Irish journal of medical science
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Following the declaration by the World Health Organization (WHO) of the Covid-19 pandemic on March 11, 2020, health organisations and staff have had to adapt and restructure services in order to respond to this global health emergency. Numerous containment strategies have been, and continue to be, introduced in this rapidly evolving and fluid situation with a significant shift towards virtual or remote patient assessment. The concept of virtual patient evaluation has previously been adopted across a range of medical and surgical specialities yielding safe and efficient pathways associated with good Patient Reported Outcome Measures (PROMs) and patient satisfaction rates. Whilst the idea of virtual patient review may be perceived as counterintuitive to the basic foundations and principles of face-to-face clinical practice, the current global pandemic, now more than ever, highlights the importance, need and benefits of this care model.
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Musculoskeletal pain is commonly described in surgeons. Research suggests that 21-60% of at-risk physicians may experience significant work-related pain in their back, shoulders, neck or upper extremity and the consequences of this may impact negatively on patient care. Laparoscopic surgery in particular has become increasingly associated with musculoskeletal pain, especially in the cervical spine. Due to a number of constraints, however, it is difficult to evaluate musculoskeletal movement (particularly cervical spine motion) in the operating room environment. ⋯ Based on our results, we believe that laparoscopic surgery requires more prolonged periods of static neck posture when compared with open surgery. This difference may assist in understanding the contributing factors for musculoskeletal (in particular cervical) pain encountered in minimally invasive surgeons. Further investigation of static posture in the operating surgeon is warranted.
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Slaintecare, the Irish government's plan for the coming decade, relies heavily on integrated, team-based care in the community to achieve its goals. General practice nursing is a key component of that care, both now and in the future, but little is known about the experience and views of those providing this service. This preliminary study is part of a wider national project on teamworking in primary care. ⋯ Practice nursing contributes extensively to general practice, and an expansion of the role is advocated by PNs and practices.
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Despite its clinical utility, progressive reliance on imaging technology can lead to devaluing the physical examination in patients with chronic pain. The primary objective of this study was to determine whether chronic pain patients have a positive or negative perception of the physical examination. ⋯ Patients with chronic pain indicate that the physical examination is a highly positive aspect of their care. There are some negative aspects of been examined which physicians should be aware of. This study adds to our knowledge regarding the physical exam in chronic pain patients. It will inform practice and training.