Caregivers Of Patients Research Articles

Detecting functional impairment with the Digital Clock and Recall.

Distinguishing between mild cognitive impairment (MCI) and early dementia requires both neuropsychological and functional assessment that often relies on caregivers' insights. Contacting a patient's caregiver can be time-consuming in a physician's already-filled workday. To assess the utility of a brief, machine learning (ML)-enabled digital cognitive assessment, the Digital Clock and Recall (DCR), for detecting functional dependence. We evaluated whether the DCR can help identify individuals at risk of functional deficits as measured by the informant-rated Functional Activities Questionnaire (FAQ) in older individuals including cognitively unimpaired, MCI, and dementia likely due to Alzheimer's disease. The DCR scaled well with FAQ scores, and ML classifiers trained on multimodal DCR features demonstrated strong performance in predicting functional impairment on a held-out test set. Differences in FAQ scores between DCR-predicted classes were comparable across key demographic groups. The DCR can streamline the clinical decision-making, triage, and intervention planning associated with functional impairment in primary care.

Facilitated Advance Care Planning Interventions: A Narrative Review.

Introduction: Multiple interventions have been designed to employ facilitators to address gaps in Advance Care Planning (ACP). Objective: To collect and review available evidence related to facilitated ACP interventions. Methods/Design: Narrative review using a previously described framework for scoping reviews. We searched PubMed using structured criteria and report synthesized themes detailing the design, target populations, methods, and outcome measurements for interventions in which a facilitator-who may or may not be clinical staff-engaged a patient and/or a patient's caregiver in some part of the ACP process. Results: Of 1492 articles discovered on our search, 28 met the inclusion criteria. Twelve (42.9%) studies utilized a nurse facilitator, two (7.1%) utilized trained social workers, and one (3.6%) embedded multiple facilitators. The remaining 13 (46.4%) utilized facilitators from other various professional and community backgrounds, such as lay navigators, care coordinators, and peer mentors. Twenty-five (89.2%) studies included patients with serious or chronic illness, at the end-of-life, or having a high risk of need for medical care. Four (14.3%) articles focused on marginalized populations. Intervention settings varied notably across studies. Eighteen (64.3%) integrated interventions into existing clinical workflows. Primary outcomes were measured in one of three ways: documentation in the Electronic Health Record (EHR) (25.0%); questionnaires, scales, patient reports, or non-EHR documentation (64.3%); or multiple measures (10.7%). Twenty-three (82.1%) of the studies were determined a success by study authors. Conclusion: We identified a variety of key characteristics that can be modified to target facilitated ACP interventions towards gaps in current applications of ACP.

An evaluation of frontal syndrome 20 years after traumatic injury to the frontal lobes of the right and left cerebral hemispheres

Traumatic brain injury (TBI), particularly damage to the frontal lobes, often produces a specific configuration of behavioral and personality changes known as frontal syndrome. Recent data, however, indicate that patients, depending on whether the damage has occurred in the left or right hemisphere of the brain, manifest one of two profiles of this syndrome in which negative or positive behavioral disturbances predominate. The purpose of this study was to evaluate the differences in frontal syndrome profiles present in patients 20 years after injury to the frontal lobes of the right and left hemispheres.The study included a total of 360 patients with brain injury confirmed by neuroimaging studies, rehabilitated at the Reintegration and Training Center of the Polish Neuropsychological Society. The subjects were matched by age and gender into 2 experimental groups: Group A, included 180 patients (including 90 men and 90 women) with post-traumatic frontal lobe damage in the left hemisphere of the brain, and Group B, which included 180 patients (including 90 men and 90 women) with post-traumatic frontal lobe damage in the right hemisphere of the brain. The study employed documentation analysis, clinical interview and the Frontal Syndrome Behavior Questionnaire (FBInv). In accordance with the guidelines of this questionnaire, assessments were made based on an interview with the patient's caregiver in the absence of the patient. The study was conducted twice: two years (baseline) and about 20 years (follow up) after the brain injury.It was found that thepatients with left frontal lobe damage were characterised by significantly higher levels of so-called negative behavioural disorders overall and in the dimensions of apathy, passivity, indifference, concreteness, disorganisation, logopenia, apraxia of speech and perseveration, as well as significantly lower levels of loss of insight. While the patients with right frontal lobe damage were characterised by significantly higher levels of so-called positive conduct disorder overall and in the dimensions of hypersensitivity and irritability, excessive cheerfulness, unreasonable behaviour, inappropriateness and an absence of polite behaviour, aggressiveness, hyper-orality, hyper-sexuality, compulsivity, urinary and faecal incontinence and alien handedness. In addition, it should be noted that most of the recorded effects were found to be strong (η2> 0.14). The results indicated that 20 years after the brain injury, in terms of positive behavioural disorders overall, the group of patients with right frontal lobe damage showed a stronger decrease in disorders (η2= 0.64) over time when compared to patients with left frontal lobe damage (η2= 0.14).We found that in the patients 20 years after post-traumatic damage to the frontal lobes is still manifesting frontal syndrome, however its profile is dependent on whether the damage occurred in the left frontal lobe or the right frontal lobe. The Frontal Syndrome Behavior Questionnaire can be used in the differential diagnosis of frontal syndrome after damage to the frontal lobes of the right and left hemispheres of the brain.

Secure IoT Assistant-Based System For Alzheimer’s Disease

Alzheimer's disease is a neurological condition that gradually impairs a person's capacity for thought and memory. Gradually, it gets worse until it becomes a major hindrance to the way the person with the illness lives and functions in the world. The purpose of this research is to create a prototype for mild to moderate AD that provides safe information transmission and support services, allowing a family member to investigate it and safeguard the AD patient. The wearable prototype can distinguish between family and non-family members in recognized images and give a vocal communication with the individual's name. Additionally, the prototype makes it possible to track the AD person's location. The prototype makes their daily lives easier. Thus far, the prototype follows the individual with AD around and notifies caregivers of their whereabouts so that, if the patient leaves the house, they can securely return them home. Additionally, by detecting dampness, this prototype informs the patient's caregiver of their excrement. So, the prototype will help the patient in their daily life very efficiently.

Adapted physical activity as part of the pre-habilitation program

Adapted physical activity (APA) is one of the pillars of prehabilitation. The creation and personalization of an APA program is based on an assessment carried out by the APA teacher, who identifies the patient's obstacles and levers. The aim of this personalized program assessment is to support the person being cared for in adopting a more active and less sedentary lifestyle, and to ensure that these changes have a positive impact on their health. Relying on resources in the city and on the patient's caregivers are all ways of reinforcing the patient's adherence to APA.

Is it too early to recommend local treatment in oligometastatic non-small cell lung cancer: a plea for equipoise.

Oligometastatic non-small cell lung cancer (OMD NSCLC) has been proposed to bridge the spectrum between non-metastatic and widely metastatic states and is perceived as an opportunity for potential cure if removed. Twelve clinical trials on local treatment have been reported, yet none are conclusive. These trials informed the development of a joint clinical practice guideline by the American & European Societies for Radiation Oncology, which endorses local treatment for OMD NSCLC. However, the heterogeneity between prognostic factors within these trials likely influenced outcomes and can only support guidance at this time. Caution against an uncritical acceptance of the guideline is discussed, as strong recommendations are offered based on expert opinion and inconclusive evidence. The guideline is also examined by a patient's caregiver, who emphasizes that uncertain evidence impedes shared decision making.

Influence of demographic factors on prolonged length of stay in an emergency department.

A prolonged length of stay in an emergency department is related to lower quality of care and adverse outcomes, which are often linked with overcrowding. Examine the influence of demographic factors on prolonged length of stay in the emergency department. This study used a cross-sectional design. It used secondary data for all patients admitted during the specific duration at the emergency department of a governmental hospital in Saudi Arabia. The independent variables were gender, age, disposition status, shift time, and clinical acuity (CTAS) level while the dependent variable was prolonged length of stay. The study shows that 30% of patients stay at the emergency department for four hours or more. The results also show a significant association between demographic factors which are age, gender, disposition status, shift time, clinical acuity (CTAS) level and prolonged length of stay in an emergency department. Based on the results males are more likely to stay in the emergency department than females (OR = 1.20; 95% CI = 1.04 to 1.38). Patients aged 60 and older are less likely to stay in the emergency department than patients aged 29 or smaller (OR = 0.58; 95% CI = 0.39 to 0.84). According to disposition status discharged patients after examination stays in the emergency department more than admitted patients after the examination (OR = 2.78; 95% CI = 1.67 to 4.99). Patients who come to the night shift are less likely to stay in the emergency department than patients who come in the morning shift (OR = 0.67; 95% CI = 0.56 to 0.81). Patients who are classified in level three of CTAS are less likely to stay in the emergency department than patients who are classified in level one (OR = 0.28; 95% CI = 0.88 to 0.023). Demographic factors such as age, gender, shift time, disposition status and clinical acuity (CTAS) were important factors that needed to be considered to reduce the length of stay of patients in the emergency department. it is possible to formulate a machine learning model to predict the anticipated length of stay in the hospital for each patient. This prediction with an accepted margin of uncertainty will help the clinicians to communicate the evidence-based anticipated length of stay with the patient's caregivers. In addition, hospital managers need to provide the emergency department with enough staff and materials to reduce the length of stay of patients.

An assessment of treatment compliance using the Morisky scale-8 tool in adult hypertensive patients of Eastern India.

Adequate management of hypertension is crucial for decreasing the likelihood of cardiovascular ailments and associated complications. Nonetheless, in the Indian context, maintaining compliance with prescribed hypertensive therapies presents a notable hurdle, impeding the attainment of favorable health outcomes. Thus, this study was conducted with the aim to evaluate the prevalence of treatment adherence and explore the diverse factors that impact adherence patterns among individuals diagnosed with hypertension. A community-based cross-sectional questionnaire-based study was carried out among the diagnosed hypertensive patients from 12 purposefully selected villages of Khagaul block, Patna. A total of 262 participants were recruited in the study by using non-probability sampling. The 8-item Morisky Medication Adherence Scale (MMAS-8) was used for measuring adherence. The Statistical Package for the Social Sciences (SPSS) for Windows version 21.0 (SPSS Inc; Chicago, IL, USA) was used for statistical analysis of data. As per MMAS scores, 10 (3.8%) had high, 133 (50.8%) moderate, and 119 (45.4%) poor adherence. However, good adherence was reported among geriatric patients [1.65 (1.01-2.7)], those with a history of absence of comorbidities [2.15 (1.21-3.85)], more than 5 years' duration of hypertension [3.2 (1.89-5.41)], once-a-day drug intake [2.8 (1.61-4.87)], and having controlled blood pressure [5.2 (3.08-8.96)]. Controlled blood pressure (AOR = 0.048, 0.023-0.098), perception of high benefit of treatment [0.497 (0.255-0.97)], and absence of comorbidity [0.016 (0.168-0.832)] were identified as predictors of good treatment adherence. Overall medication adherence in the current study was 54.6%. Achieving treatment adherence frequently demands proactive patient engagement, highlighting their active role in disease management. Also, involving the patient's caregivers can offer an additional tactic to tackle non-adherence stemming from forgetfulness of the patient.

Participant and caregiver perspectives on health feedback from a healthy lifestyle check.

The usual output following health consultations from paediatric services is a clinical letter to the referring professional or primary care provider, with a copy sent to the patient's caregiver. There is little research on how patients and caregivers perceive the letter content. We aimed to: first understand child, young people and caregiver experiences of and preferences for receiving a health feedback letter about the child/young person's health measures within a healthy lifestyle programme; and second to provide a set of recommendations for designing letters to children, young people and their families within a healthy lifestyle programme. This qualitative study, informed by Kaupapa Māori principles, included focus groups of children aged 5-11 years and young people aged 12-18 years who were participants in a healthy lifestyle programme in Taranaki, Aotearoa New Zealand and of their respective caregivers (total n = 47). Discussions were audio-recorded, transcribed and analysed using thematic analysis. Key themes were identified: letters sometimes acted as 'discourses of disempowerment'-some participants experienced a lack of safety, depersonalisation with medical jargon and 'feeling like a number'. Participants described the need for acknowledgement and affirmation in written communication-health feedback should include validation, choice regarding content, respectful tone and a strengths-based approach to health messages. Letters to referrers, copied to families, can be perceived as disempowering, and participant and caregiver perspectives of content should be considered. This study challenges conventional practice in communicating health feedback with broader implications for written communication in healthcare. We propose separate letters aimed at the child/young person and their caregiver that offer choice in the information they receive. The administrative burden of multiple letters can be mitigated by advances in digital health. This study originated in response to feedback from service users that current health feedback was not meeting their needs or expectations. Patient perspectives, especially from children, are rarely considered in the generation of clinic letters from health professionals. Participants were child participants in the community-based clinical service and their caregivers, and care was taken to represent the demographic backgrounds of service users. Collection and interpretation of Māori data were led by researchers who were local community members to ensure prioritisation and preservation of participant voice. Where possible, results are illustrated in the text by direct quotes from participants, whose identities are protected with a pseudonym.

Effectiveness of information technology assisted relapse prevention program on relapse among people who live with severe mental disorders.

Severe Mental Disorders (SMDs) cause mental health worldwide challenges because of several relapses and extensive recovery periods of hospitalization, which put a lot of economic and social burden on families and governments. Therefore, interventions are necessary to decrease the relapse of these disorders. This study was conducted to investigate the effect of Information Technology Assisted Relapse Prevention Program (ITAREP) on relapse among people who live with SMDs. This study was a randomized clinical trial with intervention and control groups. ITAREP is a remote intervention based on monitoring the Early Warning Signs (EWS) to decrease the number of potential relapses. Using convenience sampling, people with SMDs admitted to Sina Juneqan Psychiatric Hospital and their caregivers were recruited in this study and randomly allocated to the control and intervention groups. Two checklists of the EWS for the patient and the patient's caregiver were used for monitoring the relapse signs. Data were collected at baseline and 90 days after discharge and were analyzed using t-test and Chi-square statistical tests and linear regression in SPSS software. Fifty-two patients who lived with SMDs participated in this study (26 in the intervention group and 26 in the control group). The two groups were homogeneous regarding age, gender, type of mental disorder, and duration of the disorder. Forty-two males and ten females participated in this research. Most of the participants were diagnosed with schizophrenia. The results showed that the number of relapses in the intervention group was significantly lower than in the control group in the post-test. Social workers, as the case managers and a member of the interdisciplinary psychiatric team, can actively perform follow-up measures after discharge using ITAREP, and it can be expected that these interventions will reduce the number of relapses among patients who live with SMDs.

A Novel, Closed-Line Mini Extracorporeal Photopheresis (ECP) Technique Using the Therakos TM CellEx TM Photopheresis System, Developed for Patients with Contraindications Against Conventional ECP Therapy

Introduction: Conventional ECP has proven efficacy for treating several diseases, most significantly steroid-refractory chronic GVHD. Unfortunately, body weight and sufficient venous access limit the availability of this treatment modality. Children, in particular, usually have limited access to ECP. A simplified mini buffy coat ECP technique that allows treating small children and patients with apheresis contraindications has been tested in selected cases during the last 20 years. However, this method relies on an open-line system that requires a longer time and a cell processing laboratory, making this approach challenging. A new -closed-line- method, using the Therakos TM CellEx TM Photopheresis System, has been developed and evaluated in our Center. This method requires no processing laboratory or other special equipment and takes only 60-120 minutes, making the procedure potentially usable in routine practice. Design and methods: A 7-year-old girl had been treated at our Pediatric Bone Marrow Transplantation Unit with grade IV chronic steroid-refractory GVHD (skin, and less severe liver involvement). As all other options were exhausted, ECP became a desirable form of treatment. However, the patient's low body weight and serious venous access problems hindered conventional ECP treatment. We developed a solution that requires 200-250 ml whole blood collection from the patient, takes less than 2 hours, does not need special cell processing equipment, and allows the ECP treatment to commence in the form of a regular autotransfusion. Consent forms were obtained from the patient's caregivers as well as from the local Ethical Committe. The patient's age at the start of treatment was seven years, and her body weight was 28 kg. A total of 17 mini-ECPs were performed weekly up until the submission of this abstract, and the number of treatments per patient was 33. The duration of mini-ECP treatment has been five months. 5 to 8 mL/kg of whole blood was drawn from the patient. Separation of the white blood cell (WBC) rich buffy coat of the patient's blood - with donor blood product supplementation as needed - was performed through an individualized use of the CellEx TM photopheresis kit and blood prime program. The buffy coat was ultraviolet A (UVA)-irradiated after adding 8-methoxypsoralen (8-MOP) within the Therakos TM CellEx TM Photopheresis System and divided into two fractions under a laminar air flow cabinet. The autologous residual blood with the first fraction of the UVA irradiated buffy coat was transfused immediately. The second buffy coat fraction was stored at 4 °C and transfused the following morning through a peripheral vein. Results : The median volume of the collected whole blood was 250 mL (203-250 mL). The median volume was 72 ml (48-88 mL) for the first fraction of the irradiated buffy coat and 71 ml for the second fraction (48- 88 mL). Apoptosis and cell death were analyzed by annexin V staining; apoptosis and lymphocyte proliferation was measured by flow cytometry. UVA irradiation of the 8-MOP infused buffy coat resulted in significant induction of WBC apoptosis at 24 hours. No clinical side effects were observed during mini ECP treatment; all microbiological control tests were negative. Partial response was observed within three months (skin), and the tapering of systemic immunosuppression (methylprednisolone and ruxolitinib) began at five months. Conclusion: Mini whole blood ECP induces apoptosis and lymphocyte proliferation inhibition, both occurring after standard ECP. The closed-line method requires no special equipment and is not demanding for the patient, providing a viable solution to the technical difficulties children with the need for ECP treatment face.

Analysis on the predictors of knowledge of medication adherence among care-givers of patients with Schizophrenia in some selected Hospitals of Jigawa State, Nigeria

Family caregivers of persons with bipolar disorder and schizophrenia experience high level of burden and compromised quality of life. A considerable amount of burden on the caregivers often leads to display of certain attitudes towards persons with severe mental illness called expressed emotion, which then leads to poor quality of patients as well. Although numerous studies dealing with these issues separately are present, but studies dealing with relationship, using mixed methodology, among these issues are scarce. Adherence to a drug regime is a significant issue in the clinical management of schizophrenia. A study of adherence in bipolar disorder showed that slightly more than one-half of the patients studied were fully adherent, 20% were partially adherent, and nearly 30% were non-adherent. Risk factors for non-adherence in this group included younger age, minority status, substance abuse, and homelessness (Shehu, et al., 2019). This study assessed and Analysis on the predictors of good knowledge of medication Adherence among care- givers of patients with Schizophrenia in some selected Hospital of Jigawa State, Nigeria. A quasi-experimental psycho-educational intervention study was conducted with before and after design among care givers of patients with Schizophrenia in some selected hospitals of Jigawa State, Nigeria. The study population comprised all the eligible care- givers of patients with schizophrenia within the study area, who were selected and agreed to participate in the study. A sample size of one hundred and thirty participants each for both the experimental and control groups were selected using a multistage sampling technique. Data was collected using Questionnaire Data collected was coded, entered, and analyzed using the Statistical Package for the Social Sciences (SPSS) version 22. After adjusting for the confounding effects using logistic regression analysis; type of treatment (ECT) was found to be negative predictors of good knowledge on medication adherence to treatment among study participants (AOR=0.50, 95%CI=0.27 – 0.85). While, cost of treatment of more than one thousand five hundred naira per day (AOR=2.5, 95%CI=2.11 – 8.33), combination of drugs and ECT (AOR=3.01, 95%CI=1.85 – 14.76), presence of side effects (AOR=4.00, 95%CI=2.05-21.55) and monthly income (AOR=3.00, 95%CI=1.01-15.88) were positive predictors of good knowledge on medication adherence among the study participants in the experimental groupSocial support had a significant correlation with caregivers' QoL. Caregivers should be encouraged to request assistance from other family members and friends in providing care, especially when caregivers are unemployed or long-time carers. Mental health education campaigns and helping families to maintain and enhance a supportive social network may provide useful means to improve caregivers.

H - 51 Neuropsychological Evaluation of Non-Fluent English Speakers: a Case Study.

Sometimes patients are referred for neuropsychological evaluation who do not speak English as their first language. In many cases, we have declined evaluating patients who were not fluent in English, and when we have evaluated bilingual patients, have qualified the limitations of our interpretations. However, there are no neuropsychologists providing services in languages besides English in the state of Oklahoma, and most patients never received services. Patient is 83-year-old woman with five years of progressive decline in memory, unable to manage instrumental activities of daily living, presenting with family history of Alzheimer's disease, and neuroimaging negative for atrophy or cerebrovascular disease. Patient was not fluent in English. Efforts to find a neuropsychologist able to evaluate in Spanish were unsuccessful, so testing was modified, and measures were administered by a bilingual psychometrist. Attention, orientation, and memory were impaired (MMSE = 14). Verbal fluency was intact in Spanish. Auditory memory was not assessed due to unavailability of Spanish measures. Visual memory was impaired, consistent with figure copy. WAIS-IV was administered in English, with instructions in Spanish. Patient was diagnosed with possible Alzheimer's disease. Recommended PET scan or spinal tap for Alzheimer's disease biomarkers and reevaluation in Spanish in one year. Since neuropsychological evaluation is not available in every language, evaluation in English and highlighting the limitations of our findings may meet the ethical principle of beneficence, if we consider the impact of language and additional sources of data, such as collateral report of the patient's caregivers, and medical tests.

Burden of care on family caregivers of patients of gastrointestinal cancers in a tertiary care institute

Background: Gastrointestinal tract cancers are one of the leading causes of morbidity and mortality globally and cause family members to become primary caregivers. Method: The observational cross- sectional study was conducted using a pretested questionnaire and BSFC short form scale on 156 primary family care givers of patients suffering from and seeking treatment for cancer of the gastrointestinal tract from June 2021 to May 2022 in a tertiary care institute. Result: Mean age of family caregiver was 48.6 (4.7) years and the majority were female 111 (71.1 %). Average duration of primary care given was 2.62(1.24) years. 94 (60.2%) family care givers provided > 8hr duration of care. 103 (66%) of the family caregivers suffered from moderate burden, 39 (25%) from heavy burden and only 14 (8.97%) family caregivers considered burden as mild. Significant association was found between >8 hours of caregiving, caregiver having a comorbid illness, treatment outcome and financial distress borne during the course of treatment and burden of caregiving. Conclusion: Burden of caregiving in the family caregivers of cases of gastrointestinal cancer has the capacity to create ripples in the primary life domains of the caregiver and needs to be looked into.

The perception of pediatric sickle cell anemia patient's caregivers toward hematopoietic stem cell transplantation (single-center experience, Saudi Arabia).

Sickle cell disease (SCD) is a relatively common genetic disorder in Saudi Arabia characterized by the predominance of sickle hemoglobin (HbS). Although multiple supportive care options exist for patients with SCD, hematopoietic stem cell transplantation (HSCT) is the only cure available and has become highly successful, with an almost 91% overall survival rate. However, pursuing this procedure is still restrained as a curative treatment option. Therefore, this study aimed to evaluate the perception of parents' caregivers at the National Guard Hospital pediatric hematology clinic regarding using HSCT as a curative approach for their children with SCD. This is a cross-sectional study of the interviewer-administered survey distributed utilizing electronic devices to caregivers of pediatric patients with SCD. Subjects were recruited from Pediatric Hematology & Oncology clinics at National Guard Hospital Affairs in King Abdulaziz Medical City, Jeddah, Saudi Arabia. An estimated sample size of 100 was initially calculated out of 140 pediatric SCD patients; 72 responses were collected from participants. All study participants gave informed consent. All results were analyzed using SPSS; moreover, statistics were set at a CI of 95% and a p < 0.05. In addition, inferential and descriptive statistics were done. Of all respondents, 42 (67.8%) would accept HSCT if their hematologist recommended it. However, approximately 7 (11.3%) were not interested in the procedure, and the rest, 13 (21%), were uncertain. The most reported reasons for HSCT rejection among all respondents were attributed to side effects 31 (50.8%), lack of knowledge 8 (13.1%), and misconception toward the procedure 22 (36.1%). The results of this study were consistent with the fact that most caregivers would follow along with HSCT if it seemed to be fit and was recommended by their hematologists. However, to the best of our knowledge, our study being the first of its kind in the region, further research in the kingdom on the perception of HSCT is needed. Nonetheless, further patient education, an increase in caregivers' knowledge, and enlightenment of the medical team on HSCT as a curative option for sickle cell disease are vital.

Illustrating How to Use the Validated Alsayed_v1 Tools to Improve Medical Care: A Particular Reference to the Global Initiative for Asthma 2022 Recommendations.

The current research aimed to illustrate a real case using the validated Alsayed_v1 tools as tutorial training to improve the knowledge and skills of healthcare practitioners in the clinical problem-solving process necessary to implement medical and pharmaceutical care. The Alsayed_v1 instruments consist of principal components: data collection, assessment of treatments, the medical problem oriented plan (MPOP), as well as a care plan and patient education. This study illustrated a real case of asthma patient using the validated Alsayed_v1 tools. These validated and clinically tested tools provide a coding system for the MPOP that permits easy documentation with an open hierarchical structure where higher levels are broad and lower levels are particular, and the possibility to enter free text. The section dedicated to treatment assessments is intended to synthesize patient information to facilitate the identification of the MPOPs. Effective management requires the development of a partnership between the patient with asthma (or the patient's caregivers) and his healthcare professional(s). This partnership aims to allow the patient to control his condition with guidance from the healthcare professional(s), discuss and agree on therapy goals, and develop a personalized, written, self-management asthma care plan. By implementing Alsayed_v1 tools, the clinical practitioner can actively give the best practice for optimal patient outcomes.

Eating disorders in children and adolescents with type 1 diabetes mellitus

Introduction and purpose: Eating disorders are an ever-growing problem, both in the general population and also in the population of pediatric patients with type 1 diabetes mellitus. However, for this specific group of patients, there is a twofold higher risk of developing eating disorders, the occurrence of additional distinct forms of these disorders, the so-called diabulimia - consisting of deliberate restriction of insulin delivery or skipping insulin doses, which can consequently lead to poor metabolic control of diabetes , and even threaten the lives of patients. The purpose of this work is to present the current state of knowledge on the diagnosis, prevention and treatment of eating disorders in children and adolescents with type 1 diabetes.&#x0D; The state of knowladge: The background of the onset of eating disorders in pediatric patients with type 1 diabetes mellitus includes the lowered self-esteem accompanying early adolescence, stress, excessive focus on external appearance, as well as difficulties in accepting the diagnosis and a rather strict dietary regime. Since the treatment of eating disorders is long and difficult, the most important goal becomes effective prevention and rapid selection of patients with a predisposition to develop such disorders. The first screening tools - SEEDS, m-SCOFF and DEPS-R questionnaires - have already been developed, and the effectiveness of therapy sessions aimed at this group of patients is also being studied. &#x0D; Summary: Therapy of eating disorders in patients with type 1 diabetes should be targeted at this specific patient population. It requires cooperation and communication of teams dealing separately with these diseases, education of the staff and their thorough knowledge of the background of the problem, prompt action and, above all, the development of specific guidelines for management, methods of prevention and the earliest possible start of treatment, which will also include the patient's caregivers.

Evidence-Based Management of Pediatric Distal Radius Buckle Fractures

Distal radius fractures are the most common fracture in children younger than 16 years. A common pattern of distal radius fractures is the buckle or torus fracture. Traditional treatment of these injuries involved casting with serial x-ray imaging to evaluate for proper healing and maintained alignment. Studies of these injury patterns, however, suggest that these fractures are inherently stable and have a very low incidence of displacement. These studies posit that torus fractures can be treated definitively in a removable brace that can be discontinued by the patient's caregiver without the need for follow-up examinations or imaging. A review of pertinent literature from the past 5 years concluded that, in pediatric patients with acute radial torus fractures, clinical outcomes were equivalent between patients treated with removable braces and no scheduled follow-up and those treated with hard casting and repeat clinical evaluation. Implementation of this evidence-based treatment can significantly improve patient care by reducing unneeded follow-ups and imaging while minimizing the cost of treatment and missed school/work days by patients and their caregivers.

Paediatric heart failure in Uyo: A retrospective analysis

Background/Aim: Paediatric heart failure is a condition that continues to present challenges in management in our environment especially in its treatment and outcomes hence the aim of this study.Materials and Methods: A retrospective analysis of the case notes of all children who were diagnosed and managed for heart failure from January 2019 – October 2021 was undertaken. Data obtained included age, sex, presenting features, primary diagnosis, treatment modalities, duration ofhospital stay and outcomes.Results: A total of 2226 children were admitted over the study period with 67 children diagnosed with heart failure giving a prevalence rate of 3% although only 47 case notes could be retrieved giving a case retrieval rate of 70%. There were 26 (55.3%) males and 21 (44.7%) females (M:F ratio1.2: 1). Mean age of patients was 32.6 months (±52.23) with 28 (59.6%) of them being infants. Bronchopneumonia was the commonest cause of heart failure 31(65.9%) either singly or in combination with acyanotic congenital heart disease followed by severe anaemia in 14 (29.8%). Average duration of hospital stay was 6.9days (±5.08) and average cost of admission was N13,266. Twenty-three patients were discharged (48.9%), while 10 (21.3%) left against medical advice, 2 absconded (4.3%) while 12 (25.3%) died.Conclusion: Heart failure remains an important cause of morbidity and mortality in children in our environment arising from largely preventable causes. Urgent steps such as patient care giver education, immunization and screening for congenital heart disease are needed to reduce its effect on children in our environment.

A Study To Assess The Efficacy Of Health Empowerment Programme Among Care Givers On Management Of Patient With Cerebrovascular Accident Admitted In Medical Wards At Tertiary Care Hospital Chennai.

Cerebrovascular Accident is the second commonest cause of death worldwide. Cerebrovascular Accident is sudden death of brain cells due to lack of oxygen when the blood flow to the brain is impaired by blockage or rupture of an artery. It is the chronic disease and also a major cause of long-term disability and has potentially enormous emotional and socio economic consequences for patients, and their families. So the study was conducted to assess the effectiveness of Health empowerment programme on level of knowledge and practice regarding care of patient with CVA. The main objectives are to assess the pretest level of knowledge and practice regarding care of patient with cerebrovascular Accident, and to determine the effectiveness of Health empowerment programme on the level of knowledge and practice among care givers of patient with cerebrovascular Accident. A quantitative research approach and pre experimental, one group pre test, post test design was chosen to assess the level of knowledge and practice regarding Health empowerment programme conducted at, Government General Hospital, Chennai, caregivers of patients with cerebrovascular Accident who satisfied the inclusive criteria were selected as samples using purposive sampling technique. A health empowerment programme comprising a power point teaching, demonstration and reinforcement regarding health empowerment programme formed the intervention of the study. The pre and post-test level of knowledge and practice was assessed using structured questionnaire and observational check list respectively. The findings of the study revealed that the pre test mean score of knowledge was 6.73 with S.D of 2.11 and the post-test mean score of knowledge was 13.45 with S.D of 1.57 The calculated ‘t’ value of 25.68 was found to be statistically highly significant.