scholarly journals Insights into the complexity of presentation and management of patients: the Sport and Exercise Physician’s perspective

2021 ◽  
Vol 7 (4) ◽  
pp. e001228
Author(s):  
Prasanna J Gamage ◽  
Saran Seker ◽  
Jessica Orchard ◽  
David Humphries ◽  
Kylie Fitzgerald ◽  
...  
Keyword(s):  
Musculoskeletal Diseases ◽  
Treatment Plan ◽  
Management Strategies ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Exercise Interventions ◽  
Musculoskeletal Conditions ◽  
Exercise Medicine ◽  
Sport And Exercise ◽  
Medical Specialities

ObjectivesSport and Exercise Physicians represent a relatively new specialty focusing on exercise in complex diseases including musculoskeletal diseases. Our objective was to describe the characteristics, type and complexity of patient presentations, their management strategies and referral information in Australian practice.MethodsA cross-sectional study including a cohort of 11 senior Sport and Exercise Physicians in Australia studied all new patient consultations within an 8-week period. Data were analysed relating to presentation, referral source, follow-up referrals, and patient management strategies.ResultsData from 419 patients were recorded. The majority, 97% (n=406), had musculoskeletal conditions, 53% (n=222) had one or more associated comorbidities and 47% (n=195) had ongoing symptoms for >12 months. Most patients, 82% (n=355), were referred by general practitioners. Prior consultations included physiotherapy 72% (n=301) and orthopaedic 20% (n=85). A multidisciplinary network of referrals from Sport and Exercise Physicians was observed, including 210 referrals to 9 allied health specialities and 61 referrals to 17 medical specialities. Over 74% (n=311) of patients received exercise-based intervention as part of the treatment plan, including 57% (n=240) physician managed exercise interventions.ConclusionOur work shines a light on the nature and complexity of the role of Sport and Exercise Physicians in an Australian practice context. Findings will assist in implementing measures to promote patient care at the community level in managing musculoskeletal conditions. Sport and exercise medicine stakeholders and government policy makers can use this information in developing appropriate programmes to support patients and create integrated sport and exercise medicine services for the community.

scholarly journals Clinical Assessment and Management of Spondyloarthritides in the Middle East: A Multinational Investigation

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Mohammed Hammoudeh ◽  
Hanan Al Rayes ◽  
Adel Alawadhi ◽  
Kamel Gado ◽  
Khalid Shirazy ◽  
...  
Keyword(s):  
Middle East ◽  
Disease Burden ◽  
Clinical Laboratory ◽  
Management Strategies ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
East Region ◽  
Appropriate Treatment ◽  
Treatment Data ◽  
Middle East Region

Data on spondyloarthritis (SpA) from the Middle East are sparse and the management of these diseases in this area of the world faces a number of challenges, including the relevant resources to enable early diagnosis and referral and sufficient funds to aid the most appropriate treatment strategy. The objective was to report on the characteristics, disease burden, and treatment of SpA in the Middle East region and to highlight where management strategies could be improved, with the overall aim of achieving better patient outcomes. This multicenter, observational, cross-sectional study collected demographic, clinical, laboratory, and treatment data on 169 consecutive SpA patients at four centers (Egypt, Kuwait, Qatar, and Saudi Arabia). The data collected presents the average time from symptom onset to diagnosis along with the presence of comorbidities in the region and comparisons between treatment with NSAIDs and biologics. In the absence of regional registries of SpA patients, the data presented here provide a rare snapshot of the characteristics, disease burden, and treatment of these patients, highlighting the management challenges in the region.

scholarly journals Use of the Nursing Outcomes Classification - NOC to assess the knowledge of patients with venous ulcer

2020 ◽  
Vol 41 (spe) ◽  
Author(s):  
Viviane Maria Osmarin ◽  
Fernanda Guarilha Boni ◽  
Taline Bavaresco ◽  
Amália de Fátima Lucena ◽  
Isabel Cristina Echer
Keyword(s):  
Chronic Disease ◽  
Disease Management ◽  
Chronic Disease Management ◽  
Management Strategies ◽  
Venous Ulcer ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Nursing Outcomes ◽  
Treatment And Prevention ◽  
Nursing Outcomes Classification

Abstract Objective: To evaluate the knowledge of patients with venous ulcers (VU) on their chronic disease, treatment, and prevention of complications, according to the Nursing Outcomes Classification-NOC. Methods: This is a cross-sectional study conducted between 2017 and 2018 in a Brazilian hospital. The sample consisted of 38 patients with VU attended in outpatient nursing consultations. The study analyzed sociodemographic, clinical and nine indexes from the Knowledge: Chronic Disease Management (1847) of the NOC, assessed using a five-point Likert scale, analyzed using descriptive statistics. Results: The mean of the result Knowledge: Chronic Disease Management (1847) was 3.56±1.42. The clinical index Procedures involved in treatment regimen had the highest mean 4.18±0.21, followed by Pain management strategies with 3.92±0.27. In the association between knowledge and healing, the best scores were in patients with at least one healed VU. Conclusion: The knowledge of the patients was moderate and it was necessary to promote educational actions according to individual demands.

scholarly journals Effect of caregiver characteristics on dementia management strategies

2016 ◽  
Vol 10 (2) ◽  
pp. 143-147 ◽  
Author(s):  
Débora Dalpai ◽  
Ramon Castro Reis ◽  
Analuiza Camozzato de Pádua
Keyword(s):  
Caregiver Burden ◽  
Management Strategies ◽  
Cross Sectional Study ◽  
Porto Alegre ◽  
Cross Sectional ◽  
Bivariate Correlation ◽  
Gender Education ◽  
Correlation Tests ◽  
Spearman’S Correlation ◽  
Moderate Positive Correlation

ABSTRACT Caregiving has an important influence on the prognosis of dementia, particularly regarding the management strategy implemented. Therefore, evaluating which characteristics of caregivers can influence the choice of a particular strategy for managing dementia is needed. Objective: To evaluate the association between characteristics of caregivers and their management strategies as applied to patients with dementia. Methods: A cross-sectional study involving 45 professional caregivers from two nursing homes in Porto Alegre, Brazil, was conducted. Age, gender, education, years as a caregiver, income, burden, depressive and anxiety symptoms and dementia management strategies were evaluated for all participants. Pearson's or Spearman's correlation tests were applied according to the variable distribution (parametric or non-parametric). Bivariate correlation analysis was applied. P<0.05 was considered statistically significant. Results: There was a significant and moderate positive correlation between burden measured by the Zarit Burden Interview and criticism measured by the Dementia Management Strategies Scale (Spearman's rho = 0.555, p < 0.001). No other correlations were observed. Conclusion: Among the caregiver characteristics that directly affect the approach to managing dementia, high caregiver burden was found to be associated with high criticism, an authoritative way of managing dementia. This exploratory study indicated that a possible way of decreasing negative dementia management is to reduce caregiver burden.

Epidemiology of atrial fibrillation in northeast China: a cross-sectional study, 2017–2019

Heart ◽  
2019 ◽  
Vol 106 (8) ◽  
pp. 590-595 ◽  
Author(s):  
Liying Xing ◽  
Min Lin ◽  
Zhi Du ◽  
Li Jing ◽  
Yuanmeng Tian ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Rural Areas ◽  
Northeast China ◽  
Management Strategies ◽  
Cross Sectional Study ◽  
Liaoning Province ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Difference ◽  
Urban And Rural Areas

ObjectiveTo evaluate the epidemiology of atrial fibrillation (AF) in northeast China.MethodsThis cross-sectional survey using a multistage, stratified and cluster random sampling method was conducted in Liaoning Province between September 2017 and March 2019. A total of 18 796 participants (28.9% urban, 71.1% rural) aged ≥40 years were included. All participants completed a questionnaire and underwent a physical examination and ECG. AF was diagnosed according to history and ECG findings.ResultsThe overall AF prevalence was 1.1%; it increased steeply with age. AF was more prevalent in men than in women (1.5% vs 0.9%, p<0.001); however, the difference between urban and rural areas was not significant (1.3% vs 1.1%, p=0.228). Among the AF population, the overall AF awareness rate was 52.6%, higher in women than in men (61.5% vs 44.1%, p=0.011); however, the difference between areas was not statistically significant (60.0% vs 49.0%, p=0.129). According to the CHA2DS-VASc score, almost all (90.2%, 194/215) of our subjects required oral anticoagulant (OAC) therapy; however, only 4.1% actually received it. Moreover, hypertension (66.5%), dyslipidaemia (32.6%) and diabetes (24.2%) were highly prevalent in patients with AF, but their control rates were unacceptably low (7.0%, 8.6% and 28.8%, respectively).ConclusionsThe burden of AF in northeast China was substantial. Underuse of OAC therapy and uncontrolled comorbidities will likely contribute to the cardiovascular outcomes of patients with AF in the coming decades. Long-term management strategies for AF and related risk factors are required in northeast China.

Self‐efficacy in patients with chronic musculoskeletal conditions discharged from physical therapy service: A cross‐sectional study

2020 ◽  
Vol 18 (3) ◽  
pp. 365-371
Author(s):  
Carolina Matiello Souza ◽  
Jaqueline Martins ◽  
Thiele de Cássia Libardoni ◽  
Anamaria Siriani Oliveira
Keyword(s):  
Physical Therapy ◽  
Self Efficacy ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Musculoskeletal Conditions ◽  
Therapy Service

scholarly journals Quantifying subclinical trauma associated with calving difficulty, vigour, and passive immunity in newborn beef calves

2019 ◽  
Vol 6 (1) ◽  
pp. e000325 ◽  
Author(s):  
Jennifer M Pearson ◽  
Elizabeth R Homerosky ◽  
Nigel A Caulkett ◽  
John R Campbell ◽  
Michel Levy ◽  
...  
Keyword(s):  
Mucous Membrane ◽  
Management Strategies ◽  
Blood Parameters ◽  
Cross Sectional Study ◽  
Passive Immunity ◽  
Sectional Study ◽  
Cross Sectional ◽  
Beef Calves ◽  
Traumatic Birth ◽  
Calving Difficulty

This cross-sectional study quantifies subclinical trauma associated with calving difficulty, calf vigour, and passive immunity (PI) in newborn beef calves. The degree of calving difficulty was categorised as: unassisted, easy assist (one or two people manually pulling to deliver the calf) and difficult assist (more than two people pulling, a fetal extractor (ie, calf jack), or caesarean section). Vigour assessment occurred at 10 minutes and blood sampling at 24 hours after birth in 77 beef calves. The measured blood parameters associated with trauma were creatine kinase (CK), aspartate aminotransferase (AST), and haptoglobin. Serum IgG concentration was measured, and an IgG concentration at least 24 g/l was considered as adequate PI. Calving difficulty was associated with elevated levels of CK (P=0.002) and AST (P=0.01), weak suckle reflex (P=0.001), abnormal mucous membrane colour (P<0.0001), and decreased odds of adequate PI (P=0.004). Elevated levels of CK and AST were associated with abnormal mucous membrane colour, incomplete tongue withdrawal and weak suckle reflex at birth (P<0.001). An incomplete tongue withdrawal (P=0.005) and weak suckle reflex (P=0.02) were associated with decreased IgG concentrations. Abnormal mucous membrane colour, incomplete tongue withdrawal, and a weak suckle reflex were associated with decreased odds of having adequate PI (P<0.05). Haptoglobin was not associated with any of the parameters measured. Subclinical trauma was associated with calving difficulty, decreased vigour and decreased odds of having adequate PI. Understanding the impacts of a traumatic birth may aid the development of management strategies for compromised newborn beef calves.

scholarly journals Musculoskeletal examination in young athletes and non-athletes: the Finnish Health Promoting Sports Club (FHPSC) study

2018 ◽  
Vol 4 (1) ◽  
pp. e000376 ◽  
Author(s):  
Kerttu Toivo ◽  
Pekka Kannus ◽  
Sami Kokko ◽  
Lauri Alanko ◽  
Olli J Heinonen ◽  
...  
Keyword(s):  
Movement Control ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Exercise Medicine ◽  
Sports Club ◽  
Jump Test ◽  
Medicine Physician ◽  
Sports And Exercise ◽  
Periodic Health Evaluation ◽  
Musculoskeletal Examination

ObjectivesTo determine the inter-rater repeatability of a musculoskeletal examination and to compare findings between adolescent athletes and non-athletes in Finland.MethodsIn this cross-sectional study, a musculoskeletal examination assessing posture, mobility and movement control was carried out by a sports and exercise medicine physician on 399 athletes aged 14–17 years and 177 non-athletes. Within 2 weeks another sports and exercise medicine physician repeated the examination for 41 adolescents to test the inter-rater repeatability.ResultsIn total, 10 of the 11 tests performed had at least moderate inter-rater reliability (κ ≥0.4 or percentage agreement >80%). Athletes more often than non-athletes had one shoulder protruded (8.0% vs 4.0%, OR 2.81, 95% CI 1.16 to 6.81). Forty-six per cent of athletes had good knee control in the two-legged vertical drop jump test compared with 32% of non-athletes (OR 1.99, 95% CI 1.29 to 3.06). Athletes had better core muscle control with 86.3% being able to remain in the correct plank position for 30 s compared with 68.6% of non-athletes (OR 2.70, 95% CI 1.67 to 4.36). In the deep squat test, good lumbar spine control was maintained only by 35.8% of athletes and 38.4% of non-athletes.ConclusionA basic musculoskeletal examination is sufficiently reliable to be performed by trained physicians as a part of a periodic health evaluation. Shortfalls in mobility, posture and movement control are common in both athletes and non-athletes. These deficits could have been caused by sedentary behaviour, monotonous training, or both.

scholarly journals Prevalence and gender differences of buccally displaced canines of 12 years school children and 18-23 years adults in Shah-Alam, Malaysia

2021 ◽  
Vol 6 (2) ◽  
pp. 39-42
Author(s):  
Majda T. Elfseyie ◽  
◽  
Nagham M.A. Al-Jaf ◽  
Mohamed I. Abu Hassan ◽  
◽  
...  
Keyword(s):  
Gender Differences ◽  
School Children ◽  
Treatment Plan ◽  
Age Groups ◽  
Clinical Signs ◽  
Clinical Situation ◽  
Cross Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
And Gender

Background: The buccally displaced canines (BDC) are more commonly encountered conditions in orthodontic clinics. It is a positional variation result of several factors such as retained deciduous canines, crowding, and lateral incisors anomalous. Aims: To determine the prevalence and gender differences of one-two-three-four buccally displaced canines in the area of Shah-Alam, Malaysia. Methods: A cross-sectional study of 399 subjects; was consist of two age groups; 208 subjects of school children aged 12 years and 191 subjects of adults aged 18-23 years were examined clinically to determine the prevalence of BDC. Statistical analysis: The data were statistically analyzed using SPSS version 16; a Chi-square test was performed to assess the gender differences. Results: No gender differences were found in the school-children group while in the adults group a significant gender difference was found regarding one and four canine displacements (P < 0.05). The prevalence of one-two-three canine displacement was higher significantly between the two groups (P < 0.05). However, the frequency of one canine displacement was higher significantly in adult females and girls (P < 0.05). The frequency of three canines displacement was approximately equal in both genders. Conclusion: The frequency of one canine displacement was higher significantly in females. However, the frequency of four canines displacement was higher significantly in males. These features may help in providing additional clinical signs in diagnosis and interception of such clinical situation. It will be effective in treatment plan procedure if canine displacement is detected early, help clinicians on the prevention of impaction possibility.

scholarly journals Clinically Relevant Drug-Drug Interactions and Management Strategies: A Hospital based Study

2020 ◽  
Vol 2 (2) ◽  
pp. 109-114
Author(s):  
Arun Sharma ◽  
Sitaram Khadka ◽  
Bimal Kunwar ◽  
Kapil Amgain ◽  
Rinku Joshi ◽  
...  
Keyword(s):  
Drug Interactions ◽  
Management Strategies ◽  
Clinical Importance ◽  
Cross Sectional Study ◽  
Automated System ◽  
Clinical Settings ◽  
Evaluation Tool ◽  
Cross Sectional ◽  
Medication Therapy ◽  
Clinically Significant

Background: Drug-drug interactions (DDIs) are one of the significant drug related problems encountered in clinical settings. Better understanding of the mechanisms, severity, and likely consequences of clinically significant DDIs are essential for proper medication therapy management (MTM). This study is conducted with the aim to aware clinical practitioners about clinically significant DDIs that occur in clinical settings and to help them manage such events with the accurate knowledge and technique. Methods: A descriptive cross-sectional study was conducted in Shree Birendra Hospital, Kathmandu on the prescription of medical out-patient department from June to November 2020. Total 483 prescriptions were selected randomly. A panel of physicians, pharmacologists and clinical pharmacists under the supervision of a consultant physician using MICROMEDEX DRUG-REAX, Evaluation of Drug Interactions, Drug Interaction Facts, Drug Interactions: Analysis and Management was conducted. Main outcome measure was obtained by the supervisor’s endorsement on panelists' opinion about clinical importance of DDIs. Results: A total of 2006 medicines were prescribed in 483 prescription samples. The number of drugs per prescription was in a range from 2 to 11 with 4.15 on average. DDIs were found in 21.53% prescriptions (n=104). 168 DDIs were identified with major, moderate, and minor types in 32 (19%), 85 (51%), and 51 (30%) respectively. As per occurrence, the panel determined that 13 interactions were clinically important. Conclusion: The drug interactions identified by a panel of expert using standard evaluation tool are considered to be clinically important and likely to occur in the clinical settings. Clinically significant DDIs can be preventable and can also be used for the beneficial effects in MTM. Adequate knowledge regarding nature of DDIs, inclusion of automated system in prescribing and dispensing area, and inter-professional collaboration of a clinical team is liable to prevent and manage such events and help in rational drug therapy.

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