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Promoting Sports Practice in Persons with Hemophilia: A Survey of Clinicians' Perspective.

ABSTRACT: Historically, people with hemophilia have been warned to avoid physical activities as a possible cause of bleeding; however, currently, sport is considered necessary, especially in the developmental age, for providing a good quality of life. A survey was proposed to a group of hematologists and sports physicians working in Puglia, Italy, to explore their approach to physical activities for their patients with hemophilia and to obtain suggestions about possible interventions to promote the access of patients to sports. The survey was answered by 6 hematologists and 15 sports physicians. In total, 71% (about six patients/year/physician) of patients with hemophilia seen by sports physicians asked for counseling about sports, and 67% (about five patients/year/physician) actually practiced sports. On the other hand, only 31% (about 16 patients/year/hematologist) of patients asked hematologists questions on sports, and only 16% (about seven patients/year/hematologist) of patients with hemophilia and that were followed-up by hematologists practiced sports. The sports most often recommended to patients with hemophilia by physicians included swimming, athletics, tennis, running and gymnastics. According to hematologists, physical activity was very efficient in improving the quality of life of patients; stability of joints; their psychological, social and musculoskeletal wellbeing; and in reducing the risk of bleedings. On the other hand, physical activity was considered less important in all these areas by sport physicians. In conclusion, answers to this survey suggested that sports could be promoted among hemophilic patients by increasing the sports physicians' knowledge about hemophilia and their special role in this area. In addition, interviewed clinicians were of the opinion that increased awareness of specific guidelines and clinical practice protocols among both hematologists and sports physicians could be beneficial. Finally, answers suggested that access to fitness certification should be facilitated.

SUBMITTER: Lassandro G

PROVIDER: S-EPMC8625842 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BACKGROUND:Chest radiographs are taken daily as a part of routine investigations in Intensive care unit (ICU) patients. They are less effective and unlikely to alter the management of the majority of these patients compared to the radiographs obtained when indicated. According to the American College of Radiology (ACR) Appropriateness criteria, only selective ordering of chest radiographs is recommended, including elderly or high risk patients. The aim of this study was to identify and assess the clinician's perspective in abandoning the current practice of daily routine chest radiograph and replacing with the on-demand radiograph in Saudi hospitals. METHODS:This was a cross-sectional study. A valid self-administered questionnaire was distributed to all clinical staff members working in ICUs in the major tertiary hospitals in Saudi Arabia. The study population was primarily the ICU intensivists (physicians), nurses and respiratory therapists (RT). The data collected were statistically processed using SPSS version 20.0; descriptive and inferential analyses were done. RESULTS:Out of 730 questionnaires sent, we received only 495 completed questionnaires with a response rate of 67.8%. Majority of them (n?=?351) are working at academic hospitals. About half of the respondents (n?=?247) are working in an open-format ICUs. Findings showed that the daily routine chest X-ray was performed in almost 96.8% of ICUs patients, which the majority of the clinical staff members (73%) thought that this current daily routine CXR protocol in the ICUs should be replaced with the on-demand CXR policy. Interestingly, the differences in demographic and work-related characteristics had no significant impact on the clinician's view and supported moving to on-demand CXR policy and practice. CONCLUSIONS:The daily routine CXR is still a common practice in most of the Saudi hospitals ICUs although enough empirical evidence shows that it can be avoided. We observed that intensivists support the change of the current practice and recommend an on-demand CXR policy likely to be followed in intensive care management.

Project description:Global warming caused by carbon emissions has been recognized as a challenge to human sustainable development, and low-carbon city development is widely considered as an effective strategy to address this challenge. Numerous emission reduction measures have been implemented, and considerable efforts have been devoted in promoting low-carbon city. This paper examines whether sufficient efforts have been paid to these typical emission sectors, including Building, Industry, Energy Transformation, and Transportation by referring to the shared responsibility of each sector. The shared responsibility of individual emission sector is calculated by applying energy consumption data in 2014 World Energy Balance. The efforts contributed in emission reduction by each sector are examined by analyzing the low-carbon city work plans of 24 representative sample cities, which are selected globally. The research results demonstrate that sufficient emission reduction efforts have been paid in the Building sector and Transportation sector. But the Industry sector and Energy Transformation sector are less-attended in addressing emission reduction. The reason for the sufficient efforts paid in the Building sector and Transportation sector is considered as that the efforts for emission reduction in these two sectors can bring more co-benefits. However, emission reduction in Industrial sector is generally considered to have the effects of holding back economic growth, and the emission reduction in the sector of Energy Transformation will need enormous investment for advanced technologies. Policy for emission reduction in the Industry sector and Energy Transformation sector is indispensable to promote low-carbon city. This study appeals that (1) low-carbon city can be effectively implemented only if carbon reduction policy is adopted to all industrial activities; (2) multiple channels of financial resources should be established to support cities to mitigate carbon emissions in Industry sector; (3) cooperation on the development of clean energy technology between cities should be promoted; and (4) efforts should be paid to reduce carbon emission from using traditional energy transformation equipment by improving their efficiency.

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Promoting Sports Practice in Persons with Hemophilia: A Survey of Clinicians' Perspective.

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