scholarly journals The Pilot Survey of the Perception on the Practice Pattern, Diagnosis, and Treatment on Korean Medicine Insomnia: Focusing on the Difference between Korean Medical Neuropsychiatry Specialists and Korean Medical General Practitioners

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Jung-Hwa Lim ◽  
Jin-Hyung Jeong ◽  
Sang-Ho Kim ◽  
Kyeong-Ok Kim ◽  
Seung-Yeon Lee ◽  
...  
Keyword(s):  
Clinical Practice ◽  
General Practitioners ◽  
Medical Diagnosis ◽  
Response Rate ◽  
Diagnosis And Treatment ◽  
Pilot Survey ◽  
Pattern Diagnosis ◽  
The Difference ◽  
Guipi Decoction

Introduction. This study aims to investigate the clinical practice states on the diagnosis and treatment for insomnia between Korean medical general practitioners (KMGPs) and Korean medical neuropsychiatry specialists (KMNPSs). Methods. We distributed questionnaires via email or in person to 1,017 KMGPs and via email to 165 KMNPSs. We collected and analyzed responses from 305 (30.00%) KMGPs and 53 (32.12%) KMNPSs. Results. Most KMGPs and KMNPSs responded that the number of new patients visiting the clinic for treatment of insomnia was less than 10 per month (78.2%). Frequently utilized therapies for insomnia are acupuncture and herbal decoctions. Particularly acupoint GV20 and Guipi decoction were chosen with the highest response rate. There was no difference between KMNPSs and KMGPs in the traditional Korean medical diagnosis methods. However, KMNPSs utilized more various methods to diagnose, treat, and evaluate insomnia and educated more actively sleep hygiene compared to KMGPs. Conclusions. This survey showed how insomnia is currently diagnosed and treated in Korean medical care settings. Moreover, we identified some differences between KMNPSs and KMGPs. Further research is required to explore the underlying reasons for these discrepancies among KMDs and to improve the quality of Korean medical clinical practice in treating insomnia.

scholarly journals Barriers and facilitators to a health information exchange system for general practitioners

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
N S Centemero ◽  
B Rechel
Keyword(s):  
Clinical Practice ◽  
Health Information ◽  
General Practitioners ◽  
Information Exchange ◽  
Medical Information ◽  
Health Information Exchange ◽  
Barriers And Facilitators ◽  
Local Health ◽  
Care Providers

Abstract Background Health information exchange (HIE) systems, that are computer-based tools used by healthcare providers for secure access to share patient's medical information electronically, seem to help reduce the use of specific resources and improve the quality of care. This highlights the importance of this issue in the Public Health sector. This research goal is to identify barriers and facilitators perceived by general practitioners (GPs) when using an HIE system in a Southern Switzerland area. Methods we performed a qualitative study using semi-structured interviews, interviewed 10 GPs, randomly selected among some 500 HIE system local users and analysed interview transcripts using thematic content analysis with an abductive approach (a mix of deductive and inductive approaches). Results findings showed the following key facilitators: a) perception of dealing with a secure system; b) possibility of delegating management to secretaries and healthcare assistants; c) technical support and training; d) high quality of the information exchange; e) positive impact on clinical practice; and f) regional context. However, major challenges persist, and GPs reported the following main barriers to using an HIE system: a) frequent lack of all patient information needed; b) no effective workflow improvements; c) lack of some technical features. Conclusions We propose four recommendations based on findings: 1. Future initiatives should focus on developing HIE systems giving GPs access to all possible patient medical information; 2. Crucial data privacy and security issues should never be overlooked; 3. Technical and workflow improvements should particularly consider the socio-technical nature of HIE systems; 4. Much attention needs to be paid to the importance of relationships between health care providers and between these and local health institutions when implementing HIE systems. Key messages This study filled a research gap as it is the first that tackles HIE system barriers and facilitators in Ticino. When information sharing for clinical practice focuses on improving the quality and costs of healthcare, GP's trust in HIE system security is crucial.

scholarly journals Pediatric migraine equivalents

2021 ◽  
Vol 13 (1) ◽  
pp. 94-100
Author(s):  
P. V. Zhmylyova ◽  
G. R. Tabeeva ◽  
A. V. Sergeev
Keyword(s):  
Quality Of Life ◽  
Clinical Practice ◽  
Migraine Headache ◽  
Management Strategies ◽  
Diagnosis And Treatment ◽  
Common Disease ◽  
Pediatric Practice ◽  
Pediatric Migraine ◽  
Migraine Equivalents

Migraine is a common disease in pediatric practice. Its manifestations are extremely diverse in children. Pediatric migraine equivalents are a group of different disorders that are closely related to migraine and are more common in children long before the manifestation of migraine headache. Their verification presents significant difficulties in clinical practice, and this often predetermines the use of inadequate management strategies for these patients. Meanwhile, the diagnosis of and approaches to treating pediatric migraine equivalents have their own characteristics, the knowledge of which can significantly determine quality of life in patients. The paper considers modern ideas about pediatric periodic syndromes and data on their relationship to migraine and discusses the issues of their diagnosis and treatment.

scholarly journals Efficacy, quality of life, and safety of cabazitaxel in Canadian metastatic castration-resistant prostate cancer patients treated or not with prior abiraterone

2016 ◽  
Vol 10 (3-4) ◽  
pp. 102 ◽  
Author(s):  
Fred Saad ◽  
Eric Winquist ◽  
Stacey Hubay ◽  
Scott Berry ◽  
Hussein Assi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Overall Survival ◽  
Clinical Practice ◽  
Response Rate ◽  
Routine Clinical Practice ◽  
Castration Resistant Prostate Cancer ◽  
Castration Resistant ◽  
Psa Response

<p><strong>Introduction:</strong> In the TROPIC study, cabazitaxel improved overall survival in abiraterone-naïve metastatic castration-resistant prostate cancer (mCRPC) patients post-docetaxel. To evaluate cabazitaxel in routine clinical practice, an international, single-arm trial was conducted. Efficacy, safety, and quality of life (QoL) data were collected from Canadian patients enrolled. Overall survival and progression-free survival were not collected as part of this study. Importantly, prior abiraterone use was obtained and its impact on clinical parameters was examined.</p><p><strong>Methods:</strong> Sixty-one patients from nine Canadian centres were enrolled, with prior abiraterone use known for 60 patients. Prostatespecific antigen (PSA) response rate, safety, and impact on QoL life were analyzed as a function of prior abiraterone use.</p><p><strong>Results:</strong> Overall, 92% of patients were ECOG 0/1, 88% had bone metastases, and 25% visceral metastases. Patients treated without prior abiraterone (NoPriorAbi) (n=35, 58%) and with prior abiraterone (PriorAbi) (n=25, 42%) had similar baseline characteristics, except for age and prior cumulative docetaxel dose. Median number of cabazitaxel cycles received was similar between groups (NoPriorAbi=6, PriorAbi=7), as was PSA response rate (NoPriorAbi=36.4%, PriorAbi=45.0%, p=0.54). Almost one-third (31%) of patients received prophylactic granulocyte colony-stimulating factors. Most frequent Grade 3/4 toxicities were neutropenia (14.8%); anemia, febrile neutropenia, fatigue (each at 9.8%); and diarrhea (8.2%). No treatment-related adverse event leading to death was observed. QoL and pain were improved with no difference seen between groups. Treatment discontinuation was mainly due to disease progression (45.9%) and adverse events (32.8%).</p><p><strong>Conclusions:</strong> In routine clinical practice, cabazitaxel’s risk-benefit ratio in mCRPC patients previously treated with docetaxel seems to be maintained independent of prior abiraterone use.</p>

scholarly journals Effect of Deproteinized Dialysate from Vealers’ Blood on the Collagenogenesis in the Area of Polypropylene Hernioendoprosthesis ​​Implantation: аn Experimental Study

2021 ◽  
Vol 14 (1) ◽  
pp. 61-68
Author(s):  
Evgenij Gennadievich Obedkov ◽  
Sergej Viktorovich Ivanov ◽  
Ilya Sergeevich Ivanov ◽  
Inna Anatolievna Ivanova ◽  
Anna Igorevna Denisenko ◽  
...  
Keyword(s):  
Experimental Study ◽  
Clinical Practice ◽  
Connective Tissue ◽  
Necessary Conditions ◽  
Maximum Value ◽  
The Difference ◽  
Ventral Hernias ◽  
Postoperative Scar ◽  
Optimal Type

Introduction. The choice of the optimal type of hernia endoprosthesis, as well as introduction of drugs with a collagen-forming effect into clinical practice, will improve the quality of treatment in patients with ventral hernias due to the formation of the full-fledged connective tissue both in the area of ​​the postoperative scar and in the area of ​​the hernia endoprosthesis placement. The aim of the study was to identify the effect of deproteinized dialysate from vealers blood on neocollagenesis in the area of endoprosthetics.Materials and methods. The experimental study included 80 laboratory white mice, Wistar line. All animals were divided into two groups (control and experimental). A polypropylene hernioendoprosthesis was implanted in animals of both groups. The division into groups was due to the use of deproteinized dialysate from the vealers blood.Results. The use of a polypropylene hernioendoprosthesis for abdominal wall plasty combined with the use of deproteinized dialysate created the necessary conditions for accelerating the processes of proliferation and maturation of fibroblastic cells.Conclusion. The maximum value of the ratio of collagen fibers of types I and III was achieved on the 90th day of the study, the difference between the value of this parameter was 1.24 times greater in the group of animals where deproteinized dialysate was used.

scholarly journals Etat Des Lieux Et Evaluation Des Formations En Radiologie Dans Un Pays En Developpement, Cas Du Togo

2018 ◽  
Vol 14 (6) ◽  
pp. 269
Author(s):  
Mazamaesso Tchaou ◽  
Dandjeffo L. C. Houadjeto ◽  
Lantam Sonhaye ◽  
Lama-Kegdigoma Agoda-Koussema ◽  
Komlanvi Adjenou ◽  
...  
Keyword(s):  
Response Rate ◽  
Conventional Radiography ◽  
Descriptive Study ◽  
Opinion Survey ◽  
The Difference ◽  
Level Of Training ◽  
Practical Instruction ◽  
Academic Year ◽  
Junior Residents

Objective: to make an inventory and assess the training in radiology in Togo. Methodology: Descriptive study, with opinion survey, carried out from June to August 2016 including students in Master and Residents in radiology of the academic year 2015 - 2016. Results: The response rate was 91%. All the training sites had conventional radiography and functional ultrasound. For 57% of students the quality of practical instruction was 4/5. The availability of teachers was acceptable (3/5) to good (4/5) according to 84%. Competence for examinations varies from bad (2/5) to excellent (5/5) for the Master 1 and from good to excellent in Master 2. The difference in responses was not significant regardless of the year of study or training course (p> 0.05). For the performance and interpretation of radiological examinations, the junior residents were considered mediocre (1/5) to acceptable versus acceptable to seniors. For an ultrasound, this score varied from 1/5 for the juniors residents to 4/5 for the seniors. The competence to carry out a vessels ultrasound Doppler was 1/5 for the junior residents and 2/5 for the senior. Conclusion: Learners in radiology in Togo are generally satisfied with the training they receive. Acquisitions of significant skills have been observed from one level of training to another.

Acceptable outcomes after fundoplication—different views are held by patients, GPs, and surgeons

2019 ◽  
Vol 32 (8) ◽  
Author(s):  
Andrew C Currie ◽  
Tim Bright ◽  
Sarah K Thompson ◽  
Lorelle Smith ◽  
Peter G Devitt ◽  
...  
Keyword(s):  
General Practitioners ◽  
Antireflux Surgery ◽  
Laparoscopic Fundoplication ◽  
Response Rate ◽  
Multivariate Statistical ◽  
Female Patients ◽  
Clinical Scenarios ◽  
Male Patients ◽  
Acceptable Outcome

SUMMARY Antireflux surgery aims to improve quality of life. However, whether patients and clinicians agree on what this means, and what is an acceptable outcome following fundoplication, is unknown. This study used clinical scenarios pertinent to laparoscopic fundoplication for gastroesophageal reflux to define acceptable outcomes from the perspective of patients, surgeons, and general practitioners (GPs). Patients who had previously undergone a laparoscopic fundoplication, general practitioners, and esophagogastric surgeons were invited to rank 11 clinical scenarios of outcomes following laparoscopic fundoplication for acceptability. Clinicopathological and practice variables were collated for patients and clinicians, respectively. GPs and esophagogastric surgeons additionally were asked to estimate postfundoplication outcome probabilities. Descriptive and multivariate statistical analyses were undertaken to examine for associations with acceptability. Reponses were received from 331 patients (36.4% response rate), 93 GPs (13.4% response), and 60 surgeons (36.4% response). Bloating and inability to belch was less acceptable and dysphagia requiring intervention more acceptable to patients compared to clinicians. On regression analysis, female patients found bloating to be less acceptable (OR: 0.51 [95%CI: 0.29–0.91]; P = 0.022), but dysphagia more acceptable (OR: 1.93 [95%CI: 1.17–3.21]; P = 0.011). Postfundoplication estimation of reflux resolution was higher and that of bloating was lower for GPs compared to esophagogastric surgeons. Patients and clinicians have different appreciations of an acceptable outcome following antireflux surgery. Female patients are more concerned about wind-related side effects than male patients. The opposite holds true for dysphagia. Surgeons and GPs differ in their estimation of event probability for patient recovery following antireflux surgery, and this might explain their differing considerations of acceptable outcomes.

scholarly journals Evidence-based Practice (EBP): beliefs, knowledge and behavior of physiotherapists. A survey research.

2021 ◽  
pp. 19-35
Author(s):  
Collebrusco Luca ◽  
Gambacorta Andrea ◽  
Visciano Gennaro
Keyword(s):  
Clinical Practice ◽  
Patient Care ◽  
Practice Guidelines ◽  
Response Rate ◽  
Evidence Based Practice ◽  
Evidence Based ◽  
Demographic Information ◽  
Quality Of Patient Care ◽  
And Behaviors

An analytical observational study was conduct using a web-based questionnaire. Evidence-based practice is one of the most relevant concern of all health professions. This research has been done taking account of demographic information, attitudes and skills in reference to Evidence Based Practice (EBP) for application in the daily clinical practice. To describe beliefs and behaviors of physiotherapists from two Italian regions about EBP and its implementation in clinical practice, their knowledge in this field and the perception of its benefits and barrier in application in clinical practice. The participants completed a designed questionnaire, whose purpose was to determine beliefs, attitudes, knowledge, and behaviors regarding EBP, as well as demographic information about themselves and their practice settings. This survey was activated through the TSRM-PSTRP registers of Marche and Umbria regions that sent the questionnaire to all the registered physiotherapists. There was a response rate of 7.64% for Marche region, equal to a sample of 132 physiotherapists, and a response rate of 12.99% for Umbria region, equal to a sample of 110 physiotherapists, for a total sample of 242 physiotherapists. The questionnaire was filled out through an online Google platform called “Forms”. The responses were summarized for each item and the logistic regression analyses and the chi-square test were used to examine relationships among variables. The respondents agreed that the use of evidence in practice was necessary, that the literature was helpful in their practices and that the quality of patient care was better when evidence were used. For physiotherapists from Umbria, with more than 15 years of qualification, the following answers are statistically significant (p<0.05): “the application of EBP is necessary in the practice of physical therapy, EBP helps me making decisions about patient care and I actively seek practice guidelines pertaining to areas of my practice and EBP improves the quality of patient care”. For physiotherapists from Marche, with more than 15 years of qualification, the following answers are statistically significant (p<0.05): “EBP helps me making decisions about patient care, I actively seek practice guidelines pertaining to areas of my practice and I am confident in my ability to find relevant research to answer my clinical questions”. Training, familiarity with and confidence in search strategies, use of databases, and critical appraisal tended to be associated to younger therapists with fewer years of qualification. Physical therapists stated they have a positive attitude about EBP and they are interested in learning or improving the necessary skills to implement EBP. They noticed that they needed to increase the use of evidence in their daily practice.

scholarly journals T237. PERSON-CENTERED PSYCHOSIS CARE –HOW INCREASING PERSON-CENTEREDNESS IN PSYCHOSIS INPATIENT CARE RELATE TO CARE CONSUMPTION AND WARD BURDEN

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S323-S323
Author(s):  
Katarina Allerby ◽  
Anneli Goulding ◽  
Lilas Ali ◽  
Andreas Gremyr ◽  
Margda Waern
Keyword(s):  
Data Collection ◽  
Response Rate ◽  
Length Of Hospital Stay ◽  
Participatory Approach ◽  
Care Plan ◽  
Patient Needs ◽  
Centered Care ◽  
Ward Level ◽  
The Difference

Abstract Background Since person-centered care (PCC) is widely embraced and internationally considered to increase effectiveness and quality of complex health care today this study sets out to investigate its relation to ward level outcomes such as length of hospital stay (LoS), involuntary treatments and ward burden. An educational intervention for staff, using a participatory approach, was created to increase the person-centeredness of the care delivered at four inpatient psychosis wards. 6 conference days spread over a 6 months period with practical work at home wards in-between let participants receive information on, discuss and test the principles of PCC, such as acknowledge patients resources, preferences and experiences, working in partnership with patients to co-create the care plan, and documenting agreements. Methods Data for all patients receiving care at the inpatient services during data collection periods before (n = 416) and after (n = 375) the intervention, including LoS, length of involuntary stay (LoIS) as well as number of episodes involving restraints, seclusions and forced injections, were extracted from the clinic registry. During the same data collection periods one staff member per day and ward filled out a VAS rating (1 = no burden – 10 =highest imaginable burden) capturing experienced ward burden (n = 505, 60% response rate vs n = 465, 45% response rate). Mean or median of each variable was used for comparative analysis. Results A longer LoS was found after implementation (Md = 21.1, n = 416 vs Md = 26.2, n = 375), U = 85894, p = .014, r = .09. LoIS was shorter after implementation (Md = 10.6 vs Md = 6.6), the difference was however not significant U = 74263, p = .231. Analysis of data on involuntary treatments are underway and will be presented. Ward burden was rated significantly lower after implementation (M = 5.4, SD = 1.94 vs M = 4.5, SD = 2.08), t = 7.5 (968), p &lt;.0005. Discussion Although study design prevents conclusions on cause and effect, the results indicate a beneficial development for perceived care burden after implementation of PCC. The increased LoS could be interpreted as a result of more thorough attention to patient needs. It could also be due to differences between groups in terms of severity of symptom and functional ability at admission.

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