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3.
J Bodyw Mov Ther ; 37: 109-114, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38432790

RESUMEN

BACKGROUND: Hypertension (HTN) is a chronic medical condition that affects 1.13 billion people globally. Successful management of HTN is accomplished through both pharmacological and non-pharmacological interventions. Massage therapy, a widely practiced complementary and alternative medicine therapy that alleviates physical discomfort and promotes overall well-being. The current meta-analysis aims to evaluate the effect of massage on blood pressure in patients with HTN. METHODS: Electronic databases, including PubMed, Prospero, Scopus, ClinicalTrials.gov, Embase, and the Cochrane Library, were searched from their inception up to March 2021. All experimental trials that met the (PICO) criteria were included. The primary outcome of the study was blood pressure. A meta-analysis was conducted using a random-effects model to generate a summary of treatment effects, expressed as the effect size (Standardized Mean Difference - SMD), along with a 95% Confidence Interval (CI). RESULTS: Six studies were included in the review, in which 290 patients participated, 148 were in the experimental group and 142 in the control group. Meta-analysis showed a minimal reduction of systolic blood pressure (SMD: -0.65 mmHg, 95% CI: -4.75, 3.55) and diastolic blood pressure (SMD: -0.68 mmHg, 95% CI: -2.43, 1.06) with considerable heterogeneity (I2> 94%). CONCLUSION: The findings demonstrated that massage therapy resulted in a minimal reduction in blood pressure among patients with hypertension. To suggest massage as an effective intervention to reduce blood pressure further randomized control trials are recommended. Additionally, the literature is limited and still emerging, further large prospective studies with long follow-ups are warranted to verify the findings from this meta-analysis.


Asunto(s)
Hipertensión , Humanos , Presión Sanguínea , Estudios Prospectivos , Hipertensión/terapia , Masaje , Examen Físico
4.
Comput Biol Med ; 170: 107920, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38244474

RESUMEN

Traditional Chinese medicine (TCM) observation diagnosis images (including facial and tongue images) provide essential human body information, holding significant importance in clinical medicine for diagnosis and treatment. TCM prescriptions, known for their simplicity, non-invasiveness, and low side effects, have been widely applied worldwide. Exploring automated herbal prescription construction based on visual diagnosis holds vital value in delving into the correlation between external features and herbal prescriptions and offering medical services in mobile healthcare systems. To effectively integrate multi-perspective visual diagnosis images and automate prescription construction, this study proposes a multi-herb recommendation framework based on Visual Transformer and multi-label classification. The framework comprises three key components: image encoder, label embedding module, and cross-modal fusion classification module. The image encoder employs a dual-stream Visual Transformer to learn dependencies between different regions of input images, capturing both local and global features. The label embedding module utilizes Graph Convolutional Networks to capture associations between diverse herbal labels. Finally, two Multi-Modal Factorized Bilinear modules are introduced as effective components to fuse cross-modal vectors, creating an end-to-end multi-label image-herb recommendation model. Through experimentation with real facial and tongue images and generating prescription data closely resembling real samples. The precision is 50.06 %, the recall rate is 48.33 %, and the F1-score is 49.18 %. This study validates the feasibility of automated herbal prescription construction from the perspective of visual diagnosis. Simultaneously, it provides valuable insights for constructing herbal prescriptions automatically from more physical information.


Asunto(s)
Medicina Tradicional China , Examen Físico , Humanos , Cara , Aprendizaje , Prescripciones
5.
J Wound Care ; 33(1): 43-50, 2024 Jan 02.
Artículo en Inglés | MEDLINE | ID: mdl-38197283

RESUMEN

OBJECTIVE: Scar adherence due to a pathological healing process can cause physical and psychological disturbance. Soft tissue mobilisation (STM) techniques are widely used to treat and prevent scar adherence, but little is known on their effects. We aimed to analyse the effect of STM in patients with subacute post-surgical scar adhesions affecting the extremities. METHOD: A single-group quasi-experimental study was conducted on consecutive patients undergoing post-surgery limb rehabilitation. Patients with a baseline Adhesion Severity (AS) index of <0.5 at the worst scar point, as measured by the Adheremeter, were eligible. All patients who completed a minimum of five manual treatment sessions were included. The primary outcome was the AS index and the secondary outcome was the Italian version of the Patient and Observer Scar Assessment Scales (POSAS-I). RESULTS: A cohort of 19 patients underwent an average of eight STM sessions over a period of one month. The AS index value increased from a median of 0.12 at baseline (interquartile range (IQR): 0.05-0.25) to 0.41 post-treatment (IQR: 0.26-0.63; median change: 0.24; IQR: 0.16-0.40; p<0.001). A large effect size was observed for both AS and Observer Scar Assessment Scale (OSAS-I) (Cohen r=0.6), with a large probability of superiority (PS) (87% and 86%, respectively). A moderate effect was observed for the Patient Scar Assessment Scale (PSAS-I) (Cohen=0.4; PS=71%). Pre-post treatment changes exceeded the minimal detectable changes for the AS and OSAS-I in 68% of subjects, and for PSAS-I in 21% of subjects. CONCLUSION: STM manual techniques may produce a large effect on the mobility of adherent subacute post-surgical scars.


Asunto(s)
Cicatriz , Apnea Obstructiva del Sueño , Humanos , Cicatriz/prevención & control , Cicatrización de Heridas , Masaje , Examen Físico
6.
PLoS One ; 19(1): e0297714, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38271355

RESUMEN

Manifold visualisation techniques are commonly used to visualise high-dimensional datasets in physical sciences. In this paper, we apply a recently introduced manifold visualisation method, slisemap, on datasets from physics and chemistry. slisemap combines manifold visualisation with explainable artificial intelligence. Explainable artificial intelligence investigates the decision processes of black box machine learning models and complex simulators. With slisemap, we find an embedding such that data items with similar local explanations are grouped together. Hence, slisemap gives us an overview of the different behaviours of a black box model, where the patterns in the embedding reflect a target property. In this paper, we show how slisemap can be used and evaluated on physical data and that it is helpful in finding meaningful information on classification and regression models trained on these datasets.


Asunto(s)
Inteligencia Artificial , Aprendizaje Automático , Examen Físico , Física , Terapia por Relajación
7.
BMJ Case Rep ; 17(1)2024 Jan 31.
Artículo en Inglés | MEDLINE | ID: mdl-38296501

RESUMEN

Proptosis is a frequent presenting symptom/sign of many paediatric malignancies. Acute-onset proptosis is an ophthalmic emergency that can endanger vision if not treated promptly. Appropriate treatment must be instituted only after investigating for the underlying aetiology. Here, we report a developmentally delayed boy in middle childhood who presented with recent onset bilateral proptosis. Clinical examination followed by radiological evaluation suggested scurvy to be the underlying cause and vitamin C supplementation led to prompt reversal of proptosis. The relevant literature has been reviewed and presented here to apprise the paediatric oncologists about this rare but easily treatable cause of proptosis.


Asunto(s)
Exoftalmia , Escorbuto , Masculino , Humanos , Niño , Escorbuto/diagnóstico , Exoftalmia/etiología , Exoftalmia/diagnóstico , Visión Ocular , Tomografía Computarizada por Rayos X/efectos adversos , Examen Físico
8.
Health Commun ; 39(2): 323-338, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-36693813

RESUMEN

Touch is a fundamental resource mobilized by clinicians in physical examinations in outpatient clinical consultations. However, few studies have been conducted to explore the sequential organization of touch in the interactional process of physical examinations where clinicians' touch is launched and responded to in Chinese medical settings. Based on a collection of video recordings of naturally occurring clinician-patient interaction in an orthopedic outpatient clinic in China, we observed four types of clinicians' touch in the physical examination framework: the guiding touch, the diagnostic touch, the demonstrative touch, and the therapeutic touch. Together with clinical expertise, the sensorial knowledge obtained through touch enables clinicians to professionally evaluate patients' physical conditions and diagnose their illnesses. We also demonstrated that patients do not merely put themselves into clinicians' hands as clinical objects for inspection and defer to clinicians' medical authority. Instead, they actively and agentively participate in physical examinations to jointly accomplish social actions and activities through the temporal and sequential mobilization of their multimodal resources. This study not only adds to an emerging body of research on touch in medical settings but also sheds some light on the understanding of the clinician-patient interaction in Chinese outpatient clinics.


Asunto(s)
Pacientes Ambulatorios , Tacto Terapéutico , Humanos , Tacto , Examen Físico , Derivación y Consulta
9.
Spine J ; 24(4): 590-600, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38103739

RESUMEN

BACKGROUND CONTEXT: Nonoperative management of lumbar spinal stenosis (LSS) includes activity modification, medication, injections, and physical therapy. Conventional physical therapy includes a multimodal approach of exercise, manual therapy, and electro-thermal modalities. There is a paucity of evidence supporting the use of spinal manipulation and dry needling as an adjunct to conventional physical therapy in patients with LSS. PURPOSE: This study aimed to determine the effects of adding thrust spinal manipulation and electrical dry needling to conventional physical therapy in patients with LSS. STUDY DESIGN/SETTING: Randomized, single-blinded, multi-center, parallel-group clinical trial. PATIENT SAMPLE: One hundred twenty-eight (n=128) patients with LSS from 12 outpatient clinics in 8 states were recruited over a 34-month period. OUTCOME MEASURES: The primary outcomes included the Numeric Pain Rating Scale (NPRS) and the Oswestry Disability Index (ODI). Secondary outcomes included the Roland Morris Disability Index (RMDI), Global Rating of Change (GROC), and medication intake. Follow-up assessments were taken at 2 weeks, 6 weeks, and 3 months. METHODS: Patients were randomized to receive either spinal manipulation, electrical dry needling, and conventional physical therapy (MEDNCPT group, n=65) or conventional physical therapy alone (CPT group, n=63). RESULTS: At 3 months, the MEDNCPT group experienced greater reductions in overall low back, buttock, and leg pain (NPRS: F=5.658; p=.002) and related-disability (ODI: F=9.921; p<.001; RMDI: F=7.263; p<.001) compared to the CPT group. Effect sizes were small at 2 and 6 weeks, and medium at 3 months for the NPRS, ODI, and RMDI. At 3 months, significantly (p=.003) more patients in the MEDNCPT group reported a successful outcome (GROC≥+5) than the CPT group. CONCLUSION: Patients with LSS who received electrical dry needling and spinal manipulation in addition to impairment-based exercise, manual therapy and electro-thermal modalities experienced greater improvements in low back, buttock and leg pain and related-disability than those receiving exercise, manual therapy, and electro-thermal modalities alone at 3 months, but not at the 2 or 6 week follow-up.


Asunto(s)
Manipulación Espinal , Estenosis Espinal , Humanos , Estenosis Espinal/cirugía , 60575 , Dolor , Examen Físico , Vértebras Lumbares , Resultado del Tratamiento
10.
Bol. pediatr ; 64(267): 11-15, 2024. ilus
Artículo en Español | IBECS | ID: ibc-VR-499

RESUMEN

Introducción: La disfagia orofaríngea o dificultad para la deglución puede ser causada por anomalías anatómicas, incluyendo malformaciones óseas cervicales. La evaluación integral y el tratamiento individualizado, que pueden involucrar a varios especialistas, son cruciales para prevenir complicaciones y mejorar la calidad de vida del paciente y su familia. Se presenta un caso clínico que ilustra la relación entre la disfagia orofaríngea y sus complicaciones en un paciente con malformaciones anatómicas craneocervicales y pulmonares. Caso clínico. Niña de 3 años con antecedentes médicos complejos incluyendo malformación congénita ósea cervical que presenta, a raíz de última intervención quirúrgica a ese nivel, episodios recurrentes de neumonía. Dados los antecedentes, se piensa como primera posibilidad diagnóstica etiología aspirativa, constatándose en el estudio disfagia a líquidos, compensable con adaptación de la dieta. A pesar del adecuado tratamiento de la disfagia, la persistencia de los episodios siempre en la misma localización hace replantearse la etiología. La TAC torácica reveló a ese nivel una malformación pulmonar, sometiéndose de forma exitosa a una lobectomía toracoscópica. Actualmente no ha vuelto a presentar neumonías de repetición y gracias al tratamiento por parte de logopeda ha presentado mejoría progresiva de su disfagia. Conclusiones. La disfagia orofaríngea es un síntoma infradiagnosticado. Es imprescindible que se empiece a codificar en informes y registros. Existen herramientas de cribado que nos facilitan su diagnóstico en cualquier nivel asistencial que deberían ser usadas sobre todo en población de riesgo. Requiere reevaluación periódica por ser un síntoma dinámico.(AU)


Introduction: Oropharyngeal dysphagia, or difficulty swallowing, may be due to anatomic abnormality, including cervical malformations. A comprehensive assessment and an individualized care, which may include multiple specialists, are crucial in preventing complications and improving the quality of life for both the patient and family. A clinical case is presented that illustrates the relationship between oropharyngeal dysphagia and its complications in a patient with craniocervical and pulmonary malformations. Case report. 3-year-old girl with a complex medical history including congenital cervical bone malformation, who presents with recurrent episodes of pneumonia following her last surgical intervention at that level. Given her medical history, aspirational etiology is considered as first diagnostic possibility with studies confirming dysphagia to liquids, compensable with dietary adaptation. Despite adequate treatment of dysphagia the persistence of episodes, always in the same location, makes us reconsider the etiology. The chest CT revealed a pulmonary malformation at that level and the patient underwent a successful thoracoscopic lobectomy. Currently, she has not had recurrent pneumonia and, thanks to treatment by a speech therapist, she has shown progressive improvement in her dysphagia. Conclusions. Oropharyngeal dysphagia is an underdiagnosed symptom. It is essential we begin to codify it in reports and records. There are screening tools to facilitate the diagnosis at any level of health care that should be used especially in at risk population. It requires periodic reevaluation as it is a dynamic symptom.(AU)


Asunto(s)
Humanos , Femenino , Niño , Trastornos de Deglución , Pacientes Internos , Examen Físico , Anomalías Congénitas , Pediatría , Huesos/anomalías
11.
Clin Ter ; 174(6): 473-477, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38048107

RESUMEN

Background: Brachial plexus injury is a serious peripheral nerve injury that severely disables upper limbs and affects patients' daily life and work Acupuncture and Electroacupuncture have traditionally been used to treat neuropathic pain. However, there is still lacking evidence as regard to their effects on pain following traumatic nerve and plexus lesions. Neurotmesis after brachial plexus injury also causes movement disorders of the denervated muscles and loss of sensory function in the skin. Case report: We report a case of a brachial plexus injury due to humeral fracture, predominantly involving the lower trunk and the medial cord, treated with electroacupuncture. Results. We documented a positive significant response, based on clinical examination, pain scores and neurophysiologic findings. Conclusions: Repeated Electroacupuncture can relieve neuropathic pain due to brachial plexus injury. However, additional studies are needed to verify the efficacy and effectiveness of this approach.


Asunto(s)
Plexo Braquial , Electroacupuntura , Neuralgia , Humanos , Neuralgia/etiología , Neuralgia/terapia , Neurofisiología , Examen Físico
12.
Hu Li Za Zhi ; 70(6): 18-24, 2023 Dec.
Artículo en Chino | MEDLINE | ID: mdl-37981880

RESUMEN

Patients with dementia often display related sleep disturbance, depression, and behavioral and psychological symptoms, which are traditionally managed through the use of antipsychotic medications or physical restraint. However, these management interventions can have negative effects on the physical and psychological health of patients. The results of several meta-analyses suggest non-pharmacological interventions, including light therapy, should be used for the first-line management of these dementia symptoms. Light therapy uses artificial light to compensate for insufficient light exposure during the daytime and to help patients with dementia properly regulate their circadian rhythms. Sleep disturbance and depression in those with dementia may be effectively relieved through the application of light therapy. Nurses should assess the needs and symptoms of patients with dementia and consider applying light therapy as a complementary care intervention to improve quality of care.


Asunto(s)
Demencia , Trastornos del Sueño-Vigilia , Humanos , Fototerapia , Ritmo Circadiano , Salud Mental , Examen Físico , Demencia/terapia
13.
Zhongguo Zhen Jiu ; 43(9): 1086-93, 2023 Sep 12.
Artículo en Chino | MEDLINE | ID: mdl-37697887

RESUMEN

OBJECTIVE: To analyze the report status of outcomes and measurement instruments of randomized controlled trials (RCTs) of acupuncture for post-stroke dysphagia, so as to provide a basis for designing clinical trials and developing the core outcome set in acupuncture for post-stroke dysphagia. METHODS: RCTs of acupuncture for post-stroke dysphagia were searched in databases i.e. CNKI, SinoMed, Wanfang, PubMed, EMbase, Web of Science and clinical trial registries i.e. ClinicalTrials.gov and Chinese Clinical Trial Registry (ChiCTR), from January 1st, 2012 to October 30th, 2021. By literature screening and data extraction, outcomes and measurement instruments were summarized and analyzed. RESULTS: A total of 172 trials (including 165 RCTs and 7 ongoing trials registrations) were included, involving 91 outcomes. The outcomes could be classified into 7 domains according to functional attributes, namely clinical manifestation, physical and chemical examination, quality of life, TCM symptoms/syndromes, long-term prognosis, safety assessment and economic evaluation. It was found that there were various measurements instruments with large differences, inconsistent measurement time point and without discriminatively reporting primary or secondary outcomes. CONCLUSION: The status quo of outcomes and measurement instruments of RCTs of acupuncture for post-stroke dysphagia is not conducive to the summary and comparison of each trial's results. Thus, it is suggested to develop a core outcome set for acupuncture for post-stroke dysphagia to improve the normative and research quality of their clinical trial design.


Asunto(s)
Terapia por Acupuntura , Trastornos de Deglución , Accidente Cerebrovascular , Humanos , Trastornos de Deglución/etiología , Trastornos de Deglución/terapia , Ensayos Clínicos Controlados Aleatorios como Asunto , Bases de Datos Factuales , Examen Físico , Accidente Cerebrovascular/complicaciones
14.
Mil Med ; 188(Suppl 5): 8-11, 2023 09 04.
Artículo en Inglés | MEDLINE | ID: mdl-37665579

RESUMEN

Total Force Fitness (TFF) was conceived as a holistic framework for building and sustaining Human Performance Optimization for Warfighters and their families. As such, TFF research must also be holistic in nature. During the research breakout, group barriers and challenges to TFF research were discussed, and critical research focus areas were prioritized. The top approaches discussed were (1) using big data to identify best practices and health trajectories; (2) applying community-based participatory research principles to military units; (3) focusing on "Whole-Person," integrative research (physical, behavioral, spiritual, and biological) across the Department of Defense; and, finally, (4) prioritizing key opportunities to advance TFF across the active duty and Reserve/Guard enterprises and their families. The research group noted that coordinated action would be needed to move the prioritized agenda forward. Finally, translating research into action is essential because TFF is a way of honoring our service members as whole persons with careers, goals, and families.


Asunto(s)
Macrodatos , Personal Militar , Estados Unidos , Humanos , Ejercicio Físico , Examen Físico
15.
Sci Rep ; 13(1): 15953, 2023 09 24.
Artículo en Inglés | MEDLINE | ID: mdl-37743388

RESUMEN

Mind-body interventions such as mindfulness-based stress reduction (MBSR) may improve well-being by increasing awareness and regulation of physiological and cognitive states. However, it is unclear how practice may alter long-term, baseline physiological processes, and whether these changes reflect improved well-being. Using respiration rate (RR), which can be sensitive to effects of meditation, and 3 aspects of self-reported well-being (psychological well-being [PWB], distress, and medical symptoms), we tested pre-registered hypotheses that: (1) Lower baseline RR (in a resting, non-meditative state) would be a physiological marker associated with well-being, (2) MBSR would decrease RR, and (3) Training-related decreases in RR would be associated with improved well-being. We recruited 245 adults (age range = 18-65, M = 42.4): experienced meditators (n = 42), and meditation-naïve participants randomized to MBSR (n = 72), active control (n = 41), or waitlist control (n = 66). Data were collected at pre-randomization, post-intervention (or waiting), and long-term follow-up. Lower baseline RR was associated with lower psychological distress among long-term meditators (p* = 0.03, b = 0.02, 95% CI [0.01, 0.03]), though not in non-meditators prior to training. MBSR decreased RR compared to waitlist (p = 0.02, Cohen's d = - 0.41, 95% CI [- 0.78, - 0.06]), but not the active control. Decreased RR related to decreased medical symptoms, across all participants (p* = 0.02, b = 0.57, 95% CI [0.15, 0.98]). Post-training, lower RR was associated with higher PWB across training groups compared to waitlist (p* = 0.01, b = 0.06, 95% CI [0.02, 0.10]), though there were no significant differences in change in PWB between groups. This physiological marker may indicate higher physical and/or psychological well-being in those who engage in wellness practices.


Asunto(s)
Meditación , Distrés Psicológico , Adulto , Humanos , Adolescente , Adulto Joven , Persona de Mediana Edad , Anciano , Autoinforme , Frecuencia Respiratoria , Examen Físico
16.
Multisens Res ; 36(6): 557-572, 2023 08 03.
Artículo en Inglés | MEDLINE | ID: mdl-37582513

RESUMEN

Temporal perception in multisensory processing is important for an accurate and efficient understanding of the physical world. In general, it is executed in a dynamic environment in our daily lives. In particular, the motion-binding property is important for correctly identifying moving objects in the external environment. However, how this property affects multisensory temporal perception remains unclear. We investigate whether the motion-binding property influences audiovisual temporal integration. The study subjects performed four types of temporal-order judgment (TOJ) task experiments using three types of perception. In Experiment 1, the subjects conducted audiovisual TOJ tasks in the motion-binding condition, between two flashes, and in the simultaneous condition, in which the two flashes are perceived as simultaneous stimuli without motion. In Experiment 2, subjects conducted audiovisual TOJ tasks in the motion-binding condition and the short and long successive interval condition, in which the two stimuli are perceived as successive with no motion. The results revealed that the point of subjective simultaneity (PSS) and the just-noticeable difference (JND) in the motion-binding condition differed significantly from those in the simultaneous and short and long successive interval conditions. Specifically, the PSS in the motion-binding condition was shifted toward a sound-lead stimulus in which the PSS became closer to zero (i.e., physical simultaneity) and the JND became narrower compared to other conditions. This suggests that the motion-binding property contributes to accurate temporal integration in multisensory processing by precisely encoding the temporal order of the physical stimuli.


Asunto(s)
Percepción del Tiempo , Percepción Visual , Humanos , Percepción Auditiva , Umbral Diferencial , Examen Físico , Juicio , Estimulación Acústica , Estimulación Luminosa
17.
Musculoskelet Sci Pract ; 66: 102780, 2023 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-37268552

RESUMEN

INTRODUCTION: The concept that headaches may originate in the cervical spine has been discussed over decades and is still a matter of debate. The cervical spine has been traditionally linked to cervicogenic headache; however, current evidence supports the presence of cervical musculoskeletal dysfunctions also in tension-type headache. PURPOSE: This position paper discusses the most updated clinical and evidence-based data about the cervical spine in tension-type headache. IMPLICATIONS: Subjects with tension-type headache exhibit concomitant neck pain, cervical spine sensitivity, forward head posture, limited cervical range of motion, positive flexion-rotation test and also cervical motor control disturbances. In addition, the referred pain elicited by manual examination of the upper cervical joints and muscle trigger points reproduces the pain pattern in tension-type headache. Current data supports that the cervical spine can be also involved in tension-type headache, and not just in cervicogenic headache. Several physical therapies including upper cervical spine mobilization or manipulation, soft tissue interventions (including dry needling) and exercises targeting the cervical spine are proposed for managing tension-type headache; however, the effectiveness of these interventions depends on a proper clinical reasoning since not all will be equally effective for all individuals with tension-type headache. Based on current evidence, we propose to use the terms cervical "component" and cervical "source" when discussing about headache. In such a scenario, in cervicogenic headache the neck can be the cause (source) of the headache whereas in tension-type headache the neck will have a component on the pain pattern, but it will be not the cause since it is a primary headache.


Asunto(s)
Cefalea Postraumática , Cefalea de Tipo Tensional , Humanos , Cefalea Postraumática/terapia , Cefalea/etiología , Examen Físico , Vértebras Cervicales
18.
BMJ Open ; 13(6): e071234, 2023 06 21.
Artículo en Inglés | MEDLINE | ID: mdl-37344121

RESUMEN

INTRODUCTION: Chronic disease remains the leading cause of morbidity and mortality among Aboriginal and Torres Strait Islander peoples in Australia. Regular structured, comprehensive health assessments are available to Aboriginal and Torres Strait Islander people as annual health checks funded through the Medicare Benefits Schedule. This realist review aims to identify context-specific enablers and tensions and contribute to developing an evidence framework to guide the implementation of health checks in the prevention and early detection of chronic diseases for Aboriginal and Torres Strait Islander people. METHODS AND ANALYSIS: The review will involve the following steps: (1) Aboriginal and Torres Strait Islander engagement and research governance; (2) defining the scope of the review; (3) search strategy; (4) screening, study selection and appraisal; (5) data extraction and organisation of evidence; (6) data synthesis and drawing conclusions. This realist review will follow the Realist and MEta-narrative Evidence Syntheses: Evolving Standards guidance and will be reported as set up by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols statement. The realist programme theory will be developed through a literature review using multiple database searches from 1 November 1999 to 31 June 2022, limited to the English language, and stakeholder consultation, which will be refined throughout the review process. The study findings will be reported by applying the context-mechanism-outcome configuration to gain a deeper understanding of context and underlying mechanisms that influence the implementation of health checks in the prevention and early detection of chronic diseases among Aboriginal and Torres Strait Islander people in Australia. ETHICS AND DISSEMINATION: Ethical approval is not required as this review will be using secondary data. Findings will be published in a peer-reviewed journal and presented at scientific conferences. SYSTEMATIC REVIEW REGISTRATION: The review protocol has been registered on the international prospective register of systematic reviews: CRD42022326697.


Asunto(s)
Aborigenas Australianos e Isleños del Estrecho de Torres , Enfermedad Crónica , Servicios de Salud del Indígena , Examen Físico , Humanos , Australia/epidemiología , Enfermedad Crónica/prevención & control , Programas Nacionales de Salud , Revisiones Sistemáticas como Asunto , Tamizaje Masivo
19.
Rev Med Suisse ; 19(832): 1228-1233, 2023 Jun 21.
Artículo en Francés | MEDLINE | ID: mdl-37341315

RESUMEN

Mindfulness meditation is a mind-body approach that helps to cope with psychological or physical symptoms such as pain. To date, this approach is still not widely available to patients in our French-speaking somatic clinical settings, despite its scientific validation. This article describes three mindfulness meditation programs delivered at Lausanne University Hospital (CHUV) to people living with HIV, cancer or chronic pain. It highlights the issues related to the involvement of participants in these programs as well as those related to their implementation in a Swiss somatic, teaching French-speaking hospital.


La méditation de pleine conscience est une approche corps-esprit qui permet de faire face à des symptômes psychiques ou physiques tels que la douleur. À ce jour, malgré sa validation scientifique, cette approche reste peu accessible pour les patient-e-s dans nos contextes cliniques somatiques romands. Cet article décrit trois programmes de méditation de pleine conscience délivrés au sein du CHUV (Lausanne), à des personnes qui vivent avec un VIH, un cancer ou une douleur chronique. Il met en lumière les enjeux liés à l'engagement des participant-e-s dans ces programmes mais aussi ceux en lien avec leur implémentation dans un contexte hospitalier somatique romand.


Asunto(s)
Dolor Crónico , Meditación , Atención Plena , Humanos , Examen Físico , Dolor Crónico/terapia , Hospitales Universitarios
20.
Zhongguo Zhen Jiu ; 43(5): 493-8, 2023 May 12.
Artículo en Chino | MEDLINE | ID: mdl-37161800

RESUMEN

OBJECTIVE: To observe the clinical efficacy of bamboo-based medicinal moxibustion for chronic fatigue syndrome (CFS), and to preliminarily explore its action mechanism. METHODS: Sixty-four patients with CFS were randomly divided into a moxibustion group (32 cases, 1 case dropped off, 1 case excluded) and an acupuncture group (32 cases, 2 cases dropped off). The patients in the moxibustion group were treated with bamboo-based medicinal moxibustion, while the patients in the acupuncture group were treated with routine acupuncture. Both groups were treated once a day, 6 days as a course of treatment with 1 day interval, for a total of 2 courses of treatment. Before treatment, 1 and 2 courses into treatment and in the follow-up of 14 days after treatment, the fatigue scale-14 (FS-14) and somatic and psychological health report (SPHERE) scores were observed in the two groups. Before and after treatment, the contents of CD+3, CD+4, CD+8 of peripheral blood T lymphocyte subsets were measured and CD+4/CD+8 ratio was calculated; the clinical efficacy of the two groups was compared. RESULTS: Compared before treatment, the FS-14 and SPHERE scores in the two groups were decreased 1 and 2 courses into treatment and in the follow-up (P<0.01), and the FS-14 and SPHERE scores in the moxibustion group were lower than those in the acupuncture group (P<0.01, P<0.05). Compared before treatment, the contents of CD+3, CD+4 and CD+4/CD+8 ratio in the moxibustion group were increased after treatment (P<0.01). There was no significant difference of CD+3, CD+4, CD+8 and CD+4/CD+8 ratio between before and after treatment in the acupuncture group (P>0.05). After treatment, the contents of CD+3 and CD+4 in the moxibustion group were higher than those in the acupuncture group (P<0.05). The total effective rate was 93.3% (28/30) in the moxibustion group, which was higher than 73.3% (22/30) in the acupuncture group (P<0.05). CONCLUSION: Bamboo-based medicinal moxibustion could improve the physical and mental fatigue symptoms and psychological status in patients with CFS. Its effect may be related to regulating the contents of CD+3, CD+4 of peripheral blood T lymphocyte subsets and CD+4/CD+8 ratio.


Asunto(s)
Terapia por Acupuntura , Síndrome de Fatiga Crónica , Moxibustión , Humanos , Síndrome de Fatiga Crónica/terapia , Examen Físico
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