-
Holland Kirby posted an update 3 days, 8 hours ago
The family meeting is an essential component of effective palliative care (PC); however, medical students and junior doctors-in-training often consider leading a family meeting to be a daunting task. The old “see one, do one, teach one” axiom should not apply in preparing trainees to conduct a family meeting. After a review of the literature on established PC curricula, trainee perceptions of their PC educational experiences, and documented educational interventions in preparing trainees to conduct a family meeting, we have compiled a list of 10 tips for clinical educators to consider in assisting their students to feel better equipped to conduct productive family meetings.Bariatric surgery represents the most valid option to treat the chronic disease of morbid obesity and all its related comorbid conditions with the purpose to increase life expectancy. Despite multiple recommendations of the different scientific societies, bariatric surgery remains worldwide largely underused. Considering only a 16% rate of obesity disease, with the largest number of bariatric surgeries performed in Europe of 50k procedures a year, France should need more than 200 years to surgically approach all morbid obese patients. Similarly, in the United States, obesity is a chronic condition that affects more than 1 in 3 adults, with a mean number of 250k bariatric procedures a year, hence they would need 437 years to manage this population. Definitely, the bariatric surgery is very poorly used and there are several factors to explain it. Inadequate access to medical care and insufficient information provided by the general practitioner are frequently encountered in our practice. But the main limitation for the bariatric treatment remains the patients’ “fear” of a surgical complication.Rationale Patients with chronic obstructive pulmonary disease (COPD) and anxiety or depression experience more symptoms and exacerbations than patients without these comorbidities. Failure to provide beneficial COPD therapies to appropriate patients (underuse) and provision of potentially harmful therapies to patients without an appropriate indication (overuse) could contribute to respiratory symptoms and exacerbations. Anxiety and depression are known to affect the provision of health services for other comorbid conditions; therefore, underuse or overuse of therapies may explain the increased risk of severe symptoms among these patients.Objectives To determine whether diagnosed anxiety and depression, as well as significant anxiety and depression symptoms, are associated with underuse and overuse of appropriate COPD therapies.Methods We analyzed data from a multicenter prospective cohort study of 2,376 participants (smokers and control subjects) enrolled between 2010 and 2015. We identified two subgroups of depression nor significant anxiety and depression symptoms were associated with overuse or underuse. At least 50% of patients in both subgroups with significant symptoms of anxiety or depression did not report a preexisting mental health diagnosis.Conclusions Underuse of LABDs and overuse of ICSs are common but are not associated with comorbid anxiety or depression diagnosis or symptoms. Approximately one-third of individuals with COPD experience anxiety or depression, and most are undiagnosed. Selleckchem GF120918 There are significant opportunities to improve disease-specific and patient-centered treatment for individuals with COPD.
To estimate the incidence and recurrence rates of acute hamstring injuries in all levels of soccer.
Epidemiology systematic review.
We searched the PubMed (including MEDLINE), CINAHL, SPORTDiscus, Embase, and Cochrane Central Register of Controlled Trials electronic databases.
We included prospective studies of all levels of adult soccer players that registered acute hamstring injuries and provided a description of incidence of acute hamstring injuries per 1000 playing hours (or available data to calculate this).
Due to heterogeneity, we synthesized the data descriptively.
Thirteen studies including 3868 players met the inclusion criteria. Two of 13 included studies reported on hamstring injuries in women, and all reported the same in men. The incidence of acute hamstring injury ranged from 0.3 to 0.5 per 1000 exposure hours in women and 0.3 to 1.9 per 1000 exposure hours in men. Hamstring injuries accounted for 5% to 15% of all soccer-related injuries. Hamstring injury recurrence rates ranged from 4% to 68%, depending on the injury definition. Certainty of evidence ranged from moderate to very low.
The incidence of acute hamstring injury in soccer was 0.3 to 1.9 per 1000 exposure hours. The recurrence rate was 4% to 68%. The strength of the evidence was limited by a lack of methodological rigor, the use of varying definitions for acute hamstring injury, and heterogeneous methods of reporting on acute hamstring injuries.
.
The incidence of acute hamstring injury in soccer was 0.3 to 1.9 per 1000 exposure hours. The recurrence rate was 4% to 68%. The strength of the evidence was limited by a lack of methodological rigor, the use of varying definitions for acute hamstring injury, and heterogeneous methods of reporting on acute hamstring injuries. J Orthop Sports Phys Ther 2021;51(1)27-36. Epub 11 Dec 2020. doi10.2519/jospt.2021.9305.
To assess the value of the patient interview and electronic questionnaire methods of health history data collection in elite athletes.
Cohort study.
A retrospective chart review compared health history data collected by questionnaire and by interview in a cohort of 142 athletes who participated in a periodic health evaluation at the US Olympic & Paralympic Training Center sports medicine clinic. The main outcome measure was number of injuries reported by either interview or written questionnaire.
Six hundred twenty-six injuries were reported by interview and 157 by questionnaire. The mean ± SD number of injuries reported per participant was 4.4 ± 4.2 by interview and 1.1 ± 1.3 by questionnaire (difference, 3.3;
<.001). Capture rate by method was similar across sexes and for both Olympic and Paralympic athletes. More injuries were reported by interview than by questionnaire for all injury categories, except for concussions and surgeries.
Patient interviews capture 4 times as many past or current injuries than electronic questionnaires in athletes training for the Olympic and Paralympic Games.