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Behavioural medicine

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https://www.readbyqxmd.com/read/28730671/many-faces-of-rationality-implications-of-the-great-rationality-debate-for-clinical-decision-making
#1
Benjamin Djulbegovic, Shira Elqayam
Given that more than 30% of healthcare costs are wasted on inappropriate care, suboptimal care is increasingly connected to the quality of medical decisions. It has been argued that personal decisions are the leading cause of death, and 80% of healthcare expenditures result from physicians' decisions. Therefore, improving healthcare necessitates improving medical decisions, ie, making decisions (more) rational. Drawing on writings from The Great Rationality Debate from the fields of philosophy, economics, and psychology, we identify core ingredients of rationality commonly encountered across various theoretical models...
July 20, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28726526/integrated-care-coordination-by-an-interprofessional-team-reduces-emergency-department-visits-and-hospitalisations-at-an-academic-health-centre
#2
Anne H Gaglioti, Patrick Barlow, Kate DuChene Thoma, George R Bergus
People with chronic behavioural and physical health conditions have higher healthcare costs and mortality rates than patients with chronic physical conditions alone. As a result, there has been promotion of integrated care for this group. It is important to train primary care residents to practice in integrated models of care with interprofessional teams and to evaluate the effectiveness of integrated care models to promote high-quality care for this at-risk group. We implemented an integrated, interprofessional care management programme for adults with chronic mental and physical health needs as part of a curriculum for family medicine and family medicine psychiatry residents...
July 20, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28718732/molecular-imaging-a-way-forward-in-translating-disease-behaviour-in-an-era-of-personalized-medicine
#3
A S Fathinul Fikri
No abstract text is available yet for this article.
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28710713/a-consensus-for-the-development-of-a-vector-model-to-assess-clinical-complexity
#4
Gino Roberto Corazza, Catherine Klersy, Pietro Formagnana, Marco Vincenzo Lenti, Donatella Padula
The progressive rise in multimorbidity has made management of complex patients one of the most topical and challenging issues in medicine, both in clinical practice and for healthcare organizations. To make this easier, a score of clinical complexity (CC) would be useful. A vector model to evaluate biological and extra-biological (socio-economic, cultural, behavioural, environmental) domains of CC was proposed a few years ago. However, given that the variables that grade each domain had never been defined, this model has never been used in clinical practice...
July 14, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28710228/longitudinal-qualitative-study-describing-family-physicians-experiences-with-attempting-to-integrate-physical-activity-prescriptions-in-their-practice-it-s-not-easy-to-change-habits
#5
Mathieu Bélanger, Emily Wolfe Phillips, Connor O'Rielly, Bertin Mallet, Shane Aubé, Marylène Doucet, Jonathan Couturier, Maxime Mallet, Jessica Martin, Christine Gaudet, Nathalie Murphy, Jennifer Brunet
OBJECTIVE: Physical activity (PA) prescriptions provided by family physicians can promote PA participation among patients, but few physicians regularly write PA prescriptions. The objective of this study was to describe family physicians' experiences of trying to implement written PA prescriptions into their practice. DESIGN: Longitudinal qualitative study where participants were interviewed four times during a 12-month period. After the first interview, they were provided with PA prescription pads...
July 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28710209/does-a-one-day-workshop-improve-clinical-faculty-s-comfort-and-behaviour-in-practising-and-teaching-evidence-based-medicine-a-canadian-mixed-methods-study
#6
David Allen, Jacques Abourbih, Marion Maar, Lisa Boesch, James Goertzen, Catherine Cervin
OBJECTIVE: The purpose of this study was to determine the impact of a 1-day evidence-based medicine (EBM) workshop on physician attitudes and behaviours around teaching and practicing EBM. DESIGN: A mixed methods study using a before/after cohort. SETTING: A medical school delivering continuing professional development to 1250 clinical faculty over a large geographic area in Canada. PARTICIPANTS: 105 physician clinical faculty members...
July 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28704621/making-sense-of-low-back-pain-and-pain-related-fear
#7
Samantha Bunzli, Anne Smith, Robert Schütze, Ivan Lin, Peter O'Sullivan
Synopsis Pain-related fear is implicated in the transition from acute to chronic low back pain and the persistence of disabling low back pain, making it a key target for physiotherapy intervention. The current understanding of pain-related fear is that it is a psychopathological problem where people who catastrophise about the meaning of pain become trapped in a vicious cycle of avoidance behaviour, pain and disability, as recognised in the Fear Avoidance Model. However there is evidence that pain-related fear can also be seen as a common sense response to deal with low back pain, for example, when one is told that their back is vulnerable, degenerating or damaged...
July 13, 2017: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/28701460/clinician-self-efficacy-in-initiating-discussions-about-gestational-weight-gain
#8
Helena Piccinini-Vallis
OBJECTIVE: To compare prenatal care providers' perceived self-efficacy in starting discussions about gestational weight gain with pregnant women under a variety of conditions of gradated difficulty, when weight gain has been in excess of current guidelines. DESIGN: A 42-item online questionnaire related to the known barriers to and facilitators of having discussions about gestational weight gain. SETTING: Canada. PARTICIPANTS: Prenatal care providers were contacted through the Family Medicine Maternity Care list server of the College of Family Physicians of Canada...
July 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28700715/the-pharmacological-and-non-pharmacological-treatment-of-attention-deficit-hyperactivity-disorder-in-children-and-adolescents-a-systematic-review-with-network-meta-analyses-of-randomised-trials
#9
Ferrán Catalá-López, Brian Hutton, Amparo Núñez-Beltrán, Matthew J Page, Manuel Ridao, Diego Macías Saint-Gerons, Miguel A Catalá, Rafael Tabarés-Seisdedos, David Moher
BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is one of the most commonly diagnosed psychiatric disorders in childhood. A wide variety of treatments have been used for the management of ADHD. We aimed to compare the efficacy and safety of pharmacological, psychological and complementary and alternative medicine interventions for the treatment of ADHD in children and adolescents. METHODS AND FINDINGS: We performed a systematic review with network meta-analyses...
2017: PloS One
https://www.readbyqxmd.com/read/28693591/aphrodisiac-potentials-of-the-ethanol-extract-of-aloe-barbadensis-mill-root-in-male-wistar-rats
#10
Joseph O Erhabor, MacDonald Idu
BACKGROUND: Aloe barbadensis (AB) is a short stemmed succulent medicinal herb that is being used by locals in Nigeria to enhance libido. Therefore this study evaluates the aphrodisiac potential and acute toxicological effect of A. barbadensis (AB) root in male Wistar rats. METHODS: Aphrodisiac potential was determined following the oral administration of graded doses (100, 200 and 400 mg/kg) of ethanol extract of A. barbadensis root. Sildenafil citrate (Viagra) and distilled water served as positive and negative controls respectively...
July 11, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/28691476/genetic-effects-of-vicryl%C3%A2-on-fibroblast-primary-culture
#11
A Baj, G A Beltramini, M Romano, D Lauritano, R M Gaudio, A Palmieri, F Cura, A B Giannì
Vicryl® (polyglactin 910) is an absorbable, synthetic, usually braided suture, indicated for soft tissue approximation and ligation. Vicryl® has a special coating for minimizing friction, easing passage through tissue and easy knot tie down. It is synthetic for minimal tissue reaction. Fibroblasts are the main cells of connective tissue that synthesize extracellular matrix. In this work, we tried to judge the action of Vicryl® on fibroblasts behaviour. We evaluated the expression levels of some adhesion and traction-resistance related genes (ELN, DSP, FN1, FBN1, ITGB1, ITGA1, ITGA5, ITGA2, COL1A1, COL3A1) by using real time Reverse Transcription-Polymerase Chain Reaction (real time RT-PCR)...
April 2017: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/28690885/cancer-research-in-the-arab-world-a-review-of-publications-from-seven-countries-between-2000-2013
#12
REVIEW
Randah R Hamadeh, Saif M Borgan, Abla M Sibai
This review aimed to examine trends in cancer research in the Arab world and identify existing research gaps. A search of the MEDLINE® database (National Library of Medicine, Bethesda, Maryland, USA) was undertaken for all cancer-related publications published between January 2000 and December 2013 from seven countries, including Bahrain, Kuwait, Iraq, Lebanon, Morocco, Palestine and Sudan. A total of 1,773 articles were identified, with a significant increase in yearly publications over time (P <0.005)...
May 2017: Sultan Qaboos University Medical Journal
https://www.readbyqxmd.com/read/28683579/communication-disability-in-fiji-community-self-help-and-help-seeking-support
#13
Suzanne C Hopf, Sharynne McLeod, Sarah H McDonagh, Cen Wang, Epenisa N Rakanace
PURPOSE: To understand how a Fijian community supports people with communication disability (PWCD) and whether their support is associated with participant demographics. METHOD: Thematic analysis of 144 questionnaires that asked about participants' actions to support a fictional child and adult with communication disability. RESULT: Participant responses fell into two categories: what they would do directly (self-help) and people and places where they would seek assistance (help-seeking)...
July 7, 2017: International Journal of Speech-language Pathology
https://www.readbyqxmd.com/read/28675195/how-to-deal-with-violent-and-aggressive-patients-in-acute-medical-settings
#14
R H Harwood
Dealing with violence and aggression is an area where health professionals often feel uncertain. Standing at the interface between medicine, psychiatry and law, the best actions may not be clear, and guidelines neither consistently applicable nor explicit. An aggressive, violent or abusive patient may be behaving anti-socially or criminally. But in acute medical settings it is more likely that a medical, mental health or emotional problem, or some combination thereof, is the explanation and usually we will not know the relative contribution of each element...
June 2017: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/28674145/the-strataa-study-protocol-a-programme-to-assess-the-burden-of-enteric-fever-in-bangladesh-malawi-and-nepal-using-prospective-population-census-passive-surveillance-serological-studies-and-healthcare-utilisation-surveys
#15
Thomas C Darton, James E Meiring, Susan Tonks, Md Arifuzzaman Khan, Farhana Khanam, Mila Shakya, Deus Thindwa, Stephen Baker, Buddha Basnyat, John D Clemens, Gordon Dougan, Christiane Dolecek, Sarah J Dunstan, Melita A Gordon, Robert S Heyderman, Kathryn E Holt, Virginia E Pitzer, Firdausi Qadri, K Zaman, Andrew J Pollard
INTRODUCTION: Invasive infections caused by Salmonella enterica serovar Typhi and Paratyphi A are estimated to account for 12-27 million febrile illness episodes worldwide annually. Determining the true burden of typhoidal Salmonellae infections is hindered by lack of population-based studies and adequate laboratory diagnostics.The Strategic Typhoid alliance across Africa and Asia study takes a systematic approach to measuring the age-stratified burden of clinical and subclinical disease caused by typhoidal Salmonellae infections at three high-incidence urban sites in Africa and Asia...
July 2, 2017: BMJ Open
https://www.readbyqxmd.com/read/28667231/educational-video-to-improve-cpap-use-in-patients-with-obstructive-sleep-apnoea-at-risk-for-poor-adherence-a-randomised-controlled-trial
#16
Amy S Guralnick, Jay S Balachandran, Shane Szutenbach, Kevin Adley, Leila Emami, Meelad Mohammadi, Jeanne M Farnan, Vineet M Arora, Babak Mokhlesi
BACKGROUND: Suboptimal adherence to CPAP limits its clinical effectiveness in patients with obstructive sleep apnoea (OSA). Although rigorous behavioural interventions improve CPAP adherence, their labour-intensive nature has limited widespread implementation. Moreover, these interventions have not been tested in patients at risk of poor CPAP adherence. Our objective was to determine whether an educational video will improve CPAP adherence in patients at risk of poor CPAP adherence. METHODS: Patients referred by clinicians without sleep medicine expertise to an urban sleep laboratory that serves predominantly minority population were randomised to view an educational video about OSA and CPAP therapy before the polysomnogram, or to usual care...
June 30, 2017: Thorax
https://www.readbyqxmd.com/read/28667224/improving-patient-safety-through-better-teamwork-how-effective-are-different-methods-of-simulation-debriefing-protocol-for-a-pragmatic-prospective-and-randomised-study
#17
Julia Freytag, Fabian Stroben, Wolf E Hautz, Dorothea Eisenmann, Juliane E Kämmer
INTRODUCTION: Medical errors have an incidence of 9% and may lead to worse patient outcome. Teamwork training has the capacity to significantly reduce medical errors and therefore improve patient outcome. One common framework for teamwork training is crisis resource management, adapted from aviation and usually trained in simulation settings. Debriefing after simulation is thought to be crucial to learning teamwork-related concepts and behaviours but it remains unclear how best to debrief these aspects...
June 30, 2017: BMJ Open
https://www.readbyqxmd.com/read/28666440/do-medical-students-and-young-physicians-assess-reliably-their-self-efficacy-regarding-communication-skills-a-prospective-study-from-end-of-medical-school-until-end-of-internship
#18
Tore Gude, Arnstein Finset, Tor Anvik, Anders Bærheim, Ole Bernt Fasmer, Hilde Grimstad, Per Vaglum
BACKGROUND: This prospective study from end of medical school through internship investigates the course and possible change of self- reported self-efficacy in communication skills compared with observers' ratings of such skills in consultations with simulated patients. METHODS: Sixty-two medical students (43 females) from four Norwegian universities performed a videotaped consultation with a simulated patient immediately before medical school graduation (T1) and after internship (internal medicine, surgery and family medicine, half a year each - T2)...
June 30, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28665490/impact-of-china-s-essential-medicines-scheme-and-zero-mark-up-policy-on-antibiotic-prescriptions-in-county-hospitals-a-mixed-methods-study
#19
Xiaolin Wei, Jia Yin, John D Walley, Zhitong Zhang, Joseph P Hicks, Yu Zhou, Qiang Sun, Jun Zeng, Mei Lin
OBJECTIVE: To evaluate the impact of the national essential medicines scheme and zero-mark-up policy on antibiotic prescribing behaviour. METHODS: In rural Guangxi, a natural experiment compared one county hospital which implemented the policy with a comparison hospital which did not. All outpatient and inpatient records in 2011 and 2014 were extracted from the two hospitals. Primary outcome indicator was antibiotic prescribing rate (APR) among children aged 2-14 presenting in outpatients with a primary diagnosis of upper respiratory tract infection (URTI)...
June 30, 2017: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/28664583/corticosterone-influences-gerbil-meriones-unguiculatus-prostatic-morphophysiology-and-alters-its-proliferation-and-apoptosis-rates
#20
Julia Quilles Antoniassi, Ricardo Alexandre Fochi, Rejane Maira Góes, Patricia Simone Leite Vilamaior, Sebastião Roberto Taboga
Glucocorticoids (GCs) are hormones that are widely used in medicine; but although side effects are generally recognised, little is known about the precise mechanisms that implicated in many of these side effects. Furthermore, GCs are highly correlated with stress and behaviour disorders. This study evaluated the effects of the glucocorticoid corticosterone on the ventral prostate of the Mongolian gerbil. Male gerbils (Meriones unguiculatus) (n = 5) received intraperitoneal injections of saline or corticosterone in doses of 0...
June 29, 2017: International Journal of Experimental Pathology
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