Search

Few studies have defined the association of physician-patient communication with physical activity levels in patients with peripheral arterial disease. We hypothesized that a face-to-face intervention versus video watching would improve physical activity levels in patients with peripheral arterial disease. The authors conducted a randomized trial involving 2 interventions. The face-to-face intervention included a brief dialogue with patients to understand their perceptions of peripheral arterial disease and importance of walking. The comparison group watched a video that included an overview of peripheral arterial disease. The primary outcome was changed from baseline to follow-up in levels of physical activity. Fifty-one patients with peripheral arterial disease were randomized. There were no statistically significant differences between the 2 groups in reported activity level or walking ability at 12 weeks. For within group changes, the patients in the video-watching group improved their walking speed (8.5%; SD = 4.1; P = .05). Patients with peripheral arterial disease may benefit from the use of an educational video to increase the use of unsupervised physical activity. Further research is needed to identify interventions that can increase the use of unsupervised physical activity in this population. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To describe the meaning of active participation from the patient's perspective. METHODS: We used a narrative framework to analyze transcripts generated from 16 qualitative open-ended, semi-structured interviews with primary care patients in Houston, Texas. RESULTS: Patients' illness narratives reflected several themes related to patient participation. These included patients' perspectives of illness (i.e., how central the illness is in the patient's overall life story and how changeable the patient believes their illness to be) and aspects of actions pursued in the context of patients' illness narratives (i.e., the degree of illness-related activity that a patient engages in and the role of partnership with the patient's physician in health decision making and illness management). The relationships among these themes explained a limited number of distinct illness-management strategies pursued by patients. CONCLUSION: Our findings revealed a level of complexity to patients' healthcare participation that has not been previously described. Patients' illness-management strategies were explained by four thematic story elements in dynamic interplay with unique variations for each individual. Further research is needed to explore how these story elements influence communication between patients and physicians. PRACTICE IMPLICATIONS: By understanding the nature of and relationships between the thematic elements in patients' illness narratives, practitioners will be able to better inform their negotiations with patients regarding participation in healthcare. [ABSTRACT FROM AUTHOR]

Canine separation anxiety is a common behavioral problem presented to veterinarians. Associated behaviors are distressing to both dog and owner, have the potential to disrupt the human-companion animal bond, and may lead to euthanasia. The results of this study demonstrate the clinical efficacy and safety of Reconcile (fluoxetine, 1 to 2 mg/kg/day [0.45 to 0.91 mg/lb/day]), in conjunction with behavior management, for the treatment of canine separation anxiety. The beef flavored chewable formulation was palatable to treated dogs and easy to administer. This study provides to veterinarians and owners valuable information about an effective separation anxiety treatment plan that combines use of Reconcile with behavior modification.

To test the predictive value of a doll and an artificial hand, reactions of dogs (n=100) were compared to histories of behavior toward children. Each dog's reaction to the doll and the hand was categorized as normal, fearful, fearfully aggressive, or offensively aggressive. Sixty-five percent (n=37) of the dogs that had a normal or no reaction to the stimuli had a history of being good with children. Eighty-eight percent (n=34) of the dogs that had an aggressive reaction to the doll had a history of aggressive behavior toward a child. Dogs that were fearfully aggressive were significantly more likely to show fearful responses to the doll, and dogs that were either dominant or fearfully aggressive were more likely to exhibit aggression of the same type to the hand. The results of this study indicate that the doll and, to a lesser extent, the hand may be useful components in determining the aggressive tendencies of dogs. The results also point out the major limitations, because the false positives and false negatives are too frequent.