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31.
Simone Postma Henk Schers Tom van de Belt Kees van Boven Huib ten Napel Hugo Stappers Debby Gerritsen Tim Olde Hartman 《Health expectations》2022,25(4):1363
BackgroundIn primary care, a shift from a disease‐oriented approach for patients with multimorbidity towards a more person‐centred approach is needed.AimTo transform a self‐report questionnaire for patients with chronic conditions in primary care, the Primary Care Functioning Scale (PCFS), into an understandable, visually attractive and feasible consultation tool for patients and health care providers. The consultation tool consists of a web‐based version of the PCFS, which is filled in by the patient and is processed to a feedback report that summarizes and visualizes the main findings. The feedback report can be discussed with the patient to facilitate a more person‐centred conversation for patients with chronic conditions and multimorbidity in general practice.Design and SettingIn this qualitative study, we developed the consultation tool by using design thinking in a participatory developmental process.MethodsIn the first phase, we constructed five different feedback report templates to summarize and display the results of a completed PCFS questionnaire in a series of two expert meetings with patients and general practitioners (GPs). In the second phase, we performed an exploratory qualitative interview study involving dyads of patients with chronic conditions and their practice nurses. In an iterative process, we explored their experiences with the consultation tool.ResultsPatients, as well as GPs, preferred a clear manner of presenting the results of the questionnaire in a feedback report. In 18 interviews with patients and practice nurses during three different interview rounds, we adjusted the feedback report and consultation tool based on the input from patients and practice nurses. After the final interview round, patients and practice nurses consented that the consultation tool was useful for having a more in‐depth consultation about functioning and patients'' preferences when integrated into the regularly scheduled consultations.ConclusionWe were able to develop an understandable and feasible consultation tool that is applicable in already existing chronic disease management programmes in general practice in the Netherlands.Patient or Public ContributionTo increase the understandability and feasibility of the consultation tool, we collaborated with end‐users and actively involved patients, GPs and practice nurses in a participatory development process. 相似文献
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Molly L. Hartman Anne G. Fisher Leslie Duran 《Scandinavian journal of occupational therapy》2013,20(3):111-118
The aim of this study was to examine the sensitivity of the Assessment of Motor and Process Skills (AMPS) in discriminating between independent people, those with dementia of the Alzheimer's type (DAT) requiring minimal assistance to live in the community (DAT-min) and those with DAT requiring moderate to maximal assistance (DAT-mod). The subjects comprised 329 non-disabled older adults, 167 people with DAT-min and 292 with DAT-mod. The AMPS was used to measure the subjects' ADL motor and ADL process abilities. Significant main effects were seen for ADL motor and ADL process abilities. All three groups differed significantly in both motor and process mean ability measures and the proportion of people with DAT with ability measures below AMPS cut-off measures increased significantly as the functional level decreased. The ADL process scale was a more discriminative measure of ability to function in the community than was the ADL motor scale. 相似文献
34.
Steven J. Weisholtz Barry J. Hartman Richard B. Roberts 《The American journal of medicine》1983,75(2):199-205
The hospital records of 264 patients with 277 episodes of pneumococcal bacteremia occurring at New York Hospital-Cornell Medical Center over the period 1970 to 1980 were examined to determine whether serotype distribution varied with the underlying disease or age of the patient. The patients were placed into three groups according to their underlying disease. Group A consisted of all patients with significant impairment of their immune system. Group B included those patients with underlying conditions that were not associated with immune deficiency. Group C comprised those patients considered to be normal hosts. Overall, 84 percent of blood isolates were serotypes included in the vaccine. In Group A, only 73 percent of these isolates were vaccine types, compared with 85 percent in Group B and 97 percent in Group C (differences significant at p < 0.001). Vaccine serotypes were more common in children than adults (92 versus 81 percent), but in analysis that controlled for underlying disease, the elderly did not differ from younger adults in serotype distribution. The apparent predilection of nonvaccine serotypes to cause bacteremia in immunocompromised patients may be one factor limiting vaccine efficacy in this high-risk population. 相似文献
35.
Travis WD Hunninghake G King TE Lynch DA Colby TV Galvin JR Brown KK Chung MP Cordier JF du Bois RM Flaherty KR Franks TJ Hansell DM Hartman TE Kazerooni EA Kim DS Kitaichi M Koyama T Martinez FJ Nagai S Midthun DE Müller NL Nicholson AG Raghu G Selman M Wells A 《American journal of respiratory and critical care medicine》2008,177(12):1338-1347
36.
Neurocognitive predictors of substance use disorders and nicotine dependence in ADHD probands,their unaffected siblings,and controls: a 4‐year prospective follow‐up 下载免费PDF全文
37.
Pey‐Jen Yu MD Hugh A. Cassiere MD Sophia L. Dellis MS Frank Manetta MD Nina Kohn MA Alan R. Hartman MD 《JPEN. Journal of parenteral and enteral nutrition》2015,39(7):870-874
Background: Preoperative malnutrition is increasingly prevalent in patients undergoing cardiac surgery. Although prealbumin is a widely used indicator of nutrition status, its use in the preoperative assessment of patients undergoing cardiac surgery is not well defined. The purpose of this study is to determine the impact of preoperative prealbumin levels on outcomes after cardiac surgery. Materials and Methods: Data were prospectively gathered from February 2013 to July 2013 on 69 patients undergoing cardiac surgery. Prealbumin levels were obtained within 24 hours of surgery. Patients were divided into 2 groups based on a prealbumin cutoff value of 20 mg/dL. Results: Of the 69 patients, 32 (46.4%) had a preoperative prealbumin ≤20 mg/dL. There was no correlation between prealbumin levels and body mass index (r = ?0.13, P = .28). Likewise, there was no correlation between preoperative albumin and prealbumin levels (r = 0.09, P = .44). Nine of 32 (28.1%) patients with low preoperative prealbumin levels had postoperative infections compared with 2 of 37 (5.4%) patients with high prealbumin levels (P = .010). Patients with low prealbumin levels also had increased risk of postoperative intubation for >12 hours (P = .010). Conclusions: Patients undergoing cardiac surgery with preoperative prealbumin levels of ≤20 mg/dL have an increased risk for postoperative infections and the need for longer mechanical ventilation. If feasible, nutrition optimization of such patients may be considered prior to cardiac surgery. 相似文献
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The mechanisms underlying the impaired utilization of transferrin-bound iron by erythroid cells in the anemia of the Belgrade laboratory rat were investigated using reticulocytes from homozygous anemic animals and transferrin labeled with 59Fe and 125I. The results were compared with those obtained using reticulocytes from phenylhydrazine-treated rats and iron-deficient rats. Each step in the iron uptake mechanism was investigated, ie, transferrin-receptor interaction, transferrin endocytosis, iron release from transferrin, and transferrin exocytosis. Although there were quantitative differences, no fundamental difference was found in any of the abovementioned aspects of cellular function when the reticulocytes from Belgrade rats were compared with those from iron-deficient animals. The basic defect in the Belgrade reticulocytes must therefore reside in subsequent steps in iron uptake, after it is released from transferrin within endocytotic vesicles, ie, in the mechanism by which it is transferred across the lining membrane of the vesicles into the cell cytosol. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) of reticulocyte ghosts extracts demonstrated a prominent protein band of mol wt 69,000 that was absent or present only in low concentration extracts from the other two types of reticulocytes. This may be a result of the genetic defect. 相似文献
40.
Vugteveen Jorien de Bildt Annelies Hartman Catharina A. Reijneveld Sijmen A. Timmerman Marieke E. 《European child & adolescent psychiatry》2021,30(12):1983-1994
European Child & Adolescent Psychiatry - The Strengths and Difficulties Questionnaire (SDQ) is widely used, based on evidence of its value for screening. This evidence primarily regards the... 相似文献