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[Association between life space and health literacy in community-dwelling older adults].

Health Literacy - Sat, 2019-04-20 07:47
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[Association between life space and health literacy in community-dwelling older adults].

Nihon Ronen Igakkai Zasshi. 2018;55(4):650-656

Authors: Matsuda N, Murata S, Ono R

Abstract
AIM: To examine the association between health literacy (HL) and life space in community-dwelling older adults.
METHODS: In this cross-sectional study, we analyzed 210 community-dwelling older adults (mean age: 74.6 years, women: 63.8%). Health literacy was measured using the 14-item Health Literacy Scale (HLS-14). The 14 items consist of 5 items for functional HL (FHL), 5 items for interactive HL (CHL), and 4 items for critical HL (IHL). We calculated the total score, FHL score, CHL score, and IHL score. Life space was measured using the life-space assessment (LSA). A linear regression model was used to analyze the association between the HLS-14 score and LSA score. We adjusted for variables associated with the LSA score.
RESULTS: The FHL score was significantly associated with the LSA score (crude model: β = 1.40, p < 0.01, adjusted model: β = 1.11, p = 0.01). However, the total score, IHL, and CHL were not significantly associated with the LSA score.
CONCLUSIONS: A higher FHL is significantly associated with a greater larger life space in community-dwelling older adults. This finding may help elderly people maintain a greater life space which will help them to improve their HL while also making it possible for them to obtain easy-to-understand information.

PMID: 30542031 [PubMed - indexed for MEDLINE]

Categories: Health Literacy

[The association of limited health literacy and risk of arterial stiffness in community-dwelling older adults].

Health Literacy - Sat, 2019-04-20 07:47
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[The association of limited health literacy and risk of arterial stiffness in community-dwelling older adults].

Nihon Ronen Igakkai Zasshi. 2018;55(4):605-611

Authors: Uemura K, Yamada M, Kuzuya M, Okamoto H

Abstract
AIM: This study aimed to investigate the effects of limited health literacy on arterial stiffness measured by the cardio-ankle vascular index (CAVI) in community-dwelling older adults.
METHODS: A total of 288 older adults (mean age, 72.4 years, men, n = 99) participated. The degree of arterial stiffness was assessed based on the CAVI using the VS-1500 device (Fukuda Denshi Co., Ltd., Tokyo, Japan). Arterial stiffness was defined according to a cut-off point of ≥9.0. Comprehensive health literacy was assessed using the 47-item European Health Literacy Survey Questionnaire (HLS-EU-Q47). Other potential confounding factors, such as demographics, number of prescribed medications, mini-mental state examination results, grip strength, gait speed, current smoking, alcohol consumption, and physical inactivity, were also assessed. An analysis of variance for continuous variables or chi-square test for categorical variables was used for group comparisons. A logistic regression analysis was performed to examine the association between quartiles of HLS-EU-Q47 and arterial stiffness in crude and multivariate models adjusted for age, gender, and other confounding factors.
RESULTS: The first quartile with the lowest health literacy showed a significantly higher CAVI and prevalence of arterial stiffness than the fourth quartile with the highest health literacy (p<0.05). In logistic regression, the crude model showed that the third quartile (odds ratio [95% confidence interval] = 0.48 [0.24-0.93]) and fourth quartile (0.39 [0.19-0.77]) were significantly associated with arterial stiffness, while the multivariate model showed that to fourth quartile was significantly associated with arterial stiffness (0.44 [0.19-0.98]).
CONCLUSIONS: Older adults with limited health literacy might be at a higher risk of arterial stiffness after accounting for confounding factors.

PMID: 30542026 [PubMed - indexed for MEDLINE]

Categories: Health Literacy

[Characteristics of health literacy, social capital, and health behavior acquired through experiences by health promotion volunteers].

Health Literacy - Sat, 2019-04-20 07:47
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[Characteristics of health literacy, social capital, and health behavior acquired through experiences by health promotion volunteers].

Nihon Koshu Eisei Zasshi. 2018;65(3):107-115

Authors: Hayashi C, Maeuma R, Yamada K, Morioka I

Abstract
Objectives In order to promote health in the community, collaborative activities with community organizations are, in addition to individual health guidance, considered to be effective. Health promotion volunteers (HPVs) are now gaining attention as one such community organization. The purposes of this research were to clarify the characteristics of health literacy, social capital, and health behavior acquired through experience by HPVs and to obtain findings with which to examine ways to foster HPVs.Methods An anonymous, self-administered questionnaire survey was conducted through the postal system in a town with 87 currently active HPVs, 158 former HPVs who served between April 2009 and March 2015, and 299 people with no experience as HPVs. The respondents were 54 active HPVs (response rate, 62.1%); 69 former HPVs (43.7%); and 136 people with no experience (45.5%). Participants were asked about their sociodemographic characteristics; activity status as an HPV; self-rated health; whether they had undergone a medical examination (recently) or not; health literacy; social capital; health behaviors; etc.Results Health literacy, social capital, and health behavior scores of active HPVs showed no significant difference among the three groups. Many of the active HPVs felt that the work was "of help to the local government." The number of participants who tried to encourage others and who self-rated their health statuses as healthy in the active HPV group were significantly higher compared with the former HPVs and the group with no experience.Conclusion In fostering HPVs, it is necessary to support them in order to ensure that they proactively engage in activities promoting health.

PMID: 29618708 [PubMed - indexed for MEDLINE]

Categories: Health Literacy

Integrated Cancer Treatment in the Course of Metastatic Pancreatic Cancer: Complete Resolution in 2 Cases.

Mind-Body Medicine - Sat, 2019-04-20 07:47
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Integrated Cancer Treatment in the Course of Metastatic Pancreatic Cancer: Complete Resolution in 2 Cases.

Integr Cancer Ther. 2018 09;17(3):994-999

Authors: Bonucci M, Pastore C, Ferrera V, Fiorentini C, Fabbri A

Abstract
Pancreatic cancer (PC) has a very low average survival, but its prognosis is further reduced in the case of metastatic spread. Medical therapy in these cases is the only applicable methodology in the international guidelines. During anticancer treatments, common side effects are nausea, vomiting, arthralgia, neuropathy, and alopecia as well as a myelosuppressive effect. The toxicity of various drugs not only affects the quality of life of the patient, but often its severity requires a reduction in if not the termination of drug administration. Scientific studies have shown that a combined use of chemotherapy and certain natural substances, in the form of standardized extracts, can lead to an enhancement of the action of the chemotherapy. Here, we describe 2 cases of metastatic PC. The first case concerns the integrated treatment of a patient with cancer of the pancreas tail with metastatic involvement ab initio of peripancreatic lymph nodes and liver parenchyma, with numerous secondary lesions greater than 9.5 cm. The second case concerns the integrated treatment of a patient with cancer of the pancreatic body with metastatic involvement of the liver parenchyma, with a small secondary lesion. In both cases, an integrated cancer treatment approach, combining chemotherapy with natural remedies, extracts, and hyperthermia, induced a notable remission of primary and metastatic lesions.

PMID: 29478350 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

Use of Mindfulness or Self-Hypnosis Provides Immediate Pain Relief to Hospitalized Patients.

Mind-Body Medicine - Sat, 2019-04-20 07:47
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Use of Mindfulness or Self-Hypnosis Provides Immediate Pain Relief to Hospitalized Patients.

Am Fam Physician. 2017 Nov 15;96(10):Online

Authors: Shrikant Kulkarni N

PMID: 29431391 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

[Feedback on a complementary care program combining physical activity, mindfulness-based meditation and socio-aesthetic care].

Mind-Body Medicine - Fri, 2019-04-19 07:45
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[Feedback on a complementary care program combining physical activity, mindfulness-based meditation and socio-aesthetic care].

Bull Cancer. 2019 Apr;106(4):304-315

Authors: Charles C, Boinon D, Renvoisé N, Pallubicki G, Borch-Jacobsen C, Laplanche O, Ginsbourger T, Dauchy S

Abstract
INTRODUCTION: Increasing physical activity among cancer patients is one of the priority recommendations in tertiary prevention; the level of physical activity is one of the determining factors in reducing the risk of relapse and mortality. However, many barriers to initiation and maintenance of regular physical activity have been identified. A program combining bi-weekly adapted physical activity sessions, mindfulness-based meditation and socio-aesthetic care was put together in 2015, in a Cancer Center, in order to facilitate adherence and sustainable attendance.
METHODS: Data on patient participation of program components, patient satisfaction, and psycho-corporal changes, collected in ecological conditions between 2015 and 2017 from 144 participants, were retrospectively analyzed to provide a first assessment.
RESULTS: Nearly 60% of the patients were in treatment, 17% were metastatic. The average participation time was 9 months, with an average of one physical activity session per week. Changes were observed, both quantitatively and qualitatively, in terms of emotional state, sleep and body image. The overall satisfaction rate was 96%.
DISCUSSION: The conclusions of the study support the continuation of the program. The methodological limitations of this pilot format may be overtaken in future research, which will allow further in-depth investigations into the effects of combined approaches on sustainable physical activity.

PMID: 30777301 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

Benefit of Gender-Affirming Medical Treatment for Transgender Elders: Later-Life Alignment of Mind and Body.

Mind-Body Medicine - Fri, 2019-04-19 07:45
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Benefit of Gender-Affirming Medical Treatment for Transgender Elders: Later-Life Alignment of Mind and Body.

LGBT Health. 2019 Jan;6(1):34-39

Authors: Cai X, Hughto JMW, Reisner SL, Pachankis JE, Levy BR

Abstract
PURPOSE: This study examined whether older age moderates the association between gender-affirming medical treatment and quality of life (QOL) among transgender individuals.
METHODS: Transgender men and women from the National Transgender Discrimination Survey who had either recently or never undergone medical treatment were included (n = 2420). A moderation analysis was utilized.
RESULTS: As predicted, participants who initiated medical treatment had higher QOL than those who did not. Age moderated this association. The QOL difference was greater for older than for younger transgender individuals.
CONCLUSION: Among all transgender men and women, gender-affirming medical treatment can be especially beneficial for elders.

PMID: 30562128 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

Robust desynchronization of Parkinson's disease pathological oscillations by frequency modulation of delayed feedback deep brain stimulation.

Mind-Body Medicine - Fri, 2019-04-19 07:45
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Robust desynchronization of Parkinson's disease pathological oscillations by frequency modulation of delayed feedback deep brain stimulation.

PLoS One. 2018;13(11):e0207761

Authors: Daneshzand M, Faezipour M, Barkana BD

Abstract
The hyperkinetic symptoms of Parkinson's Disease (PD) are associated with the ensembles of interacting oscillators that cause excess or abnormal synchronous behavior within the Basal Ganglia (BG) circuitry. Delayed feedback stimulation is a closed loop technique shown to suppress this synchronous oscillatory activity. Deep Brain Stimulation (DBS) via delayed feedback is known to destabilize the complex intermittent synchronous states. Computational models of the BG network are often introduced to investigate the effect of delayed feedback high frequency stimulation on partially synchronized dynamics. In this study, we develop a reduced order model of four interacting nuclei of the BG as well as considering the Thalamo-Cortical local effects on the oscillatory dynamics. This model is able to capture the emergence of 34 Hz beta band oscillations seen in the Local Field Potential (LFP) recordings of the PD state. Train of high frequency pulses in a delayed feedback stimulation has shown deficiencies such as strengthening the synchronization in case of highly fluctuating neuronal activities, increasing the energy consumed as well as the incapability of activating all neurons in a large-scale network. To overcome these drawbacks, we propose a new feedback control variable based on the filtered and linearly delayed LFP recordings. The proposed control variable is then used to modulate the frequency of the stimulation signal rather than its amplitude. In strongly coupled networks, oscillations reoccur as soon as the amplitude of the stimulus signal declines. Therefore, we show that maintaining a fixed amplitude and modulating the frequency might ameliorate the desynchronization process, increase the battery lifespan and activate substantial regions of the administered DBS electrode. The charge balanced stimulus pulse itself is embedded with a delay period between its charges to grant robust desynchronization with lower amplitudes needed. The efficiency of the proposed Frequency Adjustment Stimulation (FAS) protocol in a delayed feedback method might contribute to further investigation of DBS modulations aspired to address a wide range of abnormal oscillatory behavior observed in neurological disorders.

PMID: 30458039 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

Quality and Safety in Health Care, Part XLVI: Mindfulness, Meditation, and Burnout.

Mind-Body Medicine - Fri, 2019-04-19 07:45
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Quality and Safety in Health Care, Part XLVI: Mindfulness, Meditation, and Burnout.

Clin Nucl Med. 2019 Apr;44(4):289-291

Authors: Harolds JA

Abstract
Some of the approaches to prevent and recover from burnout focus on the individual, and others focus on organizational initiatives. A common recommendation for the individual with burnout is to practice meditation and mindfulness. Mindfulness may be defined as focused awareness without judgment regarding the current instance in time. The practice of mindfulness and the outcome of various mindfulness courses will be discussed in this article. Other approaches on the subject of burnout regarding individual efforts and organizational changes will be discussed in subsequent articles in this series.

PMID: 30273202 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

Differential Experimental Effects of a Short Bout of Walking, Meditation, or Combination of Walking and Meditation on State Anxiety Among Young Adults.

Mind-Body Medicine - Fri, 2019-04-19 07:45
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Differential Experimental Effects of a Short Bout of Walking, Meditation, or Combination of Walking and Meditation on State Anxiety Among Young Adults.

Am J Health Promot. 2018 05;32(4):949-958

Authors: Edwards MK, Rosenbaum S, Loprinzi PD

Abstract
INTRODUCTION: Single bouts of aerobic exercise and meditation have been shown to improve anxiety states. Yet to be evaluated in the literature, we sought to examine the effects of a single, short bout of aerobic exercise or meditation, as well as exercise and meditation combined on state anxiety among young adults.
DESIGN: Randomized controlled trial.
SETTING: University.
SUBJECTS: Participants (N = 110, mean age = 21.4 years) were randomly assigned to walk, meditate, walk then meditate, meditate then walk, or to sit (inactive control).
MEASURES: All walking and meditation bouts were 10 minutes in duration. Participants' state anxiety was monitored before and after the intervention using the State Trait Anxiety Inventory questionnaire.
RESULTS: Significant group × time interaction effects were observed ( P = .01). Post hoc paired t tests revealed that state anxiety significantly decreased from baseline to postintervention in the meditation ( P = .002), meditation then walk ( P = .002), and walk then meditation ( P = .03) groups but not the walk ( P = .75) or control ( P = .45) groups.
CONCLUSION: Meditation (vs a brisk walk) may be a preferred method of attenuating anxiety symptomology. Individuals desiring the health benefits associated with aerobic exercise may achieve additional anxiolytic benefits if they employ a brief meditation session before or after exercising.

PMID: 29216745 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

Association between health literacy, communication and psychological distress among myelodysplastic syndromes patients.

Health Literacy - Thu, 2019-04-18 07:44
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Association between health literacy, communication and psychological distress among myelodysplastic syndromes patients.

Leuk Res. 2018 10;73:44-50

Authors: Ousseine YM, Butow PN, Fenaux P, Dring R, Festy P, Restivo L, Vey N, Mancini J

Abstract
MDS is a complex and potentially severe disease which can trigger psychological distress. A lack of information received and understood about MDS may also arouse feelings of distress. Low health literacy (HL) might play a role particularly among older patients. Our aim was to assess MDS-related distress and to study the factors associated with it, including medical and non-medical factors such as HL. A self-administered questionnaire was mailed to all members of French and Australian patients' national MDS associations. Data of 280 patients were analysed. A majority of patient (59.5%) reported low functional HL and 50% reported regular difficulties in asking physicians questions. Distress was not modified by gender, awareness of increased risk of developing leukaemia or MDS characteristics. French patients had a higher mean IES score (adjusted β = 5.9, p = 0.004) compared to Australian patients. Poor satisfaction with information provided about MDS, lower functional HL and difficulties in asking physician's questions were also independently associated with distress. MDS-related distress seems more related to HL and communication with physicians than to MDS characteristics. More efforts are needed to improve health literacy, tailor information for MDS patients and support them psychologically in order to improve their emotional well-being.

PMID: 30216938 [PubMed - indexed for MEDLINE]

Categories: Health Literacy

Addressing Potential Health Disparities in the Adoption of Advanced Breast Imaging Technologies.

Health Literacy - Thu, 2019-04-18 07:44
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Addressing Potential Health Disparities in the Adoption of Advanced Breast Imaging Technologies.

Acad Radiol. 2018 05;25(5):547-551

Authors: Miles RC, Onega T, Lee CI

Abstract
With the advent of new screening technologies, including digital breast tomosynthesis, screening ultrasound, and breast magnetic resonance imaging, there is growing concern that existing disparities among traditionally underserved populations will worsen. These newer screening modalities purport improved cancer detection over mammography alone but are not offered at all screening facilities and often require a larger co-pay or out-of-pocket expense. Thus, the potential for worsening disparities with regard to access and appropriate utilization of supplemental screening technologies exists. Currently, there is a dearth of literature on the topic of health disparities related to access and the use of supplemental breast cancer screening and their impact on outcomes. Identifying and addressing explanatory factors for persistent and potentially worsening disparities remain a central focus of efforts to improve equity in breast cancer care. Therefore, this paper provides an overview of factors that may contribute to present and future disparities in breast cancer screening and outcomes, and explores specific relevant topics requiring greater research efforts as more personalized, multimodality breast cancer screening approaches are adopted into clinical practice.

PMID: 29729855 [PubMed - indexed for MEDLINE]

Categories: Health Literacy

The Effects of Mind-Body Exercise on Cognitive Performance in Elderly: A Systematic Review and Meta-Analysis.

Mind-Body Medicine - Thu, 2019-04-18 07:44
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The Effects of Mind-Body Exercise on Cognitive Performance in Elderly: A Systematic Review and Meta-Analysis.

Int J Environ Res Public Health. 2018 12 09;15(12):

Authors: Zhang Y, Li C, Zou L, Liu X, Song W

Abstract
Background: As the situation of cognitive aging is getting worse, preventing or treating cognitive decline through effective strategies is highly important. This systematic review aims to investigate whether mind-body exercise is an effective approach for treating cognition decline. Methods: Searches for the potential studies were performed on the eight electronic databases (MEDLINE, Scopus, Web of Science, SPORTDiscus, CINAHL, PsycArtilces, CNKI, and Wanfang). Randomized controlled trials (RCTs) examining the effect of mind-body exercise on cognitive performance in older adults were included. Data were extracted and effect sizes were pooled with 95% confidence intervals (95% CI) using random-effects models. The Physiotherapy Evidence Database Scale was employed to examine the study quality. Results: Nineteen RCTs including 2539 elders (67.3% female) with fair to good study quality were identified. Mind-body exercise, relative to control intervention, showed significant benefits on cognitive performance, global cognition (Hedges'g = 0.23), executive functions (Hedges'g = 0.25 to 0.65), learning and memory (Hedges'g = 0.37 to 0.49), and language (Hedges'g = 0.35). In addition, no significant adverse events were reported. Conclusion: Mind-body exercise may be a safe and effective intervention for enhancing cognitive function among people aged 60 years or older. Further research evidence is still needed to make a more conclusive statement.

PMID: 30544873 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

Teaching stress management in undergraduate dental education: are we doing enough?

Mind-Body Medicine - Thu, 2019-04-18 07:44
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Teaching stress management in undergraduate dental education: are we doing enough?

Br Dent J. 2018 03 23;224(6):405-407

Authors: Colley JM, Harris M, Hellyer P, Radford DR

Abstract
Dentistry is recognised as a stressful profession. A number of studies focusing on undergraduate education have shown high levels of stress in dental students. However, despite calls to do so, little has been published on methods to teach future dental professionals about stress and how to manage it on a personal level. Psychological stress which is uncontrolled may have an effect on general health. It is recognised, however, that stress can be beneficial if channelled appropriately. Techniques and ways to teach management of potential stresses of a career in dentistry have still not been widely reported in either dental undergraduate or postgraduate education. An intervention used with final year dental students at the University of Portsmouth for the last four years has highlighted some of the problems raised by students coping with a stressful programme of study. Students' comments indicated the need for an educational intervention on recognising and reducing stress to be introduced earlier on in their curriculum and that it should be universally taught.

PMID: 29545543 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

Using Feedback Control to Reduce Limb Impedance during Forceful Contractions.

Mind-Body Medicine - Thu, 2019-04-18 07:44
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Using Feedback Control to Reduce Limb Impedance during Forceful Contractions.

Sci Rep. 2017 08 24;7(1):9317

Authors: Hu X, Ludvig D, Murray WM, Perreault EJ

Abstract
Little is known about the ability to precisely regulate forces or torques during unexpected disturbances, as required during numerous tasks. Effective force regulation implies small changes in force responding to externally imposed displacements, a behavior characterized by low limb impedance. This task can be challenging, since the intrinsic impedance of muscles increases when generating volitional forces. The purpose of this study was to examine the ability to voluntarily reduce limb impedance during force regulation, and the neural mechanisms associated with that ability. Small displacement perturbations were used to quantify elbow impedance during the exertion of volitional elbow torques from 0% to 20% of maximum voluntary contraction. Subjects were instructed either to not intervene with the imposed perturbations or to explicitly intervene so as to minimize the influence of the perturbations on the elbow torque. Our results demonstrated that individuals can reduce the low frequency components of elbow impedance by 35%. Electromyographic analysis suggested that this behavior is mediated by volitional and possibly long-latency reflex pathways with delays of at least 120 ms. These results provide a context for understanding how feedback altered by aging or injuries may influence the ability to regulate forces precisely.

PMID: 28839242 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

Provision of somatosensory inputs during motor imagery enhances learning-induced plasticity in human motor cortex.

Mind-Body Medicine - Thu, 2019-04-18 07:44
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Provision of somatosensory inputs during motor imagery enhances learning-induced plasticity in human motor cortex.

Sci Rep. 2017 08 24;7(1):9300

Authors: Bonassi G, Biggio M, Bisio A, Ruggeri P, Bove M, Avanzino L

Abstract
Motor learning via physical practice leads to long-term potentiation (LTP)-like plasticity in motor cortex (M1) and temporary occlusion of additional LTP-like plasticity. Motor learning can be achieved through simulation of movement, namely motor imagery (MI). When combined with electrical stimulation, MI influenced M1 excitability to a larger extent than MI itself. We explored whether a training based on the combination of MI and peripheral nerve stimulation (ESMI) modulates M1 LTP-like plasticity inducing retention of a new acquired skill. Twelve subjects mentally performed thumb-index movements, with synchronous electrical nerve stimulation, following an acoustic cue, in order to increase movement speed. Two control groups physically performed or imagined the same number of finger movements following the acoustic cue. After each training session, M1 LTP-like plasticity was assessed by using PAS25 (paired associative stimulation) technique. Performance was tested before and after training and 24 hours after training. Results showed that physical practice and ESMI training similarly increased movement speed, prevented the subsequent PAS25-induced LTP-like plasticity, and induced retention of motor skill the following day. Training with MI had significant, but minor effects. These findings suggest that a training combining MI with somatosensory input influences motor performance through M1 plasticity similarly to motor execution.

PMID: 28839226 [PubMed - indexed for MEDLINE]

Categories: Mind Body Medicine

Lower Neurocognitive Functioning Disrupts the Effective Use of Internet-Based Health Resources in HIV Disease: The Mediating Effects of General Health Literacy Capacity.

Health Literacy - Wed, 2019-04-17 07:40
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Lower Neurocognitive Functioning Disrupts the Effective Use of Internet-Based Health Resources in HIV Disease: The Mediating Effects of General Health Literacy Capacity.

AIDS Behav. 2019 Mar;23(3):676-683

Authors: Woods SP, Sullivan KL

Abstract
HIV-associated neurocognitive impairment is an independent predictor of low general health literacy, which can be associated with poor disease outcomes (e.g., viremia). Given the increasing frequency with which health behaviors occur in an online environment (e.g., health information seeking, provider interactions), there is a specific need to understand the predictors of electronic health (eHealth) literacy of persons living with HIV disease. In this study, 90 HIV+ persons completed the eHealth Literacy Scale (eHEALS), which measures one's awareness, skills and evaluation of online health resources. Participants also completed a comprehensive battery of clinical neurocognitive tests and well-validated performance-based measures of general health literacy capacity (e.g., knowledge, numeracy). Results showed that, independent of education, lower neurocognitive function was moderately related to lower eHEALS scores, particularly in the domains of learning and motor skills. Of particular note, general health literacy capacity emerged as a significant mediator of the relationship between neurocognition and eHealth literacy. Thus, the adverse effects of neurocognition on health literacy capacity carries a downstream adverse influence on HIV+ persons' awareness, skills, and evaluation of health-related resources in the online environment.

PMID: 30506473 [PubMed - indexed for MEDLINE]

Categories: Health Literacy

Making dietary changes following a diagnosis of prediabetes: a qualitative exploration of barriers and facilitators.

Health Literacy - Wed, 2019-04-17 07:40
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Making dietary changes following a diagnosis of prediabetes: a qualitative exploration of barriers and facilitators.

Diabet Med. 2018 12;35(12):1693-1699

Authors: Abel S, Whitehead LC, Coppell KJ

Abstract
AIM: To explore the experiences of people recently diagnosed with prediabetes and overweight or obese in making dietary changes following a six-month primary care nurse-delivered dietary intervention pilot.
METHODS: Semi-structured interviews were conducted with 20 participants, purposefully selected to ensure a mix of ethnicity, gender and glycaemic outcome. Thematic analysis of interview data was undertaken.
RESULTS: Participants described feeling shocked when they received the diagnosis of prediabetes. Three core themes, each containing subthemes, emerged: (i) supportive factors - determination not to develop diabetes, clear information and manageable strategies, and supportive relationships; (ii) barriers - lack of family support, financial constraints, social expectations around food, and chronic health issues; and (iii) overcoming challenges - growing and sharing food, using frozen vegetables and planning. Challenges related to cultural expectations around providing and partaking of food were more evident for indigenous Māori participants.
CONCLUSIONS: A diagnosis of prediabetes provides a window of opportunity for healthcare professionals to work with those diagnosed and their families to make healthful dietary changes. Dietary guidance is likely to be most effective when individuals' life circumstances are taken into account. Clear information and supportive relationships to facilitate lifestyle change are extremely important. (Clinical Trials Registry No; ANZCTR ACTRN1261500080656).

PMID: 30092618 [PubMed - indexed for MEDLINE]

Categories: Health Literacy

Primary care intervention to address cardiovascular disease medication health literacy among Indigenous peoples: Canadian results of a pre-post-design study.

Health Literacy - Wed, 2019-04-17 07:40
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Primary care intervention to address cardiovascular disease medication health literacy among Indigenous peoples: Canadian results of a pre-post-design study.

Can J Public Health. 2018 02;109(1):117-127

Authors: Smylie J, O'Brien K, Xavier CG, Anderson M, McKnight C, Downey B, Kelaher M, De dwa da dehs nye>s Aboriginal Health Centre

Abstract
CONTEXT: Cardiovascular diseases (CVD) are a leading cause of illness and death for Indigenous people in Canada and globally. Appropriate medication can significantly improve health outcomes for persons diagnosed with CVD or for those at high risk of CVD. Poor health literacy has been identified as a major barrier that interferes with client understanding and taking of CVD medication. Strengthening health literacy within health services is particularly relevant in Indigenous contexts, where there are systemic barriers to accessing literacy skills.
OBJECTIVE: The aim of this study is to test the effect of a customized, structured health literacy educational program addressing CVD medications.
METHODS: Pre-post-design involves health providers and Indigenous clients at the De dwa da dehs nye>s Aboriginal Health Centre (DAHC) in Ontario, Canada. Forty-seven Indigenous clients with or at high risk of CVD received three educational sessions delivered by a trained Indigenous nurse over a 4- to 7-week period. A tablet application, pill card and booklet supported the sessions. Primary outcomes were knowledge of CVD medications and health literacy practices, which were assessed before and after the programe.
RESULTS: Following the program compared to before, mean medication knowledge scores were 3.3 to 6.1 times higher for the four included CVD medications. Participants were also more likely to refer to the customized pill card and booklet for information and answer questions from others regarding CVD.
CONCLUSIONS: This customized education program was highly effective in increasing medication knowledge and health literacy practice among Indigenous people with CVD or at risk of CVD attending the program at an urban Indigenous health centre.

PMID: 29981069 [PubMed - indexed for MEDLINE]

Categories: Health Literacy

The Electronic Health Literacy and Utilization of Technology for Health in a Remote Hawaiian Community: Lana'i.

Health Literacy - Wed, 2019-04-17 07:40
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The Electronic Health Literacy and Utilization of Technology for Health in a Remote Hawaiian Community: Lana'i.

Hawaii J Med Public Health. 2018 03;77(3):51-59

Authors: Witten NA, Humphry J

Abstract
The Lana'i Community Health Center (LCHC) like other health care organizations, is striving to implement technology-enabled care (TEC) in the clinical setting. TEC includes such technological innovations as patient portals, mobile phone applications, wearable health sensors, and telehealth. This study examines the utilization of communication technology by members of the Lana'i community and LCHC staff and board members in the home and in their daily lives and evaluates the community's electronic health literacy. Quantitative surveys and qualitative focus groups were utilized. These revealed that members of the Lana'i community and LCHC staff and board members regularly utilize technology, in the form of smart cell phones, WiFi, and internet texting. This community has integrated technology into their daily lives, even though they live on an isolated island with 3,102 people; however, despite this integration, the electronic health literacy of this population appears insufficient for proper understanding and utilization of TEC, limiting the potential of patient portals or remote monitoring of patient generated data for chronic disease prevention and management without additional education and mentoring. It is therefore in the best interest of the LCHC and other health organizations wishing to implement TEC in a rural community such as Lana'i to include a strong educational component with use of TEC, and perhaps establish a mentor/partnership program for the highly-challenged patient.

PMID: 29541550 [PubMed - indexed for MEDLINE]

Categories: Health Literacy

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