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Lu Q, Schulz PJ, Chang A. Medication safety perceptions in China: Media exposure, healthcare experiences, and trusted information sources. Patient Educ Couns 2024; 123:108209. [PMID: 38367304 DOI: 10.1016/j.pec.2024.108209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 01/01/2024] [Accepted: 02/12/2024] [Indexed: 02/19/2024]
Abstract
OBJECTIVE Amid ongoing medication safety concerns in China and limited research on public perceptions, this study investigates the correlations between media exposure, healthcare experiences, and individuals' perceptions of medication safety. It also examines individuals' reliance on information sources during safety crises. METHODS A multistage stratified random sampling was employed with the gross sample containing 3090 Chinese adults aged 18-60 years. Data were analyzed using multiple linear regression. RESULTS Social media exposure was found to negatively correlate with perceptions of current medication safety and its perceived improvement, while exposure to television and print media showed positive correlations. Positive healthcare experiences were associated with improved medication safety perceptions. Among various information sources, healthcare professionals were deemed most trustworthy during medication safety incidents. CONCLUSIONS Media exposure and personal healthcare experiences significantly shape individuals' perceptions of medication safety in China, with healthcare professionals playing a crucial role in this context. Practiceimplications: Effective health crisis communication in China needs to be multifaceted, integrating traditional media and social media platforms to disseminate accurate information broadly. Additionally, healthcare professionals should be actively involved in crisis communication. Their role as trusted sources can be leveraged to clarify misconceptions, and reassure the public during medication safety incidents.
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Affiliation(s)
- Qianfeng Lu
- Faculty of Communication, Culture and Society, Università della Svizzera italiana (USI), Lugano, Switzerland
| | - Peter J Schulz
- Faculty of Communication, Culture and Society, Università della Svizzera italiana (USI), Lugano, Switzerland; Department of Communication & Media, Ewha Womans University, Seoul, South Korea.
| | - Angela Chang
- Faculty of Social Sciences, University of Macau, Macau, China
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Xian X, Neuwirth RJ, Chang A. Government-Nongovernmental Organization (NGO) Collaboration in Macao's COVID-19 Vaccine Promotion: Social Media Case Study. JMIR Infodemiology 2024; 4:e51113. [PMID: 38502184 PMCID: PMC10988378 DOI: 10.2196/51113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 11/19/2023] [Accepted: 11/29/2023] [Indexed: 03/20/2024]
Abstract
BACKGROUND The COVID-19 pandemic triggered unprecedented global vaccination efforts, with social media being a popular tool for vaccine promotion. OBJECTIVE This study probes into Macao's COVID-19 vaccine communication dynamics, with a focus on the multifaceted impacts of government agendas on social media. METHODS We scrutinized 22,986 vaccine-related Facebook posts from January 2020 to August 2022 in Macao. Using automated content analysis and advanced statistical methods, we unveiled intricate agenda dynamics between government and nongovernment entities. RESULTS "Vaccine importance" and "COVID-19 risk" were the most prominent topics co-occurring in the overall vaccine communication. The government tended to emphasize "COVID-19 risk" and "vaccine effectiveness," while regular users prioritized vaccine safety and distribution, indicating a discrepancy in these agendas. Nonetheless, the government has limited impact on regular users in the aspects of vaccine importance, accessibility, affordability, and trust in experts. The agendas of government and nongovernment users intertwined, illustrating complex interactions. CONCLUSIONS This study reveals the influence of government agendas on public discourse, impacting environmental awareness, public health education, and the social dynamics of inclusive communication during health crises. Inclusive strategies, accommodating public concerns, and involving diverse stakeholders are paramount for effective social media communication during health crises.
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Affiliation(s)
- Xuechang Xian
- Department of Publicity, Zhaoqing University, Zhaoqing, China
- Department of Communication, University of Macau, Macao SAR, China
| | - Rostam J Neuwirth
- Department of Global Legal Studies, University of Macau, Macao SAR, China
| | - Angela Chang
- Department of Communication, University of Macau, Macao SAR, China
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de Jersey S, Keramat SA, Chang A, Meloncelli N, Guthrie T, Eakin E, Comans T. A cost-effectiveness evaluation of a dietitian-delivered telephone coaching program during pregnancy for preventing gestational diabetes mellitus. Cost Eff Resour Alloc 2024; 22:18. [PMID: 38429805 PMCID: PMC10908067 DOI: 10.1186/s12962-024-00520-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 01/26/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND This study aimed to evaluate the cost-effectiveness of a telehealth coaching intervention to prevent gestational diabetes mellitus (GDM) and to calculate the breakeven point of preventing GDM. METHODS Data to inform the economic evaluation model was sourced directly from the large quaternary hospital in Brisbane, where the Living Well during Pregnancy (LWdP) program was implemented, and further supplemented with literature-based estimates where data had not been directly collected in the trial. A cost-effectiveness model was developed using a decision tree framework to estimate the potential for cost savings and quality of life improvement. A total of 1,315 pregnant women (49% with a BMI 25-29.9, and 51% with a BMI ≥ 30) were included in the analyses. RESULTS The costs of providing routine care and routine care plus LWdP coaching intervention to pregnant women were calculated to be AUD 20,933 and AUD 20,828, respectively. The effectiveness of the LWdP coaching program (0.894 utility) was slightly higher compared to routine care (0.893). Therefore, the value of the incremental cost-effectiveness ratio (ICER) was negative, and it indicates that the LWdP coaching program is a dominant strategy to prevent GDM in pregnant women. We also performed a probabilistic sensitivity analysis using Monte Carlo simulation through 1,000 simulations. The ICE scatter plot showed that the LWdP coaching intervention was dominant over routine care in 93.60% of the trials using a willingness to pay threshold of AUD 50,000. CONCLUSION Findings support consideration by healthcare policy and decision makers of telehealth and broad-reach delivery of structured lifestyle interventions during pregnancy to lower short-term costs associated with GDM to the health system.
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Affiliation(s)
- Susan de Jersey
- Department of Dietetics and Food Services, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia.
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia.
| | - Syed Afroz Keramat
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Angela Chang
- Centre for Allied Health Research, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia
| | - Nina Meloncelli
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Taylor Guthrie
- Department of Dietetics and Food Services, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Elizabeth Eakin
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Tracy Comans
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
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Brummund D, Chang A, Michienzi J. Nontuberculous Mycobacterial Infection of Facial Implant Following Cosmetic Surgery Abroad. Eplasty 2024; 24:QA4. [PMID: 38501143 PMCID: PMC10948198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
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Sun HL, Zhao YJ, Sha S, Li XH, Si TL, Liu YF, Su Z, Cheung T, Chang A, Liu ZM, Li X, Ng CH, An FR, Xiang YT. Depression and anxiety among caregivers of psychiatric patients during the late stage of the COVID-19 pandemic: A perspective from network analysis. J Affect Disord 2024; 344:33-40. [PMID: 37793475 DOI: 10.1016/j.jad.2023.09.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 09/17/2023] [Accepted: 09/30/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND Depressive and anxiety symptoms (depression and anxiety hereafter) are common among psychiatric patients and their caregivers during the COVID-19 pandemic. Network analysis is a novel method to assess the associations between psychiatric syndromes/disorders at the symptom level. This study examined depression and anxiety among caregivers of psychiatric inpatients during the late stage of the COVID-19 pandemic from the perspective of network analysis. METHODS A total of 1101 caregivers of psychiatric inpatients were included in this study. The severity of depression was assessed using the nine-item Patient Health Questionnaire (PHQ-9), while anxiety was assessed with the seven-item Generalized Anxiety Disorder Scale (GAD-7). The expected index (EI) and bridge EI index were used to identify the central and bridge symptoms, respectively. The stability of the network was evaluated via a case-dropping bootstrap procedure. RESULTS The prevalence of depression and anxiety were 32.4 % (95%CI: 29.7 %-35.3 %) and 28.0 % (95%CI: 25.4 %-30.7 %), respectively while the prevalence of comorbid depression and anxiety was 24.9 % (95%CI: 22.4 %-27.6 %). The most central symptom was "Fatigue", followed by "Trouble Relaxing" and "Restlessness". The highest bridge symptom was "Restlessness", followed by "Uncontrollable worry" and "Suicide ideation". The bootstrap test indicated that the whole network model was stable, and no network difference was detected between genders and between different education levels. CONCLUSIONS Depression, anxiety, and comorbid depression and anxiety were common among caregivers of psychiatric inpatients during the late stage of the COVID-19 pandemic. Central and bridge symptoms identified in this network analysis should be considered key target symptoms to address in caregivers of patients.
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Affiliation(s)
- He-Li Sun
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
| | - Yan-Jie Zhao
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Sha Sha
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Xiao-Hong Li
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, China
| | - Tong Leong Si
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Yu-Fei Liu
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Zhaohui Su
- School of Public Health, Southeast University, Nanjing, China
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Angela Chang
- Department of Communication, Faculty of Social Sciences, University of Macau, Macau SAR, China
| | - Zhao-Min Liu
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xinyue Li
- School of Data Science, City University of Hong Kong, Hong Kong SAR, China
| | - Chee H Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, Victoria, Australia.
| | - Feng-Rong An
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China.
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Wu X, Zhai F, Chang A, Wei J, Guo Y, Zhang J. Application of machine learning algorithms to predict osteoporosis in postmenopausal women with type 2 diabetes mellitus. J Endocrinol Invest 2023; 46:2535-2546. [PMID: 37171784 DOI: 10.1007/s40618-023-02109-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 05/03/2023] [Indexed: 05/13/2023]
Abstract
PURPOSE The screening and diagnosis of osteoporosis in patients with type 2 diabetes mellitus (T2DM) based on bone mineral density remains challenging because of the limited availability and accessibility of dual-energy X-ray absorptiometry. We aimed to develop and validate models to predict the risk of osteoporosis in postmenopausal women with T2DM based on machine learning (ML) algorithms. METHODS This retrospective study included 303 postmenopausal women with T2DM. To develop prediction models for osteoporosis, we applied nine ML algorithms combined with demographic, clinical, and laboratory data. The least absolute shrinkage and selection operator were used to perform feature selection. We used the bootstrap resampling technique for model training and validation. To test the performance of the models, we calculated indices including the area under the receiver operating characteristic curve (AUROC), accuracy, sensitivity, specificity, positive predictive value, negative predictive value, F1 score, calibration curve, and decision curve analysis. Furthermore, we conducted fivefold cross-validation for parameter optimization and model validation. Feature importance was assessed using the SHapley additive explanation (SHAP). RESULTS We identified 10 independent predictors as the most valuable features. An AUROC of 0.616-1.000 was observed for nine ML algorithms. The extreme gradient boosting (XGBoost) model exhibited the best performance, outperforming conventional risk assessment tools and registering 0.993 in the training set, 0.798 in the validation set, and 0.786 in the test set for fivefold cross-validation. Using SHAP, we found that the explanatory variables contributed to the model and their relationship with osteoporosis occurrence. Furthermore, we developed a user-friendly tool for calculating the risk of osteoporosis. CONCLUSIONS With the integration of demographic and clinical risk factors, ML algorithms can accurately predict osteoporosis. The XGBoost model showed ideal performance. With the incorporation of these models in the clinic, patients may benefit from early osteoporosis diagnosis and treatment.
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Affiliation(s)
- X Wu
- Department of Endocrinology, Cangzhou Central Hospital, 16 Xinhua West Road, Cangzhou, 061000, Hebei, People's Republic of China.
| | - F Zhai
- Gynecological Clinic, Cangzhou Central Hospital, 16 Xinhua West Road, Cangzhou, 061000, Hebei, People's Republic of China
| | - A Chang
- Department of Endocrinology, Cangzhou Central Hospital, 16 Xinhua West Road, Cangzhou, 061000, Hebei, People's Republic of China
| | - J Wei
- Department of Endocrinology, Cangzhou Central Hospital, 16 Xinhua West Road, Cangzhou, 061000, Hebei, People's Republic of China
| | - Y Guo
- Department of Endocrinology, Cangzhou Central Hospital, 16 Xinhua West Road, Cangzhou, 061000, Hebei, People's Republic of China
| | - J Zhang
- Department of Endocrinology, Cangzhou Central Hospital, 16 Xinhua West Road, Cangzhou, 061000, Hebei, People's Republic of China
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Jiao W, Chang A, Ho M, Lu Q, Liu MT, Schulz PJ. Predicting and Empowering Health for Generation Z by Comparing Health Information Seeking and Digital Health Literacy: Cross-Sectional Questionnaire Study. J Med Internet Res 2023; 25:e47595. [PMID: 37902832 PMCID: PMC10644182 DOI: 10.2196/47595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 06/30/2023] [Accepted: 07/18/2023] [Indexed: 10/31/2023] Open
Abstract
BACKGROUND Generation Z (born 1995-2010) members are digital residents who use technology and the internet more frequently than any previous generation to learn about their health. They are increasingly moving away from conventional methods of seeking health information as technology advances quickly and becomes more widely available, resulting in a more digitalized health care system. Similar to all groups, Generation Z has specific health care requirements and preferences, and their use of technology influences how they look for health information. However, they have often been overlooked in scholarly research. OBJECTIVE First, we aimed to identify the information-seeking preferences of older individuals and Generation Z (those between the ages of 18 and 26 years); second, we aimed to predict the effects of digital health literacy and health empowerment in both groups. We also aimed to identify factors that impact how both groups engage in digital health and remain in control of their own health. METHODS The Health Information National Trends Survey was adopted for further use in 2022. We analyzed 1862 valid data points by conducting a survey among Chinese respondents to address the research gap. A descriptive analysis, 2-tailed t test, and multiple linear regression were applied to the results. RESULTS When compared with previous generations, Generation Z respondents (995/1862, 53.44%) were more likely to use the internet to find out about health-related topics, whereas earlier generations relied more on traditional media and interpersonal contact. Web-based information-seeking behavior is predicted by digital health literacy (Generation Z: β=.192, P<.001; older population: β=.337, P<.001). While this was happening, only seeking health information from physicians positively predicted health empowerment (Generation Z: β=.070, P=.002; older population: β=.089, P<.001). Despite more frequent use of the internet to learn about their health, Generation Z showed lower levels of health empowerment and less desire to look for health information, overall. CONCLUSIONS This study examined and compared the health information-seeking behaviors of Generation Z and older individuals to improve their digital health literacy and health empowerment. The 2 groups demonstrated distinct preferences regarding their choice of information sources. Health empowerment and digital health literacy were both significantly related to information-seeking behaviors.
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Affiliation(s)
- Wen Jiao
- School of Communication, Soochow University, Suzhou, China
| | - Angela Chang
- Department of Communication, Faculty of Social Sciences, University of Macau, Macao, China
- Institute of Communication and Health, University of Lugano, Lugano, Switzerland
| | - Mary Ho
- Faculty of Communication, Culture and Society, University of Lugano, Lugano, Switzerland
| | - Qianfeng Lu
- Faculty of Communication, Culture and Society, University of Lugano, Lugano, Switzerland
| | | | - Peter Johannes Schulz
- Institute of Communication and Health, University of Lugano, Lugano, Switzerland
- Faculty of Communication, Culture and Society, University of Lugano, Lugano, Switzerland
- Department of Communications and Media, Ewha Womans University, Seoul, Republic of Korea
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Bell DC, Greg Lin HY, Akey A, Kraemer S, Borenstein JT, Dvorin JD, Chang A. From Archeology to the Malaria Parasite, the Exciting Quests of Microscopy. Microsc Microanal 2023; 29:86-87. [PMID: 37613100 DOI: 10.1093/micmic/ozad067.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Affiliation(s)
- David C Bell
- Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA
| | - Hao-Yu Greg Lin
- Center for Nanoscale Systems, Harvard University, Cambridge, MA, USA
| | - Austin Akey
- Center for Nanoscale Systems, Harvard University, Cambridge, MA, USA
| | - Stephan Kraemer
- Center for Nanoscale Systems, Harvard University, Cambridge, MA, USA
| | | | - Jeffrey D Dvorin
- Boston Children's Hospital, Boston, MA, USA
- Research groups thereof
| | - Angela Chang
- Harvard Art Museums, Harvard University, Cambridge, MA, USA
- Research groups thereof
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Brummund D, Chang A. Distal Dorsal Thumb Mass: Giant Cell Tumor of the Tendon Sheath in an Unusual Location. Cureus 2023; 15:e41532. [PMID: 37551250 PMCID: PMC10404461 DOI: 10.7759/cureus.41532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2023] [Indexed: 08/09/2023] Open
Abstract
Giant cell tumor of the tendon sheath (GCTTS) is a common mass in the digits, hands, and upper extremities. Diagnosis is made on clinical examination, adjunctive imaging, and distinct intraoperative findings. Surgical excision is the mainstay of treatment. GCTTS are typically found on flexor surfaces with the dorsal distal thumb being an unusual location. Any surgical approach to the digit should balance oncologic margins with preserving function. GCTTS have a tendency to recur and should be approached in a methodical manner with risk factors of recurrence in mind. This case report reviews the history of GCTTS, surgical approaches to the digit, and risk factors for recurrence to achieve success in the surgical management of these tumors.
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Affiliation(s)
| | - Angela Chang
- Anesthesiology, Aventura Hospital and Medical Center, Miami, USA
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Voss C, Liu J, Chang A, Kosmas JA, Biehl A, Flynn RL, Kruzan KP, Wildes JE, Graham AK. Weight Loss Expectations of Adults With Binge Eating: Cross-sectional Study With a Human-Centered Design Approach. JMIR Form Res 2023; 7:e40506. [PMID: 36853750 PMCID: PMC10015344 DOI: 10.2196/40506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 12/17/2022] [Accepted: 01/03/2023] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND People tend to overestimate their expectations for weight loss relative to what is achievable in a typical evidence-based behavioral weight management program, which can impact treatment satisfaction and outcomes. We are engaged in formative research to design a digital intervention that addresses binge eating and weight management; thus, understanding expectations among this group can inform more engaging intervention designs to produce a digital intervention that can achieve greater clinical success. Studies examining weight loss expectations have primarily focused on people who have overweight or obesity. Only one study has investigated weight loss expectations among people with binge eating disorder, a population that frequently experiences elevated weight and shape concerns and often presents to treatment with the goal of losing weight. OBJECTIVE The aim of the study is to investigate differences in weight loss expectations among people with varying levels of binge eating to inform the design of a digital intervention for binge eating and weight management. Such an evaluation may be crucial for people presenting for a digital intervention, given that engagement and dropout are notable problems for digital behavior change interventions. We tested the hypotheses that (1) people who endorsed some or recurrent binge eating would expect to lose more weight than those who did not endorse binge eating and (2) people who endorsed a more severe versus a low or moderate overvaluation of weight and shape would have higher weight loss expectations. METHODS A total of 760 adults (n=504, 66% female; n=441, 58% non-Hispanic White) completed a web-based screening questionnaire. One-way ANOVAs were conducted to explore weight loss expectations for binge eating status as well as overvaluation of shape and weight. RESULTS Weight loss expectations significantly differed by binge eating status. Those who endorsed some and recurrent binge eating expected to lose more weight than those who endorsed no binge eating. Participants with severe overvaluation of weight or shape expected to lose the most weight compared to those with low or moderate levels of overvaluation of weight and shape. CONCLUSIONS In the sample, people interested in a study to inform a digital intervention for binge eating and weight management overestimated their expectations for weight loss. Given that weight loss expectations can impact treatment completion and success, it may be important to assess and modify weight loss expectations among people with binge eating prior to enrolling in a digital intervention. Future work should design and test features that can modify these expectations relative to individuals' intended treatment goals to facilitate engagement and successful outcomes in a digital intervention.
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Affiliation(s)
- Claire Voss
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Jianyi Liu
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Angela Chang
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Jacqueline A Kosmas
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Abigail Biehl
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Rebecca L Flynn
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Kaylee P Kruzan
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Jennifer E Wildes
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, United States
| | - Andrea K Graham
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
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Liu PL, Chang A, Liu MT, Ye JF, Jiao W, Ao HS, Hu W, Xu K, Zhao X. Effect of information encounter on concerns over healthy eating- mediated through body comparison and moderated by body mass index or body satisfaction. BMC Public Health 2023; 23:254. [PMID: 36747209 PMCID: PMC9901112 DOI: 10.1186/s12889-023-15069-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 01/17/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Understanding factors that influence healthy or unhealthy eating can inform intervention strategies. This study ascertained whether and how unintentional exposure to food and nutrition information influenced healthy eating concerns. The study tested body comparison, body satisfaction, and body mass index as three mechanisms that potentially link food information encounter, commonly known as information scanning, to healthy eating concerns. METHODS A sample of 440 online participants (mean age = 29.15 years) was used to investigate: (1) how unintentional exposure to food and nutrition information, i.e., information encounter (IE), affects healthy eating concerns (HEC); (2) how the effect of IE on HEC is mediated by body comparison (BC); (3) how the paths of the mediation model are moderated by body satisfaction (BS) or body mass index (BMI). RESULTS The findings show a positive and sizable total effect of IE on HEC - a whole-scale increase in information encounter is associated with a substantial increase in healthy eating concerns by 15 percentage points (bp = 0.150). BC is found to mediate the effect of IE on HEC in an all-positive complementary mediation. Both the indirect and the direct-and-remainder paths show sizable effects. The mediated path contributes about 20% of the total effect between IE and HEC (cp = 20%), while the direct-and-remainder path contributes the rest (cp = 80%). BS was found to moderate the relationship between IE and BC, the first leg of the mediation. The moderation effect is large - the effect of IE on BC is much smaller on the highly and the moderately satisfied than on the lowly satisfied (slope differential bp = -.60). BMI was found to moderate the direct-and-remainder effect of IE on HEC, controlling BC. That is, the effect of IE on HEC, after filtering out the mediated effect through BC, is much larger for those with high or low BMI than those with healthy BMI (slope differential bp = .32). CONCLUSIONS Exposure, even if unintentional, to food and nutrition information is an important predictor of HEC. BC, BS, and BMI are important factors that help to explain the process through which information affects behaviors.
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Affiliation(s)
- Piper Liping Liu
- Department of Communication / Institute of Collaborative Research, University of Macau, Macau, China.
| | - Angela Chang
- Department of Communication, University of Macau, Macau, China.
| | - Matthew Tingchi Liu
- grid.437123.00000 0004 1794 8068Department of Management and Marketing, University of Macau, Macau, China
| | - Jizhou Francis Ye
- grid.437123.00000 0004 1794 8068Department of Communication, University of Macau, Macau, China
| | - Wen Jiao
- grid.437123.00000 0004 1794 8068Department of Communication / Center for Research in Greater Bay Area, University of Macau, Macau, China
| | - Harris Song Ao
- grid.437123.00000 0004 1794 8068Department of Communication / Institute of Collaborative Research / Center for Research in Greater Bay Area, University of Macau, Macau, China
| | - Weixing Hu
- grid.437123.00000 0004 1794 8068Faculty of Social Sciences / Center for Research in Greater Bay Area, University of Macau, Macau, China
| | - Kaibin Xu
- grid.49470.3e0000 0001 2331 6153School of Journalism and Communication, Wuhan University, Wuhan, China
| | - Xinshu Zhao
- Department of Communication / Institute of Collaborative Research / Center for Research in Greater Bay Area, University of Macau, Macau, China. .,Department of Communication, Faculty of Social Sciences, University of Macau, Room 2051, E21B, Humanities and Social Sciences Building, Avenida da Universidade, Taipa, Macau, China.
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Hwang T, Tsai T, Chou K, Ho C, Chang A. Cadherin-11 blockade activates pyroptosis-mediated anti-tumor immunity in bladder cancer. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00585-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Yu A, Yim AY, Nyaw S, Li KM, Lau Y, Li S, Mok S, Tang G, Chang A, Prêtre V, Jin N, Kai A, Kan T, Lee H, Chan T, Wong CC, Cho W, Loong H. 312P ClinMatch: A clinical trial matching platform that improves trial accessibility among NSCLC patients through comprehensive genomic and clinical profiling. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
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Boyd R, Chang A, Graham F, Honzel E, Kentros PA, Kim J, McKetta S, Mignin R, Devlin MJ. Interdisciplinary refugee partnership in health: A pilot project. Med Educ 2022; 56:1144-1145. [PMID: 35984363 DOI: 10.1111/medu.14898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
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Monick A, Chang A, Zhang X. 408EMF Do Framing and Time Pressure Influence Diagnostic Reasoning Among Emergency Physicians? Ann Emerg Med 2022. [DOI: 10.1016/j.annemergmed.2022.08.425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Asikhia O, Bhatnagar N, Au A, Lewiss R, Fields M, Chang A, Maloney K, Chu T, Bollinger E, Tam A. 351 The Accuracy of Handheld Ultrasound in the Evaluation of Symptomatic Pregnant Patients in the Emergency Department. Ann Emerg Med 2022. [DOI: 10.1016/j.annemergmed.2022.08.380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Liu Y, Deng B, Hu B, Zhang W, Zhu Q, Liu Y, Wang S, Zhang P, Yang J, Zheng Q, Yu X, Gao Z, Zhou C, Han W, Chang A, Zhang Y. EFFICACY AND SAFETY OF SEQUENTIAL DIFFERENT B CELL ANTIGEN-TARGETED CAR T-CELL THERAPY FOR PEDIATRIC REFRACTORY/ RELAPSED BURKITT LYMPHOMA WITH SECONDARY CENTRAL NERVOUS SYSTEM INVOLVEMENT. Leuk Res 2022. [DOI: 10.1016/s0145-2126(22)00240-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Azari F, Meijer R, Kennedy G, Chang A, Nadeem B, Din A, Marfatia I, CAILLER F, Pèlegrin A, Vahrmeijer A, Singhal S. OA14.05 Intraoperative Molecular Imaging Guided Resection of CEACAM5+ Lung Tumors: First In-Human SGM-101 Lung Cancer Surgical Trial. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Lu Q, Chang A, Yu G, Yang Y, Schulz PJ. Social capital and health information seeking in China. BMC Public Health 2022; 22:1525. [PMID: 35948901 PMCID: PMC9364581 DOI: 10.1186/s12889-022-13895-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 07/27/2022] [Indexed: 11/10/2022] Open
Abstract
Background People’s potentials to seek health information can be affected by their social context, such as their social networks and the resources provided through those social networks. In the past decades, the concept of social capital has been widely used in the health realm to indicate people’s social context. However, not many such studies were conducted in China. Chinese society has its special quality that many Western societies lack: people traditionally render strong value to family relations and rely heavily on strong social ties in their social life. Therefore, the purpose of this study was to examine the association between different types of social capital and health information-seeking behavior (HISB) in the Chinese context. The different types of social capital were primarily bonding and bridging, as well as cognitive and structural ones. Methods Our analysis is based on a total of 3090 cases taken from the Health Information National Trends Survey (HINTS) – China, 2017. Dataset was weighted due to the overrepresentation of female respondents and hierarchical multiple regression analyses as well as binary logistic regression tests were operated to examine the associations between people’s social capital and their HISB. Results Some aspects of social capital emerged as positive predictors of HISB: information support (standing in for the cognitive component of social capital) promoted health information seeking, organization memberships (standing in for the structural component) encouraged cancer information seeking, and both the use of the internet and of traditional media for gaining health information were positively linked with bridging networks and organization memberships. Bonding networks (structural component) were not correlated with any other of the key variables and emotional support (cognitive social capital) was consistently associated with all health information-seeking indicators negatively. Conclusions Social capital demonstrated significant and complex relationships with HISB in China. Structural social capital generally encouraged HISB in China, especially the bridging aspects including bridging networks and organization memberships. On the other hand, emotional support as cognitive social capital damaged people’s initiatives in seeking health-related information. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13895-2.
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Affiliation(s)
- Qianfeng Lu
- Faculty of Communication, Culture and Society, Università Della Svizzera Italiana, Via Buffi 13, 6900, Lugano, Switzerland
| | - Angela Chang
- Faculty of Social Sciences, University of Macau, Macau, China
| | - Guoming Yu
- School of Journalism and Communication, Beijing Normal University, Beijing, China
| | - Ya Yang
- School of Journalism and Communication, Beijing Normal University, Beijing, China
| | - Peter J Schulz
- Faculty of Communication, Culture and Society, Università Della Svizzera Italiana, Via Buffi 13, 6900, Lugano, Switzerland. .,Department of Communication & Media, Ewha Womans University, Seoul, South Korea.
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Wilkerson K, Williams J, De Marchis E, Rudd N, Amerson E, Chang A. 326 High patient acceptability of social needs screening in dermatology clinic. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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21
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Baghoomian W, Dunlap R, Chang A, Foster E, Simpson E. 335 Developing a treatment decision aid for patients with moderate to severe atopic dermatitis. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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22
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Brummund D, Chang A, Michienzi J. Pedunculated Natal Tooth: A Case Report. Cureus 2022; 14:e25992. [PMID: 35859971 PMCID: PMC9288129 DOI: 10.7759/cureus.25992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2022] [Indexed: 11/05/2022] Open
Abstract
Natal teeth are teeth present at birth and are a rare finding. They most commonly occur in the mandibular incisor region and are thought to occur as an accelerated premature growth of normal primary teeth. They may present in the varying stages of tooth eruption and rarely on a pedunculated stalk of alveolar mucosa as described in this case. Natal teeth may be surgically extracted if difficulty feeding or ventral tongue ulceration develops. This report presents the case of an unusual pedunculated natal tooth in a newborn at a community hospital and describes its surgical management.
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Perkins R, Swallow E, Wang W, Gao E, Olson S, Sung J, Nguyen H, Peterson D, Billmyer E, Chang A. POS-050 THE PATIENT JOURNEY FOR IMMUNOGLOBULIN A NEPHROPATHY: DIAGNOSTIC DELAY AND CHANGE IN KIDNEY FUNCTION FROM FIRST CLINICAL SIGN. Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.04.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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24
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Brummund D, Chang A, Castrellon R. Minimally Invasive Magnetic Removal of Forehead Foreign Body. Cureus 2022; 14:e25168. [PMID: 35746999 PMCID: PMC9206858 DOI: 10.7759/cureus.25168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2022] [Indexed: 12/01/2022] Open
Abstract
Residual foreign bodies are common sequelae of penetrating injuries. These may be left in situ or extracted and can be difficult to localize, often requiring wide exposure, which can be difficult to achieve in cosmetically sensitive areas. Different technological adjuncts are used to facilitate foreign body removal including fluoroscopy, ultrasound, and more recently, surgical magnets. This case describes and illustrates the unusual technique of using a sterile surgical magnet to both localize and remove a foreign body in the head and neck region using a minimally invasively technique.
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Chang A, Xian X, Liu MT, Zhao X. Health Communication through Positive and Solidarity Messages Amid the COVID-19 Pandemic: Automated Content Analysis of Facebook Uses. Int J Environ Res Public Health 2022; 19:6159. [PMID: 35627696 PMCID: PMC9141526 DOI: 10.3390/ijerph19106159] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/15/2022] [Accepted: 05/16/2022] [Indexed: 12/31/2022]
Abstract
The COVID-19 outbreak has caused significant stress in our lives, which potentially increases frustration, fear, and resentful emotions. Managing stress is complex, but helps to alleviate negative psychological effects. In order to understand how the public coped with stress during the COVID-19 pandemic, we used Macao as a case study and collected 104,827 COVID-19 related posts from Facebook through data mining, from 1 January to 31 December 2020. Divominer, a big-data analysis tool supported by computational algorithm, was employed to identify themes and facilitate machine coding and analysis. A total of 60,875 positive messages were identified, with 24,790 covering positive psychological themes, such as "anti-epidemic", "solidarity", "hope", "gratitude", "optimism", and "grit". Messages that mentioned "anti-epidemic", "solidarity", and "hope" were the most prevalent, while different crisis stages, key themes and media elements had various impacts on public involvement. To the best of our knowledge, this is the first-ever study in the Chinese context that uses social media to clarify the awareness of solidarity. Positive messages are needed to empower social media users to shoulder their shared responsibility to tackle the crisis. The findings provide insights into users' needs for improving their subjective well-being to mitigate the negative psychological impact of the pandemic.
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Affiliation(s)
- Angela Chang
- Department of Communication, Faculty of Social Sciences, University of Macau, Macao, China; (X.X.); (X.Z.)
- Institute of Communication and Health, Lugano University, 6900 Lugano, Switzerland
| | - Xuechang Xian
- Department of Communication, Faculty of Social Sciences, University of Macau, Macao, China; (X.X.); (X.Z.)
- Department of Communication, Zhaoqing University, Zhaoqing 526060, China
| | - Matthew Tingchi Liu
- Department of Management and Marketing, Faculty of Business Administration, University of Macau, Macao, China;
| | - Xinshu Zhao
- Department of Communication, Faculty of Social Sciences, University of Macau, Macao, China; (X.X.); (X.Z.)
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Liu J, Munson SA, Chang A, Voss C, Graham AK. Understanding self-monitoring to inform a mobile intervention for binge eating and weight management: A proof-of-concept randomized trial. Int J Eat Disord 2022; 55:642-652. [PMID: 35277986 PMCID: PMC9314870 DOI: 10.1002/eat.23700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 02/24/2022] [Accepted: 02/24/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE This study explored consumers' perspectives on self-monitoring, a common feature in behavioral interventions that helps inform consumers' progress and answer their questions, to learn what outcome metrics matter to consumers and whether self-selection of these metrics leads to greater engagement (i.e., compliance, satisfaction) in self-monitoring than monitoring only default options. METHODS In a proof-of-concept randomized trial, 48 adult participants were randomly assigned to "clinician-determined monitoring" or "clinician + self-determined monitoring" conditions. Before starting monitoring, all participants shared outcomes that would matter to them in a mobile intervention for binge eating and weight management. Then, for 3 weeks, participants in the "clinician-determined" condition monitored their weight and binge-eating episodes, and participants in the "clinician + self-determined" condition monitored these and another metric of their choosing. After, satisfaction and compliance were assessed. RESULTS Participants identified 116 metrics, grouped into 12 themes, that mattered to them. During monitoring, participants in the "clinician + self-determined" condition monitored 41 metrics. Surprisingly, participants in the "clinician-determined" condition also monitored metrics besides weight and binge eating. This resulted in a failure of our experimental manipulation, which represents a significant limitation of this research. No significant differences emerged in satisfaction or compliance between conditions. DISCUSSION Although our proof-of-concept trial yielded null quantitative results, findings also suggested binge eating and weight management interventions may benefit from including an individually customizable monitoring option in addition to default metrics, warranting testing in future research. PUBLIC SIGNIFICANCE Examining consumers' self-monitoring preferences for a mobile intervention for binge eating and weight management revealed a variety of metrics that matter to consumers, although binge eating and weight were still most valued. Findings from our proof-of-concept trial suggest design implications of encouraging an individually customizable monitoring option, in addition to default metrics, which needs to be tested in future research over a longer period and during actual mobile intervention delivery.
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Affiliation(s)
- Jianyi Liu
- Center for Behavioral Intervention TechnologiesNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
- Department of Psychiatry & Behavioral ScienceNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Sean A. Munson
- Human Centered Design & EngineeringUniversity of WashingtonSeattleWashingtonUSA
| | - Angela Chang
- Center for Behavioral Intervention TechnologiesNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
- Department of Medical Social SciencesNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Claire Voss
- Center for Behavioral Intervention TechnologiesNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Andrea K. Graham
- Center for Behavioral Intervention TechnologiesNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
- Department of Medical Social SciencesNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
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Chan J, Lau R, Chang A, Chu C, Mok T, Ng C. 96P Transbronchial microwave ablation: Important role in the battle of lung preservation for multifocal lung primaries or metastases. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.02.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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28
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Wang N, Zhang X, Rothrauff BB, Fritch MR, Chang A, He Y, Yeung M, Liu S, Lipa KE, Lei G, Alexander PG, Lin H. Novel role of estrogen receptor-α on regulating chondrocyte phenotype and response to mechanical loading. Osteoarthritis Cartilage 2022; 30:302-314. [PMID: 34767957 DOI: 10.1016/j.joca.2021.11.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 10/29/2021] [Accepted: 11/01/2021] [Indexed: 02/09/2023]
Abstract
OBJECTIVE In knee cartilage from patients with osteoarthritis (OA), both preserved cartilage and damaged cartilage are observed. In this study, we aim to compare preserved with damaged cartilage to identify the molecule(s) that may be responsible for the mechanical loading-induced differences within cartilage degradation. METHODS Preserved and damaged cartilage were harvested from the same OA knee joint. RNA Sequencing was performed to examine the transcriptomic differences between preserved and damaged cartilage cells. Estrogen receptor-α (ERα) was identified, and its function of was tested through gene knockin and knockout. The role of ERα in mediating chondrocyte response to mechanical loading was examined via compression of chondrocyte-laded hydrogel in a strain-controlled manner. Findings from the studies on human samples were verified in animal models. RESULTS Level of estrogen receptor α (ERα) was significantly reduced in damaged cartilage compared to preserved cartilage, which were observed in both human and mice samples. Knockdown of ESR1, the gene encoding ERα, resulted in an upregulation of senescence- and OA-relevant markers in chondrocytes. Conversely, knockin of ESR1 partially reversed the osteoarthritic and senescent phenotype of OA chondrocytes. Using a three-dimensional (3D) culture model, we demonstrated that mechanical overload significantly suppressed ERα level in chondrocytes with concomitant upregulation of osteoarthritic phenotype. When ESR1 expression was suppressed, mechanical loading enhanced hypertrophic and osteogenic transition. CONCLUSION Our study demonstrates a new estrogen-independent role of ERα in mediating chondrocyte phenotype and its response to mechanical loading, and suggests that enhancing ERα level may represent a new method to treat osteoarthritis.
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Affiliation(s)
- N Wang
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15219, USA; Department of Orthopaedic Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China; Xiangya Third Hospital, Central South University, Changsha, Hunan, China.
| | - X Zhang
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15219, USA; Department of Orthopaedic Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China; Xiangya Third Hospital, Central South University, Changsha, Hunan, China.
| | - B B Rothrauff
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15219, USA.
| | - M R Fritch
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15219, USA.
| | - A Chang
- Department of Bioinformatics, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15219, USA.
| | - Y He
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15219, USA; Department of Orthopaedic Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China; Xiangya Third Hospital, Central South University, Changsha, Hunan, China.
| | - M Yeung
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15219, USA; Department of Bioengineering, University of Pittsburgh Swanson School of Engineering, 15219, USA.
| | - S Liu
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15219, USA.
| | - K E Lipa
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15219, USA; Department of Bioengineering, University of Pittsburgh Swanson School of Engineering, 15219, USA.
| | - G Lei
- Department of Orthopaedic Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China.
| | - P G Alexander
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15219, USA; McGowan Institute for Regenerative Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15219, USA.
| | - H Lin
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15219, USA; Department of Bioengineering, University of Pittsburgh Swanson School of Engineering, 15219, USA; McGowan Institute for Regenerative Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15219, USA.
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Fu E, Neubert SW, Chang A, Smith JD, Graham AK. Characterizing behavior change techniques used in the self-management of binge eating and weight: Applying a user-centered design approach. Eat Behav 2022; 44:101591. [PMID: 34920208 PMCID: PMC8885842 DOI: 10.1016/j.eatbeh.2021.101591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 10/15/2021] [Accepted: 11/30/2021] [Indexed: 01/03/2023]
Abstract
User-centered design methods aim to increase intervention engagement by focusing on consumers' needs and preferences. We conducted a needs assessment (the first step in user-centered design) via a digital diary study to understand how individuals with recurrent binge eating (≥12 episodes in 3 months) and obesity (BMI ≥30 kg/m2) manage these problems in their day-to-day lives and the approaches they use to change their behavior. Specifically, we applied the Behavior Change Technique (BCT)-Taxonomy to characterize which standardized BCTs individuals use to change binge eating and health-related behaviors and their motivations to use them, to inform the design of a mobile intervention. We analyzed qualitative data from 22 adults (64% female, 32% White) who submitted 176 diary entries. For each entry, we coded the BCTs used, motivation for use, and whether the BCT(s) were perceived as beneficial for behavior change. Across participants, investigators identified 50 of the 93 standardized BCTs (54%). Each participant used an average of 12 (SD = 4) BCTs, most commonly Behavior Substitution (72.3%), Distraction (68.2%), Goal Setting (Behavior) (63.6%), Action Planning (59.1%) and Adding Objects to the Environment (59.1%). More BCTs were coded as beneficial (49%) versus detrimental (24%) or neutral (27%). Techniques were most commonly motivated by preventing binge eating (95.5%), losing weight (95.5%), reducing unhealthy food choices (90.9%), or managing stress (59.1%). Results help inform how interventions could be designed to support consumers in changing binge eating and weight-related behaviors, although such designs would need to be tested for their impact on engagement and outcomes.
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Affiliation(s)
- Emily Fu
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America
| | - Sarah W Neubert
- Weinberg College of Arts and Sciences, Northwestern University, Evanston, IL, United States of America
| | - Angela Chang
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, United States of America
| | - J D Smith
- Department of Population Health Sciences, University of Utah Spencer Fox Eccles School of Medicine, Salt Lake City, UT, United States of America
| | - Andrea K Graham
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, United States of America.
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Williams TM, Costa DFA, Wilson CS, Chang A, Manning J, Swain D, Trotter MG. Sensor-based detection of parturition in beef cattle grazing in an extensive landscape: a case study using a commercial GNSS collar. Anim Prod Sci 2022. [DOI: 10.1071/an21528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Chang A, Schulz PJ, Jiao W, Yu G, Yang Y. Unfolding Media Source Characteristics Regarding Food Fraud Misinformation: A Comparative Study of the Health Information National Trends Survey (HINTS) in China. JMIR Form Res 2021; 6:e32302. [PMID: 34939565 PMCID: PMC8968551 DOI: 10.2196/32302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 09/02/2021] [Accepted: 12/17/2021] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND The ongoing rumors and fake news regarding food fraud, adulteration, and contamination are highly visible. Health risk information circulating through media and interpersonal communication channels has made health crisis an important research agenda. OBJECTIVE This study explores the issue of food fraud and the effect of rumors, incidents, and misinformation. Further, it studies whether and how these issues have provided evidence-based interventions for food handlers and regulators to mitigate food fraud misinformation. METHODS The Health Information National Trends Survey (HINTS) was adopted for collaborative study in China, after which a cross-sectional survey with door-to-door interviews was performed. Participants from Beijing and Hefei were selected using multistage sampling of adults during May, 2017. Based on four government surveillance reports on food rumors and safety incidents, a descriptive, correlation, and multivariate variance analysis was applied to the data. RESULTS A total of 3,090 results were gathered and analyzed. An average of 83.6% (n = 2,584) respondents heard at least one food rumor. Learning about food fraud is correlated with interpersonal connections (e.g., doctors or health specialists) for accessing food health information. Overall, Chinese citizens with a higher level of interpersonal connection were more likely to be concerned about food incidents with the statistical difference (P< .001). The Interpersonal connection was the highest frequency of communication sources (n = 698, 55.7%), followed by traditional media (n = 325, 25.9%) and Internet portal (n = 144, 11.5%). There was a significant relationship between media use and media category in Beijing (P<.001) and in Hefei (P<.001). Overall, Beijing's responses to the food fraud and incidents risks were lower than in Hefei (P < .01). The respondents in Beijing were confronted more frequently by food rumors (range 346-1253) than those in Hefei (range 155-946). The urban dwellers in Beijing and their rural counterparts in Hefei also differ in terms of perceiving different levels of food risk from different media sources. The food rumor narratives examined the conspiracy belie finds that social media play a more important role in influencing attitude against misinformation for users in Hefei, rather than in Beijing. CONCLUSIONS A media complementarity and food fraud information acquisition examined food fraud rumors and incidents with intent to harm, mainly done for economic gain. The HINTS China reports that around 73.6% out of 2,584 Chinese respondents prefer to go to their physicians for quarrying food health information first; however, when asked where they actually went and got access to food rumors, up to 36.6% of out of 1,462 Beijing respondents and 55.6% out of 1,122 Hefei respondents reported going online first. This study extends beyond local food products to foreign countries that import conspiracy beliefs with fake food. Nonetheless, consumers have to be on guard not just against fake food, but also spreading fake information and rumors about food. The aim of this study is to focus on characterizing media sources, types of food fraud misinformation, and risk perception of food safety, which mixes urgency and suspicions, and to provide evidence-based interventions for risk management guidance, with the hypotheses of the significant correlations between media types and sources and consumers' exposing and perceiving levels of food rumors and risks. CLINICALTRIAL
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Affiliation(s)
- Angela Chang
- Faculty of Social Sciences, University of Macau, Macao, CN.,Institute of Communication and Health, Lugano University, Lugano, CH
| | - Peter J Schulz
- Institute of Communication and Health, Lugano University, Lugano, CH
| | - Wen Jiao
- Faculty of Social Sciences, University of Macau, Macao, CN
| | - Guoming Yu
- School of Journalism and Communication, Beijing Normal University, #15 Xinjiekouwai Street, Haidian District, Beijing, China, Beijing, CN
| | - Ya Yang
- School of Journalism and Communication, Beijing Normal University, #15 Xinjiekouwai Street, Haidian District, Beijing, China, Beijing, CN
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Chang A, Schulz PJ, Jiao W, Liu MT. Obesity-Related Communication in Digital Chinese News From Mainland China, Hong Kong, and Taiwan: Automated Content Analysis. JMIR Public Health Surveill 2021; 7:e26660. [PMID: 34817383 PMCID: PMC8663590 DOI: 10.2196/26660] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 07/27/2021] [Accepted: 09/21/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The fact that the number of individuals with obesity has increased worldwide calls into question media efforts for informing the public. This study attempts to determine the ways in which the mainstream digital news covers the etiology of obesity and diseases associated with the burden of obesity. OBJECTIVE The dual objectives of this study are to obtain an understanding of what the news reports on obesity and to explore meaning in data by extending the preconceived grounded theory. METHODS The 10 years of news text from 2010 to 2019 compared the development of obesity-related coverage and its potential impact on its perception in Mainland China, Hong Kong, and Taiwan. Digital news stories on obesity along with affliction and inferences in 9 Chinese mainstream newspapers were sampled. An automatic content analysis tool, DiVoMiner was proposed. This computer-aided platform is designed to organize and filter large sets of data on the basis of the patterns of word occurrence and term discovery. Another programming language, Python 3, was used to explore connections and patterns created by the aggregated interactions. RESULTS A total of 30,968 news stories were identified with increasing attention since 2016. The highest intensity of newspaper coverage of obesity communication was observed in Taiwan. Overall, a stronger focus on 2 shared causative attributes of obesity is on stress (n=4483, 33.0%) and tobacco use (n=3148, 23.2%). The burdens of obesity and cardiovascular diseases are implied to be the most, despite the aggregated interaction of edge centrality showing the highest link between the "cancer" and obesity. This study goes beyond traditional journalism studies by extending the framework of computational and customizable web-based text analysis. This could set a norm for researchers and practitioners who work on data projects largely for an innovative attempt. CONCLUSIONS Similar to previous studies, the discourse between the obesity epidemic and personal afflictions is the most emphasized approach. Our study also indicates that the inclination of blaming personal attributes for health afflictions potentially limits social and governmental responsibility for addressing this issue.
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Affiliation(s)
- Angela Chang
- Faculty of Social Sciences, University of Macau, Taipa, Macao.,Institute of Communication and Health, University of Lugano, Lugano, Switzerland
| | | | - Wen Jiao
- Faculty of Social Sciences, University of Macau, Taipa, Macao
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Yoon S, Suh R, Abtin F, Moghanaki D, Genshaft S, Kamrava M, Drakaki A, Liu S, Venkat P, Lee A, Chang A. FP08.03 Outcomes With Multi-Disciplinary Management of Central Lung Tumors Treated With Percutaneous High-Dose-Rate Brachytherapy. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Burner E, Chang A, Hazime D, Gonzalez J, Garcia V, Mercado J, Berumen A, Menchine M, Arora S. 211 Long Term Effects of Mobile Health and Augmented Social Support on Emergency Department Patients With Diabetes. Ann Emerg Med 2021. [DOI: 10.1016/j.annemergmed.2021.09.223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Wade AN, Payne CF, Berkman L, Chang A, Gómez-Olivé FX, Kabudula C, Kahn K, Salomon JA, Tollman S, Witham M, Davies J. Multimorbidity and mortality in an older, rural black South African population cohort with high prevalence of HIV findings from the HAALSI Study. BMJ Open 2021; 11:e047777. [PMID: 34526338 PMCID: PMC8444254 DOI: 10.1136/bmjopen-2020-047777] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES Multimorbidity is associated with mortality in high-income countries. Our objective was to investigate the relationship between multimorbidity (≥2 of the following chronic medical conditions: hypertension, diabetes, dyslipidaemia, anaemia, HIV, angina, depression, post-traumatic stress disorder, alcohol dependence) and all-cause mortality in an older, rural black South African population. We further investigated the relationship between HIV multimorbidity (HIV as part of the multimorbidity cluster) and mortality, while testing for the effect of frailty in all models. DESIGN Population cohort study. SETTING Agincourt subdistrict of Mpumalanga province, South Africa. PARTICIPANTS 4455 individuals (54.7% female), aged ≥40 years (median age 61 years, IQR 52-71) and resident in the study area. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome measure was time to death and the secondary outcome measure was likelihood of death within 2 years of the initial study visit. Mortality was determined during annual population surveillance updates. RESULTS 3157 individuals (70.9%) had multimorbidity; 29% of these had HIV. In models adjusted for age and sociodemographic factors, multimorbidity was associated with greater risk of death (women: HR 1.72; 95% CI: 1.18 to 2.50; men: HR 1.46; 95% CI: 1.09 to 1.95) and greater odds of dying within 2 years (women: OR 2.34; 95% CI: 1.32 to 4.16; men: OR 1.51; 95% CI: 1.02 to 2.24). HIV multimorbidity was associated with increased risk of death compared with non-HIV multimorbidity in men (HR 1.93; 95% CI: 1.05 to 3.54), but was not statistically significant in women (HR 1.85; 95% CI: 0.85 to 4.04); when detectable, HIV viral loads were higher in men (p=0.021). Further adjustment for frailty slightly attenuated the associations between multimorbidity and mortality risk (women: HR 1.55; 95% CI: 1.06 to 2.26; men: HR 1.36; 95% CI: 1.01 to 1.82), but slightly increased associations between HIV multimorbidity and mortality risk. CONCLUSIONS Multimorbidity is associated with mortality in this older black South African population. Health systems which currently focus on HIV should be reorganised to optimise identification and management of other prevalent chronic diseases.
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Affiliation(s)
- Alisha N Wade
- MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of the Witwatersrand Faculty of Health Sciences, Johannesburg, Gauteng, South Africa
| | - Collin F Payne
- School of Demography, Research School of Social Sciences, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Lisa Berkman
- MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of the Witwatersrand Faculty of Health Sciences, Johannesburg, Gauteng, South Africa
- Harvard Centre for Population and Development Studies, Harvard University T H Chan School of Public Health, Cambridge, Massachusetts, USA
| | - Angela Chang
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Danish Institute for Advanced Study, University of Southern Denmark, Odense, Denmark
| | - F Xavier Gómez-Olivé
- MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of the Witwatersrand Faculty of Health Sciences, Johannesburg, Gauteng, South Africa
| | - Chodziwadziwa Kabudula
- MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of the Witwatersrand Faculty of Health Sciences, Johannesburg, Gauteng, South Africa
| | - Kathleen Kahn
- MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of the Witwatersrand Faculty of Health Sciences, Johannesburg, Gauteng, South Africa
- Umeå Centre for Global Health Research, Umeå University, Umeå, Sweden
| | - Joshua A Salomon
- Department of Health Policy, Stanford University School of Medicine, Palo Alto, California, USA
| | - Stephen Tollman
- MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of the Witwatersrand Faculty of Health Sciences, Johannesburg, Gauteng, South Africa
- Umeå Centre for Global Health Research, Umeå University, Umeå, Sweden
| | - Miles Witham
- MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of the Witwatersrand Faculty of Health Sciences, Johannesburg, Gauteng, South Africa
- AGE Research Group, NIHR Newcastle Biomedical Research Centre, Translational Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Justine Davies
- MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of the Witwatersrand Faculty of Health Sciences, Johannesburg, Gauteng, South Africa
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Centre for Global Surgery, Department of Global Health, Stellenbosch University, Stellenbosch, Western Cape, South Africa
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Chang A, Sivasubramaniam M, Souchon A, Pacilli M, Nataraja RM. Current assessment of parental and health professional perception of the colour of neonatal vomiting: Results of a scoping survey. Pediatr Surg Int 2021; 37:1243-1250. [PMID: 33899141 DOI: 10.1007/s00383-021-04908-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/10/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE To determine current perceptions of doctors, nurses and parents for the colour of a neonatal vomit which should prompt an urgent surgical review. METHODS A voluntary scoping survey of parents/guardians of patients and non-surgical healthcare professionals was conducted with respondents asked to choose from 8 different selections in a colour swatch from pale yellow to dark green. A control group consisted of 13 paediatric surgeons. Data were analysed using the paired t test, Fishers exact test. A p value of < 0.05 was considered to be significant. RESULTS 365 participants responded: 36% (131/365) parents, 18% (64/365) nurses and 46% (166/365) doctors. 4/365 (1%) did not state their role. 343 participants completed all questions and responses were analysed using total responses for each question. 82% (121/148) of doctors and 78% (50/64) of nurses had more than 3 years of post-graduate experience. Overall, 63% (227/361) of participants (100% paediatric surgeons, 78% other doctors, 75% nurses/midwives & 30% parents) considered dark and light green vomits to be a sign of intestinal obstruction. 67% (242/361) of participants (100% paediatric surgeons, 72% other doctors, 56% nurses/midwives and 62% parents) believed dark and light green vomiting needed an urgent surgical referral. There were significant differences between the control group and other groups in terms of whether the neonate could wait until the next day for a review; nursing staff (p = 0.0002), postnatal/midwifery (p = < 0.0001), emergency medicine (p = 0.04), general practice (p = 0.002), neonatal (p = 0.0001) and paediatricians (p = 0.005). Only the neonatologists (p = 0.04), nursing staff (p = 0.001) and postnatal/midwifery (p = 0.004) believed that the neonate could have safe observation. CONCLUSION Although the perception that green vomiting is potentially serious is acknowledged by the majority of healthcare professionals surveyed, there is still a requirement for more targeted educational practices in nursing, midwifery and medical staff.
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Affiliation(s)
- A Chang
- Department of Paediatric Surgery and Surgical Simulation, Monash Children's Hospital, 246 Clayton Road, Melbourne, 3168, Australia
| | - M Sivasubramaniam
- Department of Paediatric Surgery and Surgical Simulation, Monash Children's Hospital, 246 Clayton Road, Melbourne, 3168, Australia
| | - A Souchon
- Department of Paediatric Surgery and Surgical Simulation, Monash Children's Hospital, 246 Clayton Road, Melbourne, 3168, Australia
| | - M Pacilli
- Department of Paediatric Surgery and Surgical Simulation, Monash Children's Hospital, 246 Clayton Road, Melbourne, 3168, Australia.,Departments of Paediatrics and Surgery, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - R M Nataraja
- Department of Paediatric Surgery and Surgical Simulation, Monash Children's Hospital, 246 Clayton Road, Melbourne, 3168, Australia. .,Departments of Paediatrics and Surgery, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.
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Zakaria A, Chang A, Kim-Lim P, Arakaki R, Shinkai K, Haemel A, Fox L, Amerson E. LB742 Predictors of post-discharge follow-up attendance among hospitalized dermatology patients. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.07.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
A 63-year-old male with a history of hiatal hernia presented with one day of hematemesis and acute peritonitis. Computed tomographic imaging revealed perigastric pneumoperitoneum concerning perforated viscus. Exploratory laparotomy revealed a Type III hiatal hernia with a perforated posterior gastric ulcer, which was reduced and repaired. This report describes a case of acute abdomen secondary to hiatal hernia, a rare presentation of hiatal hernia, along with its surgical management and postoperative care.
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Affiliation(s)
- Dieter Brummund
- Department of General Surgery, Aventura Hospital and Medical Center, Aventura, USA
| | - Angela Chang
- Department of Anesthesiology, Aventura Hospital and Medical Center, Miami, USA
| | - Michael Renda
- Department of General Surgery, Kendall Regional Medical Center, Miami, USA
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Venkatesh A, Chang A, Green EA, Randall T, Gallagher R, Wildes JE, Graham AK. Perceived Facilitators and Barriers to Engaging with a Digital Intervention among Those with Food Insecurity, Binge Eating, and Obesity. Nutrients 2021; 13:2458. [PMID: 34371967 PMCID: PMC8308534 DOI: 10.3390/nu13072458] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 07/13/2021] [Accepted: 07/15/2021] [Indexed: 12/11/2022] Open
Abstract
Interventions that address binge eating and food insecurity are needed. Engaging people with lived experience to understand their needs and preferences could yield important design considerations for such interventions. In this study, people with food insecurity, recurrent binge eating, and obesity completed an interview-based needs assessment to learn facilitators and barriers that they perceive would impact their engagement with a digital intervention for managing binge eating and weight. Twenty adults completed semi-structured interviews. Responses were analyzed using thematic analysis. Three themes emerged. Participants shared considerations that impact their ability to access the intervention (e.g., cost of intervention, cost of technology, accessibility across devices), ability to complete intervention recommendations (e.g., affordable healthy meals, education to help stretch groceries, food vouchers, rides to grocery stores, personalized to budget), and preferred intervention features for education, self-monitoring, personalization, support, and motivation/rewards. Engaging people with lived experiences via user-centered design methods revealed important design considerations for a digital intervention to meet this population's needs. Future research is needed to test whether a digital intervention that incorporates these recommendations is engaging and effective for people with binge eating and food insecurity. Findings may have relevance to designing digital interventions for other health problems as well.
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Affiliation(s)
- Anu Venkatesh
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; (A.V.); (A.C.)
| | - Angela Chang
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; (A.V.); (A.C.)
| | - Emilie A. Green
- Department of Psychology, Rosalind Franklin University for Medical Sciences, Chicago, IL 60064, USA;
| | - Tianna Randall
- Weinberg College of Arts and Sciences, Northwestern University, Evanston, IL 60208, USA; (T.R.); (R.G.)
| | - Raquel Gallagher
- Weinberg College of Arts and Sciences, Northwestern University, Evanston, IL 60208, USA; (T.R.); (R.G.)
| | - Jennifer E. Wildes
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Chicago, IL 60611, USA;
| | - Andrea K. Graham
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; (A.V.); (A.C.)
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Mattos MK, Chang A, Pitcher K, Whitt C, Ritterband LM, Quigg MS. A Review of Insomnia Treatments for Patients with Mild Cognitive Impairment. Aging Dis 2021; 12:1036-1042. [PMID: 34221547 PMCID: PMC8219491 DOI: 10.14336/ad.2021.0423] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 04/23/2021] [Indexed: 12/21/2022] Open
Abstract
Mild cognitive impairment (MCI) impacts approximately 20% of older adults, with many also experiencing sleep disorders, such as insomnia. Given the relationship between sleep and dementia, addressing sleep issues may offer an opportunity to treat reversible causes. There are two primary treatments for insomnia: behavioral-based (cognitive behavioral therapy for insomnia, CBT-I) and pharmacological interventions. Although CBT-I is recommended as first-line treatment for insomnia in older adults, sedative-hypnotics are more likely to be recommended than non-pharmacological treatments given their convenience and accessibility. However, there are significant concerns in prescribing medications to patients with MCI. To explore this disconnect, we reviewed insomnia treatments in older adults with MCI studies and current guidelines of pharmacological therapy. First, we reviewed studies presenting non-pharmacological treatment of insomnia in older adults with MCI. Although the search yielded over 4,000 non-duplicate titles, only one article presented data on non-pharmacological treatment of insomnia in MCI. The literature covering comorbid insomnia, CBT-I, and MCI is sparse. In contrast to review of non-pharmacological studies, studies on the pharmacological treatment of insomnia in older adults were ample. Finally, we reviewed international guidelines for pharmacological treatment of insomnia in cognitive disorders. More widely used pharmacological interventions show short-term effectiveness with problems of recurrence, ineffectiveness in inadvertent or purposeful chronic use, and adverse side effects. Despite evidence regarding adverse consequences, pharmacological treatment of insomnia remains the most common treatment for insomnia. Reflecting on age-related changes in older adults, particularly those with MCI, inappropriate or mismanagement of medication can lead to unnecessary complications. Further research examining effective behavioral-based sleep management options in older adults with cognitive impairment is needed with exploration of improved sleep on cognitive function.
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Affiliation(s)
- Meghan K Mattos
- University of Virginia, School of Nursing, Charlottesville, VA 22903, USA.
| | - Angela Chang
- Northwestern University Feinberg School of Medicine, Department of Medical Social Sciences, Chicago, IL 60611, USA.
| | - Katherine Pitcher
- University of Virginia Medical Center, Charlottesville, VA 22903, USA.
| | - Carley Whitt
- University of Virginia, School of Medicine, Charlottesville, VA 22903, USA.
| | - Lee M Ritterband
- University of Virginia, School of Medicine, Charlottesville, VA 22903, USA.
| | - Mark S Quigg
- University of Virginia, School of Medicine, Charlottesville, VA 22903, USA.
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Sahai V, Chang A, Crysler O, Zhen D, Luther S, Zalupski M. P-176 A multicenter, randomized phase 1b/2 study of gemcitabine and cisplatin with or without CPI-613 as first-line therapy for patients with advanced unresectable biliary tract cancer (BilT-04). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Graham AK, Neubert SW, Chang A, Liu J, Fu E, Green EA, Kornfield R, Nicholas J. Applying User-Centered Design Methods to Understand Users' Day-to-Day Experiences Can Inform a Mobile Intervention for Binge Eating and Weight Management. Front Digit Health 2021; 3:651749. [PMID: 34713124 PMCID: PMC8521863 DOI: 10.3389/fdgth.2021.651749] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 04/06/2021] [Indexed: 12/18/2022] Open
Abstract
Introduction: Weight loss apps to date have not directly addressed binge eating. To inform the design of a new mobile behavioral intervention that addresses binge eating and weight management, we applied user-centered design methods to qualitatively assess how target intervention consumers experience these conditions in their day-to-day lives. Methods: The participants were 22 adults with self-reported obesity (body mass index ≥30) and recurrent binge eating (≥12 episodes in 3 months) who were interested in losing weight and reducing binge eating. The participants completed a digital diary study, which is a user-centered design technique for capturing individuals' day-to-day experiences in relevant contexts. Qualitative data describing the participants' experiences with binge eating and obesity were analyzed using thematic analysis. The results were then used to create personas (i.e., character archetypes of different intervention consumers). Results: The participants described triggers for binge eating and indicated that binge eating and excess weight negatively impact their mental health, physical health, and quality of life. The resulting personas reflected five different struggles individuals with these health problems experience in managing their binge eating and weight. Conclusions: Individuals with binge eating and obesity have varying precipitants of problematic eating as well as varying motivations for and challenges to behavior change. To meet the needs of all who seek intervention, an ideal intervention design will account for variations in these factors and be relevant to diverse experiences. Insights from the diary study and resulting personas will inform the next phases of the user-centered design process of iteratively designing prototypes and testing the intervention in practice.
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Affiliation(s)
- Andrea K. Graham
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Sarah W. Neubert
- Weinberg College of Arts and Sciences, Northwestern University, Evanston, IL, United States
| | - Angela Chang
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Jianyi Liu
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- Department of Psychiatry and Behavioral Science, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Emily Fu
- Department of Psychiatry and Behavioral Science, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Emilie A. Green
- Weinberg College of Arts and Sciences, Northwestern University, Evanston, IL, United States
| | - Rachel Kornfield
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Jennifer Nicholas
- Orygen, Melbourne, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
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Khetrapal P, Ó Scanaill P, Stafford R, Kocadag H, Chang A, Duncan J, Catto J, Lin P, Jin Li F, Walker D, Drobnjak I, Kelly J. Using a remote monitoring kit to predict re-admissions for patients discharged following radical cystectomy. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01356-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Chang A, Cabana MD, LaFlam TN, Patel S, Okumura M. Early Peanut Introduction and Testing: A Framework for General Pediatrician Beliefs and Practices. Pediatr Allergy Immunol Pulmonol 2021; 34:53-59. [PMID: 34143689 PMCID: PMC8329693 DOI: 10.1089/ped.2020.1190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 07/24/2020] [Indexed: 11/13/2022]
Abstract
Background: Peanut introduction guidelines have undergone significant reversal since 2001 from recommending delayed introduction to rescinding the recommendations in 2008 to actively recommending early introduction of peanut between 4 and 11 months of age in high-risk infants in 2015. This qualitative study aims to explore pediatrician beliefs, practices, facilitators, and barriers regarding peanut introduction and testing. Methods: General pediatricians from academic, private, large group, and underserved practices in Northern California underwent individual semi-structured interviews in 2017. We asked about experiences surrounding infant peanut introduction, strategies for staying up-to-date with current recommendations, and barriers and facilitators to the new peanut introduction and testing recommendations. The data were coded, and using grounded theory methodology, a conceptual framework was developed around early peanut introduction and testing in infants. Results: Eighteen general pediatricians participated. We identified barriers that may contribute to pediatrician reluctance to recommending early peanut introduction or testing including lack of awareness, lack of agreement, lack of resources, and lack of outcome expectancy. A framework was created that suggests that pediatricians need to be knowledgeable about new recommendations, agree with the recommendations, have resources to carry out the counseling and testing, and have buy-in from the parents in order for successful uptake of peanut introduction guidelines. Conclusion: Recommending early peanut introduction or testing causes significant apprehension in some pediatricians, and there are many barriers to following recent early peanut introduction recommendations. A potential limitation of the study is that it was conducted right after the addendum guidelines were changed, leaving the possibility that attitudes and practices may have evolved since 2017. It is still likely that a multifaceted approach that addresses primary care provider guideline awareness, limited primary care resources for education and testing, and includes support and collaboration from subspecialty practices is more likely to lead to improved early peanut introduction uptake.
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Affiliation(s)
- Angela Chang
- Department of Pediatrics and UCSF Benioff Children's Hospital, University of California San Francisco, San Francisco, California, USA
| | - Michael D. Cabana
- Department of Pediatrics and UCSF Benioff Children's Hospital, University of California San Francisco, San Francisco, California, USA
- Department of Epidemiology & Biostatistics, UCSF Benioff Children's Hospital, University of California San Francisco, San Francisco, California, USA
| | - Taylor N. LaFlam
- Department of Pediatrics and UCSF Benioff Children's Hospital, University of California San Francisco, San Francisco, California, USA
| | - Saharsh Patel
- Department of Pediatrics and UCSF Benioff Children's Hospital, University of California San Francisco, San Francisco, California, USA
| | - Megumi Okumura
- Department of Pediatrics and UCSF Benioff Children's Hospital, University of California San Francisco, San Francisco, California, USA
- Department of Internal Medicine, University of California San Francisco, San Francisco, California, USA
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Graham AK, Munson SA, Reddy M, Neubert SW, Green EA, Chang A, Spring B, Mohr DC, Wildes JE. Integrating User-Centered Design and Behavioral Science to Design a Mobile Intervention for Obesity and Binge Eating: Mixed Methods Analysis. JMIR Form Res 2021; 5:e23809. [PMID: 33970114 PMCID: PMC8145081 DOI: 10.2196/23809] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 12/01/2020] [Accepted: 12/24/2020] [Indexed: 12/13/2022] Open
Abstract
Background Accounting for how end users engage with technologies is imperative for designing an efficacious mobile behavioral intervention. Objective This mixed methods analysis examined the translational potential of user-centered design and basic behavioral science to inform the design of a new mobile intervention for obesity and binge eating. Methods A total of 22 adults (7/22, 32% non-Hispanic White; 8/22, 36% male) with self-reported obesity and recurrent binge eating (≥12 episodes in 3 months) who were interested in losing weight and reducing binge eating completed a prototyping design activity over 1 week. Leveraging evidence from behavioral economics on choice architecture, participants chose treatment strategies from 20 options (aligned with treatment targets composing a theoretical model of the relation between binge eating and weight) to demonstrate which strategies and treatment targets are relevant to end users. The process by which participants selected and implemented strategies and their change in outcomes were analyzed. Results Although prompted to select one strategy, participants selected between 1 and 3 strategies, citing perceived achievability, helpfulness, or relevance as selection reasons. Over the week, all practiced a strategy at least once; 82% (18/22) struggled with implementation, and 23% (5/22) added a new strategy. Several themes emerged on successes and challenges with implementation, yielding design implications for supporting users in behavior change. In postexperiment reflections, 82% (18/22) indicated the strategy was helpful, and 86% (19/22) planned to continue use. One-week average within-subject changes in weight (–2.2 [SD –5.0] pounds) and binge eating (–1.6 [SD –1.8] episodes) indicated small clinical improvement. Conclusions Applying user-centered design and basic behavioral science yielded design insights to incorporate personalization through user choice with guidance, which may enhance engagement with and potential efficacy of digital health interventions.
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Affiliation(s)
- Andrea K Graham
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.,Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Sean A Munson
- Department of Human Centered Design & Engineering, University of Washington, Seattle, WA, United States
| | - Madhu Reddy
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.,Department of Communication Studies, Northwestern University, Chicago, IL, United States
| | - Sarah W Neubert
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.,Weinberg College of Arts and Sciences, Northwestern University, Evanston, IL, United States
| | - Emilie A Green
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.,Weinberg College of Arts and Sciences, Northwestern University, Evanston, IL, United States
| | - Angela Chang
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.,Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Bonnie Spring
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - David C Mohr
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.,Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Jennifer E Wildes
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Chicago, IL, United States
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Lin J, Li S, Li S, Kiamanesh E, Aasi S, Kwong B, Chang A. 241 Association of ruxolitinib with NMSCs risk in patients with polycythemia vera and myelofibrosis. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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47
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Meng L, Pourali S, Hitchcock MM, Ha DR, Mui E, Alegria W, Fox E, Diep C, Swayngim R, Chang A, Banaei N, Deresinski S, Holubar M. Discontinuation Patterns and Cost Avoidance of a Pharmacist-Driven Methicillin-Resistant Staphylococcus aureus Nasal Polymerase Chain Reaction Testing Protocol for De-escalation of Empiric Vancomycin for Suspected Pneumonia. Open Forum Infect Dis 2021; 8:ofab099. [PMID: 34386545 PMCID: PMC8355456 DOI: 10.1093/ofid/ofab099] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 03/02/2021] [Indexed: 12/28/2022] Open
Abstract
A pharmacist-driven methicillin-resistant Staphylococcus aureus (MRSA) nasal polymerase chain reaction (PCR)-based testing protocol with a 70% acceptance rate for vancomycin discontinuation within 24 hours of negative results significantly reduced unnecessary vancomycin use with an estimated cost avoidance of $40 per vancomycin course. We found high concordance (141 of 147, 96%) of culture-based versus PCR-based MRSA nasal screening.
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Affiliation(s)
- L Meng
- Department of Quality, Patient Safety and Effectiveness, Stanford Health Care, Stanford, California, USA
- Stanford Antimicrobial Safety and Sustainability Program, Stanford, California, USA
| | - S Pourali
- Department of Pharmacy, Stanford Health Care, Stanford, California, USA
| | - M M Hitchcock
- Division of Infectious Diseases, Department of Internal Medicine, Virginia Commonwealth University Medical Center, Richmond, Virginia, USA
| | - D R Ha
- Department of Quality, Patient Safety and Effectiveness, Stanford Health Care, Stanford, California, USA
- Stanford Antimicrobial Safety and Sustainability Program, Stanford, California, USA
| | - E Mui
- Department of Quality, Patient Safety and Effectiveness, Stanford Health Care, Stanford, California, USA
- Stanford Antimicrobial Safety and Sustainability Program, Stanford, California, USA
| | - W Alegria
- Department of Quality, Patient Safety and Effectiveness, Stanford Health Care, Stanford, California, USA
- Stanford Antimicrobial Safety and Sustainability Program, Stanford, California, USA
| | - E Fox
- Department of Pharmacy, Stanford Health Care, Stanford, California, USA
| | - C Diep
- Department of Pharmacy, Stanford Health Care, Stanford, California, USA
| | - R Swayngim
- Department of Pharmacy, Stanford Health Care, Stanford, California, USA
| | - A Chang
- Department of Quality, Patient Safety and Effectiveness, Stanford Health Care, Stanford, California, USA
- Stanford Antimicrobial Safety and Sustainability Program, Stanford, California, USA
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - N Banaei
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
- Department of Pathology, Stanford University School of Medicine, Stanford, California, USA
| | - S Deresinski
- Department of Quality, Patient Safety and Effectiveness, Stanford Health Care, Stanford, California, USA
- Stanford Antimicrobial Safety and Sustainability Program, Stanford, California, USA
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - M Holubar
- Department of Quality, Patient Safety and Effectiveness, Stanford Health Care, Stanford, California, USA
- Stanford Antimicrobial Safety and Sustainability Program, Stanford, California, USA
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
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Chang A, Moore B, Singh G, Mirshahi T. POS-419 GENOTYPE-PHENOTYPE CORRELATIONS OF PREDICTED LOSS OF FUNCTION MUTATIONS IN ATYPICAL ADPKD GENES. Kidney Int Rep 2021. [DOI: 10.1016/j.ekir.2021.03.442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Chang A, Winquist NW, Wescott AB, Lattie EG, Graham AK. Systematic review of digital and non-digital non-pharmacological interventions that target quality of life and psychological outcomes in adults with systemic lupus erythematosus. Lupus 2021; 30:1058-1077. [PMID: 33779388 DOI: 10.1177/09612033211005085] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Patients with systemic lupus erythematous (SLE) experience psychological comorbidities and impaired quality of life (QOL). We conducted a systematic review to examine the efficacy of non-pharmacological interventions for improving psychological outcomes and/or QOL in patients with SLE. To expand on a previous systematic review in this area and enhance our understanding of efficacious interventions for this population, our search included quasi-experimental and experimental studies of interventions delivered or supported by remote methods (including digitally) or in person. METHODS A comprehensive literature search was conducted with a research librarian using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered before data extraction on the international prospective register of systematic reviews PROSPERO Web site (CRD42020154962). The search included controlled-vocabulary and title/abstract terms related to non-pharmacological interventions for SLE published through October 2019 in MEDLINE (Ovid), Cochrane Library databases (Wiley), Embase (Elsevier), CINAHL (EBSCO), PsycINFO (EBSCO), Web of Science (Clarivate), ACM Digital (Association of Computer Machinery), and IEEE Xplore. Studies were synthesized using a systematic narrative synthesis framework. Risk of bias was assessed. RESULTS Twenty-three studies were included: 21 randomized controlled trials and two quasi-experimental studies. Non-pharmacological diet, physical activity, psychological, and course-based interventions improved QOL and psychological outcomes, and were delivered in traditional settings (e.g., hospital) or remotely. No studies assessing digital non-pharmacological interventions were identified in our search. Quality assessments showed serious risk of bias for the two quasi-experimental studies, and high risk of bias in a subset of experimental studies. CONCLUSIONS Non-pharmacological interventions benefit patients with SLE. Future research should include more representative samples in rigorous evaluations and consider ways to incorporate digital technologies to increase accessibility.
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Affiliation(s)
- Angela Chang
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Nathan W Winquist
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Annie B Wescott
- Galter Health Sciences Library and Learning Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Emily G Lattie
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Andrea K Graham
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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50
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Brummund D, Chang A, Azimi-Ghomi O, Diaz B, Sendzischew H. Superficial Temporal Artery True Fusiform Aneurysm With Several Lateral Feeding Vessels. Cureus 2021; 13:e13973. [PMID: 33880302 PMCID: PMC8052991 DOI: 10.7759/cureus.13973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
A 49-year-old man flight attendant with a past medical history of Roux-en-Y bypass and massive weight loss 18 months prior was referred for surgical management of a superficial temporal artery aneurysm. Imaging confirmed the diagnosis. Intraoperatively a 1 cm fusiform aneurysm was identified with numerous feeding side branch vessels. The aneurysm was suture ligated and excised in toto with pathologic analysis showing involvement of all vessel layers. This case highlights a rare true aneurysm of the superficial temporal artery and aberrant anatomy of multiple side branches feeding the aneurysm and complicating dissection and excision.
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Affiliation(s)
- Dieter Brummund
- Department of General Surgery, Aventura Hospital and Medical Center, Aventura, USA
| | - Angela Chang
- Department of Anesthesiology, Aventura Hospital and Medical Center, Aventura, USA
| | - Obteene Azimi-Ghomi
- Department of General Surgery, Aventura Hospital and Medical Center, Aventura, USA
| | - Brandon Diaz
- Department of General Surgery, Aventura Hospital and Medical Center, Aventura, USA
| | - Harry Sendzischew
- Department of General Surgery, Mount Sinai Medical Center, Miami Beach, USA
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