Contemporary Healthcare Practice Research Articles

A Clinical Study to Evaluate the Efficacy of Vyoshadi Sakthu on Elevated Lipid Profile

This single-armed open clinical study explores the efficacy of Vyoshadi Sakthu in managing hyperlipidemia, a condition marked by elevated levels of cholesterol and triglycerides, posing substantial health risks such as cardiovascular diseases and obesity. Administered orally with buttermilk, Vyoshadi Sakthu leverages its Lekhana and Medohara properties to target excess fat accumulation. The study involved 20 participants meeting diagnostic criteria, with lipid profiles assessed at baseline and after a 60th day Vyoshadi Sakthu trial. Statistical analysis, employing the paired t-test, revealed significant reductions in serum cholesterol, LDL, and VLDL levels (p < 0.001) post-intervention. These findings suggest a meaningful impact on lipid metabolism attributed to Vyoshadi Sakthu's Lekhana properties. Additionally, the study highlights potential synergies between Vyoshadi Sakthu treatment and lifestyle modifications, including dietary adjustments and regular exercise. This integrated approach may enhance treatment outcomes, emphasizing holistic management strategies for hyperlipidemia and related metabolic disorders. The results contribute to the growing evidence supporting Ayurvedic interventions' therapeutic efficacy in hyperlipidemia management. However, larger controlled studies are required to validate these findings and ensure the long-term safety and efficacy of Vyoshadi Sakthu. This underscores the importance of integrating traditional knowledge systems like Ayurveda into contemporary healthcare practices to address the complexities of metabolic disorders effectively.

Anticariogenic, Antidiabetic, and Toxicology Evaluation of the Ethanolic Extract of Croton bonplandianum: An In Vitro Study.

Background Herbal medicine has gathered increasing attention in contemporary healthcare practices, offering natural remedies for a wide range of ailments such asskin diseases, liver disorders,bronchitis, and asthma. Among the plethora of medicinal plants, Croton bonplandianum, commonly known as "Ban Tulsi," holds significant medicinal value owing to its diverse pharmacological properties. This study investigated the cytotoxicity, embryotoxicity, antidiabetic, and anticariogenic effects of an ethanolic extract derived from C. bonplandianum.The research objectives were to explore the preparation of an ethanolic extract of C. bonplandianum and employ a multifaceted approach by evaluating its cytotoxicity, embryotoxicity, anticariogenic, and antidiabetic potentials. Materials and methods In this study, the β-glucosidase inhibitory and the α-amylase inhibitory assays were utilized to evaluate the antidiabetic activity of theC. bonplandianum ethanolic extract. The in vitro cytotoxicity activity was assessed by using the brine shrimp lethality assay (BSLA), and embryotoxicity was evaluated using zebrafish embryos and larvae. Through the agar well diffusion method and the time-kill curve analysis, the anticariogenic activity was evaluated. Results In α-amylase andβ-glucosidase inhibitory assays, the ethanolic extract ofC. bonplandianum showed potent antidiabetic properties, near those ofstandard acarbose. The cytotoxicity evaluation using the BSLA showed less toxicity. The anticariogenic activity of the ethanolic extract of C. bonplandianumwas assessed by comparing the standard (Amoxyrite) in terms of its zone of inhibition against oral pathogens such asStreptococcus mutans and Lactobacillus species (spp.). The antibacterial efficiency was validated using a time-kill curve assay in which the study depends on the concentration of the bacterial pathogenic organisms, namely, Lactobacillus spp. and S. mutans. In embryotoxicity evaluation, there were no morphological malformations in zebrafish larvae or embryos when exposed to high concentrations of C. bonplandianum ethanolic extract. Conclusion The ethanolic extract ofC. bonplandianum exhibited promising antidiabetic and anticariogenic effects, supporting its conventional usage inalternative medicine. The outcomes of these research analyses suggest the plantpotential as a natural source of compounds with bioactive qualities and can be utilized in the healthcare and pharmaceutical industries.

Unlocking the food treasures: Trachyspermum ammi–A comprehensive exploration from field to pharmacology

AbstractRecent pharmacological research on Tracyspermum ammi has unveiled its diverse medicinal properties, bolstering its status as a notable herbaceous plant. Cultivated extensively in regions like Egypt, Iran, Afghanistan, Pakistan, and India, T. ammi has drawn attention due to its rich essential oil content, prominently thymol. Commonly used in food processing, such as in pickles, this plant exhibits a wide array of pharmacological effects, from diuretic and antibacterial properties to potential as an antitussive, antiplatelet, antihypertensive, bronchodilator, and antihyperlipidemic agent. While the medicinal potential of T. ammi is acknowledged, challenges persist in optimizing its efficacy. The preclinical and clinical trials of T. ammi have been performed and data are compiled to assess its efficacy in humans. Novel drug delivery systems, including nanoparticles, microemulsions, niosomes, and liposomes, among others, offer a means to overcome the constraints associated with conventional formulations. In conclusion, the comprehensive overview presented here highlights the morphological characteristics, food processing, chemical constituents, pharmacological significance, preclinical and clinical trials along with traditional use and novel dosage forms of T. ammi which underscores the need for modernization in drug delivery systems to maximize its therapeutic potential thereby advancing the addition of herbal medicines into contemporary healthcare practices.

Revolutionizing Education: Crafting a Progressive Teaching Methodology for Ayurveda Undergraduate Courses

In the realm of education, the teaching methodology employed plays a pivotal role in shaping the future practitioners of any field. Ayurveda, being a venerable science with roots deeply embedded in tradition, is ripe for a transformative teaching approach that marries ancient wisdom with contemporary educational practices. The traditional guru-shishya parampara (teacher-student tradition) has been the cornerstone of Ayurvedic education. While the essence of this sacred relationship must be preserved, there is a pressing need to integrate modern teaching methods into Ayurveda undergraduate courses. Embracing innovation, integrating technology, fostering interdisciplinary collaboration, and emphasizing practical experiences will not only elevate the quality of education but also empower the next generation of Ayurvedic practitioners to navigate the complexities of modern healthcare with confidence and competence. It is through such progressive educational approaches that the timeless wisdom of Ayurveda can be seamlessly woven into the fabric of contemporary healthcare practices. This editorial explores the imperative of evolving teaching methodologies to enhance the learning experience for aspiring Ayurvedic practitioners.

Ayurvedic Pharmacology for Mutrakrichra

Mutrakrichra roga (urinary disorders), is a prevalent ailment described in Ayurveda with diverse aetiologies and manifestations. Managing Mutrakrichra (urinary disorders) involves using various herbal drugs with diuretic, lithotriptic, and soothing properties. This study aims to compile and compare the drugs used in treating Mutrakrichra roga (urinary disorders) from different classical Ayurvedic texts or Samhitas, including Charaka Samhita, Sushruta Samhita, Ashtanga Hridaya, and other manuscripts. A systematic review of these texts was conducted to identify the drugs recommended for managing Mutrakrichra roga (urinary disorders). The findings revealed a rich repository of medicinal plants and formulations used for their therapeutic effects on urinary disorders, including Gokshura (Tribulus terrestris), Punarnava (Boerrhavia diffusa), and many others. This compilation of drugs from different Samhitas provides valuable insights into the traditional knowledge and practices of Ayurveda in managing Mutrakrichra roga. It underscores the need for further research and clinical studies to validate the efficacy and safety of these herbal remedies in contemporary healthcare practices.

Beyond the Clinic Walls: Examining Radiology Technicians' Experiences in Home-Based Radiography.

In recent years, the landscape of diagnostic imaging has undergone a significant transformation with the emergence of home radiology, challenging the traditional paradigm. This shift, bringing diagnostic imaging directly to patients, has gained momentum and has been further accelerated by the global COVID-19 pandemic, highlighting the increasing importance and convenience of decentralized healthcare services. This study aims to offer a nuanced understanding of the attitudes and experiences influencing the integration of in-home radiography into contemporary healthcare practices. The research methodology involves a survey administered through Computer-Aided Web Interviewing (CAWI) tools, enabling real-time engagement with a diverse cohort of medical radiology technicians in the health domain. A second CAWI tool is submitted to experts to assess their feedback on the methodology. The survey explores key themes, including perceived advantages and challenges associated with domiciliary imaging, its impact on patient care, and the technological intricacies specific to conducting radiologic procedures outside the conventional clinical environment. Findings from a sample of 26 medical radiology technicians (drawn from a larger pool of 186 respondents) highlight a spectrum of opinions and constructive feedback. Enthusiasm is evident for the potential of domiciliary imaging to enhance patient convenience and provide a more patient-centric approach to healthcare. Simultaneously, this study suggests areas of intervention to improve the diffusion of home-based radiology. The methodology based on CAWI tools proves instrumental in the efficiency and depth of data collection, as evaluated by 16 experts from diverse professional backgrounds. The dynamic and responsive nature of this approach allows for a more allocated exploration of technicians' opinions, contributing to a comprehensive understanding of the evolving landscape of medical imaging services. Emphasis is placed on the need for national and international initiatives in the field, supported by scientific societies, to further explore the evolving landscape of teleradiology and the integration of artificial intelligence in radiology. This study encourages expansion involving other key figures in this practice, including, naturally, medical radiologists, general practitioners, medical physicists, and other stakeholders.

Playing well with others: lessons from theatre for the health professions about collaboration, creativity and community.

Despite collaboration among different professions being recognized as fundamentally important to contemporary and future healthcare practice, the concept is woefully undertheorized. This has implications for how health professions educators might best introduce students to interprofessional collaboration and support their transition into interprofessional, collaborative workplaces. To address this, we engage in a conceptual analysis of published collaborative, interprofessional practices and conceptual understandings in theatre, as a highly collaborative art form and industry, to advance thinking in the health professions, specifically to inform interprofessional education. Our analysis advances a conceptualization of collaboration that takes place within a work culture of creativity and community, that includes four modes of collaboration, or the ways theatre practitioners collaborate, by: (1) paying attention to and traversing roles and hierarchies; (2) engaging in reciprocal listening and challenging of others; (3) developing trust and communication, and; (4) navigating uncertainty, risk and failure. We conclude by inviting those working in the health professions to consider what might be gleaned from our conceptualization, where the embodied and human-centred aspects of working together are attended to alongside structural and organizational aspects.

Ayurvedic Management of Duchenne Muscular Dystrophy in Children: A Narrative Review

Duchenne Muscular Dystrophy (DMD) is the most common primary myopathy of children. There are many muscular diseases in children which are inherited through generations. All those are known as congenital myopathy. This disease is an X-linked recessive disorder produced by the abnormality of the gene Xp21. It is a severe condition that poses a life-threatening risk and significantly reduces a patient's lifespan. It is characterised by progressive symmetrical muscular weakness, with proximal muscles being more affected than distal ones. Additionally, individuals with DMD often exhibit pseudohypertrophy of the calf muscles. The compilation of data from classical Ayurvedic texts contributes to a holistic understanding of potential interventions, aiming to improve patient quality of life and prevent contractures. The study is crucial in bridging traditional and contemporary healthcare practices, offering valuable insights for clinicians and the wider medical community in addressing the multifaceted challenges posed by DMD. This research underscores the need for an integrative and comprehensive approach to enhance therapeutic strategies for this prevalent X-linked recessive disorder. In pursuit of this objective, concerted efforts have been directed towards raising awareness among both the general public and the medical community. Furthermore, the review delves into the exploration of various Panchakarma treatments, a traditional therapeutic approach rooted in Ayurveda. By consolidating and synthesising data derived from classical Ayurvedic texts pertaining to DMD, this review seeks to provide a holistic understanding of potential interventions. The goal is to contribute to the advancement of therapeutic strategies that can ameliorate the impact of DMD on patients' lives, fostering a more comprehensive and integrated approach to managing this challenging condition.

Book review: The philosophy of person‐centred healthcare, By DerekMitchell, MichaelLoughlin, Cambridge: Cambridge Scholars Publishing. 2023. 201 pp. £64.99. ISBN (10): 1‐5275‐9058‐5, ISBN (13): 978‐1‐5275‐9058‐8

Book review: The philosophy of person‐centred healthcare, By DerekMitchell, MichaelLoughlin, Cambridge: Cambridge Scholars Publishing. 2023. 201 pp. £64.99. ISBN (10): 1‐5275‐9058‐5, ISBN (13): 978‐1‐5275‐9058‐8

What Black Mothers with Preterm Infants Want for Their Mental Health Care: A Qualitative Study.

"I think that some culturally sensitive mental health information could have been provided": What Black mothers with preterm infants want for their mental health care: A qualitative study. In the United States, preterm birth (PTB) rates in Black women are 50% higher than in non-Hispanic White and Hispanic mothers. Existing discriminatory sociohistorical and contemporary health care practices have been linked to the alarmingly higher rates of PTB among Black families. While it is well-known that PTB is associated with increased mental health (MH) problems, Black women experience elevated MH burdens due to inequities along the care continuum in the neonatal intensive care unit (NICU). Consequently, culturally responsive MH care holds promises to achieve maternal MH equity. This study aimed to explore the available MH services and resources in the NICU for Black mothers with preterm infants. We also sought to discover potential recommendations and strategies for MH programs through a cultural lens. Semistructured interviews were conducted with Black mothers with preterm infants using a Grounded Theory approach embedded in the Black feminist theory. Eleven mothers who gave birth to a preterm infant between 2008 and 2021 participated in this study. Eight women reported not receiving MH services or resources in the NICU. Interestingly, of the three mothers who received MH referrals/services, two did so one-year postbirth and did not utilize the services. Three main themes emerged: stress and the NICU experience, coping mechanisms, and culturally appropriate MH care with diverse providers are needed. Overall, our finds suggest that MH care is not prioritized in the NICU. Black mothers with preterm infants encounter numerous negative and stressful experiences that exacerbate their MH during and beyond the NICU. However, MH services in the NICU and follow-up services are scarce. Mothers in this study endorsed creating culturally appropriate MH programs that addresses their unique intersections.

Using a mediating model of death attitude and meaning in life to understand nursing students attitude about hospice care

BackgroundNurse-led hospice teams are an emerging trend in contemporary health care practice in China. However, Chinese nursing students are often ill-prepared to work in hospice care. Study findings on the attitude of nursing students toward the care of people who are dying and death varied among different countries and regions. ObjectivesTo propose and empirically test a mediating model that examines how death attitude and meaning in life interact to affect Chinese undergraduate nursing students and their attitude toward the care of people who are dying. DesignA cross-sectional study. ParticipantsA convenience sample of 1410 Chinese undergraduate nursing students. MethodsData were collected from July to December 2020 using Chinese versions of the Frommelt Attitude Toward Care of the Dying Scale, Form B (FATCOD-B-C), Death Attitude Profile-Revised (DAP-R-C), and Purpose in Life Test (CPLT-C). SPSS version 22.0 and AMOS version 24.0 were used for statistical analysis. ResultsThe average FATCOD-B-C score was 98.28 ± 8.02. Death attitude and meaning in life were positively correlated with attitude toward care of the dying (p < 0.001), but death attitude was negatively correlated with meaning in life (p < 0.001). Pathway analysis showed that fear of death was significantly and positively correlated with attitude toward care of people who are dying. A mediating role was found among neutral acceptance, escape acceptance, and meaning in life to some extent. Meaning in life suppressed effects among the model. ConclusionThis study revealed that Chinese undergraduate nursing students' attitude toward care of the dying was a positive nurturing process. Future nurse education should first identity the fear of death, neutral acceptance, or escape acceptance of nursing students' death attitude, and then develop a hospice curriculum based on fear management.

Demographic, practice and clinical management characteristics of osteopaths referring to podiatrists: secondary analysis of a nationally representative sample of Australian osteopaths

BackgroundInterprofessional care is paramount in contemporary healthcare practice. How different professions interact, and the characteristics of those practitioners who practice in an interprofessional way are rarely described in the literature. The aim of the current work was to identify the demographic, practice and clinical management characteristics of Australian osteopaths who report referring to podiatrists.MethodsThe study was a secondary analysis of data from the Osteopathy Research and Innovation Network (ORION). Inferential statistics were generated to identify statistically significant demographic, practice and clinical management characteristics associated with referrals to podiatrists by Australian osteopaths.ResultsNine-hundred and ninety-two Australian osteopaths responded to the questionnaire. Sending referrals to a podiatrist was reported by 651 participants (65.6%). Female Australian osteopaths were less likely to report referring to podiatrists compared to male osteopaths (OR 0.76, 95%CI 0.59–0.99). Australian osteopaths who reported referring to podiatrists were more likely to report receiving referrals from podiatrists (OR 9.75, 95%CI 6.98–13.61), use orthopaedic testing in patient assessment (OR 7.62, 95%CI 2.82–20.60), and often treat patients with postural disorders (OR 1.71, 95%CI 1.03–2.26), compared to osteopaths who do not refer to podiatrists.ConclusionThis study provides initial evidence for the referral relationship between Australian osteopaths and podiatrists. Further work could explore the nature of these referrals, including the complaints resulting in referral and outcomes of care. This information will be useful to those involved in health policy development and the professions advocating for their role in the wider healthcare system.

Reimagining quarantine: Assuring hopefulness in nursing and healthcare.

This article aimed to explore issues of concern related to quarantine, its social consequences and influences, challenging its effects on human behavioral expressions during social isolation. The advent of the coronavirus disease 2019 (COVID-19) pandemic impacted human lives in multifarious ways, threatening the meaning of normalcy. Quarantine, lockdown, isolation, and other terms reflecting conditions limiting human freedoms have become synonymous in importance to safety, security, and survival. To understand human defiance in the face of maintaining limited mobility during the COVID-19 pandemic, reimagining situations of "unfreedoms" is explained as thinking of changes to inspire and improve the meaning of living lives meaningfully. During the pandemic, issues regarding healthcare practices and social behaviors focused much attention on interactive challenges that enhance ways to mitigate the spread of contagious diseases. Illuminating these issues, discussing concerns and highlighting recommendations to engage in alternative approaches and practices, heightens the declaration of efficiency of quarantine outcomes and effectiveness. Implications are proposed with the hope that they may lead the way forward in exercising contemporary healthcare practices.

Integrating service learning into the RN to BSN curriculum with the application of QSEN competencies.

To accomplish the goal of a more highly educated nursing workforce, academic nursing has supported a significant increase in the number of RN to BSN programs. The focus of educating practicing registered nurses is moving toward revising and designing curriculum that promote positive patient outcomes and supports contemporary healthcare practices. Facilitating a service-learning model for RN to BSN curricula and applying the Quality and Safety Education in Nursing (QSEN) competencies are two effective methods for enhancing professional practice. The purpose of this article is to promote the concept of integrating service learning into the RN to BSN curriculum and applying the QSEN competencies to learning activities to achieve improved quality and patient safety.

Seeing the Elephant: A Systematic Scoping Review and Comparison of Patient-Centeredness Conceptualizations from Three Seminal Perspectives.

“Patient-Centeredness” (PC) is a theoretical construct made up of a diverse constellation of distinct concepts, processes, practices, and outcomes that have been developed, arranged, and prioritized heterogeneously by different communities of professional healthcare practice, research, and policy. It is bound together by a common ethos that puts the holistic individual at the functional and symbolic center of their care, a quality deemed essential for chronic disease management and health promotion. Several important contributions to the PC research space have adeptly integrated seminal PC conceptualizations to improve conceptual clarity, measurement, implementation, and evaluation in research and practice. This systematic scoping review builds on that work, but with a purpose to explicitly identify, compare, and contrast the seminal PC conceptualizations arising from the different healthcare professional groups. The rationale for this work is that a deeper examination of the underlying development and corresponding assumptions from each respective conceptualization will lead to a more informed understanding of and meaningful contributions to PC research and practice, especially for healthcare professional groups newer to the topic area like pharmacy. The literature search identified four seminal conceptualizations from the healthcare professions of Medicine, Nursing, and Health Policy. A compositional comparison across the seminal conceptualizations revealed a shared ethos but also six distinguishing features: (1) organizational structure; (2) predominant level of care; (3) methodological approach; (4) care setting origin; (5) outcomes of interest; and (6) language. The findings illuminate PC’s stable theoretical foundations and distinctive nuances needed to appropriately understand, apply, and evaluate the construct’s operationalization in contemporary healthcare research and practice. These considerations hold important implications for future research into the fundamental aims of healthcare, how it should look when practiced, and what should reasonably be required of it.

Possible advantages of the clinical policy ethics assessment tool: institutional support or unnecessary bureaucracy?

Contemporary healthcare practice has been progressively more regulated to increase efficiency, service user safety and practice quality. However, ethical issues in clinical practice that have not been implemented into regulations are undervalued by policymakers and healthcare institutions Considering the issues found by other authors, the use of a simple tool for policymakers to consider recurrent ethical issues could reduce those issues in a policy-driven clinical practice. The lack of tools to support structured ethical assessment of clinical policies was the main reason to create the Clinical Policy Ethics Assessment Tool, but we realised of its possible advantages: limiting ethical dilemmas posed by policies, ensuring ethical practice by the use of policies and developing a consistent process for policymakers, institutions and healthcare professionals. Nonetheless, even if a tool can be implemented and it supports the creation of policies that reduce ethical issues, if the healthcare professionals are not aware of them they will not be implemented and the issues will continue.

Knowledge, evidence, expertise? The epistemics of experience in contemporary healthcare

This paper explores how personal experience acquires the status of knowledge and/or evidence in contemporary healthcare contexts that emphasise being both patient-centred and evidence-based. Drawing on a comparative analysis of three case studies – self-help and mutual aid groups; online patient activism; and patient feedback in healthcare service delivery – we foreground: a) the role that different technologies and temporalities play in how experience is turned (or fails to be turned) into knowledge or evidence; b) the role that experts-of-experience, in addition to the more frequently referenced experts-by-experience, play in mediating how, when and why experience is turned into an epistemic resource; and finally, c) how the need to be ‘evidence-based’ remains a persistent, yet at times productive, challenge to how patient and user experiences are incorporated in contemporary healthcare policy and practice. Throughout the paper, we argue that it is necessary to look at both democratic and epistemic imperatives for including patient and service users in healthcare services and policymaking based on their experience.

Perceptions and experiences of nurses involved in quality-improvement processes in acute healthcare facilities: a qualitative systematic review protocol.

The objective of this review is to understand the perceptions of nurses working in acute healthcare environments in relation to quality-improvement processes. Quality improvement requirements and processes are firmly embedded in contemporary healthcare practice; however, the evidence is unclear on the extent to which nurses are engaged across the continuum of quality improvement. Nurses are required to consult these processes, but clinical nurses in particular may have limited input into the planning and implementation of quality improvement. The population to be reviewed is nurses working in acute healthcare settings. The phenomena of interest is the perceptions and experiences of these nurses in relation to quality-improvement processes. A defined search strategy will be used. PubMed, CINAHL, Embase, and SCOPUS will be searched. Informit, MedNar, and ProQuest will be searched to identify gray literature. The search will be limited to studies published in English. No date limits will be set. After screening the titles and abstracts of identified citations, potentially relevant studies will be retrieved in full. The review will be conducted following the JBI methodology for qualitative evidence. The JBI process of meta-aggregation will be used to identify categories and synthesize findings. The ConQual approach will be used to assess confidence in the findings. Synthesis of the data will be presented in a table with accompanying narrative. PROSPERO CRD42019146833.

Healthcare management and the 2020 Nightingale bicentenary celebrations

Nursing and midwifery will be in the spotlight throughout 2020, which has been declared the international year of the nurse and midwife by the World Health Organization. In conjunction with this, the Nightingale bicentenary celebrations are also taking place globally this year. Healthcare managers worldwide are encouraged to look back on the contribution that Florence Nightingale made to contemporary healthcare management and healthcare practice, as well as reflecting on the crucial role of nurses and midwives today.

Discourse analysis as a tool for uncovering the lived experience of dementia: Metaphor framing and well-being in early-onset dementia narratives

The aim of this article is to explore how metaphor is mobilized to frame and describe the lived experience of dementia in a corpus of illness narratives compiled from 10 blogs initiated and maintained by individuals diagnosed with early-onset dementia. The article is set against the background of contemporary healthcare practices and discourse around chronic illness and focuses on the metaphors that patients use to communicate about their dementia experience in relation to three basic psychological needs: autonomy, competence and relatedness, which are essential for human well-being and are heavily challenged in complex medical situations. Results are discussed in terms of the framing metaphors provide of the emotional, psychological impact of dementia and their implications for patient-centered care. This study expands prior work by researching metaphors used for a condition that has been scarcely explored from this point of view and by focusing on the patient’s perspective exclusively.