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The article, based on the analysis of world and Ukrainian theoretical and methodological sources, identifies the main views of well-known scientific schools, their theoretical foundations and beliefs that self-awareness is a necessary and effective component of the process of self-development of the individual, an internal psychological mechanism for launching effective activity; an opportunity and psychological factor of influence on the processes of self-regulation, a perfect condition for the formation of motivation, self-esteem and quality of communication, psychological attitudes towards the perception and acceptance of people from other ethnic groups. It is noted that the human brain plays a major role in ensuring the purity of thought, beliefs, sensitivity, emotional harmony and understanding of the essence of everyday life. The article presents the understanding of consciousness by different authors, in particular, self-consciousness by researchers of different world scientific schools of philosophical, humanistic, behavioristic, cognitive, social and cognitive orientation, which may compete with each other, have different methodology, but their understanding of consciousness allows us to rethink at the methodological level the problem of forming the self-consciousness of those who teach, educate, rehabilitate, correct and compensate persons with special educational needs. The totalitarian views of students, the roles and functions of teachers who were tasked with forming fear, anxiety, panic, psychological pressure and negative influence on the child's psyche from an early age, so that he or she would think and speak as directed, without having his or her own opinion, are already in the past. This was also the task of specialists who were not allowed, that is, it was not in the trend to make analytical operations, conclusions and generalizations, to present their own opinion, to study the literature that limited their conscious tendency to self-development and self-improvement. In special education, there are few studies of the phenomenon of selfconsciousness of correctional teachers, and almost no research has been conducted on orthopedic teachers. Based on the results of a survey of orthopedic teachers, a new approach to determining the parameters of their professional self-awareness development is proposed. [ABSTRACT FROM AUTHOR]

Copyright of Health Problems of Civilization is the property of Termedia Publishing House and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Orthopedists prefer imaging studies for the diagnosis, treatment, and follow-up of patients.Purpose: To determine the effect of orthopedists' characteristics, including subspecialty, age, education, and professional experience, in collaboration with radiologists and the usefulness of radiology reports for orthopedists in diagnosis and patient management.Material and Methods: Questionnaires, consisting of 21 questions investigating the orthopedists' characteristics, their behavior with radiology reports, their thoughts on communication, and collaboration with radiologists, were distributed to 205 orthopedists. Descriptive analysis was performed, and the effects of orthopedist characteristics on the outcomes was evaluated.Results: In total, 161 out of 205 enrolled participants were included in the analysis. A total of 156 (96.9%) participants stated that they reviewed at least one official radiology report, with MRI receiving the highest rate (92.4%). The main reason provided for not reviewing the radiology reports and requests regarding changes to radiology report formats seemed to be mostly related to time pressure. Despite a significant portion of the participants stating that clinical and surgical findings were inconsistent with radiology reports, less than half were inclined to contact the radiologist most of the time or always. Increasing age (P = 0.005), experience (P = 0.016), and university hospital specialization (P = 0.007) increased the tendency to form multidisciplinary team meetings. Communication with radiologists increased with age (P < 0.001), while more experience reduced the impact of radiology reports on decision-making (P = 0.035).Conclusion: Increasing cooperation between orthopedists and radiologists will make a significant contribution to decision-making and treatment processes. Orthopedists' characteristics are influential factors in establishing this communication. [ABSTRACT FROM AUTHOR]

Abstract Background The introduction of non-VKA oral anticoagulants (NOACs) has changed the landscape of preventing thromboembolism events in many countries. However, the prescription trends of oral anticoagulant (OAC) in China are still unclear, which were evaluated in this study through data extracted and summarized from 5 major cities as representatives. Methods This study was designed as a time-series study which was based on pharmacy prescription data. Analysis was performed on yearly aggregated visits and expenditure. The results were also stratified by indications and specialties. Results A total of 189,006 prescriptions of 67 hospitals in 6 years were included in the study. The average growth rates of overall visit and expenditure of OAC were 15.8 and 57.5%, respectively. The share of warfarin decreased and NOACs had taken 92% of cost, covering 28% of patients in 2017. The more frequently used NOACs were rivaroxaban and dabigatran. The use of OAC was differed by indication and specialty. Conclusion The use of NOACs was found increasing rapidly in both visits and cost, sharing a majority of cost with a minority of patients. Attentions should be paid on the rational use of NOACs.

Background: The perception of major versus minor complications may vary according to surgeons, institutions, and different specialties. Here, we analyzed the geographic distribution of the different types/severities of the most frequent complications in spinal surgery, and assessed how the perception of spine surgeons about postoperative complications differed. Methods: We performed a cross-sectional study using a questionnaire, we developed to encompass different clinical scenarios of surgeons' perceptions of spine surgery complications. The survey involved the members of AOSpine Latin America (LA) (January 28, 2017-March 15, 2017). The main variables studied included: specialty, age, years of experience, country, individual surgeon's perception of different clinical scenarios, and the surgeon's classification of complications for each scenario (e.g., major, minor, or none). Our results from LA were then analyzed and compared to North American (NA) responses. Results: Orthopedic surgeons represented about 58.2% (n = 412) of the 708 questionnaires answered. Of interest, 45.6% (n = 323) of those responding had >10 years of experience. The countries analyzed included Brazil (31.5%), Mexico (17.5%), Argentina (14.4%), Colombia (8.0%), and Venezuela (7.6%). Four of the 11 scenarios showed consensus in the results (e.g., average being over 82.5%). A tendency toward consensus was present in 45.4% of the clinical cases, while two out of 11 clinical cases did not present a consensus among surgeons. Of interest, the perception of complications was similar between cohorts (LA 85% vs. NA 80%). Conclusion: Significant consensus in the perception of complications was observed in most of the analyzed scenarios for both LA and NA. However, within the LA data, responses to different clinical scenarios varied. [ABSTRACT FROM AUTHOR]

Background: The introduction of non-VKA oral anticoagulants (NOACs) has changed the landscape of preventing thromboembolism events in many countries. However, the prescription trends of oral anticoagulant (OAC) in China are still unclear, which were evaluated in this study through data extracted and summarized from 5 major cities as representatives.Methods: This study was designed as a time-series study which was based on pharmacy prescription data. Analysis was performed on yearly aggregated visits and expenditure. The results were also stratified by indications and specialties.Results: A total of 189,006 prescriptions of 67 hospitals in 6 years were included in the study. The average growth rates of overall visit and expenditure of OAC were 15.8 and 57.5%, respectively. The share of warfarin decreased and NOACs had taken 92% of cost, covering 28% of patients in 2017. The more frequently used NOACs were rivaroxaban and dabigatran. The use of OAC was differed by indication and specialty.Conclusion: The use of NOACs was found increasing rapidly in both visits and cost, sharing a majority of cost with a minority of patients. Attentions should be paid on the rational use of NOACs. [ABSTRACT FROM AUTHOR]

The authors proposed using simulants (training models) to practice the methods of tendon suturing during the pedagogical process. During practical classes training model allows orthopedists to master and improve their skills in suturing the ends of the ruptured tendon independently. The existing models for practicing tendon suturing are discussed in details. The description of the simulant is presented. The advisability of its application during thematic practice-oriented classes is justified.

Context: Osteoarthritis (OA) is a degenerative disorder characterized by pain, stiffness, and loss of mobility of the joint. As the most prevalent form of arthritis and a leading cause of impairment, it is imperative to understand the treating doctor's perception of pain relief among these patients. Objectives: To assess orthopedists' perspectives on pain management in OA. Materials and Methods: In this qualitative study, a guide-based interview was conducted on 15 orthopedists of a tertiary care hospital and audio-recorded simultaneously. A grounded theory approach was adopted for data transcription with an inductive approach for thematic manual analysis. Results: Five themes emerged - (1) quality of life: OA produces significant disease burden causing severe impairment; (2) pain management: although patients usually demand immediate pain relief, a multipronged approach to treatment emphasizing on physiotherapy and surgery rather than analgesics is needed. Most participants preferred individual discretion while others felt the need for systematizing pain management; (3) precautions/side effects of treatment: paracetamol is often prescribed due to its better benefit - adversity profile as compared to nonsteroidal anti-inflammatory drugs and weakopioids; (4) barriers: participants expressed several barriers to optimal pain management; (5) counseling: Participants concurred that counseling would improve patients' quality of life. Conclusions: Participants agreed that OA being associated with debilitating pain and impairment requires optimal pain management for improving patients' quality of life. As crucial as counseling is, it is often compromised due to the large outpatient load. The doctors concurred that a multi-disciplinary team approach is needed to integrate and optimize pain management in OA. [ABSTRACT FROM AUTHOR]

Background: There have been several reports concerning the survival time after symptom onset in patients with amyotrophic lateral sclerosis (ALS). However, little is known about how the choice of physician (i.e., general practitioner, neurologist, etc.) may affect the time it takes for a diagnosis of ALS to be made. Methods: We conducted a retrospective study, covering a 20-year period, comparing the type of physician first consulted by an ALS patient at the time of initial symptoms and the amount of time that elapsed to the final diagnosis of ALS. A total of 202 patients were diagnosed and stratified according to the onset of ALS symptoms (bulbar onset [BO] and limb onset [LO]). We noted the type of physician first seen by the patient. The diagnostic interval was calculated as the time between onset of symptoms and the final diagnosis of ALS. Results: A total of 202 ALS patients were examined. Clinical BO and LO was observed in 78 (36.6%) and in 124 (61.4%) of these patients, respectively. The type of physician examining these patients at the first symptoms of disease was as follows (BO and LO): neurologist (38.5% and 25.8%), general practitioner (14.1% and 35.5%), orthopedist (12.8% and 35.5%), otolaryngologist (15.4% and 0%), and neurosurgeon (14.1% and 3.2%). Mean diagnostic interval (standard deviation) for patients with either set of symptoms was 13.1 (6.5) months; the diagnostic interval of patients with BO and LO was 9.2 (4.5) and 15.2 (7.7) months, respectively. ALS diagnosis in LO patients was delayed by more than 10 months when the patient first consulted an orthopedist rather than a neurologist. Conclusion: More than 50% of the ALS patients included in this study did not visit a neurologist at the first symptoms of disease onset. The diagnosis of ALS was prolonged in LO patients visiting an orthopedist. We speculate that this increase in the diagnostic interval in LO patients visiting an orthopedist was due to a lack of bulbar symptoms in the early stages of this disease. [ABSTRACT FROM AUTHOR]

The treatment of rheumatoid arthritis (RA) has improved dramatically with the advent of the latest generation of disease-modifying antirheumatic drugs. Despite these advances, in some patients inflammation is not diminished sufficiently to prevent irreversible musculoskeletal damage, thereby necessitating surgical intervention to reduce pain and improve function. For RA treatment, Japanese orthopedic surgeons also prescribe medication. In this study, we examined whether this Japanese system is effective for RA treatment. We analyzed the clinical condition of RA patients treated by rheumatologists and those treated by orthopedists in a linked registry study using information from a large observational cohort of RA patients followed every half year from 2000 to 2010 (the IORRA cohort). Two groups of patients were compared: patients treated by rheumatologists (rheumatologic group) and patients treated by orthopedists (orthopedic group). The results revealed that patients in the orthopedic group were older, more likely to be female, and had a longer disease duration than patients in the rheumatologic group. The proportion of patients with a history of joint surgery was also much higher in the orthopedic group than in the rheumatologic group. The average scores on the Japanese version of the Health Assessment Questionnaire, and the remission ratio determined using a Boolean-based definition gradually increased from 2000 until 2010, and these findings were consistently better in the rheumatologic group than in the orthopedic group. These data suggest that patients treated primarily by orthopedists are more likely to have long-standing RA compared to patients treated by rheumatologists. Therefore, it is critical for rheumatologists and orthopedists to complement each other medically in the treatment of RA patients. [ABSTRACT FROM AUTHOR]

Background: Tibial shaft fractures are the most frequent among long bone fractures. They are described in the literature according to the device and method of treatment, with recommendations that range from full weight bearing to non-weight bearing restrictions. There are studies comparing osteosynthesis devices and surgical aspects, but no references were found on how or when to allow weight bearing on the affected limb in the standing position. Objectives: The present study learned from Brazilian orthopedists which methods of osteosynthesis they use to treat open tibial fractures, whether they refer patients to physical therapy, when and why they allow partial weight bearing for both physical activity and therapy. Methods: Two hundred and thirty-five orthopedists answered a questionnaire during the 14th Brazilian Conference of Orthopedic Trauma. Results: The results showed that, in Brazil, the most widely used osteosynthesis device is the external fixator, but earlier weight bearing while standing occurs when intramedullary nails are used. Most orthopedists refer patients to physical therapy and allow partial weight bearing in the standing position according to the material used for synthesis. Conclusions: It was concluded that there is a preference for external fixation, that most orthopedists refer patients to physical therapy and that the synthesis material influences restrictions on partial weight bearing. [ABSTRACT FROM AUTHOR]

The article reports on the study on the correlation between the number of patients visiting judo therapist and those visiting physicians for musculoskeletal diseases in Japan. The study does not find a negative correlation between the number of patients who visited judo therapist and the number of patients with musculoskeletal disease who visited physicians. It adds that the result does not support the claims of orthopedists regarding competition for patients.

Background: Judo therapy is a unique and long-established Japanese comedical profession, specialized in manually treating fractures and sprains in practitioners' offices. Having the overlapped scopes of services between judo therapists and orthopedists, disputes between the 2 have gradually emerged recently. Objective: To examine the relationship between judo therapists and orthopedists by comparing their geographic distributions at the whole country level and at prefecture level. Study Design: Cross-sectional study. Methods: The numbers of judo therapist facilities and orthopedists per 100000 population in each municipality were obtained through web yellow pages and from the Japanese census data. Lorenz curves and Gini indices were calculated to show the distributions and to compare the numbers of judo therapist facilities and orthopedists per 100000 population. Results: The median number of judo therapist facilities per 100000 population in all municipalities was 12.0 (range 0–135) and that for orthopedists was 4.3 (0–186). The Gini indices of the nationwide judo therapist facilities and those for orthopedists were 0.29 and 0.36, respectively. Conclusion: These data show the relatively homogeneous distribution of judo therapist facilities compared with orthopedists. In smaller municipalities, judo therapist facilities may fill in the absence of orthopedists. As for lager municipalities, further study is needed to examine whether the relationships between them are competitive or complementary. [ABSTRACT FROM AUTHOR]

Copyright of Manuelle Medizin is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: To evaluate social media usage of orthopaedic patients to search for solutions to their health problems., Methods: The study data were collected using face-to-face questionnaire with randomly selected 1890 patients aged over 18 years who had been admitted to the orthopaedic clinics in different cities and provinces across Turkey. The questionnaire consists of a total of 16 questions pertaining to internet and social media usage and demographics of patients, patients' choice of institution for treatment, patient complaints on admission, online hospital and physician ratings, communication between the patient and the physician and its effects., Results: It was found that 34.2% ( n = 647) of the participants consulted with an orthopaedist using the internet and 48.7% ( n = 315) of them preferred websites that allow users to ask questions to a physician. Of all question-askers, 48.5% ( n = 314) reported having found the answers helpful. Based on the educational level of the participants, there was a highly significant difference between the rates of asking questions to an orthopaedist using the internet ( P = 0.001). The rate of question-asking was significantly lower in patients with an elementary education than that in those with secondary, high school and undergraduate education ( P = 0.001) The rate of reporting that the answers given was helpful was significantly higher in participants with an undergraduate degree compared to those who were illiterate, those with primary, elementary or high school education ( P = 0.001). It was also found that the usage of the internet for health problems was higher among managers-qualified participants than unemployed-housewives, officers, workers-intermediate staff ( P < 0.05)., Conclusion: We concluded that patients have been increasingly using the internet and social media to select a specific physician or to seek solution to their health problems in an effective way. Even though the internet and social media offer beneficial effects for physicians or patients, there is still much obscurity regarding their harms and further studies are warranted for necessary arrangements to be made., Competing Interests: Conflict-of-interest statement: There are no conflicts of interest.