scholarly journals A Retrospective Analysis of Owner-reported Reasons for Canine Illness and Injury Visits in Veterinary General Practice: A List of the Top 50% of Complaints

2020 ◽  
Author(s):  
Gilbert Patterson ◽  
Michele O. Trofatter ◽  
Kathryn E. Daily-Trude ◽  
Rebecca L. Pierce ◽  
Stanley R. Robertson ◽  
...  
Keyword(s):  
General Practice ◽  
Retrospective Analysis ◽  
Care Delivery ◽  
Evidence Based ◽  
Delivery Methods ◽  
Veterinary Students ◽  
List Ranking ◽  
Veterinary Practice ◽  
One Year ◽  
Case Presentations

Abstract Background Veterinarians are required to use critical thinking and communication skills to proficiently guide a client through available options for disease treatment or management. While multiple viable approaches exist for treating common problems, data describing the actual types of owner-reported complaints most often encountered in general veterinary practices is lacking. An understanding of the nature and distribution of common conditions, as reported by the owner, is a key step in providing the evidence-based foundation directing further efforts toward solutions to overcome barriers in general practice, veterinary-care delivery. Methods A retrospective analysis of common canine owner-reported complaints presented in general veterinary practice over a one-year period was performed. Data was collected from participating practices, cleaned, and analyzed to reflect the top 50% new presenting complaints of owners at all participating practices for canine patients with an illness or injury during their visit. Results The outcome is a comprehensive list ranking the top canine owner-reported presenting illnesses/injuries complaints seen by general veterinary practices included in the study. Conclusions These results provide evidence-based knowledge of the distribution of owner complaints potentially encountered in general practice, providing justification for the need to emphasize certain clinical case presentations in veterinary educational curriculums. Being prepared with such knowledge, veterinary students can be empowered with the necessary skills and tools required to provide informed, ethical, and affordable choices for canine care in the general veterinary practice setting. This information also provides the scientific foundation for canine conditions which may benefit from additional evidence-based trials to better identify the outcomes of spectrum of care interventions for benefits to the owner, the canine, and the veterinarian.

scholarly journals Postoperative Antibacterial Prophylaxis in Vascular Surgery: Analysis of its Parameters Before and After Evaluation of Justification of Chosen Indications

2020 ◽  
Vol 18 (1) ◽  
pp. 48-51
Author(s):  
Edgars Supols
Keyword(s):  
Vascular Surgery ◽  
Retrospective Analysis ◽  
Structural Unit ◽  
Infectious Complications ◽  
University Hospital ◽  
Antibacterial Prophylaxis ◽  
Evidence Based ◽  
Surgical Practice ◽  
Before And After ◽  
One Year

SummaryIn surgical practice, antibacterial prophylaxis (AP) is widely used to reduce the risk of possible infectious complications; it is not always administrated according to evidence-based clinical indications. Administration of AP in cases when its inefficiency for exact situation has been scientifically proven, should be considered as unwarranted. A one-year-long retrospective analysis of AP cases in the Department of Vascular Surgery of Pauls Stradins Clinical University Hospital was performed and the results were broadly analyzed within the local structural unit. It was followed by the development of the local guidelines for administration of antibiotics, as a result, a significant decrease in cases of unwarranted AP has been achieved.

Tennis- und Golfer-Ellenbogen

2015 ◽  
Vol 63 (4) ◽  
Keyword(s):  
Spontaneous Recovery ◽  
Clinical Symptoms ◽  
Lateral Epicondylitis ◽  
High Rate ◽  
Evidence Based ◽  
Physical Methods ◽  
Local Injections ◽  
One Year ◽  
Golfer’S Elbow ◽  
Non Surgical Treatment

“Tennis and golfer’s elbow” are common pathologies due to overload of forearm extensors and flexors, and actually occur mostly outside tennis and golf sports. Several differential diagnoses of medial and lateral epicondylitis have to be excluded as there are a number of other conditions with similar clinical symptoms. The high rate of spontaneous recovery has to be considered in treatment. Evidence based conservative treatment comprises excentric physiotherapy, local injections, and physical methods. Surgery is reserved for patients with persistence of symptoms for more than one year despite non-surgical treatment.

scholarly journals Pros and cons of navigated versus conventional total knee arthroplasty—a retrospective analysis of over 2400 patients

2021 ◽  
Author(s):  
Matthias Meyer ◽  
Tobias Renkawitz ◽  
Florian Völlner ◽  
Achim Benditz ◽  
Joachim Grifka ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Retrospective Analysis ◽  
Outcome Measures ◽  
Knee Arthroplasty ◽  
Mechanical Axis ◽  
Complication Rates ◽  
Total Knee ◽  
One Year ◽  
Navigated Tka ◽  
Surgery Duration

Abstract Introduction Because of the ongoing discussion of imageless navigation in total knee arthroplasty (TKA), its advantages and disadvantages were evaluated in a large patient cohort. Methods This retrospective analysis included 2464 patients who had undergone TKA at a high-volume university arthroplasty center between 2012 and 2017. Navigated and conventional TKA were compared regarding postoperative mechanical axis, surgery duration, complication rates, one-year postoperative patient-reported outcome measures (PROMs) (WOMAC and EQ-5D indices), and responder rates as defined by the criteria of the Outcome Measures in Rheumatology and Osteoarthritis Research Society International consensus (OMERACT-OARSI). Results Both navigated (1.8 ± 1.6°) and conventional TKA (2.1 ± 1.6°, p = 0.002) enabled the exact reconstruction of mechanical axis. Surgery duration was six minutes longer for navigated TKA than for conventional TKA (p < 0.001). Complication rates were low in both groups with comparable frequencies: neurological deficits (p = 0.39), joint infection (p = 0.42 and thromboembolic events (p = 0.03). Periprosthetic fractures occurred more frequently during conventional TKA (p = 0.001). One-year PROMs showed excellent improvement in both groups. The WOMAC index was statistically higher for navigated TKA than for conventional TKA (74.7 ± 19.0 vs. 71.7 ± 20.7, p = 0.014), but the increase was not clinically relevant. Both groups had a similarly high EQ-5D index (0.23 ± 0.24 vs. 0.26 ± 0.25, p = 0.11) and responder rate (86.5% [256/296] vs. 85.9% [981/1142], p = 0.92). Conclusion Both methods enable accurate postoperative leg alignment with low complication rates and equally successful PROMs and responder rates one year postoperatively. Level of evidence III. Retrospective cohort study.

scholarly journals Evaluation of Patient Experience During Virtual and In-Person Urgent Care Visits: Time and Cost Analysis

2021 ◽  
Vol 8 ◽  
pp. 237437352098148
Author(s):  
Saif Khairat ◽  
Xi Lin ◽  
Songzi Liu ◽  
Zhaohui Man ◽  
Tanzila Zaman ◽  
...  
Keyword(s):  
Patient Experience ◽  
Care Delivery ◽  
Turnaround Time ◽  
Cross Sectional Study ◽  
Emergency Department Visits ◽  
Urgent Care ◽  
Cross Sectional ◽  
Significant Difference ◽  
Virtual Visits ◽  
One Year

Urgent care (UC) is one of the fastest growing venues of health care delivery for nonemergent conditions. This study compared the patient experience during virtual and in-person urgent care visits. We conducted a cross-sectional study of patients with the same diagnosis during Virtual Urgent Care (VUC) and in-person UC visits with the same diagnosis with regard to time and cost over a period of one year. We recorded and analyzed 16 685 urgent care visits: In-person UC (n = 14 734), VUC (n = 1262). Significant differences were found in the average total time for a visit in an in-person UC (70.89 minutes), and VUC (9.38 minutes). The average total cost of VUC ($49) and in-person UC ($142.657) differed significantly. Significant difference was found between UC turnaround time and VC turnaround time (Dependent variable (DV): 53.77, P < .01). We found significant differences in cost and time between in favor of virtual visits. Our findings suggest additional policy reform to expand the use of virtual care among target populations to improve access, reduce costs, meet the needs of patients, and reduce emergency department visits.

scholarly journals Applying evidence-based medicine in general practice: a video-stimulated interview study on workplace-based observation

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Lisanne S. Welink ◽  
Kaatje Van Roy ◽  
Roger A. M. J. Damoiseaux ◽  
Hilde A. Suijker ◽  
Peter Pype ◽  
...  
Keyword(s):  
Decision Making ◽  
General Practice ◽  
Evidence Based Medicine ◽  
Evidence Based ◽  
Clinical Expertise ◽  
Stimulated Recall ◽  
Previous Discussion ◽  
Based Medicine ◽  
Stimulated Recall Interviews ◽  
Gp Training

Abstract Background Evidence-based medicine (EBM) in general practice involves applying a complex combination of best-available evidence, the patient’s preferences and the general practitioner’s (GP) clinical expertise in decision-making. GPs and GP trainees learn how to apply EBM informally by observing each other’s consultations, as well as through more deliberative forms of workplace-based learning. This study aims to gain insight into workplace-based EBM learning by investigating the extent to which GP supervisors and trainees recognise each other’s EBM behaviour through observation, and by identifying aspects that influence their recognition. Methods We conducted a qualitative multicentre study based on video-stimulated recall interviews (VSI) of paired GP supervisors and GP trainees affiliated with GP training institutes in Belgium and the Netherlands. The GP pairs (n = 22) were shown fragments of their own and their partner’s consultations and were asked to elucidate their own EBM considerations and the ones they recognised in their partner’s actions. The interview recordings were transcribed verbatim and analysed with NVivo. By comparing pairs who recognised each other’s considerations well with those who did not, we developed a model describing the aspects that influence the observer’s recognition of an actor’s EBM behaviour. Results Overall, there was moderate similarity between an actor’s EBM behaviour and the observer’s recognition of it. Aspects that negatively influence recognition are often observer-related. Observers tend to be judgemental, give unsolicited comments on how they would act themselves and are more concerned with the trainee-supervisor relationship than objective observation. There was less recognition when actors used implicit reasoning, such as mindlines (internalised, collectively reinforced tacit guidelines). Pair-related aspects also played a role: previous discussion of a specific topic or EBM decision-making generally enhanced recognition. Consultation-specific aspects played only a marginal role. Conclusions GP trainees and supervisors do not fully recognise EBM behaviour through observing each other’s consultations. To improve recognition of EBM behaviour and thus benefit from informal observational learning, observers need to be aware of automatic judgements that they make. Creating explicit learning moments in which EBM decision-making is discussed, can improve shared knowledge and can also be useful to unveil tacit knowledge derived from mindlines.

Psychoanalytic Therapy

2021 ◽  
Author(s):  
Helmut Thomä ◽  
Horst Kächele
Keyword(s):  
Outcome Research ◽  
Evidence Based Medicine ◽  
Salient Feature ◽  
Evidence Based ◽  
Conversational Analysis ◽  
Significant Aspect ◽  
Process And Outcome ◽  
Case Presentations ◽  
Based Medicine ◽  
Insight Into

Conversational analysis has turned out to be the salient feature to understand what promotes change in the psychoanalytic situation. This significant aspect of the first edition of this textbook is expanded in the second edition presenting prominent examples of contemporary process and outcome research fulfilling the criteria of evidence-based medicine. The case presentations included in this volume provide insight into thinking and acting in psychoanalysis and relate directly to the theories taught in.

A role for traditional doctors in health promotion: experience from a trial of HIV prevention in Botswana

2018 ◽  
Vol 27 (2) ◽  
pp. 114-116 ◽  
Author(s):  
Anne Cockcroft ◽  
Leagajang Kgakole ◽  
Nobantu Marokoane ◽  
Neil Andersson
Keyword(s):  
Primary Prevention ◽  
Hiv Prevention ◽  
Young Women ◽  
Hiv Risk ◽  
Discussion Groups ◽  
Gender Violence ◽  
Evidence Based ◽  
Intervention Programme ◽  
Structural Intervention ◽  
One Year

Traditional doctors have been largely ignored in HIV prevention, particularly primary prevention. As part of a structural intervention programme to reduce HIV risk among young women in Botswana, we trained 147 traditional doctors in four districts as well as government health education assistants (HEAs) and teachers to run discussion groups in the community and schools, using an evidence-based eight-episode audio-drama, covering gender roles, gender violence, and how these are related to HIV risk. One year later, we contacted 43 of the 87 trained traditional doctors in two districts. Most (32) were running discussion groups with men and women, with links to the local HEAs and teachers. They were adept at recruiting men to their groups, often a challenge with community interventions, and reported positive changes in attitudes and behaviour of group participants. Traditional doctors can play an important role in primary prevention of gender violence and HIV.

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