How do hand therapists conservatively manage acute, closed mallet finger? A survey of members of the British Association of Hand Therapists

Hand Therapy ◽  
2016 ◽  
Vol 22 (1) ◽  
pp. 13-25 ◽  
Author(s):  
Samantha Cook ◽  
Nikki Daniels ◽  
Sarah Woodbridge
Keyword(s):  
Best Practice ◽  
Online Survey ◽  
Response Rate ◽  
Clinical Skills ◽  
Current Treatment ◽  
Therapeutic Management ◽  
British Association ◽  
Mallet Finger ◽  
Clinical Practices ◽  
Diverse Range

Introduction Previous research concerning the conservative management of mallet finger has focused on splint application, with limited representation of supplementary rehabilitation and best practice. This research sought to investigate the practice and opinions of members of the British Association of Hand Therapists regarding their current treatment and to determine whether any specific exercise prescription or rehabilitation protocols are followed. Methods British Association of Hand Therapists members were contacted via e-mail and requested to complete an online survey. Thirty-five responses (5.7% response rate), 30 (4.8% response rate) of which were fully completed were obtained over the eight-week data collection period. The questionnaire consisted of 30 questions (20 quantitative and 10 qualitative) concerning therapists’ roles and condition management. Responses were analysed in terms of response frequencies, percentages and thematic text analysis. Results The results demonstrated current clinical practices in line with available best-evidenced practice. Conservative therapeutic management is diverse and varied. Therapists believe their role to be significant in optimising outcome success. Discussion Exercises and other interventions supplementary to splinting are commonly utilised in the therapeutic management of acute, closed mallet finger. This research found hand therapists implement a diverse range of clinical skills in order to optimise outcome success. Recommendations for best practice and further research are presented.

8 How do hospices facilitate social support?

2018 ◽  
Vol 8 (3) ◽  
pp. 362.3-363
Author(s):  
Natasha Bradley ◽  
Mari Lloyd-Williams ◽  
Chris Dowrick
Keyword(s):  
Social Support ◽  
Palliative Care ◽  
Best Practice ◽  
Online Survey ◽  
Hospice Care ◽  
List Type ◽  
Negative Consequences ◽  
Physical And Mental Health ◽  
Diverse Range ◽  
Service Models

IntroductionSocial isolation is increasing with negative consequences for both physical and mental health. People with life-limiting illness and their carers are at risk of inadequate social support and loneliness.Hospices support social wellbeing with services including traditional day care support groups befriending multi-component interventions and community activities. Existing research suggests that access to social support is highly valued. However models of support used in practice are poorly documented and outcomes difficult to ascertain. The significance of social support in palliative care is under-researched.AimTo establish an overview of hospice service models that facilitate social support for adults living in the community with life-limiting illness.MethodAn online survey was developed piloted and disseminated to adult hospices in the UK and ROI. Questions include hospice characteristics provision of services facilitating social support access issues use of patient outcomes and availability of cost data.Results107 hospices responded to the survey (>50% of eligible hospices). A diverse range of service models were identified. Preliminary results presented include: descriptive statistics of the sample categories and aims of services and salient access issues. Implications of findings for research and economic evaluation are discussed.ConclusionThis survey demonstrates hospices to be interested and active in facilitating social support. It is possible that increasingly diverse approaches used in practice may improve issues regarding access to and awareness of hospice care. More work is needed to share best practice document outcomes and consider cost-effectiveness.Reference. Bradley N, Lloyd-Williams M, Dowrick C. Effectiveness of palliative care interventions offering social support to people with life-limiting illness – A systematic review. Eur J Cancer Care2018. doi:10.1111/ecc.12837

scholarly journals P115: Bounceback reports-improving patient care

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S97-S98
Author(s):  
F. Pinto ◽  
M. B-Lajoie
Keyword(s):  
Online Survey ◽  
Response Rate ◽  
Clinical Skills ◽  
High Yield ◽  
Academic Hospital ◽  
Outcome Feedback ◽  
Improving Patient Care ◽  
The Impact ◽  
Final Disposition

Introduction: Seeking patient outcome feedback (POF), defined as obtaining information on a patients clinical course beyond ones care, is crucial to the learning process. However, the lack of POF is a major pitfall of emergency medicine. Emergency department (ED) bouncebacks, which are characterized as patients with unplanned returns to the ED after being discharged, are an important type of POF to study because they represent a potential misdiagnosis or mismanagement and can highlight areas for physician self-improvement. Currently, most hospitals do not relay details about ED bouncebacks back to the treating physician, unless a grave error occurred. This studys purpose is to provide weekly reports to all physicians in the ED on patients who have unplanned returns within 7 days of discharge from the ED, and evaluate the impact this has on the physicians practice on seeking POF. Methods: A new weekly report was distributed to physicians working at an academic hospital outlining the patients who have returned within 7 days of discharge from the ED, their new presenting complaint and final disposition. An online survey was also administered to all ED staff evaluating the amount of POF they sought pre and post report, and their attitude towards the new reports. Results: 22 responses were received, for a response rate of 85%. The majority of respondents follow the reports (73%) and actively seek POF by looking up patients charts and results(70%). Additionally, 58% state that they seek POF more often since receiving these reports, for both the bouncebacks and their other patients. Furthermore, 37% claimed that the reports helped improve the appropriateness of their referrals and 32% stated it helped increase their confidence in their clinical practice. The majority of physicians (87%) found the reports to be helpful and would like to continue receiving it. Conclusion: Weekly bounceback reports are a high-yield tool for increasing POF sought in the ED and have benefits for both the physician and the department as a whole. They can be used to not only identify patients who may have had an error in their management, but also help to improve physicians’ clinical skills by encouraging and enabling follow-up of patients they managed. Thus, bounceback reports are a valuable tool to provide to physicians and should be considered by ED Departments.

Antiplatelet drugs in elective ENT surgery

2012 ◽  
Vol 126 (9) ◽  
pp. 886-892 ◽  
Author(s):  
J R Savage ◽  
A Parmar ◽  
P J Robinson
Keyword(s):  
Head And Neck ◽  
Online Survey ◽  
Response Rate ◽  
Expert Panel ◽  
Operative Management ◽  
Low Risk ◽  
British Association ◽  
Antiplatelet Drugs ◽  
Main Text ◽  
Ent Surgery

AbstractIntroduction:Oral antiplatelet drugs are increasingly being encountered in patients scheduled for elective ENT surgery. Their pre-operative cessation can have potentially serious complications in some patients, particularly those with intracoronary stents.Methods:In order to gain an impression of current peri-operative management of patients taking antiplatelet drugs, an online survey was distributed to the Expert Panel of ENT UK, the British Association of Otolaryngologists Head and Neck Surgeons, between 13 January and 15 February 2011.Results:Three hundred and three members were contacted. The response rate was 55 per cent (167 replies); 78 per cent of respondents were consultants. Results are presented in the main text.Conclusion and recommendations:Patients can be categorised as high or low risk, depending on their indication for taking antiplatelet drugs. Recommendations taken from the literature are given on how best to manage these two groups.

scholarly journals Elastomeric liners for people with transtibial amputation: Survey of prosthetists’ clinical practices

2016 ◽  
Vol 41 (2) ◽  
pp. 149-156 ◽  
Author(s):  
Brian J Hafner ◽  
John C Cagle ◽  
Katheryn J Allyn ◽  
Joan E Sanders
Keyword(s):  
Online Survey ◽  
Selection Process ◽  
Clinical Practices ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Transtibial Amputation ◽  
Diverse Range ◽  
Prescription Practices ◽  
Selection Processes ◽  
Selection Practices

Background: A diverse range of elastomeric liner products are available to people with transtibial amputation. However, little information is available about how prosthetists select the product best suited to each patient. Objectives: To determine how prosthetists obtain information about liners, which features are most relevant to the selection process, and which products are used most for patients with transtibial amputation. Study design: Cross-sectional survey. Methods: A custom online survey was developed to solicit information about prosthetists’ liner selection practices. Prosthetists with experience managing transtibial patients were recruited via advertisements posted in magazines, at conferences, and on a listserv. Responses were analyzed to characterize prosthetists’ liner selection practices. Results: Data from 106 experienced prosthetists (mean age: 44.4 years, mean experience: 15.7 years) were included. Most prosthetists (94%) obtained liner information from manufacturer representatives, websites, or literature. On average, respondents factored nine different liner characteristics into their selection processes. Prosthetists reported experience with 16 unique liner products with their transtibial patients, but routinely used fewer than 3. Conclusion: Although many different prosthetic liners are available, prosthetists regularly use only a few select liner products. Tools or strategies to objectively compare prosthetic liners across manufacturers are likely needed to facilitate more diverse prescription practices. Clinical relevance Knowledge of prosthetists’ prosthetic liner selection practices may guide development of evidence-based resources or tools to facilitate matching patients with appropriate liners. Results of this study may also inform researchers and manufacturers about desirable liner characteristics and direct development of novel liner products to address prosthetists’ clinical needs.

Knowledge, Perceptions and Practices on Modified Release Tablets among Prescribers: A Preliminary Study

2020 ◽  
Vol 01 (01) ◽  
pp. 05-14
Author(s):  
M.G.K.M. Fernando ◽  
K.I.J. Priyadarshi ◽  
L.G.T. Shanika ◽  
N.R. Samaranayake
Keyword(s):  
Online Survey ◽  
Product Information ◽  
Response Rate ◽  
Immediate Release ◽  
State Universities ◽  
Modified Release ◽  
Validated Questionnaire ◽  
Therapeutic Outcomes ◽  
Medical Faculties ◽  
Enteric Coated

Introduction: Modified release tablets (MRTs) are developed to achieve different therapeutic outcomes and are frequently prescribed. This study aims to evaluate the knowledge, perceptions and practices on using MRTs among a selected cohort of prescribers. Methods: A self administered online survey was conducted using a pre-validated questionnaire, prepared in-house to assess knowledge, perceptions and practices on using MRTs, among academics with an MBBS degree in medical faculties of State universities in Sri Lanka. Results: The response rate was 15.5% among 375 prescribers. Most were females (53.4%) and were 46-55 years (29.3%). Over 50% correctly expanded abbreviations related to MRTs. Most defined enteric coated (87.9%) and targeted release (77.6%) forms accurately. However, 87.0% mixed-up definitions of sustained release with controlled release. Most believed that inability to split tablets (70.7%) and high cost (70.7%), as disadvantages of MRTs. Nearly half did not identify the risk of dose dumping (53.5%) and inflexible dosing schedule (44.8%) as disadvantages. For frequency of administering MRTs, 86.2% referred the product information leaflet (PIL) while 29.0% depended on the frequency of the corresponding immediate release tablet. Most (79.3%) prescribed MRTs to increase patient compliance while 12.1% prescribed them to reduce cost. When problems regarding MRTs were encountered, most referred PILs (81.0%) and clarified with experts (75.9%). Conclusions: Although the response rate was low, a clear gap in knowledge, perceptions and practices on using MRTs were identified among prescribers who responded. Interventions are needed to improve the knowledge, perceptions, and practices on using MRTs among prescribers.

scholarly journals Assessing the utility and attitudes toward molecular testing in neuro-oncology: a survey of the Society for Neuro-Oncology members

2021 ◽  
Author(s):  
Shannon Fortin Ensign ◽  
Maya Hrachova ◽  
Susan Chang ◽  
Maciej M Mrugala
Keyword(s):  
Online Survey ◽  
Clinical Decision Making ◽  
Unmet Needs ◽  
Practice Patterns ◽  
Response Rate ◽  
Clinical Decision ◽  
Molecular Testing ◽  
Newly Diagnosed ◽  
Tumor Boards ◽  
Oncology Practice

Abstract Background Molecular testing (MT) is utilized in neuro-oncology with increasing frequency. The aim of this study was to determine clinical practice patterns to acquire this information, interpret and utilize MT for patient care, and identify unmet needs in the practical clinical application of MT. Methods We conducted a voluntary online survey of providers within the Society for Neuro-Oncology (SNO) membership database between March and April 2019. Results We received 152 responses out of 2022 SNO members (7.5% of membership). 88.8% of respondents routinely order MT for newly diagnosed gliomas. Of those who do not, testing is preferentially performed in younger patients or those with midline tumors. 82.8% use MT in recurrent gliomas. Other common indications included: metastatic tumors, meningioma, and medulloblastoma. Many providers utilize more than one resource (36.0%), most frequently using in-house (41.8%) over commercially available panels. 78.1% used the results for clinical decision-making, with BRAF, EGFR, ALK, and H3K27 mutations most commonly directing treatment decisions. Approximately, half (48.5%) of respondents have molecular tumor boards at their institutions. Respondents would like to see SNO-endorsed guidelines on MT, organized lists of targeted agents available for specific mutations, a database of targetable mutations and clinical trials, and more educational programs on MT. Conclusion This survey was marked by several limitations including response rate and interpretation of MT. Among respondents, there is routine use of MT in Neuro-Oncology, however, there remains a need for increased guidance for providers to effectively incorporate the expanding genomic data resulting from MT into daily Neuro-Oncology practice.

scholarly journals Cost-effectiveness of new MDR-TB regimens: study protocol for the TB-PRACTECAL economic evaluation substudy

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e036599
Author(s):  
Sedona Sweeney ◽  
Gabriela Gomez ◽  
Nichola Kitson ◽  
Animesh Sinha ◽  
Natalia Yatskevich ◽  
...  
Keyword(s):  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Best Practice ◽  
Current Treatment ◽  
Outcome Data ◽  
London School ◽  
Main Trial ◽  
Ethical Approval ◽  
Mdr Tb ◽  
The Impact

IntroductionCurrent treatment regimens for multidrug-resistant tuberculosis (MDR-TB) are long, poorly tolerated and have poor outcomes. Furthermore, the costs of treating MDR-TB are much greater than those for treating drug-susceptible TB, both for health service and patient-incurred costs. Urgent action is needed to identify short, effective, tolerable and cheaper treatments for people with both quinolone-susceptible and quinolone-resistant MDR-TB. We present the protocol for an economic evaluation (PRACTECAL-EE substudy) alongside an ongoing clinical trial (TB-PRACTECAL) aiming to assess the costs to patients and providers of new regimens, as well as their cost-effectiveness and impact on participant poverty levels. This substudy is based on data from the three countries participating in the main trial.Methods and analysisPrimary cost data will be collected from the provider and patient perspectives, following economic best practice. We will estimate the probability that new MDR-TB regimens containing bedaquiline, pretomanid and linezolid are cost-effective from a societal perspective as compared with the standard of care for MDR-TB patients in Uzbekistan, South Africa and Belarus. Analysis uses a Markov model populated with primary cost and outcome data collected at each study site. We will also estimate the impact of new regimens on prevalence of catastrophic patient costs due to TB.Ethics and disseminationEthical approval has been obtained from the London School of Hygiene & Tropical Medicine and Médecins Sans Frontières. Local ethical approval will be sought in each study site. The results of the economic evaluation will be shared with the country health authorities and published in a peer-reviewed journal.Trial registration numberClinicalTrials.gov Registry (NCT04207112); Pre-results.

scholarly journals 434 - Treatment Patterns and Needs for Dementia-related Psychosis Described by Patients and Care Partners (Caregivers): an Observational, Prospective Study to Describe the Patient Experience

2020 ◽  
Vol 32 (S1) ◽  
pp. 151-151
Author(s):  
Teresa Brandt ◽  
Theresa Frangiosa ◽  
Virginia Biggar ◽  
Angela Taylor ◽  
Bill Keller ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Prospective Study ◽  
Online Survey ◽  
Atypical Antipsychotics ◽  
Qualitative Interviews ◽  
Unmet Need ◽  
Current Treatment ◽  
Treatment Patterns ◽  
Symptom Improvement ◽  
Vas Score

AbstractBackground:We aimed to describe current treatment patterns and unmet needs of persons with DRP from a patient and care partner (CP) perspective.Methods:This observational, non-interventional, prospective study used a mixed-methods approach with qualitative interviews and a quantitative online survey. Persons with DRP and CP of persons with DRP reported the effectiveness of current treatments using a visual analog scale (VAS) of 0 (“not at all well”) to 5 (“extremely well”) and ranked benefits of an ideal treatment. CP burden was outside the scope of this study.Results:The qualitative interview was completed by 1 patient and 15 CP. Current treatments included atypical antipsychotics, antidepressants, anxiolytics, and benzodiazepines. Participants commonly indicated a need to improve patients’ ability to know what is real vs not real.The online survey was completed by 26 patients and 186 CP on behalf of patients under their care. Common treatments used included atypical antipsychotics (27% of patients, 41% of CP) and psychological/ behavioral therapy (23% of patients, 8% of CP). Many participants reported no current treatment (42% of patients, 42% of CP). Participants reported that current treatment methods were less than moderately helpful in treating patients’ most impactful symptoms with a median VAS score of 2.0/5 reported by patients and CP (mean VAS score [standard deviation] = 2.33 [1.0] for patients [n=15], mean [standard deviation] VAS score = 2.4 [1.3] for CP [n=104]). Discontinuation of a treatment was reported by 11 patients and 115 CP, most commonly due to a side effect (27% of patients, 31% of CP), doctor’s recommendation (27% of patients, 14% of CP), or lack of symptom improvement (9% of patients, 28% of CP). Participants ranked the ability to distinguish what is real vs not real (35% of patients, 49% of CP) and overall symptom improvement (42% of patients, 23% of CP) as the most important benefits of an ideal treatment.Conclusions:Patients and CPs reported either not taking any DRP treatments or that current treatments were associated with side effects along with limited efficacy. There is an unmet need for safe and effective treatments for DRP.Study Sponsored By:ACADIA Pharmaceuticals Inc.DisclosuresTF is a consultant with Frangiosa & Associates, LLC.VB and AT have no relevant financial relationships to disclose.TB, BK, and VA are employees of and may hold stock and/or stock options with ACADIA Pharmaceuticals Inc.

scholarly journals Delivery of the National Child Measurement Programme in England

2020 ◽  
pp. 1-21
Author(s):  
Martin Čadek ◽  
Stuart W. Flint ◽  
Ralph Tench
Keyword(s):  
Public Health ◽  
Local Government ◽  
Best Practice ◽  
Online Survey ◽  
The Other ◽  
Service Availability ◽  
Healthy Weight ◽  
Weight Category ◽  
Convenience Sampling

Abstract Objective: The National Child Measurement Programme (NCMP) is a mandatory initiative delivered in England to children in reception and year 6. To date, no research has explored the methods used to deliver the NCMP by Local Government Authorities (LGA) across England. Design: An online survey was administered between February 2018 and May 2018 to explore the delivery of the NCMP across the 152 LGAs in England and disseminated using non-probability convenience sampling. Setting: LGAs received an anonymous link to the survey. Participants: A total of 92 LGAs participated in the survey. Results: Most LGAs who responded provide result feedback (86%), a proactive follow-up (71%) and referrals to services (80%). Additionally, 65% of the authorities tailor Public Health England specimen result letters to suit their needs, and 84% provide attachments alongside. Out of 71% of LGAs who provide proactive follow-up, 19 (29%) provide the proactive follow-up only to upper weight categories, and only 4 (6 %) include Healthy Weight category with other categories in proactive follow-up. Regarding the service availability for children, out of 80% of LGAs who indicated that services are available, 32 (43%) targeted solely upper weight categories while the other 42 (57%) offered services across all weight categories. Finally, most LGAs (88%) commission providers to manage various parts of the NCMP. Conclusions: The results show that LGAs in England localise the NCMP. Further guidance regarding standards of best practice would help LGAs to find the most suitable localisation out of various options that exist across other LGAs.

Perspectives of physicians on medical acupuncture in Lebanon: a preliminary study

2020 ◽  
pp. 096452842096883
Author(s):  
Fadila Bassem Naji ◽  
Kamal Wahab ◽  
Ghassan Hamadeh ◽  
Sani Hlais
Keyword(s):  
Integrative Medicine ◽  
Online Survey ◽  
Response Rate ◽  
Mechanisms Of Action ◽  
Medical Curricula ◽  
Chinese Acupuncture ◽  
The Future ◽  
Preliminary Study ◽  
Medical Acupuncture ◽  
The Difference

Objectives: There are no regulations governing the practice of acupuncture in Lebanon as it is not yet registered as a profession. To our knowledge, no studies have ever been conducted in Lebanon regarding the practice of acupuncture. The purpose of this preliminary study was to explore the knowledge of Lebanese physicians about acupuncture, with the intent of conducting larger scale studies and developing strategies aimed at refining this knowledge in the future, and the ultimate goal of setting guidelines for acupuncture practice in Lebanon. Methods: An online survey looking into physicians’ knowledge of acupuncture, its mechanisms of action, effectiveness, indications and safety, and physicians’ understanding of its concepts, was circulated to 4651 physicians registered in the Lebanese orders of physicians. Results: One hundred forty-nine physicians (3.2%) completed the survey. Most study respondents stated that they were unaware of the difference between traditional Chinese acupuncture (TCA) and Western medical acupuncture (WMA). Overall, 30% of respondents had personally used and/or referred patients for acupuncture. Physicians who had personally tried acupuncture were more likely to refer patients for acupuncture (p < 0.001). Those who know the difference between WMA and TCA were more likely to have tried or referred for acupuncture (p = 0.004). 72% believed that acupuncture and other integrative medicine modules should be introduced in medical curricula in Lebanon. Conclusion: Interest in acupuncture among physicians in Lebanon appears to be limited, based on the low response rate. Among respondents, physicians who had tried or referred patients for acupuncture appeared to be more well informed about different acupuncture styles.

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