scholarly journals Frequency, Causes, Diagnostics and Treatment of Constipation in Family Doctors Work

2015 ◽  
Vol 25 (2) ◽  
pp. 46-53
Author(s):  
Urtė Sudnickaitė ◽  
Brigita Aidukienė ◽  
Kazys Simanauskas
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Chronic Diseases ◽  
Feeding Habits ◽  
Family Doctors ◽  
Data Packets ◽  
Questionnaire Validity ◽  
Educational Groups ◽  
Microsoft Office ◽  
Education Groups

Constipation is a highly prevalent disorder in the primary care. The observed morbidity differences between gender, age, socioeconomic classes with different feeding habits, physical activity and related diseases. Aim. To evaluate causes, diagnostic, treatment features of constipation in the primary care. Methods: was made random interviews of people between 20-80 years old. For interview was used questionnaire of KESS (The Knowles- Eccersley- Scott- Symptom scoring system) for the diagnostic of constipation and 13 questions to assess the risks. The pilot testing of questionnaire validity was carried out, the overall Cronbach alpha coefficient is 0.978. Statistical analysis was performed using Microsoft Office Excel 2007 and SPSS 13.0 for Windows data packets. Results. Was interviewed 320 people, of which 33.13% were established constipations. The average duration of constipation ranged from 18 month up 5 years. The average age of patients with constipation was 56±14.99 years and the healthy group- 41±14.20 years (p0,05). No differences were observed between man and women (p>0.05). Educational groups incidence of constipation was: high education – 29.19%, secondary – 30.3% and basic – 70.37%. We found, that most respondents eat irregularly, 3-4 times per day. We found, that increased fiber food usage, higher intake of fluid was correlated with lower incidence of constipation, as well as higher levels of physical activity or related chronic diseases (p 0.05). In assessing treatment, laxatives was used by 132 respondents, including 75.76% of patients with constipation and enemas was used by 53 respondents, including 94.43% of patients with constipation. Observed that only 62.26% of patients with constipation reported seeing a physician and 96.23% are treated independently. Conclusions: Purposefully interview of patients observed there is a high incidence of constipation. Differences of morbidity between genders are not observe, different than age and education groups. Not all investigated risk factors affect the incidence of constipation increased; mostly affects the small fluid, fiber food intake, physical activity and related chronic diseases. Patients are not give importance to this issue, and so thats why they do not seek a physician often and are treated independently.

Nutrition for the Healthy Adult

2018 ◽  
Author(s):  
Marijane G. Staniec
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Weight Gain ◽  
Chronic Diseases ◽  
Health Care Providers ◽  
Primary Care Providers ◽  
Healthy Adults ◽  
Dietary Guidelines ◽  
Care Providers ◽  
Added Sugars

Many of today’s healthy adults will be plagued by chronic diseases, such as obesity, hypertension, heart disease, and diabetes, and be robbed of the quality of life they desire. According to the 2015–2020 Dietary Guidelines for Americans, about half of all American adults have one or more diet-related chronic diseases. The question, “What should healthy adults eat to stay healthy?” may seem simple. However, many primary care providers feel vulnerable answering questions about nutrition. This review serves as a summary of the most up-to-date guidelines about added sugars, sodium, types of fat, and cholesterol for healthy adults and a refresher for health care providers caring for them. Other important related issues, such as the latest recommendations for physical activity, the problem of adult weight gain, the need for adiposity screening, the powerful role of the primary care provider, and suggestions nutrition-focused primary care, are discussed. This review contains 5 Figures, 5 Tables and 137 references Key words: weight gain, cholesterol, Dietary Guidelines, sugar-sweetened beverages, adiposity, added sugar, hydrogenated oils, physical activity, waist-to-height ratio, nutrition-focused, Primary Care

scholarly journals Comparing the prevalence of multimorbidity using different operational definitions in primary care in Singapore based on a cross-sectional study using retrospective, large administrative data

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e039440
Author(s):  
Yi An Janis Lee ◽  
Ying Xie ◽  
Poay Sian Sabrina Lee ◽  
Eng Sing Lee
Keyword(s):  
Primary Care ◽  
Chronic Diseases ◽  
Chronic Conditions ◽  
Operational Definition ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
High Burden ◽  
Study Population ◽  
Study Methodology ◽  
Microsoft Office

ObjectivesMultimorbidity is a norm in primary care. A consensus on its operational definition remains lacking especially in the list of chronic conditions considered. This study aimed to compare six different operational definitions of multimorbidity previously reported in the literature for the context of primary care in Singapore.Design, setting and participantsThis is a retrospective study using anonymised primary care data from a study population of 787 446 patients. We defined multimorbidity as having three or more chronic conditions in an individual. The prevalence of single conditions and multimorbidity with each operational definition was tabulated and standardised prevalence rates (SPRs) were obtained by adjusting for age, sex and ethnicity. We compared the operational definitions based on (1) number of chronic diseases, (2) presence of chronic diseases of high burden and (3) relevance in primary care in Singapore. IBM SPSS V.23 and Microsoft Office Excel 2019 were used for all statistical calculations and analyses.ResultsThe SPRs of multimorbidity in primary care in Singapore varied from 5.7% to 17.2%. The lists by Fortin et al, Ge et al, Low et al and Quah et al included at least 12 chronic conditions, the recommended minimal number of conditions. Quah et al considered the highest proportion of chronic diseases (92.3%) of high burden in primary care in Singapore, with SPRs of at least 1.0%. Picco et al and Subramaniam et al considered the fewest number of conditions of high relevance in primary care in Singapore.ConclusionsFortin et al’s list of conditions is most suitable for describing multimorbidity in the Singapore primary care setting. Prediabetes and ‘physical disability’ should be added to Fortin et al’s list to augment its comprehensiveness. We propose a similar study methodology be performed in other countries to identify the most suitable operational definition in their own context.

scholarly journals Evaluation of a Primary Care Weight Management Program in Children Aged 2–5 years: Changes in Feeding Practices, Health Behaviors, and Body Mass Index

Nutrients ◽  
2019 ◽  
Vol 11 (3) ◽  
pp. 498 ◽  
Author(s):  
Jared Tucker ◽  
Renee DeFrang ◽  
Julie Orth ◽  
Susan Wakefield ◽  
Kathleen Howard
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Body Mass Index ◽  
Health Behaviors ◽  
Body Mass ◽  
Screen Time ◽  
Feeding Habits ◽  
Feeding Practices ◽  
Care Intervention ◽  
The Impact

Background: Primary care offers a promising setting for promoting parenting practices that shape healthy eating and physical activity behaviors of young children. This study assessed the impact of a parent-based, primary care intervention on the feeding habits, health behaviors, and body mass index (BMI) of 2–5 year olds with elevated or rapidly-increasing BMI. Methods: Four private pediatric offices in West Michigan were assigned as control (n = 2) or intervention (n = 2) sites based on patient load and demographics. Treatment families were recruited at well-child visits to receive physician health-behavior counseling and four visits with a registered dietitian nutritionist (RDN) over a 6-month period. Intervention outcomes were age- and sex-specific BMI metrics, including BMI z-scores and percent of the 95th percentile (%BMIp95), the Family Nutrition and Physical Activity survey (FNPA), and the Feeding Practices and Structure Questionnaire (FPSQ). Results: Of 165 enrolled families, 127 completed follow-up measures (77% retention). Mean (±SD) FNPA scores improved in treatment vs. control (4.6 ± 4.6 vs. 0.1 ± 4.2; p < 0.001), and screen time (h/day) decreased (−0.9 ± 1.8 vs. 0.3 ± 1.1; p < 0.001). Non-responsive feeding practices (i.e., reward for behavior (p = 0.006) and distrust in appetite (p < 0.015)) and structure-related feeding practices (structured meal timing (p < 0.001)) improved in treatment parents vs. controls. Reductions in child BMI measures did not differ between groups. Conclusions: Families with preschool children participating in a low-intensity, primary care intervention improved obesogenic health behaviors, parent feeding habits, and child screen time, but not child adiposity. Future research should assess the sustainability of these family lifestyle improvements, and evaluate their future impact on the health and development of the children.

scholarly journals Remote Health Coaching Text-based Walking Program in Ethnic Minority Primary Care Patients who are Overweight and Obese: A Feasibility and Acceptability Pilot (Preprint)

2021 ◽  
Author(s):  
Mary H. Smart ◽  
Nadia A. Nabulsi ◽  
Ben S. Gerber ◽  
Itika Grupta ◽  
Barbara Di Eugenio ◽  
...  
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Chronic Disease ◽  
Ethnic Minority ◽  
Chronic Diseases ◽  
Text Messaging ◽  
The United States ◽  
Overweight And Obesity ◽  
Summative Evaluation ◽  
Walking Program

BACKGROUND Over half of adults in the United States have at least one chronic disease including obesity. Although physical activity is an important component of chronic disease self-management, few reach the recommended goals for physical activity. Individuals who identify as racial and ethnic minorities are disproportionally impacted by chronic diseases and physical inactivity. Interventions utilizing consumer-based wearable devices have shown promise for increasing physical activity among patients with chronic diseases; however, populations with the most to gain such as minorities, have been poorly represented to date. OBJECTIVE To assess the feasibility, acceptability, and preliminary outcomes of an 8-week text-based coaching and Fitbit program aimed to increase steps among a predominantly ethnic minority population with overweight and obesity. METHODS Overweight (body mass index [BMI] >25 kg/m2) patients were recruited from an internal medicine clinic located within an inner-city academic medical center to participate. Fitbit devices were provided. Using 2-way text messaging, HCs guided patients to establish weekly step goals that were Specific, Measurable, Attainable, Realistic, and Time-bound (SMART). Texting and Fitbit activities were managed with a custom designed application. Program feasibility was assessed via the recruitment rate, retention rate (defined as the proportion of eligible participants completing the 8-week program) and patient engagement (based on number of weekly text message goals set with the HC across the 8-week period). Acceptability was assessed through a qualitative summative evaluation. Exploratory statistical analysis included evaluating the average weekly steps in week 1 compared to week 8 using a paired t-test and modeling daily steps over time using a linear mixed model. RESULTS Thirty (91%) of the thirty-three patients initially screened were enrolled. At baseline, the average BMI was 39.3 kg/m2 (SD = 9.3 kg/m2), with 23 (73%) of the participants presenting as obese. Nine (30%) self-rated their health as either "fair" or "poor.” Twenty-two patients (87%) set up ≥6 weekly goals across the 8-week program. Twenty-eight (93%) participants completed the qualitative summative evaluation. Ten themes emerged from the evaluation: (1) patient motivation, (2) convenient texting experience, (3) social support, (4) supportive accountability, (5) technology support, (6) self-determined goals, (7) achievable goals, (8) feedback from Fitbit, and (9) challenges, and (10) habit formation. There was no significant group change in the average weekly steps for week 1 compared to week 8 (mean difference: 7.26, p=0.99). However, five participants (17.9%) had a significant increase in their daily steps. CONCLUSIONS Overall, the results demonstrate the feasibility and acceptability for a remotely delivered walking study which included a HC, text messaging, wearable device (Fitbit), and SMART goals within a ethnic minority group of patients. These preliminary results of a walking program recruiting from primary care support further development and testing in larger samples to explore the efficacy. CLINICALTRIAL n/a

Association between quality of life, physical activity, use of medication and costs of treatment for chronic diseases in Primary Care

2020 ◽  
Vol 60 (3) ◽  
Author(s):  
Dayane C. Queiroz ◽  
Bruna C. Turi ◽  
Flávia M. Sarti ◽  
Izabela dos Santos Ferro ◽  
Luana C. de Morais ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Primary Care ◽  
Chronic Diseases ◽  
Costs Of Treatment

The impact of participant pathways on the effectiveness of a community-based physical activity intervention grounded in motivational interviewing

2020 ◽  
Author(s):  
Matthew Wade ◽  
Nicola Brown ◽  
James Steele ◽  
Steven Mann ◽  
Bernadette Dancy ◽  
...  
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Motivational Interviewing ◽  
Social Action ◽  
Multilevel Models ◽  
Physical Activity Intervention ◽  
Mental Wellbeing ◽  
Community Based ◽  
The Impact ◽  
Time Point

Background: Brief advice is recommended to increase physical activity (PA) within primary care. This study assessed change in PA levels and mental wellbeing after a motivational interviewing (MI) community-based PA intervention and the impact of signposting [SP] and Social Action [SA] (i.e. weekly group support) pathways. Methods: Participants (n=2084) took part in a community-based, primary care PA programme using MI techniques. Self-reported PA and mental wellbeing data were collected at baseline (following an initial 30-minute MI appointment), 12-weeks, six-months, and 12-months. Participants were assigned based upon the surgery they attended to the SP or SA pathway. Multilevel models were used to derive point estimates and 95%CIs for outcomes at each time point and change scores. Results: Participants increased PA and mental wellbeing at each follow-up time point through both participant pathways and with little difference between pathways. Retention was similar between pathways at 12-weeks, but the SP pathway retained more participants at six-months and 12-months. Conclusions: Both pathways produced similar improvements in PA and mental wellbeing, suggesting the effectiveness of MI based PA interventions. However, due to lower resources required yet similar effects, SP pathways are recommended over SA to support PA in primary care settings.

Experiences in physical activity promotion in health care settings for primary prevention in the UK

2014 ◽  
Vol 62 (2) ◽  
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Health Professionals ◽  
Controlled Trial ◽  
Full Range ◽  
Tertiary Care ◽  
Physical Activity Promotion ◽  
Community Based ◽  
Activity Promotion ◽  
Randomised Controlled

In addition to the delivery of primary care services, recent changes to the NHS in the United Kingdom have placed increasing responsibility on GPs for the commissioning of the full range of health services from prevention through to clinical interventions and rehabilitation. Whilst historically there has always been an expectation that primary care professionals were ideally placed to provide support for prevention as well as treatment, their active engagement in the promotion of physical activity has remained largely superficial. With notable exceptions where individuals have a personal interest or commitment, the majority of health professionals tend to limit themselves to peremptory non-specific advice at best, or frequently don’t broach the subject at all. There are a number of reasons for this including increasing time pressures, a general lack of knowledge, limited evidence and concerns about litigation in the event of an adverse exercise induced event. However in the 1990s there was a surge of interest in the emerging “Exercise on Prescription” model where patients could be referred to community based exercise instructors for a structured “prescription” of exercise in community leisure centres. Despite the continuing popularity of the model there remain problems particularly in getting the active support of health professionals who generally cite the same barriers as previously identified. In an attempt to overcome some of these problems Wales established a national exercise referral scheme with an associated randomised controlled trial. The scheme evaluated well and had subsequently evolved with new developments including integration with secondary and tertiary care pathways, accredited training for exercise instructors and exit routes into alternative community based exercise opportunities.

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