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1.
Disabil Rehabil ; 46(6): 1188-1203, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-37070568

RESUMEN

PURPOSE: Telehealth may help meet the growing demand for orthotic/prosthetic services. Despite the resurgence of telehealth due to COVID-19, there is limited evidence to inform policy and funding decisions, nor guide practitioners. METHODS: Participants were adult orthosis/prosthesis users or parents/guardians of child orthosis/prosthesis users. Participants were convenience sampled following an orthotic/prosthetic telehealth service. An online survey included: demographics, Telehealth Usability Questionnaire, and the Orthotic Prosthetic Users Survey - Client Satisfaction with Services. A subsample of participants took part in a semi-structured interview. RESULTS: Most participants were tertiary educated, middle-aged, female, and lived in metropolitan or regional centres. Most telehealth services were for routine reviews. Most participants chose to use telehealth given the distance to the orthotic/prosthetic service, irrespective of whether they lived in metropolitan cities or regional areas. Participants were highly satisfied with the telehealth mode and the clinical service they received via telehealth.While orthosis/prosthesis users were highly satisfied with the clinical service received, and the telehealth mode, technical issues affected reliability and detracted from the user experience. Interviews highlighted the importance of high-quality interpersonal communication, agency and control over the decision to use telehealth, and a degree of health literacy from a lived experience of using an orthosis/prosthesis.


Orthotic/prosthetic users were highly satisfied with the clinical services they received via telehealth.Satisfaction was linked to having agency and control over the decision to use telehealth, a clear understanding of the purpose of the appointment and any requirements, and a degree of health literacy that facilitated communication.Orthosis/prosthesis users and practitioners can make informed choices about using telehealth which suggests that many telehealth guidelines maybe unnecessarily risk averse.Telehealth is a useful tool to overcome barriers to accessing orthotic/prosthetic care for people in both metropolitan and regional areas.There are opportunities to support clinicians with targeted telehealth education to improve practice and reduce barriers to high-quality telehealth services.


Asunto(s)
Miembros Artificiales , Telemedicina , Adulto , Niño , Femenino , Humanos , Persona de Mediana Edad , Aparatos Ortopédicos , Satisfacción del Paciente , Reproducibilidad de los Resultados , Masculino
2.
J Clin Med ; 12(4)2023 Feb 17.
Artículo en Inglés | MEDLINE | ID: mdl-36836145

RESUMEN

This umbrella review aimed to systematically identify the peri-operative risk factors associated with post-operative cognitive dysfunction (POCD) using meta-analyses of observational studies. To date, no review has synthesised nor assessed the strength of the available evidence examining risk factors for POCD. Database searches from journal inception to December 2022 consisted of systematic reviews with meta-analyses that included observational studies examining pre-, intra- and post-operative risk factors for POCD. A total of 330 papers were initially screened. Eleven meta-analyses were included in this umbrella review, which consisted of 73 risk factors in a total population of 67,622 participants. Most pertained to pre-operative risk factors (74%) that were predominantly examined using prospective designs and in cardiac-related surgeries (71%). Overall, 31 of the 73 factors (42%) were associated with a higher risk of POCD. However, there was no convincing (class I) or highly suggestive (class II) evidence for associations between risk factors and POCD, and suggestive evidence (class III) was limited to two risk factors (pre-operative age and pre-operative diabetes). Given that the overall strength of the evidence is limited, further large-scale studies that examine risk factors across various surgery types are recommended.

3.
JMIR Form Res ; 6(10): e38387, 2022 Oct 31.
Artículo en Inglés | MEDLINE | ID: mdl-36315225

RESUMEN

BACKGROUND: App-based interventions designed to prevent and treat eating disorders have considerable potential to overcome known barriers to treatment seeking. Existing apps have shown efficacy in terms of symptom reduction; however, uptake and retention issues are common. To ensure that apps meet the needs and preferences of those for whom they were designed, it is critical to understand the lived experience of potential users and involve them in the process of design, development, and delivery. However, few app-based interventions are pretested on and co-designed with end users before randomized controlled trials. OBJECTIVE: To address the issue, this study used a highly novel design thinking approach to provide the context and a lived experience perspective of the end user, thus allowing for a deeper level of understanding. METHODS: In total, 7 young women (mean age 25.83, SD 5.34, range 21-33 years) who self-identified as having a history of body image issues or eating disorders were recruited. Participants were interviewed about their lived experience of body image and eating disorders and reported their needs and preferences for app-based eating disorder interventions. Traditional (thematic analysis) and novel (empathy mapping; visually depicting and empathizing with the user's personal experience) analyses were performed, providing a lived experience perspective of eating disorders and identifying the needs and preferences of this population in relation to app-based interventions for eating disorders. Key challenges and opportunities for app-based eating disorder interventions were also identified. RESULTS: Findings highlighted the importance of understanding and identifying problematic eating disorder symptoms for the user, helpful practices for recovery that identify personal values and goals, the role of social support in facilitating hope, and aspects of usability to promote continued engagement and recovery. CONCLUSIONS: Practical guidance and recommendations are described for those developing app-based eating disorder interventions. These findings have the potential to inform practices to enhance participant uptake and retention in the context of app-based interventions for this population.

4.
MedEdPublish (2016) ; 8: 148, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-38089310

RESUMEN

This article was migrated. The article was marked as recommended. Objectives:The primary aim of the study was to determine whether classroom-based acute care teaching delivered by junior doctors is comparable to that by senior doctors or faculty. This study reviews student opinions of near-peer and faculty led teaching on acute medicine to explore the differences and student preferences. Methods:This study aimed to evaluate the role of trainees as near-peer tutors in the acute medicine tutorial based setting by randomly allocating the sessions to a junior or senior doctor. Student opinions were then invited through questionnaires and focus groups. Results:There was no statistical difference in students' perception of the level, pace and usefulness of the sessions. All teachers were approachable and enthusiastic. Students felt that senior doctors were more knowledgeable and better able to explain concepts. Students felt that all sessions were useful to their learning. Conclusion:Students enjoyed and derived educational benefit from both types of teaching session. Students found that senior doctor-led tutorials were more beneficial to their technical medical knowledge but felt that they gained more practical advice from junior doctor-led teaching. Trainees could provide reassurance, advice and mentorship regarding their careers and role of a doctor. Students recognised the value of tutorials by junior and senior doctors and requested the inclusion of both in their undergraduate curriculum.

5.
Clin Med (Lond) ; 16(4): 335-8, 2016 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-27481376

RESUMEN

Having benign paroxysmal positional vertigo (BPPV) puts patients at a significantly higher risk of falling. It is poorly recognised and diagnosis is frequently delayed. BPPV has been studied in outpatient settings, but there have been no studies looking at the prevalence in patients admitted with falls. This study aims to establish how common BPPV is in these patients.For a 4-month period, patients admitted on an unselected medical take were screened for an admission precipitated by a fall. Patients who consented were assessed for BPPV using the Dix-Hallpike manoeuvre. Patients who tested positive were treated using the Epley manoeuvre. The assessments were carried out by specialist physiotherapists who were experienced at assessing and diagnosing patients with peripheral vestibular disorders. Out of the 111 patients initially identified, 37 (33%) were considered to be appropriate and consented to be part of the study. Of these, 20 patients (54%) had a positive Dix-Hallpike manoeuvre.Of the patients included in the study, over half tested positive for BPPV. This merits further study. Potentially, there is a proportion of patients admitted with falls who have an easily treatable contributing factor that is not being identified with standard practice.


Asunto(s)
Accidentes por Caídas/prevención & control , Vértigo Posicional Paroxístico Benigno/diagnóstico , Hospitales Generales , Anciano , Anciano de 80 o más Años , Vértigo Posicional Paroxístico Benigno/fisiopatología , Femenino , Humanos , Pacientes Internos , Masculino , Admisión del Paciente , Estudios Prospectivos
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