I began my volunteering career working with fellow college and university students – as a student – in building advocacy groups, networks and activities to end violence on college campuses. My professional experience entails working with – in prior roles – survivors of domestic and sexual violence. (For kids ages 2 to 7 only)įocuses on teaching kids to become responsible, respectful and resourceful members of their communities by helping them feel a sense of connection (belonging and significance), parents being kind and firm at the same time to build mutual respect (considers what the child is thinking, feeling, learning, and deciding about themselves and their world). A didactic approach to working with families where parents are initially taught relationship enhancement and discipline skills that they practice in session and at home with their child. Use of encouragement, address feelings of insecurity, develop feelings of connectedness, redirect striving for significance into more socially beneficial directions, challenge mistaken assumptions/attitudes/behaviors/feelings about self and the world, increase confidence, increase desire and ability to cooperate, replace exaggerated self-protection with courageous social contribution.Īn evidence-based training for parents and treatment for young children with emotional and behavioral disorders with a focus on improving the quality of the parent-child relationship and changing parent-child interaction patterns. All rights reserved.I love seeing people of all ages adults, kids, couples and families. Hip arthroplasty hip osteoarthritis knee arthroplasty knee osteoarthritis nonoperative treatment physical therapy.Ĭopyright © 2020 Elsevier Inc. Patients with hip OA and those with severe radiographic changes are more likely to require surgery and should not be delayed if there is not an adequate response to conservative measures. More than 50% of the patients referred to secondary care with mild-moderate knee OA may not need surgery at 7 years. Factors associated with increased likelihood of surgery were joint affected (hip, hazard ratio 2.80), Kellgren-Lawrence (KL) grade (KL 3, HR 2.02 KL 4, 4.79), and Oxford Hip/Knee Score (HR 1.34 for each 5 points worse at baseline). ![]() ![]() The 7-year surgery-free survival for hip OA was 23.7% and knee OA 55.9% (P <. Patients with hip OA were more likely to have required surgery (111/151, 74%) than patients with knee OA (77/186, 41%) (chi-square = 33.6, P <. Kaplan-Meier survival curves were used to determine survivorship of the affected joint and Cox regression used to determine factors associated with time to surgery.Īt mean 6-year follow up, 188 (56%) patients had undergone or were awaiting total joint arthroplasty, 127 (38%) were still being managed nonoperatively, and 22 (7%) had died without having surgery. This is an observational cohort study of 337 patients with hip (n = 151, 45%) or knee OA (n = 186, 55%) seen at the Joint Clinic, at 5-7 years of follow-up. The purpose of this study is to determine outcomes of a nonoperative treatment service for hip and knee osteoarthritis (OA), the "Joint Clinic," at minimum 5-year follow-up, and investigate factors that may influence progression to joint replacement surgery.
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