scholarly journals Joint injection practice variations in pediatric rheumatology – a global survey and call for action

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Anita Dhanrajani ◽  
Raju P. Khubchandani
Keyword(s):  
Pediatric Rheumatology ◽  
Therapeutic Agent ◽  
Response Rate ◽  
Collaborative Study ◽  
Clinical Implications ◽  
Injection Practice ◽  
Efficacious Treatment ◽  
Collaborative Study Group ◽  
Practice Variations ◽  
The Cost

Abstract Background Intraarticular injections (IAI) were first reported in adult rheumatology in the 1950s and subsequently gained acceptance as a safe and efficacious treatment in Juvenile idiopathic arthritis (JIA). IAIs are now widely performed and recommended as the initial or only treatment of oligoarticular JIA and ancillary treatment of actively inflamed joints in other varieties of JIA. However, the performance of the procedure is currently not guided by standardized recommendations, and several practice variations are observed. Methods This worldwide survey of pediatric rheumatologists (with 48.5% response from Pediatric Rheumatology International Trials Organization [PRINTO and Pediatric Rheumatology Collaborative Study Group [PRCSG] members) captures the differences in pre-procedural, procedural and post-procedural protocols and practices observed across the globe and asks the necessity of developing consensus in this area of Pediatric Rheumatology. Results This worldwide survey of Pediatric Rheumatologists had a response rate of just under 50% and the views of about 42% who routinely performed the procedure. It captured the differences in IAI protocols and practices observed across the globe. Significant variations in practice were noted in use of Local anesthesia, choice, and dose of therapeutic agent for the intraarticular injection and use of ultrasound to guide injections. While some practice variations may be explained by institutional protocols in different parts of the world, the clinical implications of these are largely unknown and beg the need for further studies. Conclusions Given these practice variations, the authors recommend further studies to explore the cost and clinical implications and subsequently work towards developing consensus plans to ensure uniformity in this widely used procedure in Pediatric Rheumatology.

scholarly journals Joint injection practices in Pediatric Rheumatology - A global survey

2020 ◽  
Author(s):  
Anita Dhanrajani ◽  
Raju P Khubchandani
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Pediatric Rheumatology ◽  
Response Rate ◽  
Collaborative Study ◽  
Study Group ◽  
Joint Injection ◽  
Efficacious Treatment ◽  
Collaborative Study Group ◽  
Practice Variations ◽  
Injection Practices

Abstract Background: Intraarticular injections (IAI) were first reported in adult rheumatology in the 1950s and subsequently gained acceptance as a safe and efficacious treatment in Juvenile Idiopathic arthritis (JIA). IAIs are now widely performed and recommended as the initial or only treatment of Oligoarticular JIA and ancillary treatment of actively inflamed joints in other varieties of JIA. However, the performance of the procedure is not currently guided by standardized recommendations, thereby several practice variations are observed.Methods: This worldwide survey of pediatric rheumatologists (with 50% response from Pediatric Rheumatology International Trials Organization: PRINTO and Pediatric Rheumatology Collaborative Study Group: PRCSG members) captures the differences in pre-procedural, procedural and post procedural protocols observed across the globe and asks the necessity of developing consensus in this area of Pediatric Rheumatology. Results: This worldwide survey of Pediatric Rheumatologists had a response rate of almost 50% and captured the differences in IAI protocols observed across the globe. Conclusions: Consensus plans are needed to ensure uniformity in this widely used procedure in Pediatric Rheumatology.

The cost of improving the outcome for infants of birthweight 500-999 g in Victoria: THE VICTORIAN INFANT COLLABORATIVE STUDY GROUP

1993 ◽  
Vol 29 (1) ◽  
pp. 56-62 ◽  
Author(s):  
W. H. KITCHEN ◽  
E. BOWMAN ◽  
C. CALLANAN ◽  
N. T. CAMPBELL ◽  
E. A. CARSE ◽  
...  
Keyword(s):  
Collaborative Study ◽  
Study Group ◽  
Collaborative Study Group ◽  
The Cost

Radiation Oncology Education Collaborative Study Group Annual Spring Symposium: Initial Impact and Feedback

2021 ◽  
Author(s):  
David M. Rosenberg ◽  
Steve E. Braunstein ◽  
Emma C. Fields ◽  
Erin F. Gillespie ◽  
Jillian R. Gunther ◽  
...  
Keyword(s):  
Radiation Oncology ◽  
Collaborative Study ◽  
Study Group ◽  
Oncology Education ◽  
Collaborative Study Group

scholarly journals Cognitive therapy training for psychiatrists: impact on individual clinical practice

2004 ◽  
Vol 28 (4) ◽  
pp. 117-119 ◽  
Author(s):  
G. Swift ◽  
I. Durkin ◽  
C. Beuster
Keyword(s):  
Clinical Practice ◽  
Cognitive Therapy ◽  
Response Rate ◽  
Postal Questionnaire ◽  
Clinical Implications ◽  
Previous Survey ◽  
Therapy Training ◽  
Training And Supervision ◽  
Improved Outcomes ◽  
Therapy Sessions

Aims and MethodWe aimed to survey how psychiatrists with in-depth training in cognitive therapy use these skills. A postal questionnaire based on a previous survey was sent to all psychiatrists who are accredited members of the British Association for Behavioural and Cognitive Psychotherapies.ResultsThere was a 94% response rate. Psychiatrists in non-psychotherapy posts used formal cognitive therapy, with an average of 20% of new patients compared with 65% for those in psychotherapy posts, and were less satisfied with the extent to which they were able to use their skills (20%v. 80%). A total of 85% of respondents described themselves as being involved in teaching, training and supervision of cognitive therapy.Clinical ImplicationsUnless psychiatrists are planning on working in specialised psychotherapy posts, they are unlikely to use cognitive therapy training in formal therapy sessions. Further research is needed to determine whether cognitive therapy training for psychiatrists translates into improved outcomes for patients.

scholarly journals Sulodexide Protects Renal Tubular Epithelial Cells from Oxidative Stress-Induced Injury via Upregulating Klotho Expression at an Early Stage of Diabetic Kidney Disease

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Yu Ning Liu ◽  
Jingwei Zhou ◽  
Tingting Li ◽  
Jing Wu ◽  
Shu Hua Xie ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Kidney Disease ◽  
Epithelial Cells ◽  
Diabetic Kidney Disease ◽  
Early Stage ◽  
Collaborative Study ◽  
Oxidative Activity ◽  
Dependent Manner ◽  
Diabetic Kidney ◽  
Collaborative Study Group

The hypoalbuminuric effect of sulodexide (SDX) on diabetic kidney disease (DKD) was suggested by some clinical trials but was denied by the Collaborative Study Group. In this study, the diabetic rats were treated with SDX either from week 0 to 24 or from week 13 to 24. We found that 24-week treatment significantly decreased the urinary protein and HAVCR1 excretion, inhibited the interstitial expansion, and downregulated the renal cell apoptosis and interstitial fibrosis. Renoprotection was also associated with a reduction in renocortical/urinary oxidative activity and the normalization of renal klotho expression. However, all of these actions were not observed when SDX was administered only at the late stage of diabetic nephropathy (from week 13 to 24). In vitro, advanced glycation end products (AGEs) dose-dependently enhanced the oxidative activity but lowered the klotho expression in cultured proximal tubule epithelial cells (PTECs). Also, H2O2 could downregulate the expression of klotho in a dose-dependent manner. However, overexpression of klotho reduced the HAVCR1 production and the cellular apoptosis level induced by AGEs or H2O2. Our study suggests that SDX may prevent the progression of DKD at the early stage by upregulating renal klotho expression, which inhibits the tubulointerstitial injury induced by oxidative stress.

Retirement intentions of older consultant psychiatrists

2004 ◽  
Vol 28 (4) ◽  
pp. 130-132 ◽  
Author(s):  
Alex Mears ◽  
Tim Kendall ◽  
Cornelius Katona ◽  
Carole Pashley ◽  
Sarah Pajak
Keyword(s):  
Early Retirement ◽  
Response Rate ◽  
Important Determinant ◽  
Clinical Implications ◽  
Consultant Psychiatrist ◽  
Health Officer ◽  
Decisions To Leave ◽  
The Mean ◽  
The Uk ◽  
Retirement Intentions

Aims and MethodThis survey gathered data on the retirement intentions of consultant psychiatrists over the age of 50 years, in order to address retention issues. A questionnaire was sent to all 1438 consultants over this age in the UK.ResultsA total of 848 questionnaires were returned, an adjusted response rate of 59%. The mean age at which consultants intended to retire in this sample was 60 years (s.d. 4.16), suggesting a potential loss of 5725 consultant years. Reasons for early retirement are complex: factors encouraging retirement include too much bureaucracy, lack of free time and heavy case-loads; those discouraging retirement include enjoyment of work, having a good team and money. Mental Health Officer status is an important determinant in the decision to retire early.Clinical ImplicationsWith numerous vacancies in consultant psychiatrist posts throughout the UK, premature retirement is a cause for concern, possibly contributing to an overall reduction in consultant numbers of 5%. Addressing factors that influence consultants' decisions to leave the health service early should form an important part of an overall strategy to increase consultant numbers.

scholarly journals Attitudes of psychiatrists to evidence-based guidelines

2002 ◽  
Vol 26 (11) ◽  
pp. 421-424 ◽  
Author(s):  
Harvey Rees ◽  
Attila Sipos ◽  
Matthew Spence ◽  
Glynn Harrison
Keyword(s):  
Response Rate ◽  
Postal Questionnaire ◽  
Clinical Implications ◽  
Evidence Based ◽  
Previous Survey ◽  
Health Partnership ◽  
Improved Outcomes ◽  
Actual Use ◽  
Evidence Based Guidelines ◽  
Improving Patient Care

Aims and MethodWe aimed to survey clinicians' attitudes on using evidence-based guidelines. A postal questionnaire based on a previous survey of general practitioners was sent to 105 psychiatrists working within Avon and Western Wiltshire Mental Health Partnership NHS Trust.ResultsThere was a 91% response rate. Respondents were generally in favour of clinical guidelines, with scores indicating a positive attitude to guidelines in 13 of the 18 statements. The majority felt that guidelines were effective in improving patient care, could be used flexibly to suit individual patients and did not impinge on their clinical judgement.Clinical ImplicationsPsychiatrists welcomed the increasing use of guidelines. Further research is needed to determine whether this will translate into actual use and improved outcomes for patients.

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