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Teachable Moment

Kei Ouchi, Naomi George, Jeremiah D Schuur, Emily L Aaronson, Charlotta Lindvall, Edward Bernstein, Rebecca L Sudore, Mara A Schonberg, Susan D Block, James A Tulsky
During the last 6 months of life, 75% of older adults with preexisting serious illness, such as advanced heart failure, lung disease, and cancer, visit the emergency department (ED). ED visits often mark an inflection point in these patients' illness trajectories, signaling a more rapid rate of decline. Although most patients are there seeking care for acute issues, many of them have priorities other than to simply live as long as possible; yet without discussion of preferences for treatment, they are at risk of receiving care not aligned with their goals...
February 12, 2019: Annals of Emergency Medicine
Jennifer Bass
No abstract text is available yet for this article.
February 5, 2019: Academic Pediatrics
Nicole P M Ezendam, Randi V Karlsen, Jane Christensen, Anne Tjønneland, Lonneke V van de Poll-Franse, Annika von Heymann-Horan, Christoffer Johansen, Pernille E Bidstrup
BACKGROUND: The cancer diagnosis is regarded as a stressful life event that is thought to trigger a teachable moment to induce health behavior changes among cancer patients. However, this may also hold true for their partners. We assessed if partners of cancer patients make more health behavior changes compared to persons whose partner remained cancer-free. METHODS: Lifestyles was assessed in the prospective Danish Diet, Cancer and Health study. Logistic regression analyses were used to assess health behavior change among partners of cancer patients (n = 672) compared to partners of persons who remained cancer-free (n = 5534)...
February 1, 2019: Acta Oncologica
Ann Cameron Barr, Martina L Badell, Theresa E Vettese
No abstract text is available yet for this article.
January 28, 2019: JAMA Internal Medicine
Kartik Sampath, Sameer D Saini, Audrey H Calderwood
No abstract text is available yet for this article.
January 22, 2019: JAMA Internal Medicine
Mary Beth Miller, Angelo M DiBello, Ellen Meier, Eleanor L S Leavens, Jennifer E Merrill, Kate B Carey, Thad R Leffingwell
Alcohol-induced amnesia ("blackout") is a reliable predictor of alcohol-related harm. Given its association with other negative consequences, experience of alcohol-induced amnesia may serve as a teachable moment, after which individuals are more likely to respond to intervention. To test this hypothesis, alcohol-induced amnesia was evaluated as a moderator of brief intervention effect on (a) alcohol-related consequences and (b) the proposed intervention mediators, protective behavioral strategies and peak blood alcohol concentration (BAC)...
January 2019: Behavior Therapy
Karen Poole, Jane Ogden, Sophie Gasson, Agnieszka Lemanska, Fiona Archer, Bruce Griffin, John Saxton, Karen Lyons, Sara Faithfull
OBJECTIVE: It is well established that exercise and lifestyle behaviours improve menꞋs health outcomes from prostate cancer. With 3.8 million men living with the disease worldwide, the challenge is creating accessible intervention approaches that lead to sustainable lifestyle changes. We carried out a phase II feasibility study of a lifestyle intervention delivered by nine community pharmacies in the UK to inform a larger efficacy study. Qualitative interviews explored how men experienced the intervention and these data are presented here...
January 18, 2019: Psycho-oncology
Claire Stevens, Samuel G Smith, Samantha L Quaife, Charlotte Vrinten, Jo Waller, Rebecca J Beeken
BACKGROUND: Lung cancer screening could be a 'teachable moment' for behaviour change. Little is known about how advice about smoking cessation, or other behavioural cancer risk factors, would be received in this setting. METHODS: Using a population-based survey of 459 English adults (current smokers and recent quitters aged 50-75) we assessed willingness to receive lifestyle advice (about smoking, diet, weight, physical activity, alcohol consumption) at lung screening...
February 2019: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
Amer Raheemullah, Anna Lembke
No abstract text is available yet for this article.
January 14, 2019: JAMA Internal Medicine
Eric W Rudofker, Emily W Gottenborg
No abstract text is available yet for this article.
January 7, 2019: JAMA Internal Medicine
Sarah P Huepenbecker, Leping Wan, Andrea Leon, Diane Rosen, John Hoff, Lindsay M Kuroki, Katherine C Fuh, Matthew A Powell, David G Mutch, Graham A Colditz, Andrea R Hagemann
To determine how obstetricians and gynecologists (OB/GYNs) perceive the gynecologic health effects of obesity and to identify perceived obstacles to counseling. OB/GYNs with 3 St. Louis health systems were emailed a 46-question survey regarding physicians' role in counseling women on the health risks of obesity and barriers faced in achieving this counseling. Differences between respondents' gender, age, practice type, years in practice, and body mass index were assessed using Chi-square or Fisher's exact tests as appropriate...
February 2019: Gynecologic Oncology Reports
Antonio Salas, Matthew M Hamill, Susan Tuddenham
No abstract text is available yet for this article.
December 21, 2018: JAMA Internal Medicine
Ka Yan Ho, William Ho Cheung Li, Katherine Ka Wai Lam, Man Ping Wang, Wei Xia, Lok Yin Ho, Kathryn Choon Beng Tan, Hubert Kit Man Sin, Elaine Cheung, Maisy Pik Hung Mok, Tai Hing Lam
OBJECTIVES: Patients admitted to hospitals represent an excellent teachable moment for smoking cessation, as they are required to abstain from tobacco use during hospitalisation. Nevertheless, smoking behaviours of hospitalised patients, and factors that lead to smoking abstinence thereafter, remain relatively underexplored, particularly in a Hong Kong Chinese context. This study aimed to examine the smoking behaviours of hospitalised patients and explore factors leading to their abstaining from cigarette use after being hospitalised...
December 19, 2018: BMJ Open
H Russell Searight
Family physicians spend substantial time counseling patients with psychiatric conditions, unhealthy behaviors, and medical adherence issues. Maintaining efficiency while providing counseling is a major challenge. There are several effective, structured counseling strategies developed for use in primary care settings. The transtheoretical (stages of change) model assesses patients' motivation for change so that the physician can select the optimal counseling approach. Structured sequential strategies such as the five A's (ask, advise, assess, assist, arrange) and FRAMES (feedback, responsibility of patient, advice to change, menu of options, empathy, self-efficacy enhancement) are effective for patients who are responsive to education about health risk behavior...
December 15, 2018: American Family Physician
Anna K Donovan, David R Linz, Doris M Rubio, Melissa A McNeil, Carla L Spagnoletti
OBJECTIVES: New competency requirements from the Accreditation Council for Graduate Medical Education have prompted greater emphasis on developing residents' teaching skills. Many residents make their first foray into teaching during internship, making it an important yet underrecognized opportunity to develop basic teaching skills. In addition, in the current graduate medical education climate, residents' tasks are compressed into an even shorter time, which has caused teaching opportunities and expectations to be balanced with the need for efficiency...
December 2018: Southern Medical Journal
Hasmeena Kathuria, Elisa Koppelman, Belinda Borrelli, Christopher G Slatore, Jack A Clark, Karen E Lasser, Renda Soylemez Wiener
Introduction: Little is known about whether patients and physicians perceive lung cancer screening as a teachable moment to promote smoking cessation or the degree to which physicians in 'real world' settings link lung cancer screening discussions with smoking cessation counseling. We sought to characterize patient and physician perspectives of discussions about smoking cessation during lung cancer screening. Methods: We conducted a qualitative study (interviews and focus groups) with 21 physicians and 28 smokers screened in 4 diverse hospitals...
November 23, 2018: Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco
Angad S Uberoi, Timothy J Brown, Arjun Gupta
No abstract text is available yet for this article.
November 19, 2018: JAMA Internal Medicine
Sarah N Price, Jamie L Studts, Heidi A Hamann
BACKGROUND: Smoking after a cancer diagnosis negatively impacts health outcomes; smoking cessation improves symptoms, side effects, and overall prognosis. The Public Health Service and major oncology organizations have established guidelines for tobacco use treatment among cancer patients, including clinician assessment of tobacco use at each visit. Oncology care clinicians (OCCs) play important roles in this process (noted as the 5As: Asking about tobacco use, Advising users to quit, Assessing willingness to quit, Assisting in quit attempts, and Arranging follow-up contact)...
November 16, 2018: Oncologist
Rachel S Fisher, Joseph R Rausch, Amanda C Ferrante, Kemar V Prussien, Randal S Olshefski, Kathryn A Vannatta, Bruce E Compas, Cynthia A Gerhardt
OBJECTIVE: The majority of childhood cancer survivors develop at least one late effect subsequent to treatment (eg, cardiovascular disease and obesity). Consistent engagement in recommended health behaviors may mitigate some of these conditions. Researchers have identified early survivorship as a teachable moment, yet few studies have examined positive health behaviors during this period. METHODS: Families of children with cancer (ages 5-17) were initially recruited following a diagnosis or relapse of cancer...
November 6, 2018: Psycho-oncology
Stephen S O'Connor, Michael M Mcclay, Shujah Choudhry, Angela D Shields, Richard Carlson, Yaima Alonso, Kyle Lavin, Lisa Venanzi, Katherine Anne Comtois, Jo Ellen Wilson, Stephen E Nicolson
OBJECTIVE: The aim of this study was to further evaluate the acceptability and feasibility of the Teachable Moment Brief Intervention (TMBI). METHOD: A single blind, pilot randomized controlled trial of the TMBI + care as usual (CAU) compared to CAU was conducted for patients who survived a recent suicide attempt that required medical inpatient hospitalization. The intervention was delivered on medical/surgical and inpatient psychiatry units in the medical center...
August 10, 2018: General Hospital Psychiatry
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