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Purpose: The purpose of this study was to explore the impact of recurrent bacterial vaginosis (BV) and its treatment on quality of life (QOL), acceptance of current treatment options, and psychosocial issues related to lifestyle practices associated with BV. Data sources: Qualitative and quantitative data were obtained from 23 African American women with recurrent BV. Participants completed a short survey, developed by the researchers based on a prior study which examined factors associated with recurrent BV, and a one-on-one interview assessing the impact of BV, current treatment modalities, and lifestyle practices related to recurrent BV. Conclusions: Emerging themes suggest that recurrent BV is associated with psychosocial issues that are currently not addressed in a typical office visit. Reported feelings of shame and embarrassment often cause women to engage in hypervigilant routines of hygiene that negatively impact their professional, personal, and intimate relationships, significantly affecting their QOL. Implications for practice: Without proper education, advice, and support, BV is perpetuated by lifestyle practices leading to recurrent infection and associated symptoms. With proper guidance, it is expected that women with recurrent BV will see an improvement in their QOL, with fewer complications from BV infection, and healthy relationships with intimate partners, family, and friends. [ABSTRACT FROM AUTHOR]

OBJECTIVE: While there is ongoing debate about the role of physician-offered prayer during the physician-patient encounter, many physicians feel inclined to include prayer in their practices. This randomized-controlled trial evaluated patients' acceptance of physician-offered prayer in a family practice setting, and the impact of physician-offered prayer on patient satisfaction with the physician-patient encounter. METHOD: Subjects were 137 patients in an urban, largely African American, Southeastern family medicine practice who were randomized to receive usual care plus an offer of physician-led prayer or usual care alone. Satisfaction surveys were administered following the clinical encounter. The outcomes of interest were the rate of acceptance of physician-offered prayer and the impact of the prayer offer on patient satisfaction. Personal characteristics and satisfaction scores for patients accepting prayer were compared to those for patients declining prayer. RESULTS: Over 90% of patients accepted the offer of prayer. The offer of prayer had no significant impact on patient satisfaction scores. The number of patients declining prayer was too low to permit comparison of prayer decliners with acceptors. CONCLUSIONS: This small pilot trial demonstrated that patient responses to spiritual interventions by physicians can be evaluated using randomized study designs. A large majority of patients accepted an offer of physician-led prayer, but no significant short-term impact on patient satisfaction was detected. Future research with larger sample sizes and more diverse patient populations should evaluate the effects of physician-offered prayer on the physician-patient relationship. Difficulties in conducting such research are discussed. [ABSTRACT FROM AUTHOR]

Background: Poorly managed diabetes mellitus increases health care expenditures and negatively impacts health outcomes. There are 34 million people living with diabetes in the United States with a direct annual medical cost of $237 billion. The patient-centered medical home (PCMH) was introduced to transform primary care by offering team-based care that is accessible, coordinated, and comprehensive. Although the PCMH is believed to address multiple gaps in delivering care to people living with chronic diseases, the research has not yet reported clear benefits for managing diabetes., Objective: The study reviews the scientific literature about diabetes mellitus outcomes reported by PCMHs, and understands the impact of team-based care, interdisciplinary communication, and care coordination strategies on the clinical, financial, and health-related outcomes., Methods: The systematic review was performed according to the Cochrane method and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Eight databases were systematically searched for articles. The Oxford Centre for Evidence-based Medicine Levels of evidence and the Critical Appraisal Skills Programme systematic review checklist were used to evaluate the studies., Results: The search resulted in 596 articles, of which 24 met all the inclusion criteria. Care management resulted in more screenings and better preventive care. Pharmacy-led interventions and technology were associated with positive clinical outcomes, decreased utilization, and cost savings. Most studies reported decreased emergency room visits and less inpatient admissions., Conclusion: The quality and strength of the outcomes were largely inconclusive about the overall effectiveness of the PCMH. Defining and comparing concepts across studies was difficult as universal definitions specific to the PCMH were not often applied. More research is needed to unpack the care model of the PCMH to further understand how the individual key components, such as care bundles, contribute to improved outcomes. Further evaluations are needed for team-based care, communication, and care coordination with comparisons to patient, clinical, health, and financial outcomes., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)