A5004351044- Pain Mechanisms and Treatments
- Telemedicine and Telehealth Implementation
- Heart Rate Variability and Autonomic Control
- Pain Management and Placebo Effect
- Health Systems, Economic Evaluations, Quality of Life
- Musculoskeletal pain and rehabilitation
- Chronic Disease Management Strategies
- Mobile Health and mHealth Applications
- Cardiac Health and Mental Health
- Mental Health Treatment and Access
- Diabetes Management and Education
- Pharmacogenetics and Drug Metabolism
- Olfactory and Sensory Function Studies
- Tryptophan and brain disorders
- Health Promotion and Cardiovascular Prevention
- Neural and Behavioral Psychology Studies
- Treatment of Major Depression
- Digital Mental Health Interventions
- Global Health Care Issues
- Metabolism and Genetic Disorders
- Mental Health and Patient Involvement
- Cerebrovascular and Carotid Artery Diseases
- Organ Donation and Transplantation
- Renal Transplantation Outcomes and Treatments
- Blood Pressure and Hypertension Studies
Queen Elizabeth Hospital
2023-2025
University of British Columbia
2021-2024
Vancouver Coastal Health
2022-2024
Vancouver Coastal Health Research Institute
2022-2024
Simon Fraser University
2019-2023
Fraser Health
2023
Positive Living North
2023
The University of Adelaide
2023
University of Virginia
2021
Faculty of Public Health
2019
Background: There is growing interest in telehealth—the use of technology to support the remote delivery health care and promote self-management—as a potential alternative face-to-face for patients with chronic diseases. However, little known about what precipitates telehealth among these patients. Objective: This survey forms part research program develop evaluate intervention two exemplar diseases: depression raised cardiovascular disease (CVD) risk. The was designed explore key factors...
Many countries are exploring the potential of telehealth interventions to manage rising number people with chronic disorders. However, evidence effectiveness is ambiguous. Based on an evidence-based conceptual framework, we developed integrated service (the Healthlines Service) for disorders and assessed its in patients depression. We aimed compare Depression Service plus usual care alone.This study was a pragmatic, multicentre, randomised controlled trial participants recruited from 43...
<h3>Background:</h3> Pharmacogenomic testing to identify variations in genes that influence metabolism of antidepressant medications can enhance efficacy and reduce adverse effects pharmacotherapy for major depressive disorder. We sought establish the cost-effectiveness implementing pharmacogenomic guide prescription antidepressants. <h3>Methods:</h3> developed a discrete-time microsimulation model care pathway disorder British Columbia, Canada, evaluate effectiveness from public payer's...
To develop a conceptual model for effective use of telehealth in the management chronic health conditions, and to this evaluate an intervention people with two exemplar conditions: raised cardiovascular disease risk depression.
<b>Objective</b> To assess whether non-clinical staff can effectively manage people at high risk of cardiovascular disease using digital health technologies. <b>Design</b> Pragmatic, multicentre, randomised controlled trial. <b>Setting</b> 42 general practices in three areas England. <b>Participants</b> Between 3 December 2012 and 23 July 2013 we recruited 641 adults aged 40 to 74 years with a 10 year 20% or more, no previous event, least one modifiable factor (systolic...
Carotid baroreceptor stimulation has been shown to dampen pain. This study tested, in 40 normotensive adults, the hypothesis that pain is lower during systole when arterial maximal than diastole minimal. The sural nerve was stimulated electrocutaneously obtain a nociceptive flexion reflex (NFR) threshold, and then delivered for 28 trials at 100% NFR threshold seven intervals after R-wave. Nociceptive responding indexed by electromyographic (EMG) activity elicited biceps femoris. Significant...
The visceral afferent feedback hypothesis proposes that sensorimotor function is impaired by cortical inhibition associated with increased baroreceptor activation. This study the first to examine effects of naturally occurring variations in activity across cardiac cycle on cutaneous sensory detection thresholds. In each trial, an electrocutaneous stimulus was delivered index finger at one three intervals (0, 300, 600 ms) after R-wave electrocardiogram. Separate interleaving up-down...
Telehealth interventions use information and communication technology to provide clinical support. Some randomised controlled trials of telehealth report high patient decline rates. A large study was undertaken determine which patients participate in their reasons for doing so. Two linked were undertaken, one with depression raised cardiovascular disease risk (the Healthlines Study). The compared usual care additional support delivered by the telephone internet. Patients recruited via...
Fecal microbiota transplantation (FMT) sourced from a bank of prescreened anaerobically processed frozen donor stool has been available in South Australia since 2013. This study aimed to evaluate the real-world clinical and safety outcomes FMT for recurrent, refractory, and/or severe or fulminant Clostridioides difficile infection (CDI) facilitated via this centralized facility. Donor screening test data were prospectively collected on all donors who passed prescreening evaluations between...
A baroreflex mechanism may explain hypertensive hypoalgesia. At rest, arterial baroreceptors are stimulated during the systolic upstroke of pressure pulse wave. This study examined effects naturally occurring variations in baroreceptor activity cardiac cycle on an objective measure pain, nociceptive flexion reflex (NFR). Two interleaved up–down staircase procedures determined separate NFR thresholds systole and diastole 36 healthy, normotensive young adults. On odd‐numbered trials, sural...
Evidence suggests that the arterial baroreceptors modulate pain. To examine whether cortical processing of nociception is modulated by natural variations in baroreceptor stimulation during cardiac cycle, peak-to-peak amplitudes N2–P2 pain-related potential and pain ratings were recorded response to noxious laser at different times cycle 10 healthy males. Significant occurred across with smaller midcycle, indicating was attenuated systole compared diastole. Pain did not vary cycle. These data...
Abstract Hypertension is characterized by cognitive deficits. As evidence for impaired psychomotor speed, including slower reaction times, mixed, we aimed to provide a detailed investigation of simple time in hypertension. Pre‐motor and motor times were measured across the cardiac cycle 30 hypertensives 29 normotensives determine effects phasic tonic blood pressure on performance. Auditory, visual, tactile tasks completed with stimuli presented 0, 300, 600 ms after R‐wave electrocardiogram....
The forehead was studied as a possible sampling site for capturing changes in volatile organic compound (VOC) profiles associated with psychological-stress. Skin-VOCs were sampled polydimethylsilicone (PDMS)-coupon and the resulting VOCs recovered analysed two-stage thermal desorption gas chromatography-mass spectrometry. Fifteen young adult volunteers (19 years-26 years) participated two interventions run randomised crossover design. One intervention, termed 'Neutral', required participants...
Abstract The arterial baroreflex may mediate hypertensive hypoalgesia. Carotid baroreceptors can be artificially stimulated by neck suction and inhibited compression. Effects of brief compression on nociceptive responding pain were studied in 25 normotensive adults. sural nerve was electrocutaneously at threshold intensity during systole or diastole combined with suction, compression, no pressure. Nociceptive indexed electromyographic activity elicited the biceps femoris. Participants rated...
As the population ages, more people are suffering from long-term health conditions (LTCs). Health services around world exploring new ways of supporting with LTCs and there is great interest in use telehealth: technologies such as Internet, telephone home self-monitoring. This study aims to evaluate effectiveness cost-effectiveness a telehealth intervention delivered by NHS Direct support patients LTCs. Two randomized controlled trials will be conducted parallel, recruiting two exemplar...
To investigate the cost-effectiveness of a telehealth intervention for primary care patients with raised cardiovascular disease (CVD) risk.
Abstract Inhibition of the nociceptive flexion reflex during systole could be due to activation arterial baroreceptors. Physiological arousal, characterized by raised blood pressure, increases afferent activity from baroreceptors but attenuates baroreflex. This study examined effects arousal on systolic inhibition in 38 adults. The threshold current elicit leg was determined, and participants were stimulated at intensity for 12 trials two conditions: rest (low arousal) mental arithmetic...
Background: Evidence of benefit for telehealth chronic conditions is mixed. Two linked randomized controlled trials tested the Healthlines Service 2 conditions: depression and high risk cardiovascular disease (CVD). This new service consisted regular telephone calls from nonclinical, trained health advisers who followed standardized scripts generated by interactive software. Advisors facilitated self-management supporting participants to use Web-based resources helped optimize medication,...
This study sought to identify if detectable changes in human breath profiles may be observed following a psychological intervention designed induce stress, paced auditory serial addition test (PASAT). Breath samples were collected from 22 participants (10 male and 12 female) double cross-over randomized design with two experimental interventions. One required listen classical music chosen neutral. The other undertake PASAT that induced cardiovascular responses consistent acute stress. Both...