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ObjectiveTo investigate the knowledge and management of Relative Energy Deficiency in Sport (RED-S), from the perspective of lightweight rowers and physiotherapists.DesignSemi-structured individual qualitative interviews.MethodsPhysiotherapists who had worked with lightweight rowers, and current and former lightweight rowers (who had experienced at least one symptom of RED-S), undertook audio-recorded semi-structured telephone interviews. An inductive thematic analysis was performed, facilitated by NVivo software.ResultsTwelve physiotherapists (n = 6 females, 1–20 years of experience managing lightweight rowers) and twelve lightweight rowers (n = 8 females, 1–8 years lightweight rowing experience, intermediate to elite/international level) were interviewed. Five key themes were identified: insufficient knowledge of RED-S, inadequate RED-S education, inappropriate management of RED-S, referral to other health professionals, prioritising performance over health. Participants provided suggestions for improving knowledge and management of RED-S in lightweight rowers, including formal physiotherapy education and training, and targeted education for athletes and coaches.ConclusionsThere was a significant lack of awareness of RED-S amongst physiotherapists and lightweight rowers. Most physiotherapists were not confident discussing or managing RED-S in athletes, and lightweight rowers were dissatisfied with the management they received. Improving RED-S education for physiotherapists and athletes may have important health implications for lightweight rowers. 相似文献
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Luis Miguel Azogil-López Juan José Pérez-Lázaro Patricia Ávila-Pecci Esther María Medrano-Sánchez María Valle Coronado-Vázquez 《Atencion primaria / Sociedad Espa?ola de Medicina de Familia y Comunitaria》2019,51(5):278-284
Aim
The purpose of this study is to find out whether telephone referral from Primary Health Care to Internal Medicine Consult manages to reduce waiting days as compared to traditional referral. This study also aims to know how acceptable is the telephone referral to general practitioners and their patients.Design
No blind randomized controlled clinical trial.Setting
Northern Huelva Health District.Participants
154 patients.Interventions
Patients referrals from intervention clinicians were sent via telephone consultation, whereas patients referrals from control clinicians were sent by traditional via.Measurements
Number of days from referral request to Internal Medicine Consult. Number of telephone and traditional referrals. Number of doctors and patients denied. Denial reasons.Results
A statistically significant difference was found between groups, with an average of 27 (21-34) days. Among General Practitioners, 8 of the first 58 total doctors after randomization and, subsequently, 6 of the 20 doctors of the test group refused to engage in the trial because they considered “excessive time and effort consuming”. 50% of patients referred by the 14 General Practitioners finally randomized to the intervention group were denied referral by telephone due to patient's complexity.Conclusions
Telephone referral significantly reduces waiting days for Internal Medicine consult. This type of referral did not mean an “excessive time and effort consuming” to General Practitioners and was not all that beneficial to complex patients 相似文献5.
The natural history of occult spinal dysraphism in children is one of progressive and unpredictable neurological deficit. The modern role of neurosurgery is in the prevention of deterioration rather than correction of established disability. A prospective study was carried out on 40 consecutive patients to analyse the referral pattern of children with this condition. The age, reason for referral, clinical history and source of referral was recorded in each case. The reason for referral varied with age. Of the 40 patients studied, only 12 were found to be without neurological deficit at the time of referral. The incidence of progressive neurological deterioration increased with increasing age. The referral source in different age groups varied, but in all age groups relatively few were referred by the general paediatricians or paediatric neurologists. For optimum surgical results, early referral and treatment is desirable and should become our objective. 相似文献
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T. Clerici R. Warschkow F. Triponez M. Brändle 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》2007,392(5):611-615
Background From the endocrine surgeon’s perspective, it is important to know how endocrinologists manage patients with primary hyperparathyroidism
(pHPT). The aim of this survey was to evaluate the preoperative diagnostic workup and referral pattern for parathyroidectomy
by Swiss endocrinologists.
Materials and methods The survey was conducted by mailing a questionnaire to all members of the Swiss Society for Endocrinology and Diabetes in
spring 2005.
Results The questionnaire was sent back by 68 of 124 endocrinologists (55%). The median annual case volume of patients with pHPT was
6 (range 1–50). The mean fraction of these patients referred for surgery was 59 ± 24%. This fraction was significantly higher
in the German-speaking part of Switzerland than in the French-speaking part (67 ± 21% vs 51 ± 27%). When considering surgery
for asymptomatic pHPT, 62% of the endocrinologists rely routinely on the recommendations of the NIH consensus conference and
86% on the subsequent guidelines of the workshop in 2002. Sixty-seven percent of the endocrinologists routinely perform localization
studies before possible referral for surgical exploration. Typically, they consisted of an ultrasonography of the neck (93%)
and a 99mTc-MIBI scintigraphy (80%). The impact of the availability of a minimally invasive surgical procedure on the number of patients
referred for surgery seems to be considerable. Sixty-one percent of the participants would expand the indication for surgery
if the operation could be done by a limited surgical approach.
Conclusions In a relevant fraction of patients with pHPT, endocrinologists still do not regard curative therapy as mandatory. Surprisingly,
there are significant cultural differences concerning referral patterns to surgery between the German-speaking and the French-speaking
parts of Switzerland. Minimally invasive procedures seem to lower the threshold for referral for surgical therapy.
This work was presented at the 2nd Biennial Congress of the ESES, May 2006, Krakow, Poland. 相似文献
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Grech V 《European journal of epidemiology》1999,15(10):881-887
Differing pathological haemodynamics in cardiac malformations lead to varying modes and timings of presentation. This study identifies historical trends in presentation of congenital heart disease in a population-based study. All patients diagnosed as having congenital heart disease in Malta between 1960–1994 were included (n = 868). Analysis was carried out on trends in referral sources, modes of presentation and birth prevalence. The number of patients diagnosed with congenital heart disease increased over the period under study. For both patients not requiring intervention (n = 283) and those requiring intervention (n=585), the proportion diagnosed prior to hospital discharge increased (p 0.005). There was a decreasing trend for general practitioners to refer cases (p < 0.0001), and an increasing trend for paediatricians to refer such patients (p 0.0003). The commonest presentation to the general practitioner was an incidental finding (92%), while paediatricians referred more patients for cyanosis or heart failure (p 0.005). For lesions not requiring intervention, the commonest lesion referred was ventricular septal defect from all sources. For lesions requiring intervention, the commonest lesion detected prior to hospital discharge was tetralogy of Fallot. Atrial septal defects were the commonest lesions detected after discharge by both paediatricians and general practitioners. An increase in the proportion of hospital diagnoses is attributed to increasing rate of hospital delivery, and greater training and experience in doctors performing neonatal examinations prior to discharge. Patients diagnosed after discharge are increasingly diagnosed by paediatricians due to an increasing pool of paediatricians and better parent awareness and education. 相似文献
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为营造公平、合理、有效的门诊就诊环境,建立精确候诊就医通道,通过中国移动集团寻呼功能,结合医院信息系统(HIS),建立了医院门诊智能寻呼排队系统。该系统利用就诊业务流程实现了医院门诊管理的实时、快捷和通畅,提高了服务效率,提升了医院良好的窗口服务形象。 相似文献
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以预约挂号为抓手,不断优化门诊业务流程。在现有信息系统的基础上,重新修改、设计,省去了预约患者在就诊当日还需在窗口排队确认的过程,将人群有效分流至各分诊台。一方面有效解决了患者窗口排队等候时间长的问题,另一方面提高了医院的门诊服务质量。系统上线后,取得了良好效果。 相似文献