Topical Review: Vision and Gait in Older Adults: A Clinician’s Perspective

2021 ◽  
pp. 95-106
Keyword(s):  
Sensory Integration ◽  
Sensory Feedback ◽  
Sensory Input ◽  
Management Plan ◽  
Vision Impairment ◽  
Evidence Based ◽  
Care Providers ◽  
Risk Of Falling ◽  
Human Function ◽  
The Impact

Gait is an important human function, and vision is the dominant sensory input used during gait. Vision aids pathfinding decisions and provide ongoing sensory feedback to maintain appropriate balance and prevent falls. Eye care providers who wish to effectively address the impact of vision impairment on the risk of falling will customize their management plan based on specific impairments. This article provides an overview of normal sensory integration as it applies to gait, with an emphasis on vision. It also presents an evidence-based review of visual dysfunctions that cause falls, as well as strategies to reduce falls in adults with visual impairment, with emphasis on patients over age 65.

scholarly journals Navigating Naturopathic Remedies in Oncology

2020 ◽  
Author(s):  
Nafis Hossain ◽  
Mary Nguyen
Keyword(s):  
Cancer Treatment ◽  
Health Care Providers ◽  
Evidence Based ◽  
Care Providers ◽  
Middle Ground ◽  
Cancer Treatments ◽  
Evidence Based Practices ◽  
London Health ◽  
Clinician Scientist ◽  
The Impact

The use of naturopathic and other alternative forms of cancer treatment are pervasive, and many patients may firmly believe in their effectiveness. This can present headwinds for physicians who have been trained to incorporate evidence-based practices into their care. This underscores the need for health care providers to be cognizant of the impact of these alternative therapies; it is imperative to understand patient perspectives regarding their use and find middle ground where it exists. We had the opportunity to speak with Dr. David Palma, who is a radiation oncologist and clinician-scientist at the London Health Sciences Centre who has had a vested interest in improving patient access to quality cancer treatment. In this article, Dr. Palma discusses his thoughts about the rising trend of alternative cancer treatments, and how we as future physicians can reconcile with their growing influence.

Early Enteral Feeding for the Very Low Birth Weight Infant: The Development and Impact of a Research-Based Guideline

2005 ◽  
Vol 24 (4) ◽  
pp. 9-19 ◽  
Author(s):  
Joan Renaud Smith
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Health Care Providers ◽  
Neonatal Intensive Care ◽  
Very Low Birth Weight ◽  
Neonatal Period ◽  
Evidence Based ◽  
Care Providers ◽  
Vlbw Infant ◽  
The Impact

Providing optimal nutrition for the very low birth weight (VLBW) infant is critical during the neonatal period. Evidence-based practice guidelines are essential in managing these fragile infants. Putting scientific research into daily clinical practice may be arduous at times, however. A multidisciplinary team of health care providers successfully established a practical feeding guideline for a 52-bed, teaching-affiliated, Level III neonatal intensive care unit in St. Louis. This guideline identifies human milk as the recommended source of nutrition for the VLBW infant, a suggestion that has significantly affected lactation services in the unit. This article describes the process of developing, implementing, and evaluating a feeding guideline based on current research and describes the impact on lactation rates of having such a guideline in place within the unit.

Grace and Glory: How One Free Clinic Can Make a Difference

2013 ◽  
Vol 19 (3) ◽  
pp. 148-152
Author(s):  
Johnny Ng
Keyword(s):  
Primary Care ◽  
Primary Care Providers ◽  
Oklahoma City ◽  
Evidence Based ◽  
Advanced Practice ◽  
Care Providers ◽  
Free Clinic ◽  
Access To Medical Care ◽  
Financial Burdens ◽  
The Impact

In 2010, a free clinic in northeast Oklahoma City opened its doors and began seeing nonemergent patients. This evidence-based article illustrates the impact of the clinic on its community. It discusses the benefits and financial implications and the operation of the free clinic through contributions and volunteerism, and highlights strengths and limitations. A survey conducted over a period of three months on 50 clinic patients concluded that one free clinic can make a difference by providing much-needed access to medical care, decreasing financial burdens on area hospitals, and enhancing public opinion of Advanced Practice Registered Nurses (APRNs) as primary care providers.

scholarly journals Evaluating the Impact of Pharmacist Counselling for Asthmatic Children at Karbala Teaching Hospital for Children: An Interventional Prospective Study (Conference Paper )#

2022 ◽  
Vol 30 (Suppl.) ◽  
pp. 22-30
Author(s):  
Mohammed Al-Musawi ◽  
Zinah M. Anwer
Keyword(s):  
Asthma Control ◽  
Health Care Providers ◽  
Signs And Symptoms ◽  
Management Plan ◽  
Structural Factors ◽  
Care Providers ◽  
Patient Counseling ◽  
Asthma Control Test ◽  
Asthmatic Children ◽  
The Impact

Asthma is one of the most common chronic, non-communicable diseases affecting children worldwide. The estimated prevalence of pediatric asthma in Iraq is 15.8%. Physiologic, inflammatory and structural factors contribute to the development of asthma. Assessment and monitoring of asthma control can be done by a validated children asthma control test (CACT). Management of asthma must address three components which are an appropriate management plan, the most appropriate medication if necessary, and the use of safe and effective medication. The management plan should consider patient counseling and education about the definition of asthma, signs, and symptoms, the pathophysiology of asthma, common triggers for asthma and how can avoid them, what are the rescue medication and the controller one, proper inhaler techniques, and how to monitor asthma control. Patient education accounts for 90% of success and this can be achieved by an active collaboration among health care providers. This is a prospective interventional study that aims at evaluating pharmacist counseling for asthmatic children. The study involved 105 participants whose consent was taken and underwent a face-to-face interview about asthma counseling and inhaler technique for those who use it. Ninety-two eligible participants remained. Their CACT was recorded at the first visit and then followed up weekly for one month either by phone or physical to assess asthma control. In the fourth week, a CACT was recorded and compared to the first one before intervention. There was a significant improvement in CACT after providing the counselling and weekly follow up.

scholarly journals Principles for Managing Patients with Spinal Ailments in the Coronavirus Disease 2019 Era: What Do We Know So Far? An Evidence-Based, Narrative Review

2020 ◽  
Vol 14 (4) ◽  
pp. 572-580 ◽  
Author(s):  
Vibhu Krishnan Viswanathan ◽  
Surabhi Subramanian ◽  
Arthi K. Rao
Keyword(s):  
Spine Surgery ◽  
Spinal Surgery ◽  
Current Knowledge ◽  
Neurological Deficits ◽  
Evidence Based ◽  
Care Providers ◽  
Current Topic ◽  
Guidelines Adherence ◽  
Heath Care ◽  
The Impact

The coronavirus disease 2019 (COVID-19) pandemic has significantly affected all specialty practices in medicine, including the field of spinal surgery. Spinal surgery is unique in that the procedures include not only fully elective and fully emergent interventions, but also involve a separate group of semi-emergent surgeries, where delayed intervention may lead to permanent neurological deficits. Here, we present an evidence-based review on the impact of the COVID-19 pandemic on spinal surgery and our current knowledge about this issue. We conducted a thorough search of the PubMed, Medline, and Google Scholar databases using the keywords, “COVID-19,” “COVID-19 impact on spine surgery,” “coronavirus impact on spine surgery,” “COVID-19 impact on neurosurgery,” “coronavirus impact on neurosurgery,” “COVID-19 impact on spine surgeons,” and “coronavirus impact on spine surgeons” on May 6, 2020. A total of 8,322 articles were identified in the initial search. Articles that were duplicated, those that did not pertain to COVID-19 or spine surgeries, those with details not pertaining to the current topic of interest, and those published in languages other than English were excluded from our analyses. After complete screening, six articles were included in this review. During the previous few weeks, the COVID pandemic has significantly influenced all major aspects of spine surgery across the world. Outpatient care has been gradually shifted from physical visits to tele-health and online consultations. General recommendations have favored the conservative approach over surgeries, although no patient should be deprived of standard care owing to concerns about COVID. The general principles followed by spine surgeons should include early detection of COVID symptomatology; triaging of patients based on underlying spinal pathology; prescription of appropriate investigations to confirm the COVID status; isolation, as needed; selection of optimal management method as per the guidelines; adherence to best intraoperative practices; and ensuring protective measures for non-infected patients, family members, fellow heath care providers, and themselves against the disease.

The Impact of TimeSlips on Undergraduate Students in Service Learning With Older Adults

2020 ◽  
pp. 1-8
Author(s):  
Sabine Heuer
Keyword(s):  
Older Adults ◽  
Service Learning ◽  
Undergraduate Students ◽  
Attitude Scale ◽  
Evidence Based ◽  
Attitudes Toward Older Adults ◽  
Students Attitudes ◽  
Attitude Shift ◽  
The Impact ◽  
Journal Entries

Purpose Future speech-language pathologists are often unprepared in their academic training to serve the communicative and cognitive needs of older adults with dementia. While negative attitudes toward older adults are prevalent among undergraduate students, service learning has been shown to positively affect students' attitudes toward older adults. TimeSlips is an evidence-based approach that has been shown to improve health care students' attitudes toward older adults. The purpose of this study is to explore the change in attitudes in speech-language pathology students toward older adults using TimeSlips in service learning. Method Fifty-one students participated in TimeSlips service learning with older adults and completed the Dementia Attitude Scale (DAS) before and after service learning. In addition, students completed a reflection journal. The DAS data were analyzed using nonparametric statistics, and journal entries were analyzed using a qualitative analysis approach. Results The service learners exhibited a significant increase in positive attitude as indexed on the DAS. The reflective journal entries supported the positive change in attitudes. Conclusions A noticeable attitude shift was indexed in reflective journals and on the DAS. TimeSlips is an evidence-based, patient-centered approach well suited to address challenges in the preparation of Communication Sciences and Disorders students to work with the growing population of older adults.

The Perspective of Older Men With Depression on Suicide and Its Prevention in Primary Care

Crisis ◽  
2018 ◽  
Vol 39 (5) ◽  
pp. 397-405 ◽  
Author(s):  
Steven Vannoy ◽  
Mijung Park ◽  
Meredith R. Maroney ◽  
Jürgen Unützer ◽  
Ester Carolina Apesoa-Varano ◽  
...  
Keyword(s):  
Primary Care ◽  
Low Socioeconomic Status ◽  
Thematic Analysis ◽  
Older Men ◽  
Primary Care Providers ◽  
Depression Treatment ◽  
Care Providers ◽  
Low Socioeconomic ◽  
Self Image ◽  
The Impact

Abstract. Background: Suicide rates in older men are higher than in the general population, yet their utilization of mental health services is lower. Aims: This study aimed to describe: (a) what primary care providers (PCPs) can do to prevent late-life suicide, and (b) older men's attitudes toward discussing suicide with a PCP. Method: Thematic analysis of interviews focused on depression and suicide with 77 depressed, low-socioeconomic status, older men of Mexican origin, or US-born non-Hispanic whites recruited from primary care. Results: Several themes inhibiting suicide emerged: it is a problematic solution, due to religious prohibition, conflicts with self-image, the impact on others; and, lack of means/capacity. Three approaches to preventing suicide emerged: talking with them about depression, talking about the impact of their suicide on others, and encouraging them to be active. The vast majority, 98%, were open to such conversations. An unexpected theme spontaneously arose: "What prevents men from acting on suicidal thoughts?" Conclusion: Suicide is rarely discussed in primary care encounters in the context of depression treatment. Our study suggests that older men are likely to be open to discussing suicide with their PCP. We have identified several pragmatic approaches to assist clinicians in reducing older men's distress and preventing suicide.

45. Education at distance: Broadcasting ECG rounds to Southeastern Ontario (BESO Project). An innovative approach for teaching electrocardiography

2007 ◽  
Vol 30 (4) ◽  
pp. 51 ◽  
Author(s):  
A. Baranchuk ◽  
G. Dagnone ◽  
P. Fowler ◽  
M. N. Harrison ◽  
L. Lisnevskaia ◽  
...  
Keyword(s):  
Health Care ◽  
Real Time ◽  
Digital Signal ◽  
Teaching Methodology ◽  
Care Providers ◽  
Long Distance ◽  
Medicine Clerkship ◽  
Time Problem ◽  
The Impact ◽  
Ecg Interpretation

Electrocardiography (ECG) interpretation is an essential skill for physicians as well as for many other health care professionals. Continuing education is necessary to maintain these skills. The process of teaching and learning ECG interpretation is complex and involves both deductive mechanisms and recognition of patterns for different clinical situations (“pattern recognition”). The successful methodologies of interactive sessions and real time problem based learning have never been evaluated with a long distance education model. To evaluate the efficacy of broadcasting ECG rounds to different hospitals in the Southeastern Ontario region; to perform qualitative research to determine the impact of this methodology in developing and maintaining skills in ECG interpretation. ECG rounds are held weekly at Kingston General Hospital and will be transmitted live to Napanee, Belleville, Oshawa, Peterborough and Brockville. The teaching methodology is based on real ECG cases. The audience is invited to analyze the ECG case and the coordinator will introduce comments to guide the case through the proper algorithm. Final interpretation will be achieved emphasizing the deductive process and the relevance of each case. An evaluation will be filled out by each participant at the end of each session. Videoconferencing works through a vast array of internet LANs, WANs, ISDN phone lines, routers, switches, firewalls and Codecs (Coder/Decoder) and bridges. A videoconference Codec takes the analog audio and video signal codes and compresses it into a digital signal and transmits that digital signal to another Codec where the signal is decompressed and retranslated back into analog video and audio. This compression and decompression allows large amounts of data to be transferred across a network at close to real time (384 kbps with 30 frames of video per second). Videoconferencing communication works on voice activation so whichever site is speaking has the floor and is seen by all the participating sites. A continuous presence mode allows each site to have the same visual and audio involvement as the host site. A bridged multipoint can connect between 8 and 12 sites simultaneously. This innovative methodology for teaching ECG will facilitate access to developing and maintaining skills in ECG interpretation for a large number of health care providers. Bertsch TF, Callas PW, Rubin A. Effectiveness of lectures attended via interactive video conferencing versus in-person in preparing third-year internal medicine clerkship students for clinical practice examinations. Teach Learn Med 2007; 19(1):4-8. Yellowlees PM, Hogarth M, Hilty DM. The importance of distributed broadband networks to academic biomedical research and education programs. Acad Psychaitry 2006;30:451-455

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