Prevalence and predictors of seizure clusters: A prospective observational study of adult patients with epilepsy

2018 ◽  
Vol 88 ◽  
pp. 349-356 ◽  
Author(s):  
Kamil Detyniecki ◽  
Jane O'Bryan ◽  
Tenzin Choezom ◽  
Grzegorz Rak ◽  
Chanthia Ma ◽  
...  
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Adult Patients ◽  
Patients With Epilepsy

scholarly journals Impact of an Educational Comic to Enhance Patient-Physician–Electronic Health Record Engagement: Prospective Observational Study (Preprint)

2020 ◽  
Author(s):  
Maria A Alkureishi ◽  
Tyrone Johnson ◽  
Jacqueline Nichols ◽  
Meera Dhodapkar ◽  
M K Czerwiec ◽  
...  
Keyword(s):  
Primary Care ◽  
African American ◽  
Observational Study ◽  
Electronic Health Record ◽  
Prospective Observational Study ◽  
Adult Patients ◽  
Health Record ◽  
Self Advocacy ◽  
Improve Patient

BACKGROUND Electronic health record (EHR) use can impede or augment patient-physician communication. However, little research explores the use of an educational comic to improve patient-physician-EHR interactions. OBJECTIVE To evaluate the impact of an educational comic on patient EHR self-advocacy behaviors to promote patient engagement with the EHR during clinic visits. METHODS We conducted a prospective observational study with adult patients and parents of pediatric patients at the University of Chicago General Internal Medicine (GIM) and Pediatric Primary Care (PPC) clinics. We developed an educational comic highlighting EHR self-advocacy behaviors and distributed it to study participants during check-in for their primary care visits between May 2017 and May 2018. Participants completed a survey immediately after their visit, which included a question on whether they would be interested in a follow-up telephone interview. Of those who expressed interest, 50 participants each from the adult and pediatric parent cohorts were selected at random for follow-up telephone interviews 8 months (range 3-12 months) post visit. RESULTS Overall, 71.0% (115/162) of adult patients and 71.6% (224/313) of pediatric parents agreed the comic encouraged EHR involvement. African American and Hispanic participants were more likely to ask to see the screen and become involved in EHR use due to the comic (adult <i>P</i>=.01, <i>P</i>=.01; parent <i>P</i>=.02, <i>P</i>=.006, respectively). Lower educational attainment was associated with an increase in parents asking to see the screen and to be involved (ρ=−0.18, <i>P</i>=.003; ρ=−0.19, <i>P</i>&lt;.001, respectively) and in adults calling for physician attention (ρ=−0.17, <i>P</i>=.04), which was confirmed in multivariate analyses. Female GIM patients were more likely than males to ask to be involved (median 4 vs 3, <i>P</i>=.003). During follow-up phone interviews, 90% (45/50) of adult patients and all pediatric parents (50/50) remembered the comic. Almost half of all participants (GIM 23/50, 46%; PPC 21/50, 42%) recalled at least one best-practice behavior. At subsequent visits, adult patients reported increases in asking to see the screen (median 3 vs 4, <i>P</i>=.006), and pediatric parents reported increases in asking to see the screen and calling for physician attention (median 3 vs 4, <i>P</i>s&lt;.001 for both). Pediatric parents also felt that the comic had encouraged them to speak up and get more involved with physician computer use since the index visit (median 4 vs 4, <i>P</i>=.02) and that it made them feel more empowered to get involved with computer use at future visits (median 3 vs 4, <i>P</i>&lt;.001). CONCLUSIONS Our study found that an educational comic may improve patient advocacy for enhanced patient-physician-EHR engagement, with higher impacts on African American and Hispanic patients and patients with low educational attainment.

scholarly journals Perioperative Risk Factors for Intraoperative Hypothermia in Adult Patients Undergoing Elective Surgery at a National Referral Hospital in Bhutan: A Prospective Observational Study

2019 ◽  
Author(s):  
Kinley Zangmo ◽  
Sunisa Chatmongkolchart ◽  
Pasuree Sangsupawanich
Keyword(s):  
Risk Factors ◽  
Heart Rate ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Elective Surgery ◽  
Perioperative Risk ◽  
Referral Hospital ◽  
Adult Patients ◽  
Intraoperative Hypothermia ◽  
National Referral Hospital

Objective: Intraoperative hypothermia is commonly encountered in anesthetic practice. It is related to several risk factors and can lead to various adverse events. It is important to detect it early and prevent the complications related to it. This study was done to identify incidence and perioperative risk factors of intraoperative hypothermia at a national referral hospital in Bhutan.Material and Methods: A prospective observational study was conducted in adult patients who underwent elective surgery lasting more than 30 minutes. Patient characteristics, incidence of hypothermia, and any interventions for treatment of hypothermia during the operation were recorded. Intraoperative hypothermia was defined as a core body temperature less than 36 °C measured with an esophageal probe.Results: Data were obtained from 91 patients with a mean (±standard deviation; S.D.) age of 42.3 (17.2) and American Society of Anesthesiologists (ASA) scores of 1 and 2 in 62.6% and 37.4% of the patients, respectively The patients underwent elective surgery with a mean (S.D.) duration of 73.24 (48.1) minutes and a mean (S.D.) duration of anaesthesia of 80.9 (49.2) minutes. The incidence of intraoperative hypothermia was 61.5% (56/91). Preoperative heart rate more than 80 beats per minute [hazard ratio (HR) 0.45, 95% confidence interval (CI), 0.26-0.77] was a protective factor and duration of anesthesia more than 60 minutes (HR 1.82, 95% CI, 0.98–3.38) was a risk factor for intraoperative hypothermia.Conclusion: Patients with a preoperative heart rate less than 80 beats per minute and undergoing duration of anesthesia more than 60 minutes should be assessed from the preoperative period and continuously monitored throughout the intraoperative period.

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