Treatments for irritable bowel syndrome: patients' attitudes and acceptability

<p>Abstract</p> <p>Background</p> <p>Irritable Bowel Syndrome, a highly prevalent chronic disorder, places significant burden on the health service and the individual. Symptomatic distress and reduced quality of life are compounded by few efficacious treatments available. As researchers continue to demonstrate the clinical efficacy of alternative therapies, it would be useful to gain a patient-perspective of treatment acceptability and identify patient's attitudes towards those modalities considered not acceptable.</p> <p>Methods</p> <p>Six hundred and forty-five participants identified from an earlier IBS-prevalence study received a postal questionnaire to evaluate preferences and acceptability of nine forms of treatment. Proportions accepting each form of treatment were calculated and thematic analysis of qualitative data undertaken.</p> <p>Results</p> <p>A total of 256 (39.7%) of 645 potential respondents completed the questionnaire (mean age 55.9 years, 73% female). Tablets were most acceptable (84%), followed by lifestyle changes (diet (82%), yoga (77%)). Acupuncture (59%) and suppositories (57%) were less acceptable.</p> <p>When explaining lack of acceptability, patient views fell into four broad categories: dislike treatment modality, do not perceive benefit, general barriers and insufficient knowledge. Scepticism, lack of scientific rationale and fear of CAM were mentioned, although others expressed a dislike of conventional medical treatments. Past experiences, age and health concerns, and need for proof of efficacy were reported.</p> <p>Conclusion</p> <p>Most patients were willing to accept various forms of treatment. However, the reservations expressed by this patient-population must be recognised with particular focus directed towards allaying fears and misconceptions, seeking further evidence base for certain therapies and incorporating physician support and advice.</p

The Role of Spirituality Healing with Perceptions of the Medical Encounter among Latinos

Little is known about the relationship between spirituality healing and perceptions about the medical encounter among Latinos. To examine the association between spirituality healing and attitudes of self-reported perceptions about the medical encounter. A cross-sectional telephone survey. 3,728 Latinos aged ≥18 years residing in the United States from Wave 1 of the Pew Hispanic Center/Robert Wood Johnson Foundation Latino Health Survey. Dependent variables were ever prayed for healing (yes/no), ever asked others to pray for healing (yes/no), considered important spiritual healing (very vs. somewhat or not important), and ever consulted a ‘curandero’ (folk healer in Latin America) (yes/no). The primary independent variables were feelings about the last time seeing a Doctor (confused by information given, or frustrated by lack of information) and perception of quality of medical care (excellent, good, fair or poor) within the past 12 months. Six percent of individuals reported that they had ever consulted a curandero, 60% prayed for healing, 49% asked others to pray for healing, and 69% considered spiritual healing as very important. In multivariable analyses, feeling confused was associated with increased odds of consulting a curandero (OR = 1.58; 95% CI, 1.02–2.45), praying for healing (OR = 1.30; 95% CI, 1.03–1.64), asking others to pray for healing (OR = 1.29; 95% CI, 1.03–1.62), and considering spiritual healing as very important (OR = 1.30; 95% CI, 1.01–1.66). Feeling frustrated by a lack of information was associated with asking others to pray for healing (OR = 1.29; 95% CI, 1.04–1.60). A better perception of quality of medical care was associated with lower odds of consulting a curandero (OR = 0.83; 95% CI, 0.70–0.98). Feelings about the medical encounter were associated with spirituality healing, praying for healing, and asking others to pray for healing. Feeling confused and perception of poor quality of medical care were associated with consulting a curandero

Self-care and adherence to medication: a survey in the hypertension outpatient clinic

<p>Abstract</p> <p>Background</p> <p>Self-care practices for patients with hypertension include adherence to medication, use of blood pressure self-monitoring and use of complementary and alternative therapies (CAM) The prevalence of CAM use and blood pressure self-monitoring have not been described in a UK secondary care population of patients with hypertension and their impact on adherence to medication has not been described. Adherence to medication is important for blood pressure control, but poor adherence is common. The study aimed to determine the prevalence of self-care behaviours in patients attending a secondary care hypertension clinic.</p> <p>Methods</p> <p>Cross-sectional questionnaire survey. 196 patients attending a secondary care hypertension clinic in a teaching hospital serving a multiethnic population, Birmingham, UK. Main outcome measures: Prevalence of use of CAM, home monitors, adherence to anti-hypertensive medication.</p> <p>Results</p> <p>CAM use in previous 12 months was reported by 66 (43.1%) respondents. CAM users did not differ statistically from non-CAM users by age, gender, marital status or education. Vitamins, prayer a dietary supplements were the most commonly used CAM. Nine (12.7%) women reported using herbal CAM compared to one man (1.2%), (p = 0.006). Ten (6.7%) respondents reported ever being asked by a doctor about CAM use. Perfect adherence to anti-hypertensive medication was reported by 26 (44.8%) CAM-users and 46 (60.5%) non-CAM users (p = 0.07). Being female and a CAM user was significantly associated with imperfect adherence to anti-hypertensive medication. Older and white British respondents were significantly more likely to report perfect adherence. Blood pressure monitors were used by 67 (43.8%) respondents, which was not associated with gender, CAM use or adherence to medication.</p> <p>Conclusion</p> <p>Hypertensive patients use a variety of self-care methods, including CAM, home blood pressure monitors, and adherence to prescribed medication. This study found the prevalence of CAM use in hypertensive patients was higher than in the UK population. It is important to acknowledge the self-care behaviour of hypertensive patients, in order to assess potential harm, and encourage effective methods of self-care.</p

Does trust in health care influence the use of complementary and alternative medicine by chronically ill people?

BACKGROUND: People's trust in health care and health care professionals is essential for the effectiveness of health care, especially for chronically ill people, since chronic diseases are by definition (partly) incurable. Therefore, it may be understandable that chronically ill people turn to complementary and alternative medicine (CAM), often in addition to regular care. Chronically ill people use CAM two to five times more often than non-chronically ill people. The trust of chronically ill people in health care and health care professionals and the relationship of this with CAM use have not been reported until now. In this study, we examine the influence of chronically ill people's trust in health care and health care professionals on CAM use. METHODS: The present sample comprises respondents of the 'Panel of Patients with Chronic Diseases' (PPCD). Patients (≥25 years) were selected by GPs. A total of 1,625 chronically ill people were included. Trust and CAM use was measured by a written questionnaire. Statistical analyses were t tests for independent samples, Chi-square and one-way analysis of variance, and logistic regression analysis. RESULTS: Chronically ill people have a relatively low level of trust in future health care. They trust certified alternative practitioners less than regular health care professionals, and non-certified alternative practitioners less still. The less trust patients have in future health care, the more they will be inclined to use CAM, when controlling for socio-demographic and disease characteristics. CONCLUSION: Trust in future health care is a significant predictor of CAM use. Chronically ill people's use of CAM may increase in the near future. Health policy makers should, therefore, be alert to the quality of practising alternative practitioners, for example by insisting on professional certification. Equally, good quality may increase people's trust in public health care

NOAA-GFDL/FMS: 2023.03

&lt;h2&gt;[2023.03] - 2023-10-27&lt;/h2&gt; &lt;h3&gt;Known Issues&lt;/h3&gt; &lt;ul&gt; &lt;li&gt;GCC 9 and below as well as GCC 11.1.0 are unsupported due to compilation issues. See prior releases for more details.&lt;/li&gt; &lt;li&gt;&lt;code&gt;NO_QUAD_PRECISION&lt;/code&gt; macro is no longer set by FMS, the &lt;code&gt;ENABLE_QUAD_PRECISION&lt;/code&gt; macro has replaced prior usage of &lt;code&gt;NO_QUAD_PRECISION&lt;/code&gt;. &lt;code&gt;-DENABLE_QUAD_PRECISION&lt;/code&gt; should be set if quad precision is to be used, otherwise FMS will not use quad precision reals where applicable.&lt;/li&gt; &lt;/ul&gt; &lt;h3&gt;Added&lt;/h3&gt; &lt;ul&gt; &lt;li&gt;UNIT_TESTS: New unit tests have been created or and existing ones expanded on for any modules utilizing mixed precision support.&lt;/li&gt; &lt;/ul&gt; &lt;h3&gt;Changed&lt;/h3&gt; &lt;ul&gt; &lt;li&gt;MIXED PRECISION: Most subroutines and functions in FMS have been updated to simultaneously accept both 4 byte and 8 byte reals as arguments. This deprecates the &lt;code&gt;--enable-mixed-mode&lt;/code&gt; option, which enabled similar functionality but was limited to certain directories and was not enabled by default. To facilitate easier testing of these code changes, the CMake precision options for default real size were left in (along with an equivalent &lt;code&gt;--disable-r8-default&lt;/code&gt; flag for autotools). The resulting libraries will support mixed-precision real kinds regardless of default real size. It should also be noted that many routines that accept real arguments have been moved to include files along with headers in order to be compiled with both kinds. Most module level variables were explicitly declared as r8_kind for these updates.&lt;/li&gt; &lt;li&gt;Some type/module changes were made to facilitate mixed precision support. They are &lt;strong&gt;intended&lt;/strong&gt; to have minimal impact to other codebases:&lt;ul&gt; &lt;li&gt;COUPLER_TYPES: In coupler_types.F90, &lt;code&gt;coupler_nd_field_type&lt;/code&gt; and &lt;code&gt;coupler_nd_values_type&lt;/code&gt; have been renamed to indicate real kind value: &lt;code&gt;coupler_nd_real4/8_field_type&lt;/code&gt; and &lt;code&gt;coupler_nd_real4/8_values_type&lt;/code&gt;. The &lt;code&gt;bc&lt;/code&gt; field within &lt;code&gt;coupler_nd_bc_type&lt;/code&gt; was modified to use r8_kind within the value and field types, and an additional field added &lt;code&gt;bc_r4&lt;/code&gt; to use r4_kind values.&lt;/li&gt; &lt;li&gt;TRIDIAGONAL: Module state between r4 and r8 calls are distinct (ie. subsequent calls will only be affected by calls of the same precision). This behaviour can be changed via the &lt;code&gt;save_both_kinds&lt;/code&gt; optional argument to &lt;code&gt;tri_invert&lt;/code&gt;.&lt;/li&gt; &lt;/ul&gt; &lt;/li&gt; &lt;li&gt;CODE_STYLE: has been updated to reflect the formatting used for the mixed precision support updates.&lt;/li&gt; &lt;/ul&gt; &lt;h3&gt;Fixed&lt;/h3&gt; &lt;ul&gt; &lt;li&gt;DIAG_MANAGER: Tile number (ie. tileX) will now be added to filenames for sub-regional diagnostics.&lt;/li&gt; &lt;li&gt;MPP: Bug affecting non-intel compilers coming from uninitialized pointer in the &lt;code&gt;nest_domain_type&lt;/code&gt;&lt;/li&gt; &lt;li&gt;MPP: Bug fix for unallocated field causing seg faults in &lt;code&gt;mpp_check_field&lt;/code&gt;&lt;/li&gt; &lt;li&gt;FMS2_IO: Fixed segfault occuring from use of cray pointer remapping along with mpp_scatter/gather&lt;/li&gt; &lt;li&gt;TEST_FMS: Added various fixes for different compilers within test programs for fms2_io, mpp, diag_manager, parser, and sat_vapor_pres.&lt;/li&gt; &lt;li&gt;INTERPOLATOR: Deallocates fields in the type that were previously left out in &lt;code&gt;interpolator_end&lt;/code&gt;&lt;/li&gt; &lt;/ul&gt; &lt;h3&gt;Removed&lt;/h3&gt; &lt;ul&gt; &lt;li&gt;CPP MACROS:&lt;ul&gt; &lt;li&gt;&lt;code&gt;no_4byte_reals&lt;/code&gt; was removed and will not set any additional macros if used. &lt;code&gt;no_8byte_integers&lt;/code&gt; is still functional.&lt;/li&gt; &lt;li&gt;&lt;code&gt;NO_QUAD_PRECISION&lt;/code&gt; was removed. It was conditionally set if ENABLE_QUAD_PRECISION was undefined. ENABLE_QUAD_PRECISION should be used in model components instead (logic is flipped)&lt;/li&gt; &lt;li&gt;&lt;code&gt;use_netCDF&lt;/code&gt; was set by autotools previously but wasn't consistently used in the code. FMS should always be compiled with netcdf installed so this was removed with the exception of its use in deprecated IO modules.&lt;/li&gt; &lt;/ul&gt; &lt;/li&gt; &lt;li&gt;DRIFTERS: The drifters subdirectory has been deprecated. It will only be compiled if using the &lt;code&gt;-Duse_drifters&lt;/code&gt; CPP flag.&lt;/li&gt; &lt;/ul&gt; &lt;h3&gt;Tag Commit Hashes&lt;/h3&gt; &lt;ul&gt; &lt;li&gt;2023.03-beta1 06b94a7f574e7794684b8584391744ded68e2989&lt;/li&gt; &lt;li&gt;2023.03-alpha3 b25a7c52a27dfd52edc10bc0ebe12776af0f03df&lt;/li&gt; &lt;li&gt;2023.03-alpha2 9983ce308e62e9f7215b04c227cebd30fd75e784&lt;/li&gt; &lt;li&gt;2023.03-alpha1 a46bd94fd8dd1f6f021501e29179003ff28180ec&lt;/li&gt; &lt;/ul&gt