scholarly journals Chronic Constipation: Is a Nutritional Approach Reasonable?

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3386
Author(s):  
Massimo Bellini ◽  
Sara Tonarelli ◽  
Federico Barracca ◽  
Francesco Rettura ◽  
Andrea Pancetti ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Health Professionals ◽  
Chronic Constipation ◽  
Mineral Water ◽  
Bulking Agents ◽  
Lifestyle Modifications ◽  
Scientific Validity ◽  
Pharmacological Agents ◽  
Scientific Arguments

Chronic constipation (CC) is one of the most common gastroenterological diagnoses in clinical practice. Treatment includes several steps, depending on the severity of symptoms. Lifestyle modifications and increased intake of fiber and water are suggested by most health professionals. Unfortunately, the recommendations in this regard are the most varied, often conflicting with each other and not always based on solid scientific arguments. This paper aims to clarify this topic by providing practical indications for the management of these patients in every day clinical practice. The literature available on this topic is scarce, and dietary studies have important methodological biases. However, fiber, mainly by binding water and acting as bulking agents and/or as prebiotics for the intestinal microbiota, and mineral water, especially if rich in magnesium and/or bicarbonate, are useful tools. An adequate, well-designed diet should be a cornerstone of any effective treatment for chronic constipation. High-quality studies on larger samples are mandatory to give scientific validity to the role of the food in CC therapy and to enable professionals to choose the best approach for their patients, combining nutritional and pharmacological agents.

scholarly journals Barriers Perceived by Managers and Clinical Professionals Related to the Implementation of Clinical Practice Guidelines for Breastfeeding through the Best Practice Spotlight Organization Program

2020 ◽  
Vol 17 (17) ◽  
pp. 6248
Author(s):  
Antonio Jesús Ramos-Morcillo ◽  
David Harillo-Acevedo ◽  
David Armero-Barranco ◽  
César Leal-Costa ◽  
José Enrique Moral-García ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Health Professionals ◽  
Best Practice ◽  
Research Study ◽  
Structured Interviews ◽  
Qualitative Research Study ◽  
Implementation Program

International institutions facilitate the contact of health professionals to evidence-based recommendations for promoting exclusive breast feeding (BF). However, the achievement of good rates of exclusive BF is still far from the optimum. The intention of the present work is to determine the barriers identified by managers and health professionals involved in the implementation and sustainability of Clinical Practice Guidelines (CPG) for breastfeeding under the auspices of the Best Practice Spotlight Organization program. A qualitative research study was carried out. The participants were managers, healthcare assistants, nurses, midwives, pediatricians and gynecologists. Semi-structured interviews were conducted which were transcribed and analyzed using the six steps of thematic analysis. Twenty interviews were conducted, which defined four major themes: (1) Lack of resources and their adaptation; (2) Where, Who and How; (3) Dissemination and reach of the project to the professionals; and (4) The mother and her surroundings. This research identifies the barriers perceived by the health professionals involved in the implementation, with the addition of the managers as well. Novel barriers appeared such as the ambivalent role of the midwives and the fact that this CPG is about promoting health. The efforts for promoting the implementation program should be continuous, and the services should be extended to primary care.

scholarly journals Effects of the diagnostic label ‘schizophrenia’, actively used or passively accepted, on general practitioners’ views of this disorder

2017 ◽  
Vol 63 (3) ◽  
pp. 224-234 ◽  
Author(s):  
Lorenza Magliano ◽  
Antonella Strino ◽  
Rosanna Punzo ◽  
Roberta Acone ◽  
Gaetana Affuso ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Psychosocial Factors ◽  
General Practitioners ◽  
Social Distance ◽  
Health Professionals ◽  
Process Of Care ◽  
Diagnostic Label ◽  
Psychiatric Problems

Background: General practitioners (GPs) play a key role in the care of somatic and psychiatric problems in people diagnosed with schizophrenia (PWS). It is probable that, like other health professionals, GPs are not all free of prejudices toward PWS. In clinical practice, GPs sometimes interact with clients diagnosed with schizophrenia by specialists, passively accepting this diagnosis. Other times, GPs interact with clients having symptoms of schizophrenia but who have not been diagnosed. In this case, GPs are expected to actively make a diagnosis. Giving the key role of GPs in the process of care, it is worthwhile examining whether passive acceptance and active usage of the diagnosis schizophrenia have differential effects on GPs’ attitudes toward people with this disorder. Aims: To investigate GPs’ views of schizophrenia and whether they were influenced by a ‘schizophrenia’ label, passively accepted or actively used. Methods: A total of 430 randomly selected GPs were invited to complete a questionnaire about their views of schizophrenia, either after reading a description of this disorder and making a diagnosis, or without being provided with a description but passively accepting the label ‘schizophrenia’ given in the questionnaire. Results: The GPs who passively accepted the label schizophrenia ( n = 195) and those who actively identified schizophrenia from the description ( n = 127) had similar views. Compared to the GPs who did not identify schizophrenia in the description ( n = 65), those who used the diagnosis, actively or passively: more frequently reported heredity and less frequently psychosocial factors as causes of the disorder; were more skeptical about recovery; were more convinced of the need for long-term pharmacotherapies; believed more strongly that PWS should be discriminated against when in medical hospital; and perceived PWS as more dangerous and as kept at greater social distance. Conclusion: The diagnosis ‘schizophrenia’, however used, is associated with pessimistic views. Stigma education should be provided to GPs.

scholarly journals Antipsychotic long-acting injections in clinical practice: Medication management and patient choice

2009 ◽  
Vol 195 (S52) ◽  
pp. s51-s56 ◽  
Author(s):  
Richard Gray ◽  
Rosalyn Spilling ◽  
David Burgess ◽  
Tim Newey
Keyword(s):  
Mental Health ◽  
Clinical Practice ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Treatment Plan ◽  
Good Practice ◽  
Patient Choice ◽  
Joint Decision ◽  
Long Acting

BackgroundA patient-centred approach to care, focusing on recovery, demands a reconsideration of how choices are made about treatment, how this affects medication adherence, and the role of long-acting antipsychotics (LAIs) in this process.AimsTo explore the role of the mental health professional (particularly nurses) in helping patients manage their medication, with a specific focus of the use and administration of LAIs.MethodA pragmatic review of the literature.ResultsPatients (by experience) and mental health professionals (by training and clinical practice) are experts in the care and treatment of psychosis. When patients and clinicians make a joint decision both are more likely to adhere to the treatment plan. In this paper we consider good practice in the administration of LAIs that focuses on where and when they should be given and administration techniques. Skills for talking with patients about their medication that include exchanging information, monitoring the effects of medication and making advance choices about treatment in the event of a crisis are also discussed.ConclusionsMental health professionals require a range of competences to help patients manage their medication effectively.

The miR-21 potential of serving as a biomarker for liver diseases in clinical practice

2020 ◽  
Vol 48 (5) ◽  
pp. 2295-2305
Author(s):  
Jiawei Zhang ◽  
Dandan Li ◽  
Rui Zhang ◽  
Peng Gao ◽  
Rongxue Peng ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Liver Diseases ◽  
Hepatic Disease ◽  
Noninvasive Detection ◽  
Diagnosis And Prognosis ◽  
Expected Performance ◽  
Potential Biomarker ◽  
Disease Condition ◽  
Complex Regulatory Network

The role of miR-21 in the pathogenesis of various liver diseases, together with the possibility of detecting microRNA in the circulation, makes miR-21 a potential biomarker for noninvasive detection. In this review, we summarize the potential utility of extracellular miR-21 in the clinical management of hepatic disease patients and compared it with the current clinical practice. MiR-21 shows screening and prognostic value for liver cancer. In liver cirrhosis, miR-21 may serve as a biomarker for the differentiating diagnosis and prognosis. MiR-21 is also a potential biomarker for the severity of hepatitis. We elucidate the disease condition under which miR-21 testing can reach the expected performance. Though miR-21 is a key regulator of liver diseases, microRNAs coordinate with each other in the complex regulatory network. As a result, the performance of miR-21 is better when combined with other microRNAs or classical biomarkers under certain clinical circumstances.

Enhancing clinical practice: The role of practice guidelines.

1994 ◽  
Vol 49 (1) ◽  
pp. 30-33 ◽  
Author(s):  
J. Jarrett Clinton ◽  
Kathleen McCormick ◽  
Jacqueline Besteman
Keyword(s):  
Clinical Practice ◽  
Practice Guidelines
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