Methodological approach to risk prediction noncompliance in patients with myocardial infarction

Aim. To develop a methodological approach in order to predict the risk of noncompliance in patients with myocardial infarction.Methods. 416 patients were questioned in the single-centered, prospective, non-randomized study using the original author's method. The patients were treated in specialized cardiological departments of the city of Kemerovo with the diagnosed myocardial infarction. The methodological approach to predicting the risk of non-compliance in patients with myocardial infarction covered 29 factors in 6 main blocks: sociodemographic and socio-economic characteristics, health status, medical and pharmaceutical culture of the patient, awareness of medical and pharmaceutical services, patient adherence to medical recommendations.Results. Patients with myocardial infarction were characterized by insufficient adherence to the therapy, low awareness of the disease, which can negatively affect the longterm disease prognosis. The identification of a large number of subjective factors limiting adherence to the therapy is the reason for the widespread use of noncompliance risk measurement among patients with myocardial infarction, which will allow determining the range of the risk group for each individual patient.Conclusion. The adherence to the treatment of patients with myocardial infarction is revealed as 80% which is indicated as low and requires the prophylactic use of educational and psychological programs that increase medical and social awareness and readiness to comply with the doctor's recommendations, and also justifies the need for complex risk measurement of non-compliance patients for personalized identification and addressing risk factors for poor adherence to therapy.

The Utility of Pharmacogenetics Testing in Psychiatric Populations

The implementation of pharmacogenetic tests including multiple gene variants has shown promising potential as a decision-making tool for optimizing psychopharmacological treatment regimens and reducing treatment costs. However, the varying clinical validity of gene variants included in pharmacogenetic test batteries, and inconsistencies in their translation into medical recommendations between commercially available pharmacogenetic tests, complicates their rational implementation. Thus, there is a need for well-designed, reproducible studies documenting the clinical significance of the various genetic variants.

Small Animal Veterinarians' Communication With Dog Owners From a Motivational Interviewing Perspective

Veterinary communication skills are fundamentally important in animal practice. Despite client-centered communication being recommended as the optimal medical communication style, a paternalistic approach is still common in veterinary medical encounters with pet owners. Motivational interviewing (MI) is a client-centered, evidence-based counseling method aiming to strengthen a person's motivation and commitment to behavior changes. In this exploratory study, the aim was to investigate Swedish small animal veterinarians' use of client centered communication with dog owners regarding dental home care in dogs. This was achieved by analyzing the use of MI-techniques among veterinarians without previous training or knowledge of the method. Individual telephone calls, reflecting a veterinary clinical scenario, between small animal veterinarians (n = 8) and a trained professional actor playing a dog owner were recorded and coded according to an MI coding protocol (MITI 4.2.1). In the present study, the degree of spontaneously used MI was low. From an MI-communication perspective, with a simulated dog owner, the veterinarians predominantly relied on asking questions, giving information, and persuasive talk. The veterinarians dominated the conversations and made minimal attempts to involve the dog owner resulting in a power imbalance between veterinarian and client. As the degree of spontaneously used MI was found to be low, MI-training may be required in order to apply the method in professional counseling. The veterinarians' communication pattern suggested a paternalistic communication style, when attempting to motivate a client to brush his or her dog's teeth. We suggest that Motivational Interviewing (MI) has a potential to improve veterinary communication and adherence to medical recommendations if introduced and implemented in veterinary practice.

"It's a... does it matter?": Theorising "boy or girl" binary classifications, intersexuality and medical practice in New Zealand

<p>This thesis investigates the clinical management of intersexuality in New Zealand and support for intersex New Zealanders and their families. My research is informed by the narratives of New Zealanders with intersex conditions, parents of children with intersex conditions, registered nurses, specialist clinicians, representatives from community/support organisations and a former member of parliament. This thesis also investigates medical teaching in New Zealand: not only about intersex anatomy but two key issues which shape society – gender and sexuality. Feminist, postmodern and queer theorising about these issues also inform this thesis in relation to traditional assumptions about gender and sexuality, and medical recommendations for sex assignment and rearing. Historical accounts of societal attitudes and medical thinking towards sex classification, sexuality and intersexuality also inform this thesis. Despite New Zealand's reputation as an egalitarian democracy, my findings show that judgemental attitudes towards difference still exist in parts of New Zealand society. This is discussed with reference to poststructuralist and oral history theorising about societal power structures and research on sensitive topics. Undertaking research in New Zealand, on what can be regarded as a sensitive topic, can be difficult in terms of maintaining confidentiality in a small population. The implications of practising medicine in New Zealand are highlighted as, due to its smaller population, the number of intersex individuals coming to clinicians' attention is small compared to some other countries. From my findings, it appears that specialist clinicians and medical schools in New Zealand rely on medical models from other countries with larger populations, which have a greater number of babies born with intersex conditions and consequently more specialised medical practice and education. The narratives of intersex people and their parents also highlight the implications of living in a smaller population. This is not only with regard to medical experiences (such as hospitals which often have little experience of intersex issues), but also societal prejudices and judgements towards lesser known variations of sexual anatomy.</p>

"It's a... does it matter?": Theorising "boy or girl" binary classifications, intersexuality and medical practice in New Zealand

<p>This thesis investigates the clinical management of intersexuality in New Zealand and support for intersex New Zealanders and their families. My research is informed by the narratives of New Zealanders with intersex conditions, parents of children with intersex conditions, registered nurses, specialist clinicians, representatives from community/support organisations and a former member of parliament. This thesis also investigates medical teaching in New Zealand: not only about intersex anatomy but two key issues which shape society – gender and sexuality. Feminist, postmodern and queer theorising about these issues also inform this thesis in relation to traditional assumptions about gender and sexuality, and medical recommendations for sex assignment and rearing. Historical accounts of societal attitudes and medical thinking towards sex classification, sexuality and intersexuality also inform this thesis. Despite New Zealand's reputation as an egalitarian democracy, my findings show that judgemental attitudes towards difference still exist in parts of New Zealand society. This is discussed with reference to poststructuralist and oral history theorising about societal power structures and research on sensitive topics. Undertaking research in New Zealand, on what can be regarded as a sensitive topic, can be difficult in terms of maintaining confidentiality in a small population. The implications of practising medicine in New Zealand are highlighted as, due to its smaller population, the number of intersex individuals coming to clinicians' attention is small compared to some other countries. From my findings, it appears that specialist clinicians and medical schools in New Zealand rely on medical models from other countries with larger populations, which have a greater number of babies born with intersex conditions and consequently more specialised medical practice and education. The narratives of intersex people and their parents also highlight the implications of living in a smaller population. This is not only with regard to medical experiences (such as hospitals which often have little experience of intersex issues), but also societal prejudices and judgements towards lesser known variations of sexual anatomy.</p>

Social Media as a Source of Medical Information for Parents of Premature Infants: A Content Analysis of Prematurity-Related Facebook Groups

Objective Parents are increasingly turning to social media for medical recommendations. Our objective was to systematically examine posts on Facebook for parents of infants hospitalized in the neonatal intensive care unit (NICU) to analyze how advice on medical topics was requested and given, and whether this advice was potentially medically inappropriate. Study Design One hundred Facebook groups were screened for study eligibility. In each group, up to 400 posts on medical topics were evaluated. The first 10 comments of each post were classified based on content and presence of medical advice. Appropriateness of advice was evaluated by a neonatologist. Results Of 28 groups meeting study criteria, 10 permitted access for data collection. We identified 729 posts requesting medical advice of which 29% referenced the NICU period. Posts on diagnosis and development (30 and 32% of posts, respectively) were the most common topics, and most likely to receive advice (78 and 76% of posts on these topics, respectively). We identified 238 comments containing potentially inappropriate medical advice and 30 comments recommending going against medical advice. Conclusion Parents are utilizing Facebook as a source of support and medical information. Parents are most likely to give development-related advice from their own parenting experiences. The high percentage of posts requesting advice about diagnosis and development in the post-NICU stage suggests parents seek increased anticipatory guidance. Key Points

PHYSICAL MEDICINE AND REHABILITATION APPROACHES IN THROMBOSIS ASSOCIATED WITH COVID-19

An increasing number of publications have supported the determination of thrombosis associated with coronavirus disease 2019 (COVID-19). Despite prophylactic drug applications, post-COVID-19 thrombosis cannot be completely prevented. Thrombosis becomes a complex problem that is difficult to avoid, particularly in intensive care patients. It is also possible to see cases of thromboembolism secondary to quarantine and home isolation. In addition to the classical pathophysiological mechanisms in Virchow’s triad, more complex processes specific to COVID-19 may also trigger thrombosis. The aims of this review were to describe physical medicine and rehabilitation practices that can be applied in addition to medical recommendations for thrombosis in COVID-19 patients, and to explain the specific features and mechanism of action of these methods. This process, which starts with education sessions, should continue to reduce immobility as much as possible. Personalized exercise programs should be recommended after evaluating the individual’s condition, exercise history, risk of falling, and comorbid diseases. In parallel with technological progress, more innovative devices have been developed and thus mechanical compression methods and neuromuscular electrical stimulation have become available for this purpose. The most important features of physical medicine and rehabilitation practices are the relatively low cost and the low incidence of complications.

Modern Approaches to Examination of Andrological and Sexological Patients During Covid-pandemia

Rapid increase in the overall incidence of pathologies of the reproductive and genitourinary systems in the conditions of a covid epidemic is predictable and requires certain medical and social steps (the formation of a preventive direction of treatment, the restoration of dispensary observation measures, the introduction of social health programs, the ability of citizens to receive qualified and timely specialized medical care etc.). The global spread of the SARS-CoV-2 coronavirus has led to a restriction in the provision of specialized urological care at the time of lockdown, which also negatively affected the dynamic examination of patients, due to a decrease in scheduled examinations. Remotely provided medical recommendations are not always correct due to the lack of the possibility of direct examination of the patient by a doctor. Significant assistance in the classification of patient complaints with the indicated clinical groups of symptoms is provided by questionnaires using generally recognized questionnaires, which must be used when interviewing each patient to establish a clinical syndrome, and it is possible to get a general idea of the state of human health only through a comprehensive analysis of the questionnaire data. The diagnosis by a doctor is established according to the anamnesis in 50% of cases, on the basis of clinical observation – in 30% and according to laboratory data – in 20%. The first remote contact of such patients with a doctor should include a detailed questioning of complaints, a review of the medical history, a review of his own medical, sometimes auto photographic, materials. Such men should always be examined on a second visit. In conditions of remote examination with lockdown, all the above examinations of patients with androgen deficiency are difficult to carry out, therefore, a less short diagnostic protocol can be applied, which will include the data: 1) ultrasound scan of the thyroid gland, abdominal organs, retroperitoneal space, small pelvis, scrotum; 2) data from clinical and laboratory tests. It is mandatory to provide medical information about the somatic and mental (psychological) state of the patient. Andrological patients usually do not have emergency conditions, but diagnostics, especially prescribing treatment, is a painstaking and individually directed process, therefore remote medical procedures are not the best option and require direct contact between the doctor and the patient.

Health Behavior and Associated Factors in Young Adult Cancer Patients

Objectives: Having cancer in young adulthood increases the risk of adverse long-term health effects. These risks can be influenced by one’s health behavior (HB). The aim of this study is therefore to investigate the presence of health behavior in adolescents and young adults (AYAs) and to identify associated factors.Design: Young cancer patients (18–39 years old at time of diagnosis) were surveyed at baseline and 12 months later via online or as a paper-pencil version.Methods: A spectrum of indicators for HB was assessed via seven items from the Questionnaire of Multiple Health Behavior (MHB). Multiple linear regression analyses were conducted to determine factors associated with patients’ HB indicators.Results: Five-hundred and fourteen AYAs (75% women) reported the highest level of health-conscious behavior for “avoidance of consumption of nicotine,” “follow medical recommendations,” and “being considerate in road traffic.” Less health-conscious behavior was reported for “keeping an appropriate and balanced diet” and “physical activity.” Significant improvements from baseline to the follow-up were observed for “regularly attending health screening” (Hedges’ g = 0.44). The analyzed factors explained up to 10% of the HB indicators. Women reported significantly more health-conscious behavior than men in four out of seven HB indicators. Higher quality of life (QoL) was associated with more health behavior in three out of seven HB indicators.Conclusion: Findings show a predominantly health-conscious lifestyle in AYA cancer patients, though we also found harmful behavior which needs to be better approached—e.g., through improving AYAs’ health education. AYA men should be particularly targeted in specific prevention and health promotion measures. Future work should identify other factors associated with HB to evaluate targets for intervention.

EXPRESS: Hype News Diffusion and Risk of Misinformation: The Oz Effect in Healthcare

Consumers' choices about health products are heavily influenced by public information, such as news articles, research articles, online customer reviews, online product discussion, and TV shows. Dr. Oz, a celebrity doctor, often makes medical recommendations with limited or marginal scientific evidence. Although reputable news agencies have traditionally acted as gatekeepers of reliable information, they face the intense pressure of “the eyeball game.” Customer reviews, despite their authenticity, may come from deceived consumers. Therefore, it remains unclear whether public information sources can correct the misleading health information. In the context of over-the-counter weight loss products, the authors carefully analyze the cascading of information post endorsement. The analysis of extensive textual content with deep-learning methods reveals that legitimate news outlets respond to Dr. Oz's endorsement by generating more news articles about the ingredient; on average, articles after the endorsement contain a higher sentiment, so news agencies seem to amplify rather than rectify the misleading endorsement. The finding highlights a serious concern: the risk of hype news diffusion. Research articles react too slowly to mitigate the problem, and online customer reviews and product discussions provide only marginal corrections. The findings underscore the importance of oversight to mitigate the risk of cascading hype news.