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1.
Charlotte Baker Jill Powell Dominic Le Melissa S. Creary Lori-Ann Daley Mary Anne McDonald Charmaine DM. Royal 《Journal of the National Medical Association》2018,110(6):564-573
Objective
To describe the perspectives and experiences of athletic trainers, coaches, and student-athletes approximately three years post-implementation of the NCAA sickle cell trait (SCT) screening policy.Participants
Two-hundred and eight student-athletes, 32 athletic trainers, and 43 coaches from 10 NCAA Division I (DI) institutions in North Carolina from January to June 2014.Methods
Two online surveys were used to assess knowledge, perspectives, and experiences.Results
Athletic staff were more supportive than student-athletes of the need for the policy. Noted challenges included variation in implementation and follow-up for SCT-positive athletes, financial costs to institutions and athletes, and timing of the screening.Conclusions
More education about SCT is needed for student-athletes and athletic staff in order to help make the implementation more successful. All parties need to be in agreement regarding the importance of knowing which student-athletes have SCT and how that information will be utilized. 相似文献2.
Sarah M. Reilly Megan Wilson Crowley Pamela Harold Deborah Hemphill Laurene Tumiel Berhalter 《Journal of the National Medical Association》2018,110(5):448-454
Background/Purpose
African American women are diagnosed with breast cancer at later stages and have higher mortality rates than white women. The Patient Voices Network (PVN), a community group whose vision is “a community of educated and involved patients working hand in hand with physicians in making decisions about their own health care,” conceived of and implemented a walk to raise awareness of breast cancer and link women to screening resources in a low-income, urban communityObjectives
To describe the planning and implementation of the Concerned About You: Breast Cancer Awareness Walk & Wellness Event and its impact on an academic community partnership.Methods
A narrative approach was used. Meeting minutes and event planning notes were reviewed. Community participation rates and participant satisfaction were tracked using registration records and a survey administered at the event.Results
328 community members registered and 194 attended. Responses to a satisfaction survey indicated community buy-in and interest in future events. Two women were screened at the event and 78 were screened at a follow-up opportunity at their primary care practices. The process was driven by participatory guidelines and laid the foundation for future activities.Conclusions
Community input addressed the need for screening mammography in an underserved community. The partnership approach featured complementary strengths of both patients and University staff, fostered skill building and co-learning, and ultimately strengthened our partnership. A partnered approach may be effective in engaging hard-to-reach populations to address health disparities. 相似文献3.
Gabriel S. Tajeu Jewell Halanych Lucia Juarez Jeff Stone Irena Stepanikova Alexander Green Andrea L. Cherrington 《Journal of the National Medical Association》2018,110(5):464-472
Background
Racial bias is associated with suboptimal healthcare treatment for minorities. Research focuses on bias among physicians rather than non-physician healthcare staff (e.g., receptionists). Patients spend considerable amounts of time with non-physician staff. Therefore, we investigate differences in implicit and explicit racial bias by healthcare staff race and occupation using the Implicit Association Test and Modern Racism Scale, respectively.Methods
Staff (n = 107) were recruited using the Alabama based Primary Care Research Coalition. Occupation was categorized into “medical doctors/registered nurses” (MD/RN) and “non-MD/RN” (e.g., receptionists).Results
Implicit bias scores were higher among whites compared with blacks (0.62, ?0.04, respectively; p < 0.01). Among whites, non-MD/RNs demonstrated more pro-white implicit bias compared with MD/RNs (0.67, 0.44, respectively; p < 0.01). Whites had higher explicit bias scores than blacks (17.7, 12.3, respectively; p < 0.01).Conclusion
Non-MD/RNs should not be overlooked for cultural competency training, and efforts are needed to reduce racial bias among healthcare workers identified as having higher levels of bias. 相似文献4.
Wen-Yi Tseng Yeong-Jian Jan Wu Tai-Yun Yang Nien-Yi Chiang Wen-Pin Tsai Siamon Gordon Gin-Wen Chang Chang-Fu Kuo Shue-Fen Luo Hsi-Hsien Lin 《Journal of microbiology, immunology, and infection》2018,51(4):485-491
Background
GPR56/ADGRG1 is a member of the adhesion-class G protein-coupled receptor (aGPCR) family important in brain development, oncogenesis and tumor metastasis. Like other aGPCRs, GPR56 is cleaved at the GPCR proteolysis site (GPS) motif into an N-terminal fragment (NTF) and a C-terminal fragment (CTF). Existence of soluble GPR56 (sGPR56) has been shown in vitro, however the underlying mechanism and its pathophysiologic role remains undetermined.Objective
To assess the presence of sGPR56 in human serum using ELISA assay and compare the serum sGPR56 levels among patients of various chronic inflammatory diseases and healthy subjects.Patients and methods
In this study, serum samples from patients with systemic lupus erythematosus (SLE) (n = 57), rheumatoid arthritis (RA) (n = 95), Sjögren's syndrome (SS) (n = 29), ankylosing spondylitis (AS) (n = 51), and normal controls (n = 81) were analyzed using sGPR56-specific ELISA.Result
We show that serum sGPR56 levels are increased in patients of RA, but not in those with SLE, SS and AS. Intriguingly, serum sGPR56 levels in RA patients correlated with positive rheumatoid factor, a marker of bone erosion and poor outcome. In addition, an elevated sGPR56 level is also noted in RA patients with higher tumor necrosis factor level.Conclusion
we conclude that sGPR56 is present in vivo and sGPR56 level is elevated in certain chronic inflammatory diseases such as RA. Hence, sGPR56 might be considered a potential biomarker for RA disease progression. 相似文献5.
Ching-Yuan Yeh Fu-Der Wang Yu-Chung Chuang Chia-Jui Yang Shiang-Fen Huang Wen-Sung Weng Chun-Hsin Liaw Wang-Huei Sheng 《Journal of microbiology, immunology, and infection》2018,51(6):697-704
Background
Few studies have investigated patients with severe influenza who receive intravenous peramivir for salvage therapy.Methods
We retrospectively analyzed data from 71 patients with severe influenza who received intravenous peramivir therapy in the intensive care units of three medical centers between 2012 and 2016. All patients received oseltamivir or zanamivir before the administration of peramivir.Results
A total of 44 men and 27 women with a median age of 55 years were enrolled. Fifty-five (78%) had underlying comorbidities and 57 (80%) patients were infected with influenza type A. Forty-four (62%) patients survived and 27 (38%) died. Five patients (7%) had attributable adverse events, including elevated hepatic aminotransferase levels (n = 2), hyperbilirubinemia (n = 2), leukopenia (n = 1), and skin rash (n = 1). Multivariable logistic regression analysis revealed that initial bacteremia (odds ratio [OR], 27.59; 95% confidence interval [95% CI], 2.36–322.07; P = 0.008) and septic shock (OR, 8.00; 95% CI, 1.69–37.90; P = 0.009) were the independent predictors of mortality. However, there was also a trend towards a positive correlation between mortality and steroid use (OR, 11.29; 95% CI, 0.67–188.86; P = 0.092).Conclusion
As a salvage therapy, intravenous peramivir provided a survival rate of 62% and was well tolerated in patients with severe influenza. The initiation of effective antiviral treatment as early as possible within 48 h is recommended for hospitalized patients. 相似文献6.
Amani M. Ali Samah Selim Maggie M. Abbassi Nirmeen A. Sabry 《Annals of allergy, asthma & immunology》2017,118(5):557-563
Background
Despite the use of alfacalcidol in the management of corticosteroid-induced osteoporosis, it has never been considered an adjunct treatment for asthma management. It can target vitamin D deficiency, a possible risk factor for asthma, and, hence, improve pulmonary function of patients with asthma.Objective
To explore the effect of alfacalcidol administration on pulmonary function and study the pattern of vitamin D deficiency in adults with asthma in Egypt.Methods
Serum 25-hydroxyvitamin D was measured in 115 adults: 33 healthy subjects and 82 patients with asthma. Then, patients with asthma were randomized to receive standard asthma treatment only (n = 39) or receive it in addition to 1 μg of alfacalcidol daily for 4 months (n = 43). Randomization was stratified by the stage of asthma severity. Spirometry and measurement of 25-hydroxyvitamin were performed at baseline and end of follow-up.Results
Vitamin D deficiency was more common in patients with asthma (57.3%) than in healthy subjects (21.2%; P < .001). In patients with asthma, alfacalcidol significantly improved forced expiratory volume in the first second and forced vital capacity (P < .001 for the 2 tests). Moreover, more patients in the intervention arm showed improvement in asthma severity stage (P = .04). A nonsignificant difference was observed in improvement of forced expiratory volume in the first second between patients with vitamin D deficiency and those without deficiency in the intervention group (P > .05).Conclusion
Alfacalcidol supplementation improved the pulmonary function and severity stage of adult patients with asthma regardless of deficiency.7.
8.
Chih-Cheng Lai Cong-Tat Cia Hsiu-Tzy Chiang Yung-Chung Kung Zhi-Yuan Shi Yin-Ching Chuang Chun-Ming Lee Wen-Chien Ko Po-Ren Hsueh 《Journal of microbiology, immunology, and infection》2018,51(5):666-671
Background/purpose
This study assessed the effect of the central line bundle on the rate of central line-associated bloodstream infections (CLABSI) in intensive care units (ICUs) in Taiwan.Methods
This national study was conducted in 27 ICUs with 404 beds total, including 15 medical ICUs, 11 surgical ICUs, and one mixed ICU. The study period was divided into two phases: a pre-intervention (between June 1, 2011 and October 31, 2011) and intervention phase (between December 1, 2011 and October 31, 2012). Outcome variables, including CLABSI rates (per 1000 catheter-days) and catheter utilization rates, were measured.Results
The overall rate of CLABSI significantly decreased by 12.2% (p < 0.001) from 5.74 per 1000 catheter-days in the pre-intervention phase to 5.04 per 1000 catheter-days in the intervention phase. The catheter utilization rate decreased by 1.1% from 55.3% in the pre-intervention phase to 54.2% in the intervention phase. The decline in CLABSI varied significantly among hospital and ICU levels, except surgical ICUs (p = 0.59).Conclusions
Implementing a multidimensional central-line bundle significantly reduced the rates of CLABSI by 12.2% in nearly all participating ICUs, except surgical ICUs. 相似文献9.
Oh Samuel Jacqueise M. Unonu Kierra Dotson Soon Park Richard Parker Anthony K. Wutoh Euni Lee 《Journal of the National Medical Association》2018,110(4):378-383
Background
Human immunodeficiency virus (HIV) infection presents a significant burden, especially in the Washington, DC area. Literature is limited in describing the role of pharmacists in the outpatient clinic setting to provide patient-centered pharmaceutical care for patients with HIV.Objective
Our study aims to describe an interdisciplinary HIV care model including a clinical pharmacist at a community-based transcultural clinic in the Washington, DC area, and to describe the role of the pharmacist as indicated by an association between non-adherence to antiretroviral therapy (ART) and an ART regimen change.Methods
Using the electronic health record at the clinic from May 2011 through July 2013, 53 patients were identified who were referred to the clinical pharmacist.Results
The average age of the patients with HIV was 46.57 years in the clinic. About 28% of patients had documented non-adherence to ART and 30% of patients had one or more ART regimen changes during the study period. Medication non-adherence was a significant predictor of ART regimen change (ORadj 8.44; 95% CI 1.91–37.29). Substance use was a strong predictor of ART regimen change (ORunadj 3.47; 95% CI 1.02–11.81), but the relationship disappeared in the multivariate analysis.Conclusions
A strong association between pharmacist's evaluation of non-adherence to ART and a regimen change was demonstrated and the role of the pharmacist as the interdisciplinary team member was described. A follow-up study should be made to assess the services provided by the pharmacist on clinical, economic, and humanistic outcomes in the community-based clinical setting. 相似文献10.
Kimberly S. Johnson Kevin L. Thomas Sandro O. Pinheiro Laura P. Svetkey 《Journal of the National Medical Association》2018,110(4):305-313
Background
Disparities in health and healthcare are widely documented for underrepresented racial and ethnic populations across a spectrum of diseases and care settings. An evidence base for addressing racial and ethnic disparities in health and healthcare requires investigators trained to conduct health disparities research.Objective
To increase knowledge, stimulate interest, teach skills to evaluate and conduct, and foster collaborations in health disparities research.Design
We designed, implemented and evaluated a Health Disparities Research Curriculum (HDRC).Participants were early-stage investigators.Intervention
HDRC included twelve monthly sessions during 2015–2016. Instructors were mostly HDR investigators. Sessions combined didactic presentations, discussions, small group activities, and participant presentations.Measures
Pre- and post-surveys to assess participants' perceptions of knowledge and skills.Results
Of 21 enrollees, 13 were from under-represented groups and 14 were women. Four reported some prior training in HDR, and 12 reported currently conducting HDR.Among the 12 participants who completed both the pre and post HDRC survey, initially the most commonly cited barriers to pursuing HDR were lack of knowledge (N = 6) and funding (N = 7). In the post-survey, the number citing lack of knowledge decreased (N = 2) and the number listing lack of funding increased (N = 9). There were increases in the number of participants reporting increased knowledge of HDR methods (pre-post: 4 vs. 8) and competence to design (3 vs. 7) and implement (2 vs. 9) HDR research.Conclusions
The Duke HDRC augments efforts to reduce health disparities by providing training in HDR for young investigators. Our data indicate that the course was feasible, well-received, and increased perceived knowledge and competence. HDRC and similar courses may increase the quantity, quality and scope of HDR and thus move us closer to health equity. 相似文献11.
Roya Nikjou Rafat Kazemzadeh Firoozeh Asadzadeh Razzag Fathi Farideh Mostafazadeh 《Journal of the National Medical Association》2018,110(3):265-269
Objectives
The menopause is a natural biological process that is happened by a permanent regal stop due to the loss of performance. The aim of this research is to evaluate the effect of lavender aromatherapy on the menopause symptoms.Study design
This double-blind cross over clinical trial carried out on 100 menopause women (between 45 and 155 years old) referring to health centers in Ardabil in 2013-14. The samples blocked randomly, placed in two experimental (Lavender) and control (diluted milk) groups. Lavender aroma is smelled two times daily for 20 min during 12 weeks by research subjects. Data were collected by Green questionnaire and the analysis of data carried out in SPSS v.16 by paired t-test.Main outcome measures
The level of the symptoms has been decreased significantly after using lavender.Results
Comparing the level of the symptoms before and after using lavender in experimental group suggested that the rate of the menopause symptoms has been decreased significantly (P = 0.000). The comparison of the mean of the menopause symptoms after intervention between two groups suggested that the menopause symptoms in the experimental group had a significant decrease comparing the control group (P = 0.000).Conclusion
Using the lavender aromatherapy decreases menopause symptoms. According to the undesirable effect of the menopause symptoms on the quality of life of the menopausal women, these interventions may be instructed by midwives in the treatment and care centers as a health activity. 相似文献12.
Christopher Couch Tim Franxman Matthew Greenhawt 《Annals of allergy, asthma & immunology》2017,118(5):591-596.e3
Background
Characteristics and outcomes of tree nut (TN) oral food challenges (OFCs) in patients with TN allergy or sensitization alone are poorly studied.Objective
To determine the relation between TN sensitization levels and OFC outcomes.Methods
Open TN OFCs performed from 2007 through 2015 at a referral center were analyzed to compare outcome based on skin prick test (SPT) wheal size, food-specific immunoglobulin E (sIgE), peanut co-allergy, and TN sensitization only vs TN allergy with sensitization to other TNs. Delayed OFC was defined as longer than 12 months from the time of an sIgE level lower than 2 kUA/L.Results
Overall passage rate was 86% for 156 TN OFCs in 109 patients (54 almond, 28 cashew, 27 walnut, 18 hazelnut, 14 pecan, 13 pistachio, and 2 Brazil nut). Passage rates were 76% (n = 67) in patients with a history of TN allergy who were challenged to another TN to which they were sensitized and 91% (n = 65) in those with TN sensitization only (mean sIgE 1.53 kUA/L; range 0.35–9.14). Passage rates were 89% (n = 110 of 124) for a TN sIgE level lower than 2 kUA/L and 69% (11 of 16) for a TN sIgE level of at least 2 kUA/L. In 44 challenges in patients with peanut allergy and TN co-sensitization, the TN OFC passage rate was 96%. In 41 TN OFCs with a TN SPT wheal size of at least 3 mm, 61% passed, with a mean wheal size of 4.8 mm (range 3–11) in those passing vs 9 mm (range 3–20) in those failing.Conclusion
TN challenges are frequently passed in patients with TN sensitization with or without a history of TN reactivity despite a TN SPT wheal of at least 3 mm or a TN sIgE level of at least 2 kUA/L. Nearly all patients with peanut allergy and TN co-sensitization passed the TN challenge, questioning the clinical relevance of “co-allergy.” 相似文献13.
Wu-Pu Lin Yu-Ching Chang Un-In Wu Mei-Chuan Hung Pao-Yu Chuang Jann-Tay Wang Wang-Huei Sheng Yee-Chun Chen Shan-Chwen Chang 《Journal of microbiology, immunology, and infection》2018,51(5):644-651
Background
Central line (CL)-associated bloodstream infection (CLABSI) poses a major threat to patient safety and is associated with additional cost. This study investigated the sustained effect of multimodal interventions focusing on CL bundle improvement in the adult intensive care units (ICUs) of a teaching hospital in Taiwan.Methods
A before–after prospective study was conducted in 17 adult ICUs of a medical center in northern Taiwan from January 2009 to December 2013. Many interventions that aimed to facilitate CL bundle implementation were initiated in January 2011. The incidence rates of CLABSI and catheter-related bloodstream infection (CRBSI) were compared between the baseline and intervention periods. Catheter utilization ratios and microbiological characteristics were also analyzed.Results
The incidence rates of both CLABSI and CRBSI decreased significantly from the baseline to the intervention periods (from 9.27 to 7.66 per 1000 CL-days and from 1.51 to 0.89 per 1000 CL-days, respectively). The yearly incidence rate decreased by up to 31% (incidence rate ratio [IRR], 0.69; 95% confidence interval [CI], 0.59–0.81) for CLABSI and 59% (IRR, 0.41; 95% CI, 0.26–0.65) for CRBSI since the initiation of the interventions. The catheter utilization ratio also decreased from 0.71 to 0.63 (p < 0.001). Microbiological analysis showed that among all CLABSI isolates, the proportion of coagulase-negative staphylococci significantly decreased during the intervention period.Conclusion
Implementing multimodal interventions focusing on CL bundle improvement was effective in reducing the incidence rates of CLABSI and CRBSI in Taiwan's adult ICUs. 相似文献14.
Derek A. DuBay Nataliya Ivankova Ivan Herby Yu-Mei Schoenberger David T. Redden Cheryl Holt Laura Siminoff Mona Fouad Michelle Y. Martin 《Journal of the National Medical Association》2017,109(4):287-293
Background
African Americans (AA) are a third as likely as Caucasians to become registered organ donors at the Department of Motorized Vehicles (DMV). The Department of Health and Human Services has set the goal that at least 50% of adults in each state are registered donors.Aims
The purpose of this study was to explore the personal, behavioral and environmental factors associated with AA donor registration decision-making at the DMV.Methods
Guided by the Social Cognitive Theory, 13 focus groups (n = 100 participants) were conducted with AAs within 3 months of visiting a DMV and making a decision regarding whether to become or to not become a registered donor. The data were analyzed using inductive thematic and qualitative content analyses.Results
Study participants expressed a desire to learn more information while waiting in line at the DMV. Knowing a family member or friend in need of an organ transplant, and the desire to make one's own decision were two salient factors associated with the decision to become a registered organ donor. Several aspects of the DMV environment (e.g., noisy, overcrowded, lacking privacy) were cited as deterrents to becoming a registered donor.Discussion
This study highlights the personal, behavioral and environmental factors associated with AA organ donor registration decision-making at the DMV.Conclusion
The DMV is a setting where many adults make a decision about organ donation. Policies that create an environment in the DMV to support informed decision-making (e.g., privacy, informed clerks, available educational materials, etc.) are indicated. 相似文献15.
Monireh Toosi Marzieh Akbarzadeh Zahra Ghaemi 《Journal of the National Medical Association》2017,109(3):164-171
Objectives
Infertility is one of the main stressful events of life and a crisis affecting various dimensions of infertile couples' lives. Relaxation, as a strategy, can be effective in the individuals' resistance to stress and anxiety. Therefore, the present study aimed to assess the effect of relaxation on mother's anxiety and maternal–fetal attachment in primiparous women who used In Vitro Fertilization (IVF) to get pregnant.Methods
In this clinical trial, 80 primiparous women who had used IVF to get pregnant were randomly divided into a control and an intervention group. The intervention group took part in four 90-min relaxation classes in addition to receiving the routine pregnancy care. Anxiety and maternal–fetal attachment were evaluated before and one month after the intervention. Also, maternal–infantile attachment score was computed after delivery. The statistical analyses were performed using the SPSS statistical software. Chi-square and independent t-test was used to analyze the data.Results
The results revealed no significant difference between the two groups regarding the mean scores of anxiety and attachment before the intervention. However, a significant difference was observed in this regard after the intervention (41.4 ± 4.1 vs. 51.0 ± 10.4, P < 0.01).Conclusion
The study results showed that relaxation training was effective in reduction of anxiety and increase of maternal–fetal attachment in the women who had used IVF to get pregnant. Although there are other methods for reducing anxiety, relaxing can be used for IVF women due to its ease of use and its wide acceptance. 相似文献16.
Yun Heng Zhou Hong Xia Ma Xiao Xing Shi Yang Liu 《Journal of microbiology, immunology, and infection》2018,51(6):778-783
Objective
We investigated the prevalence of Ureaplasma spp. in semen samples of infertile men in Shanghai, China and evaluated the correlation between the sperm parameters (seminal volume, sperm concentration, progressive motility and non-progressive) and the secretary function in these infectious populations.Methods
Semens were collected from 540 infertile men and 260 fertile control group in shanghai, China and subjected to standard bacterial and Ureaplasma spp. culture. Positive Ureaplasma spp. isolates were further tested by PCR to detect the biovars and serotypes of Ureaplasma spp. Sperm seminological variabilities were analyzed by Computer-Assisted Semen Analysis according to the fifth edition of World Health Organization (WHO) laboratory manual for the examination and processing of human semen. Seminal markers were measured by the automatic analyzer.Results
The prevalence of Ureaplasma spp. in semen specimens was 39.6% (214/540) and 19.2% (50/260) in infertile and control group, respectively. Significant difference was observed between the two groups (P < 0.001). Among all clinical isolates from infertile men (n = 214), 59.3% (n = 127) was Ureaplasma parvum (UPA), 26.2% (n = 56) was Ureaplasma urealyticum (UUR), and 14.5% (n = 31) was mixed species. While those numbers in control group (n = 50) were 64.0% (n = 32), 20.0% (n = 10), 16.0% (n = 8), respectively. There was no significant difference between any two groups (P > 0.05). The progressive motility and the NAG activity of infertile men infected with UPA and mixed species were significantly lower than those of UUR infected subgroup (P < 0.05).Conclusions
The infection of Ureaplasma spp. plays an important pathogenic role in male infertility. UPA has higher pathogenicity on the progressive motility and the secretary function of epididymis than UUR. 相似文献17.
18.
Mina Tadrous Wayne Khuu Gerald Lebovic Matthew B. Stanbrook Diana Martins J. Michael Paterson Muhammad M. Mamdani David N. Juurlink Tara Gomes 《Annals of allergy, asthma & immunology》2018,120(1):59-65.e2
Background
Omalizumab is indicated for the treatment of moderate to severe asthma. There is limited observational evidence on the costs and effectiveness of omalizumab.Objective
To examine the costs and effectiveness of omalizumab for treatment of severe asthma relative to nonusers.Methods
We conducted a within-person repeated-measures matched cohort study in Ontario, Canada from April 1, 2012 to March 31, 2014. Continuous users of omalizumab were matched with up to 4 nonusers according to age, sex, recent specialist visits, oral corticosteroid use, asthma severity, and Charlson comorbidity score. The primary outcome was direct health care costs. Secondary outcomes were asthma-related hospitalizations or emergency department visits and oral corticosteroid use. The association between omalizumab use and each outcome was assessed using mixed-effects models adjusting for confounders.Results
Ninety-five omalizumab users and 352 nonusers were matched. Among users, there was a significant increase in health care costs of $1,796 per person owing to the cost of the medication at treatment initiation (P < .0001). Costs did not change significantly among nonusers ($85 increase in average monthly costs per person; P = .59). We found no significant changes in the rates of asthma-related hospitalizations or emergency department visits among omalizumab users (P = .44) or nonusers (P = .99) between pre- and postintervention periods.Conclusion
The use of omalizumab was associated with increased costs but no evidence of lower rates of clinically important outcomes. These results suggest omalizumab had limited effectiveness in our study population. Future studies should further explore subsets of patients most likely to benefit from omalizumab therapy. 相似文献19.
Minal R. Patel Peter X.K. Song Georgiana Sanders Belinda Nelson Elena Kaltsas Lara J. Thomas Mary R. Janevic Kausar Hafeez Wen Wang Margaret Wilkin Timothy R. Johnson Randall W. Brown 《Annals of allergy, asthma & immunology》2017,118(2):212-219
Background
Few interventions have focused on the difficulties that African American women face when managing asthma.Objective
To evaluate a telephone-based self-regulation intervention that emphasized African American women's management of asthma in a series of 6 sessions.Methods
A total of 422 African American women with persistent asthma were randomly assigned to either an intervention or control group receiving usual care. Behavioral factors, symptoms and asthma control, asthma-related quality of life, and health care use at baseline and 2 years after baseline were assessed. Generalized estimating equations were used to assess the long-term effect of the intervention on outcomes.Results
Compared with the control group, those who completed the full intervention (6 sessions) had significant gains in self-regulation of their asthma (B estimate, 0.73; 95% CI, 0.17–1.30; P < .01), noticing changes to their asthma during their menstrual cycle (B estimate, 1.42; 95% CI, 0.69–2.15; P < .001), and when having premenstrual syndrome (B estimate, 1.70; 95% CI, 0.67–2.72; P < .001). They also had significant reductions in daytime symptoms (B estimate, ?0.15; 95% CI, ?0.27 to ?0.03; P < .01), asthma-related hospitalization (B estimate, 0.51; 95% CI, 0.00–1.02; P < .05), and improved asthma control (B estimate, 1.34; 95% CI, 0.57–2.12; P < .001). However, neither grouped changed over time in outcomes.Conclusion
Despite high comorbidity, African American women who completed a culturally responsive self-management program had improvements in asthma outcomes compared with the control group. Future work should address significant comorbidities and psychosocial issues alongside asthma management to improve asthma outcomes in the long term.20.
Yetunde A. Kuyinu Babatunde A. Odugbemi Shukrat O. Salisu-Olatunji Funmilade O. Adepoju Olumuyiwa O. Odusanya 《Journal of the National Medical Association》2018,110(1):88-91