scholarly journals Spinal Orthoses Prescription for Vertebral Fragility Fractures by Italian Physical and Rehabilitation Medicine Physicians: The SPIN-VER Survey

Healthcare ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 892
Author(s):  
Alessandro de Sire ◽  
Antonio Ammendolia ◽  
Alessandra Gimigliano ◽  
Roberto Tiberi ◽  
Carlo Cisari ◽  
...  
Keyword(s):  
Osteoporotic Fractures ◽  
Fragility Fractures ◽  
Rehabilitation Medicine ◽  
Cross Sectional Survey ◽  
High Quality Research ◽  
Cross Sectional ◽  
Physical And Rehabilitation Medicine ◽  
Common Clinical Practice ◽  
Spinal Orthosis ◽  
Spinal Orthoses

Vertebral fragility fractures (VFFs) are the most common type of osteoporotic fractures, related to pain and disability. In this scenario, physical and rehabilitative medicine (PRM) physicians prescribe a patient-tailored rehabilitation plan, including spinal orthoses. However, there is a high heterogeneity in the clinical indications of spinal orthoses. Thus, the aim of this survey was to investigate common clinical practice in terms of the prescription of spinal orthoses. This nationwide cross-sectional survey recruited Italian PRM physicians commonly involved in the management of patients with VFFs. One hundred twenty-six PRM physicians completed the survey. The results showed that most PRM physicians prescribe spinal orthoses in outpatients suffering from VFFs (n = 106; 83.9%). The most prescribed spinal orthosis for acute VFF patients was the three-point rigid orthosis (n = 64; 50.8%), followed by the semirigid thoraco-lumbar orthosis (n: 20; 15.9%). However, most PRM physicians prescribed dynamic orthoses in outpatients with chronic VFFs (n = 66; 52.4%). Albeit that a correct management of VFFs is mandatory to improve pain and reduce disability, our findings highlighted uncertainty in the type of spinal orthosis prescription in both the acute and chronic VFF phase. Therefore, high-quality research trials are warranted to provide clear recommendations for the correct clinical management of VFF.

scholarly journals Implementation of a Postfracture Care Program in a Private Hospital in Colombia

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
M. A. Sánchez ◽  
J. E. Segura ◽  
G. Alajmo ◽  
J. M Nossa ◽  
A. Correa ◽  
...  
Keyword(s):  
Private Hospital ◽  
Osteoporotic Fractures ◽  
Fragility Fractures ◽  
Care Program ◽  
Osteoporosis Treatment ◽  
Adherence Rate ◽  
First Year ◽  
Full Time ◽  
Cross Sectional

Purpose. To describe the implementation of a postfracture care program in a private hospital in Colombia, the results achieved after the program’s first year, and the challenges encountered. Methods. A cross-sectional descriptive study of the first year’s outcomes. The program was implemented following best practices described in the “Capture the Fracture” framework. We assessed the management of fractures before the launch of the program. A multidisciplinary group was established to collaborate on the diagnosis and treatment of patients with osteoporotic fractures. A full-time program coordinator was appointed. We analyzed the program’s clinical outcomes and limitations. Results. One-hundred and ninety patients were included in the study, with an average age of 76.7. Hip fracture was the most frequent one (33.6%). After the first year of implementing the program, 39.4% of patients received osteoporosis treatment, with an adherence rate of 73%. The incidence of subsequent falls was 5.8% and 1% for new fractures. Conclusions. The implementation of a program for patients’ care with fragility fractures is challenging for healthcare institutions. The role of a full-time coordinator is critical for the proper operation of such programs.

scholarly journals Osteoporosis and osteoporotic fractures risk factors in men aged 50 years and older

2017 ◽  
Vol 20 (1) ◽  
pp. 7-11 ◽  
Author(s):  
Oksana A. Nikitinskaya ◽  
Natalya V. Toroptsova
Keyword(s):  
Risk Factors ◽  
Calcium Intake ◽  
Osteoporotic Fractures ◽  
Fragility Fractures ◽  
Individual Risk ◽  
Cross Sectional ◽  
Random Samples ◽  
Federal Districts ◽  
Proximal Forearm ◽  
Individual Risk Factors

Cross-sectional screening of random samples of men aged 50 years and older living in five cities (Arkhangelsk, Murmansk, Tyumen, Krasnoyarsk, and Chelyabinsk) from three Federal Districts (FD) of the Russian Federation was conducted to evaluate the frequency of individual risk factors (RF) of osteoporotic fractures among them. Total 1330 men were included in the study.  We found that the most common were the following RF: smoking, prior fragility fractures after age 40, secondary causes of OP, insufficient calcium intake. Significantly more smokers were among males in Siberian (S) FD and North –Western (NW)FD compared with those from Ural (U) FD (p=0,0011 and p=0,047, respectively), the frequency of other RF did not differ depending on region. The рprevalence of osteoporosis according to peripheral x-ray densitometry of the proximal forearm was higher among residents of the UFD (26%) than among men in the NWFD (17%) and SFO (19%). More than 50% of men in each region had 2 or more RF, while those with 3 or more RF were significantly more in the UFD at any age, and at the age of 50-59 years - in the NWFD. Calcium intake was inadequate in 85% of the respondents in these regions.

scholarly journals Variation in the Care of Acute Liver Failure: A Survey of Intensive Care Professionals

2021 ◽  
pp. 1-9
Author(s):  
Filipe S. Cardoso ◽  
Mark J. Mcphail ◽  
Constantine J. Karvellas ◽  
Valentin Fuhrmann ◽  
Nuno Germano ◽  
...  
Keyword(s):  
Intensive Care ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Further Education ◽  
Cross Sectional Survey ◽  
High Quality Research ◽  
Cross Sectional ◽  
Level Of Training ◽  
Paracetamol Toxicity ◽  
The Individual

<b><i>Introduction:</i></b> Acute liver failure (ALF) is a rare disease with potentially high mortality. We sought to assess the individual approach to ALF by intensive care unit (ICU) professionals. <b><i>Methods:</i></b> Cross-sectional survey of ICU professionals. Web-based survey capturing data on respondents’ demographics, characteristics of patients with ALF admitted to ICU, and their management. <b><i>Results:</i></b> Among 204 participants from 50 countries, 140 (68.6%) worked in Europe, 146 (71.6%) were intensivists, 142 (69.6%) admitted &#x3c;25 patients with ALF per year, and 166 (81.8%) reported &#x3c;25% of patients had paracetamol-related ALF. On patients’ outcomes, 126 (75.0%) reported an emergency liver transplantation (ELT) rate &#x3c;25% and 140 (73.3%) a hospital mortality rate &#x3c;50%. The approach to ALF in the ICU varied with age, region, level of training, type of hospital, and etiology (prescribing N-acetylcysteine for paracetamol toxicity, triggers for endotracheal intubation, measurement of and strategies for lowering serum ammonia, extracorporeal device deployment, and prophylactic antibiotics). <b><i>Conclusions:</i></b> The management of patients with ALF by ICU professionals differed substantially concerning the relevant clinical measures taken. Further education and high-quality research are warranted.

scholarly journals Service user and carer experiences of the advanced nurse practitioner role in a memory assessment team

2020 ◽  
Vol 29 (16) ◽  
pp. 960-967
Author(s):  
Karen Greenbank ◽  
Steve Hemingway ◽  
Subha Thiyagesh ◽  
John Stephenson
Keyword(s):  
Nurse Practitioners ◽  
Service User ◽  
Direct Care ◽  
Care Practice ◽  
Cross Sectional Survey ◽  
High Quality Research ◽  
Cross Sectional ◽  
Memory Assessment ◽  
The Cost

Background: Advanced nurse practitioners (ANPs) within memory services can support prompt diagnoses of dementia. Further understanding of the role is necessary as evidence on its effectiveness is limited. Aim: To assess service user and carer satisfaction with the ANP role within Kirklees memory assessment team. Methods: A cross-sectional survey was undertaken to evaluate carer and patient perceptions of the ANP role in a local memory assessment team. The survey was developed using the Royal College of Nursing's four pillars as a structure: clinical/direct care practice, leadership and collaborative practice, improving quality and developing practice, and developing self and others. Results: One hundred and fifteen surveys were sent out, and 85 were completed, a response rate of 73.9%. Patients expressed significant satisfaction with the ANP, in particular in the areas of direct clinical practice (84%) and quality of care received (87%). Conclusion: Patients and families are highly satisfied with the service provided by the ANP. High-quality research is needed on the cost effectiveness and outcomes of ANP interventions.

scholarly journals AB1354-HPR CURRENT SITUATION OF TRAINING IN RHEUMATOLOGY IN THE POSTGRADUATE CURRICULUMS OF INTERNAL MEDICINE, FAMILY MEDICINE, GERIATRICS, PAIN MEDICINE AND, PHYSICAL AND REHABILITATION MEDICINE ACROSS COLOMBIA

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1964.3-1965
Author(s):  
D. G. Fernández-Ávila ◽  
L. Patino ◽  
J. Gutiérrez
Keyword(s):  
Internal Medicine ◽  
Family Medicine ◽  
Rheumatic Disease ◽  
Assistant Professor ◽  
Rehabilitation Medicine ◽  
Cross Sectional Study ◽  
Physical Rehabilitation ◽  
Pain Medicine ◽  
Cross Sectional ◽  
Physical And Rehabilitation Medicine

Background:Rheumatic diseases are an important complaint in patients, although the incidence is low, they cause disability and impact on the health system. Currently, in Colombia, there are 198 rheumatologist, so it’s important to know how is rheumatology training in specialties related to rheumatology, which are the specialties that the patient with a suspected rheumatic disease will visit at first.Objectives:To describe the training status in rheumatology in the postgraduate curriculums of internal medicine, family medicine, geriatrics, pain medicine and, physical and rehabilitation medicine across Colombia.Methods:This is a descriptive cross-sectional study. A survey was applied in each participating medical school using the RedCap® platform. The questionnaire included multiple-choice responses and a textbox to complete. The survey was done to the 29 registered medical schools which offer the specializations already mentioned. The program director or an assistant professor was asked to fill the survey out between April 2019 and January 2020. The sample was described through means and standard deviations or frequency and percentages according to the type of variable.Results:Data was obtained from all the programs of specialization in internal medicine (n = 29), family medicine (n= 9), pain medicine (n= 8), physical and rehabilitation medicine (n= 6), geriatrics (n= 4). All the programs of internal medicine, geriatrics, and physical/rehabilitation medicine have rheumatology as a mandatory subject within the curriculum, while in family medicine and pain medicine programs: 33% (n= 3), and 57% (n= 4) respectively, does not have a rheumatology training. In internal medicine the average duration of rheumatology training is 56 days (28 to 90 days), in geriatrics, it is 56 days (45-60 days), in family medicine 26.1 days (3 to 30), in medicine physical and rehabilitation medicine 35 days (30 to 60) and in pain medicine 40 days (30 to 60). 93.8% (n= 45) of the programs surveyed have a rheumatologist as a teacher in charge of both, the academic activities and the external rheumatology consultation and in the rest of the programs these activities are done by an specialist in internal medicine, family medicine or pain medicine. The theoretical components most frequently offered in seminars or master classes are: rheumatoid arthritis, lupus, vasculitis, spondyloarthritis, gout, osteoarthritis, sjogren’s syndrome and osteoporosis. The specialization programs have an average of 3 rheumatologists as professors (range 1 to 8). 43.8% of the programs use some virtual resources to complement the teaching in rheumatology such as video conferencing in virtual platform or YouTube (8.3%), online course (6.3%), mobile application (16.7%), others such as moodle and webcast platform (12.5%). 92.9% (n = 52) offer their students an elective rotation in the rheumatology service, in addition to the mandatory one. Finally, 89.6% (n = 43) of the interviewees agree with the way in which the curriculum is structured in their programs, to approach initial diagnostic and therapeutic in patients with suspected or established rheumatic disease. However, 23.2% (n = 13) of the professors of the surveyed programs (6 of internal medicine, 4 of family medicine, 2 of pain medicine and 1 of physical/rehabilitation medicine), consider that the rheumatology subject should not be mandatory within their programs.Conclusion:All physicians need to be familiar with rheumatological conditions since the rate of rheumatologists in Colombia is low. Knowing rheumatology is an increasingly important role in a clinical scenario in many postgraduate curriculums as we explain in this study.References:[1]Sivera F, et al; Working Group on Training in Rheumatology across Europe. Differences and similarities in rheumatology specialty training programmes across European countries. Ann Rheum Dis. 2015 Jun;74(6):1183-7Disclosure of Interests:None declared

scholarly journals Research challenges in Africa – an exploratory study on the experiences and opinions of African researchers

2018 ◽  
Author(s):  
Lem Ngongalah ◽  
Wepngong Emerson ◽  
Ngwa Niba Rawlings ◽  
James Muleme Musisi
Keyword(s):  
Research Output ◽  
Research Capacity ◽  
Sub Saharan Africa ◽  
Research Activity ◽  
African Countries ◽  
Cross Sectional Survey ◽  
Online Questionnaire ◽  
High Quality Research ◽  
Cross Sectional ◽  
Priority Areas

AbstractBackgroundInsufficient research is a major impediment to growth, development and advancement of health in Africa. Africa produces less than 1% of global research output. Meanwhile, African countries face some of the toughest challenges worldwide, most of which can only be tackled through robust and efficient research. Addressing the barriers to conducting research in Africa is a step towards improving research capacity and output. This study aimed to identify the key challenges affecting research practice and output in Africa; and to highlight priority areas for improvement.MethodsA cross-sectional survey was administered through an online questionnaire, including participants from six countries in Sub-Saharan Africa. Participants included research professionals, research students, research groups and academics.ResultsA total of 424 participants responded to this survey. The ability to conduct and produce high-quality research was seen to be influenced by multiple factors, most of which were related to the research environment in African countries. Priority areas for improvement included providing more training, raising awareness on the importance of research in Africa, encouraging governments to commit to research and increasing collaboration between researchers in Africa.ConclusionThe conditions under which research is done in Africa are severely flawed and do not encourage engagement in research, or continuity of research activity. African governments need to develop initiatives that accelerate and support research and research-based education in Africa, in order to build a solid foundation for research, increase research capacity, and enable institutions to provide valuable training and develop sustainable research opportunities in Africa.

Caregiver Burden among Parents of Hearing Impaired and Intellectually Disabled Children in Pakistan

2020 ◽  
Author(s):  
Imran Haider SYED ◽  
Waqar Ahmed AWAN ◽  
Unaiza Batool SYEDA
Keyword(s):  
Caregiver Burden ◽  
Sampling Technique ◽  
Rehabilitation Medicine ◽  
Hearing Impaired ◽  
Disabled Children ◽  
Intellectually Disabled ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Impaired Children ◽  
Hearing Impaired Children

Background: Caregiver burden is a multidimensional response to physical, psychological, emotional, social and financial stressors, usually associated with the experience of caring and can be objective or subjective. The objective of current study was to explore the caregiver burden among parents of hearing impaired and intellectually challenged children in Pakistan. Methods: A Comparative cross sectional survey was conducted on n=162 parents of hearing impaired (HI) and intellectually challenged (IC) children from July 2018 to February 2019. Convenient sampling technique was used to collect the data from Parents of hearing impaired and intellectually challenged children with age range 1-16 years in National Institute of Rehabilitation Medicine and Al-Farabi Special Education Institute Islamabad. Caregiver Burden Inventory was used to assess the caregiver burden. Results: The results showed a greater need for respite and other services in both groups. Parents of intellectually challenged children need more respite and other services as compared to hearing impaired children (60.62±11.43 ver. 45.74±11.20, p<0.001). A total of 3 (4.0%) parents of hearing impaired children reported rare need for respite and other services, 32(42.7%) reported sometimes and 40(53.3%) reported frequent need. On the other hand 12(13.8%) parents of intellectually disabled children reported sometimes, 66(75.9%) reported quite frequently and 9(10.3%) nearly always a greater need for respite and other services. Conclusion: The parents of hearing impaired or intellectually challenged children face significant burden of their disabled child. In addition, due to cognitive deficits that lead to behavioural abnormalities the parents of intellectually challenged children face more burden and stress.

scholarly journals Systematic review support received and needed by researchers: a survey of libraries supporting Ontario medical schools

2021 ◽  
Vol 42 (3) ◽  
Author(s):  
Sandra McKeown ◽  
Zuhaib Mir ◽  
Jennifer Ritonja ◽  
Eleftherios Soleas
Keyword(s):  
Systematic Review ◽  
Online Education ◽  
Review Process ◽  
Medical Schools ◽  
Cross Sectional Survey ◽  
High Quality ◽  
High Quality Research ◽  
Cross Sectional ◽  
Educational Modules ◽  
Systematic Review Process

Introduction: Finding efficient ways to meet the growing demand for library systematic review support is imperative for facilitating the production of high-quality research. The objectives of this study were threefold: 1) to ascertain the systematic review support provided by health sciences libraries at Ontario medical schools and their affiliated hospitals, 2) to determine the perceived educational needs by researchers at these institutions, and 3) to assess the potential usefulness of freely available, online educational modules for researchers that discuss all stages of the systematic review process. Methods: We conducted a cross-sectional survey in June and July of 2020. Data were analyzed and presented using median and interquartile range (IQR) for continuous measures, and in proportions for categorical measures. Results: Thirteen of 19 libraries invited provided usable data. Most libraries spent more time supporting systematic reviews via collaboration/participation than by providing educational support. The perceived needs of library users were contrary to the perceived gaps in researcher support provided by the library/institution. All libraries reported they would find freely available, online educational modules useful for training researchers. Discussion: The next steps for our inter-professional research team will be to develop freely available, online education modules that introduce researchers to all stages of the systematic review process. These modules cannot replace the value that direct support from librarians, biostatisticians or methodology experts can provide, however, they may offer a more efficient way for libraries to familiarize researchers and trainees with best practices and universally accepted reporting guidelines for performing a high-quality review.  

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