SpringerPlus
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There are 62 million Americans currently residing in rural areas who are more likely to have multiple chronic conditions and be economically disadvantaged, and in poor health, receive less recommended preventive services and attend fewer visits to health care providers. Recent advances in mobile healthcare (mHealth) offer a promising new approach to solving health disparities and improving chronic illness care. It is now possible and affordable to transmit health information, including values from glucometers, automated blood pressure monitors, and scales, through Bluetooth-enabled devices. Additionally, audio and video communications technologies can allow healthcare providers to conduct many parts of a physical exam remotely from varied settings. These technologies could remove geographical distance as a barrier to care and diminish the access to care issues faced by patients who live rurally. However, currently there is lack of studies that provide evidence of feasibility, acceptability, and effectiveness of mHealth initiatives on improved outcomes of care, a needed step to make the translation to implementation studies in healthcare systems. The purpose of this paper is to present the protocol for the first study of mI SMART (mobile Improvement of Self-Management Ability through Rural Technology), a new integrated mHealth intervention. ⋯ We expect that the mI SMART intervention, refined from participant and provider feedback, will be acceptable and feasible. We anticipate high patient-provider satisfaction, enhanced patient-provider communication, and improved health related quality of life, adherence to treatment, and self-management ability. In addition, we hypothesize that patients who use mI SMART will demonstrate improved physical outcomes such as blood glucose, blood pressure, and weight.
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Chronic migraine affects 2 % of the population and has substantial impact on quality of life and considerable burden on healthcare resources. 50-80 % patients with chronic migraine have excessive consumption of analgesic medications. Withdrawal of analgesics is often advised before commencing preventive treatments. ⋯ The data shows no difference in the therapeutic outcome in patients with or without analgesic overuse with substantial reduction in headache and migraine days and an increment in headache-free days in both groups in a real-life clinical setting. OnabotulinumtoxinA is equally effective in patients with chronic migraine with or without analgesic overuse.
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Existing literature suggests that cancer survivors present with high rates of morbidity due to various treatment and disease induced factors. Research globally has shown exercise to be beneficial in improving treatment outcomes and quality of life. India has a high prevalence of cancer and not much is known about exercise interventions for cancer survivors in India. ⋯ A broad range of outcomes were found including symptoms, speech and swallowing, and quality of life and largely supported the benefits of exercise-based interventions. At present, research involving exercise-based rehabilitation interventions in India is limited in volume, quality and scope. With the growing burden of cancer in the country, there is an immediate need for research on exercise based interventions for cancer survivors within the sociocultural context of India.
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Women with breast cancer may experience symptoms of depression, anxiety, pain, fatigue and sleep disturbances during chemotherapy. However, there are few modalities that address multiple, commonly occurring symptoms that may occur in individuals receiving cancer treatment. Cranial electrical stimulation (CES) is a treatment that is FDA cleared for depression, anxiety and insomnia. CES is applied via electrodes placed on the ear that deliver pulsed, low amplitude electrical current to the head. ⋯ In this study, women receiving chemotherapy for breast cancer experienced multiple symptoms in the mild to moderate range. Although there is no evidence for the routine use of CES during the chemotherapy period for symptom management in women with breast cancer, further symptom management modalities should be evaluated to mitigate symptoms of depression, anxiety, fatigue, pain and sleep disturbances over the course of chemotherapy.
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OnabotulinumtoxinA (OnabotA) was approved for treatment of chronic migraine (CM) after publication of PREEMPT trials. Thus, we set out to evaluate the efficacy of OnabotA in a series of patients with CM treated according to the PREEMPT protocol. In May 2012 we began to offer OnabotA to patients with CM who did not respond to topiramate and at least one other preventive therapy (beta blocker and/or calcium channel antagonist). ⋯ Twelve (23.1%) patients failed to perceive a positive effect after the first procedure and it was not repeated in 4 of them. By contrast, there was a significant decreasing in all the variables evaluated compared to the baseline in the 39 patients that received a second series of injections. The use of OnabotA according to the PREEMPT paradigm is an effective treatment in patients with chronic migraine in a real-life setting.