Role In Preventive Care Research Articles

Clinical Advances in Cardiovascular Computed Tomography: From Present Applications to Promising Developments.

This review aims to provide a profound overview on most recent studies on the clinical significance of Cardiovascular Computed Tomography (CCT) in diagnostic and therapeutic pathways. Herby, this review helps to pave the way for a more extended but yet purposefully use in modern day cardiovascular medicine. In recent years, new clinical applications of CCT have emerged. Major applications include the assessment of coronary artery disease and structural heart disease, with corresponding recommendations by major guidelines of international societies. While CCT already allows for a rapid and non-invasive diagnosis, technical improvements enable further in-depth assessments using novel imaging parameters with high temporal and spatial resolution. Those developments facilitate diagnostic and therapeutic decision-making as well as improved prognostication. This review determined that recent advancements in both hardware and software components of CCT allow for highly advanced examinations with little radiation exposure. This particularly strengthens its role in preventive care and coronary artery disease. The addition of functional analyses within and beyond coronary artery disease offers solutions in wide-ranging patient populations. Many techniques still require improvement and validation, however, CCT possesses potential to become a "one-stop-shop" examination.

Nutraceutical Foods: Pioneering the Future of Nutrition

Abstract: Nutraceuticals are an important part of the food industry due to their health benefits and potential to address nutritional deficiencies. This article explores the changes, importance, challenges and future prospects of nutraceuticals as innovative solutions to improve human health and well-being. It provides an in-depth study of the ingredients, classification and different types of nutraceuticals in terms of their role in preventive care and their ability to alleviate various ailments. Additionally, this article highlights the technological advances, regulatory processes, consumer markets, and ethical considerations shaping the nutraceutical landscape, positioning it as an important part of the food industry in the future.

Co-Design, Development, and Evaluation of a Health Monitoring Tool Using Smartwatch Data: A Proof-of-Concept Study

Computational analysis and integration of smartwatch data with Electronic Medical Records (EMR) present potential uses in preventing, diagnosing, and managing chronic diseases. One of the key requirements for the successful clinical application of smartwatch data is understanding healthcare professional (HCP) perspectives on whether these devices can play a role in preventive care. Gaining insights from the vast amount of smartwatch data is a challenge for HCPs, thus tools are needed to support HCPs when integrating personalized health monitoring devices with EMR. This study aimed to develop and evaluate an application prototype, co-designed with HCPs and employing design science research methodology and diffusion of innovation frameworks to identify the potential for clinical integration. A machine learning algorithm was developed to detect possible health anomalies in smartwatch data, and these were presented visually to HCPs in a web-based platform. HCPs completed a usability questionnaire to evaluate the prototype, and over 60% of HCPs scored positively on usability. This preliminary study tested the proposed research to solve the practical challenges of HCP in interpreting smartwatch data before fully integrating smartwatches into the EMR. The findings provide design directions for future applications that use smartwatch data to improve clinical decision-making and reduce HCP workloads.

Family wellbeing in general practice: a study protocol for a cluster-randomised trial of the web-based resilience programme on early child development

BackgroundSocial, emotional and behavioural problems in early childhood are associated with increased risk for a wide range of poor outcomes associated with substantial cost and impact on society as a whole. Some of these problems are rooted in the early mother-infant relationship and might be prevented. In Denmark, primary health care has a central role in preventive care during pregnancy and the first years of the child’s life and general practice provides opportunities to promote a healthy mother-infant relationship in early parenthood.ObjectiveIn the context of standardised antenatal and child development assessments focused on psychosocial wellbeing, we examine the impact of a complex intervention designed to improve maternal mentalisation skills, involving training of general practice clinicians and signposting towards a web-based resource. Joint main outcomes are child socio-emotional and language development at age 30 months measured by parentally reported questionnaires (Communicative Development Inventory and Strengths and Difficulties Questionnaire).MethodsThe study is a cluster-randomised controlled trial based in general practices in the Capital Region and the Zealand Region of Denmark. Seventy practices were included. Practices were randomised by a computer algorithm in a ratio of 1:1 to intervention or control groups. Each practice was asked to recruit up to 30 women consecutively at their first scheduled antenatal assessment. Clinicians in both groups received one day of training in preventive antenatal and child development consultations with added focus on parental psychosocial well-being, social support, and parent–child interaction. These preventive consultations delivered in both trial arms require enhanced data recording about psychosocial factors. In intervention clinics, clinicians were asked to signpost a web page at three scheduled antenatal consultations and at four scheduled consultations when the child is 5 weeks, 5 months, 1 and 2 years.DiscussionWe hypothesise that the intervention will increase mothers’ ability to be sensitive to their child’s mental state to an extent that improves the child’s language and mental state at 30 months of age measured by parent-reported questionnaires.Trial registrationClinicalTrials.gov NCT04129359. Registered on Oct 16 2019.

Potentially preventable hospitalizations and use of preventive services among people with multiple sclerosis: Large cohort study, USA

BackgroundIndividuals with multiple sclerosis (MS) report barriers to accessing care, including receipt of preventive services. Potentially preventable hospitalization (PPH) is an important marker for access to, and receipt of timely care. However, few national studies have examined PPH risk in people with MS or considered the role of preventive care in reducing PPH risk among this patient population. Our objective was to examine PPH risk among adults with MS compared with their counterparts without MS. MethodsOptum® Clinformatics® Data Mart (2007–2017) was used to identify 6198 individuals with an MS diagnosis and their propensity-score matched counterparts without MS. Diagnostic and procedural codes were used to identify the presence of preventive hospitalizations, which were defined as quality indicators by the Agency for Healthcare Research and Quality (AHRQ) during the 4-year follow-up period since the diagnosis of MS. Information on receipt of preventive services and office visits was also extracted. Adjusted generalized estimating equations were used to examine the association between MS diagnosis and PPHs. To examine the role of preventive services on odds of PPH amongst people with MS, we reported the adjusted marginal odds ratio (OR) and 95% confidence intervals (CI). ResultsThe rate of any PPH among people with MS was double that of those without MS (131.6 vs 62.5 per 10,000). We identified higher odds of specific PPH indicators among people with MS compared to those without. Individuals with MS had 65% higher odds of hospitalization for pneumonia (OR=1.65, 95% CI: 1.01, 2.30), with similar significant findings observed for urinary tract infections (OR=4.90, 95% CI: 2.51, 9.57). In MS patients, receipt of preventive services, namely cholesterol screening (OR=0.76, 95% CI: 0.60, 0.95) and annual wellness visits were associated with lower odds of any PPH (OR=0.57, 95% CI: 0.43, 0.76). ConclusionPeople with MS were at a higher risk for PPHs compared with their counterparts without MS. Use of appropriate preventive services reduced the risk of PPH among the general population and among those with MS. More efforts are needed to encourage and facilitate the use of preventive care among people with MS. Receipt of timely and appropriate preventive care in this population may reduce the risk for PPH.

Influenza and Tdap Vaccines: Practices and Perception Among Hispanic Women Attending Tertiary Center in Puerto Rico [32J

INTRODUCTION: Explore influenza and Tdap immunization knowledge, attitudes, and practices among Hispanics patients attending prenatal care in a tertiary hospital in Puerto Rico as well as barriers encountered by patients regarding vaccination practices during pregnancy. METHODS: Descriptive study conducted at Adult District Hospital prenatal care clinics in the Medical Sciences Campus of Puerto Rico from September 2016 to June 2017. RESULTS: A total of 189 were recruited. Regarding Influenza vaccine: 75.6% were offered or oriented about Influenza vaccination, 51.8% had received the vaccine at least once (only 12.2% during current pregnancy) and, 57.1% reported receiving information about influenza infection risks in pregnancy, mainly from health care professionals and media. For Tdap only 20.6% of women were offered or oriented about the vaccine and 23.3% received the vaccine. 55.6% of patient had not been oriented about potential dangers of the pertussis infection; for the few oriented, health professionals were their predominant source. In terms of barriers, lack of information about vaccination and the effects/benefits during pregnancy were the most frequent. CONCLUSION: Our study identifies the existing gap of information regarding Influenza and Tdap vaccine. Physicians play a pivotal role in preventive care and new strategies are needed to optimize education to our patients.

A structural equation model of the family physicians attitude towards their role in prevention: a cross-sectional study in Switzerland

BackgroundIn contrast to many studies exploring barriers to preventive care in family medicine, there is less quantitative research regarding the self-perceived role of family physicians (FPs) in prevention and its predictive factors. Moreover, the existing studies considered this attitude as a homogeneous entity. The objective of this study is firstly, to characterize FPs’ attitudes towards prevention taking into account nine different prevention themes, and secondly, to explore the factors that could be predictive of this attitude.MethodsThe data stem from a cross-sectional national survey on prevention we conducted in Switzerland from 2015 to 2016 (170 physicians randomly drawn, online questionnaire). We first performed a confirmatory factor analysis to define a homogeneous latent variable regarding physicians’ attitude towards prevention, then, a structural equation modeling to identify potential predictors.ResultsThe FP’ attitude towards their role in preventive care was homogeneously positive whatever the topic (smoking, drinking dietary habits, physical activities, and more generally, cardiovascular risk factors) except for occupational risks and cannabis consumption. A feeling of good effectiveness was a positive predictor of this positive attitude while seniority, the lack of reimbursement and being a physician from the German-speaking area were negative predictors.ConclusionThe FP’ attitude about their role in prevention is homogeneous concerning the ‘classical’ topics of prevention, whereas they still under-recognize certain topics as important fields for prevention. To change this situation, we probably need a global effort to introduce other ways of thinking about prevention, including not only FP but also all stakeholders.

Understanding sexually transmitted infection screening and management in Indiana community health centers.

The role of community health centers (CHCs) in preventive health care is central to health reform, yet little is known about how CHCs identify and manage sexually transmitted infections (STIs). A survey of Indiana CHCs from April to May 2013 measured reported STI services, clinic expectations for STI testing and management, barriers to screening and management, and partner services. Reported practices were compared with current Centers for Disease Control and Prevention (CDC) guidelines for STI testing in clinical settings. Although most CHCs reported screening for syphilis (75.0%), chlamydia, and gonorrhea (85.7%), screening generally did not reflect CDC guidelines. Chlamydia and gonorrhea testing was provided primarily at patient request or when symptomatic by 67.9% of CHCs. Syphilis testing at 67.9% of CHCs reflected CDC guidelines for adults 65 years or younger and at 53.6% for first-trimester pregnant women. Chlamydia and gonorrhea screening reflected CDC guidelines for 17.9% of CHCs for gay/bisexual men and 60.9% for first-trimester pregnant women. One-third (35%) of CHCs reported not knowing the expectation for screening pregnant women and gay/bisexual men. It is likely that CHCs are not aware of patient sexual health risks because standard of care screening was observed only for gonorrhea and chlamydia during the first trimester and for syphilis testing when symptoms were present. As CHCs increase their role in preventive care with the implementation of the Affordable Care Act, focus must be upon clinician awareness of patient sexual health and training to identify and manage STIs in their patient populations.

Health Reform and the Future of Medical Practice

The adoption of the accountable care organization model means that coordination of care will greatly improve, doctors will end up taking a much more active role in preventive care, and access will have to increase dramatically, perhaps with office-hour changes to accommodate patients' schedules.

Patient satisfaction with a pharmacist-provided telephone medication therapy management program

Background Patient satisfaction with medication therapy management (MTM), a required component of the Medicare Part D benefit, is an important outcome to consider when evaluating MTM programs. Objective To measure patient satisfaction with a pharmacist-provided telephone MTM program. Methods The study design was nonexperimental and cross sectional. A survey was mailed to Scott & White Health Plan Medicare Part D beneficiaries (n = 60) who received telephone MTM in 2007. The survey was composed of 15 Likert-scaled questions (1 = strongly disagree to 5 = strongly agree) that assessed satisfaction with MTM. Descriptive statistics were used for quantitative data analysis. A qualitative content analysis of patients' responses to 3 open-ended questions was also conducted. Results The response rate for the survey was 80% (47 of 59). Study participants were 70.8 (±7.9) years old, and most were white (84.1%) and female (54.3%). The alpha coefficient for the satisfaction scale was 0.88. Overall mean satisfaction score was 4.0 (±0.6), with items ranging from 3.6 to 4.3. The highest level of agreement (mean = 4.3) was with the following statements: (1) I can easily contact my pharmacist when I have questions or concerns; (2) My pharmacist adequately answers my questions; and (3) I am content receiving MTM over the telephone. The patients agreed least (mean = 3.6) with the following statements: (1) When necessary, my pharmacist has encouraged me to receive preventive health care services; and (2) When needed, my pharmacist refers me to other health care providers. Conclusions Most of the beneficiaries were satisfied with their MTM care. The positive response to telephone MTM is important because Medicare Part D plans are using the telephone as a method of MTM delivery. Education regarding the pharmacist's role in preventive care and pharmacist follow-up with non-pharmacist health care providers may lead to greater satisfaction levels.

PREVENTIVE HEALTH CARE FOR ADOLESCENTS

Physicians, parents or guardians, and the community all have an important role in preventive care for adolescents. Adolescents desire more interaction with their primary care providers. Physicians can influence the health care of adolescents by developing a collaboration with them that augments protective factors and allows a reduction in risk behaviors.

HealthDesk: Personal Wellness Software

Health consciousness is not just a phase our society is going through. More and more, we find our patients expressing concerns about their own well-being, asking us how they can stay healthy and what they could be doing to live longer. They ask questions about illnesses, about new treatments and diagnostic modalities. As a primary care practitioner, I find it gratifying that our patients are willing to play an active role in preventive care. HealthDesk for Windows is promoted as an all-around health management and educational tool, which enables users to take a more active role in their personal and family health. It succeeds in these claims, and, furthermore, it is easy to use and a pleasure to operate. The program contains several modules for recording information—Medical Records—and several educational modules—Health Managers—which also monitor the state of the user's lifestyle and efforts at preventive maintenance. They are easily accessed through

Physicians, preventive care, and applied nutrition: selected literature.

The authors review a core of 25 articles (dating from 1982 through 1991) regarding medical school curricula and physicians' knowledge, attitudes, and practices related to nutritional care, with a focus on prevention of coronary heart disease through cholesterol control. They supplement this review by discussing the relation of the core articles' results to those of additional articles, which focus more generally on physicians' health promotion and patient counseling. While there appear to be modest increases in attention to nutrition at various levels of medical training and some improvement in physicians' attitudes about dietary intervention, the authors conclude that both educational opportunities and physicians' practices warrant increased and more effective attention to nutrition. Finally, in light of recent trends and growing efforts to better prepare physicians to play a leading role in preventive care, the authors identify gaps in physicians' training and in research on physicians, preventive care, and applied nutrition.

Community views about the role of general practitioners in disease prevention.

The role of preventive medicine in reducing mortality and morbidity is now widely recognized. Although general practitioners appear to be in an excellent position to offer preventive care, there is evidence that they currently do not detect or intervene for common risk behaviours. One reason for this may be the general practitioner's perception that patients do not expect such preventive activities to be a part of the doctor's role. A postal survey of 309 people randomly selected from the community was undertaken to examine perceptions about the general practitioner's role in detection and intervention for smoking, alcohol abuse, emotional problems and hypertension. Responses to the survey from 264 usable questionnaires indicated that people in the community accepted the general practitioner's role in preventive care, with most respondents indicating that they would appreciate being asked about the risks examined, would like the offer of intervention and would try treatments in these areas offered by the doctor. Few respondents indicated that they would change doctors as a result of preventive activity.