775 research outputs found

    Cultural Transformation in Healthcare: How Well Does the Veterans Health Administration Vision for Whole Person Care Fit the Needs of Patients at an Academic Rehabilitation Center?

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    Background The Veterans Health Administration is undergoing a cultural transformation toward person-driven care referred to as the Whole Health System of Care. Objective This pilot study evaluated whether the Whole Health model resonates with patients of a large public university rehabilitation clinic. Methods Thirty participants completed the Veterans Health Administration's Personal Health Inventory (PHI), and six attended the course "Taking Charge of My Life and Health." Researchers analyzed PHI responses and post-course focus group transcripts. A short post-PHI survey and post-course evaluation were collected. Results Participants agreed the PHI is a simple, useful tool. The course, while well attended, did not meet participants' expectations. Participants wanted access to integrative therapies and opportunities to contribute to healthcare transformation. Conclusion Rehabilitation patients resonated with the Whole Health vision. They expressed enthusiasm for the cultural transformation represented by the model along with frustration that standard healthcare experiences fall short of this vision

    Open Science, Closed Doors?:Countering Marginalization through an Agenda for Ethical, Inclusive Research in Communication

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    The open science (OS) movement has advocated for increased transparency in certain aspects of research. Communication is taking its first steps toward OS as some journals have adopted OS guidelines codified by another discipline. We find this pursuit troubling as OS prioritizes openness while insufficiently addressing essential ethical principles: respect for persons, beneficence, and justice. Some recommended open science practices increase the potential for harm for marginalized participants, communities, and researchers. We elaborate how OS can serve a marginalizing force within academia and the research community, as it overlooks the needs of marginalized scholars and excludes some forms of scholarship. We challenge the current instantiation of OS and propose a divergent agenda for the future of Communication research centered on ethical, inclusive research practices.</p

    Enterococcus faecalis demonstrates pathogenicity through increased attachment in an ex vivo polymicrobial pulpal infection

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    This study investigated the host response to a polymicrobial pulpal infection consisting of Streptococcus anginosus and Enterococcus faecalis, bacteria commonly implicated in dental abscesses and endodontic failure, using a validated ex vivo rat tooth model. Tooth slices were inoculated with planktonic cultures of S. anginosus or E. faecalis alone or in co-culture at ratios of 50:50 and 90:10 S. anginosus to E. faecalis. Attachment was semi-quantified by measuring area covered by fluorescently labelled bacteria. Host response was established by viable histological cell counts and inflammatory response using RT-qPCR and immunohistochemistry. A significant reduction in cell viability was observed for single and polymicrobial infections, with no significant differences between infection types (≈2000cells/mm2 for infected pulps compared to ≈4000cells/mm2 for uninfected pulps). E. faecalis demonstrated significantly higher levels of attachment (6.5%) compared to S. anginosus alone (2.3%) and mixed species infections (3.4% for 50:50 and 2.3% for 90:10), with a remarkable affinity to the pulpal vasculature. Infections with E. faecalis demonstrated the greatest increase in TNF-α (47.1 fold for E. faecalis, 14.6 fold for S. anginosus, 60.1 fold for 50:50 and 25.0 fold for 90:10) and IL-1β expression (54.8 fold for E. faecalis, 8.8 fold for S. anginosus, 54.5 fold for 50:50 and 39.9 fold for 90:10) when compared to uninfected samples. Immunohistochemistry confirmed this with the majority of inflammation localised to the pulpal vasculature and odontoblast regions. Interestingly, E. faecalis supernatant and heat killed E. faecalis treatment was unable to induce the same inflammatory response, suggesting E. faecalis pathogenicity in pulpitis is linked to its greater ability to attach to the pulpal vasculature

    Early signaling, referral, and treatment of adolescent chronic pain: a study protocol

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    <p>Abstract</p> <p>Background</p> <p>Chronic pain is prevalent among young people and negatively influences their quality of life. Furthermore, chronic pain in adolescence may persist into adulthood. Therefore, it is important early on to promote the self-management skills of adolescents with chronic pain by improving signaling, referral, and treatment of these youngsters. In this study protocol we describe the designs of two complementary studies: a signaling study and an intervention study.</p> <p>Methods and design</p> <p>The signaling study evaluates the Pain Barometer, a self-assessed signaling instrument for chronic pain in adolescents. To evaluate the feasibility of the Pain Barometer, the experiences of youth-health care nurses will be evaluated in semi-structured interviews. Also, we will explore the frequencies of referral per health-care provider. The intervention study evaluates Move It Now, a guided self-help intervention via the Internet for teenagers with chronic pain. This intervention uses cognitive behavioural techniques, including relaxation exercises and positive thinking. The objective of the intervention is to improve the ability of adolescents to cope with pain. The efficacy of Move It Now will be examined in a randomized controlled trial, in which 60 adolescents will be randomly assigned to an experimental condition or a waiting list control condition.</p> <p>Discussion</p> <p>If the Pain Barometer is proven to be feasible and Move It Now appears to be efficacious, a health care pathway can be created to provide the best tailored treatment promptly to adolescents with chronic pain. Move It Now can be easily implemented throughout the Netherlands, as the intervention is Internet based.</p> <p>Trial registration</p> <p>Dutch Trial Register NTR1926</p

    Needs and preferences for psychological interventions of people with motor neuron disease

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    Background: There is a lack of knowledge about what factors may impede or facilitate engagement in psychological interventions in people with motor neuron disease (pwMND) and how such interventions can be adapted to best meet the needs of this population. Objectives: To explore the needs and preferences of pwMND with respect to psychological interventions, and how best to adapt such interventions for pwMND. Methods: A series of semi-structured interviews (n = 22) and workshops (n = 3) were conducted with pwMND (n = 15), informal caregivers of pwMND (n = 10), and MND healthcare professionals (n = 12). These explored preferences and concerns that would need to be considered when delivering a psychological intervention for pwMND. Three areas were explored: (i) perceived factors that may hinder or facilitate pwMND engaging with psychological interventions; (ii) ways in which such interventions could be adapted to meet the individual needs of pwMND; and (iii) views regarding the main psychological issues that would need to be addressed. Workshops and interviews were audio recorded and transcribed and thematic analysis was used to inductively derive themes. Findings: Data could be classified within four overarching themes: unfamiliar territory; a series of losses; variability and difficulty meeting individual needs; and informal support. Conclusions: Flexibility, tailoring interventions to the individual needs of pwMND, and encouraging autonomy are key attributes for psychological interventions with pwMND. Psychological interventions such as Acceptance and Commitment Therapy (ACT) could be acceptable for pwMND if adapted to their specific needs
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