Personal Management Research Articles

Teaching People Management in Production Engineering Courses

Objective: The aim of the study was to analyze how courses related to personnel management and human resources are offered in Production Engineering programs at universities in the state of São Paulo. Theoretical Framework: The investigation encompasses the emergence of production engineering as a science and field of study, followed by a section on the practice of personnel management as a field of interest. Finally, it presents a topic related to the competencies required of production engineers in the job market. Method: The adopted methodology is qualitative, exploratory, descriptive, and methodological in nature, utilizing bibliographic research as the main procedure. The research methods include literature review to technically support the work, documentary research related to selected educational institutions, and a case study. Results and Discussion: Literature review results indicate that the historical evolution of Production Engineering and Personnel Management education reveals an adaptation to market demands, influenced by industrial and economic movements over time. The interdependence between these two areas reflects a strategy to address the challenges of emerging scenarios, highlighting a continuous pursuit of innovation, quality, and efficiency. Case study results reveal that some institutions offer a significant number of courses focused on personnel management. However, the credit allocation for these courses is generally low. Regarding the diversity between mandatory and elective courses, there is a balance, with a slight predominance in elective course offerings. Research Implications: The research aims to expand and enrich the theoretical framework related to production engineering and personnel management, with the goal of encouraging future research on the topics addressed at different levels of education. Originality/Value: The study initiates a discussion on the importance of production engineers in organizations and the relevance of personnel management practice in the workplace, as well as investigating the intersection of these two areas in professional development.

Revisiting the full blood count: Circulating blood cells and their role in coagulation.

There has been an expansion in our understanding of the multifaceted roles of circulating blood cells in regulating haemostasis and contributing to thrombosis. Notably, there is greater recognition of the interplay between coagulation with inflammation and innate immune activation and the contribution of leucocytes. The full blood count (FBC) is a time-honoured test in medicine; however, its components are often viewed in isolation and without consideration of their haemostatic and thrombotic potential. Here, we review how the individual components of the FBC, that is, haemoglobin, platelets and leucocytes, engage with the haemostatic system and focus on both their quantitative and qualitative attributes. We also explore how this information can be harnessed into better management of people with multiple long-term conditions because of their higher risk of adverse clinical events.

Home-office implementation: challenges and changes in people management

PurposeThis paper investigates how organisations responded to the home office imposition during the recent global health crisis and its impacts on people management, detailing the organisational factors crucial for effective home-office implementation.Design/methodology/approachWe used an exploratory design based on a multiple case study with four companies from two contrasting sectors (manufacturing and information technology (IT)). We interviewed a total of 12 managers, including one HR manager (HRms) and two team managers from each company. We also conducted an online questionnaire with open questions, reaching out to 128 home-office workers from the four participating companies. This diverse group consisted of 67 workers from the IT sector and 61 workers from the manufacturing sector. To ensure a comprehensive analysis, we opted for a qualitative approach to examine the data.FindingsFindings enabled detail of the organisational factor of the Belzunegui-Eraso and Erro-Garcés (2020) extended Baruch and Nicholson’s (1997) model into people management issues: organisational culture, team management and human resources management (HRM) practices, as well as the technological support. The results also revealed that people management benefits from the successful home-office implementation, which boosted the digitalisation of human resources (HR) processes.Originality/valueConsidering the lessons learned from the home-office imposition, this research provides original insights into the field by exploring the roles of supervisors and HR managers, in non-health organisations, with different previous remote work experiences, in a recent global disruptive moment, based on a rich qualitative approach. The paper offers concrete guidelines for companies that intend to implement remote work management programs and contributes to deepen the knowledge of home-office experience, offering a model focusing on managers’ roles (HRms and TMs) and HRM practices.

Impact of home care counseling on the quality of life of people with diabetes militus

Introduction: Diabetes mellitus is a chronic disease that requires long-term management to control blood sugar levels and prevent complications. The quality of life of diabetics is often affected by this disease, both physically, psychologically, and socially. Home care counseling has been one of the interventions considered effective in assisting diabetics in managing their condition. This study aims to evaluate the impact of home care counseling on the quality of life of people with diabetes mellitus. Methods: This research is quasi-experimental with a randomized pretest and posttest control group design. Samples are taken from patients' medical records and selected by simple random sampling. Results: The mean score before the intervention was 60.55 with a standard deviation of 2.605, which increased to 71.35 with a standard deviation of 4.107 after the intervention. Statistically, there is a difference in the quality of life before and after counseling with a value of p = 0.000 (p < 0.05), which means that home care counseling is effective for sufferers to improve the quality of life of D.M. sufferers. Conclusions: Home care counseling significantly impacts the quality of life of people with diabetes mellitus. These interventions can improve the sufferer's self-management and provide the support needed to overcome the challenges faced in daily life. Therefore, home care counseling is recommended as part of comprehensive management for people with diabetes mellitus.

Endovascular stimulation of the pudendal nerve using a stent-mounted electrode array

Objective. Previous preclinical and clinical studies have demonstrated that pudendal nerve is a promising target for restoring bladder control. The spatial proximity between the pudendal nerve and its accompanying blood vessels in the pudendal canal provides an opportunity for endovascular neurostimulation, which is a less invasive approach compared to conventional chronically implanted electrodes. In this study, we investigated the feasibility of excitatory stimulation and kilohertz-frequency block of the compound pudendal nerve in sheep using a stent-mounted electrode array.Approach. In a set of acute animal experiments, a commercially available hexapolar electrode catheter was introduced in the unilateral internal pudendal artery to deliver bipolar electrical stimulation of the adjacent compound pudendal nerve. The catheter electrode was replaced with a custom-made stent-mounted electrode array and the stimulation sessions were repeated. Global electromyogram activity of the pelvic floor and related sphincter muscles was recorded with a monopolar electrode placed within the urethra concurrently.Main results. We demonstrated the feasibility of endovascular stimulation of the pudendal nerve with both electrode types. The threshold current of endovascular stimulation was influenced by electrode-nerve distance and electrode orientation. Increasing the axial inter-electrode distance significantly decreased threshold current. Endovascular kilohertz-frequency nerve block was possible with the electrode catheter.Significance. The present study demonstrated that endovascular stimulation of the pudendal nerve with the stent-mounted electrode array may be a promising less invasive alternative to conventional implantable electrodes, which has important clinical implications in the treatment of urinary incontinence. Endovascular blocking of pudendal nerve may provide an alternative solution to the bladder-sphincter dyssynergia problem in bladder management for people with spinal cord injury.

Osteoarthritis year in review 2024: Epidemiology and therapy

This "Year in Review" presents a curated selection of research themes and individual studies within the clinical osteoarthritis (OA) field, focusing on epidemiology and therapy.The search was conducted in electronic database MEDLINE from March 4, 2023, to March 31, 2024, specifically targeting English-language articles involving human participants. Inclusions were based on perceived importance and relevance to identifying risk factors or advancing OA treatments. A total of 6,539 studies were screened by the 5 authors, resulting in 157 studies considered for potential inclusion. Ultimately, 44 studies were selected, uncovering six key OA-related themes: i) the burden of OA (mostly from Global Burden of Disease studies), ii) pain drivers and trajectories, iii) impacts of sex/gender, iv) OA risk factors, and treatments for v) hand and vi) knee OA. The prevalence of OA continues to rise, particularly affecting women, with unclear distinctions in risk factors and treatment responses between sex. Associations with atopy were demonstrated in two significant databases. Notably, the authors were particularly interested in recent high-quality methodology randomised controlled trials focusing on hand (methotrexate, denosumab, colchicine, topical bethamethasone) and knee OA with conflicting results about stem cells injection. These findings collectively contribute to show the growing burden of OA, but also to help the understanding of OA pathophysiology and inform ongoing efforts to enhance management for people with OA.

ERN GENTURIS clinical practice guidelines for the diagnosis, surveillance and management of people with Birt-Hogg-Dubé syndrome.

Birt-Hogg-Dubé syndrome (BHD syndrome) is an autosomal dominant multisystem disorder with variable expression due to pathogenic constitutional variants in the FLCN gene. Patients with BHD syndrome are predisposed to benign cutaneous fibrofolliculomas/trichodischomas, pulmonary cysts with an associated risk of spontaneous pneumothorax, and renal cell carcinoma. A requirement for updated International consensus recommendations for the diagnosis and management of BHD syndrome was identified. Based on a comprehensive literature review and expert consensus within the fields of respiratory medicine, urology, radiology, dermatology, clinical oncology and clinical genetics, updated recommendations for diagnosis, surveillance and management in BHD syndrome were developed. With the widespread availability of FLCN genetic testing, clinical scenarios in which a diagnosis should be considered and criteria for genetic testing were defined. Following a clinical and/or molecular diagnosis of BHD syndrome, a multidisciplinary approach to disease management is required. Regular renal cancer surveillance is recommended in adulthood and life-long, but the evidence base for additional tumour surveillance is limited and further research warranted. Recommendations for the treatment of cutaneous, pulmonary and renal manifestations are provided. Awareness of BHD syndrome needs to be raised and better knowledge of the clinical settings in which the diagnosis should be considered should enable earlier diagnosis. Further details, including areas for future research topics are available at: https://www.genturis.eu/l=eng/Guidelines-and-pathways/Clinical-practice-guidelines.html .

Novel Glucose Metric "Latest Spike Time" Correlated with Weight Loss at Six Months in People with Obesity Using the Signos System.

The rise of digital health applications utilizing continuous glucose monitoring (CGM) allows for novel assessments of glucose management and weight changes in people without diabetes. The Signos System incorporates a digital health app paired with a CGM to provide information and prompts aimed to help people without diabetes to manage weight. The primary objective of this study was to determine whether the average timing of the latest chronological glucose excursion ("spike") was correlated with amount of weight loss. This was a retrospective analysis of prospectively obtained glucose and weight data from people without diabetes who enrolled in the Signos System from November 2021 to August 2023. Participants were provided CGMs as well as encouraged to use the Signos app with personalized advice and logging capabilities for weight, food, physical activity, heart rate, sleep, and activities. "Latest Spike Time" was retrospectively derived from CGM data and compared to weight changes at six months. Nine hundred and twenty-six subjects met the inclusion criteria including sufficient days wearing a CGM and a weight log within fifteen days of six months from their first weight log. There was a strong correlation between an earlier spike time and increased weight loss. The top quintile of subjects, with an average latest spike time before 5:41 PM, lost over three times as much weight as the bottom quintile of users, with latest spike time after 8:40 PM; this separation was predictable within one month of data. In a large population of obese people without diabetes, continuous glucose data, specifically a novel metric "Latest Spike Time," was highly correlated with percentage of total body weight loss at six months. This research suggests that for people attempting weight loss, review and alteration of behaviors relating to later glucose excursions may be of specific benefit.

Management of Acute Coronary Syndromes in Older People: Comprehensive Review and Multidisciplinary Practice-Based Recommendations.

Managing health care for older adults aged 75 years and older can pose unique challenges stemming from age-related physiological differences and comorbidities, along with elevated risk of delirium, frailty, disability, and polypharmacy. This review is aimed at providing a comprehensive analysis of the management of acute coronary syndromes (ACS) in older patients, a demographic substantially underrepresented in major clinical trials. Because older patients often exhibit atypical ACS symptoms, a nuanced diagnostic and risk stratification approach is necessary. We aim to address diagnostic challenges for older populations and highlight the diminished sensitivity of traditional symptoms with age, and the importance of biomarkers and imaging techniques tailored for older patients. Additionally, we review the efficacy and safety of pharmacological agents for ACS management in older people, emphasizing the need for a personalized and shared decision-making approach to treatment. This review also explores revascularization strategies, considering the implications of invasive procedures in older people, and weighing the potential benefits against the heightened procedural risks, particularly with surgical revascularization techniques. We explore the perioperative management of older patients experiencing myocardial infarction in the setting of noncardiac surgeries, including preoperative risk stratification and postoperative care considerations. Furthermore, we highlight the critical role of a multidisciplinary approach involving cardiologists, geriatricians, general and internal medicine physicians, primary care physicians, and allied health, to ensure a holistic care pathway in this patient cohort.

A Cross-Sectional Evaluation of the Virtual Outpatient Management of People With Mpox.

To report on the implementation and outcomes of a virtual ward established for the management of mpox during the 2022 outbreak, we conducted a 2-center, observational, cross-sectional study over a 3-month period. All patients aged ≥17 years with laboratory polymerase chain reaction-confirmed monkeypox virus managed between 14 May and 15 August 2022, at the Hospital for Tropical Diseases at University College London Hospitals National Health Service (NHS) Foundation Trust and sexual health services at Central North and West London NHS Foundation Trust, were included. Main outcomes included the proportion of patients managed exclusively on the virtual ward, proportion of patients requiring inpatient admission, proportion of patients with human immunodeficiency virus, and duration of lesion reepithelialization. Among confirmed cases (N = 221), 86% (191/221) were managed exclusively on the virtual ward, while 14% (30/221) required admission. Treatment for concomitant sexually transmitted infections was provided to 25% (55/221) of patients, antibiotics for other infective complications to 16% (35/221), and symptomatic relief to 27% (60/221). The median time from onset to complete lesion reepithelialization and de-isolation was 18 days (range, 8-56 days). Eleven percent (24/221) of individuals disengaged from services within 4 days of testing. The virtual ward model facilitated safe and holistic outpatient management of mpox, while minimizing admissions. This approach could serve as a model for future outbreak responses.

Leveraging interdisciplinary management in people with HIV and lymphoid neoplasms.

Drug-drug interactions between antiretroviral treatment (ART) and cytostatics may have a negative impact in the prognosis of people with HIV (PWH) and cancer. The objective of this study is to evaluate the impact of the implementation of interdisciplinary management and the type of ART in PWH diagnosed with lymphoid neoplasms. This is a multicentric, retrospective observational cohort study including PWH diagnosed with lymphoid neoplasm who started first-line chemotherapy between 2008 and 2020. Demographic, clinical and therapeutic variables were obtained from the electronic medical records and associated with 5-year progression-free survival (PFS) and overall survival (OS) using Cox proportional hazard models. A total of 118 individuals were included. Boosted ART was being used in 55 (46.6%) cases at the time of neoplasm diagnosis. The Infectious Diseases or the Pharmacy Department was consulted before starting chemotherapy in 79/118 (66.9%) cases. Interdisciplinary management resulted in fewer subjects taking boosted ART (17.7% versus 71.8%, P < 0.001) and more subjects using unboosted integrase strand transfer inhibitor-based ART (74.7% versus 7.7%, P < 0.001). The use of boosted ART with chemotherapy was associated with worse 5-year PFS (P = 0.003) and 5-year OS (P = 0.016). There was a trend towards better 5-year PFS and OS when interdisciplinary management was implemented, with significant differences for individuals receiving boosted ART at neoplasm diagnosis (P = 0.0246 and P = 0.0329, respectively). Our findings underscore the significant impact of the type of ART on the prognosis of PWH undergoing chemotherapy. Encouraging collaborative management between oncologists, pharmacists and HIV teams for these patients enhances PFS and OS rates.

Assessment, diagnosis and management characteristics of people with acute Charcot neuro-osteoarthropathy in a regional Australian health service: A 3-year retrospective audit.

Acute Charcot neuro-osteoarthropathy (CN) is highly destructive, causing bone and joint damage that can result in devastating structural changes to the foot. The objective of this study was to determine the characteristics of assessment, diagnosis and management of people with acute CN attending a large regional Australian health service. Three-year retrospective medical record audit. Large regional health service with catchment area of >250 000 people in regional Australia. People with acute CN who attended emergency, orthopaedic clinics or High Risk Foot Clinic (HRFC). Participant characteristics and acute CN assessment, diagnosis and management characteristics. Trends in characteristics were investigated according to rurality as measured by the Modified Monash Model (MMM) scale. Seventeen participants (20 presentations) of acute CN were identified. Mean age was 57.1 ± 10.8 years, with 11 female participants. Median duration to seek help was 31 (IQR 14-47) days. Total Contact Casting was undertaken for 85% of cases, with those who resided in MMM1-2 regions experienced significantly shorter time to TCC therapy compared to those residing in MMM3-7 regions (U = 3.0, p < 0.01). Resolution of acute CN with or without deformity occurred in 70% of cases. Those who lived in smaller regional and rural communities were more likely to experience delayed access to gold standard treatment for acute CN. Regional models of care for acute CN should include activities to improve the knowledge of people at risk of acute CN about the condition and upskill regional health professionals for timely and local TCC therapy.

Barriers and Strategies to Optimize the Use of Glucagon-Like Peptide 1 Receptor Agonists in People with Type 2 Diabetes and High Cardiovascular Risk or Established Cardiovascular Disease: A Delphi Consensus in Spain.

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are effective for glycemic control, with many also demonstrating cardiovascular (CV) benefit, in people with type 2 diabetes (T2D). This study aimed to find a consensus on the barriers and strategies for the optimal use of GLP-1 RAs in people with T2D and high CV risk or established cardiovascular disease (CVD) in Spain. A two-round Delphi survey (53 questions) was conducted among members of four national scientific societies in Spain, including physicians experienced in the management of people with T2D. The degree of consensus was evaluated with a 7-point Likert scale, establishing consensus when≥70% of the panelists agreed (6-7) or disagreed (1-2). A total of 97 physicians participated in the first round (endocrinology: 34%, family and community medicine: 21%, internal medicine: 23%, and cardiology: 23%), and 96 in the second round. The main barriers identified were: therapeutic inertia and late use of GLP-1 RAs; lack of a comprehensive approach to CV risk; lack of knowledge on the usefulness of GLP-1 RAs in CVD prevention and treatment; and economic/administrative barriers. Strategies with a highest consensus included: the need to establish simple protocols that integrate awareness of CV risk monitoring; training professionals and patients; and the use of new technologies. Physicians identified clinical, healthcare, and economic/administrative barriers that limit the use of GLP-1 RAs in people with T2D and high CV risk or established CVD in Spain, highlighting the importance of integrating these therapies according to clinical practice guidelines.

Development of polyimide nanofiber aerogels with a 3D multi-level pore structure: A new sensor for colorimetric detection of breath acetone

Polyimide nanofiber aerogels loaded with thymol blue and hydroxylamine sulfate (TB-HAS@PI NFAs) were synthesized and employed as a novel sensor for colorimetric detection of breath acetone (BrAce). The enhancement of 3D multi-level pore structure of TB-HAS@PI NFAs for sensing performance was elucidated through systematical characterization results. Because the designed sensing system relied on the specific reaction of HAS with acetone, TB-HAS@PI NFAs exhibited a more sensitive response ability to acetone, ensuring that the colorimetric sensing detection will not be interfered by other coexisting gas in exhaled breath. Moreover, the sensor demonstrated a rapid response, with color changes quantitatively measured within 30 s of exposure to acetone gas. Importantly, the feasibility and accuracy of established method were confirmed through comparison with GC–MS. This research provided a promising strategy for daily health management of healthy people and diabetics.

Treatment options used in the management of people with temporomandibular disorders by Australian dentists and physiotherapists.

Studies documenting the treatments used by dentists in the management of temporomandibular disorders (TMDs) have been undertaken in some countries; however, no such research has been conducted in Australia. No similar studies have been documented for physiotherapists. The aim of the study was to determine the treatment options and referral patterns used by Australian dentists and physiotherapists in managing people with TMDs. Prospective nationwide online questionnaires targeting Australian dentists and physiotherapists were created for Australian dentists and physiotherapists. Seventy-eight respondents (27 dentists; 51 physiotherapists) completed all questions in the questionnaires. Sixty respondents reported actively treating people with TMDs. The treatment options used most frequently by dentists included advice and education, oral appliances, physical agents such as moist heat and medications. The treatment options most frequently used by physiotherapists included manual therapy, exercises, electrophysical agents and advice and education. Referrals were most frequently made to dentists and physiotherapists with experience and/or expertise in managing people with TMDs and to general dentists. Commonly used treatment options were mostly conservative, reversible and evidence-based. More responses are required to draw conclusions representative of Australian dentists and physiotherapists in the management of people with TMDs.

Prescribing benzodiazepines in young adults with anxiety: a qualitative study of GP perspectives.

Incident benzodiazepine prescriptions in primary care for anxiety decreased between 2003 and 2018. However, from 2008, incident prescribing of benzodiazepines for anxiety increased among those aged 18-34 years. There are increasing concerns around prescribing of benzodiazepines. Further, although guidelines state benzodiazepines should only be prescribed short term, in 2017, 44% of incident prescriptions were prescribed for longer than the recommended duration of 2-4 weeks. To understand when and why GPs prescribe benzodiazepines for anxiety in young adults. A qualitative study was undertaken using in-depth interviews with 17 GPs from 10 general practices in South West England. Interviews were conducted by telephone or videocall. A topic guide was used to ensure consistency across interviews. Interviews were audio-recorded, transcribed verbatim, and data analysed using reflexive thematic analysis. GPs described caution in prescribing benzodiazepines for anxiety in young adults, but thought they had an important role in acute situations. GPs described caution in prescribing duration, but some thought longer-term prescriptions could be appropriate. In light of these views, some GPs questioned whether primary care needs to revisit how clinicians are using benzodiazepines. GPs perceived that some young adults requested benzodiazepines and suggested this might be because they wanted quick symptom relief. GPs noted that refusing to prescribe felt uncomfortable and that the number of young adults presenting to general practice, already dependent on benzodiazepines, had increased. Patient-driven factors for prescribing benzodiazepines suggest there are current unmet treatment needs among young adults with anxiety. Given increases in prescribing in this age group, it may be timely to revisit the role of benzodiazepines in the management of people with anxiety in primary care.

Avaliação da qualidade das farmácias comunitárias: uma revisão de escopo

Introduction: Assessing quality in healthcare environments favors decision making with the lowest possible risk and the identification of strengths and weaknesses, leading to the structuring of reliable services. Objective: To synthesize current knowledge and existing literature on assessing the quality of community pharmacies (CF). Methods: This is a scoping review (SR) aligned with the methodology proposed by the JBI Manual for Evidence Synthesis, carried out in four databases, covering the period from 2012 to 2022. Basic qualitative content analysis and descriptive statistics were used. Results: Of the 1,103 documents retrieved, 64 were selected. Quality assessment has been carried out, most of the time, from the patient’s perspective (54.7%), through quantitative studies (62.5%), cross-sectional (59.4%), and using questionnaires developed or adapted by the researchers themselves (51.6%). From the analysis, seven thematic categories and 36 subcategories were identified, highlighting, respectively, “pharmaceutical services” (81.25%) and “dispensing” processes (73.44%); “infrastructure and ambience” (70.3%) and “ambience and accessibility” (54.7%); “user experience and satisfaction” (67.2%) and “evaluation of community pharmacy services” (35.9%). It was observed that the categories of “people management”, “patient safety”, and “storage and disposal of medicines” were less evaluated and not all instruments used addressed all categories. Conclusions: This SR mapped scientific production regarding quality assessment in CF. This study shows the need to develop a standardized instrument encompassing the various evaluative aspects, which were listed based on the categories and subcategories identified in this review, in order to provide a complete overview of CF.

Prevalence of diabetes and hospitalization due to poor glycemic control in people with bladder cancer or renal cell carcinoma in Sweden

BackgroundBladder cancer (BC) and Renal cell carcinoma (RCC) are the most common urogenital cancers among both sexes, with a yearly global incidence of around 500 000 each. Both BC and RCC have been linked to diabetes. Poor glycemic control (malglycemia) is a serious consequence of diabetes and a possible consequence of systemic treatments used in BC and RCC. The objective of this study was to investigate the prevalence of diabetes and use of hospital-based care for malglycemia in people with BC or RCC.MethodsThis Swedish retrospective population-based register study used national health-data registers for longitudinal data on cancer incidence covering 15 years, use of hospital-based health care, and filled prescriptions of outpatient medications. Study endpoints included co-prevalence of diabetes in individuals with BC/RCC, healthcare resource utilization due to malglycemia, use of systemic corticosteroids, and changes in diabetes management for people with concomitant type 2 diabetes.ResultsWe identified 36,620 and 15,581 individuals diagnosed with BC and RCC, respectively, between 2006 and 2019. The proportion of individuals registered with diabetes was 24% in BC and 23% in RCC. An association between BC/RCC and poor glycemic control was found, although the number of malglycemic events in hospital-based care were few (65/59 per 1000 individuals with diabetes and BC/RCC respectively with at least one event). An earlier switch to insulin-based diabetes management was observed in BC/RCC compared to matched individuals with type 2 diabetes but no cancer. The results also indicated an association between steroid treatment and poor glycemic control, and that systemic corticosteroids were more common among people with BC/RCC compared to diabetes controls.ConclusionThe high prevalence of diabetes and increased use of systemic corticosteroid treatment observed in this large national study highlights the need for specific clinical management, risk-assessment, and monitoring of individuals with BC/RCC and diabetes.

Shoulder osteoarthritis: A survey of current (2024) UK physiotherapy practice.

Shoulder osteoarthritis can cause significant pain and disability. It is thought that the wider principles of osteoarthritis management can be applied in the management of people with shoulder osteoarthritis, but most prior research has been conducted with people experiencing osteoarthritis of the hip and knee. There is a paucity of evidence to guide the non-surgical management of shoulder osteoarthritis and limited understanding of current physiotherapy practice. We aimed to investigate the current treatment recommendations by physiotherapists in the UK for people with shoulder OA. An online survey using a clinical vignette was designed and distributed to UK registered physiotherapists with experience of managing people with shoulder osteoarthritis, via social media and professional networks. Descriptive statistics were used to analyse demographic and multiple-choice questions, and free text responses were summarised narratively. 114 respondents accessed the survey with 110 valid responses; 105 (95%) respondents would offer face-to-face consultations, with 89 (81%) respondents expecting to offer 2-4 appointments. 108 (98%) respondents would offer advice/education; 79 (72%) would offer weight management; 82 (75%) prescribed exercises to improve movement; and 101 (92%) offered exercises to increase strength. If a person lived with obesity or had a treatment preference, the majority of respondents would change their recommendations. This is the first survey of NHS physiotherapy practice for people with shoulder osteoarthritis. The responses largely align with NICE guidelines; despite this alignment, it is not known whether such guideline-based care is acceptable to people with shoulder osteoarthritis or clinically effective.

Revolutionizing Care: Unleashing the Potential of Digital Health Technology in Physiotherapy Management for People With Cystic Fibrosis.

This viewpoint paper explores the dynamic intersection of physiotherapy and digital health technologies (DHTs) in enhancing the care of people with cystic fibrosis (CF), in the context of advancements such as highly effective modulator therapies that are enhancing life expectancy and altering physiotherapy needs. The role of DHTs, including telehealth, surveillance, home monitoring, and activity promotion, has expanded, becoming crucial in overcoming geographical barriers and accelerated by the recent pandemic. Physiotherapy, integral to CF care since 1946, has shifted toward patient-centered approaches, emphasizing exercise training and a physically active lifestyle. The reduction in inpatient admissions due to highly effective modulator therapies has led to increased home care and online or electronic consultations, and DHTs have revolutionized service delivery, offering flexibility, self-management, and personalized care options; however, there is a need to comprehensively understand user experiences from both people with CF and physiotherapists. This paper highlights the essential exploration of user experiences to facilitate clinician adaptation to the digital requirements of modern clinical management, ensuring equitable care in the "future hospitals" arena. Identifying research gaps, this paper emphasizes the need for a thorough evaluation of DHT use in CF physiotherapy education, training, and self-monitoring, as well as the experiences of people with CF with online or electronic consultations, self-monitoring, and remote interventions. Online group exercise platforms address historical challenges relating to infection control but necessitate comprehensive evaluations of user experiences and preferences. Future-proofing DHTs within the physiotherapy management of CF demands a shift toward full integration, considering stakeholder opinions and addressing barriers. While DHTs have the potential to extend physiotherapy beyond the hospital, this paper stresses the importance of understanding user experiences, addressing digital poverty, and working toward more equitable health care access. A flexible approach in the "future hospital" is advocated, emphasizing the need for a nuanced understanding of user preferences and experiences to optimize the integration of DHTs in CF care.