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Decision-support tool for telephone triage — the Canadian experience

-969. doi: 10.1136/bmj.326.7396.966 5. Wheeler, S. Telephone Triage Nursing: Roles, Tools and Rules, 2009. Retrieved April 2014 from: http://www.nursingceu.com/courses/290/index_nceu.html

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Self-harm - an overview of the tools used to assess non-suicidal self-harming behaviors

and In-tentional Self-Injury Psychological Assessment, American Psychological Association, 2006, Vol. 18, No. 3, 303–312 36. Nock M. K., Holmberg E. B., Photos V. I., Michel B. D. Self-Injurious Thoughts and Behaviors Interview: Development, Reliability, and Validity in an Adolescent Sample Psychological Assessment, American Psychological Association, 2007, Vol. 19, No. 3, 309 –317 37. Juzwin K. An Assessment Tool for Self-Injury: The Self-Injury Self-Report Inventory (SISRI). W J. Levitt, R. Sansone, L. Cohn (red.) Self-Harm Behavior and Eating

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Perceived confidence for injury self‑management increases for young men with mild haemophilia with the use of the mobile app HIRT?

-6. 20. Smartphone definition, https://en.oxforddictionaries.com/definition/smartphone, accessed 15 Jan 2017. 21. Nilson J, Mulder K, Schachter C. A new self-assessment pathway tool for young men with mild hemophilia A and B who experience musculoskeletal bleeds. Haemophilia 2012; 18 (suppl. 3): 106. 22. Canadian Wireless Technology Association. CWTA, Facts and Figures, 2015. Available from: http://www.cwta.ca/factsfigures/ (accessed 17 October 2015). 23. Future in Focus: Digital Canada. (2015). Available from: http

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Joint assessment in haemophilia – current physiotherapist practice in the UK

Abstract

Aim: UK guidelines recommend regular assessment of joint status in children with haemophilia using a standardised tool performed by haemophilia physiotherapists. We surveyed UK physiotherapists working in haemophilia care regarding their current practice with respect to joint scoring. Methods: A survey was posted on SurveyMonkey and all haemophilia physiotherapists practising in the UK were invited to respond. Responses were analysed and discussed at a roundtable meeting attended by invited physiotherapists and specialist haemophilia nurses. Results: In all, responses were received from 29 of the estimated 37 physiotherapists in the UK who see haemophilia patients. Both the survey and subsequent discussion reflected agreement that joint scoring offers a valuable tool to clinicians, but that better ways of assessing joint health were needed. There was enthusiasm for combining joint scoring with systematic and validated patient-reported outcome measures. Conclusion: Greater understanding is needed of the relationship between joint scores and measures of physical function and quality of life.

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US haemophilia centre nurses and advanced practice providers: Demographics, roles/responsibilities, training, educational barriers and employment benefits

Abstract

Introduction: As the focus on personalised treatment is refined, more products are brought to market and the life expectancy of persons with haemophilia increases, there will be an expanded need of experienced and expert healthcare providers to ensure optimal patient outcomes. Aim: This survey describes the demographics, roles/ responsibilities, practice patterns, educational opportunities/barriers and employment benefits of nurses and advanced practices providers (APPs), including advanced practice registered nurses (APRNs) and physician assistants (PAs) employed by haemophilia treatment centres (HTCs) across the United States. Methods: This one-time convenience online survey was approved by the Munson Medical Center Institutional Review Board. A survey of this type had never been attempted in the HTC nursing community; therefore. there was no opportunity to utilise a previous tool. Data was analysed using statistical tools through SurveyMonkey. Results: Gaps were identified in provider age distribution, research opportunities, and standardised educational opportunities for APPs. An aging but highly educated HTC nursing population is revealed: over 50% of respondents were over the age of 50; the majority held at least a baccalaureate degree and almost half had national board certification; most were experienced in healthcare but newer to the field of bleeding disorders. Conclusion: Development of an APP fellowship program would standardise the care and treatment of those with bleeding and clotting disorders across the United States. This fellowship should include a didactic portion, advocacy within the community, mentorship with experienced APPs and regular webinar-based case studies to review current trends in care. This survey is a call to action to begin standardised education programs for the advanced practice role.

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Management of an uncommon form of type 2M VWD: a single centre experience

Abstract

We report a single centre’s experience of the diagnosis and management of an uncommon form of type 2 von Willebrand disease (VWD) in members of two unrelated families. The affected patients presented with mild to moderate bleeding phenotypes and accompanying MCMDM-1 VWD bleeding assessment tool scores of 5 or less. Genetic analysis in both families confirmed a missense mutation in exon 30 of the von Willebrand factor (VWF) gene, a single base substitution T>A at nucleotide 5282 which led to change at codon 1761 from methionine to lysine (M1761K). This mutation lies within the A3 domain of the VWF protein, a region that is important for collagen binding. All affected patients were found to have normal coagulation profiles, normal VWF multimers and normal VWF assays except the VWF collagen-binding (VWF: CB) assay levels, which were significantly reduced. Desmopressin effected a good response in all treated patients, with a 3- to 5-fold rise of VWF:CB levels. However, there was variability in the degree to which VWF:CB levels remained elevated. Surgical procedures, including the delivery of one patient, were able to be managed with either desmopressin and/or tranexamic acid alone, with little need for recourse to VWF factor concentrate therapy.

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Multiple joint procedures in haemophilia: benefit of self-reported activities

Abstract

This paper presents a long-term follow-up (mean 6 years) of three cases, providing insight into individual changes in self-reported activities of persons with haemophilia (PWH) who underwent multiple joint procedures (MJP). The procedures include one bilateral ankle pan arthrodesis by means of an ankle arthrodesis nail (case 1) and two times bilateral total knee arthroplasty (TKA), both type Genesis II (cases 2 and 3). MJP are defined as any combination of total hip arthroplasty (THA), total knee arthroplasty (TKA) and ankle arthrodesis (AA) during one hospital admission (one session or staged). The results of MJP need meticulous long-term follow-up, including tools with the capacity to provide detailed measurements for levels of activity. Measurements performed before and after surgery included active range of motion (AROM), the Hemophilia Activities List (HAL) sub-scores for basic and complex lower extremity and the McMaster Toronto Arthritis patient disability questionnaire (MACTAR). Pain scores were only available post-surgery and were by means of a visual analogue scale (VAS), 0 indicating no pain and 10 maximum pain. Post-operative VAS scores were 0.3 on average (range 0-1), indicating only minimal pain. Pre-operative pain was the actual indication for MJP. However, it was measured with a different score, the WFH score. Regarding post-operative AROM, case 1 showed a decreased ankle plantar flexion averaging 15˚ (range 10-20˚) and dorsiflexion averaging 7.5˚ (range 5-10˚), results expected after surgical fixation of the tibiotalar joint. Cases 2 and 3 showed an increased active flexion of both knee joints, on average 6° (range 5-10˚), and extension of 11° (range 0-20˚). From these two cases the HAL showed improvement in both basic (Δ 40 and Δ 30) and complex lower extremity (Δ 40 and Δ 3,5) activities. When considering the standard deviations of the HAL normalised total score of 18, it can be appreciated that these improvements are clinically relevant (effect size Δ 1). The MACTAR showed individual progress, with emphasis on walking, standing, riding a bicycle and walking stairs. These MJP cases provide insight on the benefits of self-reported activities, as well as the relationship between body and activity of the ICF. For the long-term follow-up of this very specific population, self-reported activities should be included.

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Does a patient’s personality style impact health outcomes?

;37(2):309-25. 4. Losa Iglesias ME, Becerro de Bengoa Vallejo R. Conflict resolution styles in the nursing profession. Contemp Nurse 2012;43:73-80. 5. Kilmann R. Conflict management and change management case study with the TKI tool [video]. 2014. Available from: http://youtu.be/Tnf1OKoGSys (accessed 21 April 2016). 6. Whitworth BS. (2008), Is there a relationship between personality type and preferred conflict-handling styles? An exploratory study of registered nurses in southern Mississippi. J Nurs Manag 2008;16:921-32. doi: 10.1111/j.1365

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Transforming Transition: enhancing practice in haemophilia

/Quality-statements (accessed 19 October 2018). 8. Revans RW. ABC of action learning. London: Routledge, 2011. 9. NHS Improvement. Quality, service improvement and redesign (QSIR) tools. 2018. Available at https://improvement.nhs.uk/resources/quality-service-improvement-and-redesign-qsir-tools/ (accessed 19 October 2018). 10. Lave J, Wegner E. Situated learning: legitimate peripheral participation (Learning in doing: social, cognitive and computational perspectives). Cambridge University Press, 1991. 11. Lewin K. Action research

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Who should care for people with bleeding disorders?

://www.cysticfibrosisdata.org/ReportsUS.html (accessed 14 November 2016). 9. Hay C. The UK haemophilia database: a tool for research audit and healthcare planning. Haemophilia 2004; 10: 21-25. 10. Makris M, Calizzani G, Fischer K, et al. EUHASS: The European Haemophilia Safety Surveillance system. Thromb Res 2011; 127 (Suppl. 2): 22-25. 11. Astermark J. Inhibitor development: patient-determined risk factors. Haemophilia 2010; 16(102): 66-70. 12. Chambost H. Assessing risk factors prevention of inhibitors in haemophilia. Haemophilia 2010; 16 (Suppl. 2

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