5,208 research outputs found
Management of irritable bowel syndrome in primary care: feasibility randomised controlled trial of mebeverine, methylcellulose, placebo and a patient self-management cognitive behavioural therapy website (MIBS trial)
No full textBackground: IBS affects 10-22% of the UK population. Abdominal pain, bloating and altered bowel habit affectquality of life, social functioning and time off work. Current GP treatment relies on a positive diagnosis, reassurance,lifestyle advice and drug therapies, but many suffer ongoing symptoms. A recent Cochrane review highlighted the lack of research evidence for IBS drugs. Neither GPs, nor patients have good evidence to inform prescribing decisions. However, IBS drugs are widely used: In 2005 the NHS costs were nearly £10 million for mebeverine and over £8 million for fibre-based bulking agents. CBT and self-management can be helpful, but poor availability in the NHS restricts their use. We have developed a web-based CBT selfmanagement programme, Regul8, based on an existing evidence based self-management manual and in partnership with patients. This could increase access with minimal increased costs.Methods/Design: The aim is to undertake a feasibility factorial RCT to assess the effectiveness of the commonlyprescribed medications in UK general practice for IBS: mebeverine (anti-spasmodic) and methylcellulose(bulkingagent)and Regul8, the CBT based self-management website. 135 patients aged 16 to 60 years with IBS symptoms fulfilling Rome III criteria, recruited via GP practices, will be randomised to 1 of 3 levels of the drug condition: mebeverine, methylcellulose or placebo for 6 weeks and to 1 of 3 levels of the website condition, Regul8 with a nurse telephone session and email support, Regul8 with minimalemail support, or no website, thus creating 9 groups.Outcomes: Irritable bowel symptom severity scale and IBS-QOL will be measured at baseline, 6 and 12 weeks asthe primary outcomes. An intention to treat analysis will be undertaken by ANCOVA for a factorial trial.Discussion: This pilot will provide valuable information for a larger trial. Determining the effectiveness ofcommonly used drug treatments will help patients and doctors make informed treatment decisions regarding drugmanagement of IBS symptoms, enabling better targeting of treatment. A web-based self-management CBT programme for IBS developed in partnership with patients has the potential to benefit large numbers of patients with low cost to the NHS. Assessment of the amount of email or therapist support required for the website willenable economic analysis to be undertaken.Trial Registration: ClinicalTrials.gov Identifier (NCT number): NCT00934973
Book Discussion : PJ Powers
No full textThe UJ Campus Health Services and the Student Affairs Division in partnership with the UJ Library invite you to meet PJ Powers (Thandeka) the co-author of the book HERE I AM About the book: Here I Am, written with Marianne Thamm, is an intimate and hilarious account of the life and times of one of this country’s most recognisable and enduring performers. From the dizzying heights of international stardom to the dark depths of her struggle with alcohol, this is a must-read to explore the heady mix of politics and music of the time. More than just a story about the personal journey of one of South Africa’s most beloved music icons, this extraordinary memoir of PJ Powers – or Thandeka, as she was affectionately renamed by Soweto crowds – is set against the turbulent backdrop of South Africa’s recent political history. It features a gallery of political leaders and international celebrities, including the likes of Nelson Mandela, Graça Machel, Chris Hani, Joaquim Chissano, Queen Elizabeth II, Brenda Fassie, Sharon Stone and Robert De Niro. Facilitator: Prof Alban Burke, Director – PsyCad, University of Johannesburg PJ Powers will also perform a few songs on the day. Date: 27 August 2015 Time: 16:30 for 17:00 Venue: Auditorium (6th Floor), APK Library, University of Johannesburg (corner Kingsway and University Road, Auckland Park) RSVP: By Wednesday, 26 August 2015 to Theodorah Modise on [email protected] / 011 559 226
Book Discussion : PJ Powers
No full textThe UJ Campus Health Services and the Student Affairs Division in partnership with the UJ Library invite you to meet PJ Powers (Thandeka) the co-author of the book HERE I AM About the book: Here I Am, written with Marianne Thamm, is an intimate and hilarious account of the life and times of one of this country’s most recognisable and enduring performers. From the dizzying heights of international stardom to the dark depths of her struggle with alcohol, this is a must-read to explore the heady mix of politics and music of the time. More than just a story about the personal journey of one of South Africa’s most beloved music icons, this extraordinary memoir of PJ Powers – or Thandeka, as she was affectionately renamed by Soweto crowds – is set against the turbulent backdrop of South Africa’s recent political history. It features a gallery of political leaders and international celebrities, including the likes of Nelson Mandela, Graça Machel, Chris Hani, Joaquim Chissano, Queen Elizabeth II, Brenda Fassie, Sharon Stone and Robert De Niro. Facilitator: Prof Alban Burke, Director – PsyCad, University of Johannesburg PJ Powers will also perform a few songs on the day. Date: 27 August 2015 Time: 16:30 for 17:00 Venue: Auditorium (6th Floor), APK Library, University of Johannesburg (corner Kingsway and University Road, Auckland Park) RSVP: By Wednesday, 26 August 2015 to Theodorah Modise on [email protected] / 011 559 226
Mechanistic insight: Linking cardiovascular complications of inflammatory bowel disease
No full textCardiovascular diseases (CVD) are the leading cause of mortality worldwide despite an aggressive reduction of traditional cardiovascular risk factors. Underlying inflammatory conditions such as inflammatory bowel disease (IBD) increase the risk of developing CVD. A broad understanding of the underlying pathophysiological processes between IBD and CVD is required to treat and prevent cardiovascular events in patients with IBD. This review highlights the commonality between IBD and CVD, including dysregulated immune response, genetics, environmental risk factors, altered gut microbiome, stress, endothelial dysfunction and abnormalities, to shed light on an essential area of modern medicine.Full Tex
Technologically mediated learning: The future of training in Australia
No full textHosie, PJ ORCiD: 0000-0003-2585-024XFollowing a review of the economic imperatives currently facing Australia,
the future directions training will take are examined. Related training issues are considered; such as multiskilling, on-the-job training and legal issues. The author predicts that technologically mediated learning (TML),
especially interactive multimedia, will gain ascendancy as the predominant mode of delivery for training
Spatio-temporal dynamics in the origin of genetic information
No full textWe study evolutionary processes induced by spatio-temporal dynamics in prebiotic evolution. Using numerical simulations, we demonstrate that hypercycles emerge from complex interaction structures in multispecies systems. in this work, we also find that 'hypercycle hybrid' protects the hypercycle from its environment during the growth process. There is little selective advantage for one hypercycle to maintain coexistence with others. This brings the possibility of the outcompetition between hypercycles resulting in the negative effect on information diversity. To enrich the information in hypercycles, symbiosis with parasites is suggested. It is shown that symbiosis with parasites can play an important role in the prebiotic immunology. © 2005 Elsevier B.V. All rights reserved.Ministry of Science and Technology, Korean Systems Biology Research Grant No. M10309020000-03B5002-00000, and KOSEF, Grant No. R08-2003-000-10285-0
Changes in invertebrate assemblage composition in benthic and hyporheic zones during a severe supraseasonal drought
No full textDroughts are unpredictable disturbances characterized in streams by declining flow, reduced habitat availability, and deteriorating abiotic conditions. Such events typically reduce benthic invertebrate taxon richness and modify assemblage composition, but little is known about how hyporheic invertebrate assemblages respond to drought or how these responses relate to changes in benthic assemblages. We hypothesized that taxon richness (diversity) and variability (as within-site diversity) in benthic assemblage composition would decline as drought proceeded, whereas concurrent changes in hyporheic assemblages would be lower in this more stable environment. We predicted that benthic assemblage composition between sites would converge as epigean taxa were selectively eliminated, whereas between-site hyporheic diversity would change little. We sampled benthic and hyporheic invertebrates concurrently from 4 sites along a groundwater-fed stream during the final stages of a severe supraseasonal drought punctuated by a record heat wave. Abiotic conditions in benthic habitats deteriorated as flow declined, but changes were less pronounced in the hyporheic zone. Benthic diversity declined during drought, whereas hyporheic diversity changed little. However, benthic within-site diversity increased as the drought progressed because of localized variation in the abundance of common taxa. Temporal trends in hyporheic diversity were less consistent. Benthic assemblages at individual sites became more similar, especially during the heat wave, reflecting low diversity and abundance. Hyporheic assemblages changed markedly because of temporary increases in abundances of epigean and hypogean amphipods. These contrasting responses of benthic and hyporheic assemblages to drought should be recognized when developing management strategies for drought-impacted streams
The back home trial: general practitioner-supported leaflets may change back pain behavior
No full textStudy Design: a single-blind randomized controlled trial of a leaflet developed for people with acute low back pain was compared with the usual general practitioner management of back pain.Objective: to test the effectiveness of a patient information leaflet on knowledge, attitude, behavior, and function.Summary of Background Data: despite the commonality of back pain in general practice, little evidence on the effectiveness of simple interventions such as leaflets and advice on self-management has been reported. On the basis of a five-stage needs analysis, a simple leaflet was developed that considered the views of patients and health professionals.Methods: for this study, 64 patients with acute back pain were assigned to the leaflet or control group. The participants were visited at home after 2 days, 2 weeks, then 3, 6, and 12 months, where they completed a range of self-report measures. Behavioral aspects were discreetly recorded by a "blinded" researcher. Primary outcomes were knowledge, attitude, behavior, and function.Results: in all, 272 home visits were undertaken. The findings show that at 2 weeks, knowledge about sitting posture was greater in the leaflet group (P = 0.006), which transferred to a behavioral difference (sitting with lumbar lordosis support) when participants were unaware that they were being observed (P = 0.009). This difference remained significant at 3 months. Patients in the leaflet group also were better at maintaining a wide base of support when lifting a light object than the control subjects throughout all five assessments. There were no significant differences in the functional outcomes tested.Conclusions: this trial demonstrates that written advice for patients can be a contributory factor in the initial general practitioner consultation because it may change aspects of knowledge and behavior. This has implications for the management of acute back pain, with potential health gain.<br/
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