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https://www.readbyqxmd.com/read/28549484/the-effects-of-a-psychological-intervention-directed-at-optimizing-immune-function-study-protocol-for-a-randomized-controlled-trial
#1
Lemmy Schakel, Dieuwke S Veldhuijzen, Henriët van Middendorp, Corine Prins, Simone A Joosten, Tom H M Ottenhoff, Leo G Visser, Andrea W M Evers
BACKGROUND: Previous research has provided evidence for the link between psychological processes and psychophysiological health outcomes. Psychological interventions, such as face-to-face or online cognitive behavioral therapy (CBT) and serious games aimed at improving health, have shown promising results in promoting health outcomes. Few studies so far, however, have examined whether Internet-based CBT combined with serious gaming elements is effective in modulating health outcomes. Moreover, studies often did not incorporate psychophysiological or immunological challenges in order to gain insight into physiological responses to real-life challenges after psychological interventions...
May 26, 2017: Trials
https://www.readbyqxmd.com/read/28545538/providing-online-weight-management-in-primary-care-a-mixed-methods-process-evaluation-of-healthcare-practitioners-experiences-of-using-and-supporting-patients-using-power
#2
Emily Smith, Katherine Bradbury, Lisa Scott, Mary Steele, Paul Little, Lucy Yardley
BACKGROUND: An online weight management intervention (POWeR+) combined with a small amount of primary care healthcare practitioner support is effective in helping patients to lose weight, but little is known about how practitioners interact with the POWeR+ intervention or their experiences of providing support for patients using POWeR+. The aim of this study was to explore practitioners' usage of POWeR+ and their experiences of providing support to patients using POWeR+. METHODS: Set within a randomised controlled trial of POWeR+, practitioners' usage of POWeR+ was automatically captured and a qualitative process analysis was conducted employing semi-structured telephone interviews with practitioners who provided support to patients using POWeR+...
May 25, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28545535/electronic-audit-and-feedback-intervention-with-action-implementation-toolbox-to-improve-pain-management-in-intensive-care-protocol-for-a-laboratory-experiment-and-cluster-randomised-trial
#3
Wouter T Gude, Marie-José Roos-Blom, Sabine N van der Veer, Evert de Jonge, Niels Peek, Dave A Dongelmans, Nicolette F de Keizer
BACKGROUND: Audit and feedback is often used as a strategy to improve quality of care, however, its effects are variable and often marginal. In order to learn how to design and deliver effective feedback, we need to understand their mechanisms of action. This theory-informed study will investigate how electronic audit and feedback affects improvement intentions (i.e. information-intention gap), and whether an action implementation toolbox with suggested actions and materials helps translating those intentions into action (i...
May 25, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28545129/direct-and-indirect-costs-of-diabetes-mellitus-in-mali-a-case-control-study
#4
Clara Bermudez-Tamayo, Stéphane Besançon, Mira Johri, Sidibe Assa, Jonathan Betz Brown, Kaushik Ramaiya
BACKGROUND: Diabetes mellitus (DM) is one of the most burdensome chronic diseases and is associated with shorter lifetime, diminished quality of life and economic burdens on the patient and society as a result of healthcare, medication, and reduced labor market participation. We aimed to estimate the direct (medical and non-medical) and indirect costs of DM and compare them with those of people without DM (ND), as well as the cost predictors. METHODS AND FINDINGS: Observational retrospective case-control study performed in Mali...
2017: PloS One
https://www.readbyqxmd.com/read/28542441/dot-or-sat-for-rifampicin-resistant-tuberculosis-a-non-randomized-comparison-in-a-high-hiv-prevalence-setting
#5
Erika Mohr, Johnny Daniels, Busisiwe Beko, Petros Isaakidis, Vivian Cox, Sarah Jane Steele, Odelia Muller, Leigh Snyman, Virginia De Azevedo, Amir Shroufi, Laura Trivino Duran, Jennifer Hughes
BACKGROUND: Daily directly-observed therapy (DOT) is recommended for rifampicin-resistant tuberculosis (RR-TB) patients throughout treatment. We assessed the impact of self-administered treatment (SAT) in a South African township with high rates of RR-TB and HIV. METHODS: Community-supported SAT for patients who completed the intensive phase was piloted in five primary care clinics in Khayelitsha. We compared final treatment outcomes among RR-TB patients initiating treatment before (standard-of-care (SOC)-cohort, January 2010-July 2013) and after the implementation of the pilot (SAT-cohort, January 2012-December 2014)...
2017: PloS One
https://www.readbyqxmd.com/read/28540312/rivaroxaban-as-an-antithrombotic-agent-in-a-patient-with-st-segment-elevation-myocardial-infarction-and-left-ventricular-thrombus-a-case-report
#6
Rajeev Seecheran, Valmiki Seecheran, Sangeeta Persad, Naveen Anand Seecheran
The incidence of left ventricular (LV) thrombi in the setting of an anterior myocardial infarction has declined significantly since the advent of primary percutaneous coronary intervention coupled with contemporary antithrombotic strategies in ST-segment elevation myocardial infarctions (STE-ACS). Despite oral anticoagulation with the currently accepted, standard-of-care vitamin K antagonist, warfarin, major bleeding complications still arise. Rivaroxaban is a novel, direct oral factor X anticoagulant that has several advantageous properties, which can attenuate bleeding risk...
January 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28539425/perceptual-competition-promotes-suppression-of-reward-salience-in-behavioral-selection-and-neural-representation
#7
Mengyuan Gong, Ke Jia, Sheng Li
Visual attentional selection is influenced by the value of objects. Previous studies have demonstrated that reward-associated items lead to rapid distraction and associated behavioral costs, which are difficult to override with top-down control. However, it has not been determined whether a perceptually competitive environment could render the reward-driven distraction more susceptible to top-down suppression. Here, we trained both genders of human subjects to associate two orientations with high and low magnitudes of reward...
May 24, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28539080/keeping-candles-lit-the-role-of-concierge-medicine-in-the-future-of-primary-care
#8
Rocco Palumbo
Universal coverage and financial sustainability are two competing aims in primary care. Patient empowerment and patient engagement have been suggested as essential ingredients of the recipe for innovative primary care models aimed at sustaining universal coverage. Concierge medicine is achieving a growing popularity among both scholars and practitioners as a direct primary care practice which allows to bridge the gap between patient empowerment and patient engagement. However, ethical and legal concerns hinder the diffusion of concierge models in the current primary care practices...
May 2017: Health Services Management Research
https://www.readbyqxmd.com/read/28538936/-factors-associated-with-cross-nursing
#9
Mariana Pujól von Seehausen, Maria Inês Couto de Oliveira, Cristiano Siqueira Boccolini
This article aims to estimate the prevalence and analyze the factors associated with cross-nursing. A cross-sectional study was conducted in 2013 with interviews with a representative sample of mothers of infants less than one-year-old (n' = 695) attended in nine primary health units in Rio de Janeiro, Brazil. Sociodemographic characteristics were studied; pregnancy, childbirth and primary care assistance; maternal habits and baby features. Adjusted prevalence ratios (PR) were obtained by Poisson Regression, retaining variables associated with the outcome in the final model (p ≤ 0...
May 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28537057/physician-directed-diabetes-education-without-a-medication-change-and-associated-patient-outcomes
#10
Hun Sung Kim, Hyunah Kim, Hae Kyung Yang, Eun Young Lee, Yoo Jin Jeong, Tong Min Kim, So Jung Yang, Seo Yeon Baik, Seung Hwan Lee, Jae Hyoung Cho, In Young Choi, Hyeon Woo Yim, Bong Yun Cha
BACKGROUND: When patients with diabetes mellitus (DM) are first referred to a hospital from primary health care clinics, physicians have to decide whether to administer an oral hypoglycemic agent (OHA) immediately or postpone a medication change in favor of diabetes education regarding diet or exercise. The aim of this study was to determine the effect of diabetes education alone (without alterations in diabetes medication) on blood glucose levels. METHODS: The study was conducted between January 2009 and December 2013 and included patients with DM...
May 12, 2017: Diabetes & Metabolism Journal
https://www.readbyqxmd.com/read/28536932/thromboprophylaxis-in-extracorporeal-circuits-current-pharmacological-strategies-and-future-directions
#11
REVIEW
Gail M Annich, Oshri Zaulan, Megan Neufeld, Deborah Wagner, Melissa M Reynolds
The development of extracorporeal devices for organ support has been a part of medical history and progression since the late 1900s. These types of technology are primarily used and developed in the field of critical care medicine. Unfractionated heparin, discovered in 1916, has really been the only consistent form of thromboprophylaxis for attenuating or even preventing the blood-biomaterial reaction that occurs when such technologies are initiated. The advent of regional anticoagulation for procedures such as continuous renal replacement therapy and plasmapheresis have certainly removed the risks of systemic heparinization and heparin effect, but the challenges of the blood-biomaterial reaction and downstream effects remain...
May 23, 2017: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/28535948/the-new-us-preventive-services-task-force-c-draft-recommendation-for-prostate-cancer-screening
#12
EDITORIAL
Matthew R Cooperberg
The US Preventive Services Task Force has issued a new draft guideline, with a "C" recommendation that men aged 55-69 yr should be informed about the benefits and harms of screening for prostate cancer, and offered prostate-specific antigen testing if they choose it. For men aged ≥70 yr, the recommendation remains "D", or "do not screen." This draft represents substantial progress in the right direction towards offering men a fair opportunity to discuss the risks and benefits of screening with their primary care providers...
May 20, 2017: European Urology
https://www.readbyqxmd.com/read/28534036/highly-successful-hepatitis-c-virus-hcv-treatment-outcomes-in-human-immunodeficiency-virus-hcv-coinfected-patients-at-a-large-urban-ryan-white-clinic
#13
Manish Patel, Saira Rab, Aley G Kalapila, Alison Kyle, Ike Solomon Okosun, Lesley Miller
BACKGROUND: The introduction of direct-acting antivirals (DAAs) created a major paradigm shift in the treatment of chronic hepatitis C. Currently, there is little "real-world" data regarding hepatitis C virus (HCV) treatment outcomes in the human immunodeficiency virus (HIV)/HCV-coinfected population. METHODS: This retrospective cohort study examined HCV treatment outcomes of HIV/HCV-coinfected patients at a large, urban, Ryan White-funded clinic caring for an underserved population...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28532204/management-of-allergic-rhinitis-in-the-era-of-effective-over-the-counter-treatments
#14
Warner W Carr, Barbara P Yawn
Allergic rhinitis (AR) may be regarded as a trivial issue unworthy of the doctor's time, and with the availability of many different over-the-counter (OTC) treatments, up to two thirds of patients self-manage AR before seeking medical care. Yet, AR can have a significant impact on health-related quality of life and is associated with a greater detriment to work productivity than other chronic diseases such as diabetes and hypertension. For many patients, the impact on quality of life is greater than suggested by reported symptoms and should also be a focus of treatment...
May 22, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/28531241/effect-of-statin-treatment-vs-usual-care-on-primary-cardiovascular-prevention-among-older-adults-the-allhat-llt-randomized-clinical-trial
#15
Benjamin H Han, David Sutin, Jeff D Williamson, Barry R Davis, Linda B Piller, Hannah Pervin, Sara L Pressel, Caroline S Blaum
Importance: While statin therapy for primary cardiovascular prevention has been associated with reductions in cardiovascular morbidity, the effect on all-cause mortality has been variable. There is little evidence to guide the use of statins for primary prevention in adults 75 years and older. Objectives: To examine statin treatment among adults aged 65 to 74 years and 75 years and older when used for primary prevention in the Lipid-Lowering Trial (LLT) component of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT-LLT)...
May 22, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28531205/cost-analysis-of-human-papillomavirus-related-cervical-diseases-and-genital-warts-in-swaziland
#16
Themba G Ginindza, Benn Sartorius, Xolisile Dlamini, Ellinor Östensson
BACKGROUND: Human papillomavirus (HPV) has proven to be the cause of several severe clinical conditions on the cervix, vulva, vagina, anus, oropharynx and penis. Several studies have assessed the costs of cervical lesions, cervical cancer (CC), and genital warts. However, few have been done in Africa and none in Swaziland. Cost analysis is critical in providing useful information for economic evaluations to guide policymakers concerned with the allocation of resources in order to reduce the disease burden...
2017: PloS One
https://www.readbyqxmd.com/read/28527635/shared-decision-making-in-preventive-care-in-switzerland-from-theory-to-action
#17
Kevin Selby, Reto Auer, Jacques Cornuz
Switzerland with its decentralized, liberal health system and its tradition of direct democracy may be an ideal place for shared decision making (SDM) to take root organically, rather than using top-down regulations seen in other countries. There are now multiple directives and programmes in place to encourage SDM, with the creation of several decision aids and specific training programs in the five Swiss medical schools. There has been an emphasis on preventive care, with the integration of patient preference into an organized colorectal cancer screening program, clear recommendations for prostate cancer screening, and inroads into the primary prevention of cardiovascular disease...
May 17, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28526794/raffinose-induces-biofilm-formation-by-streptococcus-mutans-in-low-concentrations-of-sucrose-by-increasing-production-of-extracellular-dna-and-fructan
#18
Ryo Nagasawa, Tsutomu Sato, Hidenobu Senpuku
Streptococcus mutans is the primary etiological agent of dental caries and causes tooth decay by forming a firmly attached biofilm on tooth surfaces. Biofilm formation is induced by the presence of sucrose, which is a substrate for the synthesis of extracellular polysaccharides, but not in the presence of oligosaccharides. Nonetheless, in this study, we found that raffinose, which is an oligosaccharide with an intestinal regulatory function and antiallergic effect, induced biofilm formation by S. mutans in a mixed culture with sucrose which was at concentrations less than those required to induce biofilm formation directly...
May 19, 2017: Applied and Environmental Microbiology
https://www.readbyqxmd.com/read/28526255/associations-of-objective-and-subjective-sleep-disturbance-with-cognitive-function-in-older-men-with-comorbid-depression-and-insomnia
#19
Daniel J Biddle, Sharon L Naismith, Kathleen M Griffiths, Helen Christensen, Ian B Hickie, Nicholas S Glozier
OBJECTIVES: To examine whether poor objective and subjective sleep quality are differentially associated with cognitive function. DESIGN: Cross-sectional. SETTING: Participants were recruited from primary and secondary care, and directly from the community, in Sydney, Australia. PARTICIPANTS: The sample consisted of 74 men 50years and older (mean [SD], 58.4 [6.2] years), with comorbid depression and above-threshold insomnia symptoms, participating in a trial of online cognitive behavioral therapy for insomnia...
June 2017: Sleep Health
https://www.readbyqxmd.com/read/28526027/description-of-inter-institutional-referrals-after-admission-for-labor-and-delivery-a-prospective-population-based-cohort-study-in-rural-maharashtra-india
#20
Archana B Patel, Amber Abhijeet Prakash, Camille Raynes-Greenow, Yamini V Pusdekar, Patricia L Hibberd
BACKGROUND: In 2008, the Indian government introduced financial assistance to encourage health facility deliveries. Facility births have increased, but maternal and neonatal morbidity and mortality have not decreased raising questions about the quality of care provided in facilities and access to a quality referral system. We evaluated the potential role of inter-institutional transfers of women admitted for labor and delivery on adverse maternal and neonatal outcomes in an ongoing prospective, population-based Maternal and Newborn Health Registry in Central India...
May 19, 2017: BMC Health Services Research
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