Body mass index and self-reported compliance with general health care.

OBJECTIVES: The relation between elevated body mass index (BMI)/overweight-obesity and compliance with health care remains unclear; some studies have demonstrated a relation whereas others have not. To add to the confusion, a number of studies have examined specialized populations (eg, patients with diabetes mellitus) and/or only one parameter of compliance (eg, taking medication). In the present study, we examined primary care outpatients for relations between BMI and multiple parameters of healthcare adherence/compliance. METHODS: Using a cross-sectional approach and a self-report survey methodology, we examined 250 primary care outpatients using three measures of healthcare compliance: conscientiousness in following through with medical treatment; a 5-item questionnaire examining compliance with general healthcare behaviors such as regular dental checkups and arrival to doctors' appointments on time; and the Medical Outcomes Study General Adherence Items, a general measure of compliance with physician directives. RESULTS: With the exceptions of regular dental checkups, on-time arrival for doctors' appointments, and timely completion of laboratory work, the remaining variables demonstrated statistical significance at minimally the P & 0.05 level. CONCLUSIONS: Patients with higher BMIs self-report less willingness to adhere to general healthcare requests/recommendations than patients with lower BMIs.

Childhood bullying and healthcare adherence in adulthood.

BACKGROUND: The relationship between childhood bullying and healthcare adherence in adulthood has been rarely studied, but one published study suggests that being bullied in childhood is related to lower healthcare adherence among adolescents. This previous study examined few adherence variables and was limited to youths. AIMS: In this study, we assessed five variables for childhood bullying as related to seven measures of healthcare adherence among a cohort of adult primary care outpatients. METHOD: Using a cross-sectional, self-report survey methodology in a sample of 263 consecutive internal medicine outpatients, we examined five aspects of bullying and seven aspects of adherence with general healthcare. RESULTS: Being a victim of bullying, type of bullying (emotional, physical), number of years bullied and number of bullies each evidenced no statistical relationships with healthcare adherence. However, being a bully demonstrated several statistical relationships with healthcare adherence, indicating less adherence to instructions provided by healthcare professionals. CONCLUSIONS: Despite all of the deleterious psychological and physical effects of being bullied in childhood, there was no evidence that non-adherence with healthcare in adulthood is one of them. In contrast, bullies evidenced several areas of reduced healthcare adherence.

Borderline personality symptomatology and compliance with general health care among internal medicine outpatients.

OBJECTIVES: The extant literature on borderline personality disorder (BPD) and compliance with mental health treatment contains conflicting findings. However, among those individuals with this type of personality dysfunction, reduced compliance with mental health treatment appears to be the predominant theme. To our knowledge, the relationship between BPD and compliance with general health care has not been studied. In addition, there is no prior study in this area examining a primary care population. METHODS: Using a cross-sectional survey methodology among a sample of internal medicine outpatients (N = 261), we assessed borderline personality symptoms with two self-report measures and general health care compliance or adherence with four self-report measures. RESULTS: With the exception of on-time arrival for doctor appointments, the remaining compliance variables demonstrated statistically significant relationships at the p < 0.01-0.001 levels, with borderline personality symptoms predicting reduced compliance (i.e., conscientiousness with medical treatment, regular dental check-ups, timely completion of laboratory work, following doctor's exercise and nutrition instructions, remembering to take medications, and Medical Outcomes Study General Adherence Score). CONCLUSIONS: Compared with participants without borderline personality symptoms, those participants with such symptoms in this study evidenced lower general health care compliance.

Role of platelet-rich plasma in acceleration of bone fracture healing.

Platelet-rich plasma (PRP) is a common therapy for acceleration of maxillofacial and spinal fusion bone-graft healing. This study analyzes the therapeutic role of PRP during long-bone fracture healing evaluated Lewis rats. Following creation of unilateral open femur fractures, either 500 microL thrombin-activated PRP (PRP treated group) or 500 microL saline (control group) were applied once to the fracture site. Fracture healing was analyzed after 1 and 4 weeks. Following 4 weeks of fracture healing, radiographic analysis demonstrated higher callus to cortex width ratio (P < 0.05) in the PRP group (PRP: 1.65 +/- 0.06; control: 1.48 +/- 0.05). Three-point load bearing showed increased bone strength following PRP treatment (PRP: 60.85 +/- 6.06 Newton, control: 47.66 +/- 5.49 Newton). Fracture histology showed enhanced bone formation in the PRP group. Immunohistochemistry and Western-blotting demonstrated healing-associated changes in transforming growth factor (TGF)-beta1 and bone morphogenetic protein (BMP)-2. Our results suggest that PRP accelerates bone fracture healing of rat femurs via modulation of TGF-beta1 and BMP-2 growth factor expression.