Lifestyle medicine (Hoboken, N.J.)最新文献

Compelling arguments support scaling of group consultations across the National Health Service (NHS) and globally. We need to recognise self-care is the most important type of care for people with long-term health problems. Healthcare systems like the NHS are essential for diagnosis, acute care and initiating optimal therapy but people are on their own over 99.95% of waking hours. We must accept and encourage the contribution that other people with the same long-term health problems can make and enable both types of care through face-to-face and virtual group consultations.  Patients and communities need agency and choice to implement and access these patient-centred and codesigned care models. This can bring system benefits, mapped to healthcare's quintuple aim, to those electing to use group consultations and even those who do not. The process of both training and delivering group consultation models can create and sustain compassionate communities and this ‘Fourth Healthcare Revolution’ may be exactly what is needed to save primary care.

Background

Caring for children living with human immunodeficiency virus and acquired immunodeficiency syndrome (HIV/AIDS) is challenging and has a tremendous impact on the physical and psychological health of caregivers. Caregivers of children with HIV/AIDS need to adopt coping mechanisms to navigate these complexities as it influences the quality of care provided. The literature on coping strategies and support (formal and informal) available to caregivers of children living with HIV/AIDS is scant. This study aimed to explore the coping strategies and support systems for caregivers of children living with HIV/AIDS.

Methods

A phenomenological study design was adopted. A total of nine participants across three hospitals in the Tamale metropolis were interviewed using purposive sampling. The interviews were audio recorded, transcribed verbatim and analysed using Colaizzi's approach.

Results

Four main themes emerged from the analyses: (1) coping strategies, (2) types of support activities, (3) support from informal institutions and (4) support from formal institutions. The caregivers navigated the caring process with much spiritual coping. The caregivers had little or no support from informal institutions such as immediate family, faith and community leaders. Non-governmental organizations were not visible in support, and there were no support groups for caregivers.

Conclusion

Support for caregivers and the active involvement of the immediate family in paediatric HIV care is imperative.

Introduction

Parental feeding styles in the first years of life may increase childhood overweight risk. There are few studies on this association in children under 2 years. The current study aimed to investigate the association between maternal feeding styles and Caribbean infants’ risk of overweight at 18 months and determine whether maternal depression is an important confounder in the association.

Methods

It is a prospective study of mother–child dyads that participated in a three-island parenting trial. Maternal and infant characteristics were collected at infant age 6–10 weeks with maternal depression assessed using the Center for Epidemiologic Studies Depression (CES-D) scale questionnaire. Feeding styles were measured using items from the Toddler Feeding Behaviour Questionnaire at 12 months. Infant weight and length were measured at 18 months, and infants at risk of overweight were defined as weight-for-length z-scores (WLZ) > 1. Factor analysis was used to identify feeding styles and associations with overweight risk assessed using multilevel logistic regression accounting for country and health clinic. Logistic regression models were adjusted for infant and maternal covariates, with a final model including depressive symptom scores.

Results

Of 366 infants assessed, 18.9% were affected by the risk of overweight. Five feeding styles were identified—uninvolved, indulgent, forceful, restrictive and responsive. Only restrictive feeding was associated with an increased risk of overweight (OR [95% CI], 1.61 [1.22, 2.13]). The association strengthened after adjusting for maternal depressive symptoms (OR [95% CI], 1.79 [1.30, 2.30]), representing an 11.18% increase in the risk of overweight odds.

Conclusion

Interventions that address restrictive feeding may be one strategy to reduce overweight risk among Caribbean maternal–infant dyads.

Aims

To characterise continuous glucose monitor and flash glucose monitor use and related issues (both positive and negative) in the population of children and young people living with type 1 diabetes in the Southern Health and Social Care Trust (SHSCT), Northern Ireland.

Methods

Four focus groups were conducted in the SHSCT with people with type 1 diabetes and their families, to assess opinions of diabetes technology. In addition, questionnaires were distributed to diabetes specialist nurses (DSNs), young people and their families about use and access to diabetes technology.

Results

Questionnaires were completed by 68 children, young people (0–18 years) and their parents/guardians. Nearly all (98.5%) had access to their own diabetes related data, and 70.6% used diabetes data systems, for example, Libreview. Most of those using these systems found them beneficial and easy for daily use and clinical review.

Most DSNs (83.9%) agreed that the systems were easy to use, and 82.3% were confident in interpreting the data accurately. DSNs felt virtual review was beneficial in over half of young people with 62.9% advising changes to diabetes management based on the data.

Focus groups participants deemed diabetes technology a ‘gamechanger’ and ‘lifechanging’. Some drawbacks included ‘disruptive’ alarms, self-confidence issues, visible diabetes technology and problems in school.

Conclusions

Most young people, their families and healthcare professionals reported they were confident in interpreting diabetes data and technology was easy to use. Diabetes technology could improve access to care through virtual clinics, improve clinical outcomes and enhance quality of life.

Importance

There is an abundance of research demonstrating the growing challenge of burnout in healthcare professionals. This has been further exacerbated by the COVID-19 pandemic. The use of meditation using various techniques has shown promising results in the reduction of stress and its sequelae.

Objective

To determine the efficacy of a mantra-based meditation protocol developed by the American Meditation Institute to reduce caregiver stress by evaluating changes in burnout and secondary traumatic stress (components of compassion fatigue) and compassion satisfaction with the application of the meditation protocol.

Design, Setting, and Participation

This pre–post cohort analysis was conducted on prospective enrollees of the Continuing Medical Education (CME)-accredited American Meditation Institute's annual Heart and Science of Yoga^® Conference, a comprehensive training in Yoga Science as Holistic Mind/Body Medicine for physicians and other healthcare providers held in October in Lenox, Massachusetts. Enrollees were trained in mantra-based AMI Meditation at the conference and monitored during the 6-month period following the conference.

Interventions

The mantra-based AMI Meditation intervention included a 5-day in-person training, a daily practice of a guided mantra-based AMI Meditation using a 20-min CD or MP3 recording, and receipt of a monthly motivational letter. Study participants completed the Professional Quality of Life (ProQOL) Measure (a survey) and a demographic survey at baseline, and the ProQOL Measure and an informational survey at 3 and 6 months.

Main Outcomes and Measures

The primary outcome was a change from baseline in participants’ level of burnout using the ProQOL assessed at baseline and 3 and 6 months. Secondary outcomes included change from baseline in participants’ level of secondary traumatic stress and compassion satisfaction assessed at 3 and 6 months using the ProQOL Measure. Qualitative data were also collected from participant feedback, via the informational surveys, at 3 months and after completion of the program at 6 months.

Results

Of the 54 participants who en