scholarly journals Patient Experience of an Osteoporosis Telemedicine Clinic

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 432-432
Author(s):  
Melissa Steffen ◽  
Jennifer Van Tiem ◽  
Aaron Seaman ◽  
Karla Miller ◽  
Shylo Wardyn ◽  
...  
Keyword(s):  
At Risk ◽  
Bone Loss ◽  
Patient Experience ◽  
Treatment Cost ◽  
Medical Professionals ◽  
Negative Experiences ◽  
Risk Of Fracture ◽  
Telephone Interviews ◽  
Osteoporosis Care ◽  
Reduce Fracture Risk

Abstract Rural Veterans at risk of fracture due to osteoporosis remain underdiagnosed and undertreated, in part due to location-related barriers to accessing care. Despite lowered cost and travel barriers to osteoporosis care through implementation of a telehealth model directed at rural at-risk Veterans that took advantage of many strengths of the VA’s healthcare system, only 30% of eligible Veterans accepted care. To understand low acceptance, we conducted 39 semi-structured telephone interviews with Veterans eligible for the clinic, including 19 who accepted screening and treatment, 12 who completed screening but declined treatment, and 8 who declined screening and treatment. Veterans who opted to be screened and/or treated for osteoporosis did so because: it was recommended by the VA; they were interested in learning more about their health; thought they may be at risk of osteoporosis; or believed screening would not cause them harm. Conversely, Veterans refused screening or treatment because of past negative experiences with medications, both bone and non-bone; a wish to not put anything else into their bodies; or the belief that their bone loss is not severe enough to warrant treatment. Outside medical professionals and peers influenced Veterans’ decisions to not take or alter their treatment. Cost and travel distance remained a barrier for Veterans who did not live near a VA facility with the necessary screening and treatment infrastructure. Many barriers to osteoporosis care remain despite efforts to remove them. Delivery systems must account for both instrumental and social access to care to reduce fracture risk.

scholarly journals Bisphosphonates

2006 ◽  
Vol 50 (4) ◽  
pp. 735-744 ◽  
Author(s):  
Michael McClung
Keyword(s):  
Bone Resorption ◽  
Bone Loss ◽  
Bone Turnover ◽  
Bone Structure ◽  
Clinical Settings ◽  
Low Bone Mass ◽  
Dosing Regimen ◽  
Drug Induced ◽  
Excellent Safety Profile ◽  
Reduce Fracture Risk

Osteoporosis is the result of bone loss due to an imbalance in bone turnover such that bone resorption exceeds bone formation. Bisphosphonates are potent inhibitors of osteoclast activity that reduce bone turnover and re-establish the balance between bone resorption and formation. In clinical studies, several bisphosphonates prevent bone loss, preserve bone structure, improve bone strength and, in patients with osteoporosis, substantially reduce fracture risk. They are effective in multiple clinical settings including postmenopausal osteoporosis, low bone mass in men and drug-induced bone loss. Intermittent oral dosing and intravenous administration are more convenient than the original daily dosing regimen. These drugs are generally well tolerated and have an excellent safety profile in that serious side effects are uncommon. Potent bisphosphonates are generally the preferred treatment option for most patients with or at risk for osteoporosis.

PTH-241 ‘it made a big difference’-investigation of the patient experience of a community dietetic domiciliary service for patients at risk of malnutrition

Gut ◽  
2015 ◽  
Vol 64 (Suppl 1) ◽  
pp. A516.1-A516
Author(s):  
S Kennelly ◽  
S Browne ◽  
G Flanagan-Rughaboor ◽  
D Loane ◽  
C Glennon
Keyword(s):  
At Risk ◽  
Patient Experience ◽  
Patients At Risk

scholarly journals EL CUESTIONARIO DE RELACIONES EN EL CENTRO (C.R.C.): UN INSTRUMENTO PARA IDENTIFICAR ALUMNOS EN RIESGO DE SER VICTIMIZADOS

2017 ◽  
Vol 6 (1) ◽  
pp. 463
Author(s):  
Ángel R. Calvo Rodríguez
Keyword(s):  
At Risk ◽  
School Climate ◽  
Assessment Tool ◽  
Students At Risk ◽  
Negative Experiences ◽  
Relationship Of ◽  
Bullying In Schools

Abstract. QUESTIONNAIRE RELATIONSHIPS AT THE CENTER (CRC): AN INSTRUMENT TO IDENTIFY STUDENTS AT RISK OF BEING VICTIMIZEDThe situation of bullying in schools is assessed using questionnaires in which students are asked to indicate: a) if they have observed situations of harassment and intimidation and to indicate their type and frequency, frequent places where have observed harassment b) if they have suffered harassment situations and express their type and frequency and frequent places where he has been harassed. With these questions runs the risk of biasing the perception of the students because they are almost exclusively required to take into account negative experiences. The C.R.A. is an assessment tool that identifies school climate to student bullying suffered or is at risk of suffering based on student demonstrations concerning:a) The feeling of comfort and security that students have in the center.b) The perception of the teachers' attitude towards students and to the relationships established.c) The ideas and knowledge that avoid becoming involved in a relationship of victimization.Keywords: school climate survey, bullying.Resumen.La situación de acoso en los centros se suele averiguar utilizando cuestionarios en los que se pide a los alumnos que indiquen: a) si han observado situaciones de acoso e intimidación y que indiquen su tipo y frecuencia, los lugares frecuentes donde han observado el acoso y b) si han sufrido situaciones de acoso y que expresen su tipo y frecuencia y los lugares frecuentes donde ha sido acosado. Con este tipo de preguntas se corre el riesgo de sesgar la percepción de los estudiantes debido a que casi exclusivamente se les pide que tengan en cuenta experiencias negativas. El Cuestionario C.R.A. es un instrumento de valoración del clima escolar que permite identificar al alumnado que sufre acoso escolar o corre el riesgo de padecerlo basándose en las manifestaciones de los alumnos sobre: a) El sentimiento de bienestar y seguridad que tienen los alumnos en el centro.b) La percepción de la actitud del profesorado hacia los alumnos y hacia las relaciones que establecen.c) Las ideas y conocimientos que evitan verse implicados en unas relaciones de victimización.Palabras clave: cuestionario clima de centro, acoso escolar.

scholarly journals The Experience of Care Partners of Patients with Parkinsonism and Psychosis

2021 ◽  
Author(s):  
Sneha Mantri ◽  
Emily Klawson ◽  
Steven Albert ◽  
Robyn Rapoport ◽  
Chelle Precht ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lived Experiences ◽  
Emotional Reactions ◽  
Medical System ◽  
Medical Professionals ◽  
Telephone Interviews ◽  
Experience Of Care ◽  
Sources Of Knowledge ◽  
Care Partners

ABSTRACTBackgroundParkinson’s disease psychosis (PDP) has a major impact on quality of life and care partner burden; however, little is known about the lived experiences of care partners in managing PDP.ObjectiveTo understand how care partners of individuals with PDP experience their role and articulate their needs related to psychosis.MethodsThis was a qualitative study of semi-structured telephone interviews. Recruitment was conducted online via the clinical study matching tool, Fox Trial Finder; study activities took place remotely via telephone interviews. Transcripts of the phone interviews were analyzed by grounded theory methods, and a codebook of key themes that emerged from the analysis was developed.ResultsNine care partners (all female) were interviewed. Discussion topics in the codebook included (1) care partner burden and guilt; (2) communication with medical professionals; (3) coping strategies; (4) emotional reactions of the care partner to psychosis; (5) sources of knowledge about PD psychosis; (6) attitudes towards medications for PDP; (7) strategies to care for loved ones with psychosis; (8) psychosis triggers.ConclusionsThis qualitative analysis uncovers important aspects of the care partner experience, including challenges in navigating the medical system and communicating with professionals. Providers treating patients with PDP should be aware of these constraints and provide added support for strained care partners.

scholarly journals Conducting Qualitative Research Under Pandemic Restrictions – Considerations, Challenges, and Benefits

2021 ◽  
Author(s):  
Anastasia Suslow ◽  
Chantal Giehl ◽  
Jannis Hergesell ◽  
Horst Christian Vollmar ◽  
Ina Otte
Keyword(s):  
Qualitative Research ◽  
Data Collection ◽  
Medical Professionals ◽  
Multidisciplinary Teams ◽  
Services Research ◽  
Research Project ◽  
Web Based ◽  
Telephone Interviews ◽  
High Workload ◽  
Study Designs

Abstract Background: The Covid-19 pandemic had a significant impact on professionals working in the medical area, resulting in a very high workload and tightened safety restrictions for physicians, nurses, caregivers, and patients. Medical professionals pose one of the main target groups in health services research. Their experiences contribute immensely to any research project aiming to improve delivery and quality of care. Furthermore, their input contributes significantly to gaining greater insight into the current handling of the pandemic and into what future improvements should be considered. In this paper, we discuss the challenges and benefits of conducting a qualitative research project under pandemic conditions by illustrating the progress of our research project ADAPTIVE. Methods: ADAPTIVE started in March 2020 and ended in August 2021. For data collection, we asked 26 participants to take part in an interview about using a web-based program to facilitate the exchange of patient information in multidisciplinary teams. Unfortunately, due to emerging hygiene regulations, corona-related restrictions, and the ongoing workload of medical professionals, the recruiting and interviewing process was challenging. Because of that we had to modify the original study design.Results: We discussed several adjustments for the data collection. However, the privacy policies of different clinics, professionals’ lack of experience with video calls, and participants’ poor internet connectivity eliminated the option of digital video interviewing. Alternatively, we interviewed participants by telephone. Nevertheless, telephone interviews come with limitations. Firstly, it may be difficult for participants to establish a trusting relationship with the interviewer. Secondly, non-verbal communication is lost during a telephone interview. Further, the focus group discussions initially planned had to be dismissed since a simultaneous gathering of the participants was not possible due several reasons. Conclusions: Qualitative research offers greater flexibility when adapting study designs and can, therefore, be successful, even under pandemic conditions. However, recruitment and data collection showed to be more time-consuming than under non-pandemic circumstances, and some methodological instruments such as focus groups were not possible. Trial registration: https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00021603 (Registration: 02. July 2020)

scholarly journals CLINICIAN-PERCEIVED CHALLENGES OF OSTEOPOROSIS CARE IN AN INTEGRATED HEALTHCARE DELIVERY SYSTEM

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S756-S756
Author(s):  
Aaron T Seaman ◽  
Melissa J Steffen ◽  
Karla Miller ◽  
Samantha Solimeo
Keyword(s):  
Health Care ◽  
At Risk ◽  
Health Care System ◽  
Delivery System ◽  
Health Care Delivery ◽  
Bone Health ◽  
Care Delivery ◽  
Health Care Delivery System ◽  
Osteoporosis Care ◽  
Care System

Abstract The burden of osteoporosis, both on the health care system and individuals, is high. Despite this, a high percentage of patients with or at risk of osteoporosis are not identified, screened and treated appropriately. Delivering osteoporosis care to at-risk patients is complicated by a fractured health care delivery system. In this presentation, we present data from interviews with VA clinicians in order to identify challenges of osteoporosis care within the VA health care system. While clinicians reported initiating a range of bone health care delivery interventions, they identified challenges that inhibited long-term sustainability: 1) low prioritization of bone health among national and facility leadership; 2) fragmentation of clinical responsibility and care delivery; and 3) barriers endemic to the osteoporosis care delivery system. Our results indicate that, even within an integrated health care delivery system, significant coordination challenges exist.

Proximal Cementing for Revision Hip Arthroplasty

1998 ◽  
Vol 8 (2) ◽  
pp. 62-69 ◽  
Author(s):  
J. Alfaro-Adrian ◽  
R.W. Crawford ◽  
A. Wulke ◽  
D.W. Murray ◽  
P. Mclardy-Smith
Keyword(s):  
Bone Loss ◽  
Hip Arthroplasty ◽  
High Rate ◽  
Revision Hip Arthroplasty ◽  
Hip Revision ◽  
Risk Of Fracture ◽  
Slight Pain ◽  
Continued Use ◽  
A New Technique

We report the results of a new technique of proximal cement fixation in 41 patients having revision hip arthroplasty using the Oxford modular femoral component. This consists of two parts, a metaphised wedge and a stem. The metaphyseal wedge is cemented and applies the load proximally to encourage bone healing. The wedge is free to slide on an uncemented stem that gains fixation distal to areas of bone loss, with the intention of reducing the risk of fracture. The clinical and radiographic follow-up ranged from a minimum of 3 years to 7 years. There have been no re-revisions. Ninety percent of the patients had pain or slight pain. Despite a relatively high rate of early subsidence, we feel that our results are encouraging, and justify the continued use of this component in hip revision surgery.

Sign in / Sign up

Export Citation Format

Share Document