, however, need to become aware of the e-health alternatives that are offered to them and the benefits they provide.Keywords: health services, elderly, technology, Internet, TAM, patient acceptance, health-seeking behavior

  20. Bridging the Gap between Social Acceptance and Ethical Acceptability

    NARCIS (Netherlands)

    Taebi, B.

    2016-01-01

    New technology brings great benefits, but it can also create new and significant risks. When evaluating those risks in policymaking, there is a tendency to focus on social acceptance. By solely focusing on social acceptance, we could, however, overlook important ethical aspects of technological

  1. Acceptance of dying: a discourse analysis of palliative care literature.

    Science.gov (United States)

    Zimmermann, Camilla

    2012-07-01

    The subject of death denial in the West has been examined extensively in the sociological literature. However, there has not been a similar examination of its "opposite", the acceptance of death. In this study, I use the qualitative method of discourse analysis to examine the use of the term "acceptance" of dying in the palliative care literature from 1970 to 2001. A Medline search was performed by combining the text words "accept or acceptance" with the subject headings "terminal care or palliative care or hospice care", and restricting the search to English language articles in clinical journals discussing acceptance of death in adults. The 40 articles were coded and analysed using a critical discourse analysis method. This paper focuses on the theme of acceptance as integral to palliative care, which had subthemes of acceptance as a goal of care, personal acceptance of healthcare workers, and acceptance as a facilitator of care. For patients and families, death acceptance is a goal that they can be helped to attain; for palliative care staff, acceptance of dying is a personal quality that is a precondition for effective practice. Acceptance not only facilitates the dying process for the patient and family, but also renders care easier. The analysis investigates the intertextuality of these themes with each other and with previous texts. From a Foucauldian perspective, I suggest that the discourse on acceptance of dying represents a productive power, which disciplines patients through apparent psychological and spiritual gratification, and encourages participation in a certain way to die. Copyright © 2012 Elsevier Ltd. All rights reserved.

  2. Feasibility and acceptability of group music therapy vs wait-list control for treatment of patients with long-term depression (the SYNCHRONY trial): study protocol for a randomised controlled trial.

    Science.gov (United States)

    Carr, Catherine Elizabeth; O'Kelly, Julian; Sandford, Stephen; Priebe, Stefan

    2017-03-29

    Depression is of significant global concern. Despite a range of effective treatment options it is estimated that around one in five diagnosed with an acute depressive episode continue to experience enduring symptoms for more than 2 years. There is evidence for effectiveness of individual music therapy for depression. However, no studies have as yet looked at a group intervention within an NHS context. This study aims to assess the feasibility of conducting a randomised controlled trial of group music therapy for patients with long-term depression (symptom durations of 1 year or longer) within the community. This is a single-centre randomised controlled feasibility trial of group music therapy versus wait-list control with a nested process evaluation. Thirty participants will be randomised with unbalanced allocation (20 to receive the intervention immediately, 10 as wait-list controls). Group music therapy will be offered three times per week in a community centre with a focus on songwriting. Data will be collected post-intervention, 3 and 6 months after the intervention finishes. We will examine the feasibility of recruitment processes including identifying the number of eligible participants, participation and retention rates and the intervention in terms of testing components, measuring adherence and estimation of the likely intervention effect. A nested process evaluation will consist of treatment fidelity analysis, exploratory analysis of process measures and end-of-participation interviews with participants and referring staff. Whilst group music therapy is an option in some community mental health settings, this will be the first study to examine group music therapy for this particular patient group. We will assess symptoms of depression, acceptability of the intervention and quality of life. We anticipate potential challenges in the recruitment and retention of participants. It is unclear whether offering the intervention three times per week will be

  3. High Resolution Forecasts in the Florida Straits: Predicting the Modulations of the Florida Current and Connectivity Around South Florida and Cuba

    Science.gov (United States)

    Kourafalou, V.; Kang, H.; Perlin, N.; Le Henaff, M.; Lamkin, J. T.

    2016-02-01

    Connectivity around the South Florida coastal regions and between South Florida and Cuba are largely influenced by a) local coastal processes and b) circulation in the Florida Straits, which is controlled by the larger scale Florida Current variability. Prediction of the physical connectivity is a necessary component for several activities that require ocean forecasts, such as oil spills, fisheries research, search and rescue. This requires a predictive system that can accommodate the intense coastal to offshore interactions and the linkages to the complex regional circulation. The Florida Straits, South Florida and Florida Keys Hybrid Coordinate Ocean Model is such a regional ocean predictive system, covering a large area over the Florida Straits and the adjacent land areas, representing both coastal and oceanic processes. The real-time ocean forecast system is high resolution ( 900m), embedded in larger scale predictive models. It includes detailed coastal bathymetry, high resolution/high frequency atmospheric forcing and provides 7-day forecasts, updated daily (see: http://coastalmodeling.rsmas.miami.edu/). The unprecedented high resolution and coastal details of this system provide value added on global forecasts through downscaling and allow a variety of applications. Examples will be presented, focusing on the period of a 2015 fisheries cruise around the coastal areas of Cuba, where model predictions helped guide the measurements on biophysical connectivity, under intense variability of the mesoscale eddy field and subsequent Florida Current meandering.

  4. Patients’ acceptance of corticotomy-assisted orthodontics

    Science.gov (United States)

    Zawawi, Khalid H

    2015-01-01

    Objective To study patients’ acceptance of corticotomy-assisted orthodontics as a treatment option. Methods Adult patients seeking orthodontic treatment were asked to complete two sets of questionnaires; the first set included questions about age, sex, and level of education and general questions about orthodontic treatment; and the second set was related to the corticotomy-assisted orthodontics. Before answering the corticotomy questions, a brief description of the clinical procedure was explained and photographs of an actual procedure were shown. Results A total of 150 subjects were approached and 129 (86%) agreed to answer the questionnaires (72 male and 57 female patients). Of these, only 3.1% did hear about corticotomy and 7.8% selected corticotomy instead of extraction. Fear from the surgery (53.2%) was the most frequent reason for not selecting corticotomy followed by fear from pain (36.9%). The acceptance of corticotomy between males and females was similar. No relationship was found between the level of education and prior knowledge of the procedure, P=0.857. Prior knowledge about corticotomy was not a factor in selecting it as a treatment option (P=0.556) to reduce the treatment time (P=0.427). Conclusion The acceptance of corticotomy-assisted orthodontics as a treatment option was low. Fear from the surgery was the main reason for not selecting it. The acceptance of corticotomy-assisted orthodontics was not related to patient’s level of education or sex. PMID:26316719

  5. Cone penetrometer acceptance test report

    Energy Technology Data Exchange (ETDEWEB)

    Boechler, G.N.

    1996-09-19

    This Acceptance Test Report (ATR) documents the results of acceptance test procedure WHC-SD-WM-ATR-151. Included in this report is a summary of the tests, the results and issues, the signature and sign- off ATP pages, and a summarized table of the specification vs. ATP section that satisfied the specification.

  6. Acceptance conditions in automated negotiation

    NARCIS (Netherlands)

    Baarslag, T.; Hindriks, K.V.; Jonker, C.M.

    2011-01-01

    In every negotiation with a deadline, one of the negotiating parties has to accept an offer to avoid a break off. A break off is usually an undesirable outcome for both parties, therefore it is important that a negotiator employs a proficient mechanism to decide under which conditions to accept.

  7. Consumer Acceptance of Novel Foods

    NARCIS (Netherlands)

    Fischer, A.R.H.; Reinders, M.J.

    2016-01-01

    The success of novel foods depends to a considerable extent on whether consumers accept those innovations. This chapter provides an overview of current knowledge relevant to consumer acceptance of innovations in food. A broad range of theories and approaches to assess consumer response to

  8. Worldwide nuclear revival and acceptance

    International Nuclear Information System (INIS)

    Geraets, Luc H.; Crommelynck, Yves A.

    2009-01-01

    The current status and trends of the nuclear revival in Europe and abroad are outlined. The development of public opinion in the last decade is playing an important part. This has turned from clear rejection to careful acceptance. Transparency and open communication will be important aspects in the further development of nuclear acceptance. (orig.)

  9. The assessment of the impact of socio-economic factors in accepting cancer using the Acceptance of Illness Scale (AIS).

    Science.gov (United States)

    Czerw, Aleksandra I; Bilińska, Magdalena; Deptała, Andrzej

    2016-01-01

    The paper presents the results of examining the level of acceptance of the illness in cancer patients using the Acceptance of Illness Scale (AIS). The study involved cancer patients treated at the Central Clinical Hospital of the Ministry the Interior in Warsaw in 2014. The questionnaire comprised basic demographic questions (socio-economic factors) and the AIS test estimating the level of illness acceptance in patients. For the group of patients in the research group, the arithmetic mean amounted to 27.56 points. The period of time that elapsed between the first cancer diagnosis and the start of the study did not influence the score of accepting illness. The acceptance of illness in patients diagnosed with metastases differed from the acceptance of illness by patients diagnosed with metastatic cancer. Females obtained the average of 29.59 in the AIS test, whereas the average in male patients was 26.17. The patients' age did not impact the AIS test. There were no differences in the AIS test results between a group of people with secondary education and a group of people with higher education. There were no differences in the AIS test results between employed individuals versus pensioners. The inhabitants of cities were characterized by the highest degree of acceptance of their health condition. The lowest degree of acceptance of illness was observed in the group with the lowest average incomes. In the group of married individuals the average degree of acceptance of illness amounted to 27.37 points. The average degree of acceptance of illness in patients that declared themselves as single amounted to 25.75. The average degree of acceptance of illness in the study group was 27.56 points, which is a relatively high level of acceptance of cancer. The main socio-economic factor, which influenced the AIS test results was whether metastases were diagnosed or not. There were no differences between patients in groups where the time that elapsed from the first diagnosis of

  10. Solar heating and cooling demonstration project at the Florida solar energy center

    Science.gov (United States)

    1980-01-01

    The retrofitted solar heating and cooling system installed at the Florida Solar Energy Center is described. The system was designed to supply approximately 70 percent of the annual cooling and 100 percent of the heating load. The project provides unique high temperature, nonimaging, nontracking, evacuated tube collectors. The design of the system was kept simple and employs five hydronic loops. They are energy collection, chilled water production, space cooling, space heating and energy rejection. Information is provided on the system's acceptance test results operation, controls, hardware and installation, including detailed drawings.

  11. Hall v. Florida: defining intellectual disability in the shadow of the death penalty.

    Science.gov (United States)

    Appelbaum, Paul S

    2014-10-01

    When the U.S. Supreme Court held that persons with mental retardation (now called intellectual disability) could not be sentenced to death, it left the question of how to define the condition to the states. That issue was raised in Hall v. Florida, which challenged one state's "bright-line rule" barring consideration of defendants with IQs over 70. In an endorsement of the professional consensus, the justices ruled that a more flexible approach that takes into account both intellectual and adaptive functioning is required. The Court's posture may bode well for its acceptance of mental health expertise in future cases.

  12. Acceptability for French People of Physician-Assisted Suicide

    Science.gov (United States)

    Frileux, Stephanie; Sastre, Maria Teresa Munoz; Antonini, Sophie; Mullet, Etienne; Sorum, Paul Clay

    2004-01-01

    Our aim was to understand better how people judge the acceptability of physician-assisted suicide (PAS). We found that, for people in France of all ages and for elderly people with life-threatening illnesses, acceptability is an additive combination of the number of requests for PAS, the patient's age, the amount of physical suffering, and the…

  13. Acceptance of Colonoscopy Requires more than Test Tolerance

    Directory of Open Access Journals (Sweden)

    Amanda Condon

    2008-01-01

    Full Text Available BACKGROUND: Colon cancer screening, including colonoscopy, lags behind other forms of cancer screening for participation rates. The intrinsic nature of the endoscopic procedure may be an important barrier that limits patients from finding this test acceptable and affects willingness to undergo screening. With colon cancer screening programs emerging in Canada, test characteristics and their impact on acceptance warrant consideration.

  14. Artificial reef evaluation capabilities of Florida counties

    OpenAIRE

    Halusky, Joseph G.; Antonini, Gustavo A.; Seaman, William

    1993-01-01

    Florida's coastal county artificial reef sampling and data management programs are surveyed in this report. The survey describes the county level capability for artificial reef documentation and performance assessment based on their needs, interests, organizational structure and "in-situ" data collection and data management techniques. The. primary purpose of this study is to describe what staffing, training, techniques, organizational procedures and equipment are used by the c...

  15. Agkistrodon piscivorus conanti (Florida cottonmouth) Diet

    Science.gov (United States)

    Grajal-Puche, Alejandro; Josimovich, Jillian; Falk, Bryan; Reed, Robert

    2016-01-01

    Agkistrodon piscivorus is a generalist predator that feeds on a variety of prey, including snakes (Gloyd and Conant 1990. Snakes of the Agkistrodon Complex: A Monographic Review. Society for the Study of Amphibians and Reptiles, Oxford, Ohio. 614 pp.; Lillywhite et al. 2002. Herpetol. Rev. 33:259–260; Hill and Beaupre 2008. Copeia 2008:105–114). Cemophora coccinea (Scarletsnake) is not known as one of the 26 species of snakes consumed by A. piscivorus (Ernst and Ernst 2011. Venomous Reptiles of the United States, Canada, and Northern Mexico: Volume 1. Johns Hopkins University Press, Baltimore, Maryland. 193 pp.). On 16 June 2015, at 2210 h, we found a dead-on-road A. piscivorus (total length [TL] = 51.0 cm) in Everglades National Park on Main Park Road, 1.88 km S Pa-hay-okee, Miami-Dade Co., Florida, USA (25.414085°N, 80.78183146°W, WGS84; elev. 3 m). The snake had been killed by a vehicle and some internal organs were exposed. Visible stomach contents included a small (TL ca. 15 cm) C. coccinea. Photographic vouchers of the A. piscivorus (UF-Herpetology 177194) and C. coccinea (UF-Herpetology 177195) were deposited in the Division of Herpetology, Florida Museum of Natural History, University of Florida. Despite the fact that these species are sympatric over large areas of the southeastern United States, this is the first known documented predation of C. coccinea by A. piscivorus.

  16. Operational Actual Wetland Evapotranspiration Estimation for South Florida Using MODIS Imagery

    Directory of Open Access Journals (Sweden)

    Cristobal N. Ceron

    2015-03-01

    Full Text Available Evapotranspiration is a reliable indicator of wetland health. Wetlands are an important and valuable ecosystem on the South Florida landscape. Accurate wetland Actual Evapotranspiration (AET data can be used to evaluate the performance of South Florida’s Everglades restoration programs. However, reliable AET measurements rely on scattered point measurements restricting applications over a larger area. The objective of this study was to validate the ability of the Simplified Surface Energy Balance (SSEB approach and the Simple Method (also called the Abtew Method to provide large area AET estimates for wetland recovery efforts. The study used Moderate Resolution Imaging Spectroradiometer (MODIS sensor spectral data and South Florida Water Management District (SFWMD solar radiation data to derive weekly AET values for South Florida. The SSEB-Simple Method approach provided acceptable results with good agreement with observed values during the critical dry season period, when cloud cover was low (rave (n = 59 = 0.700, pave < 0.0005, but requires further refinement to be viable for yearly estimates because of poor performance during wet season months, mainly because of cloud contamination. The approach can be useful for short-term wetland recovery assessment projects that occur during the dry season and/or long term projects that compare site AET rates from dry season to dry season.

  17. The assessment of the impact of socio-economic factors in accepting cancer using the Acceptance of Illness Scale (AIS

    Directory of Open Access Journals (Sweden)

    Aleksandra I. Czerw

    2015-11-01

    Full Text Available Aim of the study : The paper presents the results of examining the level of acceptance of the illness in cancer patients using the Acceptance of Illness Scale (AIS. Materials and methods: The study involved cancer patients treated at the Central Clinical Hospital of the Ministry the Interior in Warsaw in 2014. The questionnaire comprised basic demographic questions (socio-economic factors and the AIS test estimating the level of illness acceptance in patients. Results : For the group of patients in the research group, the arithmetic mean amounted to 27.56 points. The period of time that elapsed between the first cancer diagnosis and the start of the study did not influence the score of accepting illness. The acceptance of illness in patients diagnosed with metastases differed from the acceptance of illness by patients diagnosed with metastatic cancer. Females obtained the average of 29.59 in the AIS test, whereas the average in male patients was 26.17. The patients’ age did not impact the AIS test. There were no differences in the AIS test results between a group of people with secondary education and a group of people with higher education. There were no differences in the AIS test results between employed individuals versus pensioners. The inhabitants of cities were characterized by the highest degree of acceptance of their health condition. The lowest degree of acceptance of illness was observed in the group with the lowest average incomes. In the group of married individuals the average degree of acceptance of illness amounted to 27.37 points. The average degree of acceptance of illness in patients that declared themselves as single amounted to 25.75. Conclusions : The average degree of acceptance of illness in the study group was 27.56 points, which is a relatively high level of acceptance of cancer. The main socio-economic factor, which influenced the AIS test results was whether metastases were diagnosed or not. There were no

  18. Consumer acceptance of functional foods

    DEFF Research Database (Denmark)

    Frewer, Lynn J.; Scholderer, Joachim; Lambert, Nigel

    2003-01-01

    In the past, it has been assumed that consumers would accept novel foods if there is a concrete and tangible consumer benefit associated with them, which implies that those functional foods would quickly be accepted. However, there is evidence that individuals are likely to differ in the extent...... to which they are likely to buy products with particular functional properties. Various cross-cultural and demographic differences in acceptance found in the literature are reviewed, as well as barriers to dietary change. In conclusion, it is argued that understanding consumer's risk perceptions...

  19. Shoulder dystocia--malpractice or acceptable risk?

    Science.gov (United States)

    Skolbekken, J A

    2000-09-01

    In 1988 a new patient insurance system was introduced in Norway. It was initially described as an 'objectified' system, similar to one based on the no-fault principle. Early doubts were raised about the system's status, as it contains rules stating that compensation will not be given if the medical intervention is adequate and the involved risk is acceptable. This study was undertaken to examine the practice of these rules. An archival study was performed on the 41 shoulder dystocia cases that had been closed in the decade from 1988-1997. These cases were selected as shoulder dystocia was found to be the obstetrical event most often leading to a decision on acceptable risk. The most common injury in these cases was Erb's palsy, but fatalities and brain injuries were also observed. Compensation was given in nine cases, whereas it was denied due to an acceptable medical risk in the remaining cases. Indications of inconsistency among the reached decisions were found, and judged to be a result of differences of opinion between expert witnesses on the adequacy of the obstetrical practice. Doubts are raised as to whether similar decisions are reached in similar cases. Shoulder dystocia may be an acceptable risk in the sense that it is hard to predict and prevent. Whether the consequences of such a risk should be compensated, remains a political and economical issue. Present thinking leads to decisions that create a divide between the lucky unlucky and the plainly unlucky.

  20. Market Acceptance of Smart Growth

    Science.gov (United States)

    This report finds that smart growth developments enjoy market acceptance because of stability in prices over time. Housing resales in smart growth developments often have greater appreciation than their conventional suburban counterparts.

  1. L-286, Acceptance Test Record

    International Nuclear Information System (INIS)

    HARMON, B.C.

    2000-01-01

    This document provides a detailed account of how the acceptance testing was conducted for Project L-286, ''200E Area Sanitary Water Plant Effluent Stream Reduction''. The testing of the L-286 instrumentation system was conducted under the direct supervision

  2. Standards regulations and public acceptance

    International Nuclear Information System (INIS)

    Fernandez, E.C.

    1977-01-01

    Spanish nuclear legislation and the associated procedure for the authorization of installations is summarized. Public acceptance is discussed in the context of the needs for and hazards of nuclear energy. (U.K.)

  3. A kidney offer acceptance decision tool to inform the decision to accept an offer or wait for a better kidney.

    Science.gov (United States)

    Wey, Andrew; Salkowski, Nicholas; Kremers, Walter K; Schaffhausen, Cory R; Kasiske, Bertram L; Israni, Ajay K; Snyder, Jon J

    2018-04-01

    We developed a kidney offer acceptance decision tool to predict the probability of graft survival and patient survival for first-time kidney-alone candidates after an offer is accepted or declined, and we characterized the effect of restricting the donor pool with a maximum acceptable kidney donor profile index (KDPI). For accepted offers, Cox proportional hazards models estimated these probabilities using transplanted kidneys. For declined offers, these probabilities were estimated by considering the experience of similar candidates who declined offers and the probability that declining would lead to these outcomes. We randomly selected 5000 declined offers and estimated these probabilities 3 years post-offer had the offers been accepted or declined. Predicted outcomes for declined offers were well calibrated (offers been accepted, the probabilities of graft survival and patient survival were typically higher. However, these advantages attenuated or disappeared with higher KDPI, candidate priority, and local donor supply. Donor pool restrictions were associated with worse 3-year outcomes, especially for candidates with high allocation priority. The kidney offer acceptance decision tool could inform offer acceptance by characterizing the potential risk-benefit trade-off associated with accepting or declining an offer. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

  4. The Cost of Employment Discrimination against Transgender Residents of Florida

    OpenAIRE

    Brown, Taylor NT; Herman, Jody L

    2015-01-01

    The State of Florida spends more than a half million dollars each year as the result of employment discrimination against transgender residents. Currently, 10 counties and 14 cities in Florida have ordinances prohibiting discrimination based on gender identity in public and private sector employment, but nearly 22,000 transgender adult residents are not covered by these laws. Employment discrimination against transgender adults in Florida costs the state an estimated $570,000 annually in stat...

  5. When is physician assisted suicide or euthanasia acceptable?

    Science.gov (United States)

    Frileux, S; Lelièvre, C; Muñoz Sastre, M T; Mullet, E; Sorum, P C

    2003-12-01

    To discover what factors affect lay people's judgments of the acceptability of physician assisted suicide and euthanasia and how these factors interact. Participants rated the acceptability of either physician assisted suicide or euthanasia for 72 patient vignettes with a five factor design--that is, all combinations of patient's age (three levels); curability of illness (two levels); degree of suffering (two levels); patient's mental status (two levels), and extent of patient's requests for the procedure (three levels). Convenience sample of 66 young adults, 62 middle aged adults, and 66 older adults living in western France. In accordance with the functional theory of cognition of N H Anderson, main effects, and interactions among patient factors and participants' characteristics were investigated by means of both graphs and ANOVA. Patient requests were the most potent determinant of acceptability. Euthanasia was generally less acceptable than physician assisted suicide, but this difference disappeared when requests were repetitive. As their own age increased, participants placed more weight on patient age as a criterion of acceptability. People's judgments concur with legislation to require a repetition of patients' requests for a life ending act. Younger people, who frequently are decision makers for elderly relatives, place less emphasis on patient's age itself than do older people.

  6. Public acceptance of small reactors

    International Nuclear Information System (INIS)

    McDougall, D.S.

    1997-01-01

    The success of any nuclear program requires acceptance by the local public and all levels of government involved in the decision to initiate a reactor program. Public acceptance of a nuclear energy source is a major challenge in successful initiation of a small reactor program. In AECL's experience, public acceptance will not be obtained until the public is convinced that the specific nuclear program is needed, safe and economic and environmental benefit to the community. The title of public acceptance is misleading. The objective of the program is a fully informed public. The program proponent cannot force public acceptance, which is beyond his control. He can, however, ensure that the public is informed. Once information has begun to flow to the public by various means as will be explained later, the proponent is responsible to ensure that the information that is provided by him and by others is accurate. Most importantly, and perhaps most difficult to accomplish, the proponent must develop a consultative process that allows the proponent and the public to agree on actions that are acceptable to the proponent and the community

  7. 2012 Southwest Florida Water Management District (SWFWMD) Lidar: Lake Manatee

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Geographic Information System (GIS). Southwest Florida Water Management District (SWFWMD) regularly uses digital topographic information to support regulatory, land...

  8. Florida Bay: A history of recent ecological changes

    Science.gov (United States)

    Fourqurean, J.W.; Robblee, M.B.

    1999-01-01

    Florida Bay is a unique subtropical estuary at the southern tip of the Florida peninsula. Recent ecological changes (seagrass die-off, algal blooms, increased turbidity) to the Florida Bay ecosystem have focused the attention of the public, commercial interests, scientists, and resource managers on the factors influencing the structure and function of Florida Bay. Restoring Florida Bay to some historic condition is the goal of resource managers, but what is not clear is what an anthropogenically-unaltered Florida Bay would look like. While there is general consensus that human activities have contributed to the changes occurring in the Florida Bay ecosystem, a high degree of natural system variability has made elucidation of the links between human activity and Florida Bay dynamics difficult. Paleoecological analyses, examination of long-term datasets, and directed measurements of aspects of the ecology of Florida Bay all contribute to our understanding of the behavior of the bay, and allow quantification of the magnitude of the recent ecological changes with respect to historical variability of the system.

  9. Identifying suitable sites for Florida panther reintroduction

    Science.gov (United States)

    Thatcher, Cindy A.; van Manen, Frank T.; Clark, Joseph D.

    2006-01-01

    A major objective of the 1995 Florida Panther (Puma concolor cory) Recovery Plan is the establishment of 2 additional panther populations within the historic range. Our goal was to identify prospective sites for Florida panther reintroduction within the historic range based on quantitative landscape assessments. First, we delineated 86 panther home ranges using telemetry data collected from 1981 to 2001 in south Florida to develop a Mahalanobis distance (D2) habitat model, using 4 anthropogenic variables and 3 landscape variables mapped at a 500-m resolution. From that analysis, we identified 9 potential reintroduction sites of sufficient size to support a panther population. We then developed a similar D2 model at a higher spatial resolution to quantify the area of favorable panther habitat at each site. To address potential for the population to expand, we calculated the amount of favorable habitat adjacent to each prospective reintroduction site within a range of dispersal distances of female panthers. We then added those totals to the contiguous patches to estimate the total amount of effective panther habitat at each site. Finally, we developed an expert-assisted model to rank and incorporate potentially important habitat variables that were not appropriate for our empirical analysis (e.g., area of public lands, livestock density). Anthropogenic factors heavily influenced both the landscape and the expert-assisted models. Of the 9 areas we identified, the Okefenokee National Wildlife Refuge, Ozark National Forest, and Felsenthal National Wildlife Refuge regions had the highest combination of effective habitat area and expert opinion scores. Sensitivity analyses indicated that variability among key model parameters did not affect the high ranking of those sites. Those sites should be considered as starting points for the field evaluation of potential reintroduction sites.

  10. Geohydrologic reconnaissance of drainage wells in Florida

    Science.gov (United States)

    Kimrey, J.O.; Fayard, L.D.

    1984-01-01

    Drainage wells are used to inject surface waters directly into an aquifer, or shallow ground waters directly into a deeper aquifer, primarily by gravity. Such wells in Florida may be grouped into two broad types: (1) surface-water injection wells, and (2) interaquifer connector wells. Drainage wells of the first type are further categorized as either Floridan aquifer drainage wells or Biscayne aquifer drainage wells. Floridan aquifer drainage wells are commonly used to supplement drainage for urban areas in karst terranes of central and north Florida. Data are available for 25 wells in the Ocala, Live Oak, and Orlando areas that allow comparison of the quality of water samples from these Floridan aquifer drainage wells with allowable contaminant levels. Comparison indicates that maximum contaminant levels for turbidity, color, and iron, manganese, and lead concentrations are equaled or exceeded in some drainage-well samples, and relatively high counts for coliform bacteria are present in most wells. Biscayne aquifer drainage wells are used locally to dispose of stormwater runoff and other surplus water in southeast Florida, where large numbers of these wells have been permitted in Dade and Broward Counties. The majority of these wells are used to dispose of water from swimming pools or to dispose of heated water from air-conditioning units. The use of Biscayne aquifer drainage wells may have minimal effect on aquifer potability so long as injection of runoff and industrial wates is restricted to zones where chloride concentrations exceed 1,500 milligrams per liter. Interaquifer connector wells are used in the phosphate mining areas of Polk and Hillsborough Counties, to drain mines and recharge the Floridan aquifer. Water-quality data available from 13 connector wells indicate that samples from most of these wells exceed standards values for iron concentration and turbidity. One well yielded a highly mineralized water, and samples from 6 of the other 12 wells exceed

  11. Mitigating the impacts of ASHRAE Standard 62-1989 on Florida schools

    Energy Technology Data Exchange (ETDEWEB)

    Davanagere, B.S.; Shirey, D.B. III [Florida Solar Energy Center, Cocoa, FL (United States); Rengarajan, K. [AJT and Associates, Inc., Cape Canaveral, FL (United States); Colacino, F. [Florida Power and Light, Miami, FL (United States)

    1997-12-31

    The impacts of ASHRAE Standard 62-1989 on a typical Florida elementary school were studied by performing annual building energy simulations using computer software. A single prototypical school was modeled for three cities: Miami, Orlando, and Jacksonville. The performance of a conventional heating, ventilating, and air-conditioning (HVAC) system and several alternative technologies was investigated to assess their ability to mitigate the impacts of ASHRAE Standard 62-1989 while maintaining acceptable indoor humidity levels. In addition, the installed first costs and life-cycle costs for all HVAC systems investigated were estimated and compared to identify cost-effective options. The results of this simulation study clearly indicate that the conventional HVAC system will have problems maintaining proper indoor humidity levels in Florida schools with ventilation rates prescribed by ASHRAE Standard 62-1989. Dedicated conditioning of outdoor ventilation air with alternative technologies would provide better humidity control in the occupied zones. Several of the alternative systems would also reduce the impacts of increased ventilation on equipment capacity, operating costs, and peak electric demand compared to the conventional system. All of the alternative HVAC systems studied are commercially available, and this study presents their performance in terms of ability to maintain acceptable indoor humility levels and life-cycle costs.

  12. Characteristic community structure of Florida's subtropical wetlands: the Florida wetland condition index

    Science.gov (United States)

    Depending upon the classification scheme applied, there are between 10 and 45 different wetland types in Florida. Land use and land cover change has a marked effect on wetland condition, and different wetland types are affected differentially depending on many abiotic and biotic ...

  13. Ecological characterization of the lower Everglades, Florida Bay, and the Florida Keys

    Energy Technology Data Exchange (ETDEWEB)

    Schomer, N.S.; Drew, R.D.

    1982-09-01

    A conceptual model of the study area identifies four major ecological zones: (1) terrestrial and freshwater wetlands, (2) estuarine and saltwater wetlands, (3) Florida Bay and mangrove islands, and (4) the Florida Keys. These zones are delineated by differences in basic physical-chemical background factors which in turn promote characteristic ecological communities. The terrestrial and freshwater wetlands support pinelands, sawgrass marshes, wet prairies, sloughs and occasional tree islands. The estuarine and saltwater wetlands support mangrove forests, salt marshes and oscillating salinity systems. Florida Bay exhibits oscillating meso- to hypersaline waters over grassbeds on marine lime mud sediments surrounding deeper lake areas. The exposed tips of the mud banks frequently support mangrove or salt prairie vegetation. The Florida Keys support almost all of the above communities to some small degree but are characterized by extensive offshore coral reefs. The productivity of these communities with regard to fish and wildlife reflects (1) the diversity and type of habitats available to species that are potentially capable of exploiting them, (2) the degree of alteration of these habitats by man and natural forces, and (3) historical, biogeographic and random factors that restrict organisms to specific environments or prohibit them from exploiting a potential habitat.

  14. California avocados in Florida? Finding the perfect avocado for production in East-Central Florida

    Science.gov (United States)

    Avocado (Persea americana Mill.) is a high-value fruit where most U.S. consumption is supplied using imported product. Cultivars with good fruit quality and horticultural traits may provide a useful alternative crop in east-central Florida and possibly in other locations throughout the state. A port...

  15. Supplying Community College Needs in Basic Speech Courses at Florida Junior College at Jacksonville, Florida.

    Science.gov (United States)

    Griggs, Dorothy Feldbinder; Shannon, Mary Louise

    At Florida Junior College at Jacksonville, public speaking instructors employ Jerome S. Bruner's four factors of learning--predisposition to learn, structure of knowledge, sequence, and reinforcement--to plan an effective learning program for students with diverse academic backgrounds and goals. Specifically, six learning units, tailored to both…

  16. Community Resources Guide for Central Florida = Una Guia de Recursos en la Comunidad de Florida Central.

    Science.gov (United States)

    Medina, Linda, Comp.

    Designed to orient Hispanic refugees to the services that are available in Central Florida, this bilingual guide consists of a section of general information on living and working in the United States and a section devoted to various public and private agencies. Provided first are addresses and phone numbers of various government agencies:…

  17. Enfermedades del Aguacate en La Florida

    Directory of Open Access Journals (Sweden)

    Stevens H. E.

    1942-04-01

    Full Text Available El aguacate cultivado bajo las condiciones ambienciales de La Florida, está sujeto a ser atacado por varias enfermedades parasitarias. Algunas de estas son de menor importancia y no requieren métodos de represión especiales; otras al contrario son más severas y requieren atención cada año; y otras además están sujetas a las condiciones climatológicas, y su intensidad dependerá principalmente de las condiciones meteorológicas durante algunos períodos críticos en el crecimiento del árbol.

  18. Rapid weather information dissemination in Florida

    Science.gov (United States)

    Martsolf, J. D.; Heinemann, P. H.; Gerber, J. F.; Crosby, F. L.; Smith, D. L.

    1984-01-01

    The development of the Florida Agricultural Services and Technology (FAST) plan to provide ports for users to call for weather information is described. FAST is based on the Satellite Frost Forecast System, which makes a broad base of weather data available to its users. The methods used for acquisition and dissemination of data from various networks under the FAST plan are examined. The system provides color coded IR or thermal maps, precipitation maps, and textural forecast information. A diagram of the system is provided.

  19. Population biology of the Florida manatee

    Science.gov (United States)

    O'Shea, Thomas J.; Ackerman, Bruce B.; Percival, H. Franklin

    1995-01-01

    The Florida manatee (Trichechus manatus latirostris) is a unique element of the U.S. fauna. It is a distinct subspecies of the West Indian manatee (Domning and Hayek 1986) and one of the largest inshore mammals of the continent, reaching weights to 1,650 kg (Rathbun et al. 1990). Annual migratory circuits of some individuals through the intracoastal waterways of the Atlantic Coast are 1,700 km round trips at seasonal travel rates as high as 50km/day (*3 Reid and O'Shea 1989; Reid et al. 1991), resulting in one of the longest remaining intact mammalian migrations in the eastern United States.

  20. Management case study: Tampa Bay, Florida

    Science.gov (United States)

    Morrison, G.; Greening, H.S.; Yates, K.K.

    2012-01-01

    Tampa Bay, Florida,USA, is a shallow,subtropical estuary that experienced severe cultural eutrophication between the 1940s and 1980s, a period when the human population of its watershed quadrupled. In response, citizen action led to the formation of a public- and private-sector partnership (the Tampa Bay Estuary Program), which adopted a number of management objectives to support the restoration and protection of the bay’s living resources. These included numeric chlorophyll a and water-clarity targets, as well as long-term goals addressing the spatial extent of sea grasses and other selected habitat types, to support estuarine-dependent faunal guilds.

  1. Physical Characterization of Florida International University Simulants

    Energy Technology Data Exchange (ETDEWEB)

    HANSEN, ERICHK.

    2004-08-19

    Florida International University shipped Laponite, clay (bentonite and kaolin blend), and Quality Assurance Requirements Document AZ-101 simulants to the Savannah River Technology Center for physical characterization and to report the results. The objectives of the task were to measure the physical properties of the fluids provided by FIU and to report the results. The physical properties were measured using the approved River Protection Project Waste Treatment Plant characterization procedure [Ref. 1]. This task was conducted in response to the work outlined in CCN066794 [Ref. 2], authored by Gary Smith and William Graves of RPP-WTP.

  2. Florida hospital saves 5.3 M dollars by adopting principles of lean manufacturing.

    Science.gov (United States)

    2005-01-01

    Florida hospital saves 5.3M dollars by adopting principles of lean manufacturing. Surgery cancellations have been slashed from 13% of cases to less than 3%, while emergency department admissions have increased by 20%. Those are just two of the results of a quality improvement project at Lee Memorial Health System in Fort Myers, FL, that focused on using the principles of lean manufacturing to improve patient flow in the five-hospital system

  3. Nuclear Energy and Public Acceptance

    International Nuclear Information System (INIS)

    Daifuku, K.

    2002-01-01

    The continued use of nuclear power in the European Union and elsewhere requires an adequate level of public and political acceptance. A lack of acceptance is often mistakenly cited as a reason for the slowdown in nuclear power plant construction in Western Europe and as a justification for abandoning nuclear power. In fact, the reasons for the slowdown have more to do with the following two factors: Plentiful supplies of low-priced natural gas, making gas-fired power plants a more attractive investment choice; more than adequate supplies of electricity which have curbed the need for the construction of new plant of any kind. In general, moves towards a withdrawal from nuclear in certain Community countries have been due to party political pressures and have not been a response to public opposition to nuclear. In addition, opinion polls do not show widespread public opposition to the use of nuclear power. Figures consistently indicate that the use of nuclear power does not come high on the list of most people's main worries. Their main concerns focus on other issues such as crime and financial problems. In the main, electricity is taken for granted in the industrialised world. Electric power only becomes an issue when there is a threat of shortages. So if public acceptance is not the main obstacle, what is? Political acceptance is an integral part of the process in which nuclear becomes acceptable or not. The relationship between public and political acceptance and the role of the industry in this context, on how to foster a better trialogue, will be examined. (author)

  4. Text recycling: acceptable or misconduct?

    Science.gov (United States)

    Harriman, Stephanie; Patel, Jigisha

    2014-08-16

    Text recycling, also referred to as self-plagiarism, is the reproduction of an author's own text from a previous publication in a new publication. Opinions on the acceptability of this practice vary, with some viewing it as acceptable and efficient, and others as misleading and unacceptable. In light of the lack of consensus, journal editors often have difficulty deciding how to act upon the discovery of text recycling. In response to these difficulties, we have created a set of guidelines for journal editors on how to deal with text recycling. In this editorial, we discuss some of the challenges of developing these guidelines, and how authors can avoid undisclosed text recycling.

  5. Toward an acceptable nuclear future

    International Nuclear Information System (INIS)

    Weinberg, A.M.

    1977-11-01

    The nuclear option is in danger of being foreclosed. The trend toward antinuclearism may be reversed if concerns about low-level radiation insult can be shown ultimately to be without foundation; evidence for this speculation is presented. Nevertheless it is suggested that the nuclear enterprise itself must propose new initiatives to increase the acceptability of nuclear energy. A key element of an acceptable nuclear future is cluster siting of reactors. This siting plan might be achieved by confining new reactors essentially to existing sites

  6. Florida intercity high speed rail passenger service

    Energy Technology Data Exchange (ETDEWEB)

    Najafi, F.T.; Watford, S.; Moore, G.; Des, A. [Florida Univ., Gainesville, FL (United States). Dept. of Civil Engineering

    1997-10-01

    Plans for a new high-speed rail (HSR) transportation system in Florida were reviewed. HSR is believed to be the least expensive, most energy-efficient and least environmentally harmful alternative to air and highway travel. The system in Florida will be used as a case study to determine its overall impact on the environment, people and economy. The 300-plus mile system will move travelers at speeds of over 200 mph between Miami, Orlando, and Tampa. The study will identify the impacts of a HSR system on existing transportation networks, environment, energy, growth and growth distribution, safety, economy, travel time, and tourism. Transportation problems and the innovative mechanisms needed to realize the joint public and private venture approach to planning, locating, permitting, managing, financing, constructing and maintaining an inter-regional HSR line for the state were studied. The all-electric train would greatly help the environment in two ways: (1) zero emissions from the train itself, and (2) the reduction of trips by automobile and aircraft would reduce the amount of fuel and energy being used. 4 refs., 1 fig.

  7. 7 CFR 1006.2 - Florida marketing area.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Florida marketing area. 1006.2 Section 1006.2 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Milk), DEPARTMENT OF AGRICULTURE MILK IN THE FLORIDA MARKETING AREA Order Regulating...

  8. CHARACTERISTICS OF FLORIDA FILL MATERIALS AND SOILS 1990

    Science.gov (United States)

    The report gives results of laboratory work by the University of Florida in support of the Foundation Fill Data Base project of the Foundation Fill Materials Specifications Task Area of the Florida Radon Research Program (FRRP). Work included determination of radon concentrations...

  9. Competency-Based Materials for the Florida Automotive Mechanics Curriculum

    Science.gov (United States)

    Goodson, Ludy; And Others

    1978-01-01

    Describes Florida's new automotive mechanics curriculum, an individualized, self-paced learning sequence that combines text material, review exercises and actual work activities. Development of the materials, including incorporation of Florida's V-TECS catalog of performance objectives in auto mechanics, is described. A field-test experience of a…

  10. Revisiting the Decision of Death in Hurst v. Florida.

    Science.gov (United States)

    Cooke, Brian K; Ginory, Almari; Zedalis, Jennifer

    2016-12-01

    The United States Supreme Court has considered the question of whether a judge or a jury must make the findings necessary to support imposition of the death penalty in several notable cases, including Spaziano v. Florida (1984), Hildwin v. Florida (1989), and Ring v. Arizona (2002). In 2016, the U.S. Supreme Court revisited the subject in Hurst v. Florida Florida Statute § 921.141 allows the judge, after weighing aggravating and mitigating circumstances, to enter a sentence of life imprisonment or death. Before Hurst, Florida's bifurcated sentencing proceedings included an advisory sentence from jurors and a separate judicial hearing without juror involvement. In Hurst, the Court revisited the question of whether Florida's capital sentencing scheme violates the Sixth Amendment, which requires a jury, not a judge, to find each fact necessary to impose a sentence of death in light of Ring In an eight-to-one decision, the Court reversed the judgment of the Florida Supreme Court, holding that the Sixth Amendment requires a jury to find the aggravating factors necessary for imposing the death penalty. The role of Florida juries in capital sentencing proceedings was thereby elevated from advisory to determinative. We examine the Court's decision and offer commentary regarding this shift from judge to jury in the final imposition of the death penalty and the overall effect of this landmark case. © 2016 American Academy of Psychiatry and the Law.

  11. Avocado pests in Florida: Not what you expected

    Science.gov (United States)

    Avocado, Persea americana Mill., is Florida's second most important fruit crop after citrus. Until recently, the complex of spider mite and insect pests that affected avocado in south Florida was under a 20 year Integrated Pest Management (IPM) program. The recent invasion of avocado orchards by a...

  12. Financial Management: Cash Management Practices in Florida Community Colleges.

    Science.gov (United States)

    Spiwak, Rand S.

    A study was conducted to identify those variables appearing to affect cash management practices in Florida community colleges, and recommend prescriptive measures concerning these practices. The study methodology included informal discussions with the chief fiscal officers of each Florida community college and appropriate state board staff,…

  13. 2013 SYR Accepted Poster Abstracts.

    Science.gov (United States)

    2013-01-01

    Promote Health and Well-being Among Middle School Educators. 20. A Systematic Review of Yoga-based Interventions for Objective and Subjective Balance Measures. 21. Disparities in Yoga Use: A Multivariate Analysis of 2007 National Health Interview Survey Data. 22. Implementing Yoga Therapy Adapted for Older Veterans Who Are Cancer Survivors. 23. Randomized, Controlled Trial of Yoga for Women With Major Depressive Disorder: Decreased Ruminations as Potential Mechanism for Effects on Depression? 24. Yoga Beyond the Metropolis: A Yoga Telehealth Program for Veterans. 25. Yoga Practice Frequency, Relationship Maintenance Behaviors, and the Potential Mediating Role of Relationally Interdependent Cognition. 26. Effects of Medical Yoga in Quality of Life, Blood Pressure, and Heart Rate in Patients With Paroxysmal Atrial Fibrillation. 27. Yoga During School May Promote Emotion Regulation Capacity in Adolescents: A Group Randomized, Controlled Study. 28. Integrated Yoga Therapy in a Single Session as a Stress Management Technique in Comparison With Other Techniques. 29. Effects of a Classroom-based Yoga Intervention on Stress and Attention in Second and Third Grade Students. 30. Improving Memory, Attention, and Executive Function in Older Adults with Yoga Therapy. 31. Reasons for Starting and Continuing Yoga. 32. Yoga and Stress Management May Buffer Against Sexual Risk-Taking Behavior Increases in College Freshmen. 33. Whole-systems Ayurveda and Yoga Therapy for Obesity: Outcomes of a Pilot Study. 34. Women�s Phenomenological Experiences of Exercise, Breathing, and the Body During Yoga for Smoking Cessation Treatment. 35. Mindfulness as a Tool for Trauma Recovery: Examination of a Gender-responsive Trauma-informed Integrative Mindfulness Program for Female Inmates. 36. Yoga After Stroke Leads to Multiple Physical Improvements. 37. Tele-Yoga in Patients With Chronic Obstructive Pulmonary Disease and Heart Failure: A Mixed-methods Study of Feasibility, Acceptability, and Safety

  14. Key acceptability attributes of orodispersible films.

    Science.gov (United States)

    Scarpa, Mariagiovanna; Paudel, Amrit; Kloprogge, Frank; Hsiao, Wen Kai; Bresciani, Massimo; Gaisford, Simon; Orlu, Mine

    2018-04-01

    The features rendering orodispersible films (ODFs) patient-centric formulations are widely discussed in the scientific literature. However there is a lack of research studies exploring ODF characteristics with a potential impact on end-user acceptability. The aim of this study was to identify the key ODF characteristics affecting end-user acceptability by developing in vitro test methods for the prediction of ODFs acceptability and correlate these formulation characteristics with the data obtained from a human panel study. Four drug-free single-polymer films were prepared by solvent casting. Solutions of poly(vinyl) alcohol (PVOH) 39 KDa (P1), PVOH 197 KDa (P2), carboxymethylcellulose (CMC) 395 KDa (C1), and CMC 725 KDa (C2) were prepared. Texture analysis and Dynamic Mechanical Analysis (DMA) were used to assess film tack. Petri dish and drop methods were used to assess disintegration time. A human panel of 24 healthy young adults was employed to identify end-user acceptability criteria of the four study film samples. Texture analysis data of ODF tack were not found to be in agreement with the in vivo perceived stickiness in the mouth. However, measurement of the area under the adhesive force curve obtained by DMA correlated with in vivo perceived stickiness data for all samples. The disintegration times obtained by drop method were more comparable to human panel data than the petri dish method. Hence DMA and drop methods proved t