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1.
Epilepsy Behav ; 41: 114-8, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25461200

RESUMO

OBJECTIVE: The objective of this study was to evaluate the understanding of adolescent patients regarding epilepsy. METHODS: The SAFETY (Safety, Awareness, and Familiarity regarding Epilepsy in Teenage Years) questionnaire (content validity index: 0.96, Flesch readability score: 66.6) was administered to 165 cognitively normal adolescents with epilepsy (85 females, mean age: 15.2 ± 1.6 years, range: 13-18 years). The first part of the questionnaire was devised to evaluate knowledge about epilepsy and antiepileptic medications (SAFETY-K: 7 questions). The second part queried lifestyle modifications and safety (SAFETY-S: 10 questions). Female participants answered 5 additional questions related to reproductive health (RH questionnaire). RESULTS: The correct response rate for the composite SAFETY questionnaire was 51.5%. The average rates of correct responses for the SAFETY-K and SAFETY-S questions were 47.9% and 53.9%, respectively. On univariate logistic regression analysis, factors which were significant predictors of correct responses included age (odds ratio: 1.8, C.I. = 1.3-2.4), race (Caucasian vs. African-American; odds ratio: 3.9, C.I. = 1.4-10.4), and employment of at least one parent in a professional occupation (odds ratio: 3.3, C.I. = 1.1-10.3). The correct response rate did not correlate with the duration of epilepsy, extent of seizure control, number of antiepileptic medications, parental educational, or (un)employment status. The mean rate of correct responses for the RH questions amongst teenage girls was 17.4%. CONCLUSIONS: There is lack of awareness about epilepsy and its associated lifestyle modifications in adolescents with epilepsy seen at our institution. This is especially true in young adolescents, African-American patients, and those whose parents are not employed in professional occupations. Teenage girls with epilepsy appear to have limited knowledge with respect to contraception and childbearing.


Assuntos
Conscientização , Epilepsia/psicologia , Segurança do Paciente , Reconhecimento Psicológico , Adolescente , Negro ou Afro-Americano , Anticonvulsivantes/efeitos adversos , Anticonvulsivantes/uso terapêutico , Epilepsia/tratamento farmacológico , Etnicidade , Feminino , Humanos , Estilo de Vida , Masculino , Estudos Prospectivos , Convulsões/prevenção & controle , Fatores Sexuais , Inquéritos e Questionários , População Branca
3.
Jt Comm J Qual Patient Saf ; 48(12): 674-681, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36243658

RESUMO

BACKGROUND: The rate of patients not keeping their appointments at our children's hospital outpatient pediatric neurology clinic (no-shows) was high. We conducted a quality improvement project to reduce no-show rates and improve operational efficiency. Specifically, we aimed to decrease the new patient no-show mean rate from 7% to 4% at the main campus and from 17% to 12% at the south campus. METHODS: After reviewing the previous literature on this topic and institutional data, we used the simplified failure mode and effects analysis (sFMEA) to identify the key drivers. Of the patients at the main campus who failed to keep their appointment, 84% had not confirmed their appointment. Errors in inpatient/family contact information, limited use of the electronic patient portal, and miscommunication were other key drivers identified. Three Plan-Do-Study-Act (PDSA) cycles were completed over seven months. The key interventions we implemented were bidirectional text triage, telephone reminders, and promoting the use of the electronic patient portal. A run chart was used to assess the results of these interventions. RESULTS: A statistically significant shift was noted in the run chart for the median rate of no-shows, which declined from 7% to 4% at the main campus and 17% to 10% at the south campus. CONCLUSION: We were able to successfully reduce no-shows among new patients in the neurology clinic. The limitations of our study include unknown external factors, the potential impact of COVID-19, and the brief length of the study.


Assuntos
COVID-19 , Neurologia , Envio de Mensagens de Texto , Criança , Humanos , Agendamento de Consultas , Telefone , Sistemas de Alerta
4.
Artigo em Inglês | MEDLINE | ID: mdl-34305006

RESUMO

Tourette syndrome (TS) causes academic, social, emotional, physical, and functional problems. Most TS patients also have comorbid neuropsychological conditions. The purpose of this review is to provide updated information to the clinician about phenomenology, epidemiology, comorbidities, pathophysiology and management strategies for tics (a hallmark of TS) and TS. Recent findings suggest that TS is likely due to a combination of several different genes and environmental factors, with possible involvement of the cortical-basal ganglia-thalamocortical circuit and related multiple neurotransmitters. First-line management includes psychoeducation for families, patients, and school personnel, as well as behavioral therapy. Non-medicine treatment for tics is advancing to include younger children and increase access via remote service applications. Pharmacotherapy is used if appropriate and several new medicines are under investigation (e.g., Tetrabenazine, valbenazine, deutetrabenazine, ecopipam, cannabinoids). Deep brain stimulation and Mouthguard therapy can be used for children with intractable illness.


Assuntos
Síndrome de Tourette , Terapia Comportamental , Criança , Comorbidade , Emoções , Humanos , Síndrome de Tourette/diagnóstico , Síndrome de Tourette/epidemiologia , Síndrome de Tourette/terapia , Valina
5.
Clin Pediatr (Phila) ; : 99228241260939, 2024 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-38880977
9.
Mov Disord Clin Pract ; 4(5): 784-786, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-30363417

RESUMO

http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)2330-1619/homepage/mdc312518-sup-v001.htm.

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