Articles: health.
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Breathlessness is a key symptom in chronic obstructive pulmonary disease (COPD) with prognostic implications on health status and survival. Since most conditions underlying chronic refractory breathlessness in COPD are not modifiable, the use of opioids and benzodiazepines has been proposed to relieve it. However, respiratory depression is a known adverse event of these drugs, and concerns have been raised on their use in patients with chronic respiratory failure. ⋯ Recent observations favor the use of lower doses of opioids (≤30 mg oral morphine equivalents/day) for reduction of symptoms in those patients with severe COPD receiving long-term oxygen therapy. Low dose opioids are not associated with an increased risk of hospital admission or death in cohorts of COPD patients on long term oxygen therapy. On the contrary, benzodiazepines and opioids at higher doses might increase mortality.
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Int J Health Policy Manag · Dec 2014
On the cost of shame : Comment on "Nudging by shaming, shaming by nudging".
In his editorial, Nir Eyal argues that a nudge can exploit our propensity to feel shame in order to steer us toward certain choices. We object that shame is a cost and therefore cannot figure in the apparatus of a nudge.
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A wide gap persists between the health of Aboriginal and non-Aboriginal Australians despite a recent Federal government commitment to close the gap by 2030. The complex underlying factors include socioeconomic and environmental disadvantage, inadequate education, underemployment, racial prejudice, high-risk health-related behaviours and limited access to clinical services and health promotion programmes. Over recent decades some aspects of Aboriginal health have deteriorated badly, largely from a surge in chronic 'lifestyle' diseases like diabetes, cardiovascular and kidney disorders plus the effects of tobacco smoking, alcohol and drug abuse and high rates of violence and trauma. ⋯ These include education, living conditions, vocational training, employment, closer cooperation between government and non-government agencies, access to affordable and nutritious fresh food, with better access to high-quality medical treatment, health promotion and disease prevention programmes. Indigenous people must be encouraged to become more involved in activities to improve their health and have more responsibility for the decision-making processes this will entail. Governments must support these changes to help close the Aboriginal health gap.
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Br J Health Psychol · Nov 2014
Randomized Controlled Trial Comparative StudyOptimizing engagement with Internet-based health behaviour change interventions: comparison of self-assessment with and without tailored feedback using a mixed methods approach.
Internet-based health behaviour interventions have variable effects on health-related outcomes. Effectiveness may be improved by optimizing the design of interventions. This study examined the specific effect on engagement of providing two different design features - tailoring and self-assessment. ⋯ The acceptability of self-assessment or monitoring components may be optimized by also providing tailored feedback. Without tailored feedback, these components do not appear to be any more engaging than generic information provision. Statement of contribution What is already known on this subject? Digital interventions can be effective for improving a range of health outcomes and behaviours. There is huge variation in the success of different interventions using different combinations of design features. What does this study add? This study used a systematic experimental design to identify the effect on engagement of providing interactive intervention design features alone and in combination. Intervention engagement was better when self-assessment was provided in conjunction with tailored feedback.
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The European Health and Behaviour Survey is a questionaire used to assess a wide range of health-related behaviours, attitudes to health, beliefs concerning the importance of behaviours for health, and health knowledge, using a standardized protocol suitable for translation and administration in different countries of Europe. The objective of this study was to translate and culturally adapt the EHBS-Section B (section used to assess attitudes towards the importance of 25 activities for health) to the Portuguese language and to test its reliability and validity. ⋯ The Portuguese EHBS-Section B exhibited suitable psychometric properties, in terms of internal consistency, reproducibility and construct validity. It can be used in educational and research settings.