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alternative healthcare

Wells Weymouth, Lane Thaut, Nathan Olson
Introduction The use of telemedicine by deployed healthcare providers to improve patient care has been increasing in recent foreign conflicts and humanitarian missions. These efforts have mostly been limited to email consultation with long response lag times. The United States Military has developed several modalities of telemedicine for use in austere environments, ranging from video conferencing, email, and store-and-forward technology. As of now, these efforts have required large pieces of equipment and many technical support personnel and have a delayed response time...
November 30, 2018: Curēus
Laura J den Hartigh
Obesity and its comorbidities, including type 2 diabetes and cardiovascular disease, are straining our healthcare system, necessitating the development of novel strategies for weight loss. Lifestyle modifications, such as exercise and caloric restriction, have proven effective against obesity in the short term, yet obesity persists because of the high predilection for weight regain. Therefore, alternative approaches to achieve long term sustainable weight loss are urgently needed. Conjugated linoleic acid (CLA), a fatty acid found naturally in ruminant animal food products, has been identified as a potential anti-obesogenic agent, with substantial efficacy in mice, and modest efficacy in obese human populations...
February 11, 2019: Nutrients
Kate Hopkinson
Chronic spontaneous urticaria (CSU) is a debilitating condition that can substantially affect patients' quality of life (QoL), mental health and ability to perform daily tasks. International guidelines on the management of CSU, jointly developed by the European Academy of Allergy and Clinical Immunology (EAACI), Global Allergy and Asthma European Network (GA2 LEN), European Dermatology Forum (EDF) and World Allergy Organization (WAO), recommend a treat-to-target strategy until symptom control or remission is achieved...
February 14, 2019: British Journal of Nursing: BJN
Matthew Franklin, James Lomas, Simon Walker, Tracey Young
This paper provides an educational review covering the consideration of costs for cost-effectiveness analysis (CEA), summarising relevant methods and research from the published literature. Cost data are typically generated by applying appropriate unit costs to healthcare resource-use data for patients. Trial-based evaluations and decision analytic modelling represent the two main vehicles for CEA. The costs to consider will depend on the perspective taken, with conflicting recommendations ranging from focusing solely on healthcare to the broader 'societal' perspective...
February 12, 2019: PharmacoEconomics
Savita Malhotra, Subho Chakrabarti, Ruchita Shah
Background: Using digital technology to deliver mental health care can possibly serve as a viable adjunct or alternative to mainstream services in lessening the mental health gap in a large number of resource deficient and LAMI countries. Conventional models of telepsychiatric services available so far, however, have been inadequate and ineffective, as these address only a small component of care, and rely on engagement of specialists who are grossly insufficient in numbers. Aim: To describe an innovative digital model of mental health care, enabling and empowering the non-specialists to deliver high quality mental health care in remote areas...
January 2019: Indian Journal of Psychiatry
Shandeigh N Berry, Karen Colorafi
Congenital anomalies are the leading cause of infant death in the United States, accounting for 20% of the annual infant mortality. Advancements in ultrasound diagnostic technology allow practitioners to diagnose fetal anomalies as early as 11 weeks' gestational age, 75% of which are detected in low-risk pregnancies. Communicating a fetal anomaly diagnosis to parents and initiating perinatal end-of-life discussions are difficult for healthcare providers and parents alike. Furthermore, poorly communicated diagnoses have had long-term negative impacts on perinatal grief intensity, which manifested into lifelong symptoms of adverse psychosocial outcomes such as anxiety, depression, substance abuse, and suicidal ideation...
February 6, 2019: Journal of Perinatal & Neonatal Nursing
Kiesha Prem, Sok Heng Pheng, Alvin Kuo Jing Teo, Konstantin Evdokimov, Ei Ei Khaing Nang, Li Yang Hsu, Vonthanak Saphonn, Sivanna Tieng, Tan Eang Mao, Alex R Cook
Introduction: Cambodia is among the 30 highest burden of tuberculosis (TB) countries. Active TB prevalence has been estimated using nationally representative multistage sampling that represents urban, rural and remote parts of the country, but the prevalence in non-sampled communes remains unknown. This study uses geospatial Bayesian statistics to estimate point prevalence across Cambodia, and demographic modelling that accounts for secular trends in fertility, mortality, urbanisation and prevalence rates to project the future burden of active TB...
2019: BMJ Global Health
Joseph Nelson Siewe Fodjo, Marieke C J Dekker, Richard Idro, Michel Ndahura Mandro, Pierre-Marie Preux, Alfred K Njamnshi, Robert Colebunders
BACKGROUND: Onchocerciasis-endemic regions are known to have a high epilepsy prevalence. Limited resources in these areas and poor access to healthcare by persons with epilepsy (PWE) result in a wide anti-epileptic treatment gap, poor seizure control and a high burden of seizure-related complications. Recent community-based surveys highlight the need for epilepsy management strategies suitable for remote onchocerciasis-endemic villages to ensure better health outcomes for PWE. In this paper, we propose a feasible approach to manage PWE in such settings...
February 10, 2019: Infectious Diseases of Poverty
Marwa Kaisey, Andrew J Solomon, Michael Luu, Barbara S Giesser, Nancy L Sicotte
BACKGROUND: Multiple Sclerosis (MS) specialists routinely evaluate misdiagnosed patients, or patients incorrectly assigned a diagnosis of MS. Misdiagnosis has significant implications for patient morbidity and healthcare costs, yet its contemporary incidence is unknown. We examined the incidence of MS misdiagnosis in new patients referred to two academic MS referral centers, their most common alternate diagnoses, and factors associated with misdiagnosis. METHODS: Demographic data, comorbidities, neurological examination findings, radiographic and laboratory results, a determination of 2010 McDonald Criteria fulfillment, and final diagnoses were collected from all new patient evaluations completed at the Cedars-Sinai Medical Center and the University of California, Los Angeles MS clinics over twelve months...
February 2, 2019: Multiple Sclerosis and related Disorders
Jingping Zhao, Kaida Jiang, Qingwei Li, Yanlei Zhang, Yan Cheng, Ziyi Lin, Jianwei Xuan
OBJECTIVES: This study aimed to analyse 1) the cost-effectiveness of olanzapine orally disintegrating tablet (ODT) compared to olanzapine standard oral tablet (SOT) and 2) the cost-effectiveness of olanzapine-SOT compared to aripiprazole-SOT for patients with schizophrenia in China. METHODS: A microsimulation model was adapted from a healthcare payers' perspective. The model ran over a 1-year time horizon, using quarterly cycles. The costs of adverse events were acquired through a clinical expert panel...
February 7, 2019: Journal of Medical Economics
Maria Rubio-Valera, María Teresa Peñarrubia-María, Maria Iglesias-González, Martin Knapp, Paul McCrone, Marta Roig, Ramón Sabes-Figuera, Juan V Luciano, Juan M Mendive, Ana Gabriela Murrugara-Centurión, Jordi Alonso, Antoni Serrano-Blanco
BACKGROUND: The purpose of this study was to evaluate the cost-effectiveness of antidepressants vs active monitoring (AM) for patients with mild-moderate major depressive disorder. METHODS: This was a 12-month observational prospective controlled trial. Adult patients with a new episode of major depression were invited to participate and assigned to AM or antidepressants according to General Practitioners' clinical judgment and experience. Patients were evaluated at baseline, and 6 and 12-month follow-up...
February 6, 2019: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
Ruth A White, Chris Hayes, Allison W Boyes, Simon Chiu, Christine L Paul
Background: GPs are central to opioid strategy in chronic non-cancer pain (CNCP). Lack of treatment alternatives and providers are common reasons cited for not deprescribing opioids. There are limited data about availability of multidisciplinary healthcare providers (MHCPs), such as psychologists, physiotherapists, or dietitians, who can provide broader treatments. Aim: To explore availability of MHCPs, and the association with GP opioid deprescribing and transition to therapeutic alternatives for CNCP...
December 2018: BJGP Open
Cecilia Hultstrand Ahlin, Dean Carson, Isabel Goicolea
OBJECTIVE: There is a continuing challenge to ensure equitable access to youth healthcare services in small rural communities. Sweden's 'youth clinic' system is an attempt to provide comprehensive youth health services from a single centre, but many small rural communities have not adopted the youth clinic model. This study uses one case study to examine what the issues might be in establishing a youth clinic in a small rural community. The objective of this paper is to examine the issues around youth healthcare access in one municipality without a youth clinic, and to explore whether and how a youth clinic model might contribute to access in this municipality...
February 4, 2019: BMC Research Notes
Amarjit Chahal, Abraham Rudnick
Digital health technologies (DHTs) such as health apps are rapidly emerging as a major disruptor of health care. Yet there is no well-established process of decision making for selecting DHTs that are worthy of investing resources in their validation to determine whether they are ready (safe, effective, and not too costly) for health related use. We report here on an Ontario-based initiative to support such decision making. Specifically, we developed a decision-making algorithm that uses approved criteria including the strategic direction of the health research institute and the hospital, and availability of resources...
February 4, 2019: International Journal of Technology Assessment in Health Care
Chun-Ting Cheng, Gabriel Castro, Chun-Hsin Liu, Pauline Lau
Cancer remains a major disease process with considerable healthcare and socioeconomic impact worldwide. Unfortunately, standard treatments using chemotherapy often do not effectively control cancer progression or prevent relapse. Over the past decades, the development of targeted therapies has substantially improved outcomes. Recently, immunotherapy has emerged as a new alternative for more effective cancer treatment and may even bring hope of a cure. Cancer immunotherapy functions by reinforcing a patient's immune defense system to fight the disease...
January 31, 2019: Clinica Chimica Acta; International Journal of Clinical Chemistry
Ajit Sood, Vandana Midha, Shivalingappa S Halli, Vikram Narang, Ramit Mahajan, Varun Mehta, Kirandeep Kaur, Vijay Surlikar, Subodh Kanchi, Dharmatma Singh
BACKGROUND: Financial constraints, social taboos and beliefs in alternative medicine are common reasons for delaying or not considering treatment for hepatitis C in India. The present study was planned to analyze the impact of non-banking interest free loan facility in patients affected with hepatitis C virus (HCV) in North India. METHODS: This one year observational, retrospective study was conducted in Department of Gastroenterology (January 2012-December 2013), Dayanand Medical College and Hospital Ludhiana, to evaluate the impact of program titled "Sambhav" (which provided non-banking financial assistance and counselor services) on treatment initiation and therapeutic compliance in HCV patients...
September 11, 2018: International Journal of Health Policy and Management
Alberto Papi, Jinping Zheng, Gerard J Criner, Leonardo M Fabbri, Peter M A Calverley
BACKGROUND: N-acetylcysteine (NAC) 600 mg twice daily is a well-tolerated oral antioxidant mucolytic that reduces the risk of moderate to severe chronic obstructive pulmonary disease (COPD) exacerbations. PANTHEON was one of the largest studies to evaluate NAC in COPD. It recruited current, ex- and never-smokers, concomitantly treated with other medications, and used a symptom-based definition of COPD exacerbations rather than the conventional healthcare resource utilisation (HCU) criteria...
February 2019: Respiratory Medicine
Yoonmi Choi, Ok-Hee Woo, Hye-Sun Shin, Kyu Ran Cho, Bo Kyoung Seo, Ga-Young Choi
PURPOSE: Currently in diagnostic setting for breast cancer, FFDM and DBT are performed conjunctively. However, performing two imaging modalities may increase radiation exposure by double. Two-dimensional reconstructed images created from DBT with 2DSM, has a potential to replace conventional FFDM in concerning both radiation dosage and image quality. With increasing concerns for individual radiation exposure, studies analyzing radiation dosage in breast imaging modalities are needed. This study compared radiation dosage and image quality between DBT + 2DSM versus FFDM...
January 17, 2019: Clinical Imaging
Ali Pashazadeh, Axel Boese, Michael Friebe
Nonmelanoma skin cancer (NMSC) is a major health concern due to its high incidence rate, its negative impact on the quality of life of patients as well as the associated economic burden to the healthcare system. Surgery is currently the primary treatment offered for skin cancer patients but not applicable or available in all cases. Radiation therapy (RT), with its long successful history in the management of cancer, has shown to be an effective alternative or complementary method in cutaneous oncology. Specifically, for dermatology applications, RT is very often the preferred option due to its favorable cosmetic results, besides the excellent control rate of the tumor...
January 31, 2019: Journal of Dermatological Treatment
Kim A Nguyen, Nasheeta Peer, Anniza de Villiers, Barbara Mukasa, Tandi E Matsha, Edward J Mills, Andre P Kengne
BACKGROUND: Glycated haemoglobin (HbA1c) test has been increasingly promoted as an alternative to fasting plasma glucose (FPG) or oral glucose tolerance test (OGTT) to diagnose dysglycaemia but its performance in HIV-infected Africans has yet to be established. This study aimed to assess the diagnostic accuracy of HbA1c for dysglycaemia including FPG-defined and OGTT-defined dysglycaemia, and OGTT-defined diabetes in HIV-infected Africans, and the effect of HbA1c-predicted dysglycaemia on Joint Interim Statement (JIS)-based prevalent metabolic syndrome (MS)...
2019: PloS One
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