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tive analyses.
Medication non-adherence contributes to worse health outcomes among SLE patients. selleck chemicals The underlying mechanisms that drive medication non-adherence are poorly understood. The purpose of this study was to explore possible mechanisms of medication non-adherence by eliciting patient experiences.
Consented adult patients with ACR- or SLICC-classified SLE were recruited. Ten semi-structured interviews were conducted across six participants. Interviews were audio recorded, transcribed, and analysed using an iterative process. The findings were presented to an interactive public forum with SLE patients, family members and friends of patients, and health-care professionals to assess validity and for elaboration of the concepts developed.
The following three interrelated themes emerged from the interviews. First, why do rheumatologists not know more about lupus or share what they do know with their patients? Second, why do I have to take so many drugs and why do the drugs not work? Third, if my rheumatologist cannots along with a lack of validation of their symptoms contributed to them not valuing the recommendations of physicians. This also contributed to development of a cynical outlook and little belief that medication would improve their condition. Although further work is needed to validate these findings, our preliminary work suggests that interventions focusing on the development of communication skills among both patients and rheumatologists are necessary to reduce medication non-adherence.
The aim was to explore the self-reported impact of the COVID-19 pandemic on changes to care and behaviour in UK patients with systemic autoimmune rheumatic diseases, to help ensure that patient experiences are considered in future pandemic planning.
This was a longitudinal mixed methods study, with a cohort completing baseline surveys in March 2020 and follow-up surveys in June 2020 (
= 111), combined with thematic analysis of the LUPUS UK forum and participant interviews (
= 28).
Cancellations of routine care and difficulties in accessing medical support contributed to some participants deteriorating physically, including reports of hospitalizations. The majority of participants reported that fear of COVID-19 and disruptions to their medical care had also adversely impacted their mental health. Feeling medically supported during the pandemic was correlated with multiple measures of mental health and perceptions of care, including the Warwick-Edinburgh mental well-being score (
= 0.44,
= 0.01).linician accessibility and patients feeling medically supported on multiple measures of physical and mental health.Sixty years of research on chimpanzees (Pan troglodytes) at Gombe National Park, Tanzania have revealed many similarities with human behaviour, including hunting, tool use, and coalitionary killing. The close phylogenetic relationship between chimpanzees and humans suggests that these traits were present in the last common ancestor of Pan and Homo (LCAPH). However, findings emerging from studies of our other closest living relative, the bonobo (Pan paniscus), indicate that either bonobos are derived in these respects, or the many similarities between chimpanzees and humans evolved convergently. In either case, field studies provide opportunities to test hypotheses for how and why our lineage has followed its peculiar path through the adaptive landscape. Evidence from primate field studies suggests that the hominin path depends on our heritage as apes inefficient quadrupeds with grasping hands, orthograde posture, and digestive systems that require high quality foods. Key steps along this path include (1) changes in diet; (2) increased use of tools; (3) bipedal gait; (4) multilevel societies; (5) collective foraging, including a sexual division of labor and extensive food transfers; and (6) language. Here I consider some possible explanations for these transitions, with an emphasis on contributions from Gombe.Investing in adolescent girls' nutrition is vital for health and for breaking the intergenerational cycle of malnutrition and deprivation, but limited knowledge on the type, timing, and efficacy of interventions delays progress. We describe the design of a 26-wk randomized placebo-controlled trial with multiple-micronutrient-fortified biscuits (MMBs) among adolescent girls in northeastern Ghana. Apparently healthy, premenarche (n = 312) and postmenarche (n = 309) girls (10-17 y) were randomly assigned to receive the following for 5 d/wk 1) MMBs (fortified with 11 vitamins and 7 minerals) or 2) unfortified biscuits. Data included plasma micronutrient status, anthropometry, body composition, cognitive function, psychosocial health, fertility, dietary intake, and sociodemographic and socioeconomic covariates, complemented with in-depth interviews (n = 30) and 4 focus group discussions. We hypothesized an increase in plasma ferritin and retinol-binding protein with a resultant increase in hemoglobin, cognition, vertical height, and psychosocial health. Our study seeks to investigate the efficacy and optimal timing of a multiple-micronutrient food intervention program for adolescent girls. The RCT was registered prospectively with the Netherlands Clinical Trials Register (NL7487).
Although sexuality influences well-being and quality of life (QoL), studies on sexual dysfunction (SD) in adult growth hormone deficiency (AGHD) patients are lacking.
To investigate the prevalence of SD in AGHD patients grouped according to recombinant human growth hormone (r-hGH) therapy.
Prospective, cross-over, 24 months, monocentric study.
Real-life clinical setting in a tertiary, endocrinological center.
83 AGHD patients (31 women, 52 men, mean age 56.3 ± 14.7 years) were enrolled according to stringent criteria.
Patients already on long-term r-hGH therapy (Group 1, n = 32)
untreated (Group 2, n = 51).
Serum hormones, QoL Satisfaction in Hypopituitarism (QLS-H) and QoL Assessment of GHD in Adults (QoL-AGHDA) questionnaires for QoL, Index for Erectile Function-15 (IIEF-15) in men, and Female Sexual Function Index (FSFI) in women for SD.
The overall prevalence of SD was 71.2% (60% men, 89% women). All IIEF-15 scores were lower (
= 0.001) and erectile dysfunction was more prevalent in Group 2 (75%) than Group 1 (35%).