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Community Pharmacist-Based Collaborative Disease Management Program for Patients with Poorly Controlled Diabetes

Journal of Health Science 2015年第4期3卷 150-157页

作者： Sujit S. Sansgiry Shivani k. Mhatre harshali k. patel J. DavidHayes k.m Roberson Clyde J. James Department of Clinical Sciences and Administration College of Pharmacy University of Houston Houston 77030 TX USA Texas Pharmacy Association Austin 78759 TX USA AstraZeneca Pharmaceuticals LP San Antonio 78232 TX USA

Objective： Patients with poorly controlled diabetes have more medical complications and are more difficult to manage. The objective of the present study was to evaluate the clinical outcomes of successful implementation of an employer initiated community pharmacist-based disease management program for diabetic patients with poorly controlled diabetes. Methods： Employees with poorly controlled diabetes （glycosylated hemoglobin （A1 C） level 〉 7.5%） were identified fi＇om a large diabetes disease management program, in a rural setting in Texas, US. A longitudinal retrospective study was conducted, analyzing clinical indicators in the diabetes patients following the community pharmacist-based disease management program. The program involved a comprehensive drug therapy assessment and individualized disease management education. Primary outcome measured in the present study was A1C levels, assessed at the baseline visit and at the end of the intervention. Results： A total of 64 patients with poorly controlled diabetes were identified. Significant improvement in mean clinical outcome scores was achieved for A1C levels （p = 0.0011）. At the end of the 1 year longitudinal intervention, targeted body mass index and A1C goals were attained by 35.9% （p 〈 0.001） and 15.6% patients, respectively. The 10 patients reaching goal levels post intervention were in the group that had baseline A1C of 7.5 to 9%. However, patients with 〉 9% A1C levels at baseline had a significant reduction （mean 2.1, p 〈 0.001） post intervention. Conclusion： The community pharmacist-based diabetes disease management program improved A1C levels of patients with poorly controlled diabetes.

关键词： Poorly controlled diabetes community pharmacist intervention diabetes disease management program rural.

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Acceptability and Feasibility of YouthCHAT to Detect Psychosocial Problems in Young People with Congenital Heart Disease

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International Journal of Mental Health Promotion 2021年第2期23卷 221-230页

作者： Hiran Thabrew harshali k.mar Vanessa Garcia-Hoyos Felicity Goodyear-Smith Department of Psychological Medicine Faculty of Medical and Health SciencesUniversity of AucklandAuckland1023New Zealand Adult Congenital Heart Disease Service Paediatric and Congenital CardiologyStarship HospitalAuckland1023New Zealand Department of General Practice and Primary Health Care University of AucklandAuckland1023New Zealand

Objective:Young people with congenital heart disease(CHD)are at increased risk.of psychosocial issues,includ-ing anxiety and depression that can affect their medical care and quality of *** open trial investigated the acceptability,feasibility and preliminary effectiveness of YouthCHAT,a tablet-based screener,designed to identify similar issues to a face to face psychosocial assessment,with young people who have ***:Youth-CHAT was administered to 44 such young people aged 15–25 years attending a specialist outpatient clinic at a New Zealand tertiary *** outcomes were(i)acceptability and(ii)feasibility of YouthCHAT,assessed via feedback.from young people and clinicians and(iii)detection rates for each domain of YouthCHAT,measured by mental health or lifestyle issue being‘present’or‘absent’.Results:YouthCHAT was quick.to complete(mean 9 min and 7 s)and well-received by young people(overall rating 7 out of 10)and *** of anxiety,substance use and other issues were similar to those in a previous study of young people with mixed long-term physical ***,rates of depression(41%)and life stresses(98%)were notably ***:Although further research is required,our results provide initial evidence that YouthCHAT is a viable and accep-table psychosocial screener with which to improve the holistic care of young people with CHD.

关键词： Screening adolescent anxiety depression congenital heart disease

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Sustainability of Bridges:Risk.Mitigation for Natural Hazards

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Journal of Architectural Environment & Structural Engineering Research 2023年第3期6卷 4-16页

作者： Sachidanand Joshi Atharvi Thorat harshali Dehadray Mayuri Tundalwar UBMS Research Group Mumbai400062India

Bridges serve as essential parts of transportation infrastructure,facilitating the movement of people and goods across rivers,valleys,and other ***,they are also susceptible to a wide range of natural hazards,including floods,earthquak.s,and landslides,which can damage or even collapse these structures,leading to severe economic and human losses.A risk.index has been developed to address this issue,which quantifies the lik.lihood and severity of natural hazards occurring in a specific *** application of risk.indices for natural hazards in bridge management involves a data collection process and mathematical *** data collection process gathers information on bridges’location,condition,and vulnerability,while mathematical modelling uses the data to assess the risk.of natural ***,risk.indices provide a quantitative measure of the vulnerability of bridges to natural hazards and help to prioritize maintenance and repair *** measures are then evaluated and implemented based on the risk.assessment *** using this tool,the UBMS research group has developed an algorithm for risk.assessment which will be essential in the decision-mak.ng process,specifically focused on enhancing Fund Optimization,Deterioration Modelling,and Risk.*** developments effectively fulfill the primary objectives associated with addressing and mitigating *** development also helps bridge managers understand the potential threats posed by natural hazards and allocate resources more efficiently to ensure the safety and longevity of critical transportation infrastructure.

关键词： Hazards Risk.index Vulnerability Mitigation measures Decision-mak.ng process Fund optimization Deterioration modelling Risk.analysis

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