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Reviews available literature on gender bias and the process of medical care. Current findings point to possible gender bias in treatment protocols for kidney and cardiac patients. Other clinical conditions have not been studied. Identifies methodological challenges to such research and discusses the need for further research.

The purpose of this paper is to propose a unified definition of integrated palliative care (IPC), and to identify the elements that facilitate or hinder implementation of an integrated palliative care system (IPCS).

A scoping review of the conceptualization and essential elements of IPC was undertaken, based on a search of the PubMed, Scopus and ISI Web of Science databases. The search identified 79 unduplicated articles; 43 articles were selected for content analysis.

IPC is coordinated and collaborative across different health organizations, levels of care and types of providers. Eight key elements facilitate implementation of an IPCS: coordination, early patient identification, patient-centered services, care continuity, provider education and training, a standard implementation model and screening tool, shared information technology system, and supportive policies and funding. These elements were plotted as a “Circle of Integrated Palliative Care System Elements.”

This paper offers researchers an inclusive definition of IPC and describes the essential elements of its successful implementation.

This study provides evidence from researchers on five continents, offering insights from multiple countries and cultures on the topic of IPC. The findings of this thematic analysis could assist international researchers aiming to develop a standard evaluative model or assess the level of integration in a health care system’s delivery of palliative care.

This paper’s objective is to develop a model for the appropriate and equitable use of disease‐modifying treatments in multiple sclerosis. The prevalence and incidence of multiple sclerosis was established in Leeds. A specialist multiple sclerosis team with two consultant neurologists and a multiple sclerosis support nurse was based at one centre. The team co‐operated with purchasers to develop a model of care. This included a referral protocol, strict prescribing criteria, counselling and education of patients, the use of patient‐centred outcome measures and training and feedback to other neurologists. A total of 217 people with multiple sclerosis were assessed from April 1997 to March 2000. Our experience suggests that a centralised multi‐district clinic developed by close collaboration between clinicians and health purchasers and operating under agreed rules is a feasible and effective model for the managed introduction of new treatments to the NHS.

There is significant research describing how the development of neuroscience has affected the definition and treatment of neurological and psychiatric disorders, as well as brought about changes in research and care practices. Little is still known, however, about the ways in which these changes come about and on how they affect individuals’ – in particular, patients’ – experiences. In this chapter, I describe the changes imposed by neuroscientific practices not only on patients’ experience of their neurological or psychiatric disorder, but also on how they define themselves. In so doing, I draw on ethnographic research conducted among a neuroscientific team of a French hospital which has coordinated a research trial for the application of an experimental neurosurgical treatment – deep brain stimulation (DBS) – to patients suffering from obsessive compulsive disorder who are resistant to conventional treatments. This technology has been used since 1986 for treating various neurological and psychiatric disorders. My objective is to describe how the models of pathology conveyed by DBS and the experiences of patients suffering from a neurological or psychiatric disorder interact to constitute a form of personhood. I argue that, in certain situations, some of the patients attribute more significance to cerebrally orientated – or naturalistic – explanatory models and give a new value to their subjective experience: they ‘cerebralize’ and find inside the brain and its (dys)functions – or through an intervention on it – the source or the solution of a plurality of personal situations.

This study aims to characterize the June 2020 COVID-19 outbreak at San Quentin California State Prison and to describe what made San Quentin so vulnerable to uncontrolled transmission.

Since its onset, the COVID-19 pandemic has exposed and exacerbated the profound health harms of carceral settings, such that nearly half of state prisons reported COVID-19 infection rates that were four or more times (and up to 15 times) the rate found in the state’s general population. Thus, addressing the public health crises and inequities of carceral settings during a respiratory pandemic requires analyzing the myriad factors shaping them. In this study, we reported observations and findings from environmental risk assessments during visits to San Quentin California State Prison. We complemented our assessments with analyses of administrative data.

For future respiratory pathogens that cannot be prevented with effective vaccines, this study argues that outbreaks will no doubt occur again without robust implementation of additional levels of preparedness – improved ventilation, air filtration, decarceration with emergency evacuation planning – alongside addressing the vulnerabilities of carceral settings themselves.

This study addresses two critical aspects that are insufficiently covered in the literature: how to prepare processes to safely implement emergency epidemic measures when needed, such as potential evacuation, and how to address unique challenges throughout an evolving pandemic for each carceral setting.

The purpose of this paper is to investigate the effects of an exercise education intervention on exercise behavior, depression and fatigue status of chronic kidney disease (CKD) patients.

This was a pilot study using an exercise education program as an intervention for CKD patients. The authors used the transtheoretical model (TTM) to design the exercise education programs. A total of 94 subjects diagnosed with CKD at a medical center in Taiwan participated in this quasi‐experimental study. Subjects were randomly divided into the experimental group (n=45) and the control group (n=49). The education program included written materials and teaching activities designed to encourage participants to initiate and continue regular exercise. Both groups took the pre‐test and post‐test containing a depression inventory, a fatigue scale and an exercise behavior inventory.

The findings indicated that changes in the exercise behavior, depression and fatigue status of the experimental group were statistically significant after the exercise education intervention compared with the control group.

The paper demonstrates that exercise education intervention can be administered by nursing staff, or a health educator, to encourage patients to exercise in order to enhance their quality of care.

Coeliac disease (CD) is a lifelong autoimmune disorder and is managed with a strict gluten-free (GF) diet. At diagnosis, an individual's nutritional status is affected by how long CD has been active, their dietary intake, intestinal inflammation and degree of malabsorption. This study explores if age and time since diagnosis affect nutritional knowledge, eating habits and emotional wellbeing of participants.

An online survey using Qualtrics was conducted. The survey consists of 4 sections exploring (1) demographics, (2) nutritional knowledge, (3) eating habits and (4) quality of life (QoL). A total of 162 valid questionnaires were completed.

Those who'd been diagnosed for more than 5 years demonstrated better knowledge about GF or gluten containing products. Social interactions are limited by concerns about becoming ill, unwanted attention and increased financial costs. Eight-eight % of participants would go hungry at social events. Those aged between 40–59 and above 60 years felt more financially restricted compared to younger adults (χ²(4) = 10.73, p = 0.01). Strong emotions were experienced by participants since diagnosed with CD. Anxiety, feelings of concern, sadness, depression and fear have declined and happiness, confidence and being accepting of CD have increased since diagnosis across all years.

This study is one of the first few studies to investigate time since diagnosis and age-related differences in nutritional knowledge, eating habits and QoL of adults diagnosed with CD. Over time, negative emotions could potentially be alleviated with improved knowledge and experience.

Bioelectrical impedance vector analysis (BIVA) and phase angle (PA) have importance in assessing nutritional and prognosis, and this study hypothesized that these measurements can have a relationship with nutritional risk and outcomes. This study aims to analyze the association between Nutrition Risk in the Critically ill (NUTRIC) score and bioelectrical impedance measures with hospital mortality in critically ill patients.

A prospective, cohort study was performed with a consecutive sample of patients admitted to an intensive care unit (ICU), between January and June 2017 at a hospital university in Northwest Brazil. The NUTRIC score and the bioelectric measures, such as resistance (R), reactance (Xc), PA and BIVA, were completed within the first 24 h of admission. The Student’s t or Mann–Whitney, Pearson’s or Spearman’s coefficient and Fisher’s exact tests and BIVA were used for statistical analyses.

The sample consisted of 81, with a mean age of 57 (16.7) years, with 60.5% women. It was detected that PA and Xc were lower (p < 0.001), and age was higher (p < 0.001) in a high nutritional-risk group. It was found an association between low nutritional risk and hospital discharge (p < 0.001), and that individuals who died spent more days in the ICU (p = 0.0375), had significantly lower PA and Xc values (p = 0.043 and p = 0.0172, respectively) and higher NUTRIC scores (<0.0001). There was a displacement of the mean impedance vector in men and women with high nutritional risk (p = 0.0037 and p = 0.004, respectively).

The height measurement was estimated using predictive formulas, which may affect the accuracy of the values; BIA was performed only upon admission of the patient to the ICU and the study population was heterogeneous, as it is a general ICU.

This paper shows that, in critically ill patients, nutritional screening and the assessment of bioelectrical measures help in clinical-nutritional decisions, and were able to predict outcomes.

The Epidemiologic Transition can help us understand a fundamental puzzle about aging. The puzzle stems from two seemingly contradictory facts. The first fact is that death rates from noninfectious degenerative maladies – the so-called diseases of aging – increase as people age. It seems to be at odds with the historical fact that for nearly a century in which people were aging more than ever before, the aggregate rates of such diseases have been decreasing. In what sense can both be true? Crucial to resolving the puzzle are the age-profiles of such diseases in cohorts that grew up in the different regimes of the Transition. For each cohort, noninfectious diseases had increased with age, resulting in an upward-sloping age profile, which affirms the first fact. As the regimes were transitioning from the Malthusian to the modern one, however, the profiles of successive cohorts had been shifting downward: death rates from noninfectious diseases were shrinking at each age, signifying the newer cohorts’ greater aging potentials. The shifting profiles had been renewing the cohort mix of the population, shaping the century-long descent of such diseases in aggregate, giving rise to the historical fact. The profiles had shifted early in the cohorts’ adult years, associating closely with the newer epidemiologic conditions in childhood. Those conditions appear to be a circumstance under which aging potentials of cohorts could be misgauged, including in one troubling episode in the first half of the nineteenth century when the potentials had reversed.