Exploration of provider exercise prescriptions and exercise referrals to place or professional: A pilot survey research study

Background: Physical inactivity contributes to roughly $28 billion in annual US health care expenditures, although few US-based providers write exercise prescriptions (EPs). Little research has explored the practice of provider referrals to places for exercise as part of an EP or part of general exercise counseling, despite the known relationship between place and health. The purpose of this pilot study, conducted with Northeast Ohio-based providers, was to assess a new instrument designed to explore provider practices related to EP and referral to place and professional.Methods: The 88-item survey combined standardized and new items to fully address the purpose. Providers were surveyed via paper and online methods. Logistic regression was conducted to explore factors related to referrals to a specific place or exercise professional.Results: Of 166 providers who completed the survey, 14.8% of prescribed exercise to patients and 54.3% referred patients to an exercise professional or specific place. Logistic regression analysis suggested that physicians who prescribed exercise were more likely to provide a referral to professional or place (OR = 6.12, 95% CI = 1.36 – 27.47) while physicians who had accurate knowledge of exercise recommendations were less likely to provide a referral to a professional or place (OR = 0.15, 95% CI = 0.04 – 0.57).Conclusions: A key reason for failure to prescribe place-based exercise referrals was provider unfamiliarity with convenient and safelocations other than health system owned fitness facilities, so provision of exercise location resources for providers potentially willincrease use of EPs

Using the Pathways Community HUB Care Coordination Model to Address Chronic Illnesses: A Case Study

Background/Objectives: Ohio communities are developing and expanding care coordination initiatives to integrate care for low-income pregnant women. Some of these initiatives are guided by the Pathways Community HUB model, which uses community healthworkers to address health, social, and behavioral risks for at-risk populations. This study documents the development, challenges andmanagement responses, and lessons learned from implementing a Pathways Community HUB care coordination program for anotherpopulation -- low-income adults with chronic disease risks.Methods: The study utilizes data extracted from the Care Coordination Systems (CCS) database used in Lucas County, Ohio between2015 and 2017 and interviews with program managers. Based on CCS data and insights from those interviewed, we describe the development and accomplishments of a Pathways Community HUB program for adults with chronic illnesses and identify challenges and lessons learned.Results: The Toledo/Lucas County program addressed more than half of 3,515 identified health and behavioral risks for 651 low-income adults in the program during its first two years of operation. Key challenges included building community support, establishing capacities to coordinate care, and sustaining the program over time. Establishing community networks to support program services and developing multiple funding sources are key lessons for long-term program sustainability.Conclusions: Documenting challenges and successes of existing programs and extracting lessons to guide implementation of similarpublic health efforts can potentially improve delivery of interventions. The Pathways Community HUB model has demonstrated success in addressing risks among at-risk adults. However, more comprehensive assessments of the model across different populations are warranted

Interactive Teaching and Learning in Mathematics: Key Concepts

У статті здійснено аналіз різних тлумачень поняття «інтерактивне навчання», уточнено дефініцію «інтерактивне навчання математики». Автором виділено особливості ключових понять зазначеної проблематики: інтерактивної педагогічної взаємодії, рефлексивної діяльності учнів та навчального середовища в структурі викладання математики. Наведено опис компонентів навчального середовища та здійснено системно-функціональний аналіз його структури у процесі навчання математики. Здійснено огляд характеристик мислення учнів, на які здійснюється вплив засобами інтерактивного навчання.This paper analyzes the interpretation of the concept «interactive teaching and learning». The definition of «senior pupils interactive teaching and learning of mathematics» is clarified. The author divides it into such key points as: it is such teaching and learning provided with the interaction between senior pupils and their own experiences in teaching-learning activities and between other pupils’ experiences (experience is realized, accumulated, systematized). Moreover, it comprises such teaching and learning grounded on the organization of a joint learning process, characterized by a realization of the natural senior pupils’ needs to dialogue, polylogue (communicative and interactive nature of learning) with artificially constructed system, the structure and content accompanied with the main studying purpose of Mathematics in upper school. The author describes interactive pedagogical interaction and learning environment in the structure of Mathematics. The paper views the learning environment in the study of Mathematics, as a specially created system, accompanied with the achievement of the main Mathematics teaching and learning goals. There is the emergence and development of the processes of informational-educational interaction between the pupils, the teacher and the means of new information technologies, formation of pupils’ cognitive activity in order to fulfill the components of the environment with the content of teaching in Mathematics. The description of the components of the learning environment (school material resources, training and methodological support; model of the educational process, the system interrelationships) is given and a qualitative description of these elements is suggested. The author conducts a systematic and functional analysis of the learning environment structure in the studying process of mathematics by senior pupils. This paper outlines the characteristics of interactive teaching and learning: the relationship between life experiences and pupils’ studying activities based on interaction with a resource of expertise and experience of others. The author offers a model of experience resource intensification through reflection activities, appeal to the dialogue and critical thinking. The author views this critical review by the characteristics of thinking, which is carried out by means of interactive learning means

Twin–Twin Transfusion Syndrome and Maternal Symptomatology—An Exploratory Analysis of Patient Experiences When Reporting Complaints

Objective: The aim of this study was to assess patient experiences when reporting symptoms of twin–twin transfusion syndrome (TTTS) to their health-care providers. Methodology: The study utilized an online, retrospective survey of women, over the age of 18, who were living in the United States at the time of their pregnancy and had completed a TTTS pregnancy. Results: Three hundred sixty-seven cases were included for analysis. Nearly half of the respondents (45.2%) reported experiencing maternal symptoms prior to TTTS diagnosis. The average number of symptoms experienced was 2.85. The average gestational week of symptom onset was 18.2. A total of 76.2% of respondents experiencing symptoms shared these concerns with their health-care provider; however, slightly more than half (51.2%) believed that the provider dismissed their complaints. Conclusions: Results suggest a disconnect between patients’ reporting TTTS symptoms and health-care providers responding attentively, as perceived by the patient. It would be advantageous for health-care providers to inform women pregnant with a monochorionic–diamniotic pregnancy to immediately report the presence of any symptom described in the present research, which may be associated with any number of twin pregnancy–related complications

Respondents’ descriptions of care received by providers.

<p>Respondents’ descriptions of care received by providers.</p

Patient-reported physician practices before and after 2014 (n = 312).

<p>Patient-reported physician practices before and after 2014 (n = 312).</p

Multivariate logistic regression predicting biweekly TTTS screening ultrasounds among patients diagnosed 2014 and after (n = 135).

<p>Multivariate logistic regression predicting biweekly TTTS screening ultrasounds among patients diagnosed 2014 and after (n = 135).</p

Patient-reported trends in MCDA identification and screening for TTTS.

<p>Patient-reported trends in MCDA identification and screening for TTTS.</p

Respondents’ descriptions of self-advocacy and recommendations.

<p>Respondents’ descriptions of self-advocacy and recommendations.</p