Please select the eligibility criteria that correspond to the clinical trial below.
Title: Promoting Awareness Fetal Movements and Focussing Interventions Reduce Fetal Mortality Stillbirth, a Stepped Wedge Cluster Randomised Trial.
Brief Summary: Rates of stillbirth in Scotland are among the highest in resource rich countries. The majority of stillbirths occur in normally formed infants, with (retrospective) evidence of placental insufficiency being the commonest clinical finding. Maternal perception of decreased fetal movements appears to be an early biomarker both of placental insufficiency and subsequent stillbirth.

The study proposed here will test the hypothesis that rates of stillbirth will be reduced by introduction of a package of care consisting of strategies for increasing pregnant women's awareness of the need for prompt reporting of decreased fetal movements, followed by a management plan for identification of placental insufficiency with timely delivery in confirmed cases. The odds of stillbirth fell by 30% after the introduction of a similar package of care in Norway but the efficacy of this intervention (and possible adverse effects and implications for service delivery) have not been tested in a randomized trial.

The investigators plan a stepped wedge cluster design trial, in which hospitals in Scotland and Ireland will be randomized to the timing of introduction of the care package. Outcomes (including the primary outcome of stillbirth) will be derived from Scotland and Ireland's detailed routinely collected maternity data, allowing the investigators to robustly test the hypothesis. A nested qualitative study will examine the acceptability of the intervention to patients and health care providers and identify process issues (barriers to implementation).


Options:
A: Inclusion Criteria:

* patients hospitalized at any of the six medical centers who are being actively treated for heart failure.

Exclusion Criteria:

* patients who have previously received a transplant, are being evaluated for a transplant, or who are on the wait list for a transplant,
* patients who are enrolled or enrolling in hospice, or are expected to expire shortly after discharge,
* patients with dementia,
* patients who are admitted from a skilled nursing facility (SNF), or who we anticipate will be discharged to a long term stay in a SNF,
* patients who do not have a working land line phone or reliable cell service,
* patients on chronic dialysis,
* patients who cannot identify a usual source of care (free clinic is acceptable) and who will not be assigned a provider upon discharge,
* patients with the following cardiovascular conditions: patients with valvular disorders requiring surgical intervention (except for those with incidental valvular disease, who will be included), acute myocardial infarction (except for those with demand ischemia, who will be included), percutaneous coronary intervention
* patients expected to enroll in hospice or expire after discharge,
* patients who are unable to use the intervention equipment (e.g., unable to stand on the weight scale), or who are otherwise unable to comply with the intervention
B: 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.
C: Inclusion Criteria:

* parents of 0-15 years old children with breathing difficulties caused by LRTI (bronchiolitis, laryngitis or pneumonia) or asthma exacerbation
* ability to communicate and read Norwegian

Exclusion Criteria:

* parents of children with chronic diseases who have direct access to the acute ward, children with oxygen saturation less than 90 %, or other very sick children who need urgent treatment
D: Inclusion Criteria:

* 4th-6th grade children and their parents in selected elementary public schools in the same geographical region/community with similar socioeconomic status (SES) and Ethnic composition.

Exclusion Criteria:

* School located in Harlem, New York.

Answer: B