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Khayer E, Zarei R, Damghanian M, Bőthe B, Farnam F. Compulsive sexual behaviour in Iranian married women: Prevalence, sociodemographic, sexual, and psychological predictors across-country. J Behav Addict 2024; 13:495-505. [PMID: 38551674 PMCID: PMC11220821 DOI: 10.1556/2006.2024.00009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 01/31/2024] [Accepted: 03/04/2024] [Indexed: 04/19/2024] Open
Abstract
Background and Aims This study addresses the scarcity of research on Compulsive Sexual Behavior Disorder (CSBD) in non-Western cultures and women, exploring its prevalence, sociodemographic, sexual history characteristics, and sexual and psychological health factors in Iranian married women. Methods A cross-sectional study involving 772 heterosexual married women was conducted between 2022 and 2023, covering all 31 provinces of Iran. Participants were categorized as CSBD+ (at-risk individuals) and CSBD- (low-risk individuals) based on a pre-established cut-off point of ≥18 by the Compulsive Sexual Behavior Disorder Scale -7. Depression, anxiety, obsessive-compulsive disorder, self-esteem, sexual distress, sexual satisfaction, relationship satisfaction, and sexual dysfunction were assessed as psychological and sexual health variables by standardized scales. Results The prevalence of CSBD was 3.8% in women. Linear regression analysis showed that lower education, being jobless, substance use, pornography use, paraphilic behaviors, conflict on sex frequency, relationship, orgasm and sexual dissatisfaction, higher sexual arousal, depression, and obsessive-compulsive symptoms were positively associated with CSBD. The univariate analysis, at a stringent significance level of 0.005, mirrored the regression findings. Additionally, women with CSBD+ exhibited lower religiousness and higher anxiety compared to those without CSBD-. Discussion and Conclusions Raising awareness of CSBD is crucial for health systems and individuals for better policy-making and help-seeking behavior. Identifying risk factors like substance use presents opportunities for prevention, and the association of CSBD with sexual and mental health variables suggests addressing co-occurring issues for improved treatment outcomes. Recognizing culture and gender-specific sexual and psychological correlates enables targeted and effective treatment approaches.
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Affiliation(s)
- Elnaz Khayer
- Department of Reproductive Health and Midwifery, Tehran University of Medical Sciences, TehranIran
| | - Rezvan Zarei
- Department of Reproductive Health and Midwifery, Tehran University of Medical Sciences, TehranIran
| | - Maryam Damghanian
- Department of Reproductive Health and Midwifery, Tehran University of Medical Sciences, TehranIran
- Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Beáta Bőthe
- Department of Psychology, Université de Montréal, Montréal, Canada
- Centre de recherche interdisciplinaire sur les problèmes conjugaux et les agressions sexuelles (CRIPCAS), Université de Montréal, Montréal, Canada
| | - Farnaz Farnam
- Department of Reproductive Health and Midwifery, Tehran University of Medical Sciences, TehranIran
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Basu P, Mwanahamuntu M, Pinder LF, Muwonge R, Lucas E, Nyambe N, Chisele S, Shibemba AL, Sauvaget C, Sankaranarayanan R, Prendiville W, Parham GP. A portable thermal ablation device for cervical cancer prevention in a screen-and-treat setting: a randomized, noninferiority trial. Nat Med 2024:10.1038/s41591-024-03080-w. [PMID: 38918630 DOI: 10.1038/s41591-024-03080-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 05/17/2024] [Indexed: 06/27/2024]
Abstract
Implementing standard-of-care cryotherapy or electrosurgical excision to treat cervical precancers is challenging in resource-limited settings. An affordable technological alternative that is as effective as standard-of-care techniques would greatly improve access to treatment. This randomized controlled trial aims to demonstrate the noninferiority efficacy of a portable, battery-driven thermal ablation (TA) device compared to cryotherapy and electrosurgical excision (large loop excision of transformation zone (LLETZ)) to treat cervical precancer in a screen-and-treat program in Zambia. A total of 3,124 women positive on visual inspection with acetic acid and eligible for ablative therapy were randomized to one of the treatment arms. Human papillomavirus (HPV) testing was performed at baseline and at the follow-up. The primary outcome was treatment success, defined as either type-specific HPV clearance at the follow-up in participants positive for HPV at baseline, or a negative visual inspection with acetic acid test for those who had a negative HPV test at baseline. After a median follow-up of 12 months, treatment success rates were 74.0%, 71.1% and 71.4% for the TA, cryotherapy and LLETZ arms, respectively, thus demonstrating noninferiority (P = 0.83). TA was a safe and well-accepted procedure. Only 3.6% of those randomized to TA reported moderate-to-severe pain, compared to 6.5% and 1.9% for the cryotherapy and LLETZ arms, respectively. Thus, our randomized controlled trial demonstrates the safety and efficacy of TA, which is not inferior to cryotherapy or surgical excision.ClinicalTrials.gov registration: NCT02956239 .
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Affiliation(s)
- Partha Basu
- Early Detection, Prevention & Infections Branch, International Agency for Research on Cancer, Lyon, France.
| | - Mulindi Mwanahamuntu
- Department of Obstetrics and Gynecology, University Teaching Hospital, Lusaka, Zambia
| | - Leeya F Pinder
- Department of Obstetrics and Gynecology, University Teaching Hospital, Lusaka, Zambia
| | - Richard Muwonge
- Early Detection, Prevention & Infections Branch, International Agency for Research on Cancer, Lyon, France
| | - Eric Lucas
- Early Detection, Prevention & Infections Branch, International Agency for Research on Cancer, Lyon, France
| | - Namakau Nyambe
- Department of Obstetrics and Gynecology, University Teaching Hospital, Lusaka, Zambia
| | - Samson Chisele
- Department of Obstetrics and Gynecology, University Teaching Hospital, Lusaka, Zambia
| | | | - Catherine Sauvaget
- Early Detection, Prevention & Infections Branch, International Agency for Research on Cancer, Lyon, France
| | | | - Walter Prendiville
- Early Detection, Prevention & Infections Branch, International Agency for Research on Cancer, Lyon, France
| | - Groesbeck P Parham
- Department of Obstetrics and Gynecology, University Teaching Hospital, Lusaka, Zambia
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Mills CM, Boyar L, O'Flaherty JA, Keller HH. Social Factors Associated With Nutrition Risk in Community-Dwelling Older Adults in High-Income Countries: Protocol for a Scoping Review. JMIR Res Protoc 2024; 13:e56714. [PMID: 38696645 PMCID: PMC11234053 DOI: 10.2196/56714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 03/10/2024] [Accepted: 04/02/2024] [Indexed: 05/04/2024] Open
Abstract
BACKGROUND In high-income countries (HICs), between 65% and 70% of community-dwelling adults aged 65 and older are at high nutrition risk. Nutrition risk is the risk of poor dietary intake and nutritional status. Consequences of high nutrition risk include frailty, hospitalization, death, and reduced quality of life. Social factors (such as social support and commensality) are known to influence eating behavior in later life; however, to the authors' knowledge, no reviews have been conducted examining how these social factors are associated with nutrition risk specifically. OBJECTIVE The objective of this scoping review is to understand the extent and type of evidence concerning the relationship between social factors and nutrition risk among community-dwelling older adults in HICs and to identify social interventions that address nutrition risk in community-dwelling older adults in HICs. METHODS This review will follow the scoping review methodology as outlined by the JBI Manual for Evidence Synthesis and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. The search will include MEDLINE (Ovid), CINAHL, PsycINFO, and Web of Science. There will be no date limits placed on the search. However, only resources available in English will be included. EndNote (Clarivate Analytics) and Covidence (Veritas Health Innovation Ltd) will be used for reference management and removal of duplicate studies. Articles will be screened, and data will be extracted by at least 2 independent reviewers using Covidence. Data to be extracted will include study characteristics (country, methods, aims, design, and dates), participant characteristics (population description, inclusion and exclusion criteria, recruitment method, total number of participants, and demographics), how nutrition risk was measured (including the tool used to measure nutrition risk), social factors or interventions examined (including how these were measured or determined), the relationship between nutrition risk and the social factors examined, and the details of social interventions designed to address nutrition risk. RESULTS The scoping review was started in October 2023 and will be finalized by August 2024. The findings will describe the social factors commonly examined in the nutrition risk literature, the relationship between these social factors and nutrition risk, the social factors that have an impact on nutrition risk, and social interventions designed to address nutrition risk. The results of the extracted data will be presented in the form of a narrative summary with accompanying tables. CONCLUSIONS Given the high prevalence of nutrition risk in community-dwelling older adults in HICs and the negative consequences of nutrition risk, it is essential to understand the social factors associated with nutrition risk. The results of the review are anticipated to aid in identifying individuals who should be screened proactively for nutrition risk and inform programs, policies, and interventions designed to reduce the prevalence of nutrition risk. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/56714.
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Affiliation(s)
- Christine Marie Mills
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Liza Boyar
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | | | - Heather H Keller
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
- Schlegel-UW Research Institute for Aging, Waterloo, ON, Canada
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Butler S. Using journalling to support nurses' mental well-being and self-care in challenging times. Nurs Manag (Harrow) 2024:e2136. [PMID: 38915253 DOI: 10.7748/nm.2024.e2136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2024] [Indexed: 06/26/2024]
Abstract
Nurses frequently experience multiple challenges and face numerous demands in their professional role, which may lead to adverse effects such as stress, depression, anxiety and burnout. Therefore, it is important to identify effective and accessible strategies that can support them. This article explores how nurses can use journalling as a tool for navigating the challenges they experience in their practice. It offers a step-by-step guide that provides nurses with an accessible and effective approach to journalling, which they can use to support their mental well-being and self-care.
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Affiliation(s)
- Sarah Butler
- programme director - PGCert Clinical Practice, University of Hull, Hull, England
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McGrew SJ, Thai JM, Woller SJ, Smit T, Rogers AH, Vujanovic AA, Zvolensky MJ. Posttraumatic Stress and Opioid Use and Pain among Individuals with Probable Posttraumatic Stress Disorder and Self-Reported Chronic Pain: The Role of Health Literacy. Subst Use Misuse 2024:1-8. [PMID: 38914534 DOI: 10.1080/10826084.2024.2369164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
BACKGROUND Chronic pain and opioid misuse are a prevalent comorbidity with deleterious health outcomes. Growing work indicates that posttraumatic stress disorder (PTSD) can increase the risk for chronic pain and opioid misuse and dependence. However, there is little understanding of social determinants of health (SDoH) that may account for interrelations of PTSD with chronic pain and opioid misuse and dependence. Health literacy is one relevant SDoH construct, reflecting the ability to gather, process, and comprehend health-related information required to engage in a healthcare setting. OBJECTIVE The purpose of the present cross-sectional study was to examine the indirect effect of health literacy in the association between PTSD and opioid misuse, opioid dependence, pain intensity, and pain disability. METHOD The sample included 142 adults (Mage = 35.2, SD = 9.9; 67.4% female; 70.1% White/Caucasian) with self-reported chronic pain and probable PTSD who were using opioid medication. RESULTS Results demonstrated that PTSD symptom severity had a small indirect effect on opioid misuse and opioid dependence via health literacy; no indirect effects were evident for pain intensity and disability. CONCLUSION The present investigation provides evidence that health literacy may serve as an important explanatory factor in associations between PTSD symptom severity and opioid misuse and dependence among adults with co-occurring probable PTSD and chronic pain.
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Affiliation(s)
- Shelby J McGrew
- Department of Psychological & Brain Sciences, Texas A&M University, College Station, TX, USA
| | - Jessica M Thai
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Savannah J Woller
- Department of Psychological & Brain Sciences, Texas A&M University, College Station, TX, USA
| | - Tanya Smit
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Andrew H Rogers
- Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, WA, USA
- Seattle Children's Hospital, Seattle Children's Research Institute, Seattle, WA, USA
| | - Anka A Vujanovic
- Department of Psychological & Brain Sciences, Texas A&M University, College Station, TX, USA
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, TX, USA
- Department of Behavioral Science, The University of Texas Maryland Anderson Cancer Center, Houston, TX, USA
- HEALTH Institute, University of Houston, Houston, TX, USA
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Omar M, Soffer S, Charney AW, Landi I, Nadkarni GN, Klang E. Applications of large language models in psychiatry: a systematic review. Front Psychiatry 2024; 15:1422807. [PMID: 38979501 PMCID: PMC11228775 DOI: 10.3389/fpsyt.2024.1422807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Accepted: 06/05/2024] [Indexed: 07/10/2024] Open
Abstract
Background With their unmatched ability to interpret and engage with human language and context, large language models (LLMs) hint at the potential to bridge AI and human cognitive processes. This review explores the current application of LLMs, such as ChatGPT, in the field of psychiatry. Methods We followed PRISMA guidelines and searched through PubMed, Embase, Web of Science, and Scopus, up until March 2024. Results From 771 retrieved articles, we included 16 that directly examine LLMs' use in psychiatry. LLMs, particularly ChatGPT and GPT-4, showed diverse applications in clinical reasoning, social media, and education within psychiatry. They can assist in diagnosing mental health issues, managing depression, evaluating suicide risk, and supporting education in the field. However, our review also points out their limitations, such as difficulties with complex cases and potential underestimation of suicide risks. Conclusion Early research in psychiatry reveals LLMs' versatile applications, from diagnostic support to educational roles. Given the rapid pace of advancement, future investigations are poised to explore the extent to which these models might redefine traditional roles in mental health care.
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Affiliation(s)
- Mahmud Omar
- Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Shelly Soffer
- Internal Medicine B, Assuta Medical Center, Ashdod, Israel
- Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | | | - Isotta Landi
- Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Girish N Nadkarni
- Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Eyal Klang
- Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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Moein S, Peterson EW, Rice LA. Factors associated with fear of falling and fall-related injuries among people who use wheelchairs and motorized mobility scooters: a cross-sectional study. Disabil Rehabil 2024:1-9. [PMID: 38910322 DOI: 10.1080/09638288.2024.2365984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 06/05/2024] [Indexed: 06/25/2024]
Abstract
PURPOSE To identify the factors associated with the fear of falling (FOF) and fall-related injuries (FRI) among full-time wheelchair and motorized mobility scooter (WC/S) users with various health conditions. METHODS This cross-sectional study included participants (≥18 years old) who used WC/S for at least one year for ≥ 75% of mobility and had a history of ≥ 1 fall in the past three years. Logistic regression models identified factors associated with FOF (yes/no) and FRI (yes/no) during the past year. Data on demographics, prior falls, mental health, environmental accessibility, and WC/S usage were used as independent variables. RESULTS Among 156 participants, 96% reported at least one fall within the past year, among whom 94.6% reported FOF, and 74% reported FRI within the same period. FOF was associated with fall incidence in the past year (OR = 17.75, p = 0.001). FRI was associated with higher levels of anxiety (OR = 1.15, p = 0.003) and fewer hours of WC/S use per week (OR = 0.98, p = 0.012). CONCLUSION This study highlights the high prevalence of FOF and FRI among WC/S users who had falls. The findings emphasized the relation between prior fall experiences and FOF and underscored the significance of addressing anxiety symptoms and WC/S usage in relation to FRI.
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Affiliation(s)
- Sahel Moein
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Elizabeth W Peterson
- Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL, USA
| | - Laura A Rice
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA
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Al-Wathinani AM, Dhafar YO, Aljarallah SA, Alqahtani MS, Alamri FA, Aljohani AO, Alanazi MD, Arbaein TJ, Zaidan AM, Aljuaid M, Goniewicz K. Healthcare Providers' Experience with Saudi Arabia's 937 Virtual Medical Call Centers and Telehealth. J Multidiscip Healthc 2024; 17:2949-2960. [PMID: 38933694 PMCID: PMC11203774 DOI: 10.2147/jmdh.s467172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 06/14/2024] [Indexed: 06/28/2024] Open
Abstract
Introduction This cross-sectional descriptive study evaluates the experiences and perceptions of healthcare providers (HCPs) regarding the 937 medical call center in Saudi Arabia, a key telemedicine initiative. Aim To assess HCP satisfaction, identify challenges, and provide recommendations for improvement. Methods Conducted from November 20th to December 15th, 2022, the study surveyed 454 HCPs, achieving a 90.5% response rate. Results A majority (86.8%) of respondents were satisfied with the call center, valuing its ease of use and effectiveness in healthcare delivery. However, challenges such as the accuracy of remote medical assessments, the need for clearer telehealth regulations, and concerns over management support and consultation overlaps were identified. The study also highlights the importance of ongoing support and updates, comprehensive telehealth regulations, integration of more medical specialties, and improvements in system integration and data confidentiality. Conclusion The study underscores the need for strategic enhancements to the 937 call center to further improve healthcare accessibility and efficiency in Saudi Arabia. These enhancements are vital for aligning telehealth services with Saudi Arabia's healthcare objectives under Saudi Vision 2030.
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Affiliation(s)
- Ahmed M Al-Wathinani
- Department of Emergency Medical Services, Prince Sultan bin Abdulaziz College for Emergency Medical Services, King Saud University, Riyadh, 11541, Saudi Arabia
| | - Yahia O Dhafar
- SEHA Virtual Hospital, Ministry of Health, Riyadh, 1154, Saudi Arabia
| | - Salah A Aljarallah
- Department of Family Medicine, King Khaled University Hospital, King Saud University, Riyadh, Saudi Arabia
| | - Muqbil Saad Alqahtani
- Department of Dentistry, College of Dentistry, King Faisal University, Alhafouf, 36932, Saudi Arabia
| | | | - Awad O Aljohani
- Fresenius Kabi Scientific Office Alsaif Building, Riyadh, 1141, Saudi Arabia
| | - Majed D Alanazi
- Department of Family Medicine, General Directorate of Health Affairs in Riyadh Region, Ministry of Health, Riyadh, 12822, Saudi Arabia
| | - Turky J Arbaein
- Department of Health Administration and Hospitals, College of Public Health and Health Informatics, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Amal M Zaidan
- College of Public Health and Health Informatics, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia, King Abdullah International Medical Research Center’s (KAIMRC), Riyadh, Saudi Arabia
| | - Mohammed Aljuaid
- Department of Health Administration, College of Business Administration, King Saud University, Riyadh, Saudi Arabia
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Moczeniat G, Jankowski M, Duda-Zalewska A, Gujski M. Awareness of Genitourinary Cancers Risk Factors-A 2024 Population-Based Cross-Sectional Study in Poland. Int J Public Health 2024; 69:1607264. [PMID: 38974046 PMCID: PMC11224143 DOI: 10.3389/ijph.2024.1607264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Accepted: 06/10/2024] [Indexed: 07/09/2024] Open
Abstract
Objective This study aimed to assess the awareness of genitourinary cancers risk factors among adults in Poland and to identify factors associated with public awareness of risk factors for genitourinary cancers. Methods This cross-sectional survey was carried out between 1 and 4 March 2024 in a nationwide sample of 2,165 adults in Poland. Quota sampling was used. Data were collected using computer-assisted web interview (CAWI) method. Results Regardless of the type of cancer (kidney, bladder, or prostate cancer), a family history of cancer was the most recognized risk factor indicated by over half of respondents. Over one-third were aware that chemical exposure increases the risk for bladder cancer (39.4%) or prostate cancer (34.2%). Smoking was recognized as a risk factor for kidney cancer by 40.6% of respondents. Female gender, having higher education, being occupationally active and the presence of chronic diseases were the most important factors (p < 0.05) associated with a higher level of awareness of genitourinary cancers risk factors. Conclusion This study revealed gaps in public awareness of genitourinary cancers risk factors among adults in Poland, especially lifestyle-related and workplace-related risk factors.
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Affiliation(s)
- Gabriela Moczeniat
- Department of Public Health, Medical University of Warsaw, Warsaw, Poland
- Department of Urology, Mazovia Hospital Warsaw, Warsaw, Poland
| | - Mateusz Jankowski
- School of Public Health, Centre of Postgraduate Medical Education, Warsaw, Poland
| | | | - Mariusz Gujski
- Department of Public Health, Medical University of Warsaw, Warsaw, Poland
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Chua JYX, Choolani M, Chee CYI, Yi H, Chan YH, Lalor JG, Chong YS, Shorey S. Parents' Perceptions of Their Parenting Journeys and a Mobile App Intervention (Parentbot-A Digital Healthcare Assistant): Qualitative Process Evaluation. J Med Internet Res 2024; 26:e56894. [PMID: 38905628 PMCID: PMC11226932 DOI: 10.2196/56894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 03/16/2024] [Accepted: 04/18/2024] [Indexed: 06/23/2024] Open
Abstract
BACKGROUND Parents experience many challenges during the perinatal period. Mobile app-based interventions and chatbots show promise in delivering health care support for parents during the perinatal period. OBJECTIVE This descriptive qualitative process evaluation study aims to explore the perinatal experiences of parents in Singapore, as well as examine the user experiences of the mobile app-based intervention with an in-built chatbot titled Parentbot-a Digital Healthcare Assistant (PDA). METHODS A total of 20 heterosexual English-speaking parents were recruited via purposive sampling from a single tertiary hospital in Singapore. The parents (control group: 10/20, 50%; intervention group: 10/20, 50%) were also part of an ongoing randomized trial between November 2022 and August 2023 that aimed to evaluate the effectiveness of the PDA in improving parenting outcomes. Semistructured one-to-one interviews were conducted via Zoom from February to June 2023. All interviews were conducted in English, audio recorded, and transcribed verbatim. Data analysis was guided by the thematic analysis framework. The COREQ (Consolidated Criteria for Reporting Qualitative Research) checklist was used to guide the reporting of data. RESULTS Three themes with 10 subthemes describing parents' perceptions of their parenting journeys and their experiences with the PDA were identified. The main themes were (1) new babies, new troubles, and new wonders; (2) support system for the parents; and (3) reshaping perinatal support for future parents. CONCLUSIONS Overall, the PDA provided parents with informational, socioemotional, and psychological support and could be used to supplement the perinatal care provided for future parents. To optimize users' experience with the PDA, the intervention could be equipped with a more sophisticated chatbot, equipped with more gamification features, and programmed to deliver personalized care to parents. Researchers and health care providers could also strive to promote more peer-to-peer interactions among users. The provision of continuous, holistic, and family-centered care by health care professionals could also be emphasized. Moreover, policy changes regarding maternity and paternity leaves, availability of infant care centers, and flexible work arrangements could be further explored to promote healthy work-family balance for parents.
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Affiliation(s)
- Joelle Yan Xin Chua
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Mahesh Choolani
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore, Singapore
| | - Cornelia Yin Ing Chee
- Department of Psychological Medicine, National University Hospital, Singapore, Singapore
| | - Huso Yi
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Yiong Huak Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | | | - Yap Seng Chong
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore, Singapore
| | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Jiang J, Zheng Z. Medical Information Protection in Internet Hospital Apps in China: Scale Development and Content Analysis. JMIR Mhealth Uhealth 2024; 12:e55061. [PMID: 38904994 PMCID: PMC11226934 DOI: 10.2196/55061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 03/23/2024] [Accepted: 05/22/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Hospital apps are increasingly being adopted in many countries, especially since the start of the COVID-19 pandemic. Web-based hospitals can provide valuable medical services and enhanced accessibility. However, increasing concerns about personal information (PI) and strict legal compliance requirements necessitate privacy assessments for these platforms. Guided by the theory of contextual integrity, this study investigates the regulatory compliance of privacy policies for internet hospital apps in the mainland of China. OBJECTIVE In this paper, we aim to evaluate the regulatory compliance of privacy policies of internet hospital apps in the mainland of China and offer recommendations for improvement. METHODS We obtained 59 internet hospital apps on November 7, 2023, and reviewed 52 privacy policies available between November 8 and 23, 2023. We developed a 3-level indicator scale based on the information processing activities, as stipulated in relevant regulations. The scale comprised 7 level-1 indicators, 26 level-2 indicators, and 70 level-3 indicators. RESULTS The mean compliance score of the 52 assessed apps was 73/100 (SD 22.4%), revealing a varied spectrum of compliance. Sensitive PI protection compliance (mean 73.9%, SD 24.2%) lagged behind general PI protection (mean 90.4%, SD 14.7%), with only 12 apps requiring separate consent for processing sensitive PI (mean 73.9%, SD 24.2%). Although most apps (n=41, 79%) committed to supervising subcontractors, only a quarter (n=13, 25%) required users' explicit consent for subcontracting activities. Concerning PI storage security (mean 71.2%, SD 29.3%) and incident management (mean 71.8%, SD 36.6%), half of the assessed apps (n=27, 52%) committed to bear corresponding legal responsibility, whereas fewer than half (n=24, 46%) specified the security level obtained. Most privacy policies stated the PI retention period (n=40, 77%) and instances of PI deletion or anonymization (n=41, 79%), but fewer (n=20, 38.5%) committed to prompt third-party PI deletion. Most apps delineated various individual rights, but only a fraction addressed the rights to obtain copies (n=22, 42%) or to refuse advertisement based on automated decision-making (n=13, 25%). Significant deficiencies remained in regular compliance audits (mean 11.5%, SD 37.8%), impact assessments (mean 13.5%, SD 15.2%), and PI officer disclosure (mean 48.1%, SD 49.3%). CONCLUSIONS Our analysis revealed both strengths and significant shortcomings in the compliance of internet hospital apps' privacy policies with relevant regulations. As China continues to implement internet hospital apps, it should ensure the informed consent of users for PI processing activities, enhance compliance levels of relevant privacy policies, and fortify PI protection enforcement across the information processing stages.
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Affiliation(s)
- Jiayi Jiang
- Law School, Central South University, Changsha, China
| | - Zexing Zheng
- Law School, Central South University, Changsha, China
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Bjerke K, Brænd AM, Fossum GH. Parental Concerns for Children With Cold-like Symptoms With Reduced Access to Evaluation in Primary Care Settings During the COVID-19 Pandemic: A Qualitative Study. J Pediatr Health Care 2024:S0891-5245(24)00137-8. [PMID: 38904595 DOI: 10.1016/j.pedhc.2024.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 05/06/2024] [Accepted: 05/22/2024] [Indexed: 06/22/2024]
Abstract
INTRODUCTION We aimed to explore the concerns of parents when their children had symptoms of infection during the COVID-19 pandemic. METHOD Two Norwegian internet forums were searched for parents' experiences when their children had upper respiratory infection symptoms in 2020-2021. A total of 197 posts were included and analyzed using thematic analysis. RESULTS Parents described COVID-19-related and general worries regarding their children with upper respiratory infection symptoms. The first theme, "It is not 'just a cold' during the pandemic," captures how infection control measures influenced parents' concerns. The second theme, "Concerns and consequences of fever and cold symptoms," describes general parental worries. Varying levels of worries regarding health care services, limitations of family life, and concerns for relatives were highlighted. DISCUSSION Knowledge of parents' concerns about cold symptoms may help primary health care providers target individual patient counseling and provide background information when policymakers develop information material for infection prevention and treatment.
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Higgins DM, O’Leary ST. A World without Measles and Rubella: Addressing the Challenge of Vaccine Hesitancy. Vaccines (Basel) 2024; 12:694. [PMID: 38932423 PMCID: PMC11209163 DOI: 10.3390/vaccines12060694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 05/28/2024] [Accepted: 05/30/2024] [Indexed: 06/28/2024] Open
Abstract
The worldwide elimination of measles and rubella is feasible, but not without overcoming the substantial challenge of vaccine hesitancy. This challenge is complicated by the spread of misinformation and disinformation fueled by rapidly progressing technologies and evolving forms of online communication. The recent COVID-19 pandemic has only added further complexity to this challenge. However, considerable progress has been made in understanding the scope of the problem and the complex factors that influence vaccine hesitancy. Our understanding of evidence-based strategies for addressing vaccine hesitancy has grown significantly, including evidence for effective communication and behavioral interventions. In this article, we review measles and rubella vaccines and vaccine hesitancy. We then provide an overview of evidence-based strategies for addressing vaccine hesitancy, including communication strategies and behavioral interventions. This article is relevant to healthcare professionals, health system leaders, public health professionals, policymakers, community leaders, and any individuals who have a role in addressing vaccine hesitancy in their communities. Finally, we review future directions and major areas of research need.
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Affiliation(s)
| | - Sean T. O’Leary
- Adult and Child Center for Outcomes Research and Delivery Science (ACCORDS), Children’s Hospital Colorado, University of Colorado School of Medicine, Aurora, CO 80045, USA;
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Rojas NK, De Stavola BL, Norris T, Cortina-Borja M, Nugawela MD, Hargreaves D, Dalrymple E, McOwat K, Simmons R, Stephenson T, Shafran R, Pereira SMP. Developing survey weights to ensure representativeness in a national, matched cohort study: results from the children and young people with Long Covid (CLoCk) study. BMC Med Res Methodol 2024; 24:134. [PMID: 38902672 PMCID: PMC11188173 DOI: 10.1186/s12874-024-02219-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 04/15/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Findings from studies assessing Long Covid in children and young people (CYP) need to be assessed in light of their methodological limitations. For example, if non-response and/or attrition over time systematically differ by sub-groups of CYP, findings could be biased and any generalisation limited. The present study aimed to (i) construct survey weights for the Children and young people with Long Covid (CLoCk) study, and (ii) apply them to published CLoCk findings showing the prevalence of shortness of breath and tiredness increased over time from baseline to 12-months post-baseline in both SARS-CoV-2 Positive and Negative CYP. METHODS Logistic regression models were fitted to compute the probability of (i) Responding given envisioned to take part, (ii) Responding timely given responded, and (iii) (Re)infection given timely response. Response, timely response and (re)infection weights were generated as the reciprocal of the corresponding probability, with an overall 'envisioned population' survey weight derived as the product of these weights. Survey weights were trimmed, and an interactive tool developed to re-calibrate target population survey weights to the general population using data from the 2021 UK Census. RESULTS Flexible survey weights for the CLoCk study were successfully developed. In the illustrative example, re-weighted results (when accounting for selection in response, attrition, and (re)infection) were consistent with published findings. CONCLUSIONS Flexible survey weights to address potential bias and selection issues were created for and used in the CLoCk study. Previously reported prospective findings from CLoCk are generalisable to the wider population of CYP in England. This study highlights the importance of considering selection into a sample and attrition over time when considering generalisability of findings.
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Affiliation(s)
- Natalia K Rojas
- Division of Surgery & Interventional Science, Faculty of Medical Sciences, University College London, London, WC1E 6BT, UK.
| | - Bianca L De Stavola
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK
| | - Tom Norris
- Division of Surgery & Interventional Science, Faculty of Medical Sciences, University College London, London, WC1E 6BT, UK
| | - Mario Cortina-Borja
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK
| | - Manjula D Nugawela
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK
| | - Dougal Hargreaves
- Mohn Centre for Children's Health & Wellbeing, School of Public Health, Imperial College London, London, UK
| | - Emma Dalrymple
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK
| | - Kelsey McOwat
- Immunisation Department, Health Security Agency, 61 Colindale Avenue, London, NW9 5EQ, UK
| | - Ruth Simmons
- Immunisation Department, Health Security Agency, 61 Colindale Avenue, London, NW9 5EQ, UK
| | - Terence Stephenson
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK
| | - Roz Shafran
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK
| | - Snehal M Pinto Pereira
- Division of Surgery & Interventional Science, Faculty of Medical Sciences, University College London, London, WC1E 6BT, UK
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Wang C, Jiang H, Chen S, Zhao Y, Li J, Huang C, Zhou Y, Wang Q, Tian X, Li M, Zeng X, Zhao Y, Wu C, Zhao J. Exploring the impact of acute viral exposure on clinical characteristics and antibody profiles in antiphospholipid syndrome: a study in CAPSTONE. Clin Exp Med 2024; 24:130. [PMID: 38888664 PMCID: PMC11189343 DOI: 10.1007/s10238-024-01400-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 06/10/2024] [Indexed: 06/20/2024]
Abstract
The relationship between antiphospholipid syndrome (APS) and acute viral infection, such as SARS-CoV-2, is unclear. This study aims to assess symptoms, antiphospholipid antibody (aPL) fluctuations, and complication risks in APS patients infected with SARS-CoV-2. APS patients from Peking Union Medical College Hospital during the COVID-19 outbreak (October-December 2022) were included. Age- and gender-matched APS patients without infection served as controls. Data on demographics, symptoms, treatments, and serum aPL levels were analyzed. Of 234 APS patients, 107 (45.7%) were infected with SARS-CoV-2. Typical symptoms included high fever (81.3%), cough/expectoration (70.1%), and pharyngalgia (52.3%). Age- and gender-based matching selected 97 patients in either infected or uninfected group. After infection, anti-β-2-glycoprotein I-IgG (aβ2GP1-IgG) increased from 4.14 to 4.18 AU/ml, aβ2GP1-IgM decreased from 9.85 to 7.38 AU/ml, and anticardiolipin-IgA (aCL-IgA) significantly increased with a median remaining at 2.50 APLU/ml. Lupus anticoagulants and other aPLs remained stable. Arterial thrombosis incidence increased from 18 (18.6%) to 21 (21.6%), while venous thrombosis incidence did not change. Additionally, 7 (6.5%) patients presented either new-onset or worsening thrombocytopenia, characterized by a significant decline in platelet count (no less than 10 × 109/L) within two weeks of SARS-CoV-2 infection, all of which recovered within 2 weeks. Acute SARS-CoV-2 infection may induce or worsen thrombocytopenia but does not substantially increase thrombotic events in APS. The process of SARS-CoV-2 infection was related to mild titer fluctuation of aβ2GP1-IgG, aβ2GP1-IgM and aCL-IgA in APS patients, necessitating careful monitoring and management.
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Affiliation(s)
- Chuhan Wang
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Beijing, 100730, China
| | - Hui Jiang
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Beijing, 100730, China
| | - Siyun Chen
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Beijing, 100730, China
| | - Yuan Zhao
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Beijing, 100730, China
| | - Jun Li
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Beijing, 100730, China
| | - Can Huang
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Beijing, 100730, China
- National Clinical Research Center of Dermatologic and Immunologic Diseases (NCRC-DID), Beijing, 100730, China
- Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, 100730, China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Beijing, 100730, China
| | - Yangzhong Zhou
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Beijing, 100730, China
- National Clinical Research Center of Dermatologic and Immunologic Diseases (NCRC-DID), Beijing, 100730, China
- Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, 100730, China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Beijing, 100730, China
| | - Qian Wang
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Beijing, 100730, China
- National Clinical Research Center of Dermatologic and Immunologic Diseases (NCRC-DID), Beijing, 100730, China
- Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, 100730, China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Beijing, 100730, China
| | - Xinping Tian
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Beijing, 100730, China
- National Clinical Research Center of Dermatologic and Immunologic Diseases (NCRC-DID), Beijing, 100730, China
- Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, 100730, China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Beijing, 100730, China
| | - Mengtao Li
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Beijing, 100730, China
- National Clinical Research Center of Dermatologic and Immunologic Diseases (NCRC-DID), Beijing, 100730, China
- Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, 100730, China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Beijing, 100730, China
| | - Xiaofeng Zeng
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Beijing, 100730, China
- National Clinical Research Center of Dermatologic and Immunologic Diseases (NCRC-DID), Beijing, 100730, China
- Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, 100730, China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Beijing, 100730, China
| | - Yan Zhao
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Beijing, 100730, China
- National Clinical Research Center of Dermatologic and Immunologic Diseases (NCRC-DID), Beijing, 100730, China
- Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, 100730, China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Beijing, 100730, China
| | - Chuancong Wu
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Beijing, 100730, China.
- Department of Rheumatology and Immunology, Affiliated Qingyuan Hospital, The Sixth Clinical Medical School, Guangzhou Medical University, Qingyuan People's Hospital, Qingyuan, 511518, Guangdong, China.
| | - Jiuliang Zhao
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Beijing, 100730, China.
- National Clinical Research Center of Dermatologic and Immunologic Diseases (NCRC-DID), Beijing, 100730, China.
- Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, 100730, China.
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Beijing, 100730, China.
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Ferrucci V, Miceli M, Pagliuca C, Bianco O, Castaldo L, Izzo L, Cozzolino M, Zannella C, Oglio F, Polcaro A, Randazzo A, Colicchio R, Galdiero M, Berni Canani R, Salvatore P, Zollo M. Modulation of innate immunity related genes resulting in prophylactic antimicrobial and antiviral properties. J Transl Med 2024; 22:574. [PMID: 38886736 PMCID: PMC11184722 DOI: 10.1186/s12967-024-05378-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 06/06/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND The innate immunity acts during the early phases of infection and its failure in response to a multilayer network of co-infections is cause of immune system dysregulation. Epidemiological SARS-CoV-2 infections data, show that Influenza Virus (FLU-A-B-C) and Respiratory Syncytial Virus (RSV) are co-habiting those respiratory traits. These viruses, especially in children (mostly affected by 'multi-system inflammatory syndrome in children' [MIS-C] and the winter pandemic FLU), in the aged population, and in 'fragile' patients are causing alteration in immune response. Then, bacterial and fungal pathogens are also co-habiting the upper respiratory traits (e.g., Staphylococcus aureus and Candida albicans), thus contributing to morbidity in those COVID-19 affected patients. METHODS Liquid chromatography coupled with high-resolution mass spectrometry using the quadrupole orbital ion trap analyser (i.e., UHPLC-Q-Orbitrap HRMS) was adopted to measure the polyphenols content of a new nutraceutical formula (Solution-3). Viral infections with SARS-CoV-2 (EG.5), FLU-A and RSV-A viruses (as performed in BLS3 authorised laboratory) and real time RT-PCR (qPCR) assay were used to test the antiviral action of the nutraceutical formula. Dilution susceptibility tests have been used to estimate the minimum inhibitory and bactericidal concentration (MIC and MBC, respectively) of Solution-3 on a variety of microorganisms belonging to Gram positive/ negative bacteria and fungi. Transcriptomic data analyses and functional genomics (i.e., RNAseq and data mining), coupled to qPCR and ELISA assays have been used to investigate the mechanisms of action of the nutraceutical formula on those processes involved in innate immune response. RESULTS Here, we have tested the combination of natural products containing higher amounts of polyphenols (i.e., propolis, Verbascum thapsus L., and Thymus vulgaris L.), together with the inorganic long chain polyphosphates 'polyPs' with antiviral, antibacterial, and antifungal behaviours, against SARS-CoV-2, FLU-A, RSV-A, Gram positive/ negative bacteria and fungi (i.e., Candida albicans). These components synergistically exert an immunomodulatory action by enhancing those processes involved in innate immune response (e.g., cytokines: IFNγ, TNFα, IL-10, IL-6/12; chemokines: CXCL1; antimicrobial peptides: HBD-2, LL-37; complement system: C3). CONCLUSION The prophylactic antimicrobial success of this nutraceutical formula against SARS-CoV-2, FLU-A and RSV-A viruses, together with the common bacteria and fungi co-infections as present in human oral cavity, is expected to be valuable.
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Affiliation(s)
- Veronica Ferrucci
- Department of Molecular Medicine and Medical Biotechnology (DMMBM), University of Naples 'Federico II', Via Sergio Pansini 5, 80131, Naples, Italy.
- CEINGE Biotecnologie Avanzate 'Franco Salvatore', Via Gaetano Salvatore 486, 80145, Naples, Italy.
- Elysium Cell Bio Ita, Via Gaetano Salvatore 486, 80145, Naples, Italy.
| | - Marco Miceli
- CEINGE Biotecnologie Avanzate 'Franco Salvatore', Via Gaetano Salvatore 486, 80145, Naples, Italy
| | - Chiara Pagliuca
- Department of Molecular Medicine and Medical Biotechnology (DMMBM), University of Naples 'Federico II', Via Sergio Pansini 5, 80131, Naples, Italy
| | - Orazio Bianco
- CEINGE Biotecnologie Avanzate 'Franco Salvatore', Via Gaetano Salvatore 486, 80145, Naples, Italy
| | - Luigi Castaldo
- Department of Pharmacy, University of Naples 'Federico II', Via Domenico Montesano 49, 80131, Naples, Italy
| | - Luana Izzo
- Department of Pharmacy, University of Naples 'Federico II', Via Domenico Montesano 49, 80131, Naples, Italy
| | - Marica Cozzolino
- CEINGE Biotecnologie Avanzate 'Franco Salvatore', Via Gaetano Salvatore 486, 80145, Naples, Italy
- Dipartimento Di Scienze Mediche Traslazionali, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Carla Zannella
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", 80138, Naples, Italy
| | - Franca Oglio
- CEINGE Biotecnologie Avanzate 'Franco Salvatore', Via Gaetano Salvatore 486, 80145, Naples, Italy
- Dipartimento Di Scienze Mediche Traslazionali, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Antonio Polcaro
- Polcaro Fitopreparazioni S.R.L, Via Sant Agnello, 9 D; 80030, Roccarainola, Naples, Italy
| | - Antonio Randazzo
- Department of Pharmacy, University of Naples 'Federico II', Via Domenico Montesano 49, 80131, Naples, Italy
| | - Roberta Colicchio
- Department of Molecular Medicine and Medical Biotechnology (DMMBM), University of Naples 'Federico II', Via Sergio Pansini 5, 80131, Naples, Italy
| | - Massimiliano Galdiero
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", 80138, Naples, Italy
- UOC of Virology and Microbiology, University Hospital of Campania "Luigi Vanvitelli", 80138, Naples, Italy
| | - Roberto Berni Canani
- CEINGE Biotecnologie Avanzate 'Franco Salvatore', Via Gaetano Salvatore 486, 80145, Naples, Italy
- Dipartimento Di Scienze Mediche Traslazionali, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Paola Salvatore
- Department of Molecular Medicine and Medical Biotechnology (DMMBM), University of Naples 'Federico II', Via Sergio Pansini 5, 80131, Naples, Italy
- CEINGE Biotecnologie Avanzate 'Franco Salvatore', Via Gaetano Salvatore 486, 80145, Naples, Italy
| | - Massimo Zollo
- Department of Molecular Medicine and Medical Biotechnology (DMMBM), University of Naples 'Federico II', Via Sergio Pansini 5, 80131, Naples, Italy.
- CEINGE Biotecnologie Avanzate 'Franco Salvatore', Via Gaetano Salvatore 486, 80145, Naples, Italy.
- Elysium Cell Bio Ita, Via Gaetano Salvatore 486, 80145, Naples, Italy.
- DAI Medicina di Laboratorio e Trasfusionale, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy.
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Hatef E, Wilson RF, Zhang A, Hannum SM, Kharrazi H, Davis SA, Foroughmand I, Weiner JP, Robinson KA. Effectiveness of telehealth versus in-person care during the COVID-19 pandemic: a systematic review. NPJ Digit Med 2024; 7:157. [PMID: 38879682 PMCID: PMC11180098 DOI: 10.1038/s41746-024-01152-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 05/31/2024] [Indexed: 06/19/2024] Open
Abstract
In this systematic review, we compared the effectiveness of telehealth with in-person care during the pandemic using PubMed, CINAHL, PsycINFO, and the Cochrane Central Register of Controlled Trials from March 2020 to April 2023. We included English-language, U.S.-healthcare relevant studies comparing telehealth with in-person care conducted after the onset of the pandemic. Two reviewers independently screened search results, serially extracted data, and independently assessed the risk of bias and strength of evidence. We identified 77 studies, the majority of which (47, 61%) were judged to have a serious or high risk of bias. Differences, if any, in healthcare utilization and clinical outcomes between in-person and telehealth care were generally small and/or not clinically meaningful and varied across the type of outcome and clinical area. For process outcomes, there was a mostly lower rate of missed visits and changes in therapy/medication and higher rates of therapy/medication adherence among patients receiving an initial telehealth visit compared with those receiving in-person care. However, the rates of up-to-date labs/paraclinical assessment were also lower among patients receiving an initial telehealth visit compared with those receiving in-person care. Most studies lacked a standardized approach to assessing outcomes. While we refrain from making an overall conclusion about the performance of telehealth versus in-person visits the use of telehealth is comparable to in-person care across a variety of outcomes and clinical areas. As we transition through the COVID-19 era, models for integrating telehealth with traditional care become increasingly important, and ongoing evaluations of telehealth will be particularly valuable.
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Affiliation(s)
- Elham Hatef
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.
- Center for Population Health Information Technology, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Renee F Wilson
- Johns Hopkins Evidence-based Practice Center, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, University, Baltimore, MD, USA
| | - Allen Zhang
- Johns Hopkins Evidence-based Practice Center, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, University, Baltimore, MD, USA
| | - Susan M Hannum
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Hadi Kharrazi
- Center for Population Health Information Technology, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Stacey A Davis
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Iman Foroughmand
- Center for Population Health Information Technology, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jonathan P Weiner
- Center for Population Health Information Technology, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Karen A Robinson
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Johns Hopkins Evidence-based Practice Center, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, University, Baltimore, MD, USA
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Mayette E, Scalise A, Li A, McGeorge N, James K, Mahalingaiah S. Assisted reproductive technology (ART) patient information-seeking behavior: a qualitative study. BMC Womens Health 2024; 24:346. [PMID: 38877503 PMCID: PMC11179360 DOI: 10.1186/s12905-024-03183-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Accepted: 06/05/2024] [Indexed: 06/16/2024] Open
Abstract
BACKGROUND Approximately 13% of women in the United States of reproductive age seek infertility services. Assisted reproductive technology (ART), including in vitro fertilization, is used to help patients achieve pregnancy. Many people are not familiar with these treatments prior to becoming patients and possess knowledge gaps about care. METHODS This study employed qualitative methods to investigate how patients interact with information sources during care. Patients who underwent ART including embryo transfer between January 2017 and April 2022 at a large urban healthcare center were eligible. Semi-structured, in-depth interviews were conducted between August and October 2022. Fifteen females with an average age of 39 years participated. Reflexive thematic analysis was performed. RESULTS Two main themes emerged. Participants (1) utilized clinic-provided information and then turned to outside sources to fill knowledge gaps; (2) struggled to learn about costs, insurance, and mental health resources to support care. Participants preferred clinic-provided resources and then utilized academic sources, the internet, and social media when they had unfulfilled information needs. Knowledge gaps related to cost, insurance, and mental health support were reported. CONCLUSION ART clinics can consider providing more information about cost, insurance, and mental health support to patients. TRIAL REGISTRATION The Massachusetts General Hospital Institutional Review Board approved this study (#2022P000474) and informed consent was obtained from each participant.
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Affiliation(s)
- Emma Mayette
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Massachusetts General Hospital, 55 Fruit Street, Yawkey 10, Boston, MA, 02114, USA.
| | - Ariel Scalise
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Massachusetts General Hospital, 55 Fruit Street, Yawkey 10, Boston, MA, 02114, USA
| | - Angela Li
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA, 02115, USA
| | - Nicolette McGeorge
- Charles River Analytics, Inc., 625 Mount Auburn St., Cambridge, MA, 02148, USA
| | - Kaitlyn James
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Massachusetts General Hospital, 55 Fruit Street, Yawkey 10, Boston, MA, 02114, USA
| | - Shruthi Mahalingaiah
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Massachusetts General Hospital, 55 Fruit Street, Yawkey 10, Boston, MA, 02114, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA, 02115, USA
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Petros BA, Milliren CE, Sabeti PC, Ozonoff A. Increased Pediatric Respiratory Syncytial Virus Case Counts Following the Emergence of SARS-CoV-2 Can Be Attributed to Changes in Testing. Clin Infect Dis 2024; 78:1707-1717. [PMID: 38602423 PMCID: PMC11175668 DOI: 10.1093/cid/ciae140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Respiratory syncytial virus (RSV) circulation dropped markedly early in the COVID-19 pandemic, followed by a resurgence with heightened case counts. The "immunity debt" hypothesis proposes that the RSV-naїve pediatric population increased during the period of low transmission. However, the evidence supporting this hypothesis is limited, and the role of changing testing practices in the perceived surge has not been comprehensively evaluated. METHODS We conducted a multicenter, retrospective analysis of 342 530 RSV encounters and 980 546 RSV diagnostic tests occurring at 32 US pediatric hospitals in 2013-2023. We used interrupted time series analysis to estimate pandemic-associated changes in RSV patient and test volume and to quantify changes in the proportions of patients requiring hospitalization, intensive care, or mechanical ventilation. We quantified the fraction of the shifts in case counts and in the age of diagnosed patients attributable to changes in testing. RESULTS RSV patient volume increased 2.4-fold (95% confidence interval [CI]: 1.7, 3.5) in 2021-2023 relative to the pre-pandemic phase and was accompanied by an 18.9-fold increase (95% CI: 15.0, 23.9) in RSV test volume. Shifts in patient volume and in patient age were largely attributable to increased testing. The proportions of patients with RSV that required hospitalization, intensive care, or mechanical ventilation declined significantly across all patient age groups. CONCLUSIONS A surge in RSV testing, rather than in viral circulation, likely underlies the increased case counts observed in 2021-2023. These findings warrant a critical assessment of the immunity debt hypothesis and highlight the importance of considering the testing denominator when surveillance strategies are dynamic.
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Affiliation(s)
- Brittany A Petros
- Infectious Disease and Microbiome Program, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Massachusetts, USA
- Health Sciences & Technology Program, Harvard Medical School and Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
- Harvard–Massachusetts Institute of Technology MD-PhD Program, Boston, Massachusetts, USA
- Department of Systems Biology, Harvard Medical School, Boston, Massachusetts, USA
| | - Carly E Milliren
- Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Pardis C Sabeti
- Infectious Disease and Microbiome Program, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Massachusetts, USA
- Department of Organismic and Evolutionary Biology, Harvard University, Cambridge, Massachusetts, USA
- Department of Immunology & Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
- Howard Hughes Medical Institute, Chevy Chase, Maryland, USA
| | - Al Ozonoff
- Infectious Disease and Microbiome Program, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Massachusetts, USA
- Precision Vaccines Program, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
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Samarakoon N, Chang T, Gunasekara V, Ratnayake P, Jayatillake R, Udagama P. Selected serum cytokines and vitamin D levels as potential prognostic markers of acute ischemic stroke. PLoS One 2024; 19:e0299631. [PMID: 38870172 PMCID: PMC11175438 DOI: 10.1371/journal.pone.0299631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 02/13/2024] [Indexed: 06/15/2024] Open
Abstract
Inflammation-derived oxidative stress is postulated to contribute to neuronal damage leading to poor clinical outcomes in Acute Ischemic Stroke (AIS). We aimed to investigate the association between serum levels of selected cytokines (IL-1β, IFN-γ, IL-4), and vitamin D in ischemic stroke progression, and their accuracy in predicting AIS prognosis, among Sri Lankans. We compared 60 AIS patients admitted in 4 phases post-stroke onset (<6 h; 6-24 h; 24-48 h; 48-96 h; n = 15/phase), with 15 age- and sex-matched controls. The 30-day functional outcome (FO) was assessed using the modified Rankin Scale (mRS). Serum cytokine and vitamin D levels were quantified using sandwich ELISAs, and competitive ELISA, respectively. The CombiROC web tool established optimal prognostic biomarker combinations. Serum IL-1β and IFN-γ were elevated in all four phases following stroke onset while IL-4 was elevated exclusively in the recovery phase (48-96 h) (p<0.05). Th1 bias polarization of the Th1:Th2 cytokine (IFN-γ:IL-4) ratio occurred with AIS progression while a Th2 bias occurred during AIS recovery (p<0.05). Lower serum IL-1β and higher IL-4 levels were associated with a good FO (p<0.05), while lower Vitamin D levels were related to a poor FO (p = 0.001). The triple-biomarker panel, IL-4- IFN-γ -Vit D, accurately predicted AIS prognosis (sensitivity = 100%, specificity = 91.9%, area under the curve = 0.98). Serum immunologic mediators IFN-γ, IL-4, and vitamin D may be useful biomarkers of AIS prognosis and may serve as therapeutic targets in improving stroke outcomes. Vitamin D supplementation may improve the prognosis of AIS patients. Furthermore, binary logistic model fitted for FO indicated Th1:Th2 cytokine ratio (IFN-γ:IL-4), vitamin D status, history of stroke, and ischemic heart disease as significant predictors of AIS prognosis.
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Affiliation(s)
- Nirmali Samarakoon
- Faculty of Science, Department of Zoology and Environment Sciences, University of Colombo, Colombo, Sri Lanka
| | - Thashi Chang
- Faculty of Medicine, Department of Clinical Medicine, University of Colombo, Colombo, Sri Lanka
| | - Vimukthi Gunasekara
- Faculty of Science, Department of Zoology and Environment Sciences, University of Colombo, Colombo, Sri Lanka
| | - Praneeth Ratnayake
- Faculty of Science, Department of Zoology and Environment Sciences, University of Colombo, Colombo, Sri Lanka
| | - Rasika Jayatillake
- Faculty of Science, Department of Statistics, University of Colombo, Colombo, Sri Lanka
| | - Preethi Udagama
- Faculty of Science, Department of Zoology and Environment Sciences, University of Colombo, Colombo, Sri Lanka
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71
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Yamanie N, Felistia Y, Susanto NH, Lamuri A, Sjaaf AC, Miftahussurur M, Santoso A. Prognostic model of in-hospital ischemic stroke mortality based on an electronic health record cohort in Indonesia. PLoS One 2024; 19:e0305100. [PMID: 38865423 PMCID: PMC11168658 DOI: 10.1371/journal.pone.0305100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 05/23/2024] [Indexed: 06/14/2024] Open
Abstract
Stroke patients rarely have satisfactory survival, which worsens further if comorbidities develop in such patients. Limited data availability from Southeast Asian countries, especially Indonesia, has impeded the disentanglement of post-stroke mortality determinants. This study aimed to investigate predictors of in-hospital mortality in patients with ischemic stroke (IS). This retrospective observational study used IS medical records from the National Brain Centre Hospital, Jakarta, Indonesia. A theoretically driven Cox's regression and Fine-Gray models were established by controlling for age and sex to calculate the hazard ratio of each plausible risk factor for predicting in-hospital stroke mortality and addressing competing risks if they existed. This study finally included 3,278 patients with IS, 917 (28%) of whom had cardiovascular disease and 376 (11.5%) suffered renal disease. Bivariate exploratory analysis revealed lower blood levels of triglycerides, low density lipoprotein, and total cholesterol associated with in-hospital-stroke mortality. The average age of patients with post-stroke mortality was 64.06 ± 11.32 years, with a mean body mass index (BMI) of 23.77 kg/m2 and a median Glasgow Coma Scale (GCS) score of 12 and an IQR of 5. Cardiovascular disease was significantly associated with IS mortality risk. NIHSS score at admission (hazard ratio [HR] = 1.04; 95% confidence interval [CI]: 1.00-1.07), male sex (HR = 1.51[1.01-2.26] and uric acid level (HR = 1.02 [1.00-1.03]) predicted survivability. Comorbidities, such as cardiovascular disease (HR = 2.16 [1.37-3.40], pneumonia (HR = 2.43 [1.42-4.15] and sepsis (HR = 2.07 [1.09-3.94, had higher hazards for post-stroke mortality. Contrarily, the factors contributing to a lower hazard of mortality were BMI (HR = 0.94 [0.89-0.99]) and GCS (HReye = 0.66 [0.48-0.89]. In summary, our study reported that male sex, NIHSS, uric acid level, cardiovascular diseases, pneumonia, sepsis. BMI, and GCS on admission were strong determinants of in-hospital mortality in patients with IS.
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Affiliation(s)
- Nizar Yamanie
- Doctoral Program of Medical Science, Faculty of Medicine, Airlangga University, Surabaya, Indonesia
- National Brain Centre Hospital, Jakarta, Indonesia
| | | | - Nugroho Harry Susanto
- Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Jakarta, Indonesia
| | - Aly Lamuri
- National Brain Centre Hospital, Jakarta, Indonesia
| | - Amal Chalik Sjaaf
- Department of Public Health, University of Indonesia, Jakarta, Indonesia
| | - Muhammad Miftahussurur
- Division of Gastroentero-Hepatology, Department of Internal Medicine, Faculty of Medicine-Dr. Soetomo Teaching Hospital, Airlangga University, Surabaya, Indonesia
| | - Anwar Santoso
- Department of Cardiology–Vascular Medicine, National Cardiovascular Centre–Harapan Kita Hospital, Universitas Indonesia, Jakarta, Indonesia
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Burholt V, Pillai A, Cheung G, Awatere SA, Daltrey J. Epidemiology of Faecal Incontinence for People with Dementia Living in the Community in New Zealand: A Retrospective Cohort Study Using interRAI Home Care Assessment Data. Gerontology 2024:1-10. [PMID: 38861937 DOI: 10.1159/000539753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 06/06/2024] [Indexed: 06/13/2024] Open
Abstract
INTRODUCTION Globally, there are few studies but wide variation in the epidemiology of faecal incontinence (FI) for people living with dementia in the community. Our objectives are to identify 1-year period prevalence, 5-year incidence, and risks for FI for people living with dementia. METHODS A retrospective cohort study comprising the International Residential Assessment Instrument Home Care version (interRAI-HC) assessments in a 5-year period in New Zealand (N = 109,964). For prevalence analysis, we selected a dementia cohort for a 1-year period from August 1, 2020, to July 31, 2021 (n = 7,775). For the incidence analysis, participants in the dementia cohort were followed up from the day of the first dementia diagnosis during the period August 1, 2016, and July 31, 2021. Dementia was identified by combining diagnosis of "Alzheimer's disease" and "Dementia other than Alzheimer's disease." Participants were coded with faecal incontinence if they were continent with a stoma, seldom incontinent, occasionally incontinent, often incontinent and incontinent. RESULTS One year period (1 August 2020-31 July 2021) prevalence of FI was 26.7% (2,082/7,775) of people with dementia. 5-Year incident FI rate was 19.0 per 100 person-years for people with dementia and 12.3 per 100 person-years for people without dementia. Controlling for risk factors for FI in both groups the hazard ratio for FI was 1.7 for people with dementia. CONCLUSION FI affects a significant proportion of people with dementia in New Zealand. interRAI-HC data could facilitate global epidemiological studies to estimate service or intervention needs for people with dementia to redress or manage FI.
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Affiliation(s)
- Vanessa Burholt
- School of Nursing/School of Population Health, Waipapa Taumata Rau, The University of Auckland, Auckland, New Zealand
- Centre for Innovative Ageing, Swansea University, Swansea, UK
| | - Avinesh Pillai
- Department of Statistics, Waipapa Taumata Rau, The University of Auckland, Auckland, New Zealand
| | - Gary Cheung
- Department of Psychological Medicine, Waipapa Taumata Rau, The University of Auckland, Auckland, New Zealand
| | - Sharon Aroha Awatere
- School of Nursing, Waipapa Taumata Rau, The University of Auckland, Auckland, New Zealand
| | - Julie Daltrey
- School of Nursing, Waipapa Taumata Rau, The University of Auckland, Auckland, New Zealand
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Kaufmann J, Marino M, Lucas JA, Rodriguez CJ, Boston D, Giebultowicz S, Heintzman J. Atherosclerotic Cardiovascular Disease Primary and Secondary Prevention in Latino Subgroups. J Gen Intern Med 2024:10.1007/s11606-024-08822-7. [PMID: 38858341 DOI: 10.1007/s11606-024-08822-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 05/14/2024] [Indexed: 06/12/2024]
Abstract
BACKGROUND Studies assessing equity in the prevention of atherosclerotic cardiovascular disease (ASCVD) for Latinos living in the USA collectively yield mixed results. Latino persons are diverse in many ways that may influence cardiovascular health. The intersection of Latino nativity and ASCVD prevention is understudied. OBJECTIVE To determine whether disparities in ASCVD screening, detection, and prescribing differ for US Latinos by country of birth. DESIGN A retrospective cohort design utilizing 2014-2020 electronic health record data from a network of 320 community health centers across 12 states. Analyses occurred October 1, 2022, to September 30, 2023. PARTICIPANTS Non-Hispanic White and Latino adults age 20-75 years, born in Cuba, Dominican Republic, El Salvador, Guatemala, Honduras, Mexico, and the USA. EXPOSURES Ethnicity and country of birth. MAIN MEASURES Outcome measures included prevalence of statin eligibility, of having insufficient data to establish eligibility, odds of having a documented statin prescription, and rates of statin prescriptions and refills. We used covariate-adjusted logistic and generalized estimating equations logistic and negative binomial regressions to generate absolute and relative measures. KEY RESULTS Among 108,672 adults, 23% (n = 25,422) were statin eligible for primary or secondary prevention of ASCVD using American College of Cardiology/American Heart Association guidelines. Latinos, born in and outside the USA were more likely eligible than Non-Hispanic White patients were (US-born Latino OR = 1.55 (95% CI = 1.37-1.75); non-US-born Latino OR = 1.63 (95% CI = 1.34-1.98)). The eligibility criteria that was met differed by ethnicity and nativity. Latinos overall were less likely missing data to establish eligibility and differences were again observed by specific non-US country of origin. Among those eligible, we observed no statistical difference in statin prescribing between US-born Latinos and non-Hispanic White persons; however, disparities varied by specific non-US country of origin. CONCLUSION Efforts to improve Latino health in the USA will require approaches for preventing and reversing cardiovascular risk factors, and statin initiation that are Latino subgroup specific.
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Affiliation(s)
- Jorge Kaufmann
- Department of Family Medicine, Oregon Health & Science University, Portland, Oregon, USA.
| | - Miguel Marino
- Department of Family Medicine, Oregon Health & Science University, Portland, Oregon, USA
- Biostatistics Group, School of Public Health, Oregon Health & Science University - Portland State University, Portland, OR, USA
| | - Jennifer A Lucas
- Department of Family Medicine, Oregon Health & Science University, Portland, Oregon, USA
| | - Carlos J Rodriguez
- Department of Medicine, Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | | | | | - John Heintzman
- Department of Family Medicine, Oregon Health & Science University, Portland, Oregon, USA
- OCHIN, Portland, OR, USA
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Ashcroft R, Donnelly C, Sheffield P, Lam S, Kemp C, Adamson K, Brown JB. A qualitative examination of the experiences and perspectives of interprofessional primary health care teams in the distribution of the COVID-19 vaccination in Ontario, Canada. PLoS One 2024; 19:e0304616. [PMID: 38857248 PMCID: PMC11164373 DOI: 10.1371/journal.pone.0304616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 05/15/2024] [Indexed: 06/12/2024] Open
Abstract
BACKGROUND Primary health care (PHC) teams contributed to all phases of the COVID-19 vaccination distribution. However, there has been criticism for not fully utilizing the expertise and infrastructure of PHC teams for vaccination distribution. Our study sought to understand the role PHC teams had in the distribution of the COVID-19 vaccine in Ontario, Canada. The key objective informing this study was to explore the experiences and perspectives of interprofessional PHC teams in the distribution of COVID-19 vaccination across Ontario. METHODS A qualitative approach was used for this study, which involved 39 participants from the six health regions of the province. Eight focus groups were conducted with a range of interprofessional healthcare providers, administrators, and staff working in PHC teams across Ontario. The sample reflected a diverse range of clinical, administrative, and leadership roles in PHC. Focus groups were audio-recorded and transcribed, while transcriptions were then analyzed using thematic analysis. RESULTS We identified the following four themes in the data: i) PHC teams know their patients; ii) mobilizing team capacity for vaccination, iii) intersectoral collaborations, and iv) operational challenges. CONCLUSIONS PHC teams were an instrumental component in supporting COVID-19 vaccinations in Ontario. The involvement of PHC in future vaccination efforts is key but requires additional resourcing and inclusion of PHC in decision-making. This will ensure provider well-being and maintain collaborations established during COVID-19 vaccination.
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Affiliation(s)
- Rachelle Ashcroft
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Catherine Donnelly
- Faculty of Health Sciences, Queen’s University, Kingston, Ontario, Canada
| | - Peter Sheffield
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Simon Lam
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Connor Kemp
- Frontenac, Lennox, and Addington Ontario Health Team, Kingston, Canada
| | - Keith Adamson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Judith Belle Brown
- Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
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Nuño N, Martínez A, Martínez S, Cobos M, Hernández JS, Polo R. Factors influencing the health-related quality of life of older men and women living with HIV in Spain. AIDS Care 2024:1-11. [PMID: 38838046 DOI: 10.1080/09540121.2024.2361815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 05/24/2024] [Indexed: 06/07/2024]
Abstract
The number of older people living with HIV (OPLHIV) is increasing worldwide. However, little is known about the factors that better predict their health-related quality of life (HRQoL). We administered the validated WHOQoL-HIV BREF questionnaire to 247 Spanish OPLHIV (192 men and 55 women). In addition to the six domains of the questionnaire, we constructed a seventh domain as theaverage of punctuations of all domains. Multivariable Poisson regression models with robust estimates by sex were constructed for the seven domains (14 in total). The best-subset selection method together with Mallow's Cp metric was used to select the model factors. The percentage of variability explained by Poisson models ranged from15-38% for men and 29-70% for women. The analysis showed that women were most affected by ageing (four domains), mobility impairments (five domains), and mental disorders (five domains). The factors with the greatest negative influence on men were heterosexuality (six domains), mental disorders (six domains), being single (five domains), and poverty risk (three domains). Physical activity was found to improve HRQoL in both men (six domains) and women (four domains). Future OPLHIV programmes would benefit from considering sex specific HRQoL factors. This could also improve the cost-effectiveness of interventions.
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Affiliation(s)
- Néstor Nuño
- Division for Control of HIV, STIs, Viral Hepatitis and Tuberculosis, Spanish Ministry of Health, Madrid, Spain
| | - Alberto Martínez
- Division for Control of HIV, STIs, Viral Hepatitis and Tuberculosis, Spanish Ministry of Health, Madrid, Spain
| | - Susana Martínez
- Division for Control of HIV, STIs, Viral Hepatitis and Tuberculosis, Spanish Ministry of Health, Madrid, Spain
| | - Marta Cobos
- Division for Control of HIV, STIs, Viral Hepatitis and Tuberculosis, Spanish Ministry of Health, Madrid, Spain
| | | | - Rosa Polo
- Division for Control of HIV, STIs, Viral Hepatitis and Tuberculosis, Spanish Ministry of Health, Madrid, Spain
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Alperen CC, Soydas B, Serin E, Erbayrak M, Savas NA, Unler GK, Meral CE, Toprak U, Boyacioglu AS, Dagli U. Role of Environmental Risk Factors in the Etiology of Inflammatory Bowel Diseases: A Multicenter Study. Dig Dis Sci 2024:10.1007/s10620-024-08491-w. [PMID: 38837110 DOI: 10.1007/s10620-024-08491-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 05/08/2024] [Indexed: 06/06/2024]
Abstract
BACKGROUND The increasing global incidence and prevalence of inflammatory bowel disease (IBD) necessitates an investigation into the potential influence of environmental risk factors on its origin. AIM This multicenter case-control study aimed to investigate potential environmental risk factors contributing to IBD development in Turkey. METHODS The study included 156 Crohn's disease (CD), 277 ulcerative colitis (UC) patients, and 468 controls (matched for age and gender) from six hospitals' gastroenterology departments. Data collection relied on the International Organization of IBD's questionnaire on environmental factors. Each environmental factor was initially analyzed using univariate and subsequently multivariate logistic regression models. RESULTS In the multivariate model, regular coffee consumption was associated with decreased odds for both CD (OR 0.28; 95% CI 0.14-0.55) and UC (OR 0.25; 95% CI 0.15-0.42). Stress was associated with UC (OR 3.27; 95% CI 1.76-6.10) and CD (OR 4.40; 95% CI 2.12-9.10) development. A history of childhood infectious diseases (gastroenteritis, upper respiratory tract infections, etc.) raised the odds for both CD (OR 9.45; 95% CI 2.51-35.6) and UC (OR 7.56; 95% CI 1.57-36.4). Conversely, consuming well/spring water (OR 0.22; 95% CI 0.10-0.50) and childhood antibiotic use (OR 0.41; 95% CI 0.18-0.93) showed a positive association against UC. Increased consumption of refined sugar and industrial food products emerged as risk factors for IBD. Smoking increased the risk for CD (OR 2.38; 95% CI 1.16-4.91), while ex-smoking increased the risk for UC (OR 3.16; 95% CI 1.19-8.37). CONCLUSIONS This study represents the first multicenter case-control study in Turkey examining the effects of environmental factors on IBD. It revealed that coffee consumption is positively associated, while stress and childhood infection-related diseases are risk factors. These findings, which are not supported by other studies, provide insight into the relationships between these factors and IBD.
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Affiliation(s)
- Cemile Cansu Alperen
- Department of Internal Medicine, Faculty of Medicine, Baskent University, Ankara, Turkey.
| | - Barıs Soydas
- Department of Gastroenterology, Baskent University Adana Medical and Research Center, Adana, Turkey
| | - Ender Serin
- Department of Gastroenterology, Baskent University Adana Medical and Research Center, Adana, Turkey
| | - Mustafa Erbayrak
- Department of Gastroenterology, Baskent University Alanya Medical and Research Center, Alanya, Turkey
| | - Nurten Akyurek Savas
- Department of Gastroenterology, Baskent University Istanbul Hospital, Istanbul, Turkey
| | - Gulhan Kanat Unler
- Department of Gastroenterology, Baskent University Konya Medical and Research Center, Konya, Turkey
| | - Cenk Emre Meral
- Department of Gastroenterology, Baskent University Izmir Medical and Research Center, Izmir, Turkey
| | - Ugur Toprak
- Department of Biostatistics, Faculty of Medicine, Baskent University, Ankara, Turkey
| | | | - Ulku Dagli
- Department of Gastroenterology, Faculty of Medicine, Baskent University, Ankara, Turkey
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Puthumana RM, Grosgogeat CA, Davis JK, Bocanegra LV, Patel S, Ferreira T, Parekh DJ, Gershengorn HB, Koch AL. Telemedicine and Resource Utilization in Pulmonary Clinic. BMC Pulm Med 2024; 24:267. [PMID: 38840112 PMCID: PMC11151562 DOI: 10.1186/s12890-024-03066-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 05/16/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Telemedicine use increased with the Covid-19 pandemic. The impact of telemedicine on resource use in pulmonary clinics is unknown. METHODS This retrospective cohort study identified adults with pulmonary clinic visits at the University of Miami Hospital and Clinics (January 2018-December 2021). The primary exposure was telemedicine versus in-person visits. Standard statistics were used to describe the cohort and compare patients stratified by visit type. Multivariable logistic regression models evaluated the association of telemedicine with resource use (primarily, computed tomography [CT] orders placed within 7 days of visit). RESULTS 21,744 clinic visits were included: 5,480 (25.2%) telemedicine and 16,264 (74.8%) in-person. In both, the majority were < 65-years-old, female, and identified as Hispanic white. Patients seen with telemedicine had increased odds of having CT scans ordered within 7 days (adjusted odds ratio [aOR] 1.34, [95% confidence interval 1.04-1.74]); and decreased odds of chest x-rays (aOR 0.37 [0.23-0.57]). Telemedicine increased odds of contact of any kind with our healthcare system within 30-days (aOR 1.56 [1.29-1.88]) and 90-days (aOR 1.39 [1.17-1.64]). Specifically, telemedicine visits had decreased odds of emergency department visits and hospitalizations (30 days: aOR 0.54 [0.38-0.76]; 90 days: aOR 0.68 [0.52-0.89]), but increased odds of phone calls and electronic health record inbox messages (30 days: aOR 3.44 [2.73-4.35]; 90 days: aOR 3.58 [2.95-4.35]). CONCLUSIONS Telemedicine was associated with an increased odds of chest CT order with a concomitant decreased odds of chest x-ray order. Increased contact with the healthcare system with telemedicine may represent a larger time burden for outpatient clinicians.
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Affiliation(s)
- Rose M Puthumana
- Department of Internal Medicine, University of Miami and Jackson Health Systems, 1611 NW 12th Ave, 1569 NW 17th Ave, Apt 1005, Miami, FL, 33136, 33125, United States of America.
| | - Claire A Grosgogeat
- University of Miami Miller School of Medicine, 1600 NW 10th Ave, Miami, FL, 33136, United States of America
| | - Jenna K Davis
- University of Miami Miller School of Medicine, 1600 NW 10th Ave, Miami, FL, 33136, United States of America
| | - Linda V Bocanegra
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Miami and Jackson Health Systems, 1600 NW 10th Ave, Miami, FL, 33136, United States of America
| | - Samira Patel
- University of Miami Hospitals and Clinics, 1400 NW 12th Ave, Miami, FL, 33136, United States of America
| | - Tanira Ferreira
- University of Miami Hospitals and Clinics, 1400 NW 12th Ave, Miami, FL, 33136, United States of America
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Miami Miller School of Medicine, 1600 NW 10th Ave, Miami, FL, 33136, United States of America
| | - Dipen J Parekh
- Department of Urology, University of Miami Miller School of Medicine, 1600 NW 10th Ave, Miami, FL, 33136, United States of America
| | - Hayley B Gershengorn
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Miami Miller School of Medicine, 1600 NW 10th Ave, Miami, FL, 33136, United States of America
- Albert Einstein College of Medicine, Division of Critical Care Medicine, 1300 Morris Park Ave, The Bronx, NY, 10461, United States of America
| | - Abigail L Koch
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Miami Miller School of Medicine, 1600 NW 10th Ave, Miami, FL, 33136, United States of America
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Becker C, Conduit R, Chouinard PA, Laycock R. Can deepfakes be used to study emotion perception? A comparison of dynamic face stimuli. Behav Res Methods 2024:10.3758/s13428-024-02443-y. [PMID: 38834812 DOI: 10.3758/s13428-024-02443-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2024] [Indexed: 06/06/2024]
Abstract
Video recordings accurately capture facial expression movements; however, they are difficult for face perception researchers to standardise and manipulate. For this reason, dynamic morphs of photographs are often used, despite their lack of naturalistic facial motion. This study aimed to investigate how humans perceive emotions from faces using real videos and two different approaches to artificially generating dynamic expressions - dynamic morphs, and AI-synthesised deepfakes. Our participants perceived dynamic morphed expressions as less intense when compared with videos (all emotions) and deepfakes (fearful, happy, sad). Videos and deepfakes were perceived similarly. Additionally, they perceived morphed happiness and sadness, but not morphed anger or fear, as less genuine than other formats. Our findings support previous research indicating that social responses to morphed emotions are not representative of those to video recordings. The findings also suggest that deepfakes may offer a more suitable standardized stimulus type compared to morphs. Additionally, qualitative data were collected from participants and analysed using ChatGPT, a large language model. ChatGPT successfully identified themes in the data consistent with those identified by an independent human researcher. According to this analysis, our participants perceived dynamic morphs as less natural compared with videos and deepfakes. That participants perceived deepfakes and videos similarly suggests that deepfakes effectively replicate natural facial movements, making them a promising alternative for face perception research. The study contributes to the growing body of research exploring the usefulness of generative artificial intelligence for advancing the study of human perception.
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Fitzpatrick T, Buchan SA, Mahant S, Fu L, Kwong JC, Stukel TA, Guttmann A. Pediatric Respiratory Syncytial Virus Hospitalizations, 2017-2023. JAMA Netw Open 2024; 7:e2416077. [PMID: 38861259 PMCID: PMC11167505 DOI: 10.1001/jamanetworkopen.2024.16077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 03/29/2024] [Indexed: 06/12/2024] Open
Abstract
Importance Respiratory syncytial virus (RSV) transmission was disrupted worldwide following the COVID-19 pandemic, and further study is required to better understand these changes. Objective To compare observed and expected RSV hospital and intensive care unit (ICU) admission rates and characteristics of admitted children during the 2021-2022 and 2022-2023 seasons. Design, Setting, and Participants A population-based cohort study of all children aged younger than 5 years in Ontario, Canada, July 1, 2017, through March 31, 2023, was conducted. Exposures Individual and neighborhood-level sociodemographic and clinical characteristics were identified from administrative data, including age, palivizumab eligibility, complex medical conditions, rurality, and living in a marginalized neighborhood. Main Outcomes and Measures The main outcome was RSV-associated hospitalization. Secondary outcomes included ICU admissions, mechanical ventilation, extracorporeal membrane oxygenation, and in-hospital death. Poisson generalized estimating equations were used to model weekly age- and sex-specific hospitalization rates and estimate expected rates in the postpandemic era; adjusted rate ratios (RRs) and 95% CIs are reported. Results This cohort study included approximately 700 000 children per study year. Compared with prepandemic years (2017-2018, 2018-2019, and 2019-2020), the 2021-2022 RSV season peaked slightly earlier, but overall admission rates were comparable (289.1 vs 281.4-334.6 per 100 000, or approximately 2000 admissions). The 2022-2023 season peaked a month earlier and resulted in more than twice as many hospitalizations (770.0 per 100 000; n = 4977 admissions). The proportion of children admitted to an ICU in 2022-2023 (13.9%) was slightly higher than prepandemic (9.6%-11.4%); however, the population-based rate was triple the prepandemic levels (106.9 vs 27.6-36.6 per 100 000 children in Ontario). With the exception of palivizumab-eligible children, all sociodemographic and health status characteristics were associated with lower-than-expected RSV hospitalization rates in 2021-2022. In contrast, older age of patients was associated with higher-than-expected rates in 2022-2023 (ie, 24-59 months: RR, 1.90; 95% CI, 1.35-2.66). Conclusions and Relevance There were notable differences in RSV epidemiologic characteristics in Ontario following the COVID-19 pandemic. It is not yet clear whether and how long atypical RSV epidemics may persist. Clinicians and program planners should consider the potential for ongoing impacts to health care capacity and RSV immunization programs.
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Affiliation(s)
- Tiffany Fitzpatrick
- Public Health Ontario, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Centre for Vaccine Preventable Diseases, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
| | - Sarah A. Buchan
- Public Health Ontario, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Centre for Vaccine Preventable Diseases, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Sanjay Mahant
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | | | - Jeffrey C. Kwong
- Public Health Ontario, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Centre for Vaccine Preventable Diseases, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- University Health Network, Toronto, Ontario, Canada
| | - Therese A. Stukel
- ICES, Toronto, Ontario, Canada
- Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Astrid Guttmann
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
- The Hospital for Sick Children, Toronto, Ontario, Canada
- Edwin S. H. Leong Centre for Healthy Children, University of Toronto, Toronto, Ontario, Canada
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Sebitloane HM, Forestier M, Ginindza TG, Dhlomo W, Moodley-Govender E, Darragh TM, Baena A, Herrero R, Almonte M, Broutet N, De Vuyst H. Cervical Cancer Screening and Treatment Algorithms Using Human Papillomavirus Testing-Lessons Learnt from a South African Pilot Randomized Controlled Trial. Cancer Epidemiol Biomarkers Prev 2024; 33:779-787. [PMID: 37955560 PMCID: PMC11145165 DOI: 10.1158/1055-9965.epi-23-0752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 10/06/2023] [Accepted: 11/08/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND To report quantitative and qualitative results on cervical cancer human papillomavirus (HPV)-based screening and treatment algorithms, with/out triage with visual inspection after acetic acid (VIA), followed by ablative treatment (AT). METHODS Women 30 to 54 years old from Durban, South Africa were recruited, regardless of human immunodeficiency virus (HIV) status, randomized into one of two study arms and screened for HPV. VIA triage arm: HPV-positive women were triaged using VIA, biopsied and received AT if VIA positive and eligible; no triage arm: eligible HPV-positive women received AT. Women ineligible for AT were referred to colposcopy. Women were asked about side effects immediately and 1 week after AT. Retention to screening and treatment algorithms was compared between arms. RESULTS A total of 350 women [275 HIV-uninfected and 75 women living with HIV, (WLWH)] were allocated to receive HPV testing with VIA triage (n = 175) or no triage (n = 175). HPV prevalence was 28% [95% confidence interval (CI) = 23-33]; WLWH: 52% (95% CI = 40-64) versus HIV-uninfected: 21% (95% CI = 17-27; P < 0.05). Among women who underwent VIA triage with histologic diagnosis, 3/17 were VIA negative with cervical intraepithelial neoplasia (CIN)2+; 14/18 were VIA positive with CONCLUSIONS This pilot demonstrated the feasibility of implementing screening and treatment algorithms, including performing triage and treatment in one visit; however, VIA triage did not reduce overtreatment and missed some precancerous lesions. IMPACT This study reports on implementation feasibility of two World Health Organization screening and treatment algorithms (with/out VIA triage). Although the retention to screening and treatment algorithms was high in both arms, the question of how best triaging HPV-positive women deserves further consideration, particularly for WLWH. See related In the Spotlight, p. 763.
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Affiliation(s)
- Hannah M. Sebitloane
- Discipline of Obstetrics and Gynaecology, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Mathilde Forestier
- Early Detection, Prevention and Infections (EPR), International Agency for Research on Cancer, Lyon, France
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Themba G. Ginindza
- Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa
- Cancer & Infectious Diseases Epidemiology Research Unit (CIDERU), College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Wendy Dhlomo
- Discipline of Obstetrics and Gynaecology, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Eshia Moodley-Govender
- Discipline of Obstetrics and Gynaecology, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Teresa M. Darragh
- Department of Pathology, University of California, San Francisco, California
| | - Armando Baena
- Early Detection, Prevention and Infections (EPR), International Agency for Research on Cancer, Lyon, France
| | - Rolando Herrero
- Early Detection, Prevention and Infections (EPR), International Agency for Research on Cancer, Lyon, France
- Agencia Costarricense de Investigaciones Biomedicas, San José, Costa Rica
| | - Maribel Almonte
- Early Detection, Prevention and Infections (EPR), International Agency for Research on Cancer, Lyon, France
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
- Department of Non-communicable Diseases, World Health Organization, Geneva, Switzerland
| | - Nathalie Broutet
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Hugo De Vuyst
- Early Detection, Prevention and Infections (EPR), International Agency for Research on Cancer, Lyon, France
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
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Caldwell HA, Yusuf J, Carrea C, Conrad P, Embrett M, Fierlbeck K, Hajizadeh M, Kirk SF, Rothfus M, Sampalli T, Sim SM, Tomblin Murphy G, Williams L. Strategies and indicators to integrate health equity in health service and delivery systems in high-income countries: a scoping review. JBI Evid Synth 2024; 22:949-1070. [PMID: 38632975 PMCID: PMC11163892 DOI: 10.11124/jbies-23-00051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
OBJECTIVE The objective of this review was to describe how health service and delivery systems in high-income countries define and operationalize health equity. A secondary objective was to identify implementation strategies and indicators being used to integrate and measure health equity. INTRODUCTION To improve the health of populations, a population health and health equity approach is needed. To date, most work on health equity integration has focused on reducing health inequities within public health, health care delivery, or providers within a health system, but less is known about integration across the health service and delivery system. INCLUSION CRITERIA This review included academic and gray literature sources that described the definitions, frameworks, level of integration, strategies, and indicators that health service and delivery systems in high-income countries have used to describe, integrate, and/or measure health equity. Sources were excluded if they were not available in English (or a translation was not available), were published before 1986, focused on strategies that were not implemented, did not provide health equity indicators, or featured strategies that were implemented outside the health service or delivery systems (eg, community-based strategies). METHODS This review was conducted in accordance with the JBI methodology for scoping reviews. Titles and abstracts were screened for eligibility followed by a full-text review to determine inclusion. The information extracted from the included studies consisted of study design and key findings, such as health equity definitions, strategies, frameworks, level of integration, and indicators. Most data were quantitatively tabulated and presented according to 5 secondary review questions. Some findings (eg, definitions and indicators) were summarized using qualitative methods. Most findings were visually presented in charts and diagrams or presented in tabular format. RESULTS Following review of 16,297 titles and abstracts and 824 full-text sources, we included 122 sources (108 scholarly and 14 gray literature) in this scoping review. We found that health equity was inconsistently defined and operationalized. Only 17 sources included definitions of health equity, and we found that both indicators and strategies lacked adequate descriptions. The use of health equity frameworks was limited and, where present, there was little consistency or agreement in their use. We found that strategies were often specific to programs, services, or clinics, rather than broadly applied across health service and delivery systems. CONCLUSIONS Our findings suggest that strategies to advance health equity work are siloed within health service and delivery systems, and are not currently being implemented system-wide (ie, across all health settings). Healthy equity definitions and frameworks are varied in the included sources, and indicators for health equity are variable and inconsistently measured. Health equity integration needs to be prioritized within and across health service and delivery systems. There is also a need for system-wide strategies to promote health equity, alongside robust accountability mechanisms for measuring health equity. This is necessary to ensure that an integrated, whole-system approach can be consistently applied in health service and delivery systems internationally. REVIEW REGISTRATION DalSpace dalspace.library.dal.ca/handle/10222/80835.
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Affiliation(s)
- Hilary A.T. Caldwell
- Healthy Populations Institute, Dalhousie University, Halifax, NS, Canada
- Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Joshua Yusuf
- Healthy Populations Institute, Dalhousie University, Halifax, NS, Canada
- Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Cecilia Carrea
- Healthy Populations Institute, Dalhousie University, Halifax, NS, Canada
- Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Patricia Conrad
- Healthy Populations Institute, Dalhousie University, Halifax, NS, Canada
- Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | | | - Katherine Fierlbeck
- Healthy Populations Institute, Dalhousie University, Halifax, NS, Canada
- MacEachen Institute for Public Policy and Governance, Dalhousie University, Halifax, NS, Canada
- Dalhousie Libraries, Dalhousie University, Halifax, NS, Canada
| | - Mohammad Hajizadeh
- Healthy Populations Institute, Dalhousie University, Halifax, NS, Canada
- Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Sara F.L. Kirk
- Healthy Populations Institute, Dalhousie University, Halifax, NS, Canada
- Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Melissa Rothfus
- Department of Political Science, Dalhousie University, Halifax, NS, Canada
| | | | - Sarah Meaghan Sim
- Healthy Populations Institute, Dalhousie University, Halifax, NS, Canada
- Faculty of Health, Dalhousie University, Halifax, NS, Canada
- Nova Scotia Health, Halifax, NS, Canada
| | | | - Lane Williams
- Healthy Populations Institute, Dalhousie University, Halifax, NS, Canada
- Faculty of Health, Dalhousie University, Halifax, NS, Canada
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Sarwal A, Lim J, Sarwal A. Telemedicine for the Underserved Racial and Ethnic Minorities During COVID-19 and Beyond. Telemed J E Health 2024; 30:1588-1593. [PMID: 38739446 DOI: 10.1089/tmj.2023.0270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024] Open
Abstract
Objective: To demonstrate that a culturally and linguistically appropriate telehealth protocol can be implemented to improve the glycemic control of patients as an extension of regular clinical services and provide continuity of care. Methods: A telehealth platform was established during COVID-19 pandemic and from numerous telehealth encounters we sampled 498 patients who received telehealth intervention over a 12-month period for specific services: Rx refill, consultation for laboratory results, wellness evaluation and education, and acute or sick visits with appropriate referrals. This telehealth platform was integrated with a remote patient monitoring system utilizing a Bluetooth-enabled glucometer for patients with diabetes compared to their abnormal baseline hemoglobin A1C (HgA1C). The Blood sugar values were recorded at predefined intervals to monitor controls for diabetes. The ethnic diversity and level of education of patients required addressing the digital divide, language interpretation, and navigation at each monitoring step. Results: This method demonstrated that a culturally and linguistically appropriate telehealth protocol can be implemented to improve the glycemic control of patients in an intervention group compared with a control group. Validation of the glycemic control was based on 70 patients identified as eligible for participation based on the inclusion criteria: a HgA1C level of 7% or higher obtained within the last 10 months. Informed consent was obtained for 42 participants based on patient participation constraints during the COVID-19 pandemic. Conclusions: We conclude that telemedicine procedures utilized for patients with little or no prior knowledge of remote self-monitoring methods can support their treatment of chronic diseases, such as diabetes. The outcomes from the implementation of telemedicine services were observed in a well-defined group of underserved racial and ethnic minority patients at our clinic. We now have a protocol to expand this to other chronic diseases and used as a regular clinical procedure.
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Affiliation(s)
- Alok Sarwal
- Colorado Alliance for Health Equity and Practice-Family Medicine Clinic, Denver, Colorado, USA
| | - Jeehyun Lim
- Colorado Christian University, Lakewood, Colorado, USA
| | - Ashwin Sarwal
- Biochemistry and Molecular Cellular and Developmental Biology Program, University of Colorado, Boulder, Colorado, USA
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Thielking AM, Fitzmaurice KP, Sewpaul R, Chrysanthopoulou SA, Dike L, Levy DE, Rigotti NA, Siedner MJ, Wood R, Paltiel AD, Freedberg KA, Hyle EP, Reddy KP. Tobacco smoking, smoking cessation and life expectancy among people with HIV on antiretroviral therapy in South Africa: a simulation modelling study. J Int AIDS Soc 2024; 27:e26315. [PMID: 38924347 PMCID: PMC11197963 DOI: 10.1002/jia2.26315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 06/04/2024] [Indexed: 06/28/2024] Open
Abstract
INTRODUCTION As access to effective antiretroviral therapy (ART) has improved globally, tobacco-related illnesses, including cardiovascular disease, cancer and chronic respiratory conditions, account for a growing proportion of deaths among people with HIV (PWH). We estimated the impact of tobacco smoking and smoking cessation on life expectancy among PWH in South Africa. METHODS In a microsimulation model, we simulated 18 cohorts of PWH with virologic suppression, each homogenous by sex, initial age (35y/45y/55y) and smoking status (current/former/never). Input parameters were from data sources published between 2008 and 2022. We used South African data to estimate age-stratified mortality hazard ratios: 1.2-2.3 (females)/1.1-1.9 (males) for people with current versus never smoking status; and 1.0-1.3 (females)/1.0-1.5 (males) for people with former versus never smoking status, depending on age at cessation. We assumed smoking status remains unchanged during the simulation; people who formerly smoked quit at model start. Simulated PWH face a monthly probability of disengagement from care and virologic non-suppression. In sensitivity analysis, we varied smoking-associated and HIV-associated mortality risks. Additionally, we estimated the total life-years gained if a proportion of all virologically suppressed PWH stopped smoking. RESULTS Forty-five-year-old females/males with HIV with virologic suppression who smoke lose 5.3/3.7 life-years compared to PWH who never smoke. Smoking cessation at age 45y adds 3.4/2.4 life-years. Simulated PWH who continue smoking lose more life-years from smoking than from HIV (females, 5.3 vs. 3.0 life-years; males, 3.7 vs. 2.6 life-years). The impact of smoking and smoking cessation increase as smoking-associated mortality risks increase and HIV-associated mortality risks, including disengagement from care, decrease. Model results are most sensitive to the smoking-associated mortality hazard ratio; varying this parameter results in 1.0-5.1 life-years gained from cessation at age 45y. If 10-25% of virologically suppressed PWH aged 30-59y in South Africa stopped smoking now, 190,000-460,000 life-years would be gained. CONCLUSIONS Among virologically suppressed PWH in South Africa, tobacco smoking decreases life expectancy more than HIV. Integrating tobacco cessation interventions into HIV care, as endorsed by the World Health Organization, could substantially improve life expectancy.
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Affiliation(s)
- Acadia M. Thielking
- Medical Practice Evaluation CenterMassachusetts General HospitalBostonMassachusettsUSA
| | - Kieran P. Fitzmaurice
- Medical Practice Evaluation CenterMassachusetts General HospitalBostonMassachusettsUSA
| | - Ronel Sewpaul
- Human and Social Capabilities, Human Sciences Research CouncilCape TownSouth Africa
| | | | - Lotanna Dike
- Medical Practice Evaluation CenterMassachusetts General HospitalBostonMassachusettsUSA
| | - Douglas E. Levy
- Harvard Medical SchoolBostonMassachusettsUSA
- Tobacco Research and Treatment CenterMassachusetts General HospitalBostonMassachusettsUSA
- Mongan Institute Health Policy Research CenterMassachusetts General HospitalBostonMassachusettsUSA
| | - Nancy A. Rigotti
- Harvard Medical SchoolBostonMassachusettsUSA
- Tobacco Research and Treatment CenterMassachusetts General HospitalBostonMassachusettsUSA
- Mongan Institute Health Policy Research CenterMassachusetts General HospitalBostonMassachusettsUSA
- Division of General Internal MedicineMassachusetts General HospitalBostonMassachusettsUSA
| | - Mark J. Siedner
- Medical Practice Evaluation CenterMassachusetts General HospitalBostonMassachusettsUSA
- Harvard Medical SchoolBostonMassachusettsUSA
- Division of Infectious DiseasesMassachusetts General HospitalBostonMassachusettsUSA
- Africa Health Research InstituteSomkheleSouth Africa
| | - Robin Wood
- Desmond Tutu Health Foundation, MowbrayCape TownSouth Africa
- Department of MedicineUniversity of Cape TownCape TownSouth Africa
| | - A. David Paltiel
- Public Health Modeling UnitYale School of Public HealthNew HavenConnecticutUSA
| | - Kenneth A. Freedberg
- Medical Practice Evaluation CenterMassachusetts General HospitalBostonMassachusettsUSA
- Harvard Medical SchoolBostonMassachusettsUSA
- Division of General Internal MedicineMassachusetts General HospitalBostonMassachusettsUSA
- Division of Infectious DiseasesMassachusetts General HospitalBostonMassachusettsUSA
- Department of Health Policy and ManagementHarvard T. H. Chan School of Public HealthBostonMassachusettsUSA
| | - Emily P. Hyle
- Medical Practice Evaluation CenterMassachusetts General HospitalBostonMassachusettsUSA
- Harvard Medical SchoolBostonMassachusettsUSA
- Division of Infectious DiseasesMassachusetts General HospitalBostonMassachusettsUSA
| | - Krishna P. Reddy
- Medical Practice Evaluation CenterMassachusetts General HospitalBostonMassachusettsUSA
- Harvard Medical SchoolBostonMassachusettsUSA
- Tobacco Research and Treatment CenterMassachusetts General HospitalBostonMassachusettsUSA
- Division of Pulmonary and Critical Care MedicineMassachusetts General HospitalBostonMassachusettsUSA
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Ghogomu ET, Welch V, Yaqubi M, Dewidar O, Barbeau VI, Biswas S, Card K, Hsiung S, Muhl C, Nelson M, Salzwedel DM, Saragosa M, Yu C, Mulligan K, Hébert P. PROTOCOL: Effects of social prescribing for older adults: An evidence and gap map. CAMPBELL SYSTEMATIC REVIEWS 2024; 20:e1382. [PMID: 38434537 PMCID: PMC10903187 DOI: 10.1002/cl2.1382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 11/29/2023] [Accepted: 01/08/2024] [Indexed: 03/05/2024]
Abstract
Objectives This is the protocol for an evidence and gap map. The objectives are as follows: The aim of this evidence and gap map is to map the available evidence on the effectiveness of social prescribing interventions addressing a non-medical, health-related social need for older adults in any setting. Specific objectives are as follows: 1.To identify existing evidence from primary studies and systematic reviews on the effects of community-based interventions that address non-medical, health-related social needs of older adults to improve their health and wellbeing.2.To identify research evidence gaps for new high-quality primary studies and systematic reviews.3.To highlight evidence of health equity considerations from included primary studies and systematic reviews.
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Affiliation(s)
| | | | | | | | | | - Srija Biswas
- Canadian Institute of Social PrescribingCanadian Red CrossTorontoCanada
| | - Kiffer Card
- Faculty of Health SciencesSimon Fraser UniversityVancouverCanada
| | - Sonia Hsiung
- Canadian Institute of Social PrescribingCanadian Red CrossTorontoCanada
| | - Caitlin Muhl
- School of Nursing, Faculty of Health SciencesQueens UniversityKingstonCanada
| | - Michelle Nelson
- Dalla Lana School of Public HealthUniversity of TorontoTorontoCanada
| | - Douglas M. Salzwedel
- Department of Anesthesiology, Pharmacology and TherapeuticsUniversity of British ColumbiaVancouverCanada
| | | | | | - Kate Mulligan
- Dalla Lana School of Public HealthUniversity of TorontoTorontoCanada
| | - Paul Hébert
- Bruyère Research InstituteUniversity of OttawaOttawaCanada
- Centre Hospitalier de l'Université de MontréalMontrealCanada
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Ahmed MA, Obaid ZM, Hashem O, Elrifai AW, Elsaie ML. Prevalence of new onset erectile dysfunction among Damietta governorate men after contracting COVID-19. Ir J Med Sci 2024; 193:1581-1587. [PMID: 38245885 PMCID: PMC11128385 DOI: 10.1007/s11845-024-03610-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 01/12/2024] [Indexed: 01/23/2024]
Abstract
BACKGROUND Several reports showed that sexual function was affected during and after the COVID-19 pandemic. AIMS The objective of the study was to demonstrate whether a realistic association exists between the COVID-19 pandemic and erectile dysfunction (ED) among a sampled Egyptian population in Damietta governorate. METHODS This cross-sectional study consisted of 330 adult males diagnosed with COVID-19 infection. They were categorized in three age groups (18-29, 30-39, and 40-50 years, respectively). COVID-19-confirmed cases were assessed by the Arabic version of the International Index of Erectile Function questionnaire (IIEF) scores. RESULTS The prevalence of ED according to the IIEF was 55.1%. The ED was categorized into mild ED which represents 25.8% of the patients, mild to moderate which represents 22.4% of the patients, moderate which represents 7% of the patients, and severe which represents 0% of the patients. We found a significant negative correlation between the age of the patients and the IIEF score. Also, we found an association between the severity of COVID-19 infection and the IIEF score. CONCLUSION An association of new-onset ED in men who suffered COVID-19 infection was established. This may be due to virus-induced endothelial cell dysfunction; however, an underlying mechanism and causation have not yet been clearly elucidated. While it appears that COVID-19 infection may be a risk factor for ED, additional research is needed to establish causality.
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Affiliation(s)
- Mostafa A Ahmed
- Department of Dermatology, Venereology and Andrology, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt
| | - Zakaria M Obaid
- Department of Dermatology, Venereology and Andrology, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt
| | - Osama Hashem
- Department of Dermatology, Venereology and Andrology, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt
| | - Atef W Elrifai
- Department of Pulmonology, Damietta, Faculty of Medicine, Al-Azhar University, Damietta, Egypt
| | - Mohamed L Elsaie
- Department of Dermatology, Venereology and Andrology, Medical Research and Clinical Studies Institute, National Research Centre, Cairo, Egypt.
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Hitch D. Artificial Intelligence Augmented Qualitative Analysis: The Way of the Future? QUALITATIVE HEALTH RESEARCH 2024; 34:595-606. [PMID: 38064244 PMCID: PMC11103925 DOI: 10.1177/10497323231217392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2024]
Abstract
The artificial intelligence (AI) revolution is here and gathering momentum, thanks to new models of natural language processing (NLP) and rapidly increasing adoption by the public. NLP technology uses statistical analysis of language structures to analyse and generate human language, using text or speech as its source material. It can also be applied to visual mediums like images and videos. A few qualitative research early adopters are beginning to adopt this technology into their work, but our understanding of its potential remains in its infancy. This article will define and describe NLP-based AI and discuss its benefits and limitations for reflexive thematic analysis in health research. While there are many platforms available, ChatGPT is the most well-known and accessible. A worked example using ChatGPT to augment reflexive thematic analysis is provided to illustrate potential application in practice. This article is intended to inspire further conversation around the role of AI in qualitative research and offer practical guidance for researchers seeking to adopt this technology.
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Affiliation(s)
- Danielle Hitch
- Deakin University, Geelong, VIC, Australia
- Western Health, Sunshine Hospital, St Albans, VIC, Australia
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Kalani M, Anjankar A. Revolutionizing Neurology: The Role of Artificial Intelligence in Advancing Diagnosis and Treatment. Cureus 2024; 16:e61706. [PMID: 38975469 PMCID: PMC11224934 DOI: 10.7759/cureus.61706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 06/04/2024] [Indexed: 07/09/2024] Open
Abstract
Artificial intelligence (AI) has emerged as a powerful tool in the field of neurology, significantly impacting the diagnosis and treatment of neurological disorders. Recent technological breakthroughs have given us access to a plethora of information relevant to many aspects of neurology. Neuroscience and AI share a long history of collaboration. Along with great potential, we encounter obstacles relating to data quality, ethics, and inherent difficulty in applying data science in healthcare. Neurological disorders pose intricate challenges due to their complex manifestations and variability. Automating image interpretation tasks, AI algorithms accurately identify brain structures and detect abnormalities. This accelerates diagnosis and reduces the workload on medical professionals. Treatment optimization benefits from AI simulations that model different scenarios and predict outcomes. These AI systems can currently perform many of the sophisticated perceptual and cognitive capacities of biological systems, such as object identification and decision making. Furthermore, AI is rapidly being used as a tool in neuroscience research, altering our understanding of brain functioning. It has the ability to revolutionize healthcare as we know it into a system in which humans and robots collaborate to deliver better care for our patients. Image analysis activities such as recognizing particular brain regions, calculating changes in brain volume over time, and detecting abnormalities in brain scans can be automated by AI systems. This lessens the strain on radiologists and neurologists while improving diagnostic accuracy and efficiency. It is now obvious that cutting-edge artificial intelligence models combined with high-quality clinical data will lead to enhanced prognostic and diagnostic models in neurological illness, permitting expert-level clinical decision aids across healthcare settings. In conclusion, AI's integration into neurology has revolutionized diagnosis, treatment, and research. As AI technologies advance, they promise to unravel the complexities of neurological disorders further, leading to improved patient care and quality of life. The symbiosis of AI and neurology offers a glimpse into a future where innovation and compassion converge to reshape neurological healthcare. This abstract provides a concise overview of the role of AI in neurology and its transformative potential.
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Affiliation(s)
- Meetali Kalani
- Biochemistry, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Ashish Anjankar
- Biochemistry, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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88
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Kanneganti M, Byhoff E, Serper M, Olthoff KM, Bittermann T. Neighborhood-level social determinants of health measures independently predict receipt of living donor liver transplantation in the United States. Liver Transpl 2024; 30:618-627. [PMID: 38100175 DOI: 10.1097/lvt.0000000000000313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 12/06/2023] [Indexed: 01/10/2024]
Abstract
Disparities exist in the access to living donor liver transplantation (LDLT) in the United States. However, the association of neighborhood-level social determinants of health (SDoH) on the receipt of LDLT is not well-established. This was a retrospective cohort study of adult liver transplant recipients between January 1, 2005 and December 31, 2021 at centers performing LDLT using the United Network for Organ Sharing database, which was linked through patients' ZIP code to a set of 24 neighborhood-level SDoH measures from different data sources. Temporal trends and center differences in neighborhood Social Deprivation Index (SDI), a validated scale of socioeconomic deprivation ranging from 0 to 100 (0=least disadvantaged), were assessed by transplant type. Multivariable logistic regression evaluated the association of increasing SDI on receipt of LDLT [vs. deceased donor liver transplantation (DDLT)]. There were 51,721 DDLT and 4026 LDLT recipients at 59 LDLT-performing centers during the study period. Of the 24 neighborhood-level SDoH measures studied, the SDI was most different between the 2 transplant types, with LDLT recipients having lower SDI (ie, less socioeconomic disadvantage) than DDLT recipients (median SDI 37 vs. 47; p < 0.001). The median difference in SDI between the LDLT and DDLT groups significantly decreased from 13 in 2005 to 3 in 2021 ( p = 0.003). In the final model, the SDI quintile was independently associated with transplant type ( p < 0.001) with a threshold SDI of ~40, above which increasing SDI was significantly associated with reduced odds of LDLT (vs. reference SDI 1-20). As a neighborhood-level SDoH measure, SDI is useful for evaluating disparities in the context of LDLT. Center outreach efforts that aim to reduce disparities in LDLT could preferentially target US ZIP codes with SDI > 40.
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Affiliation(s)
- Mounika Kanneganti
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Elena Byhoff
- Department of Medicine, UMass Chan Medical School, Worcester, Massachusetts, USA
| | - Marina Serper
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Division of Gastroenterology and Hepatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Kim M Olthoff
- Division of Transplant Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Therese Bittermann
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Division of Gastroenterology and Hepatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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89
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Azamfirei R. ChatGPT and Neuroprognostication: A Snow Globe, Not a Crystal Ball. Crit Care Med 2024; 52:992-994. [PMID: 38752820 DOI: 10.1097/ccm.0000000000006265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2024]
Affiliation(s)
- Razvan Azamfirei
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
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90
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Rahmawati BA, Rochmawati E. Trying to understand the illness: A qualitative investigation of health literacy of patients undergoing maintenance hemodialysis. Nurs Health Sci 2024; 26:e13120. [PMID: 38605631 DOI: 10.1111/nhs.13120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 12/19/2023] [Accepted: 03/28/2024] [Indexed: 04/13/2024]
Abstract
Limited health literacy is high among patients with chronic kidney disease, which can pose challenges in health care. Evidence of health literacy in Indonesia, particularly regarding patients undergoing hemodialysis, is lacking. In this study, we aimed to explore health literacy in adult patients undergoing maintenance hemodialysis. An inductive qualitative study was conducted. Individual semi-structured interviews were conducted with 10 adult patients undergoing hemodialysis, four family caregivers, and four healthcare professionals. Interviews were transcribed verbatim and analyzed thematically. Three themes emerged from the data: "Trying to understand the illness," "searching and obtaining health information," and "applying health information." Understanding and accepting the illness included raising awareness of the changes in their lives and accepting these changes. Participants actively sought information from healthcare professionals and other sources and used it carefully. Behavioral changes included patients' adherence to therapy, although participants often felt bored during the illness trajectory. Understanding the illness and being willing to seek and critically evaluate health information before implementing it are important. These aspects may affect patient outcomes and require further intervention and research.
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Affiliation(s)
- Berlian Ayu Rahmawati
- School of Nursing, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia
- Muhammadiyah Siti Aminah Bumiayu Hospital, Brebes, Indonesia
| | - Erna Rochmawati
- School of Nursing, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia
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91
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Erturan S, Burak M, Elbasan B. Breaking barriers: exploring physiotherapists' willingness and challenges in embracing telerehabilitation in a developing country. Ir J Med Sci 2024; 193:1359-1367. [PMID: 38148393 DOI: 10.1007/s11845-023-03589-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 12/05/2023] [Indexed: 12/28/2023]
Abstract
INTRODUCTION Telerehabilitation (TR) is an innovative approach that can address the limited availability and restricted access to rehabilitation services, particularly during challenging times such as pandemics and natural disasters. This study focuses on understanding the desires, perceptions, and barriers that physiotherapists face when implementing TR in a developing country. METHOD The study was conducted with 219 physiotherapists residing in a developing country using a web-based survey on Google Docs. RESULT The findings revealed that a significant majority of physiotherapists (88.1%) recognized TR as a potential solution for individuals with physical problems during the pandemic. Additionally, 89.5% expressed satisfaction with the opportunity to receive consultations from different hospitals, indicating a positive perception of TR. However, the study also highlighted certain barriers that hindered the implementation of TR. Around 40.2% of physiotherapists reported having training deficiencies, suggesting a need for educational support in utilizing TR effectively. Furthermore, the analysis of demographic factors revealed interesting insights. It was noteworthy that the age and years of experience of physiotherapists had an impact on their willingness and adoption of TR. CONCLUSION The study reveals that physiotherapists in the developing country exhibit a positive attitude towards TR and recognize its potential benefits. However, various barriers, such as training deficiencies, need to be addressed to facilitate a broader adoption of TR in their practices. Overcoming these barriers is anticipated to heighten physiotherapists' readiness to embrace TR, ultimately enhancing the accessibility and delivery of rehabilitation services.
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Affiliation(s)
- Sinem Erturan
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Ataturk University, Erzurum, Turkey.
| | - Mustafa Burak
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Firat University, Elazığ, Turkey
| | - Bülent Elbasan
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
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92
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Vinod P, Krishnappa V, Rathell W, Amir S, Sundil S, Dogbey G, Patel H, Herzog W. Effect of Aspirin Use on the Adverse Outcomes in Patients Hospitalized for COVID-19. Cardiol Res 2024; 15:179-188. [PMID: 38994222 PMCID: PMC11236346 DOI: 10.14740/cr1645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Accepted: 05/02/2024] [Indexed: 07/13/2024] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) triggers multiple components of the immune system and causes inflammation of endothelial walls across vascular beds, resulting in respiratory failure, arterial and venous thrombosis, myocardial injury, and multi-organ failure leading to death. Early in the COVID-19 pandemic, aspirin was suggested for the treatment of symptomatic individuals, given its analgesic, antipyretic, anti-inflammatory, anti-thrombotic, and antiviral effects. This study aimed to evaluate the association of aspirin use with various clinical outcomes in patients hospitalized for COVID-19. Methods This was a retrospective study involving patients aged ≥ 18 years and hospitalized for COVID-19 from March 2020 to October 2020. Primary outcomes were acute cardiovascular events (ST elevation myocardial infarction (STEMI), type 1 non-ST elevation myocardial infarction (NSTEMI), acute congestive heart failure (CHF), and acute stroke) and death. Secondary outcomes were respiratory failure, need for mechanical ventilation, and acute deep vein thrombosis (DVT)/pulmonary embolism (PE). Results Of 376 patients hospitalized for COVID-19, 128 were taking aspirin. Significant proportions of native Americans were hospitalized for COVID-19 in both aspirin (22.7%) and non-aspirin (24.6%) groups. Between aspirin and non-aspirin groups, no significant differences were found with regard to mechanical ventilator support (21.1% vs. 15.3%, P = 0.16), acute cardiovascular events (7.8% vs. 5.2%, P = 0.32), acute DVT/PE (3.9% vs. 5.2%, P = 0.9), readmission rate (13.3% vs. 12.9%, P = 0.91) and mortality (23.4% vs. 20.2%, P = 0.5); however, the median duration of mechanical ventilation was significantly shorter (7 vs. 9 days, P = 0.04) and median length of hospitalization was significantly longer (5.5 vs. 4 days, P = 0.01) in aspirin group compared to non-aspirin group. Conclusion No significant differences were found in acute cardiovascular events, acute DVT/PE, mechanical ventilator support, and mortality rate between hospitalized COVID-19 patients who were taking aspirin compared to those not taking aspirin. However, larger studies are required to confirm our findings.
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Affiliation(s)
- Poornima Vinod
- Department of Internal Medicine, University of North Carolina Health Southeastern, Lumberton, NC, USA
- Department of Medicine, Campbell University, Buies Creek, NC, USA
| | - Vinod Krishnappa
- Department of Internal Medicine, University of North Carolina Health Southeastern, Lumberton, NC, USA
| | - William Rathell
- Department of Internal Medicine, University of North Carolina Health Southeastern, Lumberton, NC, USA
| | - Saira Amir
- Department of Nephrology, University of Maryland, Baltimore, MD, USA
| | - Subrina Sundil
- Department of Nephrology, East Carolina University, Greenville, NC, USA
| | - Godwin Dogbey
- Campbell University School of Osteopathic Medicine, Buies Creek, NC, USA
| | - Hiten Patel
- Department of Cardiology, University of North Carolina Health Southeastern, Lumberton, NC, USA
| | - William Herzog
- Department of Cardiology, University of North Carolina Health Southeastern, Lumberton, NC, USA
- Department of Cardiology, Duke University, Durham, NC, USA
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93
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London SR, Chen S, Sidhom E, Lewis JR, Wolverson E, Cardinal RN, Roalf D, Mueller C, Underwood BR. Predicting patients with dementia most at risk of needing psychiatric in-patient or enhanced community care using routinely collected clinical data: retrospective multi-site cohort study. Br J Psychiatry 2024; 224:221-229. [PMID: 38738348 PMCID: PMC7615978 DOI: 10.1192/bjp.2024.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
BACKGROUND Dementia is a common and progressive condition whose prevalence is growing worldwide. It is challenging for healthcare systems to provide continuity in clinical services for all patients from diagnosis to death. AIMS To test whether individuals who are most likely to need enhanced care later in the disease course can be identified at the point of diagnosis, thus allowing the targeted intervention. METHOD We used clinical information collected routinely in de-identified electronic patient records from two UK National Health Service (NHS) trusts to identify at diagnosis which individuals were at increased risk of needing enhanced care (psychiatric in-patient or intensive (crisis) community care). RESULTS We examined the records of a total of 25 326 patients with dementia. A minority (16% in the Cambridgeshire trust and 2.4% in the London trust) needed enhanced care. Patients who needed enhanced care differed from those who did not in age, cognitive test scores and Health of the Nation Outcome Scale scores. Logistic regression discriminated risk, with an area under the receiver operating characteristic curve (AUROC) of up to 0.78 after 1 year and 0.74 after 4 years. We were able to confirm the validity of the approach in two trusts that differed widely in the populations they serve. CONCLUSIONS It is possible to identify, at the time of diagnosis of dementia, individuals most likely to need enhanced care later in the disease course. This permits the development of targeted clinical interventions for this high-risk group.
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Affiliation(s)
- Sabina R. London
- University of Cambridge, Department of Psychiatry, Herchel Smith Building, Forvie Site, Robinson Way, Cambridge CB2 0SZ
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104
| | - Shanquan Chen
- University of Cambridge, Department of Psychiatry, Herchel Smith Building, Forvie Site, Robinson Way, Cambridge CB2 0SZ
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, United Kingdom, WC1E 7HT
| | - Emad Sidhom
- University of Cambridge, Department of Clinical Neurosciences, Level 3, A Block, Box 165, Cambridge Biomedical Campus, CAMBRIDGE, CB2 0QQ
- Cambridgeshire and Peterborough NHS Foundation Trust, Windsor Unit, Fulbourn Hospital, Cambridge CB21 5EF, United Kingdom
| | - Jonathan R. Lewis
- Cambridgeshire and Peterborough NHS Foundation Trust, Windsor Unit, Fulbourn Hospital, Cambridge CB21 5EF, United Kingdom
| | - Emma Wolverson
- Faculty of Health Sciences, University of Hull, Hull, UK
| | - Rudolf N. Cardinal
- University of Cambridge, Department of Psychiatry, Herchel Smith Building, Forvie Site, Robinson Way, Cambridge CB2 0SZ
- Cambridgeshire and Peterborough NHS Foundation Trust, Windsor Unit, Fulbourn Hospital, Cambridge CB21 5EF, United Kingdom
| | - David Roalf
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104
| | - Christoph Mueller
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Benjamin R Underwood
- University of Cambridge, Department of Psychiatry, Herchel Smith Building, Forvie Site, Robinson Way, Cambridge CB2 0SZ
- Cambridgeshire and Peterborough NHS Foundation Trust, Windsor Unit, Fulbourn Hospital, Cambridge CB21 5EF, United Kingdom
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94
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Sand P, Dervisoski E, Kollia S, Strand J, Di Leone F. Psychiatrists' Perspectives on Prescription Decisions for Patients With Personality Disorders. J Pers Disord 2024; 38:225-240. [PMID: 38857158 DOI: 10.1521/pedi.2024.38.3.225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
There is currently insufficient evidence for the use of a specific pharmacological treatment for personality disorders (PD). The research literature lacks a systematic exploration of clinicians' experiences of pharmacological treatment of PD. The aim of the qualitative study was to examine how psychiatrists make decisions about pharmacological treatment for patients with PD. The interviews were analyzed using inductive thematic analysis. The results showed that ambiguous guidelines had the effect that the psychiatrists often relied on their own experience, or that of their colleagues. As a basis for decisions concerning drug treatment, an interpersonal component was also identified. Some of the psychiatrists in the current study argued that medications may be part of the alliance-building with the patient and that medications were a way of tying the patient to the clinic. Our findings show that it is important to work on how the clinical guidelines should be implemented in practice.
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Affiliation(s)
- Peter Sand
- Department of Psychology at Gothenburg University, Gothenburg, Sweden
- Department of Psychiatry for Affective Disorders at Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Evelina Dervisoski
- Department of Psychiatry for Affective Disorders at Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Sofia Kollia
- Department of Psychiatry for Affective Disorders at Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jennifer Strand
- Department of Psychology at Gothenburg University, Gothenburg, Sweden
| | - Flavio Di Leone
- Department of Psychiatry for Affective Disorders at Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
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95
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Ahmad QA, Mahboob U, Khan RA, Waheed K, Fahim A. Factors necessary for entrustment decision-making in surgical operating rooms: A modified Delphi study. J Taibah Univ Med Sci 2024; 19:611-618. [PMID: 38800351 PMCID: PMC11126524 DOI: 10.1016/j.jtumed.2024.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 03/18/2024] [Accepted: 05/03/2024] [Indexed: 05/29/2024] Open
Abstract
Objective Resident autonomy in an operation theatre has been directly linked with patient safety in healthcare. The objective of this study was to identify the factors necessary for making resident-entrustment decisions from the perspective of a supervisor/consultant viewpoint. The second objective was to develop a checklist for assessing resident readiness for independent work. Materials and methods This study employed a mixed-method Delphi approach. In the first stage, a comprehensive literature review and a qualitative exploratory study produced a list of factors related to residents. The second phase involved content validation by a panel of experts, followed by a two-round Delphi study with 20 expert panelists. Results A total of 49 resident-related factors for entrustment were identified, which were reduced to 46 after content validation. During Delphi Round I, 17 factors were fully accepted, 7 were rejected and 22 items were partially accepted. Out of the 39 items sent to Delphi Round II, 23 items were accepted and 16 were rejected. A final 23-item checklist was formed based on the following factors; 6 Cognitive (knowledgeable, risk manager, safe doctor, general manager, field of interest, communicator), 5 Psychomotor (past performer, competent, ability to pick critical findings, ability to act situationally, decision maker) and 12 affective (responsible, leader, honest, empathetic, ethical, receptive, humble, emotionally intelligent, motivated, accountable, team player, disciplined) factors. Conclusion The study resulted in the formation of a checklist based on the factors necessary for entrustment decision-making in surgical operating rooms. Some of the novel contextual factors were 'general manager', 'field of interest', 'ability to pick critical findings', 'accountable', 'risk manager', and 'past performer'. This framework offers a guideline for supervisors and residents to evaluate progress throughout the residency program. The developed tool demonstrates good content validity and is suitable for entrustment assessment following construct validation.
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Affiliation(s)
- Qamar A. Ahmad
- Department of Medical Education, The University of Lahore, Lahore, Pakistan
- Department of Surgery, Post Graduate Medical Institute, Ameer-u-din Medical College Lahore, Pakistan
| | - Usman Mahboob
- Department of Medical Education, Institute of Health Professions Education & Research, Khyber Medical University, Peshawar, Pakistan
| | - Rehan A. Khan
- Department of Medical Education, Islamic International Medical College, Riphah International University, Islamabad, Pakistan
| | - Khadija Waheed
- Department of Obstetrics & Gynaecology, King Edward Medical University, Lahore, Pakistan
| | - Ayesha Fahim
- Department of Oral Biology, University College of Dentistry, The University of Lahore, Lahore, Pakistan
- Department of Health Sciences, The Equator University of Science and Technology, Uganda
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Uğurlu Z, Kav S, Eler ÇÖ, Kaya S, Korkmaz Y. Health literacy in older adults receiving hemodialysis in Turkey: A cross-sectional study. Ther Apher Dial 2024; 28:380-389. [PMID: 38163856 DOI: 10.1111/1744-9987.14102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 12/10/2023] [Accepted: 12/19/2023] [Indexed: 01/03/2024]
Abstract
INTRODUCTION This study aimed to determine the health literacy level and related factors of older adults receiving hemodialysis treatment. METHODS A cross-sectional study was conducted at the five dialysis centers, using the information form and Turkish Health Literacy Survey-32 (THLS-32). A total of 336 older adults receiving hemodialysis treatment participated. RESULTS The general health literacy score was found to be 25.69 ± 14.47. Based on the health literacy assessment scores, 62.5% of the participants were in the category of inadequate and limited level of health literacy. The lower level of education, perceived health status, income, and getting help in reading and writing were statistically significant predictors of the health literacy score. CONCLUSION The health literacy of older adults receiving hemodialysis treatment was inadequate and limited. Findings of this study emphasize the importance of integrating health literacy assessment in clinical care settings and supporting the health literacy of older adults receiving hemodialysis treatment.
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Affiliation(s)
- Ziyafet Uğurlu
- Faculty of Health Sciences, Department of Nursing, Baskent University, Ankara, Turkey
| | - Sultan Kav
- Faculty of Health Sciences, Department of Nursing, Baskent University, Ankara, Turkey
| | - Çiğdem Özdemir Eler
- Vocational Health School, Dialysis Program, Baskent University, Ankara, Turkey
| | - Semiha Kaya
- Umitkoy Dialysis Center Director, Baskent University, Ankara, Turkey
| | - Yasemin Korkmaz
- Cigdem Dialysis Center, Baskent University Hospital, Ankara, Turkey
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97
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Marie Mills C, Keller H, DePaul VG, Donnelly C. Social factors associated with changes in nutrition risk scores measured using SCREEN-8: data from the Canadian Longitudinal Study on Aging. CAN J DIET PRACT RES 2024; 85:83-90. [PMID: 38829673 DOI: 10.3148/cjdpr-2024-014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
Purpose: To examine the social network factors associated with changes in nutrition risk scores, measured by SCREEN-8, over three years, in community-dwelling Canadians aged 45 years and older, using data from the Canadian Longitudinal Study on Aging (CLSA).Methods: Change in SCREEN-8 scores between the baseline and first follow-up waves of the CLSA was calculated by subtracting SCREEN-8 scores at follow-up from baseline scores. Multivariable linear regression was used to examine the factors associated with change in SCREEN-8 score.Results: The mean SCREEN-8 score at baseline was 38.7 (SD = 6.4), and the mean SCREEN-8 score at follow-up was 37.9 (SD = 6.6). The mean change in SCREEN-8 score was -0.90 (SD = 5.99). Higher levels of social participation (participation in community activities) were associated with increases in SCREEN-8 scores between baseline and follow-up, three years later.Conclusions: Dietitians should be aware that individuals with low levels of social participation may be at risk for having their nutritional status decrease over time and consideration should be given to screening them proactively for nutrition risk. Dietitians can develop and support programs aimed at combining food with social participation.
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Affiliation(s)
| | - Heather Keller
- Schlegel-UW Research Institute for Aging, and Department of Kinesiology & Health Sciences, University of Waterloo, Waterloo, ON
| | - Vincent G DePaul
- School of Rehabilitation Therapy and Health Services and Policy Research Institute, Queen's University, Kingston, ON
| | - Catherine Donnelly
- School of Rehabilitation Therapy and Health Services and Policy Research Institute, Queen's University, Kingston, ON
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98
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Hu X, Zhang L, Zhang M, Mi W, Sun Y, Wang Y, Zou H, Liu C, Xu S. Correlation of subclinical hypothyroidism with sarcopenia and its components in the Chinese older adults. Endocrine 2024; 84:1030-1039. [PMID: 38151629 DOI: 10.1007/s12020-023-03654-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 12/09/2023] [Indexed: 12/29/2023]
Abstract
OBJECTIVE To identify the correlation of thyroid function and subclinical hypothyroidism (SCH) with sarcopenia and its components in the older Chinese adults. METHODS Older adults were recruited and divided into SCH group and non-SCH group. Free triiodothyronine (FT3), free thyroxine (FT4) and thyroid-stimulating hormone (TSH) were measured by electrochemiluminescence. Appendicular skeletal muscle mass (ASM) was measured, and skeletal muscle index (SMI) was further calculated. Grip strength was measured. Physical performance was graded by the Short Physical Performance Battery (SPPB) scores of the gait speed test, chair stand test and balance test. RESULTS Of the 240 older adults included, 48 (20.00%) presented with SCH. The prevalence of sarcopenia in SCH group was higher than that in non-SCH group (33.33% v.s. 18.75%). Grip strength was significantly lower in patients with SCH than those without sarcopenia. In terms of physical performance, 6-meter gait speed and SPPB score were lower in subjects with SCH than those without SCH, while 5 sit-to-stand movements was longer score in subjects with SCH than those without SCH. SCH was significantly correlated with sarcopenia, while FT3, FT4, and TSH levels were not. SCH was significantly correlated with low muscle strength and low muscle mass, but not with low physical performance. FT3 level was positively correlated with grip strength and SMI. TSH level was negatively correlated with grip strength, 6-meter gait speed, and SPPB score, but positively correlated with the time of 5 sit-to-stand movements. CONCLUSION SCH is a risk factor for sarcopenia in the older adults and correlated with low muscle strength and low muscle mass, but not with low physical performance. FT3, FT4 and TSH levels are associated with sarcopenia components, but not with sarcopenia.
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Affiliation(s)
- Xin Hu
- Endocrine and Diabetes Center, The Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Endocrine and Diabetes Center, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China
| | - Lina Zhang
- Endocrine and Diabetes Center, The Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Endocrine and Diabetes Center, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China
| | - Mengjie Zhang
- Endocrine and Diabetes Center, The Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Endocrine and Diabetes Center, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China
| | - Weinuo Mi
- Endocrine and Diabetes Center, The Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Endocrine and Diabetes Center, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China
| | - Yu Sun
- Department of Endocrinology, The Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, China
| | - Yan Wang
- Department of Geriatrics, The Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, China.
| | - Huiling Zou
- Department of Endocrinology, The Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, China
| | - Chao Liu
- Endocrine and Diabetes Center, The Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Endocrine and Diabetes Center, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China
- Key Laboratory of TCM Syndrome and Treatment of Yingbing (Thyroid Disease) of State Administration of Traditional Chinese Medicine, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China
| | - Shuhang Xu
- Endocrine and Diabetes Center, The Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China.
- Endocrine and Diabetes Center, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China.
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Huang YS, Chen JLY, Ko WC, Chang YH, Chang CH, Chang YC. Clinical Variables and Radiomics Features for Predicting Pneumothorax in Patients Undergoing CT-guided Transthoracic Core Needle Biopsy. Radiol Cardiothorac Imaging 2024; 6:e230278. [PMID: 38780426 PMCID: PMC11211933 DOI: 10.1148/ryct.230278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 02/02/2024] [Accepted: 03/27/2024] [Indexed: 05/25/2024]
Abstract
Purpose To develop a prediction model combining both clinical and CT texture analysis radiomics features for predicting pneumothorax complications in patients undergoing CT-guided core needle biopsy. Materials and Methods A total of 424 patients (mean age, 65.6 years ± 12.7 [SD]; 232 male, 192 female) who underwent CT-guided core needle biopsy between January 2021 and October 2022 were retrospectively included as the training data set. Clinical and procedure-related characteristics were documented. Texture analysis radiomics features were extracted from the subpleural lung parenchyma traversed by needle. Moderate pneumothorax was defined as a postprocedure air rim of 2 cm or greater. The prediction model was developed using logistic regression with backward elimination, presented by linear fusion of the selected features weighted by their coefficients. Model performance was assessed using the area under the receiver operating characteristic curve (AUC). Validation was conducted in an external cohort (n = 45; mean age, 58.2 years ± 12.7; 19 male, 26 female) from a different hospital. Results Moderate pneumothorax occurred in 12.0% (51 of 424) of the training cohort and 8.9% (four of 45) of the external test cohort. Patients with emphysema (P < .001) or a longer needle path length (P = .01) exhibited a higher incidence of moderate pneumothorax in the training cohort. Texture analysis features, including gray-level co-occurrence matrix cluster shade (P < .001), gray-level run-length matrix low gray-level run emphasis (P = .049), gray-level run-length matrix run entropy (P = .003), gray-level size-zone matrix gray-level variance (P < .001), and neighboring gray-tone difference matrix complexity (P < .001), showed higher values in patients with moderate pneumothorax. The combined clinical-radiomics model demonstrated satisfactory performance in both the training (AUC 0.78, accuracy = 71.9%) and external test cohorts (AUC 0.86, accuracy 73.3%). Conclusion The model integrating both clinical and radiomics features offered practical diagnostic performance and accuracy for predicting moderate pneumothorax in patients undergoing CT-guided core needle biopsy. Keywords: Biopsy/Needle Aspiration, Thorax, CT, Pneumothorax, Core Needle Biopsy, Texture Analysis, Radiomics, CT Supplemental material is available for this article. © RSNA, 2024.
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Affiliation(s)
- Yu-Sen Huang
- From the Department of Medical Imaging (Y.S.H., W.C.K., Y.C.C.) and
Statistical Consulting Unit (Y.H.C., C.H.C.), National Taiwan University
Hospital, No. 7 Chung-Shan S. Rd, Taipei 100, Taiwan; Department of Radiology,
National Taiwan University College of Medicine, Taipei, Taiwan (Y.S.H.,
J.L.Y.C., Y.C.C.); and Department of Radiation Oncology, National Taiwan
University Cancer Center, Taipei, Taiwan (J.L.Y.C.)
| | - Jenny Ling-Yu Chen
- From the Department of Medical Imaging (Y.S.H., W.C.K., Y.C.C.) and
Statistical Consulting Unit (Y.H.C., C.H.C.), National Taiwan University
Hospital, No. 7 Chung-Shan S. Rd, Taipei 100, Taiwan; Department of Radiology,
National Taiwan University College of Medicine, Taipei, Taiwan (Y.S.H.,
J.L.Y.C., Y.C.C.); and Department of Radiation Oncology, National Taiwan
University Cancer Center, Taipei, Taiwan (J.L.Y.C.)
| | - Wei-Chun Ko
- From the Department of Medical Imaging (Y.S.H., W.C.K., Y.C.C.) and
Statistical Consulting Unit (Y.H.C., C.H.C.), National Taiwan University
Hospital, No. 7 Chung-Shan S. Rd, Taipei 100, Taiwan; Department of Radiology,
National Taiwan University College of Medicine, Taipei, Taiwan (Y.S.H.,
J.L.Y.C., Y.C.C.); and Department of Radiation Oncology, National Taiwan
University Cancer Center, Taipei, Taiwan (J.L.Y.C.)
| | - Yu-Han Chang
- From the Department of Medical Imaging (Y.S.H., W.C.K., Y.C.C.) and
Statistical Consulting Unit (Y.H.C., C.H.C.), National Taiwan University
Hospital, No. 7 Chung-Shan S. Rd, Taipei 100, Taiwan; Department of Radiology,
National Taiwan University College of Medicine, Taipei, Taiwan (Y.S.H.,
J.L.Y.C., Y.C.C.); and Department of Radiation Oncology, National Taiwan
University Cancer Center, Taipei, Taiwan (J.L.Y.C.)
| | - Chin-Hao Chang
- From the Department of Medical Imaging (Y.S.H., W.C.K., Y.C.C.) and
Statistical Consulting Unit (Y.H.C., C.H.C.), National Taiwan University
Hospital, No. 7 Chung-Shan S. Rd, Taipei 100, Taiwan; Department of Radiology,
National Taiwan University College of Medicine, Taipei, Taiwan (Y.S.H.,
J.L.Y.C., Y.C.C.); and Department of Radiation Oncology, National Taiwan
University Cancer Center, Taipei, Taiwan (J.L.Y.C.)
| | - Yeun-Chung Chang
- From the Department of Medical Imaging (Y.S.H., W.C.K., Y.C.C.) and
Statistical Consulting Unit (Y.H.C., C.H.C.), National Taiwan University
Hospital, No. 7 Chung-Shan S. Rd, Taipei 100, Taiwan; Department of Radiology,
National Taiwan University College of Medicine, Taipei, Taiwan (Y.S.H.,
J.L.Y.C., Y.C.C.); and Department of Radiation Oncology, National Taiwan
University Cancer Center, Taipei, Taiwan (J.L.Y.C.)
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Kim G, Hwang M, Lee S, Park YH. Malnutrition and its associated factors among community-dwelling older men living alone. Nutr Res Pract 2024; 18:400-411. [PMID: 38854473 PMCID: PMC11156769 DOI: 10.4162/nrp.2024.18.3.400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 03/18/2024] [Accepted: 04/15/2024] [Indexed: 06/11/2024] Open
Abstract
BACKGROUND/OBJECTIVES Older men who live alone are more vulnerable to poor nutrition. However, little attention has been paid to malnutrition among this population. This study aimed to examine malnutrition and its associated factors among community-dwelling older men living alone. SUBJECTS/METHODS This cross-sectional descriptive study used cohort data of community-dwelling older adults living alone in South Korea. A total of 230 older men aged 65 and over were included in this study. Nutritional status was assessed using the Mini Nutritional Assessment-Short Form. Multidimensional factors (sociodemographic, health-related, psychosocial, and lifestyle characteristics) were evaluated. Hierarchical logistic regression analyses were conducted to identify the malnutrition-related factors. RESULTS The prevalence of malnutrition was 32.2% in older men living alone. Low income (odds ratio [OR], 2.44; 95% confidence interval [CI], 1.01-5.90), polypharmacy (OR, 2.23; 95% CI, 1.16-4.28), suicidal ideation (OR, 2.13; 95% CI, 1.02-4.45), meal skipping (OR, 3.26; 95% CI, 1.60-6.64), and smoking (OR, 2.86; 95% CI, 1.43-5.73) were significantly associated with malnutrition. CONCLUSION Malnutrition is a severe health problem in older men living alone. This study highlights the importance of comprehensive and tailored interventions to mitigate malnutrition among older men living alone.
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Affiliation(s)
- Gahye Kim
- College of Nursing, Seoul National University, Seoul 03080, Korea
| | - Minhwa Hwang
- College of Nursing, Seoul National University, Seoul 03080, Korea
| | - Seonghyeon Lee
- College of Nursing, Seoul National University, Seoul 03080, Korea
| | - Yeon-Hwan Park
- College of Nursing, Seoul National University, Seoul 03080, Korea
- The Research Institute of Nursing Science, College of Nursing, Seoul National University, Seoul 03080, Korea
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