Franksbaldwin0562

Pain neuroscience education (PNE) can be applied as the foundational core of an interdisciplinary biopsychosocial approach to persistent pain. This article outlines a noninvasive, nonpharmaceutical, and collaborative approach to providing comprehensive pain care, applying evidence-based biopsychosocial treatment strategies within the framework of PNE. Through consistent messaging across all interdisciplinary team members, persistent pain patients can sustain a deeper level of understanding and empowerment, with goals of sustainable improvement and self-management. The application of adult learning theory by patient educators also is discussed.Using the functional medicine rubric in physical medicine and rehabilitation (PM&R), a physiatrist can capitalize on addressing the root causes and downstream effects in patients with chronic diseases. Similar to the International Classification of Function model in rehabilitation, the functional medicine model uses biopsychosocial understanding with a systems biology approach to find fulcrum points to create the biggest impact on health care. Given the position of rehabilitation medicine with the type and location of patients, both functional medicine and PM&R would benefit from a mutual partnership.Lifestyle medicine is a growing field of medicine that addresses key health behaviors, which are the root causes of most premature death, chronic disease, and health care costs. Coaching patients with evidence-based behavior change strategies can help them to make lasting habits in key areas, such as physical activity, healthy eating, improved sleep, cessation of tobacco, forming and maintaining relationships, and stress management. Similarities in philosophy between lifestyle medicine and physical medicine and rehabilitation make them complementary and synergistic in treating the whole patient in their social context.Objective This study investigated evidence for the approach known as 'benefits management' (BM) used in many digital hospital initiatives. Methods A qualitative narrative overview was conducted on the BM literature and compared with a qualitative systematic overview of electronic medical record (EMR) implementation literature. Results Twenty-five articles on BM and 12 literature reviews on EMR implementation were examined. The BM approach does not have strong support in the literature and does not support all the needs of large EMR implementations. Conclusion The current BM approach provides an inadequate basis for managing and reporting on the outcomes that ensue from a digital hospital initiative. A shift is needed from benefits idealisation to value optimisation. What is known about the topic? Health services are under increasing pressure to demonstrate that the benefits anticipated from digital health investments have been realised. What does this paper add? This paper informs the practice of benefits governance in EMR implementations. The results reveal inadequacies in current BM models and practice that are currently enshrined in policy despite a lack of evidence. What are the implications for practitioners? Health service leaders must be willing to question the governance of benefits from health service transformations using more evidence-based approaches to increase the value obtained from investments in digital transformation.Older women seem to have lower GP follow-up rates after an emergency department (ED) discharge than men. This qualitative study investigated how older women seek GP follow up after an ED visit. In 2018, women aged ≥65 years were recruited from an ED in a suburban hospital in south-western Sydney, Australia, and then contacted 1 week later for a telephone interview exploring factors associated with their follow-up behaviour. Grounded theory was used to construct a potential explanatory model of follow-up behaviours. Of the 100 women recruited, 64% had attended a GP follow up by Day 7, as instructed. The balance of perceived cost and benefit of GP follow up emerged as a useful model to understand the factors affecting follow-up behaviour. Perceived costs included inconvenience caused to self and others, access to transport options and the availability of a patient's GP. Perceived benefits included previous experiences with the healthcare system, pre-existing health-seeking behaviours and ED messaging. Our findings suggest that follow-up rates could be improved by strengthening the perceived benefit of GP follow up at the point of ED discharge, in addition to addressing perceived costs. Approaches may include ensuring discharge instructions are purposeful and given in the company of an older woman's social supports.Obesity is a condition of excess body fat that has been identified as one of the most serious public health problems of the 21st century. Obesity is a leading preventable cause of death globally and increases the likelihood of cardiovascular disease, diabetes and various cancers. Obesity worldwide has tripled in the adult population over the past 40 years, with 13% of the world's adult population now obese, leading to calls for control of a global obesity epidemic. Causes of obesity can be delineated at individual, societal and systemic levels, highlighting the need for analysis that transcends the biomedical paradigm to explore the sociological influences of this condition. The pathophysiology of why obesity occurs has not changed within recent history, but the way that people live their lives and the cultural understandings that evolve within communities have. This article describes the interaction between obesity and the social environment, explores the meaning of obesity within the context of health and considers the social determinants of obesity within the community. It also discusses the influences of the professional-patient exchange in obesity, the comprehension of obesity as a disease and the challenges of addressing obesity within the healthcare system.

The Coronavirus disease 2019 (COVID-19) pandemic is an unprecedented traumatic event influencing the healthcare, economic, and social welfare systems worldwide. mTOR inhibitor In order to slow the infection rates, lockdown has been implemented almost everywhere. Italy, one of the countries most severely affected, entered the "lockdown" on March 8, 2020.

The COvid Mental hEalth Trial (COMET) network includes 10 Italian university sites and the National Institute of Health. The whole study has three different phases. The first phase includes an online survey conducted between March and May 2020 in the Italian population. Recruitment took place through email invitation letters, social media, mailing lists of universities, national medical associations, and associations of stakeholders (e.g., associations of users/carers). In order to evaluate the impact of lockdown on depressive, anxiety and stress symptoms, multivariate linear regression models were performed, weighted for the propensity score.

The final sample consisted of 20,720 participants.