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This study was designed to demonstrate the advantage of adding cancer barriers to components of decision-making in the transtheoretical model (TTM). In study 1, questionnaires were completed by 139 breast cancer survivors including decisional balance, cancer-related barriers and stages of readiness. In study 2, efficiency of directly tackling cancer-related barriers through motivational-style conversation was tested in a quasi-experimental design. From study 1, all decisionmaking variables were related to stages of readiness, but cancer-related barriers were the sole predictors of engagement in physical activity. Out of the three groups of study 2, only the group with motivational-style conversation displayed a significant progress for engagement in physical activity. Demonstrating that cancer-related barriers predict stage of change above the effects of the two components of decisional balance provides a validation of positions that put cancer-related barriers as uniquely related to stages of change, and suggests that adding them in decision making variables in TTM's model can provide a genuinely new contribution to the understanding of physical activity adherence. Regarding implication for cancer survivors, these results suggest that in order to stimulate progress in early stages of change, a greater emphasis may be needed on reducing cancer-related barriers. [ABSTRACT FROM AUTHOR]

Introduction: Nursing training in communicative skills can increase compliance and improve dietary control in Diabetes Mellitus-2 (DM-2). Our research group designed an adapted diet for patients from Pakistan with DM-2 where we found an improvement in adherence and dietary compliance. Objectives: Assess the effectivity of an adapted diet for Pakistani patients in the metabolic control of DM2. Evaluate the effectiveness of the diet on diabetic complications. Methodology: Random clinical trial developed in three primary healthcare centers: Besòs, Raval Sud in Barcelona and Fondo in Santa Coloma de Gramanet. Inclusion criteria: adult patients with DM2, Pakistani origin and HbA1c > 8%. This study falls upon professional-patient communication through detailed explanation of the diet.Random consecutive sample. The intervention group received the adapted diet and the control group the usual measures of DM2 control. Preliminary results: Initial phase of the study. We recruited 19 patients. 64.7% have poor metabolic control (HbA1c mean = 9.9, standard deviation = 2.41). Discussion: We appreciate an improvement in nurse-patient communication, better compliance with the recommendations and a patient satisfaction with the first visits. [ABSTRACT FROM AUTHOR]

Objectives: Buruli ulcer (BU) is a tropical skin disease caused by infection with Mycobacterium ulcerans, which is currently treated with 8 weeks of streptomycin and rifampicin. The evidence to treat BU for a duration of 8 weeks is limited; a recent retrospective study from Australia suggested that a shorter course of antimicrobial therapy might be equally effective. We studied the outcomes of BU in a cohort of Ghanaian patients who defaulted from treatment and as such received less than 8 weeks of antimicrobial therapy.Methods: A number of days of antimicrobial therapy and patient and lesion characteristics were recorded from charts from a cohort of BU patients treated at Nkawie-Toase hospital between 2008 and 2012. Patients who defaulted from treatment were retrieved, and lesion characteristics and functional limitations were recorded.Results: About 54% of patients defaulted from therapy or wound care. Forty-seven defaulters with follow-up completed had received <56 days of antibiotics. 84% of these patients healed after 32 days or less of antibiotics. There appeared to be an increased rate of healing in smaller lesions; 94% of WHO category I lesions had healed after 32 days or less of antibiotics.Conclusion: Although numbers were small, and a potential for bias exists, our findings suggest that a reduction in the duration of antimicrobial therapy in BU in small, early lesions is feasible. These findings can serve as a basis for future well-designed studies. [ABSTRACT FROM AUTHOR]

Objective To enable the human African trypanosomiasis (HAT) control program of the Democratic Republic of the Congo to generate data on treatment outcomes, an electronic database was developed. The database was piloted in two provinces, Bandundu and Kasai Oriental. In this study, we analysed routine data from the two provinces for the period 2006-2008. Methods Data were extracted from case declaration cards and monthly reports available at national and provincial HAT coordination units and entered into the database. Results Data were retrieved for 15 086 of 15 741 cases reported in the two provinces for the period (96%). Compliance with post-treatment follow-up was very poor in both provinces; only 25% had undergone at least one post-treatment follow-up examination, <1% had undergone the required four follow-up examinations. Relapse rates among those presenting for follow-up were high in Kasai (18%) but low in Bandundu (0.3%). Conclusions High relapse rates in Kasai and poor compliance with post-treatment follow-up in both provinces are important problems that the HAT control program urgently needs to address. Moreover, in analogy to tuberculosis control programs, HAT control programs need to adopt a recording and reporting routine that includes reporting on treatment outcomes. [ABSTRACT FROM AUTHOR]