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Whole person care

Trevor Peter, Dennis Ellenberger, Andrea A Kim, Debrah Boeras, Tsehaynesh Messele, Teri Roberts, Wendy Stevens, Ilesh Jani, Alash'le Abimiku, Nathan Ford, Zachary Katz, John N Nkengasong
Scaling up access to HIV viral load testing for individuals undergoing antiretroviral therapy in low-resource settings is a global health priority, as emphasised by research showing the benefits of suppressed viral load for the individual and the whole population. Historically, large-scale diagnostic test implementation has been slow and incomplete because of service delivery and other challenges. Building on lessons from the past, in this Personal View we propose a new framework to accelerate viral load scale-up and ensure equitable access to this essential test...
October 20, 2016: Lancet Infectious Diseases
Ishfaq A Sheikh, Ejaz Ahmad, Mohammad S Jamal, Mohd Rehan, Mourad Assidi, Iftikhar A Tayubi, Samera F AlBasri, Osama S Bajouh, Rola F Turki, Adel M Abuzenadah, Ghazi A Damanhouri, Mohd A Beg, Mohammed Al-Qahtani
BACKGROUND: Preterm birth (PTB), birth at <37 weeks of gestation, is a significant global public health problem. World-wide, about 15 million babies are born preterm each year resulting in more than a million deaths of children. Preterm neonates are more prone to problems and need intensive care hospitalization. Health issues may persist through early adulthood and even be carried on to the next generation. Majority (70 %) of PTBs are spontaneous with about a half without any apparent cause and the other half associated with a number of risk factors...
October 17, 2016: BMC Genomics
Debbie Selby, Dori Seccaraccia, Jim Huth, Kristin Kurrpa, Margaret Fitch
OBJECTIVE: The goal of this study was to explore healthcare professionals' (HCPs') perception of their role in provision of spiritual care, in addition to attempting to identify a simple question(s) to help identify spiritual distress. BACKGROUND: Spirituality is well recognized as important to whole-person care, particularly in those with terminal illnesses. Understanding the role of front-line providers in the identification and management of spiritual distress, however, remains challenging...
October 18, 2016: Journal of Palliative Medicine
Johannes Bircher, Eckhart G Hahn
This paper explores the diagnostic and therapeutic potential of a new concept of health. Investigations into the nature of health have led to a new definition that explains health as a complex adaptive system (CAS) and is based on five components (a-e). Humans like all biological creatures must satisfactorily respond to (a) the demands of life. For this purpose they need (b) a biologically given potential (BGP) and (c) a personally acquired potential (PAP). These properties of individuals are embedded within (d) social and (e) environmental determinants of health...
2016: F1000Research
Janet Landeen, Donna Carr, Kirsten Culver, Lynn Martin, Nancy Matthew-Maich, Charlotte Noesgaard, Larissa Beney-Gadsby
Ongoing curricular renewal is a necessary phenomenon in nursing education to align learning with ever-changing professional practice demands. The McMaster Mohawk Conestoga BScN Program in Hamilton, Ontario, Canada recently engaged in a comprehensive curriculum renewal. The purpose of this study was to evaluate the impact of curricular changes on students' deep learning. Faculty perceptions about student learning outcomes during final year clinical placements were gathered through a combination of individual interviews and focus groups using Interpretive Descriptive qualitative research methodology...
October 4, 2016: Nurse Education in Practice
Gowri Anandarajah, Janet Roseman, Danny Lee, Nupur Dhandhania
CONTEXT: Although spiritual care (SC) is recognized as important in whole-person medicine, physicians infrequently address patients' spiritual needs, citing lack of training. Although many SC curricula descriptions exist, few studies report effects on physicians. OBJECTIVES: To broadly examine immediate and long-term effects of a required, longitudinal, residency SC curriculum, which emphasized inclusive patient-centered SC, compassion and spiritual self-care. METHODS: We conducted in-depth individual interviews with 26 physicians (13 intervention;13 comparison) trained at a 13-13-13 residency...
October 3, 2016: Journal of Pain and Symptom Management
Sara Wallström, Kerstin Ulin, Elmir Omerovic, Inger Ekman
OBJECTIVE: The aim of the study was to investigate the meaning of narrated symptoms in connection to takotsubo syndrome. DESIGN, METHOD, PARTICIPANTS AND SETTING: Qualitative study consisting of 25 interviews, 23 women and 2 men aged 39-84 and living in Region Västra Götaland, Sweden. The transcribed text was analysed with phenomenological hermeneutics. RESULTS: The interviewees reported a large number of symptoms before, during and after the acute onset of takotsubo syndrome, including pain, affected breathing, lassitude, malaise and nausea...
October 5, 2016: BMJ Open
Catharina A Nordin, Peter Michaelson, Gunvor Gard, Margareta K Eriksson
BACKGROUND: Web-based interventions with a focus on behavior change have been used for pain management, but studies of Web-based interventions integrated in clinical practice are lacking. To emphasize the development of cognitive skills and behavior, and to increase activity and self-care in rehabilitation, the Web Behavior Change Program for Activity (Web-BCPA) was developed and added to multimodal pain rehabilitation (MMR). OBJECTIVE: The objective of our study was to evaluate the effects of MMR in combination with the Web-BCPA compared with MMR among persons with persistent musculoskeletal pain in primary health care on pain intensity, self-efficacy, and copying, as part of a larger collection of data...
October 5, 2016: Journal of Medical Internet Research
Ruth White, Chris Hayes, Scott White, Fiona J Hodson
There is a substantial clinical variation in the contemporary treatment of chronic noncancer pain reflecting different explanatory models and treatment emphasis. Hunter Integrated Pain Service and collaborators developed three key messaging videos outlining the foundations of chronic pain treatment, thus challenging unwarranted clinical variation and calling for greater therapeutic consistency. The videos were released on YouTube as a low-cost public health intervention. Each video used an evidenced informed script appropriate for low literacy and a cartoonist to provide matching images...
2016: Journal of Pain Research
Penelope Abbott, Joyce Davison, Parker J Magin, Wendy Hu
BACKGROUND: Nearly half of the people leaving prison see a general practitioner (GP) within a month of release, which provides an opportunity to promote health for this vulnerable group. OBJECTIVE: The objective of this article is to examine the expectations and experiences of GP care of women leaving prison. METHODS: Semi-structured interviews pre-release and post-release from prison were analysed using inductive thematic analysis. RESULTS: Sixty-nine interviews were conducted with 40 women while they were still in prison and 29 of these women after they were released...
October 2016: Australian Family Physician
Cynthia Yu-Wai-Man, Peng Tee Khaw
Significance: Fibrosis-related events play a part in the pathogenesis or failure of treatment of virtually all the blinding diseases around the world, and also account for over 40% of all deaths. It is well established that the eye and other tissues of some group of patients, for example Afro-Caribbean people, scar worse than others. However, there is a current lack of reliable biomarkers to stratify the risk of scarring and postsurgical fibrosis in the eye. Recent Advances: Recent studies using genomics, proteomics, metabolomics, clinical phenotyping, and high-resolution in vivo imaging techniques have revealed potential novel biomarkers to identify and stratify patients at risk of scarring in different fibrotic eye diseases...
September 1, 2016: Advances in Wound Care
Jean-Pascal Devailly, Laurence Josse
OBJECTIVE: Care programs in MPR formalize, for homogeneous profile of patients the steps of a multidisciplinary approach based on the rehabilitation potential and focused on improving functional status. The aim is to build a custom clinical pathway for patients with stroke followed in Physical Medicine and Rehabilitation Day Hospital by connecting each step systematically formalized a traceability tool in the information system in view a fair payment of a care program. MATERIAL/PATIENTS AND METHODS: Our outpatient hospital PMR team has built a clinical pathway according the method of the High Authority of Health, supported by MPR criteria defined by FEDMER and texts regulating the activity of French post-acute care (SSR)...
September 2016: Annals of Physical and Rehabilitation Medicine
Alexis Schnitzler, François Genêt, Claire Jourdan, Loic Josserand, Philippe Azouvi
OBJECTIVE: The prevalence of joint stiffness following stroke is not known. Post-stroke spasticity is considered to be an important contributing factor to disability. MATERIALS/PATIENTS AND METHODS: To evaluate the prevalence of joint stiffness in persons with a history of stroke in the whole French population, and the impact of joint stiffness on function. METHODS: The "Disability Health" survey was carried out in people's homes (DHH) and in institutions (DHI) in France...
September 2016: Annals of Physical and Rehabilitation Medicine
Andrew M Briggs, Joanne E Jordan, Ilana N Ackerman, Sharon Van Doornum
OBJECTIVE: Recognising the need for a best-practice and consistent approach in providing care to women with rheumatoid arthritis (RA) in relation to (1) general health, (2) contraception, (3) conception and pregnancy, (4) breast feeding and (5) early parenting, we sought to achieve cross-discipline, clinical consensus on key messages and clinical practice behaviours in these 5 areas. DESIGN: 3-round eDelphi study. In round 1, panellists provided free-text responses to open-ended questions about care for women with RA across the 5 areas...
September 15, 2016: BMJ Open
Natalie E Kelso-Chichetto, Chukwuemeka N Okafor, Jeffrey S Harman, Shantrel S Canidate, Christa L Cook, Robert L Cook
OBJECTIVE: The aims of this study were to describe complementary and alternative medicine (CAM) use and to assess the relationships between CAM use and antiretroviral therapy (ART) adherence and human immunodeficiency virus (HIV) RNA viral load suppression among a sample of persons living with HIV (PLWH) engaged in care in the state of Florida. DESIGN: The Florida Medical Monitoring Project (n = 803) collected repeated cross-sectional data for surveillance of clinical outcomes among PLWH from 2009 to 2010...
September 15, 2016: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
Beverley de Valois, Anthea Asprey, Teresa Young
Background. Lymphoedema, a distressing consequence of cancer treatment, has significant negative impact on health-related quality of life. Multidisciplinary approaches are needed to improve physical and psychosocial wellbeing. Acupuncture and moxibustion (acu/moxa), two modalities of traditional East Asian medicine, may contribute to improved outcomes for cancer survivors with lymphoedema. Aim. To explore how patients with lymphoedema secondary to cancer treatment perceive and experience acu/moxa treatment...
2016: Evidence-based Complementary and Alternative Medicine: ECAM
Frank Y Lin, Katie Bergstrom, Richard Person, Abhishek Bavle, Leomar Y Ballester, Sarah Scollon, Robin Raesz-Martinez, Andrew Jea, Sherri Birchansky, David A Wheeler, Stacey L Berg, Murali M Chintagumpala, Adekunle M Adesina, Christine Eng, Angshumoy Roy, Sharon E Plon, D Williams Parsons
The integration of genome-scale studies such as whole-exome sequencing (WES) into the clinical care of children with cancer has the potential to provide insight into the genetic basis of an individual's cancer with implications for clinical management. This report describes the results of clinical tumor and germline WES for a patient with a rare tumor diagnosis, rosette-forming glioneuronal tumor of the fourth ventricle (RGNT). Three pathogenic gene alterations with implications for clinical care were identified: somatic activating hotspot mutations in FGFR1 (p...
September 2016: Cold Spring Harbor Molecular Case Studies
Sylwia Krzemińska, Małgorzata Pośniak, Małgorzata Szewczyńska
BACKGROUND: A growing number of cancer cases enhances the usage of cytostatic agents and thereby contributes to the increase in the number of health care workers occupationally exposed to cytostatics. MATERIAL AND METHODS: This article presents the results of the survey aimed at obtaining data on the reduction of occupational exposure through using personal protective equipment by the medical and pharmaceutical personnel involved in handling cytostatics. The questionnaires were sent by mail or e-mail to oncology hospitals and pharmacies preparing cytostatic drugs...
2016: Medycyna Pracy
A Ribadier, I Varescon
INTRODUCTION: Defense mechanisms have been seen to greatly change over time and across different definitions made by different theoretical currents. Recently with the definition provided by the DSM IV, defense mechanisms have integrated the concept of coping as a defensive factor. These mechanisms are no longer considered just through a psychodynamic approach but also through a cognitive and behavioral one. In recent years, new theories have therefore integrated these two components of the defensive operation...
September 9, 2016: L'Encéphale
Sophia Frangou, Danai Dima, Jigar Jogia
Improved clinical care for Bipolar Disorder (BD) relies on the identification of diagnostic markers that can reliably detect disease-related signals in clinically heterogeneous populations. At the very least, diagnostic markers should be able to differentiate patients with BD from healthy individuals and from individuals at familial risk for BD who either remain well or develop other psychopathology, most commonly Major Depressive Disorder (MDD). These issues are particularly pertinent to the development of translational applications of neuroimaging as they represent challenges for which clinical observation alone is insufficient...
September 10, 2016: NeuroImage
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