Please select the eligibility criteria that correspond to the clinical trial below.
Title: Reducing Prehospital Delay in Acute Myocardial Infarction
Brief Summary: This study was conducted to test whether a focused education and counseling intervention delivered by a nurse will decrease time of delay in seeking treatment for the signs and symptoms of acute coronary syndrome (i.e., heart attack) in patients already identified as having ischemic heart disease.


Options:
A: Inclusion Criteria:

PATIENT PARTICIPANTS:

* Have one or more typical symptoms of Heart Failure (i.e. dyspnoea at rest or minimal exertion (includes orthopnoea, reduced exercise tolerance)) AND
* Have one or more typical signs of Heart Failure (i.e. elevated jugular venous pressure, pulmonary crepitations, pleural effusions, peripheral oedema) AND
* Have one or more objective measures of heart failure:

Radiological congestion.

* Elevated BNP ≥ 400 pg/mL or NT-proBNP ≥ 1000 pg/mL.
* Reduced left ventricular ejection fraction \<40% (or \<45%) in previous 12 months.

Diastolic dysfunction including tissue Doppler E/e' ratio \> 15 in previous 12 months.

* Pulmonary capillary wedge pressure \>20 mmHg.
* Diuretic therapy. The additional value of diuretic therapy (IV or oral) is debatable, as presumably unlikely (or unsafe) that patient with genuine HF will be discharged without diuretic.

CLINICIAN PARTICIPANTS:

To be eligible to participate, clinician participants (i.e. ED physicians, family physicians and monitoring nurse(s)) must have referred or have a patient enrolled in the TEC4Home monitoring service.

Exclusion Criteria:

PATIENT PARTICIPANTS:

* Physical barriers e.g. unable to stand on scales.
* Cognitive impairment (e.g. MMSE \<20), unless suitable caregiver support.
* Language (must be able to read and understand English), unless suitable caregiver support.
* Documented history of current and active substance misuse (within 3 months).
* Lack digital connectivity or landline phone connection.
* No regular care provider e.g. GP, or at least regular walk-in clinic.
* Existing intensive system of care: LVAD, transplant, dialysis.
* Anticipated improvement due to revascularization (PCI/CABG) or valve intervention during index hospitalization.
* Anticipated survival \<90 days. Active palliative care, less-than level III care, disseminated malignancy.

CLINICIAN PARTICIPANTS:

Clinicians who do not have patients enrolled in the TEC4Home service or who themselves are not involved in the implementation or operation of the TEC4Home monitoring service will not be eligible to participate.
B: Inclusion Criteria:

1. Age≥60 years
2. English speaking
3. Monroe County, New York or Dane County, Wisconsin resident
4. University of Wisconsin or University of Rochester affiliated primary care physician
5. Community dwelling (no prisoners, nursing home, assisted living residents)
6. Discharge home from the ED

Exclusion Criteria:

1. Previous study participation
2. Discharged to hospice
3. Homelessness
4. Followed by transition care team (e.g., from recent hospitalization)
5. Followed by intensive case management program
6. Emergency Severity Index 1 patients (highest acuity, as assigned by ED triage staff)
7. Unable to obtain consent from patient or proxy
C: Inclusion Criteria:

* The study will include all women delivering at one of the maternity units involved in for the duration of the study.

Exclusion Criteria:

* Women delivering in the "washout" period in each unit.
D: Inclusion Criteria:

* a diagnosis of ischemic heart disease, confirmed by their physician or medical record
* lived independently (i.e., not in an institutional setting).

Exclusion Criteria:

* complicating serious co-morbidity such as a psychiatric illness or untreated malignancy
* neurological disorder with impaired cognition
* inability to read or understand English.
* major uncorrected hearing loss

Answer: D