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en P4 and the synthetic progestins, resulting in different safety profiles when they are used during the menstrual cycle, in early and late pregnancy and in the alleviation of peri- or postmenopausal symptoms.

Changes in visual attention have been argued to influence freezing of gait (FOG) in people with Parkinson's Disease (PD). However, the specific visual search patterns of people with FOG pathology (PD + FOG) and potential underlying mechanisms are not well understood. The current study explored visual search behavior in PD + FOG while walking on a pathway featuring environmental features known to exacerbate FOG (e.g., narrow doorway and tripping hazards). Potential underpinning attentional mechanisms were also assessed, such as conscious movement processing.

Visual search behavior of twelve people with PD + FOG tested in ON-state (M

= 74.3) and twelve age-matched healthy controls (M

= 72.5) were analyzed during a complex walking task. The task required participants to step over an obstacle and navigate through a narrow doorway, surrounded by clutter.

People with PD + FOG more frequently directed visual attention to ongoing and imminent steps compared to healthy controls (Mdn = 26% vs Mdn = 14%, respeded to do this, thereby provoke freezing episodes.Health professionals working in services providing genetic counseling need objective instruments to assess genetic counseling outcomes and also to "give a voice" to those using these services. Lack of knowledge regarding such outcomes may directly impact the effectiveness and the potential benefits of counseling, quality of life, health promotion, and empowerment of those receiving counseling. There are very few instruments available for most countries, however there are none in Brazil. In this context, this study aimed to adapt and preliminarily validate the Genetic Counseling Outcome Scale (GCOS-24), a Patient-Reported Outcome Measure (PROM), originally developed in British English. This methodological study recruited 278 individuals attending a medical genetic service at a Brazilian university hospital. We performed the translation, back-translation, semantic validation, pilot study and field study for testing of some psychometric properties. The instrument's internal consistency and test-retest reliability (stability) were assessed using Cronbach's alpha coefficient and Intraclass Correlation Coefficient, respectively. The Brazilian version of the GCOS-24 presented face and content validity, satisfactory internal consistency (Cronbach's α = 0.71), and moderate stability (ICC = 0.52). It was considered reliable, easily understood and relevant to assessing the genetic counseling outcomes for the study participants. Its construct validity still needs to be assessed to verify the instrument's internal structure and its potential use to measure change in empowerment following genetic counseling provided by Brazilian clinical genetics services.

To explore the perceived quality of care transitions from hospital to the home with referral to subsequent rehabilitation in the home, and factors associated with low perceived quality, in people with stroke.

Observational study.

Eligible were patients with a suspected acute stroke admitted to 1 of 4 inpatient hospital units in the Stockholm region and discharged home with referral to a neurorehabilitation team in primary care.

Data on perceived quality of care transition was collected with the Care Transition Measure (CTM-15) 1week after discharge. Additional data were mainly retrieved from medical records. To analyze difference in mean total score of the CTM-15 between participants' characteristics, length of hospital stay, disease-related data, and functioning, the Mann-Whitney U test and independent sample t test were used for dichotomized variables and 1-way analysis of variance and the Tukey post hoc test for variables with more than 2 groups. To analyze differences between participants with lowlf-management postdischarge should be enhanced in the referral-based care transition after stroke. selleck products Special attention should be given to people with severe stroke.

The Preferences Assessment Tool (PAT) in the Minimum Data Set (MDS) 3.0 assesses 16 resident preferences for daily routines and activities. Although integrating important preferences into care planning is essential to provide person-centered care in nursing homes (NHs), preferences rated as important but unmet or unimportant may not receive much attention. This study aims to (1) identify the prevalence of unmet preferences and unimportant preferences, and (2) examine their associations with resident and facility-level characteristics.

This is a longitudinal study of residents in NHs.

We used data from 2012-2017 MDS assessments of long-stay residents aged 65 or older in 295 Minnesota NHs. In total, 51,859 assessments from 25,668 residents were included.

Generalized linear mixed models were used to analyze resident and facility-level characteristics associated with having any unmet preferences, and with the number of unimportant preferences.

Across all years for both daily routine preferences and actit. It is important for staff to elicit preferences that truly matter for residents, and to enable residents to meet their preferences.Despite the high prevalence and devastating outcomes associated with osteoporotic fractures, they are not well investigated or treated. We developed an electronic Osteoporosis and Falls Assessment Form for integration within electronic medical records (EMR) with the aim to improve osteoporosis-related care in family practice. We examined usage and collected usability feedback from 37 physicians. A medical record review was used to assess tool usage over a 6-month period after which all participants completed a survey to assess their perceptions of the tool. The tool was used at least once by 22 (59%) physicians with 119 patients. Most users reported that it enhanced their practice (64%) and they intended to use it in the future (71%). Time constraints, complexity, and requirements to manually enter sections were identified as barriers to use. Lessons learned will inform improvements, which, given the perceived value of this tool, will likely improve uptake.