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1.
Luqman Aribidesi Olayaki Isiaka Abdullateef Alagbonsi Hawau Olaide Abdulkadir Felix Oluwaseyi Idowu 《Journal of the Anatomical Society of India》2017,66(1):67-71
Introduction
Cryptorchidism has been associated with spermatotoxicity and oxidative stress while melatonin is a well-known anti-oxidant. This study investigated the possible ameliorative effect of melatonin on cryptorchidism-induced spermatotoxicity and oxidative stress.Methods
Thirty six male Wistar rats were randomised into sham-operated (n = 18) and bilaterally cryptorchid (n = 18) groups, each of which were subdivided into 3 oral treatment groups (n = 6 rats each) that received normal saline, low dose (4 mg/kg) and high dose (10 mg/kg) melatonin.Results
Cryptorchidism reduced sperm parameters, oestradiol, luteinising hormone, follicle stimulating hormone and glutathione peroxidase activity, but increased testosterone and lactate dehydrogenase activity. The cryptorchidism-induced spermatotoxicity and oxidative stress were ameliorated by low dose of melatonin but exacerbated by its high dose.Discussion
Melatonin’s effect on cryptorchidism-induced spermatotoxicity is dose-dependent. 相似文献2.
Jin Hui Joo Seungyoung Hwang Joseph J. Gallo Debra L. Roter 《Patient education and counseling》2018,101(4):665-671
Objective
The objective of this pilot study was to describe peer communication in meetings with depressed elders, associate their relationship with working alliance and depression and assess congruence of communication with training.Methods
Three peers with a history of depression, in recovery, received 20 h of training in peer mentoring for depression as part of an 8-week pilot program for 23 depressed older adults. Each peer-client meeting was recorded; a sample of 69 recorded meetings were chosen across the program period and coded with the Roter Interaction Analysis System, a validated medical interaction analysis system. Generalized linear mixed models were used to examine peer talk during meetings in relation to working alliance and client depression.Results
Peers used a variety of skills congruent with their training including client-centered talk, positive rapport building and emotional responsiveness that remained consistent or increased over time. Client-centered communication and positive rapport were associated with increased working alliance and decreased depressive symptoms (all p < 0.001).Conclusion
Trained peer mentors can use communication behaviors useful to older adults with depression. Specifically, client-centered talk may be important to include in peer training.Practice implications
Peer mentors can be a valuable resource in providing depression counseling to older adults. 相似文献3.
Objective
Synthesize quantitative empirical evidence on the role of health literacy in predicting adherence to dietary recommendations.Methods
A systematic search of 13 online databases resulted in 1498 articles eligible for screening. Of those, 20 met the predefined inclusion criteria and, together with 6 studies retrieved from their reference lists, were included for review. Screening of full-texts, data extraction and quality appraisal were independently performed by two reviewers. Inconsistencies regarding eligibility were resolved through discussion.Results
Of the 26 reviewed articles, 17 involved patients and 9 the general population. Overall, 35 associations between health literacy and various nutrition behaviours were observed. A significant direct positive association was reported in 5 cases, all of them concerning the general population. An insignificant association was reported in 20 cases, 15 of which were related to patients. The remaining associations were negative (n = 2), partially mediated (n = 1) or entirely mediated (n?=?7).Conclusion
Health literacy was scarcely determinant of dietary adherence and other nutrition behaviours, especially among patients.Practice implication
Patients’ dietary adherence is likely to be unaffected by interventions based on health literacy. Empowering approaches are expected to be more beneficial. 相似文献4.
Gwendolyn P. Quinn Rebecca D. Pentz Teresita Muñoz-Antonia Theresa A. Boyle Matthew B. Schabath Christie L. Pratt Andrea Shaffer Luisa F. Duarte Meghan Bowman-Curci Scott J. Antonia Alberto A. Chiappori Benjamin C. Creelan Jhanelle E. Gray Charles C. Williams Eric B. Haura 《Patient education and counseling》2018,101(4):703-710
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6.
Rachael Glassey Moira O’Connor Angela Ives Christobel Saunders Sarah J. Hardcastle 《Patient education and counseling》2018,101(2):318-323
Objective
The objective of this study was to explore the influences on decision-making of younger women (<35) undergoing or considering bilateral prophylactic mastectomy (BPM).Methods
Qualitative interviews guided by interpretative phenomenological analysis (IPA) were conducted with forty-six women who had a strong family history of breast cancer (BC) who had either undergone (n = 26) or were considering (n = 20) BPM. Participants were recruited from Australia and New Zealand (NZ) via hospitals, a genetics clinic, a research cohort, a registry and online.Results
Four themes underpinning the influences on decision-making were identified: fear and anxiety, children, personal experiences with BC, health professional’s influence.Conclusions
The decision to undergo BPM for younger women ( < 35) was multifaceted, however, it appeared that fear and anxiety were the main influence. Younger women appear more anxious than previous research with older women. There appears to be few differences between those with confirmed BRCA1/2 mutations and those with no known mutation and this is clinically significant.Practice implications
These findings have important practice implications, particularly improving communication of risk statistics, especially to those with no known mutation. Health professionals need to take into account the way younger women perceive information given to them when discussing risk. 相似文献7.
Wolfgang Gaissmaier Helge Giese Mirta Galesic Rocio Garcia-Retamero Juergen Kasper Ingo Kleiter Sven G. Meuth Sascha Köpke Christoph Heesen 《Patient education and counseling》2018,101(1):74-78
Objective
A shared decision-making approach is suggested for multiple sclerosis (MS) patients. To properly evaluate benefits and risks of different treatment options accordingly, MS patients require sufficient numeracy – the ability to understand quantitative information. It is unknown whether MS affects numeracy. Therefore, we investigated whether patients’ numeracy was impaired compared to a probabilistic national sample.Methods
As part of the larger prospective, observational, multicenter study PERCEPT, we assessed numeracy for a clinical study sample of German MS patients (N = 725) with a standard test and compared them to a German probabilistic sample (N = 1001), controlling for age, sex, and education. Within patients, we assessed whether disease variables (disease duration, disability, annual relapse rate, cognitive impairment) predicted numeracy beyond these demographics.Results
MS patients showed a comparable level of numeracy as the probabilistic national sample (68.9% vs. 68.5% correct answers, P = 0.831). In both samples, numeracy was higher for men and the highly educated. Disease variables did not predict numeracy beyond demographics within patients, and predictability was generally low.Conclusion
This sample of MS patients understood quantitative information on the same level as the general population.Practice implications
There is no reason to withhold quantitative information from MS patients. 相似文献8.
Marsha N. Wittink Patrick Walsh Sule Yilmaz Michael Mendoza Richard L. Street Benjamin P. Chapman Paul Duberstein 《Patient education and counseling》2018,101(2):214-220
Objective
Patients with multiple chronic conditions face many stressors (e.g. financial, safety, transportation stressors) that are rarely prioritized for discussion with the primary care provider (PCP). In this pilot randomized controlled trial we examined the effects of a novel technology-based intervention called Customized Care on stressor disclosure.Methods
The main outcomes were stressor disclosure, patient confidence and activation, as assessed by self-report and observational methods (transcribed and coded audio-recordings of the office visit).Results
Sixty patients were enrolled. Compared with care as usual, intervention patients were 6 times more likely to disclose stressors to the PCP (OR = 6.16, 95% CI [1.53, 24.81], p = 0.011) and reported greater stressor disclosure confidence (exp[B] = 1.06, 95% CI [1.01, 1.12], p = 0.028). No differences were found in patient activation or the length of the office visit.Conclusion
Customized Care improved the likelihood of stressor disclosure without affecting the length of the PCP visit.Practice implications
Brief technology-based interventions, like Customized Care could be made available through patient portals, or on smart phones, to prime patient-PCP discussion about difficult subjects, thereby improving the patient experience and efficiency of the visit. 相似文献9.
Kathleen M. Grant Lance Brendan Young Kimberly A. Tyler Jamie L. Simpson R. Dario Pulido Christine Timko 《Patient education and counseling》2018,101(1):79-84
Objective
A multisite field trial testing whether improved outcomes associated with intensive referral to mutual help groups (MHGs) could be maintained after the intervention was adapted for the circumstances and needs of rural veterans in treatment for substance use disorder (SUD).Methods
In three Veterans Affairs treatment programs in the Midwest, patients (N = 195) received standard referral (SR) or rural-adapted intensive referral (RAIR) and were measured at baseline and 6-month follow-up.Results
Both groups reported significant improvement at 6-months, but no significant differences between SR and RAIR groups in MHG participation, substance use, addiction severity, and posttraumatic stress symptoms. Inconsistent delivery of the intervention resulted in only one-third of the RAIR group receiving the full three sessions, but this group reported significantly greater 6-month abstinence from alcohol than those receiving no sessions.Conclusion
Further research should explore implementation problems and determine whether consistent delivery of the intervention enhances 12-step facilitation.Practice implications
The addition of rural-specific elements to the original intensive referral intervention has not been shown to increase its effectiveness among rural veterans. 相似文献10.
Tessie W. October Zoelle B. Dizon Debra L. Roter 《Patient education and counseling》2018,101(4):647-652
Objective
Apply turn analysis to family conferences in the pediatric intensive care unit.Methods
We analyzed 39 audio-recorded family conferences using the Roter Interaction Analysis System. A turn was defined as a continuous block of uninterrupted statements by a speaker.Results
Opening turns by the healthcare team (HCT) averaged 207 s, compared to 28 s for families. Turn density (number of statements/turn) was 6 for the HCT versus 2 for families (p < 0.0001). An average of 21 turns (26%) occurred between HCT members, resulting in substantial sections of dialogue excluding the family. Average HCT dialogue reflected a literacy demand of a 9th grade level, whereas family dialogue averaged a 5th grade level (p < 0.0001). More HCT turns were related to higher reading level demand (r = 0.34; p = 0.03) and lower levels of patient-centeredness (r = ?0.35, p = 0.03).Conclusion
The healthcare team can improve the communication experience for families by encouraging and facilitating family engagement in conference dialogue.Practice implications
Changing how the healthcare team engages with families during communication events is vital to improving the experience for families. Our data suggests simple adjustments, such as limiting medical jargon and inter-team turns may lead to increased family participation and more family-centered care. 相似文献11.
Monika Janda Nigel R Armfield Katie Page Gayle Kerr Suzanne Kurz Graeme Jackson Jason Currie Edward Weaver Anusch Yazdani Andreas Obermair 《Patient education and counseling》2018,101(3):504-510
Objective
To explore factors influencing how well-informed women felt about hysterectomy, influences on their decision making, and on them receiving a less-invasive alternative to open surgery.Methods
Online questionnaire, conducted in 2015–2016, of women who had received a hysterectomy in Australia, in the preceding two years.Results
Questionnaires were completed by 2319/6000 women (39% response). Most women (n = 2225; 96%) felt well-informed about hysterectomy. Women were more aware of the open abdominal approach (n = 1798; 77%), than of less-invasive vaginal (n = 1552; 67%), laparoscopic (n = 1540; 66%), laparoscopic-assisted (n = 1303; 56%), and robotic approaches (n = 289; 12%). Most women (n = 1435; 62%) reported their gynaecologist was the most influential information source. Women who received information about hysterectomy from a GP (OR = 1.47; 95% CI 1.15-1.90), or from a gynaecologist (OR = 1.3; 95% CI 1.06-1.58), were more likely to feel better informed (p < 0.01).Conclusion
This study is important because it helps clinicians, researchers and health policy makers to understand why many women still receive an open abdominal approach despite many learned societies recommending to avoid it if possible.Practice implications
Additional information, or education about avoiding open abdominal approach where possible may lead to a greater number of women receiving less-invasive types of hysterectomy in the future. 相似文献12.
Veerle Duprez Dimitri Beeckman Sofie Verhaeghe Ann Van Hecke 《Patient education and counseling》2018,101(2):276-284
Objective
To explore nurses’ self-perceived behavior of supporting patients’ self-management, and its association with person-related and socio-structural factors.Methods
Correlational study in a sample of nurses from nine general hospitals, three community healthcare organizations, and six private community practices. Nurses with >50% of their patients living with a chronic condition were eligible to participate. Data were collected at two time-points. Self-management support behavior was measured by the SEPSS-36 instrument. The person-related and socio-structural associated factors were derived from behavioral theories and measured by validated questionnaires.Results
Nurses (N = 477) scored overall low on self-management support behavior. Nurses lacked mainly competencies in collaborative goalsetting, shared decision making and organizing follow-up. Factors predicting nurses’ behavior in supporting patients’ self-management were self-efficacy, priority, perceived supervisor support and training in self-management support. This model explained 51.7% of the variance in nurses’ behavior.Conclusion
To date, nurses do not optimally fulfil their role in supporting patients’ self-management. Self-management support is practiced from a narrow medical point of view and primarily consists of informing patients, which is the lowest level of patient participation.Practice implications
It is essential to better prepare and support nurses ? and by extend all healthcare professionals ? for the challenges of supporting patients’ self-management. 相似文献13.
Maria Alcocer Alkureishi Wei Wei Lee Maureen Lyons Kristen Wroblewski Jeanne M. Farnan Vineet M. Arora 《Patient education and counseling》2018,101(3):481-489
Introduction
Electronic Health Record (EHR) use can enhance or weaken patient-provider communication. Despite EHR adoption, no validated tool exists to assess EHR communication skills. We aimed to develop and validate such a tool.Methods
Electronic-Clinical Evaluation Exercise (e-CEX) is a 10-item-tool based on systematic literature review and pilot-testing. Second-year (MS2s) students participated in an EHR-use lecture and structured Clinical Examination (OSCE). Untrained third-year students (MS3s) participated in the same OSCE. OSCEs were scored with e-CEX compared to a standardized patient (SP) tool. Internal consistency, discriminant validity, and concurrent validity were analyzed.Results
Three investigators used e-CEX to rate 70 videos (20 MS2, 50 MS3). Reliability testing indicated high internal consistency (Cronbach’s alpha = 0.89). MS2s scored significantly higher than untrained MS3 s on e-CEX [e-CEX 55(10.7) vs. 44.9 (12.7), P = 0.003], providing evidence of discriminant validity. e-CEX and SP score correlation was high (Pearson correlation = 0.74, P < 0.001), providing concurrent validity evidence. Item reduction suggested a three-item tool had similar explanatory power (R-squared = 0.85 vs 0.86).Conclusion
e-CEX is a reliable, valid tool to assess medical student patient-centered EHR communication skills.Practice implications
While validation is needed with other healthcare providers, e-CEX may help improve provider behaviors and enhance patients’ overall experience of EHR use in their care. 相似文献14.
Alicia Hamui-Sutton Pamela Enríquez-López Cinthya Hernández-Becerril Carlos Lavalle-Montalvo Pelayo Vilar-Puig 《Educación Médica》2018,19(1):9-18
Introduction
Teacher and student interaction, the monitoring of clinical practices, and professionalism are the issues that the teaching performance assessment tool examines by gathering the opinions of the residents on the educational skills of teaching staff and lecturers.Objective
The aim of this study was to: (i) gathering the comments of the residents about the role model and commitment of tutors to their training; (ii) to determine the educational strategies used by teachers in clinical settings; (iii) to show the current recruitment difficulties of the Medical Specialisations Plan (PUEM) affect the educational process, and (iv) to report the residents mentions of abuse and perceived unfairness by their teachers.Material and method
Qualitative study that considered the written comments by 1,628 residents in an open question regarding teaching performance in medical residencies. They were classified into 10 categories with sub-categories and the positive and negative trends were quantified. The comments were analysed according to the 3 topics of the questionnaire.Results
For residents, the categories of the educator as role model and academic commitment of the teacher obtained the largest number of positive reviews, while hiring of teachers and educational strategies employed by the latter reported the highest number of negative comments.Discussion
The free comments expressed by the residents on the teaching performance reflect the strengths and weaknesses of the teaching process in hospital contexts, which provides a qualitative approach to the relationship with their teachers. 相似文献15.
Yuhong Ye Sheng Zhang Yupeng Chen Xingfu Wang Pengcheng Wang 《Pathology, research and practice》2018,214(2):268-272
Objective
To evaluate the expression and prognostic significance of ALDH1A1 in gastric neuroendocrine carcinoma.Materials and methods
Immunohistochemical stains of ALDH1A1 were evaluated in 67 cases of gastric neuroendocrine carcinoma. The findings were correlated with clinicopathologic variables and overall survival.Results
Immunohistochemistry revealed positive cytoplasmic immunoreactivity in 35 of 67 (52.2%) tumors and strongly positive immunoreactivity in 14 of 67 (20.9%). Strongly positive ALDH1A1 expression, but not positive staining, was significantly associated with lymph node status, lymphovascular invasion, and ki-67 index (P = 0.039, 0.045, and 0.045, respectively). Kaplan‐Meier survival curves and log-rank tests showed significantly poorer prognoses in cases of high ALDH1A1 expression compared to cases of low ALDH1A1 expression or the negative control group (MST, 17 vs. 52 months; P = 0.026). Multivariate analysis showed that high ALDH1A1 expression, lymph node metastasis, and lymphovascular invasion had significant associations with decreased overall survival (P = 0.029, 0.008, and 0.005, respectively).Conclusions
High ALDH1A1 expression may be a prognostic indicator of survival in patients with gastric neuroendocrine carcinoma. 相似文献16.
Background
Massive transfusion is the clinical scenario where the presumed adverse effects of stored blood are expected to be more evident because the whole patient's blood volume is replaced by stored blood.Objective
To analyse the association between age of transfused red blood cells (RBC) and survival in massively transfused patients.Methods
In this retrospective study, clinical and transfusion data of all consecutive patients massively transfused between 2008 and 2014 in a large, tertiary-care hospital were electronically extracted from the Transfusion Service database and the patients’ electronic medical records. Prognostic factors for in-hospital mortality were investigated by multivariate logistic regression.Results
A total of 689 consecutive patients were analysed (median age: 61 years; 65% males) and 272 died in-hospital. Projected mortality at 2, 30, and 90 days was 21%, 35% and 45%, respectively. The odds ratio (OR) for in-hospital mortality among patients who survived after the 2nd day increased with patient age (OR: 1.037, 95% CI: 1.021–1.054; per year P < 0.001), with the number of RBC unit transfused in the first 48 hours (OR: 1.060; 95% CI: 1.038–1.020 per unit; P < 0.001), and the percentage of such RBC stored for more than 28 days (1.010, 95% CI: 1.005–1.018 per percent point; P = 0.01).Conclusion
Mortality after massive transfusion was associated with a higher proportion of old RBCs transfused in the first 48 hours. Other factors associated with poor prognosis were older patient's age and larger volumes of transfused RBCs. 相似文献17.
Amy Scheel Andrea Beaton Emmy Okello Chris T. Longenecker Isaac Omara Otim Peter Lwabi Craig Sable Allison R. Webel Twalib Aliku 《Patient education and counseling》2018,101(1):119-123
Objective
To assess the impact of a peer-support group on knowledge, quality of life, and social support for children with rheumatic heart disease (RHD).Methods
Children diagnosed with RHD and receiving 4-weekly injectable penicillin were invited to participate in a monthly support group for 6 months. Pre- and post-intervention assessments included a baseline RHD knowledge assessment, a measure of health related quality of life (HRQOL) (PedsQLTM4.0), and a measure of social support (Hawthorne Friendship Scale). Groups incorporated elements of cooperative play and team building, RHD education, and emotional support.Results
42 participants attended ≥3 groups and were included in the analyses. Attending support groups resulted in increased total HRQOL scores (60.3 v 70.2, p < 0.001), as well as the following HRQOL sub-scores (physical functioning 55.3 v 68.6 (p < 0.001), social functioning 64.2 v 75.8 (p < 0.001) and school functioning 59.2 v 69.1 (p = 0.001)). Significant increases in Friendship Scale scores (15.4 v 19.7, p < 0.001) and RHD Knowledge scores were observed (3.6 v 6.4, p < 0.001).Conclusions
Peer-support groups may be effective at normalizing decreased HRQOL scores and increasing RHD disease knowledge and social support.Practical implications
Peer-support groups implemented in conjunction with RHD screening can minimize the negative psychosocial effects associated with early RHD detection. 相似文献18.
Tuğba Kotil Şengül Şentürk Türkan Sarioğlu Leyla Tapul 《Experimental and toxicologic pathology》2017,69(8):643-648
Aims
Retinoic acid (RA) has a vital importance in order to ensure continuity and morphology in many tissues. Matrix metalloproteinases (MMPs) have significant roles in proliferation, the formation of cancers, and metastasis. In this study the effects of RA on MMP-2 production in cells of rat uterus were investigated.Methods
Twenty-four adult Spraque Dawley rats were divided into two groups, the experimental group was treated with 40 mg/kg/day 13-cis RA for 5 days by gavage. Uterine tissue sections were treated with BrdU and MMP-2 antibodies, evaluated using light microscopy. Tissues were fixed with 2.5% glutaraldehyde and evaluated using transmission electron miroscopy.Results
MMP-2 immunoreactivity decreased in the stromal cells compared with the control group and no staining of MMP-2 was observed in glandular epithelium in the experimental group. BrDU labeling of cells showed significant decrease in RA-treated group versus control group cells. Based on the electron microscopy evaluation, the surface epithelial cells of the experimental group showed vacuolization, and an accumulation of lipofuscin bodies was also observed in the gland epithelium. Cells involving autophagic vacuoles contained excess lipid granules in the entire uterus layers especially localized at the border of the endometrium and myometrium.Conclusion
RA had negative effects on cell proliferation and cell morphology and inhibited MMP-2 expression. 相似文献19.
Kim Beernaert Chloë Haverbeke Simon Van Belle Luc Deliens Joachim Cohen 《Patient education and counseling》2018,101(1):132-138
Objective
We assessed information provision and information needs about illness course, treatments, palliative care and euthanasia in cancer patients.Methods
Cancer patients consulting a university hospital (N = 620) filled out a questionnaire. Their cancer related data were collected through the treating oncologist. This study is performed in Belgium, where “palliative care for all” is a patient’s right embedded in the law and euthanasia is possible under certain conditions.Results
Around 80% received information about their illness course and treatments. Ten percent received information about palliative care and euthanasia. Most information about palliative care and euthanasia was given when the patient had a life expectancy of less than six months. However, a quarter of those in earlier phases in their illness trajectory, particularly those who experienced high pain, fatigue or nausea requested more information on these topics.Conclusion
Many patients want more information about palliative care and euthanasia than what is currently provided, also those in an earlier than terminal phase of their disease.Practice implications
Healthcare professionals should be more responsive, already from diagnosis, to the information needs about palliative care and possible end-of-life decisions. This should be patient-tailored, as some patients want more and some patients want less information. 相似文献20.
Ida J. Korfage Erik W. de Kwaadsteniet Arno van Voorst Anne M. Stiggelbout Marieke de Vries Arwen H. Pieterse 《Patient education and counseling》2018,101(2):310-317