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Mahmoud SS, Mahdy MHEL, Mahfouz MS, Nada IS, Aqeeli AA, Darbi MAAL, Ahmed AE. Effects of a Psychoeducational Program on Hemoglobin A1c Level and Health-Related Quality of Life in Patients with Type 2 Diabetes Mellitus, Jazan, Saudi Arabia. BIOMED RESEARCH INTERNATIONAL 2018; 2018:6915467. [PMID: 29862283 PMCID: PMC5976993 DOI: 10.1155/2018/6915467] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Revised: 03/20/2018] [Accepted: 04/05/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Diabetes mellitus (DM) is a growing health problem. Care programs should involve the patients to upgrade their diabetes condition and health-related quality of life (HRQoL). OBJECTIVE The present study aimed to assess the effects of a psychoeducational intervention program on an indicator of glycemic control and HRQoL among type 2 diabetic patients. METHODS In this quasi-experimental (pre- and postinterventional) study, 99 outpatients with type 2 diabetes were selected randomly from those attending primary health care centers in Jazan, Saudi Arabia, in 2016. Hemoglobin A1c levels (HbA1c) were measured by the colorimetric method, and HRQoL was assessed by the Arabic version of the RAND 36-Item Health Survey 1.0 (RAND-36). The psychoeducational program was conducted on the participants for 4 weeks, and preprogram findings were compared with the postprogram findings after a 5-month follow-up. RESULTS After the intervention, there was a statistically significant reduction in the mean value of HbA1c from 9.8 to 7.7 (P < 0.001), and there was significant improvement in the mean scores of the following HRQoL scales: role limitations due to emotional problems, energy/fatigue, emotional well-being, and general health (P < 0.01). In addition, the impact of the program on HRQoL was better among males and among patients who were older than forty years than among women and patients who were forty years old or younger. CONCLUSION The application of such psychoeducational intervention programs can be helpful in the improvement of HbA1c levels and HRQoL for patients with DM.
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Affiliation(s)
- Samy Shaban Mahmoud
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
- Department of Community and Occupational Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Mona Husein EL Mahdy
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Mohamed Salih Mahfouz
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Ibrahim Saad Nada
- Department of Community Medicine, Faculty of Applied Medical Sciences, Umm Al-Qura University, Mecca, Saudi Arabia
| | - Abdulwahab Abdoh Aqeeli
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | | | - Anas Elias Ahmed
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
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Racsa LD, DeLeon-Carnes M, Hiskey M, Guarner J. Identification of bacterial pathogens from formalin-fixed, paraffin-embedded tissues by using 16S sequencing: retrospective correlation of results to clinicians' responses. Hum Pathol 2016; 59:132-138. [PMID: 27717884 DOI: 10.1016/j.humpath.2016.09.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 08/20/2016] [Accepted: 09/14/2016] [Indexed: 11/16/2022]
Abstract
16S sequencing on formalin-fixed, paraffin-embedded (FFPE) material has been used to identify bacteria when culture-based phenotyping techniques have not worked. The objective of this study was to determine how frequently 16S sequencing used in FFPE material was helpful to clinicians in the diagnosis and treatment of infectious diseases. Requests for testing occurred upon consultation between an infectious disease pathologist and a surgical pathologist or an infectious disease physician. A selected paraffin block from each case was referred for 16S sequencing. Retrospectively, we correlated clinical history and management decisions on 27 cases that were tested by paneubacterial 16S sequencing. Samples included 24 surgical specimens, 1 autopsy, and 2 cytology blocks. Seventeen (63%) of the 27 cases had a positive 16S sequencing. Acute inflammation was present in 10 of these cases, and organisms were observed using special stains in 3. In 11 (65%) of the 17 cases, clinicians considered the organism identified by 16S sequencing to be the cause or possible cause of the infectious process. Organisms included common (Citrobacter) and fastidious bacteria (Haemophilus, Fusobacterium). In 3 cases, clinicians changed antibiotic treatment based on the bacteria identified, whereas in 8 (including 2 where no organism was found), clinicians continued the antibiotic treatment. The use of 16S sequencing on FFPE identified specific bacteria even when organisms were not observed histopathologically. 16S results had an impact in infectious disease management decisions.
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Affiliation(s)
- Lori D Racsa
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA 30322;.
| | - Marlene DeLeon-Carnes
- Infectious Disease Pathology Branch, Centers for Disease Control and Prevention, Atlanta, GA 30303.
| | - Matthew Hiskey
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA 30322;.
| | - Jeannette Guarner
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA 30322;.
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MacVane SH, Hurst JM, Steed LL. The Role of Antimicrobial Stewardship in the Clinical Microbiology Laboratory: Stepping Up to the Plate. Open Forum Infect Dis 2016; 3:ofw201. [PMID: 27975076 PMCID: PMC5152709 DOI: 10.1093/ofid/ofw201] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2016] [Accepted: 09/20/2016] [Indexed: 11/14/2022] Open
Abstract
We report the development of a collaborative relationship between antimicrobial stewardship and clinical microbiology that incorporates stewardship practices into daily laboratory rounds. Antimicrobial stewardship involvement on rounds was a welcomed and effective initiative with substantial rates of intervention. New opportunities to positively impact use of antimicrobials and laboratory resources were realized.
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Affiliation(s)
- Shawn H MacVane
- Department of Pharmacy Services;; Division of Infectious Diseases, College of Medicine, and
| | - John M Hurst
- Department of Pharmacy, Saint Anthony Hospital , Oklahoma City
| | - Lisa L Steed
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina , Charleston
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Allo JA, Cuello D, Zhang Y, Reddy SK, Azhar A, Bruera E. Patient Home Visits: Measuring Outcomes of a Community Model for Palliative Care Education. J Palliat Med 2016; 19:271-8. [PMID: 26652056 PMCID: PMC4779281 DOI: 10.1089/jpm.2015.0275] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Health care professionals may have limited exposure to home-based care. There is no published literature that has described the experiences and satisfaction of participation in patient home visits (PHV). OBJECTIVE The objective of this article is to describe the characteristics of PHV, our approach, and evaluation by participants over a nine-year period. METHODS We conducted a review of surveys completed by participants in PHV from 2005-2013. All participants anonymously completed the evaluation questionnaires at the end of PHVs. Different PHV assessment forms were used for the 2005-2010 and 2011-2013 time periods. RESULTS A total of 34 PHVs were conducted with 106 patients and approximately 750 participants with a mean of 3 patients and 22 participants per PHV between 2005 and 2013. For 18 PHVs there are 317 surveys completed with 353 participants, making it a 90% response rate. Responding participants were physicians 125/543 (23%) and other professionals 418/543 (77%). In both time periods of 2005-2010 and 2011-2013 a survey with a 1 (completely agree) to 5 (completely disagree) scale was used. Agreeing that PHV was an effective teaching tool during 2005-2010 were 335/341 (98%); during 2011-2013, 191/202 (95%) agreed that PHV provided increased understanding and sharing of best practices in palliative care. CONCLUSIONS PHV was perceived by participants as an effective way of providing interactive community education. A broad range of themes were addressed, and the participants reported high levels of learning in all domains of palliative care. There were no cases of patient or relative expression of distress as a result of PHV.
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Affiliation(s)
- Julio A. Allo
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Deanna Cuello
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Yi Zhang
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
- Department of Medical Oncology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Suresh K. Reddy
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ahsan Azhar
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Eduardo Bruera
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
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Guarner J, Amukele T, Mehari M, Gemechu T, Woldeamanuel Y, Winkler AM, Asrat D, Wilson ML, Rio CD. Building capacity in laboratory medicine in Africa by increasing physician involvement: a laboratory medicine course for clinicians. Am J Clin Pathol 2015; 143:405-11. [PMID: 25696799 DOI: 10.1309/ajcpnyt1wpsrclc6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVES To describe a 4-day laboratory medicine course for clinicians given at Addis Ababa University, Ethiopia, designed to improve the use of laboratory-based diagnoses. METHODS Each day was dedicated to one of the following topics: hematology, blood bank/transfusion medicine and coagulation, chemistry, and microbiology. The course included lectures, case-based learning, laboratory tours, and interactive computer case-based homework. The same 12-question knowledge quiz was given before and after the course. RESULTS Twenty-eight participants took the quiz before and 21 after completing the course. The average score was 5.28 (range, 2-10) for the initial quiz and 8.09 (range, 4-11) for the second quiz (P = .0001). Two of 12 and 8 of 12 questions were answered correctly by more than 60% of trainees on the initial and second quiz, respectively. CONCLUSIONS Knowledge and awareness of the role of the laboratory increased after participation in the course. Understanding of laboratory medicine principles by clinicians will likely improve use of laboratory services and build capacity in Africa.
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Affiliation(s)
- Jeannette Guarner
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA
| | - Timothy Amukele
- Department of Pathology and Laboratory Medicine, Johns Hopkins University, Baltimore, MD
| | - Meheretu Mehari
- Clinical Laboratory, Black Lion Hospital, Addis Ababa, Ethiopia
| | - Tufa Gemechu
- College of Health Sciences, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Anne M. Winkler
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA
| | - Daniel Asrat
- College of Health Sciences, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Michael L. Wilson
- Department of Pathology and Laboratory Medicine, University of Colorado, Denver
| | - Carlos del Rio
- Hubert Department of Global Health, Rollins School of Public Health of Emory University, Atlanta, GA
- Department of Medicine, Emory University School of Medicine, Atlanta, GA
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Evaluation of an online program to teach microbiology to internal medicine residents. J Clin Microbiol 2014; 53:278-81. [PMID: 25392364 DOI: 10.1128/jcm.02696-14] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Microbiology rounds are an integral part of infectious disease consultation service. During microbiology rounds, we highlight microbiology principles using vignettes. We created case-based, interactive, microbiology online modules similar to the vignettes presented during microbiology rounds. Since internal medicine residents rotating on our infectious disease elective have limited time to participate in rounds and learn microbiology, our objective was to evaluate the use of the microbiology online modules by internal medicine residents. We asked residents to complete 10 of 25 online modules during their infectious disease elective. We evaluated which modules they chose and the change in their knowledge level. Forty-six internal medicine residents completed assessments given before and after accessing the modules with an average of 11/20 (range, 6 to 19) and 16/20 (range, 9 to 20) correct questions, respectively (average improvement, 5 questions; P = 0.0001). The modules accessed by more than 30 residents included those related to Clostridium difficile, anaerobes, Candida spp., Streptococcus pneumoniae, influenza, Mycobacterium tuberculosis, and Neisseria meningitidis. We demonstrated improved microbiology knowledge after completion of the online modules. This improvement may not be solely attributed to completing the online modules, as fellows and faculty may have provided additional microbiology education during the rotation.
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Wilson ML. Learning to be a consultant: what should be taught. Am J Clin Pathol 2014; 142:284-5. [PMID: 25125615 DOI: 10.1309/ajcpe4pehi4aiwif] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- Michael L. Wilson
- Department of Pathology & Laboratory Services, Denver Health, Denver, CO, and Department of Pathology, University of Colorado School of Medicine, Aurora
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Guarner J. Incorporating Pathology in the Practice of Infectious Disease: Myths and Reality. Clin Infect Dis 2014; 59:1133-41. [DOI: 10.1093/cid/ciu469] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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Wilson ML. Teaching rounds: a new approach. Am J Clin Pathol 2014; 141:300-1. [PMID: 24515755 DOI: 10.1309/ajcp7qckmq2jdvme] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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