scholarly journals AB1363-HPR EVALUATION OF SELECTION CRITERIA OF CLINICIANS IN THE TREATMENT OF OSTEOPOROSIS, OSTREQ RESEARCH IN TURKEY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1968.1-1969
Author(s):  
E. G. Kahraman ◽  
S. Akar ◽  
B. Ö. Pamuk
Keyword(s):  
Health Care ◽  
Physical Therapy ◽  
Health System ◽  
Metabolic Diseases ◽  
Treatment Options ◽  
Osteoporosis Treatment ◽  
World Population ◽  
Internal Reliability ◽  
Treatment Of Osteoporosis ◽  
Significant Difference

Background:Osteoporosis is a disease with increasing prevalence in the aging and growing world population and its insidious progression and lack of findings without fracture cause certain difficulties in the diagnosis and treatment of this disease. There are many medical and paramedical treatment options for osteoporosis, and clinicians make these treatment decisions with many factors in mind.Objectives:We wanted to evaluate the importance of these factors for clinicians through a questionnaire. This 17-question questionnaire aimed to investigate the factors that clinicians consider in the planning of osteoporosis treatment and the effect of these factors on treatment planning. We made the Turkish version of the OSTEQ questionnaire in this study which factors clinicians in planning treatment for osteoporosis in Turkey we aimed to investigate that take into consideration.Methods:OSTREQ questionnaire developed by Makraz et al. are used in this research. In this survey, which consists of 8 sections (health care system, patients’ preferences regarding regimen’s administration, usage, cost, severity of disease, treatment efficacy, safety profile and pharmaceutical industry) and 17 questions, the participants were asked to evaluate their answers with 5 different scales: Absolutely Preventive, Partially Preventive, Neither Preventive or Encouraging, Partially Encouraging, Absolutely Encouraging.Clinicians of Rheumatology, Physical Therapy and Rehabilitation, Endocrinology and Metabolic Diseases participated in our study. The questionnaires were filled in by e-mail or by inviting the participants to the our university or by going to the clinics where the clinicians were working.Results:In our study 37 (21.8%) were endocrinology, 49 (28.8%) were rheumatology and 84 (49.4%) were physical therapy and rehabilitation specialists. The overall Cronbach alpha coefficient of the questionnaire was found to be 0.855. No material was found to significantly increase the internal reliability coefficient if deleted. As a result of t-test in 27% lower and upper groups to measure the discriminative power of the items, it was seen that all items made a significant difference in the lower and upper groups, which were formed according to the total score of 27 people. Confirmatory factor analysis and internal reliability results did not require removal of the substance, so the substance was not removed. When the responses of the specialist physicians participating in our study to the osteoporosis preference criteria questionnaire were examined according to their specialty, no statistically significant difference was found between specialty branches but only significant difference was found in health system and cost subscale according to branches (p = 0.013). Post-hoc test (LSD) was used to find out the group that made a significant difference in health system and cost sub-factor. higher scores (p = 0.034).Conclusion:We developed and validated a general osteoporosis treatment questionnaire that could provide assessment of the criteria that physicians take into consideration when they decide to implement a regimen for osteoporosis. This tool could assist health care systems and pharmaceutical companies understand which parameters drive physicians’ choices regarding the treatment of osteoporosis.References:[1]P. Makras, A. Galanos, S. Rizou, A. D. Anastasilakis, and G. P. Lyritis, “Development and validation of an osteoporosis treatment questionnaire (OSTREQ) evaluating physicians’ criteria in the choice of treatment,”Hormones, vol. 15, no. 3, pp. 413–422, Jul. 2016.[2]S. Tuzunet al., “Incidence of hip fracture and prevalence of osteoporosis in Turkey: The FRACTURK study,”Osteoporos. Int., vol. 23, no. 3, pp. 949–955, Mar. 2012.Disclosure of Interests:None declared

scholarly journals Access to medicines by patients of the primary health care in the Brazilian Unified Health System

2017 ◽  
Vol 51 ◽  
pp. 20s ◽  
Author(s):  
Juliana Álvares ◽  
Augusto Afonso Guerra Junior ◽  
Vânia Eloisa de Araújo ◽  
Alessandra Maciel Almeida ◽  
Carolina Zampirolli Dias ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health System ◽  
Developed Countries ◽  
Access To Medicines ◽  
Essential Medicines ◽  
Unified Health System ◽  
Primary Health ◽  
Significant Difference ◽  
Good For

OBJECTIVE: To evaluate the access to medicines in primary health care of the Brazilian Unified Health System (SUS), from the patients’ perspective. METHODS: This is a cross-sectional study that used data from the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Services, 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines), conducted by interviews with 8,591 patients in cities of the five regions of Brazil. Evaluation of access to medicines used concepts proposed by Penshansky and Thomas (1981), according to the dimensions: availability, accessibility, accommodation, acceptability, and affordability. Each dimension was evaluated by its own indicators. RESULTS: For the “availability” dimension, 59.8% of patients reported having full access to medicines, without significant difference between regions. For “accessibility,” 60% of patients declared that the basic health unit (UBS) was not far from their house, 83% said it was very easy/easy to get to the UBS, and most patients reported that they go walking (64.5%). For “accommodation,” UBS was evaluated as very good/good for the items “comfort” (74.2%) and “cleanliness” (90.9%), and 70.8% of patients reported that they do not wait to receive their medicines, although the average waiting time was 32.9 minutes. For “acceptability,” 93.1% of patients reported to be served with respect and courtesy by the staff of the dispensing units and 90.5% declared that the units’ service was very good/good. For “affordability,” 13% of patients reported not being able to buy something important to cover expenses with health problems, and 41.8% of participants pointed out the expense with medicines. CONCLUSIONS: Results show 70%–90% compliance, which is compatible with developed countries. However, access to medicines remains a challenge, because it is still heavily compromised by the low availability of essential medicines in public health units, showing that it does not occur universally, equally, and decisively to the population

scholarly journals Cultural Awareness and Sensitivity of Students in a Physical Therapy Program – A Pilot Survey

2018 ◽  
Author(s):  
Olaide Oluwole-Sangoseni ◽  
Michelle Jenkins-Unterberg
Keyword(s):  
Health Care ◽  
Physical Therapy ◽  
Cultural Sensitivity ◽  
Health Care Professionals ◽  
Cultural Awareness ◽  
Health Care Disparities ◽  
Care Delivery ◽  
The United States ◽  
Cross Sectional Survey ◽  
Significant Difference

Background: Attempts to address health and health care disparities in the United States have led to a renewed focus on the training of healthcare professionals including physical therapists. Current health care policies emphasize culturally competent care as a means of promoting equity in care delivery by health care professionals. Experts agree that cultural insensitivity has a negative association with health professionals’ ability to provide quality care. Objective: To evaluate the cultural awareness and sensitivity of physical therapy (PT) students in a didactic curriculum aimed to increase cultural awareness. Methods: Using the Multicultural Sensitivity Scale (MSS), a cross-sectional survey was conducted to assess cultural sensitivity among three groups of students, (N = 139) from a doctor of physical therapy (DPT) program at a liberal arts university in Saint Louis, MO. Results: Response rate was 76.3%. Participants (n=100) were students in first (DPT1, n=36), third (DPT3, n=36), and sixth (DPT6, n=28) year of the program. Mean ranked MSS score was DPT1 = 45.53, DPT3 = 46.60 DPT6 = 61.91. Kruskal-Wallis analysis of the mean ranked scores showed a significant difference among three groups, H = 6.05 (2, N=100), p ≤ .05. Discussion: Students who have completed the cultural awareness curriculum, and undergone clinical experiences rated themselves higher on the cultural sensitivity/awareness. Results provide initial evidence that experiential learning opportunities may help PT students to more effectively integrate knowledge from classroom activities designed to facilitate cultural competence.

scholarly journals Examining the Economic Perspective of Treatable Mortality: The Role of Health Care Financing and the Importance for Economic Prosperity

2021 ◽  
Vol 9 ◽  
Author(s):  
Viera Ivankova ◽  
Beata Gavurova ◽  
Samer Khouri ◽  
Gabriel Szabo
Keyword(s):  
Health Care ◽  
Cluster Analysis ◽  
Health System ◽  
Metabolic Diseases ◽  
Health Care Financing ◽  
Circulatory System ◽  
Economic Prosperity ◽  
Circulatory System Diseases ◽  
Working Age ◽  
Nutritional And Metabolic Diseases

Health is an essential element of economic life and is therefore considered a source of comparative economic development of countries. The aim of the study was to examine the associations between health care financing, specific treatable mortality of males and females of working age, and economic prosperity, taking into account to the classification of health systems applied in the countries of the Organization for Economic Co-operation and Development (OECD). An insurance-based health system and a tax-based health system were identified in these countries, and data were collected for the period 1994–2016. Descriptive analysis, panel regression analysis and cluster analysis were used to achieve the aim. The analytical process included economic indicators [health expenditure, gross domestic product (GDP)] and health indicators (treatable mortality from circulatory system diseases and endocrine, nutritional and metabolic diseases). The results revealed significant negative associations of health care financing with treatable mortality from circulatory system diseases and endocrine, nutritional, and metabolic diseases in both health systems and both gender categories. There were also negative associations between treatable mortality in both diagnosis groups and economic prosperity. These results have shown that health care financing is linked to economic prosperity also through health variability in the working age population. In terms of assessing economic and health outcomes, less positive and more positive countries were identified using cluster analysis. Countries such as Latvia with a tax-based health system and Hungary, Lithuania, Estonia with an insurance-based health system were characterized by great potential for improvements. Although reducing treatable mortality is a great motivation for public health leaders to increase health care financing, the importance for economic prosperity may be a more compelling argument. Effective interventions should be considered in the light of their regional, social and economic contexts.

scholarly journals An Introduction to Interprofessional Education for First Semester Doctoral Occupational Therapy and Physical Therapy Students

2021 ◽  
Author(s):  
Suzanne Trojanowski ◽  
Jillian Woodworth ◽  
Anna Rose Wiencek ◽  
Amy Yorke
Keyword(s):  
Health Care ◽  
Physical Therapy ◽  
Occupational Therapy ◽  
Professional Education ◽  
Interprofessional Education ◽  
Health Care Practitioner ◽  
Entire Group ◽  
First Semester ◽  
Significant Difference ◽  
Positive Results

Purpose: Interprofessional education (IPE) engages health care professional students in order to develop the knowledge, skills, and attitudes required of a health care practitioner. IPE can be challenging to execute; however, exposing students early in their professional education in IPE has positive results. Occupational therapy (OT) and physical therapy (PT) are health care professions who commonly work with each other. The purpose of this study is to describe the process and outcomes of implementing an IPE experience with first year doctoral OT (OTD) and PT (DPT) students completed within the first six weeks of the first semester of their respective programs. Methods: Ninety-one (31 OTD, 60 DPT) students were placed in small groups and discussed professional identities and interprofessional collaboration among OT/PT during pre-professional observations. Students completed the Readiness for Interprofessional Learning Scale (RIPLS) pre-post-meeting and a written reflection post-meeting. Results: Ninety-one students completed the Pre-RIPLS survey, while only 58 Post-RIPLS were completed (13 OTD, 45 DPT). The response rate was 63.7% overall (41.9% OT and 75% PT). A statistically significant difference was found between pre- to post-test RIPLS score among the entire group (p = 0.013), and the DPT students (p = 0.020), but not the OTD students (p = 0.414). Written reflections included the following themes: influence of personal experiences leading to choice of profession, observations shaping knowledge of the professions, similarities and differences between the two professions, and future collaboration. Conclusion: An IPE activity can be implemented early in the professional education of OTD/DPT students with positive results.

Parathyroid Hormone (1–84) and Treatment of Osteoporosis

2005 ◽  
Vol 39 (9) ◽  
pp. 1511-1516 ◽  
Author(s):  
Sarah P Shrader ◽  
Kelly R Ragucci
Keyword(s):  
Parathyroid Hormone ◽  
Subcutaneous Injection ◽  
Data Extraction ◽  
Treatment Options ◽  
Osteoporosis Treatment ◽  
Treatment Modalities ◽  
Mineral Density ◽  
Treatment Of Osteoporosis ◽  
Medline Search ◽  
Dosing Strategies

OBJECTIVE: To present the chemistry, pharmacology, and pharmacokinetics of parathyroid hormone (PTH) (1-84%) and review the available clinical trials that evaluate its efficacy and safety; clinical applicability of this agent and its relationship to other Food and Drug Administration (FDA)–approved medications for treatment of osteoporosis are also discussed. DATA SOURCES: A MEDLINE search (1996–December 2004%) was completed, along with a review of information obtained from the manufacturer, NPS Pharmaceuticals. Key search terms included parathyroid hormone, PTH (1–84%), and ALX 111. STUDY SELECTION AND DATA EXTRACTION: Studies were selected based on their relevance and availability. Pertinent information, including objectives, design, demographics, outcomes, adverse events, dosing strategies, and therapeutic controversies, was extracted. DATA SYNTHESIS: PTH (1-84%) is being developed for treatment of osteoporosis. Recent studies have shown that, when administered intermittently as a subcutaneous injection, PTH (1-84%) produces an increase in bone mineral density and prevents vertebral fractures. The fact that this agent contains the C-terminal region of PTH may differentiate it from PTH (1-34%), teriparatide, which is approved by the FDA for treatment of osteoporosis. Further trials are necessary to determine the role of PTH (1-84%) in combination with other treatments for osteoporosis and/or the order in which PTH (1-84%) is given with these other agents. There are currently no comparative trials with other osteoporosis treatment modalities. CONCLUSIONS: PTH (1-84%), when given intermittently as a subcutaneous injection, appears to be a safe and efficacious treatment option for osteoporosis. Further trials are needed to determine its specific place in therapy compared with other treatment options.

scholarly journals The burden of preventable hospitalizations before and after implementation of the health transformation plan in a hospital in west of Iran

2019 ◽  
Vol 20 ◽  
Author(s):  
Bakhtiar Piroozi ◽  
Mohammad Amerzadeh ◽  
Hossein Safari ◽  
Amjad Mohamadi-Bolbanabad ◽  
Abdorrahim Afkhamzadeh ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health System ◽  
Hospital Admissions ◽  
Chronic Obstructive ◽  
Preventable Hospitalizations ◽  
Primary Health ◽  
Significant Difference ◽  
Before And After ◽  
Bed Days

Abstract Background: Increased number of preventable hospitalizations (PHs) for ambulatory care sensitive conditions (ACSCs) represents less efficiency and low access to outpatient and primary health care, leading to waste of health system resources. Aim: The purpose of this study is to assess the quality of outpatient and primary health care using the rate of PHs for ACSCs and to estimate the economic burden of ASCS before and after the implementation of the health transformation plan (HTP) in Iran. Methods: This research was a before–after quasi-experimental study. The study population included all patients hospitalized in the largest general hospital of Kurdistan province with five diseases such as asthma, diabetes, hypertension, congestive heart failure, and chronic obstructive pulmonary disease in 2014 (before the implementation of the HTP) and 2015 (after the implementation of the HTP). Data were analyzed by SPSS v.20 using Chi-square test. Findings: Total number of hospitalizations before and after the implementation of the HTP was 1501 and 1405, respectively. Moreover, the proportion of PHs in all types of the hospital admissions before and after the implementation of the HTP was 47% and 49%, respectively. There was no statistically significant difference between the number of PHs before and after the HTP. In total, PHs imposed 885 798 US$ and 9920 bed-days on health system before and after the implementation of the HTP. Conclusion: Despite the previous expectations of policy makers for improving quality, efficiency, and access to primary health care through implementation of the HTP, proportion of PHs is considerable and it imposes a lot of costs and bed-days on the health system both before and after the HTP.

scholarly journals SYMPOSIUM PRESS RELEASE “KEY FACTORS OF SUCCESSIN THE TREATMENT OF OSTEOPOROSIS. TREATMENT TO THE GOAL. ’’held at the VIII All-Russian Congress of Osteoporosis in Kazan, September 10, 2016

2016 ◽  
Vol 19 (3) ◽  
pp. 41-45
Author(s):  
Keyword(s):  
Metabolic Diseases ◽  
Systemic Disease ◽  
Osteoporosis Treatment ◽  
Fracture Prevention ◽  
Satellite Symposium ◽  
Low Bone Mass ◽  
Key Factors ◽  
Treatment Of Osteoporosis ◽  
Antiresorptive Agents ◽  
Increased Risk

Osteoporosis - is a systemic disease characterized by low bone mass, microarchitectural violation of its structure that leads to an increased risk of fractures. Currently, the method of finding the optimal therapy for osteoporosisis given special attention. In Kazan, September 9, 2016 in the framework of the Russian Congress on Osteoporosis, osteoarthritis and other metabolic diseases of the skeleton was heldAmgen satellite symposium. The event included reports of Russian and foreign experts, dedicated to practical issues of the treatment of osteoporosis and fracture prevention with the particular emphaseson the benefits of using modern antiresorptive agents.

scholarly journals Radiofrequency Microtenotomy or Physical Therapy for Achilles Tendinopathy: Results of a Randomized Clinical Trial

2021 ◽  
Vol 9 (12) ◽  
pp. 232596712110625
Author(s):  
Zeiad Al-Ani ◽  
Dana Meknas ◽  
Jüri-Toomas Kartus ◽  
Øyvind Lyngedal ◽  
Khaled Meknas
Keyword(s):  
Physical Therapy ◽  
Controlled Trial ◽  
Treatment Options ◽  
Randomized Study ◽  
Achilles Tendinopathy ◽  
Level Of Evidence ◽  
Bipolar Radiofrequency ◽  
Significant Difference ◽  
Vas Scores

Background: Achilles tendinopathy is a painful disorder, and various treatment options are available. Bipolar radiofrequency microtenotomy (RFM) has shown promising results in treating tendinosis. Purpose/Hypothesis: The purpose was to compare the results between treatment with bipolar RFM and physical therapy (PT) for patients with midportion Achilles tendinopathy. It was hypothesized that RFM would be equivalent or superior to PT. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 38 patients with midportion Achilles tendinopathy were evaluated for 2 years. The patients were randomized to receive either RFM or PT. There were 20 patients in the RFM group and 18 patients in the PT group. Clinical outcomes were assessed using the visual analog scale (VAS) for pain and the Foot and Ankle Outcome Score (FAOS). The degree of tendinosis was evaluated with magnetic resonance imaging (MRI) of the affected ankle performed before intervention and 2 years after intervention. Results: In both groups, the VAS scores at the 2-year follow-up were significantly improved compared with preintervention: from 7.2 ± 1.5 to 1.0 ± 1.4 for the RFM group and from 5.9 ± 1.3 to 3.1 ± 1.8 for the PT group ( P < .01 for both). Compared with the PT group, the RFM group had significantly better VAS scores at both the 1- and 2-year follow-ups ( P < .01 for both) and better scores on 4 of the 5 FAOS subscales at the 2-year follow-up ( P < .01 for all). MRI revealed an improvement in the tendinosis score in both groups, without any significant difference between the groups. Conclusion: In this randomized study, the clinical assessments revealed significant improvements in the VAS, FAOS, and tendinosis score as seen on MRI 2 years after intervention with either RFM or PT in patients with midportion Achilles tendinopathy. The improvement was significantly better in the RFM group with regard to VAS and FAOS, but not in the MRI appearance. Registration: NCT03274557 ( ClinicalTrials.gov identifier).

Parent’s Experiences from the Treatment of their Children at the Physic Children’s Surgery Clinic in Skopje.

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
M. Trajchevska ◽  
A. Lleshi ◽  
S. Gjoshev ◽  
A. Trajchevski
Keyword(s):  
Health Care ◽  
Health Status ◽  
Independent Predictor ◽  
Demographic Data ◽  
Parental Satisfaction ◽  
Pediatric Care ◽  
Simple Random Sample ◽  
Significant Independent Predictor ◽  
Cross Sectional ◽  
Significant Difference

Background: The respect of the needs and wishes of the patients is in the focus of the human health system. The experience of the parents in terms of child’s health care may be used as an indicator of quality of the health care. Material and methods: The research is a quantitative analytical cross-sectional study. In accordance with the inclusion and exclusion criteria, simple random sample of 207 parents / guardians is covered, whose children in the period of three months, had been hospitalized in the hospital department JZUU Pediatric Surgery Clinic in Skopje.It was used a two parted questionnaire. The first part is a standardized questionnaire (Parent Experience of Pediatric Care - PECP), and the second part concerns the general socio-demographic data of the parent/guardian. Statistical evaluation was performed using appropriate statistical programs (Statistics for Windows 7,0 and SPSS 17.0). Results: In accordance with the age of the parents, the survey respondents were divided into two groups: a) age ≤ 33 years - 107 (51.69%) and b) age> 33 years - 100 (48.31%).Significant independent predictor of parental satisfaction from the receipt of their child to the clinic research confirms the age of the parent under / over 33 years due to 4.1% of the change in satisfaction (R2 = 0,041). Parents generally believe that their children's room of the clinic is "good", without significant difference between parental satisfaction from both age groups (Mann-Whitney U Test Z = -0,9613 p = 0,3364). Significant independent predictor of parental satisfaction from the room of their child improves the health status after treatment due to 6% of the change in satisfaction (R2 = 0,060). Parents generally believe that testing and treatment of their children in the clinic was "very good" and an independent significant predictor is to improve the health status after the treatment - 7,8% (R2 = 0,078). Conclusions: Regardless of the generally good parental satisfaction about health care for their children, it is necessary to continuously monitor the status of the clinic in order to consider the possible deficiencies and needs of intervention.

Long-term survival of the nasal NK/T cell lymphoma

2008 ◽  
Vol 149 (17) ◽  
pp. 801-805
Author(s):  
Péter Rajnics ◽  
László Krenács ◽  
András Kenéz ◽  
Zoltán Járay ◽  
Enikő Bagdi ◽  
...  
Keyword(s):  
T Cell ◽  
Treatment Guidelines ◽  
Cell Lymphoma ◽  
Treatment Options ◽  
Diagnostic Procedures ◽  
T Cell Lymphoma ◽  
Term Survival ◽  
Barr Virus ◽  
Significant Difference ◽  
Nk T Cell

The nasal NK/T cell lymphoma is a rare, extranodal non-Hodgkin lymphoma in western civilizations, which has poor prognosis. The Epstein–Barr virus can be detected in tumor cells in nearly all cases. There are no definite treatment guidelines in our days. There is no significant difference in survival between radiotherapy and chemotherapy according to Asian studies. In this case study we show our diagnostic procedures, our treatment options and we present the summary of this illness based on the data found in the literature.

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