Integrating oral health and primary care has long been a goal for many health care organizations, including Federally Qualified Health Centers. The Ohio Association of Community Health Centers (OACHC) has recently built upon this principle through an initiative that makes blood pressure screening
In order to become an IBM Certified Database Administrator - DB2 9 DBA for z/OS, you must pass two exams: DB2 9 Fundamentals Exam (Exam 730), and DB2 9 Database Administrator for z/OS (Exam 732)the primary focus focus of this book.Written by two members of the team who participated in the actual writing of the exam, this specialized study guide covers every topic that you will need to know to pass Exam 732, including database design and implementation, operation and recovery, security and auditing, performance, as well as installation and migration/upgrade. But that is only the beginning. It also covers the new features of DB2 9 for both database and application development.This comprehensive guide includes an extensive set of practice questions in each chapter that closely model the actual exam, along with an answer key with a description of why the answer is the correct one. No other source gives you this much help in passing the exam.Whether you plan to take Exam 732 or just want to master the skills needed to be an effective database administrator on z/OS systems, this is the only book youll need.With the DB2 9 for z/OS Database Administration Certification Study Guide, you will:Discover the changes to DB2 9 that youll need to know in order to besuccessful when taking the exam Learn how to effectively administer aDB2 database Receive an explanation of every objective included on thetestby someone involved in the creation of the actual exam Find 85practice questions based on the actual exams format and approach,along with comprehensive answers to help you gain understandingPublishers Note: While this book covers much of the information needed to prepare for Exam 730, a far more in-depth review of topics specifically related to Exam 730 can be found in the MC Press companion book: DB2 9 Fundamentals Certification Study Guide by Roger E. Sanders.
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IBM's definitive, authoritative DB2 for OS/390 and z/OS reference and self-study guide!
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Abstract The present study examined the test-retest reliability of a 32-item version of the Waterloo Handedness Questionnaire (Steenhuis&Bryden, 1987, 1988, 1989) on 500 subjects. The questionnaire was shown to be reliable in terms of basic factor structure. High test-retest reliability was also found within subjects' responses and across items for both right-handers and left-handers, although left-handers were less consistent than right-handers, particularly with regard to direction of hand preference on individual questionnaire items. Furthermore, the direction of hand preference was more reliable than was the degree of hand preference. These data support a multidimensional view of hand preference in which both direction and degree can be reliably assessed.
Abstract Background Unmet needs, including access to rehabilitation, support and information, are experienced by a high proportion of stroke survivors after discharge from acute and rehabilitation services (McKevitt et al.,2011). All stroke patients should be offered a structured health and social care review six-months post-diagnosis (UK Guidelines on Stroke 2016). We aim to describe patients profile including their unmet needs who attended an Interdisciplinary Stroke Clinic situated within a Dublin teaching hospital. Methods Data was collected for all patients attending an Interdisciplinary Stroke Clinic from March 2023-April 2024, including demographic information, self-reported unmet needs and residual deficits identified using modified Greater Manchester Stroke Assessment Tool (GMSAT). Access to post-acute rehabilitation was recorded. Analysis was conducted using Microsoft Excel. Results Clinic attendance: 251 patients, 13-month period (150males, 101females; mean age 68.7yrs; range 17.27-95.5yrs). Majority of patients attended their appointment alone (n=144). Ischaemic stroke was most prevalent stroke-type of attendees (n=160). Post-acute stroke rehabilitation was accessed in 27% of cases (68/251). Group mean Clinical Frailty Scale score was 3.5 (scale 0-8) equating to ‘managing well/vulnerable’. Regarding patient-reported unmet needs, the following themes were identified, mobility (18%), fatigue (13.5 %), pain (8.5%), memory (5.5%), speech (5%) and mood (3.6%). On GMSAT assessment, fatigue (64%), mobility (49%), falls (44%), dysphagia (30%) was the most frequently identified chronic issues. As a clinical-specialist lead clinic, most issues were dealt at clinic-level with physiotherapy intervention targeting mobility/gait/spasticity (45.4%) and speech and language therapy for swallow/language management (20%) initiated. Conclusion Data from this novel Interdisciplinary Stroke Clinic supports previous research indicating many stroke survivors continue to experience chronic issues, frequently mobility, swallowing and fatigue; some of which can be addressed by stroke-specific therapists. The importance of establishing clinical-specialist led post-acute stroke review clinics/pathways in the Irish setting is highlighted. Analysis of data pertaining to stroke patient readmission is underway.
Abstract Background Stroke survivors often face unmet needs after leaving acute and rehabilitation services (McKevitt et al., 2011). UK and Ireland stroke guidelines (2023) advise a 6-month health and social care review for all patients, yet resource access in hospital and community settings hinder this. Targeting those with the most unmet needs could improve service delivery. Consequently, we examined unmet needs of stroke patients post-rehabilitation, comparing those who were discharged to rehabilitation (RG) to the non-rehabilitation group (NRG). Methods Participants: All patients attending a post-stroke review clinic between March 2023 and April 2024. Groups: RG included patients discharged to Early Supported Discharge or inpatient rehabilitation; NRG included patients not discharged to these services. Data: Collected demographic information and assessed unmet needs using a modified Greater Manchester Stroke Assessment Tool. Analysis: Using Microsoft Excel, group comparisons were made using chi-squared tests and t-tests, with log transformation applied to non-normally distributed data. Results 251 patients attended during the data collection period (69 patients (27%) in RG, 182 patients (73%) in NRG). The average age was 68 in both groups. The RG had a longer mean length of stay (23 days) compared to the NRG (19 days) (p=0.0007). The RG also had a higher mean score on the clinical frailty scale (RG 4, NRG 3, p=0.05). In the RG, 97% reported no follow-up after discharge, compared to 78% in the NRG. A greater proportion of RG patients reported swallow difficulties (12% vs. 3%, p=0.03), mobility difficulties (46% vs. 30%, p=0.02), and falls (41% vs. 30%, p=0.008) compared to NRG patients. Conclusion Data from this exploratory study suggests substantial unmet needs among post-stroke patients with a significantly higher level of unmet needs among patients who were discharged to post-acute rehabilitation. Despite this, the majority of these patients were not seen by community services at the time of 6-month review.
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