Дисертації з теми "Medical screening Evaluation"
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1
Wilcken, Bridget. "Evaluation of newborn screening : studies in cystic fibrosis and disorders detectable by tandem mass spectrometry." Thesis, The University of Sydney, 2008. https://hdl.handle.net/2123/29181.
Повний текст джерелаАнотація:
I have been involved in several areas of newborn screening, and my thesis deals with two of these: -cystic fibrosis and tandem mass spectrometry. It comprises 36 papers describing work carried out between 1981 and 2008. This is arranged in sections to describe the implementation of screening and the evaluation of outcomes for each of these areas, cystic fibrosis and tandem mass spectrometry, as well as papers reviewing important general aspects of newborn screening -a review of current newborn screening, the problems of evaluation of outcome where disorders are very rare, and the ethical issues involved in screening.
I believe my major contributions to knowledge and medical practice have been:
• Fostering the recognition that the clinical diagnosis of cystic fibrosis was considerably delayed, that newborn screening was feasible in the field, and that patients with pancreatic sufficiency were readily diagnosed by newborn screening;
• The evaluation and review of different screening strategies for cystic fibrosis;
• The demonstration that identification of cystic fibrosis by screening confers a significant health benefit by greatly reducing hospitalisation in the early years, and providing nutritional and pulmonary benefits later in life;
• Initiating screening by tandem mass spectrometry in New South Wales -the first publicly-funded state-wide screening for disorders of amino acid and fatty acid metabolism -and delineating some of the disorders which could and could not be reliably detected by this technology;
• Providing the first population-based audit of the rate of diagnosis of these disorders clinically compared with diagnosis by newborn screening;
• Providing the first clear demonstration of significant clinical benefits of tandem mass spectrometry screening for the commonest disorder of fatty acid oxidation, medium-chain acyl-CoA dehydrogenase deficiency.
• Promoting the proper use of newborn screening programmes by examining the rationale for screening, ethical aspects, and what disorders should and should not be included in newborn screening programmes.
2
Zaro, Maren Lothyan. "Breast Cancer Risk Assessment: Evaluation of Screening Tools for Genetics Referral." BYU ScholarsArchive, 2016. https://scholarsarchive.byu.edu/etd/8824.
Повний текст джерелаАнотація:
Purpose: This study assessed effectiveness of five tools recommended by the US Preventive Services Task Force (USPSTF), designed to help primary care clinicians determine which unaffected patients to refer to genetics specialists for breast cancer risk assessment based on concerning family history. Design: This descriptive secondary analysis included 85 women aged 40-74. All participants had a first-degree female relative previously diagnosed with breast cancer who also had uninformative negative BRCA1/2 tests. Methods: Each pedigree was evaluated using the five tools including the Family History Screen-7 (FHS-7), Pedigree Assessment Tool (PAT), Manchester Scoring System, Referral Screening Tool (RST), and Ontario-Family History Assessment Tool (Ontario-FHAT). All five tools were applied to each study participant. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated to describe each tool’s ability to identify women with elevated risk as calculated by the Claus model. Receiver operating curves (ROC) were also plotted. Differences between areas under the curve (AUCs) for all possible pairs of tools were estimated through logistic regression to assess for differences in tool performance. Results: Claus calculations identified 14 women out of 85 whose lifetime risk of breast cancer was elevated at > 15%. Only two tools, the Ontario-FHAT and FHS-7, identified all 14 women with elevated risk, a sensitivity of 100%. The FHS-7 tool flagged all 85 participants, meaning its specificity was zero. The Ontario-FHAT flagged 59 participants as needing referral (specificity 36.2%) and had a negative predictive value (NPV) of 100%, indicating that if a woman was not found to need a referral to a genetics professional, it is likely she did not have an elevated lifetime risk of developing breast cancer. AUC values were not significantly different between tools (all p values > .05), and thus were not helpful in discriminating between the tools. Conclusion: In this population, the Ontario-FHAT out-performed other tools in terms of sensitivity and negative predictive value; however, low specificity and positive predictive value must be balanced against these findings. Thus, the Ontario-FHAT can help determine which women would benefit from referral to a genetics specialist.
3
Rai, Vijeta. "Screening of large collection of compounds for anti-human parainfluenza virus type-2 activity and evaluation of hit compounds." Thesis, Högskolan i Skövde, Institutionen för biovetenskap, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:his:diva-14385.
Повний текст джерелаАнотація:
Human parainfluenza virus type-2 (HPIV-2) is a highly contagious respiratory pathogen that can cause severe respiratory disease known as laryngotracheobronchitis or croup-like disease in children. No specific vaccine or an antiviral drug is currently approved for treatment of HPIV-2 infections. In this project, a library of 14400 diverse compounds had been screened for anti-HPIV-2 activities in cultures of African green monkey kidney cells. All compounds that inhibited the virus induced syncytium-forming activity in these cells were considered as hit compounds. Three hit compounds showed moderate anti-HPIV-2 activity characterized by the IC50 values of 20 µM and selectivity indices of approximately 5. This suggests that the antiviral activity of these compounds was due to targeting activities of cellular rather than viral components. Another hit compound, referred to as compound 5, showed anti-HPIV-2 activity that was manifested as a reduction of area of the virus-induced plaques in cells at not cytotoxic concentrations. Interestingly, this compound did not inhibit initial infection nor the virus production in infected cells as revealed by the time-of-addition assay. Moreover, it showed no direct the virus-inactivating (virucidal activity) against HPIV-2 particles. However, relatively short pre-treatment (4 hours) of the cells with compound 5 prior to the virus infection was sufficient for its plaque size-reducing activity suggesting that anti-HPIV-2 activity of compound 5 was due to targeting activities of cellular rather than viral components. Further studies are needed to elucidate the anti-HPIV-2 mechanism of activity of hit compounds identified in the present study.
4
Bilal, Dejan. "Evaluation of systolic and diastolic left ventricular function during exercise in athletes." Thesis, Malmö universitet, Fakulteten för hälsa och samhälle (HS), 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-25669.
Повний текст джерелаАнотація:
Idrottshjärta är ett kardiovaskulärt tillstånd som uppträder under längre perioder av intensiv träning som orsakar strukturella, funktionella och elektriska förändringar hos hjärtat och är en fysiologisk anpassning som svar på ett ökat hemodynamiskt behov under fysisk ansträngning. De fysiologiska anpassningarna har dock blivit ett diagnostiskt dilemma att urskilja från de patologiska förändringarna såsom hypertrofisk kardiomyopati. Det finns därför ett behov av standardisering av kardiovaskulär screening hos idrottare för att upptäcka underliggande eller dolda kardiomyopatier som kan leda till allvarliga konsekvenser under fysisk ansträngning. Studiens ändamål var att undersöka den systoliska och diastoliska vänsterkammarfunktionen under ansträngning hos idrottare och öka förståelsen om vad som händer med de olika variablerna under arbete. Nio friska idrottare genomförde stressekokardiografi där cardiac index, ejektionsfraktion, fyllnadstryck, mitralisklaffplanets longitudinella rörelse (MAPSE), mitralisinflöde, vävnadsdoppler (e´ och s´) och veninflöde undersöktes före, under och efter ett ansträngningstest på ergometercykel. Variablerna under och efter cykeltestet jämfördes sedan med värdena i vila. Resultaten visade en signifikant ökning av cardiac index, MAPSE och vävnadsdoppler under ansträngning. Sammanfattningsvis visade studien att flera av variablerna förbättrades under ansträngning och en del av de visade sig vara relativt okänsliga för störningar och artefakter vilket kan vara användbart för framtida studie protokoll som avser utföra en hjärtstudie under arbete.Athlete’s heart is a cardiovascular condition that occurs during extended periods of intense exercise that causes structural, functional and electrical changes of the heart and is a physiological adaptation in response to increased hemodynamic needs during physical exertion. However, the physiological adaptations have become a diagnostic dilemma to distinguish from the pathological changes such as hypertrophic cardiomyopathy. Therefore, there is a need for standardization of cardiovascular screening in athletes to detect underlying or hidden cardiomyopathies that can lead to severe consequences during physical exercise. The aim of the present study was to investigate the systolic and diastolic left ventricular function during exercise in athletes and to increase the understanding of what happens to the various variables during exertion. Nine healthy athletes conducted stress echocardiography where cardiac index, ejection fraction, filling pressure, mitral annular plane systolic excursion (MAPSE), mitral inflow, tissue Doppler imaging (e 'and s') and pulmonary venous inflow were examined before, during and after a cycle ergometer test. The variables during and after the cycle test were then compared to baseline. The results showed a significant increase in cardiac index, MAPSE, and tissue Doppler imaging during exertion. In conclusion, the study showed that several of the variables improved during exertion and some of them proved to be quite insensitive to disturbances and artifacts, which may be useful in future study protocols that consider carrying out a cardiac study during work.
5
De, Azevedo Moreira Reis Marta. "Evaluation of healthcare management issues in the provision of clinincal services for familial breast/ovarian cancer /." St Andrews, 2009. http://hdl.handle.net/10023/728.
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6
Olsson, Anna, and Denise Nordlöf. "Early screening diagnostic aid for heart disease using data mining : An evaluation using patient data that can be obtained without medical equipment." Thesis, KTH, Skolan för datavetenskap och kommunikation (CSC), 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-166593.
Повний текст джерелаАнотація:
Heart disease is the leading cause of death in the world. Being able to conduct an early screening diagnosis of heart disease at home, could potentially be a tool to reduce the amount of people who lose their lives to the disease in the future. This report aims at investigating if an early screening diagnostic aid using no attributes requiring advanced medical equipment to be measured can be created, that acquires the same level of accuracy as previous data sets and studies. A litera- ture study of medical background, patient data sets and attributes, as well as data mining was conducted. A unique home data set consisting of attributes that can be obtained from home was created and data mining experiments were run in WEKA, using classification algorithms Naive-Bayes and Decision Trees. The results are compared to the Cleveland data set in regards to accuracy. The study shows that the home data set does not deliver the same accuracy level as the Cleveland data set. The idea that similar accuracy can be obtained for the dierent sets has not been disproven and more exhaustive research is encouraged.
7
Jagtap, Vinayak. "Cyber Physical System for Continuous Evaluation of Fall Risks to Enable Aging-In-Place." Digital WPI, 2015. https://digitalcommons.wpi.edu/etd-theses/508.
Повний текст джерелаАнотація:
Every year, one out of three adults over the age of 65 falls, and about 30% of the falls result in moderate to severe injuries. The high rate of fall-related hospitalizations and the fact that falls are a major source of morbidity and mortality in older adults have motivated extensive interdisciplinary clinical and engineering research with a focus on fall prevention. This research is aimed at developing a medical Cyber Physical System (CPS) composed of a human supervised mobile robot and ambient intelligence sensors to provide continuous evaluation of environmental risks in the home. As a preventive measure to avoid falls, we propose use of mobile robots to detect possible fall risks inside a house. As a step-up to that, we also define a control framework for intelligent, networked mobile robots to semi-autonomously perform assistive and preventive tasks. This framework is integrated in a smart home that provides monitoring and control capabilities of environmental conditions such as objects blocking pathways or uneven surfaces. The main outcome of this work is the realization of this system at Worcester Polytechnic Institute's (WPI) @Home testbed.
8
Collett, DeShana Ann. "THE INFLUENCE OF RACE AND SOCIOECONOMIC STATUS ON ROUTINE SCREENING PRACTICES OF PHYSICIAN ASSISTANTS." UKnowledge, 2013. http://uknowledge.uky.edu/epe_etds/13.
Повний текст джерелаАнотація:
Health disparities in minorities and those of low socioeconomic status persist despite efforts to eliminate potential causes. Differences in the delivery of services can result in different healthcare outcomes and therefore, a health disparity. Some of this difference in care may attribute to discrimination resulting from clinical biases and stereotyping which may provide a possible source for the persistence of health disparities. Health disparities may occur because the delivery of services at some level is inadequate. Disparities resulting from the quality and quantity of care delivered by a practitioner result in differentiated delivery of healthcare, thus unequal health outcomes. The purpose of this study is to evaluate and identify potential disparities in routine screening practices of physician assistants.A randomized sample of practicing physician assistants in Kentucky were analyzed (N= 112) to determine if the race or socioeconomic status of a patient influenced their likelihood of offering different routine screening recommendations and screening test recommendations. Clinical vignettes were created with only the race and socioeconomic status of the patient modified, resulting in four separate vignettes. Through the use of a survey instrument, participants were randomly assigned to one of four written clinical vignettes. Statistical analysis using a MANOVA revealed that the race of a patient had a statistically significant multivariate effect on differences in screening recommendations and race and socioeconomic status had significant multivariate effects on screening test recommendations.Study results suggest that race and socioeconomic status continues to be a significant factor in the prevalence of healthcare disparities. More importantly, this study reveals that Physician Assistants may provide differentiated care based on a patient’s race. Limitations and future directions for this study may be used to examine PA educational curriculums for the inclusion of health disparities and possible continuing medical education opportunities for practicing PAs.
9
Nestleroth, Pamela Foy. "Evaluation of the Fetal Heart at 14 – 18 Weeks Gestation in Fetuses with a Screening Nuchal Translucency Greater than or Equal to the 95th Percentile." The Ohio State University, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=osu1337817349.
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10
Elangovan, Saravanan, Ashley Brown, Molly Harman, Shannon Bramlette, and Diana Wilson. "Examining the Effectiveness of Training Protocols of Universal Newborn Hearing Screeners in the Appalachia region of the United States." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/asrf/2019/schedule/164.
Повний текст джерелаАнотація:
Universal Newborn Hearing Screenings have largely been successful since the National Institute if Health Consensus Development recommended, in 1996, that all infants should receive a newborn hearing screening prior to hospital discharge. Currently, the implementation of newborn hearing screening programs is varied across states and hospitals in the U.S. Due to this high variability, it is the responsibility of each individual hospital to formulate and consistently maintain a protocol for their newborn hearing screening program. This can create a great burden among hospitals as they must obtain the appropriate equipment, as well as employ and train screeners. However, national medical groups may be utilized to alleviate this burden. These medical groups supply the equipment, and more importantly, employ and train the screeners. This not only alleviates the burden on hospitals, but also provides a degree of standardization across newborn hearing screening programs which may reduce lost-to-follow-up statistics. Hospitals who do not utilize a national medical group may not have the expertise to formulate a comprehensive newborn hearing screening protocol. Our study is interested in examining if birthing hospitals that utilize a national medical group have more standardized medical protocols and have better (lower) lost-to-follow-up statistics. A survey was administered to current universal newborn hearing screeners employed at five hospitals across the eastern region of Tennessee. The survey examined various aspects of a typical newborn hearing screening program including training protocols and requirements, screening equipment, data recording and tracking, and methods of delivery of test results. In our presentation, we will be sharing the results of this study and interpret the data in light of determining best practices for newborn hearing screenings.
11
April, Michael David. "Human immunodeficiency virus testing and linkage-to-care in South Africa : an epidemiological and economic evaluation of expansion." Thesis, University of Oxford, 2008. http://ora.ox.ac.uk/objects/uuid:0fb860b2-14cb-40b5-a080-48a95b4874b1.
Повний текст джерелаАнотація:
This thesis evaluates the cost-effectiveness of eight policies expanding human immunodeficiency virus (HIV) testing in South Africa. All policies entail provider-initiated test offers for primary healthcare users and one of two options across three policy components: (i) consent method, opt-in or opt-out; (ii) test protocol, rapid only or rapid plus acute infection testing; and (iii) linkage-to-care, standard or enhanced. This thesis highlights four methodological issues. First is the challenge of conducting a population-level analysis, projecting the cost-effectiveness of expanded testing for each member of South Africa’s adult African population. To this end, I conducted a retrospective, descriptive study to measure current population-level testing rates and epidemic descriptors in an African community near Cape Town, South Africa. Second, the effects of testing expansion on current testing uptake were estimated by distinguishing testing in the study community likely to cease after testing expansion (baseline testing) from that likely to continue (background testing). Third, because testing alone is an outcome of less interest than health benefits following treatment, study community linkage-to-care probabilities were estimated and models utilized to estimate the efficacy of treatment. Fourth, the methods to convert the study community testing data into inputs for these models’ parameters are outlined. The enhanced linkage-to-care policies proved the most cost-effective, with opt-in testing and a rapid-only test protocol the least expensive cost-effective option at $848 per life year gained (LYG). Adding an opt-out consent method or acute infection test protocol to this policy increased the LYGs, but at higher cost-effectiveness ratios.
12
Kenana, Motlatsi Queen. "An evaluation of the attitudes and understanding of HIV/AIDS that underpins the decision to comply or not comply with prenatal HIV/AIDS testing." Thesis, University of the Western Cape, 2007. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_9853_1256911768.
Повний текст джерелаАнотація:
This study aimed to explore the attitudes to HIV testing among a group of black, low socio-economic status pregnant women from Gugulethu, South Africa. The key research interest was to evaluate the attitudes and understandings of HIV/AIDS that underpin the decision to comply or not comply with prenatal HIV testing. Theories of health behaviour concur that the extent to which an individual will engage in a given health behaviour, such as HIV test compliance, will be a function of the extent to which a person believes she is personally susceptible to the particular illness and her evaluation of the severity of the consequences of contracting the disease.
13
Henriksson, Martin. "Cost-effectiveness and Value of Further Research of Treatment Strategies for Cardiovascular Disease." Doctoral thesis, Linköping : Univ, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-9788.
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14
Godlonton, Michael D. "Evaluating prevention strategies used by general practitioners in Grahamstown in terms of recommended guidelines." Thesis, Stellenbosch : University of Stellenbosch, 2015. http://hdl.handle.net/10019.1/97241.
Повний текст джерелаАнотація:
Background: Increasing attention has been paid to preventative health over the past few decades. However because of constraints on consultation time and medical funds general practitioners (GPs) are often unsure which measures are appropriate and when to carry them out. They need to be well informed about the cost-effectiveness and evidence regarding each preventative measure to help their patients make informed choices about what needs to be done. Due to the large number of recommended screening measures general practitioners are often unsure which to prioritise and also forget to carry out all recommended measures. Recommendations for screening in South Africa and research into preventive strategies used by general practitioners are lacking. This research attempts to find out whether the prevention strategies used by general practitioners in private practice in Grahamstown follow recommended guidelines.
Methods: To obtain a broad understanding of prevention strategies used by general practitioners in Grahamstown, the following tracer conditions were selected for the study: screening for smoking, breast cancer, cervical cancer, colorectal cancer, hyperlipidaemia, prostate cancer and human immunodeficiency virus (HIV) infection. Research on routine annual health checks was included as these are used by many GPs to screen for tracer conditions. The research was done in 2 parts: 1. Review of the literature to obtain evidence on the recommended prevention strategy for each of the selected tracer conditions and 2. Interviews with GPs to evaluate the prevention strategy they used for each tracer condition. The literature was reviewed for evidence on the following parameters for each tracer condition: burden of the disease prevented; cost-effectiveness of the screening measures; sensitivity and specificity of screening tests; whether the screening measure for and treatment of the tracer condition is acceptable to patients; appropriate duration between repeated screening tests and whether there is effective treatment for the tracer condition. Eleven general practitioners were interviewed on the prevention strategies they use for each of the selected tracer conditions. Transcriptions of the interviews were analysed qualitatively and qualitatively. The prevention strategies used by the general practitioners was then compared to recommended guidelines.
Results: Evidence from the literature regarding the burden of and optimal prevention strategy for each tracer condition is reported. Using this evidence an appropriate prevention strategy for each tracer condition is outlined. The prevention strategies used by the GPs for each tracer condition and the routine annual health check is reported from the analysis of the interviews. The results show a wide range of differing strategies used by the GPs, often not following recommendations from research.
Discussion: The prevention strategies used by general practitioners for each tracer condition is compared with the recommendations from the literature. Important differences between what are recommended and what general practitioners are doing is discussed. Some general practitioners are practicing largely curative medicine and are not adequately screening their patients. Others are over screening with too many unnecessary tests being done annually as a routine. The interviews reveal that generally GPs do not discuss the potential harms and limitations of screening tests with their patients; do not keep check lists for each patient and do not use registers or recall systems to ensure all screening is done.
Conclusion: General practitioners need to ensure their prevention strategies follow recommended guidelines. To do so they can use the routine annual health check or opportunistic case finding and prevention. They need to ensure that routine health checks are targeted to the individual patients’ health risks and avoid doing unnecessary tests. Check lists can help to ensure all screening is done on every patient. While registers and recall systems improve screening rates they are not always possible in busy general practices. Recommended prevention strategies for each of the tracer conditions are made.
15
Nawsheen, Sabia. "Evaluation of Fragment-Based VirtualScreening by Applying Docking onFragments obtained from Optimized Ligands." Thesis, Uppsala universitet, Institutionen för läkemedelskemi, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-446388.
Повний текст джерелаАнотація:
Fragment-based virtual screening is an in-silico method that potentially identifies new startingpoints for drug molecules and provides an inexpensive and fast exploration of the relevantchemical space compared to its experimental counterpart. It focuses on docking small potentialbinding fragments to a binding pocket and is used to design improved binders by growing thefragments or joining fragments using suitable linkers. In this project, a fragment-based virtualscreening was evaluated by docking 21 fragments that are obtained from 4 different drugs. Here,the fragments were evaluated using SP score in place and SP and XP flexible docking methodsand were compared to the results of the two decoy fragment datasets. Three of the investigatedfragments are positioned at the top and docked with the correct poses and pockets when comparedto the corresponding substructure in the crystal structure and thus could be considered a successfulfragment starting points. Out of the two flexible docking methods used, the SP method providedadditional correct poses and pockets than XP in this limited dataset.
16
Nawsheen, Sabia. "Evaluation of Fragment-Based Virtual Screening by Applying Docking on Fragments obtained from Optimized Ligands." Thesis, Uppsala universitet, Institutionen för läkemedelskemi, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-446388.
Повний текст джерелаАнотація:
Fragment-based virtual screening is an in-silico method that potentially identifies new startingpoints for drug molecules and provides an inexpensive and fast exploration of the relevantchemical space compared to its experimental counterpart. It focuses on docking small potentialbinding fragments to a binding pocket and is used to design improved binders by growing thefragments or joining fragments using suitable linkers. In this project, a fragment-based virtualscreening was evaluated by docking 21 fragments that are obtained from 4 different drugs. Here,the fragments were evaluated using SP score in place and SP and XP flexible docking methodsand were compared to the results of the two decoy fragment datasets. Three of the investigatedfragments are positioned at the top and docked with the correct poses and pockets when comparedto the corresponding substructure in the crystal structure and thus could be considered a successfulfragment starting points. Out of the two flexible docking methods used, the SP method providedadditional correct poses and pockets than XP in this limited dataset.
17
Chrástek, Radim. "Automated retinal image analysis for glaucoma screening and vessel evaluation /." Berlin : Logos-Verl, 2006. http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&doc_number=014783827&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA.
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Woo, Pao-sun Pauline. "Applications of age-period-cohort and state-transition Markov models in understanding cervical cancer incidence trends and evaluating the cost-effectiveness of cytologic screening." Click to view the E-thesis via HKUTO, 2006. http://sunzi.lib.hku.hk/hkuto/record/B36900400.
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Jonsson, Håkan. "Evaluation of service screening with mammography in Sweden with special regard to its impact on breast cancer mortality." Doctoral thesis, Umeå universitet, Onkologi, 2002. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-94113.
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20
Lindh, Martin. "Computational Modelling in Drug Discovery : Application of Structure-Based Drug Design, Conformal Prediction and Evaluation of Virtual Screening." Doctoral thesis, Uppsala universitet, Avdelningen för organisk farmaceutisk kemi, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-328505.
Повний текст джерелаАнотація:
Structure-based drug design and virtual screening are areas of computational medicinal chemistry that use 3D models of target proteins. It is important to develop better methods in this field with the aim of increasing the speed and quality of early stage drug discovery. The first part of this thesis focuses on the application of structure-based drug design in the search for inhibitors for the protein 1-deoxy-D-xylulose-5-phosphate reductoisomerase (DXR), one of the enzymes in the DOXP/MEP synthetic pathway. This pathway is found in many bacteria (such as Mycobacterium tuberculosis) and in the parasite Plasmodium falciparum. In order to evaluate and improve current virtual screening methods, a benchmarking data set was constructed using publically available high-throughput screening data. The exercise highlighted a number of problems with current data sets as well as with the use of publically available high-throughput screening data. We hope this work will help guide further development of well designed benchmarking data sets for virtual screening methods. Conformal prediction is a new method in the computer-aided drug design toolbox that gives the prediction range at a specified level of confidence for each compound. To demonstrate the versatility and applicability of this method we derived models of skin permeability using two different machine learning methods; random forest and support vector machines.
21
Lundkvist, Jonas. "The role of economic evaluations in health care decision making /." Stockholm, 2005. http://diss.kib.ki.se/2005/91-7140-423-6/.
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22
Woo, Pao-sun Pauline, and 胡寶璇. "Applications of age-period-cohort and state-transition Markov models in understanding cervical cancer incidence trends and evaluating thecost-effectiveness of cytologic screening." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2006. http://hub.hku.hk/bib/B36900400.
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Wipa, Tanasomwang Jutamaad Satayavivad. "The screening of anti-inflammatory action of Clinacanthus nutans (Burm. f.) Lindau : a critical evaluation of carrageenan-induced hind paw edema model /." Abstract, 1986. http://mulinet3.li.mahidol.ac.th/thesis/2529/29E-Wipa-T.pdf.
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Welte, Robert Alexander. "Methodological advances in the economic evaluation of infectious disease prevention : the case of Chlamydial Screening and Meningococcal C Vaccination /." Frankfurt am Main [u.a.] : Lang, 2007. http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&doc_number=015607341&line_number=0002&func_code=DB_RECORDS&service_type=MEDIA.
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Sahli, David. "Early arterial disease of the lower extremities in diabetes diagnostic evaluation and risk markers /." Doctoral thesis, Umeå : Umeå university, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-26711.
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Shaik, Rieaz. "An evaluation of a school based vision screening programme." Thesis, 1992. http://hdl.handle.net/10413/7832.
Повний текст джерелаАнотація:
The effectiveness of a vision screening programme in government schools in the Durban Functional Region under the jurisdiction of the House of Representatives was evaluated. For the purpose of the study a Comprehensive Vision Screening Programme (CVSP) was developed based on the Modified Clinical Technique (MCT) used in the Orinda Study. Of the represetative sample of 419 children assessed, the CVSP classified 85 (20.3%) as referrals. In comparison, the school health nurses referred 35 (9.6%) of the children for a complete ocular examination, 40 per cent of which were unwarranted. Analysis of the usable records showed that the school vision screening programme (SVSP) correctly categorised 307 (83.9%) of the children and incorrectly categorised 59 (16.1%) of them. The latter consisted of 3.8% over-referrals and 12.3% under-referrals. The school vision screening programme did not detect with a reasonable degree of accuracy those
children with visual disorders. The effectiveness of the SVSP, as determined by the phi coefficient, was 0.35. Approximately two thirds of the children with visual disorders were not detected by the SVSP. One in every eight children classified as having no visual problem by the SVSP
was an under-referral and two in every five children referred by the SVSP were over-referred. The high incorrect referral rates was attributed to the use of inappropriate screening techniques. The prevalence of visual disorders in the children was 20.3%; in boys 18.7% and 21.9% in girls. The relative risk of visual disorders in girls compared to boys was 1.2 (95% CI = 0.8 - 1.7). The prevalence of eye co-ordination disorders was 11.2%, refractive error problems 10.3%, visual acuity 4.5%, perceptual status (colour vision and stereopsis) 4.0% and organic disorders 1.2%. The binocular disorders were characterised as convergence insufficiencies and the disorders of accommodation were described as accommodative insufficiencies. Referable myopia (6.7%) was more prevalent than referable hyperopia (2.1%). Myopia was more prevalent in girls and hyperopia was more prevalent in boys. The clinical findings of the refractive error was compared to that measured by an autorefractor. The findings were remarkably similar and the study concluded that the difference between the two measures was not clinically
significant. The study recommended that the MCT be used as the method of choice in school vision screening protocols.Thesis (M.A.)-University of Durban-Westville, 1992.
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Bento, Maria José Afonso Teodósio. "Evaluation of breast cancer screening in the north of Portugal." Tese, 2014. https://repositorio-aberto.up.pt/handle/10216/81153.
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Bento, Maria José Afonso Teodósio. "Evaluation of breast cancer screening in the north of Portugal." Doctoral thesis, 2014. https://repositorio-aberto.up.pt/handle/10216/81153.
Повний текст джерела
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Mann, Ryan Scott. "Evaluation of digital x-ray imaging technologies for tuberculosis screening." Thesis, 2014. http://hdl.handle.net/10012/8249.
Повний текст джерелаАнотація:
Tuberculosis is a major concern in low- and middle-income countries, but may be diagnosed using standard chest x-rays. Conventional film-screen x-ray detectors require more maintenance than digital x-ray detectors and need a good supply chain of developer chemicals and film, which make them difficult to maintain in low-infrastructure areas of the world. Current digital x-ray technology is prohibitively expensive for this market, although it brings the possibility of tele-radiology and tele-medicine, quicker diagnosis time, and virtually no cost per test compared to other diagnostics for tuberculosis. This thesis examines the requirements on a small-sized, low-cost digital x-ray detector for this application.
Two small x-ray detectors were integrated into x-ray systems, then characterized for detector performance using metrics known as modulation transfer function, noise power spectrum, and detective quantum efficiency. The system designs and the results of the experiments are shown. Details are also shown about the setup of the x-ray lab, including the door interlock system for a lead-lined x-ray cabinet.
To determine whether a smaller x-ray detector is diagnostically accurate enough for tuberculosis diagnosis compared to full-size chest radiography equipment, a medical study was designed and run using a web-based survey of radiologists in Pakistan, where tuberculosis is a recognized disease.
In an attempt to compare x-ray detector performance, MATLAB code was written to measure the modulation transfer function, noise power spectrum, and detective quantum efficiency of x-ray systems. The details about this code, and challenges in simulating the performance of physically different detectors are explained in the thesis.
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Vargas, Joana Vicente. "Evaluation of Central Nervous System involvement in SLE patients. Screening psychiatric manifestations - a Systematic Review." Dissertação, 2012. https://repositorio-aberto.up.pt/handle/10216/72080.
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Lin, Tse-Hung, and 林澤宏. "Medical economic benefit evaluation of chest X-ray tour screening for high-risk group of tuberculosis infection." Thesis, 2018. http://ndltd.ncl.edu.tw/handle/a5ba2c.
Повний текст джерелаАнотація:
碩士中山醫學大學
醫療產業科技管理學系碩士班
106
Foreword: Since April 2006, Taiwan began to implement the Directly Observed Treatment Short-Course, DOTS Plan. The province''s incidence rate dropped from 63.2 per 100,000 population to 45.7 per 100,000 population in 2015. However, the incidence of tuberculosis is concentrated in the elderly population. The elderly have more than twice the incident rate compare with the young and middle-aged population. Sometimes, ten times the incident rate. The physiology of the elderly is deteriorating and the immunity is declining. As a result, the tuberculosis cells that are lurking in the body are waiting for the disease, causing tuberculosis. The incidence is higher in the older population. Coupled with the inconvenience of the elderly, the inability to take care of selves, living alone, and many other reasons, many of them live in nursing home, making this high-risk group are prone to outbreaks. Therefore, this highlight the need to implement comprehensive TB screening for the elderly population. Research purposes: The purpose of this study is to understand the resources and equipment consumed by the residents of the barrier-free X-ray to point-to-point screening for the residents of each institution, and the materials and equipment required for each X-ray tour by barrier-free X-ray tour. Costs such as depreciation and medical personnel expenses are used as cost analysis for X-ray inspection to assess their medical economic benefits. Research methods: This study is a cross-sectional study. The population of the elderly in Changhua County is used as a target. The age distribution of the elderly population and the status of screening for tuberculosis are counted, and the basis for chest X-ray screening was been used. The cost method performs the medical resources consumed by the activity in each activity. Then allocate the overhead according to the cost driver and the cost pool to calculate the cost. Finally, compares the difference between the cost of executing the plan and the government budget. This research also count the depreciation charges for X-ray tour vehicles, and the number of medical points (money) spent on the calculation of three sets of tests for suspected tuberculosis. Result: The Changhua County Health Bureau''s "106 Changhua County Health Bureau Chest X-ray roving screening, interpretation and tracking entrusted service" case, a total of 56 screen tours, including 48 institutions and 8 company or schools. The total number of X-ray inspections was 3,229. The number of abnormalities was 1,240 by the physician, accounting for 38.40% of the total subjects. Nursing home: 2,829 people. The total number of abnormalities was 1,191, which was 42.10%. Group contacts: 400 people. The total number of abnormalities was 49, and the proportion of all subjects in the group contact was 12.25%. The number of abnormal notifications was 15 and the final diagnosis was 7 with a total hospital cost of 1,428,133 yuan and a government grant of 1,341,344 yuan. The cost of a hospital for each patient is 204,019 yuan, and the cost of a government grant for each patient is 191,620.yuan Conclusion: The X-rays of the residents’ lungs in the nursing home are reconsidered as abnormally higher than all the subjects in the group contact. Most of the elderly patients who are required to stay in the nursing home are not healthy elderly people. Most of them have heart, lung diseases or ever infected in the lungs. In addition, the proportion of screening for tuberculosis in residents of nursing institutions is still much higher than that of the general public. The cost of finding a hospital for each patient is 204,019 yuan. The cost of government funding for patients is 191,620. Compared with previous studies, this means the cost of a confirmed case of tuberculosis will become higher and higher in the future, especially for residents of nursing home, which are more expensive due to inconvenient movements. For the hospitals that plan the project, regardless of the depreciation expenses of the X-ray tour vehicle, the hospital costs of are still higher than this screen plan. As long as you find a tuberculosis patient who is infected, the cost of treating patients according to health insurance, affecting the income of the caregiver or family members who are unable to work due to infection. In no more than eight years, the cost of treatment can be saved will much more than the cost of the project. In did, this screen plan is hold economic benefits. Finally, In this plan, a total of seven confirmed patients were found. According to the number of patients found and the spread speed of the disease in such proportions, the positive economic benefits could be achieved within two years. It can approve that the X-ray screening plan for residents’ lungs in nursing home is useful.
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Salveson, Roberta. "Expansion of the New York State Newborn Screening Panel and Krabbe Disease: A Systematic Program Evaluation." Thesis, 2011. https://doi.org/10.7916/D8J96D9C.
Повний текст джерелаАнотація:
The purpose of this study was to conduct a formal program evaluation of the New York State newborn screening for Krabbe disease (KD), a rare neurological disease with variable onset of symptoms to assess 1) the perceptions of stakeholders 2) KD test characteristics, and 3) actual program costs. Using the CDC Framework for Program Evaluation in Public Health, integration of qualitative and quantitative techniques was used to provide a comprehensive evaluation. Stakeholder input was elicited using semi-structured interviews of medical professionals and parents and content analysis of the interview transcripts identified five themes: Legislative/Political, Unintended Consequences, Knowledge and Science, Communication, and Moral Issues. Finally, cost and charge data were used to calculate the cost of the KD screening program from the perspective of the State. Triangulation of the results provided the conclusions for practice and policy recommendations. Using the data from the State annual reports of 9 positive KD screening results, sensitivity was calculated at 100%, specificity was 99%, positive predictive value was 5%, negative predictive value was 100% and prevalence was 1/100,000 births. However, the State reports did not include the 19 infants with low enzyme activity and mutations that could develop into later onset forms of KD. When these 19 infants were included, sensitivity, specificity, and negative predictive value remained unchanged; however, positive predictive value rose to 15%, and prevalence increased to 3/100,000 births. The total annual cost of the program from the perspective of the State was calculated at $750,652. For parents, the cost calculated from initial newborn screen to neurodiagnostic testing was $2669/family. Since 2006, there have been more than 1,000,000 infants screened for KD in New York State. While the screening has identified four infants with the early infantile form of the disease, there have been 24 others identified with low enzyme activity and mutations that may cause later onset forms of the disease, which are poorly understood. This unexpected finding suggests that newborns may be diagnosed with a disease that may not present symptomatically until adulthood. Unfortunately, the current confirmatory enzyme test and neurodiagnostic tests cannot predict onset of disease or severity of symptoms. In addition, the only available treatment, a cord blood transplant, is irreversible, has a high risk of morbidity and mortality, and long term outcomes have not been studied. While the cost of the program from the perspective of the state is not excessive, cost-effectiveness studies are needed to determine the cost of KD screening from the societal perspective, and should include treatment and follow up costs.
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Vargas, Joana Vicente. "Evaluation of Central Nervous System involvement in SLE patients. Screening psychiatric manifestations - a Systematic Review." Master's thesis, 2012. https://repositorio-aberto.up.pt/handle/10216/72080.
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Beca, Jaclyn. "Should Hepatitis B Screening Be Added to the United States Immigration Medical Exam? A Cost-utility Model." Thesis, 2010. http://hdl.handle.net/1807/25425.
Повний текст джерелаАнотація:
Hepatitis B virus (HBV) infection is a global leading cause of death as a result of its role in the development of cirrhosis, hepatic decompensation, and hepatocellular carcinoma (HCC). In industrialized nations such as the United States, chronic hepatitis B infection represents a significant and disproportionate disease burden among the foreign-born population. A Markov cohort decision model was developed to determine the cost-effectiveness of HBV screening
among new immigrants for the purposes of early detection and treatment, as compared to usual care. The incremental cost-effectiveness ratio for the screening strategy was $45,570 per quality adjusted
life year saved. Given the potential for health gains for the immigrant cohort as well as the economic attractiveness of the intervention, some consideration should be given to the addition of a universal HBV screening program to U.S. immigration policy.
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Pillai, Aravind. "Screening for common mental disorders in primary care in low and middle income countries: A rational approach to address the mental health treatment gap?" Thesis, 2020. https://doi.org/10.7916/d8-16nz-4p23.
Повний текст джерелаАнотація:
The goal of this dissertation is to examine the utility of screening for common mental disorders in primary care in low and middle income countries. Screening for common mental disorders in primary care is often considered as an important step in addressing the mental health treatment gap in low and middle income countries. Nevertheless, there is insufficient evidence to support routine mental health screening in primary care in these countries. Even in high income countries, there is a lack of consensus on the effectiveness of routine mental health screening in primary care, especially screening for depression. Challenges to screening include the high rates of false positive diagnosis, poor evidence on outcomes for people identified by screening, and potential harms due to screening.
The specific aims of this dissertation are to: 1) synthesize evidence from low and middle income countries on the current practices of screening for common mental disorders in primary care and the use of screening instruments; 2) understand the significance of a positive screen for common mental disorder in primary care, specifically the distribution and the stability of ICD-10 diagnosis for screened positive patients, their clinical course over a period of one year, and the factors associated with the clinical course; 3) examine the factors associated with antidepressant prescriptions for patients screened positive for common mental disorders in primary care and evaluate the appropriateness of antidepressant prescriptions following screening.
Based on our review of literature, evidence to support routine screening for common mental disorders in primary care in low and middle-income countries is inadequate. We highlight concerns about the fidelity with which screening is implemented, especially the flawed use of screening instruments. Introducing depression screening and physician notification in these settings seldom results in improved access to care or appropriate care. The majority of patients identified by screening in primary care have contextual, and probably non-pathological psychological distress (see page iii, for definition of key terms) which is often temporary and self-limiting. Patients with persistent distress symptoms identified by repeated screening, and those with moderate to severe depression may benefit from screening in the presence of evidence based stepped care interventions that are easily accessible and acceptable. Although, the long term effects of these interventions and the sustainability of such primary care based programs in low and middle income countries are uncertain.
Our analysis of data from a cluster randomized control trial in India confirmed that a significant proportion of patients screened positive for common mental disorders in primary care has psychological distress that is temporary and self-limiting. However, a smaller, albeit important share of patients also experienced psychological distress that persisted throughout one-year follow-up. Persistent distress was predicted by psychosocial and economic disadvantage. Thus, psychosocial support systems and structural interventions have a larger role to play in addressing psychological distress. We found poor diagnostic stability for ICD-10 based diagnoses, and the most stable and prevalent diagnosis was mixed anxiety and depressive disorder. Further, we found that antidepressants are widely prescribed following screening especially for women and older adults. While many patients with moderate to severe depression could benefit from antidepressants, it is problematic that a significant proportion of patients with less severe disorders also received anti-depressant prescription despite the availability of non-pharmacological treatment options.
In summary, there is a lack of empirical evidence to support routine screening for common mental disorders in primary care in low and middle income countries as an effective strategy to identify those in need of treatment; instead screening could lead to over diagnosis and inappropriate antidepressant prescriptions. To address psychological distress in primary care and the unmet need for treatment in low and middle income countries, there is an urgent need to focus on locally driven and culturally relevant approaches to case finding and intervention.
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Hotham, Elizabeth Dorothy. "Investigation of the alcohol, smoking and substance involvement screening test (the ASSIST) in pregnancy." Thesis, 2010. http://hdl.handle.net/2440/60650.
Повний текст джерелаАнотація:
Screening pregnant women for substance use appears unworthy of debate given the harmful impacts on the fetus, pregnancy outcomes, the woman herself and her offspring to adulthood. However while screening is routine for conditions such as impaired glucose control, obstetric care providers are often reluctant to intervene with substance use, citing knowledge deficits and a lack of effective screening tools. General negativity about the value of intervention and stereotypical views of substance users have also been identified. This study examined existing screening tools and investigated the World Health Organization’s ASSIST (Alcohol, Smoking and Substance Involvement Screening Test) Version 3.0, focussed on tobacco, alcohol and cannabis, the substances most used in the targetted public hospital clinics. The ASSIST Version 3.0’s performance in pregnancy was assessed using a two-pronged harm categorization: risk to the fetus and risk to the woman as an individual user. For the latter, levels of risk concordant with cut-offs for the general population were utilized. The ASSIST Version 3.0 performed only moderately well versus established self-report tools: the Revised Fagerstrom Tolerance Questionnaire (RTQ) for tobacco, the T-ACE for alcohol, and the Timeline FollowBack (TLFB) for cannabis. Most participants used tobacco (98 of 104); predominance of tobacco use was likely linked to the recognized difficulty in stopping, despite cessation of other substances. Kappa analyses of Specific Substance Involvement Scores (SSIS) on ASSIST Version 3.0 for tobacco did not support changing cut-offs for the woman as an individual user; however, ROC curves delineated an SSIS of 4 as indicative of fetal risk for both alcohol and cannabis. As all 98 tobacco users were ‘high risk’ users, a cut-off indicative of fetal risk for tobacco could not be determined but may be feasible by further research with first trimester women. Identifying tobacco use with an established tobacco-specific tool should be the first screening for pregnant women. If tobacco use is identified, screening for other substance use can be initiated and there may be a place for the ASSIST Version 3.0 in that context. Obstetric care providers need to then be willing and competent to address identified use, whilst avoiding unhelpful stereotyping.Thesis (Ph.D.) -- University of Adelaide, School of Medical Sciences, 2010
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Munsamy, Michelle. "A clinical audit of the implementation of the tuberculosis screening tool amongst clients who are on anti-retroviral therapy in the eThekwini local municipality clinics." Thesis, 2014. http://hdl.handle.net/10321/1168.
Повний текст джерелаАнотація:
Submitted in compliance with the requirements for the Master's Degree in Technology: Nursing, Durban University of Technology, 2014.Background : Tuberculosis (TB) is a global public health concern and is identified as the leading cause of morbidity and mortality in the population infected with Human Immune Deficiency Virus (HIV). South Africa (SA), particularly the KwaZulu-Natal Province, is burdened with persistently high rates of both TB and HIV infections. In an attempt to improve TB and HIV co-infection outcomes the South African health care system has adopted the World Health Organisation (WHO) guidelines for intensified TB case findings in all HIV positive individuals for regular screening of TB symptoms in order to promptly diagnose and treat active TB disease or to exclude TB for initiation Isoniazid Prophylactic Therapy (IPT). IPT has proven effective in preventing TB disease in People Living with HIV or AIDS (PLWHA). This critical first step of TB symptom screening is regarded as the intervention that could significantly reduce the challenge currently faced with TB-HIV co-infection. The study was conducted in selected eThekwini Municipality Primary Health Care (PHC) facilities with the focus on an investigation to determine the extent of the implementation of the TB symptom screening tool in HIV infected individuals, in addition to identifying treatment initiation or further investigations based on the tool implementation. It has been found during the literature review, that there is a lack of research in SA to show that this critical first step in TB identification has been investigated, yet one in six South African’s is HIV positive and the incidence of TB-HIV co-infection is not declining. Methodology : A quantitative, descriptive approach was utilised to conduct a retrospective patient chart review. A multistage cluster sampling technique comprising three stages was implemented to identify the sample. There was a random selection of clinics, and the required number of client records was obtained through convenience sampling from the selected clinics. Results : The findings of this study revealed there is inadequate implementation of the current national and provincial TB protocols. The study provides varied levels of information about TB symptom screening in HIV infected individuals in the PHC clinics of eThekwini Municipality. It was observed that Health Care Worker’s (HCW) in some facilities carried out TB symptom screening to an extent. However, the inconsistent and partial application of this screening tool warrants improvement to facilitate the broad success of TB-HIV care strategies.
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Carney, Timothy Jay. "An Organizational Informatics Analysis of Colorectal, Breast, and Cervical Cancer Screening Clinical Decision Support and Information Systems within Community Health Centers." Thesis, 2013. http://hdl.handle.net/1805/3243.
Повний текст джерелаАнотація:
Indiana University-Purdue University Indianapolis (IUPUI)A study design has been developed that employs a dual modeling approach to identify factors associated with facility-level cancer screening improvement and how this is mediated by the use of clinical decision support. This dual modeling approach combines principles of (1) Health Informatics, (2) Cancer Prevention and Control, (3) Health Services Research, and (4) Organizational Change/Theory. The study design builds upon the constructs of a conceptual framework developed by Jane Zapka, namely, (1) organizational and/or practice settings, (2) provider characteristics, and (3) patient population characteristics. These constructs have been operationalized as measures in a 2005 HRSA/NCI Health Disparities Cancer Collaborative inventory of 44 community health centers. The first, statistical models will use: sequential, multivariable regression models to test for the organizational determinants that may account for the presence and intensity-of-use of clinical decision support (CDS) and information systems (IS) within community health centers for use in colorectal, breast, and cervical cancer screening. A subsequent test will assess the impact of CDS/IS on provider reported cancer screening improvement rates. The second, computational models will use a multi-agent model of network evolution called CONSTRUCT® to identify the agents, tasks, knowledge, groups, and beliefs associated with cancer screening practices and CDS/IS use to inform both CDS/IS implementation and cancer screening intervention strategies. This virtual experiment will facilitate hypothesis-generation through computer simulation exercises. The outcome of this research will be to identify barriers and facilitators to improving community health center facility-level cancer screening performance using CDS/IS as an agent of change. Stakeholders for this work include both national and local community health center IT leadership, as well as clinical managers deploying IT strategies to improve cancer screening among vulnerable patient populations.
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VRZALOVÁ, Monika. "Role sestry ve screeningu deprese u seniorů." Master's thesis, 2016. http://www.nusl.cz/ntk/nusl-260905.
Повний текст джерелаАнотація:
The diploma thesis deals with problems of depression in older people. Mainly the work is focused on identifying and analyzing the role of nurses in screening for depression in older people in primary care, acute care, long-term care and home care. This thesis was focused on theoretical direction and was used the method of design and demonstration. In this thesis was set one main goals with five research questions. The main goal was to identify and analyze the role of nurses in screening for depression in the elderly. RQ 1: What is the role of the nurse in screening for depression in the elderly? RQ 2: What is the role of the nurse in the primary care in screening for depression in the elderly? RQ 3: What is the role of the nurse in screening for depression in hospitalized patients in acute care? RQ 4: What is the role of the nurse in screening for depression in seniors in long-term and home care? RQ 5: What rating scales and methods are used in screening for depression in the elderly? The thesis introduce the concept of depression. The following are specified the causes of and the important factors that affect depression in the elderly. It also deals the differences in the clinical symptomatology of depression in old age. It explains possibilities and various barriers in the diagnosis of depression. Another chapter introduces complete geriatric examination, diagnostic classification systems, possible screening methods and scales for detection of depression in the elderly population. It also deals methods of pharmacological and non-pharmacological treatment and its possible complications associated with older age. By reason of increased suicide rate caused by depressive disorder the issue of suicidal behavior in the elderly is introduced. The next chapter deals with the nursing process, which is used by nurses in practice. It consists of the evaluation of the patient's health condition, making nursing diagnosis, creating nursing plan and subsequent implementation and evaluation. The nursing process is also needy for providing quality care. The nursing process in the stage of nursing diagnosis, introduces possible nursing diagnosis for a patient suffering from depression, which are based on the latest classification. Finally is described the role of nurses in screening for depression in the elderly in different health facilities and their contribution to the timely evaluation of depression in the elderly. This chapter introduces the role of nurses, nursing screening and collaboration with a physician. The role of nurses in screening for depression in different medical facilities is based on the first phase of the nursing process of assessment. On the basis of objective and subjective information, the nurse will assess the overall health and mental condition of the patient. Primarily, it was investigated what is the role of the nurse in screening for depression. On the basis of content analysis and synthesis it was necessary to used and processed domestic and foreign literature. A number of relevant sources are the results of various studies and Meta-analyzes, mostly from abroad, but also from the Czech Republic. The thesis can serve as a basis for nurses. The result of this thesis is to create e-learning material available for students in the Faculty of Health and Social Sciences of South Bohemia in Ceske Budejovice in the tutorial called Moodle.