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Local and serum levels of adipokines in patients with obesity after periodontal therapy: one‐year follow‐up
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Eileen M. Dryden PhD Meaghan A. Kennedy MD MPH Jennifer Conti MPH Jacqueline H. Boudreau MPH Chitra P. Anwar MA Kathryn Nearing PhD MA Camilla B. Pimentel PhD MPH William W. Hung MD MPH Lauren R. Moo MD 《Health services research》2023,58(Z1):26-35
Objective
Explore the perceived benefits of a Veterans Health Administration (VHA) geriatric specialty telemedicine service (GRECC Connect) among rural, older patients and caregivers to contribute to an assessment of its quality and value.Data Sources
In Spring 2021, we interviewed a geographically diverse sample of rural, older patients and their caregivers who participated in GRECC Connect telemedicine visits.Study Design
A cross-sectional qualitative study focused on patient and caregiver experiences with telemedicine, including perceived benefits and challenges.Data Collection
We conducted 30 semi-structured qualitative interviews with rural, older (≥65) patients enrolled in the VHA and their caregivers via videoconference or phone. Interviews were recorded, transcribed, and analyzed using a rapid qualitative analysis approach.Principal Findings
Participants described geriatric specialty telemedicine visits focused on cognitive assessments, tailored physical therapy, medication management, education on disease progression, support for managing multiple comorbidities, and suggestions to improve physical functioning. Participants reported that, in addition to prescribing medications and ordering tests, clinicians expedited referrals, coordinated care, and listened to and validated both patient and caregiver concerns. Perceived benefits included improved patient health; increased patient and caregiver understanding and confidence around symptom management; and greater feelings of empowerment, hopefulness, and support. Challenges included difficulty accessing some recommended programs and services, uncertainty related to instructions or follow-up, and not receiving as much information or treatment as desired. The content of visits was well aligned with the domains of the Age-Friendly Health Systems and Geriatric 5Ms frameworks (Medication, Mentation, Mobility, what Matters most, and Multi-complexity).Conclusions
Alignment of patient and caregiver experiences with widely-used models of comprehensive geriatric care indicates that high-quality geriatric care can be provided through virtual modalities. Additional work is needed to develop strategies to address challenges and optimize and expand access to geriatric specialty telemedicine. 相似文献77.
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Hugo Figueiredo‐Ferraz Pedro R. Gil‐Monte Ester Grau‐Alberola Marta Llorca‐Pellicer Juan A. García‐Juesas 《Journal of Applied Research in Intellectual Disabilities》2012,25(5):455-463
Background The problem of mobbing has attracted a great deal of attention over the past few years. This concern has increased the study of the phenomena, which has resulted in many scientific publications. Mobbing has been characterized as an emerging risk at work. The aim of this study was to analyse the influence of some psychosocial factors at work – role clarity, interpersonal conflicts and social support – on mobbing and its consequences – that is, inclination towards absenteeism and psychosomatic disorders. Materials and methods The sample included 422 employees working with people with intellectual disabilities. Structural equation modelling (SEM) was used to test the hypotheses. Results The Hypothesized model showed an adequate fit to data, and all hypothesized relationships were significant. Conclusions The results of this study provide support for the mediator role of mobbing in the relationship between high role ambiguity, low social support and high interpersonal conflicts and psychosomatic disorders and inclination towards absenteeism. 相似文献
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Claudia Figueiredo Mello Marinella Della Negra 《The Brazilian journal of infectious diseases》2011,15(3):262-267
BackgroundBacterial pneumonia is one of the main causes of morbidity and mortality in patients infected by the human immunodeficiency virus (HIV). The main objective of this study was to evaluate the effect of macrolide therapy in combination with a beta-lactam based empiric regimen for inpatients with community-acquired pneumonia and HIV.MethodsThis is a retrospective cohort study of hospitalized patients. Adult patients who had received treatment with ceftriaxone or ceftriaxone plus clarithromycin were included.Results76 patients met the inclusion criteria. Among baseline characteristics analyzed, only respiratory rate showed significant difference: patients who had received clarithromycin were more likely to have a respiratory rate > 30/min than patients who received only ceftriaxone (64% versus 36%, p = 0.03). ICU admission was the only outcome that showed a significant difference, more frequent in the ceftriaxone plus clarithromycin group (45% versus 20%, p = 0.03).ConclusionsThis study does not support the addition of a macrolide to a beta-lactam based regimen in HIV-infected patients. This is probably related to the patients’ immunodeficiency status, which impairs the immunomodulatory properties of the macrolides. 相似文献
80.
Frederico Figueiredo Amancio Maira Alves Pereira Felipe Campos de Melo Iani Lorena D'anuncia??o Jorge Luís Carvalho de Almeida Janer Aparecida Silveira Soares Marcela Lencine Ferraz Thiago Cardoso Vale José Roberto Lambertucci Mariangela Carneiro 《Revista do Instituto de Medicina Tropical de S?o Paulo》2014,56(3):267-270
Dengue is currently a major public-health problem. Dengue virus (DENV) is
classified into four distinct serotypes, DENV 1-4. After 28 years of absence, DENV-4
was again detected in Brazil in 2010 in Roraima State, and one year later, the virus
was identified in the northern Brazilian states of Amazonas and Pará, followed by Rio
de Janeiro and São Paulo. In Minas Gerais, the first confirmed case of DENV-4
occurred in the municipality of Frutal in 2011 and has now been isolated from a
growing number of patients. Although DENV-2 is associated with the highest risk of
severe forms of the disease and death due to the infection, DENV-4 has also been
associated with severe forms of the disease and an increasing risk of hemorrhagic
manifestations. Herein, the first fatal case of confirmed DENV-4 in Brazil is
reported. The patient was an 11-year-old girl from the municipality of Montes Claros
in northern Minas Gerais State, Brazil. She had idiopathic thrombocytopenic purpura
as a comorbid condition and presented with a fulminant course of infection, leading
to death due to hemorrhagic complications. Diagnosis was confirmed by detection of
Dengue-specific antibodies using IgM capture enzyme-linked immunosorbent assay and
semi-nested RT-PCR. Primary care physicians and other health-care
providers should bear in mind that DENV-4 can also result in severe forms of the
disease and lead to hemorrhagic complications and death, mainly when dengue infection
is associated with coexisting conditions. 相似文献