The Consult Station® innovation for primary care: a proof of concept study for generalisation of teleconsultation devices (Preprint)

2021 ◽  
Author(s):  
Geraldine Falgarone ◽  
Guilhem BOUSQUET ◽  
Arnaud Willet ◽  
Valérie FAURE ◽  
albert Brizio ◽  
...  
Keyword(s):  
Primary Care ◽  
Metropolitan Areas ◽  
Young Patients ◽  
Clinical Parameter ◽  
Low Density ◽  
Proof Of Concept ◽  
Work Absenteeism ◽  
Telemedicine Technology ◽  
Medical Consultations ◽  
High Level

BACKGROUND Telemedicine technology is a growing field, especially in the context of the Covid-19 pandemic. Consult Station® is the first telemedicine device enabling a complete remote medical consultation including clinical parameter collection in a single space-time. OBJECTIVE Here, we report the multisite urban and suburban implantation of Consult Station® for primary care and its contribution to healthcare pathways in medical low-density areas. METHODS In a proof-of-concept multisite prospective cohort study, 2034 consecutive patients having a teleconsultation were included. Consultation characteristics were analysed from the patient and the practitioner perspectives. RESULTS In this study, the main users of Consult Station® were young patients consulting for seasonal infections of low severity. Interestingly, hypertension, diabetes and preventive medical consultations were almost absent, while they represent almost 50% of consultations with a GP. We showed that in the whole territory where the Consult Station® was implanted, the number of consultations increased when GP density decreased. The study of practitioner characteristics showed their motivation to work with this device, while continuing to live in metropolitan areas with a high level of technical acceptability. CONCLUSIONS Multisite implantation of Consult Station® booths is relevant for primary cares but it also could meet the challenge of medical deserts. In addition, further studies should be addressed to evaluate its possible contribution to limit work absenteeism.

Identification and Management of Psychosocial and Developmental Problems in Community-Based, Primary Care Pediatric Practices

PEDIATRICS ◽  
1992 ◽  
Vol 89 (3) ◽  
pp. 480-485 ◽  
Author(s):  
Sarah McCue Horwitz ◽  
Philip J. Leaf ◽  
John M. Leventhal ◽  
Brian Forsyth ◽  
Kathy Nixon Speechley
Keyword(s):  
Primary Care ◽  
Child Behavior Checklist ◽  
Social Issues ◽  
Young Patients ◽  
Well Being ◽  
World Health ◽  
Developmental Problems ◽  
Active Intervention ◽  
Health Organization ◽  
New Morbidity

The importance of psychological and social issues for children's well-being has long been recognized and their importance in the practice of pediatrics is well documented. However, many of the studies looking at this issue have emphasized psychiatric problems rather than issues commonly referred to as the new morbidity. The goal of this research was to refocus interest on the problems of the new morbidity. This study examined the rates and predictors of psychological problems in 19 of 23 randomly chosen pediatric practices in the greater New Haven area. Families of all 4- to 8-year-old children were invited to participate and to complete the Child Behavior Checklist prior to seeing a clinician. Clinicians completed a 13-category checklist of psychosocial and developmental problems based on a World Health Organization-sponsored primary care, child-oriented classification system. Of the 2006 eligible families, 1886 (94%) participated. Clinicians identified at least one psychosocial or developmental problem in 515 children (27.3%). Thirty-one percent of the children with problems received no active intervention, 40% received intervention by the clinician, and 16% were referred to specialty services. Not surprisingly, children whose problems were rated as moderate or severe were twice as likely to be referred compared with children with mild problems. Recognition of a problem was related to four characteristics: if the visit was for well child rather than acute care; if the clinician felt he or she knew a child well; if the child was male; and if the child had unmarried parents (all P ≤ .05). The data suggest that, when asked to use a taxonomy appropriate for primary care, clinicians recognize problems in many 4- to 8-year-old children (515/1886; 27.3%). This rate is considerably higher than the rates previously reported. Further, many children with identified problems (56%) were reported by their clinicians to receive some form of active intervention. Characteristics of the visit (type of visit, clinician's knowledge of a child) that influence the recognition of problems were also identified. These results suggest that investigators must define what types of problems they are interested in and under what circumstances to determine accurately what pediatric practitioners know about psychosocial and developmental problems in their young patients and families.

scholarly journals Using in situ simulation to improve care of the acutely ill patient by enhancing interprofessional working: a qualitative proof of concept study in primary care in England

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e028572
Author(s):  
Amy Halls ◽  
Mohan Kanagasundaram ◽  
Margaret Lau-Walker ◽  
Hilary Diack ◽  
Simon Bettles
Keyword(s):  
Primary Care ◽  
Training Session ◽  
Medical Emergency ◽  
Future Research ◽  
Proof Of Concept ◽  
In Situ Simulation ◽  
Concept Study ◽  
Interprofessional Working ◽  
General Practices

ObjectiveAcutely unwell patients in the primary care setting are uncommon, but their successful management requires involvement from staff (clinical and non-clinical) working as a cohesive team. Despite the advantages of interprofessional education being well documented, there is little research evidence of this within primary care. Enhancing interprofessional working could ultimately improve care of the acutely ill patient. This proof of concept study aimed to develop an in situ simulation of a medical emergency to use within primary care, and assess its acceptability and utility through participants’ reported experiences.SettingThree research-active General Practices in south east England. Nine staff members per practice consented to participate, representing clinical and non-clinical professions.MethodsThe intervention of an in situ simulation scenario of a cardiac arrest was developed by the research team. For the evaluation, staff participated in individual qualitative semistructured interviews following the in situ simulation: these focused on their experiences of participating, with particular attention on interdisciplinary training and potential future developments of the in situ simulation.ResultsThe in situ simulation was appropriate for use within the participating General Practices. Qualitative thematic analysis of the interviews identified four themes: (1) apprehension and (un)willing participation, (2) reflection on the simulation design, (3) experiences of the scenario and (4) training.ConclusionsThis study suggests in situ simulation can be an acceptable approach for interdisciplinary team training within primary care, being well-received by practices and staff. This contributes to a fuller understanding of how in situ simulation can benefit both workforce and patients. Future research is needed to further refine the in situ simulation training session.

scholarly journals High Level of Residual Symptoms in Young Patients After Total Knee Arthroplasty

2013 ◽  
Vol 472 (1) ◽  
pp. 133-137 ◽  
Author(s):  
Javad Parvizi ◽  
Ryan M. Nunley ◽  
Keith R. Berend ◽  
Adolph V. Lombardi ◽  
Erin L. Ruh ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Young Patients ◽  
Residual Symptoms ◽  
Total Knee ◽  
High Level

scholarly journals PENGARUH SENAM ZUMBA TERHADAP KADAR TRIGLISERIDA DARAH PADA MAHASISWA FAKULTAS KEDOKTERAN UNIVERSITAS SAM RATULANGI

2015 ◽  
Vol 3 (1) ◽  
Author(s):  
Ashael A. Rembang ◽  
J. J. V. Rampengan ◽  
Siantan Supit
Keyword(s):  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Exercise Session ◽  
Blood Levels ◽  
Normal Body Mass Index ◽  
Low Density ◽  
Research Subjects ◽  
Post Test ◽  
Negative Impacts ◽  
High Level

Abstract: Lipid is classified into several types, which include High Density Lipoprotein (HDL), Low Density Lipoprotein (LDL), Very Low Density Lipoprotein (VLDL) and triglycerides. Triglyceride is a compound consists of three fatty acid molecules esterified into glycerol. Triglycerides are neutral fats synthesized from carbohydrate that are stored in lipid cells. Normal triglyceride levels of human is < 150 mg/dL. High levels of triglyceride have negative impacts on health as it can lead to diseases such as atherosclerosis. High level of triglyceride can be prevented and lowered by exercises such as Zumba exercise. The aim of this study is to know the effect of Zumba exercise on the level of blood triglyceride. This was an experimental study with one group pre-post test design, with criteria that include ages within 16-20 years old, normal Body Mass Index, not a Zumba gymnast, and in healthy condition during research. Samples were 19 female medical faculty students of Sam Ratulangi University class of 2014. They were subjected to do Zumba exercise every day for a week. Triglyceride levels are measured before the first Zumba exercise session and after the final session of Zumba exercise. The data were analyzed using paired-t test with SPSS programme. The results showed that there was a significant change between the mean level of triglyceride before first Zumba exercise 68,11 mg/dL and after Zumba final exercise 48 mg/dL. Conclusion: There was a decrease in triglyceride blood levels of the research subjects after doing Zumba exercises everyday for a week.Keywords: triglyceride, zumba exerciseAbstrak: Lemak terbagi menjadi beberapa jenis, yaitu lemak HDL, lemak LDL, lemak VLDL, serta kadar trigliserida. Trigliserida adalah senyawa yang terdiri dari tiga molekul asam lemak teresterifikasi menjadi gliserol. Trigliserida merupakan lemak netral yang disintesis dari karbohidrat untuk disimpan dalam sel lemak. Kadar trigliserida normal dalam tubuh manusia yaitu <150 mg/dL. Namun kadar trigliserida yang berlebihan juga tidak baik untuk kesehatan. Tingginya kadar trigliserida dalam darah dapat menyebabkan terjadinya penyakit, misalnya aterosklerosis. Kadar trigliserida yang tinggi dapat dicegah dan diturunkan dengan melakukan olahraga seperti senam Zumba. Penelitian ini bertujuan untuk mengetahui pengaruh senam Zumba tehadap kadar trigliserida darah. Penelitian ini bersifat eksperimental dengan rancangan pre-post one group test dengan sampel penelitian yang memenuhi kriteria-kriteria, yaitu usia 16-20 tahun, IMT normal, bukan merupakan seorang atlit atau pesenam Zumba, dan sehat saat dilakukan penelitian. Sampel penelitian adalah mahasiswi Fakultas Kedokteran Universitas Sam Ratulangi angkatan 2014 berjumlah 19 orang. Subjek penelitian melakukan latihan setiap hari dalam seminggu. Kadar trigliserida diukur sebelum latihan Zumba pertama dan sesudah latihan Zumba terakhir. Hasil data dianalisis dengan uji t berpasangan menggunakan program SPSS. Berdasarkan penelitian diperoleh hasil yang menunjukkan perubahan yang signifikan dengan rerata kadar triglierida sebelum senam Zumba 68,11 mg/dL dan rerata sesudah senam Zumba 48,00 mg/dL.Simpulan: Terjadi penurunan kadar tigliserida darah dari subjek penelitian setelah melakukan senam Zumba setiap hari selama seminggu.Kata kunci: trigliserida, senam zumba

scholarly journals Planning the Design and Execution of Student Performance Assessment in Serious Games

2021 ◽  
Vol 12 (1) ◽  
pp. 172-190
Author(s):  
Rháleff N. R. Oliveira ◽  
Rafaela V. Rocha ◽  
Denise H. Goya
Keyword(s):  
Performance Assessment ◽  
Student Performance ◽  
Serious Games ◽  
Proof Of Concept ◽  
Personalized Feedback ◽  
Student’S Performance ◽  
Good Internal Consistency ◽  
Learning Measurement ◽  
High Level

Serious Games (SGs) are used to support knowledge acquisition and skill development. For this, there is a need to measure the results achieved (both during and after students play) to ensure the game effectiveness. In this context, the aim is to develop and evaluate the AvaliaJS, a conceptual model to structure, guide and support the planning of the design and execution of the student's performance assessment in SGs. AvaliaJS has two artifacts: a canvas model, for high-level planning, and an assessment project document, for more detailed specifications of the canvas. To analyze and exemplify the use of the model, the artifacts were applied to three ready-made games as a proof of concept. In addition, the quality of AvaliaJS was evaluated by experts in SGs development and assessment using a questionnaire. The results of experts' answers confirm a good internal consistency (Cronbach's alpha α = 0.87) which indicates that AvaliaJS is correct, authentic, consistent, clear, unambiguous and flexible. However, the model will need to be validated during the process of creating a new game to ensure its usability and efficiency. In general, AvaliaJS can be used to support the team in the planning, documentation and development of artifacts and data collection in SGs, as well as in the execution of the assessment, learning measurement and constant and personalized feedback for students.

scholarly journals Development of an IoT System for Environmental Monitoring: Software

2021 ◽  
Author(s):  
Benjamin Secker
Keyword(s):  
Environmental Monitoring ◽  
Low Cost ◽  
Proof Of Concept ◽  
Embedded Devices ◽  
Data Loggers ◽  
Environmental Monitoring System ◽  
Use Of The Internet ◽  
High Level ◽  
Monitoring Software ◽  
The Internet Of Things

Use of the Internet of Things (IoT) is poised to be the next big advancement in environmental monitoring. We present the high-level software side of a proof-of-concept that demonstrates an end-to-end environmental monitoring system,<br><div>replacing Greater Wellington Regional Council’s expensive data loggers with low-cost, IoT centric embedded devices, and it’s supporting cloud platform. The proof-of-concept includes a Micropython-based software stack running on an ESP32 microcontroller. The device software includes a built-in webserver that hosts a responsive Web App for configuration of the device. Telemetry data is sent over Vodafone’s NB-IoT network and stored in Azure IoT Central, where it can be visualised and exported.</div><br>While future development is required for a production-ready system, the proof-of-concept justifies the use of modern IoT technologies for environmental monitoring. The open source nature of the project means that the knowledge gained can be re-used and modified to suit the use-cases for other organisations.

A Visual Programming Approach for Co-designed Robots

Robotica ◽  
2020 ◽  
pp. 1-24
Author(s):  
Andrés S. Vázquez ◽  
Tomás Calvo ◽  
Raúl Fernández ◽  
Francisco Ramos
Keyword(s):  
Intelligent System ◽  
Visual Programming ◽  
Programming Approach ◽  
Proof Of Concept ◽  
Robot Operating System ◽  
Programming Framework ◽  
Ieee Standard ◽  
High Level ◽  
Visual Programming Language ◽  
Robot Configurations

SUMMARY This paper proposes an approach for the high-level programming of co-designed robots that reduces programming complexity. Particularly, the work presented focuses on the programming framework of an intelligent system, based on the IEEE Standard Ontologies for Robotics and Automation, which allows users the automatic design of robots and the automatic implementation of controllers in the Robot Operating System (ROS). In our approach, the co-designed robot functionalities are automatically translated into visual programming blocks allowing non-expert users an easy robot programming by means of a visual programming language. Several robot configurations and three case studies are provided as a proof of concept. The validation, in terms of usability, of the framework has been carried out with inexperienced users showing promising results.

A Proof of Concept for Assessing Emergency Room Use with Primary Care Data and Natural Language Processing

2013 ◽  
Vol 52 (01) ◽  
pp. 33-42 ◽  
Author(s):  
M.-H. Kuo ◽  
P. Gooch ◽  
J. St-Maurice
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Natural Language Processing ◽  
Natural Language ◽  
Emergency Room ◽  
Language Processing ◽  
Free Text ◽  
Proof Of Concept ◽  
Term Extraction ◽  
Primary Care Data

SummaryObjective: The objective of this study was to undertake a proof of concept that demonstrated the use of primary care data and natural language processing and term extraction to assess emergency room use. The study extracted biopsychosocial concepts from primary care free text and related them to inappropriate emergency room use through the use of odds ratios.Methods: De-identified free text notes were extracted from a primary care clinic in Guelph, Ontario and analyzed with a software toolkit that incorporated General Architecture for Text Engineering (GATE) and MetaMap components for natural language processing and term extraction.Results: Over 10 million concepts were extracted from 13,836 patient records. Codes found in at least 1% percent of the sample were regressed against inappropriate emergency room use. 77 codes fell within the realm of biopsychosocial, were very statistically significant (p < 0.001) and had an OR > 2.0. Thematically, these codes involved mental health and pain related concepts.Conclusions: Analyzed thematically, mental health issues and pain are important themes; we have concluded that pain and mental health problems are primary drivers for inappropriate emergency room use. Age and sex were not significant. This proof of concept demonstrates the feasibly of combining natural language processing and primary care data to analyze a system use question. As a first work it supports further research and could be applied to investigate other, more complex problems.

scholarly journals Practice Transformation: Using Team-Based Care Training to Improve Diabetes Outcomes

2018 ◽  
Vol 9 ◽  
pp. 215013271881795
Author(s):  
Lori A. Bilello ◽  
Christopher Scuderi ◽  
Charles J. Haddad ◽  
Carmen Smotherman ◽  
Edward Shahady
Keyword(s):  
Primary Care ◽  
Training Program ◽  
Hemoglobin A1c ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol ◽  
Care Training ◽  
Team Based Care

Background: One of the key factors of the patient-centered medical home (PCMH) transformation require shifting mental models at the individual level and culture change at the practice level on how clinicians and support staff work together. This culture shift requires a reeducation on the roles and communication strategies within the medical practice. The objective of this project was to implement a team-based care training program based on the AHRQ TeamSTEPPS framework in 6 primary care practices affiliated with a Primary Care Practice Based Research Network to increase communication and performance of the care teams. Methods: Clinicians and staff from these sites received external facilitation by a certified TeamSTEPPS master trainer, who is a physician specializing in diabetes care, over a 1-year period. An analysis of their established diabetes patients’ hemoglobin A1c and low-density lipoprotein cholesterol before the training program and posttraining was performed using the paired t test and verified using the Wilcoxon sign rank test. Results: There was a statistically significant decrease in the mean hemoglobin A1c levels from 7.48% to 7.32% ( P < .001) and low-density lipoprotein cholesterol from 92.34 to 88.34 mg/dL ( P = .002) for all the practices combined but only 3 practices saw significant improvement individually. Conclusions: Even though the practices participating in this training are PCMHs and are part of a larger primary care network, they have achieved different levels of success, partly due to leadership and buy-in by staff. Practice leaders and team members need to fully embrace team care concepts and continuously monitor teamwork experiences to support effective team-based care.

Primary Care Patients' Reactions to Mental Health Screening

1996 ◽  
Vol 26 (4) ◽  
pp. 431-441 ◽  
Author(s):  
Mark Zimmerman ◽  
David T. Lush ◽  
Neil J. Farber ◽  
Jon Hartung ◽  
Gary Plescia ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Psychiatric Treatment ◽  
Primary Care Clinic ◽  
Empirical Support ◽  
Medical Patients ◽  
Care Clinic ◽  
History Of ◽  
Primary Care Patients ◽  
High Level

Objective: The authors examined whether there is empirical support for the notion that medical patients are upset by being asked questions about psychiatric disorders. Method: Six hundred and one patients attending a primary care clinic completed the SCREENER—a newly developed, brief self-administered questionnaire that surveys a broad range of psychopathology. In addition, they completed a second questionnaire that assessed their attitudes toward the SCREENER. Results: We found a high level of acceptance by patients. The questions were judged easy to answer, and they rarely aroused significant negative affect. Fewer than 2 percent of the patients judged the questions difficult to answer, and fewer than 3 percent were “very much” embarrassed, upset, annoyed, or uncomfortable with the questions. Individuals with a history of psychiatric treatment and poorer current mental health reacted more unfavorably to the questionnaire. Conclusions: From the patient's perspective, it is feasible and acceptable to use self-administered questionnaires for routine screening of psychiatric problems in primary care settings.

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