68 research outputs found
A Lifesaving Quality Improvement Project - Investigating the Practicality of the Emergency Medicine Bag in a Primary Care Setting
Although uncommon, emergencies in primary care must be adequately prepared for. The Care Quality Commission (CQC) has produced a resource of emergency medications GP practices are recommended to stock. This list is neither exhaustive nor mandatory, but practices should consider the necessity within their population (1).
Many GP practices choose to have an emergency bag on site. Alnwick Medical Practice developed an emergency bag which contained all the medication and equipment required for medical emergencies in primary care.
Successful treatment in a medical emergency requires staff to be confident in using the emergency bag under pressure and be familiar with its layout and contents. This QIP explored staff confidence in navigating the emergency bag before and after a QI intervention
Physical Activity Minimum Threshold Predicting Improved Function in Adults With LowerâExtremity Symptoms
Objective
To identify an evidenceâbased minimum physical activity threshold to predict improved or sustained high function for adults with lowerâextremity joint symptoms. Methods
Prospective multisite data from 1,629 adults, age â„49 years with symptomatic lowerâextremity joint pain/aching/stiffness, participating in the Osteoarthritis Initiative accelerometer monitoring substudy were clinically assessed 2 years apart. Improved/high function in 2âyear gait speed and patientâreported outcomes (PROs) were based on improving or remaining in the best (i.e., maintaining high) function quintile compared to baseline status. Optimal thresholds predicting improved/high function were investigated using classification trees for the legacy federal guideline metric requiring 150 minutes/week of moderateâvigorous (MV) activity in bouts lasting 10 minutes or more (MVâbout) and other metrics (total MV, sedentary, light intensity activity, nonsedentary minutes/week). Results
Optimal thresholds based on total MV minutes/week predicted improved/high function outcomes more strongly than the legacy or other investigated metrics. Meeting the 45 total MV minutes/week threshold had increased relative risk (RR) for improved/high function (gait speed RR 1.8, 95% confidence interval [95% CI] 1.6, 2.1 and PRO physical function RR 1.4, 95% CI 1.3, 1.6) compared to less active adults. Thresholds were consistent across sex, body mass index, knee osteoarthritis status, and age. Conclusion
These results supported a physical activity minimum threshold of 45 total MV minutes/week to promote improved or sustained high function for adults with lowerâextremity joint symptoms. This evidenceâbased threshold is less rigorous than federal guidelines (â„150 MVâbout minutes/week) and provides an intermediate goal towards the federal guideline for adults with lowerâextremity symptoms
2019-2020 Dean\u27s Showcase
https://spiral.lynn.edu/conservatory_deansshowcase/1072/thumbnail.jp
A Randomized Trial of a Motivational Interviewing Intervention to Increase Lifestyle Physical Activity and Improve Self-Reported Function in Adults with Arthritis
Background
Arthritis is a leading cause of chronic pain and functional limitations. Exercise is beneficial for improving strength and function and decreasing pain. We evaluated the effect of a motivational interviewing-based lifestyle physical activity intervention on self-reported physical function in adults with knee osteoarthritis (KOA) or rheumatoid arthritis (RA). Methods
Participants were randomized to intervention or control. Control participants received a brief physician recommendation to increase physical activity to meet national guidelines. Intervention participants received the same brief baseline physician recommendation in addition to motivational interviewing sessions at baseline, 3, 6, and 12 months. These sessions focused on facilitating individualized lifestyle physical activity goal setting. The primary outcome was change in self-reported physical function. Secondary outcomes were self-reported pain and accelerometer-measured physical activity. Self-reported KOA outcomes were evaluated by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for KOA (WOMAC scores range from 0 to 68 for function and 0 to 20 for pain) and the Health Assessment Questionnaire (HAQ) for RA. Outcomes were measured at baseline, 3, 6, 12, and 24 months. Multiple regression accounting for repeated measures was used to evaluate the overall intervention effect on outcomes controlling for baseline values. Results
Participants included 155 adults with KOA (76 intervention and 79 control) and 185 adults with RA (93 intervention and 92 control). Among KOA participants, WOMAC physical function improvement was greater in the intervention group compared to the control group [difference = 2.21 (95% CI: 0.01, 4.41)]. WOMAC pain improvement was greater in the intervention group compared to the control group [difference = 0.70 (95% CI: â0.004, 1.41)]. There were no significant changes in physical activity. Among RA participants, no significant intervention effects were found. Conclusion
Participants with KOA receiving the lifestyle intervention experienced modest improvement in self-reported function and a trend toward improved pain compared to controls. There was no intervention effect for RA participants. Further refinement of this intervention is needed for more robust improvement in function, pain, and physical activity
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