Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 254
Filtrar
Más filtros

Tipo del documento
Intervalo de año de publicación
1.
Artículo en Inglés | MEDLINE | ID: mdl-38335076

RESUMEN

Visual guided motor imagery (MI) is commonly used in stroke rehabilitation, eliciting event-related desynchronization (ERD) in EEG. Previous studies found that immersion level and visuo-tactile stimulation could modulate ERD during visual guided MI, and both of two factors could also improve sense of ownership (SOO) over target limb (or body). Additionally, the relationship was also reported between the performance of MI and SOO. This study aims to investigate whether immersion and visuo-tactile stimulation affect visual guided MI through the SOO over virtual body in stroke patients. Nineteen stroke patients were recruited. The experiment included two phases (i.e., SOO induction and visual guided MI with SOO) that was manipulated across four conditions in a within-subject design: 2×2 , i.e., immersion (VR, 2D monitor display) × multisensory stimulation (visuo-tactile stimulation, observation without tactile stimulation). Results found peaks ERD amplitude during MI were significantly higher in stronger SOO conditions than weaker SOO conditions. Interestingly, the ERD during visual guided MI under the condition of vision only in VR and visuo-tactile stimulation in 2D monitor are similar, which indicates that SOO may be an important factor behind this phenomenon (due to the similar SOO between these two conditions). A moderate correlation was also found between SOO scores and peaks ERD amplitude during MI. This study discussed the possible factor underlying the effects of immersion and multisensory stimulation on visual guided MI in post-stroke patients, identifying the effect of SOO in this process, and could be referred in future studies for coming up with better MI paradigms for stroke rehabilitation.


Asunto(s)
Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular , Humanos , Inmersión , Propiedad , Tacto , Electroencefalografía/métodos
2.
Artículo en Inglés | MEDLINE | ID: mdl-38349835

RESUMEN

Virtual reality (VR)-based rehabilitation training holds great potential for post-stroke motor recovery. Existing VR-based motor imagery (MI) paradigms mostly focus on the first-person perspective, and the benefit of the third-person perspective (3PP) remains to be further exploited. The 3PP is advantageous for movements involving the back or those with a large range because of its field coverage. Some movements are easier to imagine from the 3PP. However, the 3PP training efficiency may be unsatisfactory, which may be attributed to the difficulty encountered when generating a strong sense of ownership (SOO). In this work, we attempt to enhance a visual-guided 3PP MI in stroke patients by eliciting the SOO over a virtual avatar with VR. We propose to achieve this by inducing the so-called out-of-body experience (OBE), which is a full-body illusion (FBI) that people misperceive a 3PP virtual body as his/her own (i.e., generating the SOO to the virtual body). Electroencephalography signals of 13 stroke patients are recorded while MI of the affected upper limb is being performed. The proposed paradigm is evaluated by comparing event-related desynchronization (ERD) with a control paradigm without FBI induction. The results show that the proposed paradigm leads to a significantly larger ERD during MI, indicating a bilateral activation pattern consistent with that in previous studies. In conclusion, 3PP MI can be enhanced in stroke patients by eliciting the SOO through induction of the "OBE" FBI. This study offers more possibilities for virtual rehabilitation in stroke patients and can further facilitate VR application in rehabilitation.


Asunto(s)
Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular , Realidad Virtual , Humanos , Masculino , Femenino , Propiedad , Electroencefalografía , Extremidad Superior
3.
PeerJ ; 11: e16518, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38107587

RESUMEN

Background: Animal-source foods are food items that come from animals. Animal-source foods provide a variety of micronutrients that plant-source foods cannot provide to the same extent and without extra precaution. Milk, eggs, poultry, flesh meat and fish are animal-source foods mainly used in Ethiopia. Low animal-source food consumption among children and mothers is a great concern in many low-income settings. This study aimed to describe animal-source food consumption frequencies among children aged 6-24 months and their mothers in rural southern Ethiopia where livestock farming is very common. We also analysed the association between livestock ownership and animal-source food consumption among children and mothers. Methods: A community-based cross-sectional study was conducted among 851 randomly selected households with child-mother pairs from August to November 2018. The study was conducted in the rural Dale District, southern Ethiopia. Structured and pre-tested questionnaires were used to collect data on mother and child information, livestock ownership, and animal-source foods consumption frequencies. Ordinal logistic regression analysis was used to describe associations between animal-source foods consumption and livestock ownership. Result: Nearly, three-quarters (74.1%) of the households owned cows, and a quarter (25%) had goats or sheep. Dairy, egg and meat consumption among children during the past month was 91.8%, 83.0% and 26.2%, respectively. Likewise, the consumption of dairy, eggs and meat among mothers was 96.0%, 49.5% and 34.0%, respectively. The percentage of children who had not consumed any animal-source foods during the month prior to our survey was 6.6%, and the figure was 2.2% for the mothers. Dairy consumption was 1.8 times higher among children (aOR = 1.8, 95% CI [1.3-2.5]) and 3.0 times higher among mothers (aOR = 3.0, 95% CI [2.2-4.2]) in households that kept cows than in households without cows. The egg consumption frequency was positively associated with hen and goat/sheep ownership for both children and mothers. Meat consumption frequency among children was negatively associated with cow ownership (aOR = 0.66, 95% CI [0.45-0.95]); however, cow ownership was not associated with meat consumption among mothers. Conclusion: Dairy products were common animal-source foods consumed by young children and mothers in the study area. However, meat consumption was low among children and mothers. Strategies like promoting the keeping of goats/sheep and hens to improve complementary feeding and mothers' nutrition are warranted in the study area.


Asunto(s)
Pollos , Ganado , Humanos , Animales , Femenino , Bovinos , Ovinos , Preescolar , Etiopía , Propiedad , Estudios Transversales , Carne , Leche , Cabras
4.
J Am Vet Med Assoc ; 261(8): 1238-1243, 2023 08 01.
Artículo en Inglés | MEDLINE | ID: mdl-36965474

RESUMEN

Friction can occur between veterinarians and their clients when they are not aligned on the goals of care for a pet and what constitutes the best outcome of a case. Veterinarians frequently concentrate on providing the diagnostic and treatment protocol that is perceived to result in the best medical outcome for their patient. Pet owners frequently consider a myriad of factors relating to the pet as well as how different diagnostic and treatment recommendations will affect individual family members and the family as a whole in both concrete and subjective terms. This misalignment can lead to veterinarians experiencing moral distress and families feeling guilt and shame about their pet's care decisions. In this paper we examine the interdependencies of families and their pets and the factors that pet owners may consider in making care decisions. These factors, adapted from the concept of Family Quality of Life as used in the human health field, can be divided into three domains including pet-centric factors, family-centric factors, and external factors. By better understanding that there are a multitude of considerations that influence owners' care decisions and communicating with owners in a nonjudgmental manner, veterinarians can more holistically support families, decrease their own moral distress, and arrive at diagnostic and treatment plans that represent the overall best approach for the family and the patient.


Asunto(s)
Veterinarios , Humanos , Animales , Calidad de Vida , Propiedad , Toma de Decisiones , Mascotas , Encuestas y Cuestionarios
5.
Schweiz Arch Tierheilkd ; 165(2): 115-0, 2023 02.
Artículo en Alemán | MEDLINE | ID: mdl-36718713

RESUMEN

INTRODUCTION: In Switzerland, compared to the United Kingdom or the United States of America, fewer veterinary anaesthetists are employed in private practice, which raises the question about the reason. The present survey aimed at investigating the awareness of pet owners concerning the specialization of veterinary anaesthesia and the value they attribute to such a specialist. Also, estimation of pain in dogs and cats and the importance of its treatment from the point of view of the pet owners was analysed. Furthermore, the necessity of veterinary anaesthetists in private practice and the influencing factors were investigated. The survey was created on LimeSurvey, an online tool for questionnaires and sent to dog and cat owners of the small animal clinic of the University Hospital of Zurich. 317 fully completed questionnaires were evaluated. In general, pet owners appreciated the specialization of veterinary anaesthesiology. Great importance was attributed to the supervision of anaesthesia and analgesic therapy by a specialist. A preliminary talk with an anaesthetist would be appreciated. Owners would be willing to cover additional costs for a specialized anaesthetist, if recommended by the private veterinarian, and to bring their animal to the University Hospital, in case of an increased anaesthetic risk.


INTRODUCTION: En Suisse, les vétérinaires anesthésistes sont moins nombreux à exercer en cabinet privé qu'au Royaume-Uni ou aux États-Unis. La question se pose dès lors de savoir pourquoi il en est ainsi. Une enquête a analysé les connaissances des propriétaires d'animaux de compagnie sur la spécialisation de l'anesthésiologie vétérinaire et l'importance qu'ils accordent à un spécialiste en la matière. L'importance de la thérapie analgésique chez les chiens ou les chats a également été évaluée. En outre, le besoin en vétérinaires anesthésistes en pratique privée et les facteurs qui l'influencent ont été examinés. L'enquête a utilisé l'outil de questionnaire Lime-Survey et a été envoyée aux propriétaires de chiens et de chats de la Clinique des petits animaux de l'Université de Zürich. 317 questionnaires complétés ont été évalués. Les propriétaires d'animaux apprécient la spécialisation en l'anesthésiologie vétérinaire. Le vétérinaire anesthésiste est considéré comme très important dans les mesures anes-thésiques et la thérapie analgésique. Une consultation anesthésique préalable est souhaitée. Les propriétaires seraient disposés à prendre en charge les coûts supplémentaires de ce service ou, sur recommandation du vétérinaire privé, à amener leur animal à la Clinique pour petits animaux de l'Université de Zürich en cas de risque anesthésique accru.


Asunto(s)
Enfermedades de los Gatos , Enfermedades de los Perros , Animales , Perros , Gatos , Humanos , Enfermedades de los Gatos/terapia , Propiedad , Enfermedades de los Perros/terapia , Anestesistas , Encuestas y Cuestionarios , Dolor/veterinaria , Mascotas
6.
Psychol Serv ; 20(1): 1-5, 2023 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-36716139

RESUMEN

At our unique juncture in history, challenged by a global pandemic, the impact of climate change, and a polarized political landscape, more and more people are seeking mental health assistance (Mochari-Greenberger & Pande, 2021), and a larger proportion of those who seek help are describing existential or spiritual concerns (Chirico, 2021; Kondrath, 2022). Many psychologists may be experiencing themselves as insufficiently prepared to help with spiritual concerns (Vogel et al., 2013); the mission of this special section is to facilitate discourse and dissemination of resources among chaplains and psychologists to explore the interdisciplinary dynamics of spiritual care and to establish a foundation for the expansion of ethically appropriate, spiritually integrated care where needed. All of the articles presented in this special section were reviewed by both chaplains and psychologists, and often by professionals cross-trained in both fields. Our hope is that this special section will serve to increase interdisciplinary collaboration so that both chaplains and psychologists can provide appropriate services to rise to the present constellation of crises. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Asunto(s)
Propiedad , Terapias Espirituales , Humanos , Espiritualidad , Clero/psicología , Salud Mental
7.
Vet Rec ; 192(11): e2343, 2023 Jun 03.
Artículo en Inglés | MEDLINE | ID: mdl-36331424

RESUMEN

BACKGROUND: Complementary and alternative veterinary medicine (CAVM) seems to be gaining acceptance by pet owners. Client-veterinarian communication about CAVM is important to explore client perceptions and facilitate open exchange of ideas between owners and veterinarians. METHODS: This study includes an online, cross-sectional survey of dog owners to evaluate CAVM use and client-veterinarian communication about CAVM. Based on the extended theory of planned behaviour, factors influencing the intention to use CAVM were evaluated. RESULTS: Past CAVM use was reported by 45.3% clients based on 1000 valid surveys. The attitude towards CAVM was generally positive. Perceived knowledge about CAVM positively predicted perceived behavioural control and attitude towards CAVM. Both were the strongest predictors of future CAVM use. Around 45.7% of clients had already talked to their veterinarian about CAVM. This conversation was mainly initiated by the owner (66.3%). Owners expected the veterinarian to have knowledge about CAVM (91.5%) and offer referral (71.5%). LIMITATIONS: The limitation is difficulty in classifying and defining CAVM modalities. CONCLUSIONS: Owners' perceived behavioural control and attitude towards CAVM predict CAVM use. Failure to engage in a conversation about CAVM hampers clients to partner with veterinarians to discuss the treatment approach and maximise patient outcome. The veterinarian plays an essential role in providing objective accurate information about CAVM.


Asunto(s)
Veterinarios , Medicina Veterinaria , Perros , Animales , Humanos , Estudios Transversales , Encuestas y Cuestionarios , Comunicación , Actitud , Propiedad
8.
J Gerontol Soc Work ; 64(7): 740-757, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33896409

RESUMEN

Care transitions (CT) are critical junctures in the healthcare delivery process. Effective transitions reduce the need for subsequent transfers between healthcare settings, including nursing homes. Understanding social services (SS) involvement in these processes in nursing homes is important from a quality and holistic care perspective. Using logistic regression, this study examines structural and relational factors identified with higher involvement of SS in care transitions and admissions. SS directors from 924 nursing homes were evaluated in relation to SS involvement in care transitions and admissions processes. Results suggest the level of SS involvement in care transitions and admissions are associated with structural factors such as size of facility, geographical location, ratio of FTE's to beds, ownership status, and standalone SS departments, as well as relational factors, including perceptions and utilization of SS staff by facility leadership, coworkers, and family. Additionally, SS staff with higher levels of expertise and with social work degrees are less involved in admissions tasks.


Asunto(s)
Casas de Salud , Transferencia de Pacientes , Hospitalización , Humanos , Propiedad , Servicio Social
9.
Nutrients ; 13(4)2021 Apr 08.
Artículo en Inglés | MEDLINE | ID: mdl-33917974

RESUMEN

Efforts to address Micronutrient deficiencies (MNDs) in lower-and middle-income countries (LMICs) have been gaining pace in recent years. Commodities such as staple foods (e.g., cereals, roots, and tubers) and condiments (e.g., salt) have been targeted as 'vehicles' for fortification and biofortification through numerous projects and initiatives. To date, there have been mixed experiences with delivery and coverage with very little documented on the range of business models applied in different geographies, business conditions and polities and this makes classification and measurement of success and failure difficult. This research aims to address this gap in knowledge through proposing a typology that clarifies similarities (internal heterogeneity) and differences (external heterogeneity) between models and that can allow all types to be defined by the combination of attributes. Building on a comprehensive literature review; NVivo was used to code initiatives from 34 key references (955 cases in total) which have been grouped into 17 categories. Using non-metric multidimensional scaling (NMDS) we find evidence of four business model groupings that typify fortification initiatives: (1) Large-scale private, unregulated, (2) Mixed-Scale, private, unregulated (3) Large-scale, public-private, regulated; and (4) Large-scale, private, regulated. We characterise these four groups with country examples and suggest that this typology can help the discourse around viability of food fortification initiatives.


Asunto(s)
Biofortificación , Alimentos Fortificados , Modelos Económicos , Análisis por Conglomerados , Países Desarrollados/economía , Países en Desarrollo/economía , Propiedad , Control Social Formal
10.
Vet Rec ; 189(2): e303, 2021 07.
Artículo en Inglés | MEDLINE | ID: mdl-33899957

RESUMEN

BACKGROUND: Complementary and alternative veterinary medicine (CAVM) is becoming increasingly popular in horses. METHODS: Online, cross-sectional survey in 1532 horse owners. Attitude towards CAVM, subjective norms, perceived behavioural control and intention for future CAVM use were measured based on the theory of planned behaviour. Structural equation modelling was performed to characterize factors influencing intention to use CAVM. RESULTS: Past use of CAVM, predominantly manual therapies and herbal supplements, was reported by 72.5% of all participants. Frequently reported indications were improving horse's well-being, illness which did not resolve after conventional treatment and chronic illness. The attitude towards CAVM was positive with a median (interquartile range) score of 6 of 7 (4.75-7.00). Predictors for past CAVM use were higher owner age, alternative medicine self-use and higher education (non-university). The strongest predictor of future CAVM usage was perceived behavioural control and perceived CAVM efficacy, as well as positive attitude towards and perceived knowledge about CAVM. The veterinarian was reported as a source of information about CAVM by 86.4% of all participants. CONCLUSIONS: Horse owners showed a high intention to use CAVM with the owners' perceived behavioural control and perceived CAVM efficacy as the strongest predictor. Veterinarian-client communication is important to inform horse owners correctly.


Asunto(s)
Terapias Complementarias/veterinaria , Conocimientos, Actitudes y Práctica en Salud , Enfermedades de los Caballos/terapia , Motivación , Medicina Veterinaria , Adolescente , Adulto , Animales , Terapias Complementarias/psicología , Terapias Complementarias/estadística & datos numéricos , Estudios Transversales , Femenino , Caballos , Humanos , Intención , Masculino , Propiedad , Encuestas y Cuestionarios , Adulto Joven
11.
J Small Anim Pract ; 62(9): 775-787, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-33788291

RESUMEN

OBJECTIVES: The relationship between the pet owners' desire for information and preference of alternative therapies and the veterinarians' ability to build partnership and communicate empathically was investigated using quantitative multifactorial analysis. MATERIALS AND METHODS: In an online survey, 1270 German pet owners were asked about their experience of veterinary appointments regarding communication and relationship building. Additional questions included the type and number of pets, years of animal husbandry, age, gender and education level. The factors associated with the pet owners' desire for further information and alternative therapies were analysed in two multivariable linear models. A recently published structural equation model consolidated the following as latent factors: veterinarian's empathic communication, veterinarian's partnership building, pet owners' desire for further information and pet owners' desire for alternative therapies (e.g. non-veterinary practitioners). RESULTS: The two veterinarian-related factors of empathic communication and partnership building were positively associated with each other, but negatively associated with the pet owners' desires. Dog owners and participants who owned animals for more than 2 years expressed less desire for further information. The desire for further information decreased with increasing age. The desire for alternative therapies was more among animal owners of more than 2 years and those visiting the same veterinary practice for over 2 years. CLINICAL SIGNIFICANCE: Veterinarians' empathic communication and partnership building are key factors that satisfy clients' desires for information and alternative therapies. This comprises communicational skills regarding information sharing, as well as emotional aspects.


Asunto(s)
Terapias Complementarias , Veterinarios , Animales , Comunicación , Terapias Complementarias/veterinaria , Perros , Empatía , Humanos , Propiedad
12.
Health Aff (Millwood) ; 40(3): 536-539, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33646877

RESUMEN

The demise of Hahnemann University Hospital demonstrates the need for health care and graduate medical education policy reform.


Asunto(s)
Quiebra Bancaria/economía , Educación de Postgrado en Medicina/economía , Hospitales Universitarios/economía , Internado y Residencia/economía , Humanos , Área sin Atención Médica , Propiedad , Philadelphia , Estados Unidos
13.
Health Serv Res ; 56(3): 453-463, 2021 06.
Artículo en Inglés | MEDLINE | ID: mdl-33429460

RESUMEN

OBJECTIVE: Building on the original taxonomy of hospital-based health systems from 20 years ago, we develop a new taxonomy to inform emerging public policy and practice developments. DATA SOURCES: The 2016 American Hospital Association's (AHA) Annual Survey; the 2016 IQVIA Healthcare Organizations and Systems (HCOS) database; and the 2017-2018 National Survey of Healthcare Organizations and Systems (NSHOS). STUDY DESIGN: Cluster analysis of the 2016 AHA Annual Survey data to derive measures of differentiation, centralization, and integration to create categories or types of hospital-based health systems. DATA COLLECTION: Principal components factor analysis with varimax rotation generating the factors used in the cluster algorithms. PRINCIPAL FINDINGS: Among the four cluster types, 54% (N = 202) of systems are decentralized (-0.35) and relatively less differentiated (-0.37); 23% of systems (N = 85) are highly differentiated (1.28) but relatively decentralized (-0.29); 15% (N = 57) are highly centralized (2.04) and highly differentiated (0.65); and approximately 9 percent (N = 33) are least differentiated (-1.35) and most decentralized (-0.64). Despite differences in calculation, the Highly Centralized, Highly Differentiated System Cluster and the Undifferentiated, Decentralized System Cluster were similar to those identified 20 years ago. The other two system clusters contained similarities as well as differences from those 20 years ago. Overall, 82 percent of the systems remain relatively decentralized suggesting they operate largely as holding companies allowing autonomy to individual hospitals operating within the system. CONCLUSIONS: The new taxonomy of hospital-based health systems bears similarities as well as differences from 20 years ago. Important applications of the taxonomy for addressing current challenges facing the healthcare system, such as the transition to value-based payment models, continued consolidation, and the growing importance of the social determinants of health, are highlighted.


Asunto(s)
Prestación Integrada de Atención de Salud/clasificación , Prestación Integrada de Atención de Salud/organización & administración , Hospitales Generales/clasificación , Hospitales Generales/organización & administración , Prestación Integrada de Atención de Salud/economía , Prestación Integrada de Atención de Salud/normas , Hospitales Generales/economía , Hospitales Generales/normas , Humanos , Propiedad , Estados Unidos
14.
Health Serv Res ; 55 Suppl 3: 1062-1072, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33284522

RESUMEN

OBJECTIVE: To examine system integration with physician specialties across markets and the association between local system characteristics and their patterns of physician integration. DATA SOURCES: Data come from the AHRQ Compendium of US Health Systems and IQVIA OneKey database. STUDY DESIGN: We examined the change from 2016 to 2018 in the percentage of physicians in systems, focusing on primary care and the 10 most numerous nonhospital-based specialties across the 382 metropolitan statistical areas (MSAs) in the US. We also categorized systems by ownership, mission, and payment program participation and examined how those characteristics were related to their patterns of physician integration in 2018. DATA COLLECTION/EXTRACTION METHODS: We examined local healthcare markets (MSAs) and the hospitals and physicians that are part of integrated systems that operate in these markets. We characterized markets by hospital and insurer concentration and systems by type of ownership and by whether they have an academic medical center (AMC), a 340B hospital, or accountable care organization. PRINCIPAL FINDINGS: Between 2016 and 2018, system participation increased for primary care and the 10 other physician specialties we examined. In 2018, physicians in specialties associated with lucrative hospital services were the most commonly integrated with systems including hematology-oncology (57%), cardiology (55%), and general surgery (44%); however, rates varied substantially across markets. For most specialties, high market concentration by insurers and hospital-systems was associated with lower rates of physician integration. In addition, systems with AMCs and publicly owned systems more commonly affiliated with specialties unrelated to the physicians' potential contribution to hospital revenue, and investor-owned systems demonstrated more limited physician integration. CONCLUSIONS: Variation in physician integration across markets and system characteristics reflects physician and systems' motivations. These integration strategies are associated with the financial interests of systems and other strategic goals (eg, medical education, and serving low-income populations).


Asunto(s)
Prestación Integrada de Atención de Salud/estadística & datos numéricos , Especialización/estadística & datos numéricos , Integración de Sistemas , Competencia Económica , Sistemas de Información en Salud/estadística & datos numéricos , Investigación sobre Servicios de Salud , Hospitales/estadística & datos numéricos , Humanos , Aseguradoras/estadística & datos numéricos , Propiedad/estadística & datos numéricos , Médicos de Atención Primaria/estadística & datos numéricos , Estados Unidos
16.
Vet Comp Oncol ; 18(4): 706-717, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-32304175

RESUMEN

This survey aimed to investigate and compare diet type and supplement use between dogs (Canis lupus familiaris, L.) with cancer and a population of owner-reported healthy dogs and to assess the sources of information dog owners consult. Respondents were mainly from English-speaking countries. Dogs were considered healthy (N = 213) if owners reported them to be in good health. Dogs were included in the cancer group (N = 132) if the owner reported that their dog had been diagnosed with cancer. An online survey was distributed to clients presenting to a tertiary oncology service, clients presenting to a local primary care veterinary practice, and through social media. Owners of dogs with cancer spent more time researching pet health (P < .001), pet nutrition (P < .01) and nutritional supplements (P < .001) than owners of healthy dogs. While veterinarians were most commonly reported to be an information source for both groups, owners of healthy dogs more likely consulted pet stores and owners of dogs with cancer tended more to social media groups and blogs. Healthy dogs were more likely fed commercial dry food (P < .001), whereas homemade cooked (P < .001) and raw diets (P < .05) were more prevalent among dogs with cancer. Supplement use, especially cannabidiol products, mushroom extracts or turmeric/curcumin, was also more common for this group (P < .001). Alternative diets and supplements were more popular among owners of dogs with cancer compared to owners of healthy dogs. These findings highlight the need for nutritional counselling and education of pet owners regarding nutrition-related topics, especially when their dog is diagnosed with cancer.


Asunto(s)
Dieta/veterinaria , Suplementos Dietéticos , Enfermedades de los Perros/terapia , Conocimientos, Actitudes y Práctica en Salud , Conducta en la Búsqueda de Información , Neoplasias/veterinaria , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Alimentación Animal , Animales , Dieta/métodos , Perros , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/terapia , Propiedad , Encuestas y Cuestionarios , Adulto Joven
17.
Acad Med ; 95(4): 499-502, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-31972677

RESUMEN

In June 2019, Hahnemann University Hospital (HUH) in Philadelphia became the largest U.S. teaching hospital to announce its closure and the closure of all of its graduate medical education (GME) programs, which displaced more than 550 residents, fellows, and other trainees. In addition to the displaced trainees, the HUH closure involved many stakeholders at both the closing hospital and hospitals willing to accept transferred residents and fellows-program directors and coordinators, designated institutional officials (DIOs), and hospital executives-as well as the Accreditation Council for Graduate Medical Education, the Centers for Medicare and Medicaid Services, the National Resident Matching Program, and other organizations. Given the rarity of such events, those involved had little experience or expertise in dealing with the closure of so many GME programs at one time. In this Invited Commentary, the DIOs of HUH and 4 other area teaching hospitals detail their experiences working to find new training opportunities for the displaced residents and fellows, discussing lessons learned and providing recommendations to prepare for any future teaching hospital closures. Stakeholder organizations should work together to develop a "playbook" for use during future closures so that the chaos that occurred this time can be avoided.


Asunto(s)
Educación de Postgrado en Medicina , Clausura de las Instituciones de Salud , Hospitales Universitarios , Acreditación , Quiebra Bancaria , Centers for Medicare and Medicaid Services, U.S. , Humanos , Propiedad , Philadelphia , Política Pública , Facultades de Medicina , Apoyo a la Formación Profesional , Estados Unidos , Universidades
18.
Med Care Res Rev ; 77(4): 357-366, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-30674227

RESUMEN

Despite the prevalence of vertical integration, data and research focused on identifying and describing health systems are sparse. Until recently, we lacked an enumeration of health systems and an understanding of how systems vary by key structural attributes. To fill this gap, the Agency for Healthcare Research and Quality developed the Compendium of U.S. Health Systems, a data resource to support research on comparative health system performance. In this article, we describe the methods used to create the Compendium and present a picture of vertical integration in the United States. We identified 626 health systems in 2016, which accounted for 70% of nonfederal general acute care hospitals. These systems varied by key structural attributes, including size, ownership, and geographic presence. The Compendium can be used to study the characteristics of the U.S. health care system and address policy issues related to provider organizations.


Asunto(s)
Prestación Integrada de Atención de Salud , Hospitales , Afiliación Organizacional , Propiedad , Humanos , Estados Unidos
19.
PLoS One ; 14(10): e0222903, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31581257

RESUMEN

INTRODUCTION: Micronutrient deficiencies are prevalent in Nepal where starchy foods constitute a large proportion of diets and consumption of micronutrient-rich foods is inadequate. We conducted a study to determine whether rice would be an appropriate vehicle for micronutrient fortification in Nepal. MATERIALS AND METHODS: In Bajura in remote rural Nepal, we conducted a household survey to characterize rice intakes in 195 households, and a double-blinded acceptability test with 177 social safety net rice consumers ≥18 years of age. Of these, 168 tasted fortified and unfortified rice to assess whether respondents could differentiate between fortified and non-fortified rice and their sensory properties. Rice was fortified by blending hot extruded kernels containing 6 micronutrients together with non-fortified rice at a 1:99 ratio. We used binomial tests to assess whether participants could correctly differentiate fortified rice, from non-fortified rice and paired t-tests to compare scores for sensory qualities of cooked fortified and non-fortified rice. We used multiple regression to test associations between per capita consumption and age, gender, wealth and food security. RESULTS: Per capita consumption of rice (median 216g/day, IQR 144.0, 288.0) did not vary by wealth but was +52.08g, (95% CI 10.43, 93.72) higher amongst moderately to severely food insecure households compared with food secure / mildly food insecure. Most respondents could not differentiate fortified rice from non-fortified rice: 37.5% identified uncooked fortified rice and 39.3% cooked rice, which was not different from the 33% expected by chance (p = 0.22 and p = 0.09 respectively). The sensory qualities of fortified rice were acceptable (scoring 3.9 out of 5) and did not differ from non-fortified rice (p>0.05). CONCLUSION: A rice fortification programme implemented through the Nepal Food Corporation's social safety nets has potential because purchase and consumption of rice is high and fortified rice is acceptable among consumers in remote food insecure areas of Nepal.


Asunto(s)
Comportamiento del Consumidor , Alimentos Fortificados , Oryza , Sensación , Adulto , Composición Familiar , Femenino , Humanos , Masculino , Persona de Mediana Edad , Nepal , Propiedad , Factores Socioeconómicos , Encuestas y Cuestionarios
20.
Crit Rev Oncol Hematol ; 143: 56-61, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31479836

RESUMEN

"Can I keep my dog while receiving chemotherapy?" "Can my cat sleep on my bed while I'm on treatment?" "What precautions should I take with my pets in order to avoid infections?"" I read that my dog could give me breast cancer, is that true?" "Do you have assistance therapy dogs at your chemotherapy day unit?" These are not uncommon questions from cancer patients in oncology/haematology consultation rooms. The answers to these questions however, are widely unknown among physicians. Pet ownership is thought to provide patients with both emotional and physical health benefits. However, owning pets may also pose health risks to immunocompromised patients through zoonotic transmission of disease. Some studies have also suggested that the ownership of domestic pets may increase the risk of developing some cancers. But what is the evidence behind these claims? This paper presents the results of a literature review of a variety of scientific literature about pet ownership as a potential risk factor for suffering cancer, zoonotic diseases and the immunocompromised, and animal-assisted-therapy in cancer patients.


Asunto(s)
Vínculo Humano-Animal , Neoplasias/psicología , Mascotas/psicología , Terapia Asistida por Animales , Animales , Gatos , Perros , Humanos , Neoplasias/epidemiología , Propiedad , Ensayos Clínicos Controlados Aleatorios como Asunto , Medición de Riesgo , Factores de Riesgo , Zoonosis/epidemiología
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA