Recollection of participating in a trial: A qualitative study of patients with severe and very severe chronic obstructive pulmonary disease

<div><p>Background</p><p>Despite having similar palliative needs to patients with lung cancer, advanced chronic obstructive pulmonary disease (COPD) patients are less likely to receive palliative care. To evaluate the effect of introducing specialized palliative care with severe to very severe COPD patients, a randomized controlled trial (RCT) was conducted in Switzerland.</p><p>Aim</p><p>To explore COPD patients’ recollection of the trial, their needs and the usefulness of the palliative care interventions.</p><p>Design and setting</p><p>Qualitative study with advanced COPD patients who participated in a specialized palliative care intervention, conducted in a general hospital.</p><p>Method</p><p>Eighteen patients with severe to very severe COPD were interviewed about their experiences. Interviews were transcribed and thematic content analysis was performed.</p><p>Results</p><p>Patients had poor recollection of the trial and difficulties understanding the palliative care intervention. No major differences were observed between patients who received the specialized intervention and those who did not. Content analysis emphasized that although they experienced disabling symptoms, participants tended to attribute their limitations to problems other than COPD and some declared that they were not sick. Patients reported restrictions due to oxygen therapy, and the burden of becoming dependent on it. This dependence resulted in intense anxiety, leading participants to focus on the present only. A strong feeling of perceived helplessness emerged from the patients’ interviews.</p><p>Conclusions</p><p>Our findings suggest that poor recollection and understanding of the palliative care intervention act as barriers to the conduct of clinical trials with severe and very severe COPD patients. Their cognitive difficulties, perception of COPD, functional limitations, overwhelming anxiety, focus on the present and perceived helplessness also seem to hinder the implementation of such care.</p></div

Antimicrobial and antifouling activities achieved by extracts of seaweeds from Gulf of California, Mexico

Six species of common seaweed extracts were tested in laboratory assays: Dictyota flabellata, Padina concrescens, Laurencia johnstonii, Gymnogongrus martinensis, Ulva lactuca and Codium fragile for potential industrial applications through evaluation of the antibacterial activity against pathogenic bacteria (5 strains) and the antifouling potency against the growth of key species of marine colonisers (7 bacteria, 5 fungi and 11 microalgae). The organic extract of L. johnstonii, U. lactuca and D. flabellata have bacterial antibiosis. The ethereal extracts were more active in comparison with buthanol extracts against the bacterial strain Staphylococcus aureus. The best antifouling results were obtained with U. lactuca and L. johnstonii (0.1-1 µg ml-1 ) against all strains tested. C.fragile exhibited significant antifouling activity with minimum inhibitory concentration (MIC) between 1-10 µg ml-1 against marine microalgae Rhodosorus magnei, Neorhodella cyanea and Prymnesium calathiferum

Recherche d'informations de santé en ligne. Perspectives des personnes souffrant de lombalgies chroniques non spécifiques et des professionnel·le·s de la santé.

Résistant aux traitements de la médecine, les lombalgies chroniques sont une cause importante d’invalidité dans le monde et représentent un problème majeur de santé publique. Malgré le développement de recommandations cliniques basées sur les évidences scientifiques, la prise en charge de ces douleurs reste encore souvent inadaptée. L’importance de l’information des patient·e·s dans le traitement des lombalgies est bien connue et a pris une nouvelle dimension à l’ère du numérique. Avec le développement d’Internet, les informations médicales ne sont plus limitées aux médecins mais sont accessibles aux patient·e·s à tout moment. Internet redéfinit ainsi les rapports de pouvoir dans la relation patient·e-professionnel·le de la santé. Des études quantitatives se sont intéressées aux recherches d’informations de santé en ligne dans la population générale, mais moins de données existent sur ces pratiques dans le domaine des lombalgies. Notre thèse a ainsi pour objectif de mieux comprendre les expériences et les besoins des personnes souffrant de lombalgies chroniques non spécifiques vis-à-vis des recherches d’informations de santé sur Internet. La manière dont les professionnel·le·s de la santé perçoivent ces pratiques et l’impact de celles-ci sur la relation de soins sont également étudiés. Pour ce faire, nous avons mis en place un dispositif de recherche qualitatif composé de 21 entretiens semi-structurés avec des personnes atteintes de lombalgies chroniques non spécifiques et de 4 groupes focalisés avec un total de 21 professionnel·le·s de la santé. Une analyse thématique des données a été réalisée et un processus de member reflections a été mobilisé avec les participant·e·s aux entretiens. Les résultats montrent que les personnes souffrant de lombalgies utilisent peu Internet pour des informations de santé. Les personnes privilégient en effet les savoirs provenant des professionnel·le·s de la santé ou de leur propre expérience de la douleur. À partir de nos résultats, les facteurs favorisant ou freinant l’engagement dans des recherches d’informations de santé en ligne ont été mis en évidence. Nous avons également élaboré des recommandations pour le développement d’un site Internet sur les maux de dos adapté aux besoins des patient·e·s. Enfin, notre recherche offre des perspectives au niveau pratique, sociétal et politique pour améliorer la prise en charge des personnes souffrant de lombalgies chroniques dans un contexte de numérisation de la santé

Réseaux sociaux et forums

Santé personnalisée - Supplément à l'occasion du symposium "Nouvelles technologies en médecine de famille" organisé dans le cadre du congrès d'automne de la Société Suisse de Médecine Interne Générale (SSMIG

Psychomotor therapy as a treatment of chronic spinal pain: A qualitative study

Psychomotor therapy is an innovative complementary approach that enhances the mind-body connection. It could have a positive effect on chronic pain syndromes but has not yet been specifically studied for spinal pain. We thus aimed to explore the experiences of chronic spinal pain patients with psychomotor therapy

Neoglacial change in deep water exchange and increase of sea-ice transport through eastern Fram Strait: evidence from radiogenic isotopes

Sediment core MSM5/5-712 from the West Spitsbergen continental margin has been investigated at high resolution for its seawater-derived neodymium (Nd) and lead (Pb) isotope compositions stored in ferromanganese oxyhydroxide coatings of the sediment particles to reconstruct Holocene changes in the sources and mixing of bottom waters passing the site. The radiogenic isotope data are used in combination with a multitude of proxy indicators for the climatic and oceanographic development of the eastern Fram Strait during the past 8500 years. To calibrate the downcore data, seawater and core top samples from the area were analysed for their radiogenic isotope compositions. Core top leachates reveal relatively high (more radiogenic) Nd isotope compositions between εNd −9.7 and −9.1, which are higher than present-day seawater εNd in eastern Fram Strait (−12.6 to −10.5) and indicate that the seawater values have only been established very recently. The core top data agree well with the downcore signatures within the uppermost 40 cm of the sediment core (εNd −9.1 to −8.8) indicating a reduced inflow of waters from the Nordic Seas, concurrent with cool conditions and a south-eastward shift of the marginal ice zone after ca 2.8 cal ka BP (Late Holocene). High sea-ice abundances in eastern Fram Strait are coeval with the well-known Neoglacial trend in the northern North Atlantic region. In contrast, warmer conditions of the late Early to Mid-Holocene were accompanied by lower (less radiogenic) εNd signatures of the bottom waters indicating an increased admixture from the Nordic Seas (−10.6 to −10.1). A shift to significantly more radiogenic εNd signatures of the detrital material also occurred at 3 cal ka BP and was accompanied by a marked increase in supply of fine-grained ice-rafted material (IRF) from the Arctic Ocean to the core site. The most likely source areas for this radiogenic material are the shallow Arctic shelves, in particular the Kara Sea shelf. The evolution of the Pb isotope compositions of past seawater was dominated by local signatures characterized by high 208, 207, 206Pb/204Pb values during the warm Early and Mid-Holocene periods related to enhanced chemical weathering on Svalbard and high glacial and riverine input derived from young granitic (more radiogenic) material to the West Spitsbergen margin. At 3 cal ka BP both detrital and seawater Pb isotope data changed towards more Kara Sea-like signatures