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Roter DL, Bugayong M, Lowe C, Joyner RL, Howard AM, Wenzel J, Dobs AS. Online communication skill training of patients with cancer: A test of the behavioral intention predictive framework for communication skills. PEC INNOVATION 2024; 4:100291. [PMID: 38872981 PMCID: PMC11169459 DOI: 10.1016/j.pecinn.2024.100291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 05/08/2024] [Accepted: 05/19/2024] [Indexed: 06/15/2024]
Abstract
Objective To assess the Behavioral Intention Predictive Framework's utility in explaining variation in cancer patients' strong behavioral intention (SBI) to use LEAPS (Listen, Educate, Assess, Partner, Support) communication skills after viewing training videos. Methods Ninety-eight patients were enrolled through anonymized online platforms to view LEAPS training videos, complete background and communication questionnaires and report their SBI to use LEAPS skills. Results On average, patients indicated SBI to use 6 of 13 skills and 46% of patients expressed SBI across individual skills. The framework explained 27.7% of the adjusted variance in SBI with significant predictors of frequent past use of LEAPS-related shared decision-making behaviors, poor emotional health, being rarely accompanied to visits and positive ratings of narrative videos. Finally, 21.7% of the adjusted variance in problem communication was explained by infrequent use of LEAPS-related information behaviors, patient accompaniment of another adult and positive narrative scores. Conclusion Patients SBI to use multiple LEAPS skills and past problem communication were explained by framework predictors. Innovation Despite theoretical and empirical evidence that behavioral intention significantly predicts behavior, it has not been studied in patient communication research. Application of the novel framework to LEAPS training videos contributes an innovative address of this research gap.
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Affiliation(s)
- Debra L. Roter
- Department of Health, Behavior and Society, Johns Hopkins School of Public Health, Baltimore, USA
| | - Marielle Bugayong
- Department of Health, Behavior and Society, Johns Hopkins School of Public Health, Baltimore, USA
| | - Chenery Lowe
- Stanford Center for Biomedical Ethics, Stanford, USA
| | | | | | | | - Adrian S. Dobs
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, USA
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Barnes RD, Lawson JL. Weight stigma and binge eating related to poorer perceptions of healthcare provider interaction quality in a community-based sample. J Eat Disord 2024; 12:128. [PMID: 39223683 PMCID: PMC11370053 DOI: 10.1186/s40337-024-01093-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 08/22/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Weight stigma refers to the social rejection, discrimination, and ideological devaluation of individuals because of body size and is a direct result of weight bias and anti-fat attitudes. Individuals with higher weight may be less likely to seek healthcare due to weight stigma, and if or when they do present for care, medical providers with weight bias may fail to provide high quality care. Little, however, is known about the intersectionality of weight stigma and perceptions of healthcare interactions as experienced by individuals who also binge eat. METHODS Community-based adults completed online self-report questionnaires regarding generalized weight stigma (Attitudes Towards Obese Persons1), healthcare interaction quality (Patient Perceptions of Healthcare Provider Interaction Quality; PPH), and disordered eating (Eating Disorder Examination-Questionnaire) via Amazon's Mechanical Turk platform. For this cross-sectional study, participants were categorized by the presence and absence of regular binge episodes. Pearson's correlations, T-tests, ANOVA/ANCOVA, and a multivariate regression were used to examine relationships among demographic variables, weight stigma, disordered eating, and the PPH. RESULTS Participants (N = 648) primarily identified as female (65.4%) and White, non-Hispanic (72.7%). Participants' average age and body mass index (BMI) were 37.5 (SD = 12.3) years old and 27.3 (SD = 6.9) kg/m2, respectively. Higher healthcare provider interaction quality ratings (PPH) were significantly related to lower BMI (r(648)=-0.098,p = 0.012), less weight stigma (r(648) = 0.149,p < 0.001), and identifying as a woman (t(514) = 2.09, p = 0.037, Cohen's d = 0.165) or White, non-Hispanic (t(646)=-2.73, p = 0.007, Cohen's d=-0.240). Participants reporting regular binge eating endorsed significantly worse perceptions of healthcare provider quality than those who did not, even after accounting for BMI, F(1, 645) = 8.42, p = 0.004, η2 = 0.013. A multivariate linear regression examining the PPH as dependent, and weight stigma and binge eating as independent, variable/s, was significant even after accounting for covariates (sex, race, BMI), F(95, 640) = 7.13,p < 0.001, R2 = 0.053 (small effect). CONCLUSIONS More negative experiences with healthcare providers was associated with worse weight stigma, higher BMI, regular binge eating and overall disordered eating, and for participants identifying as male or a Person of Color. These data have implications for non-clinical community populations and are particularly important as experiencing poorer quality of interactions with healthcare providers may decrease individuals' likelihood of seeking needed care for both disordered eating and health-related concerns. TRIAL REGISTRATION N/A.
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Affiliation(s)
- Rachel D Barnes
- Division of General Internal Medicine, University of Minnesota Medical School, MMC 741, 420 Delaware Street SE, Minneapolis, MN, 55455, USA.
| | - Jessica L Lawson
- VA Connecticut Healthcare System, West Haven, CT, USA
- Yale School of Medicine, Department of Psychiatry, New Haven, CT, USA
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3
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Turnwald BP, Fishbach A. Thinking of food: The mental representation of healthy foods as unprepared. Appetite 2024; 200:107510. [PMID: 38795945 DOI: 10.1016/j.appet.2024.107510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 05/21/2024] [Accepted: 05/22/2024] [Indexed: 05/28/2024]
Abstract
We find that people implicitly and explicitly represent healthy foods they categorize as healthy in their purest, least prepared forms but represent foods they categorize as unhealthy in their most prepared forms (e.g., a veggie patty is represented as frozen while a beef burger is represented in a bun with melted cheese and ready to eat). We find this effect across several studies using both image and word sorting measures in explicit tasks and implicit association tasks. The effect results from the perception of health and taste as two conflicting goals. Preparation (e.g., cooking, adding toppings) makes food more delicious, which creates categorization ambiguity. Hence, healthy food is thought of as unprepared. Indeed, individual differences in perceived health-taste goal conflict moderate the effect. Critically, the representation of healthy foods matters for food decisions. In an experiment that manipulated the descriptive language on a restaurant menu, emphasizing the preparation of foods increased participants' preference for healthy foods (with no improvement for unhealthy foods).
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Haim-Nachum S, Amsalem D, Lazarov A, Seedat S, Neria Y, Zhu X. Childhood maltreatment and its associations with trauma-related psychopathology: disentangling two classification approaches. NPJ MENTAL HEALTH RESEARCH 2024; 3:39. [PMID: 39152276 PMCID: PMC11329716 DOI: 10.1038/s44184-024-00082-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 08/06/2024] [Indexed: 08/19/2024]
Abstract
Childhood maltreatment (CM) is associated with various mental health disorders, including PTSD, depression, and anxiety. This study explores how specific classifications - dichotomous (abuse versus neglect) and dimensional (physical, emotional, sexual) - relate to distinct psychopathologies. We recruited 642 individuals, screening them for CM history and symptoms. ANOVA, regression, and SEM analyses compared CM approaches and symptom associations. The dichotomous approach showed significant effects of abuse and neglect on all symptoms. In the dimensional approach, sexual and physical CM were primary features for PTSD, while sexual and emotional CM were primary for depression and anxiety. Overall, the dimensional approach outperformed the dichotomous approach in capturing symptoms, suggesting its importance in understanding psychopathologies and guiding therapeutic interventions. Our findings highlight the differential associations of CM experiences with PTSD, depression, and anxiety symptoms. The findings suggest the importance of a dimensional CM approach for understanding psychopathologies and possibly informing targeted therapeutic interventions.
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Affiliation(s)
- Shilat Haim-Nachum
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA.
- New York State Psychiatric Institute, New York, NY, USA.
- School of Social Work, Tel Aviv University, Tel Aviv, Israel.
| | - Doron Amsalem
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Amit Lazarov
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Soraya Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
- South African PTSD Research Programme, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- South African Medical Research Council / Stellenbosch University Genomics of Brain Disorders Research Unit, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - Yuval Neria
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
- Department of Epidemiology, Columbia University Irving Medical Center, New York, NY, USA
| | - Xi Zhu
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
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Xu Y, Hall WJ, Scott M, Gao Y, Chiang PC, Williams DY, Srivastava A, Ramon ME, Englert AR. Strategies for Coping with Minority Stress among Queer Young Adults: Usage Frequency, Associations with Demographics, and Mental Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1052. [PMID: 39200662 PMCID: PMC11354887 DOI: 10.3390/ijerph21081052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Revised: 07/25/2024] [Accepted: 08/07/2024] [Indexed: 09/02/2024]
Abstract
Queer young adults report significantly higher levels of anxiety and depression than their heterosexual counterparts, which is linked to sexual minority stress. Therefore, it is important to understand the coping strategies employed by this population to navigate minority stress and how coping strategies may impact mental health outcomes. Drawing from a U.S. national diverse sample of 387 queer young adults (ages 18-39 years), we analyzed descriptive results of 11 behavioral strategies to cope with minority stress and used ordered logistic and linear regression to examine the following objectives: the frequency of the use of each coping strategy, and the associations between each strategy and demographic characteristics as well as depression and anxiety. Results revealed that avoidance and talking with friends were the most frequently utilized coping strategies, while prayer/religious activities and counseling/psychotherapy/support groups were infrequently used. We examined utilization preferences of coping strategies across demographic factors (e.g., assigned sex at birth and sexual orientation). The use of counseling/psychotherapy/support group was positively associated with mental health symptoms, while exercise and mindfulness/mediation were associated with lower mental health symptoms. Our findings provide insights for mental health researchers and professionals in selecting appropriate coping strategies for queer young adults in prevention and intervention efforts.
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Affiliation(s)
- Yinuo Xu
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (W.J.H.); (M.S.); (P.-C.C.); (D.Y.W.); (A.S.); (M.E.R.); (A.R.E.)
- School of Education, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA;
| | - William J. Hall
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (W.J.H.); (M.S.); (P.-C.C.); (D.Y.W.); (A.S.); (M.E.R.); (A.R.E.)
| | - McRae Scott
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (W.J.H.); (M.S.); (P.-C.C.); (D.Y.W.); (A.S.); (M.E.R.); (A.R.E.)
| | - Yutong Gao
- School of Education, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA;
| | - Pin-Chen Chiang
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (W.J.H.); (M.S.); (P.-C.C.); (D.Y.W.); (A.S.); (M.E.R.); (A.R.E.)
| | - Denise Yookong Williams
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (W.J.H.); (M.S.); (P.-C.C.); (D.Y.W.); (A.S.); (M.E.R.); (A.R.E.)
| | - Ankur Srivastava
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (W.J.H.); (M.S.); (P.-C.C.); (D.Y.W.); (A.S.); (M.E.R.); (A.R.E.)
| | - Magdelene E. Ramon
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (W.J.H.); (M.S.); (P.-C.C.); (D.Y.W.); (A.S.); (M.E.R.); (A.R.E.)
| | - Adam R. Englert
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (W.J.H.); (M.S.); (P.-C.C.); (D.Y.W.); (A.S.); (M.E.R.); (A.R.E.)
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Huang T, Safranek C, Socrates V, Chartash D, Wright D, Dilip M, Sangal RB, Taylor RA. Patient-Representing Population's Perceptions of GPT-Generated Versus Standard Emergency Department Discharge Instructions: Randomized Blind Survey Assessment. J Med Internet Res 2024; 26:e60336. [PMID: 39094112 PMCID: PMC11329854 DOI: 10.2196/60336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 06/07/2024] [Accepted: 06/22/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND Discharge instructions are a key form of documentation and patient communication in the time of transition from the emergency department (ED) to home. Discharge instructions are time-consuming and often underprioritized, especially in the ED, leading to discharge delays and possibly impersonal patient instructions. Generative artificial intelligence and large language models (LLMs) offer promising methods of creating high-quality and personalized discharge instructions; however, there exists a gap in understanding patient perspectives of LLM-generated discharge instructions. OBJECTIVE We aimed to assess the use of LLMs such as ChatGPT in synthesizing accurate and patient-accessible discharge instructions in the ED. METHODS We synthesized 5 unique, fictional ED encounters to emulate real ED encounters that included a diverse set of clinician history, physical notes, and nursing notes. These were passed to GPT-4 in Azure OpenAI Service (Microsoft) to generate LLM-generated discharge instructions. Standard discharge instructions were also generated for each of the 5 unique ED encounters. All GPT-generated and standard discharge instructions were then formatted into standardized after-visit summary documents. These after-visit summaries containing either GPT-generated or standard discharge instructions were randomly and blindly administered to Amazon MTurk respondents representing patient populations through Amazon MTurk Survey Distribution. Discharge instructions were assessed based on metrics of interpretability of significance, understandability, and satisfaction. RESULTS Our findings revealed that survey respondents' perspectives regarding GPT-generated and standard discharge instructions were significantly (P=.01) more favorable toward GPT-generated return precautions, and all other sections were considered noninferior to standard discharge instructions. Of the 156 survey respondents, GPT-generated discharge instructions were assigned favorable ratings, "agree" and "strongly agree," more frequently along the metric of interpretability of significance in discharge instruction subsections regarding diagnosis, procedures, treatment, post-ED medications or any changes to medications, and return precautions. Survey respondents found GPT-generated instructions to be more understandable when rating procedures, treatment, post-ED medications or medication changes, post-ED follow-up, and return precautions. Satisfaction with GPT-generated discharge instruction subsections was the most favorable in procedures, treatment, post-ED medications or medication changes, and return precautions. Wilcoxon rank-sum test of Likert responses revealed significant differences (P=.01) in the interpretability of significant return precautions in GPT-generated discharge instructions compared to standard discharge instructions but not for other evaluation metrics and discharge instruction subsections. CONCLUSIONS This study demonstrates the potential for LLMs such as ChatGPT to act as a method of augmenting current documentation workflows in the ED to reduce the documentation burden of physicians. The ability of LLMs to provide tailored instructions for patients by improving readability and making instructions more applicable to patients could improve upon the methods of communication that currently exist.
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Affiliation(s)
- Thomas Huang
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, United States
- Department for Biomedical Informatics and Data Science, Yale School of Medicine, New Haven, CT, United States
| | - Conrad Safranek
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, United States
- Department for Biomedical Informatics and Data Science, Yale School of Medicine, New Haven, CT, United States
| | - Vimig Socrates
- Department for Biomedical Informatics and Data Science, Yale School of Medicine, New Haven, CT, United States
- Program of Computational Biology and Bioinformatics, Yale University, New Haven, CT, United States
| | - David Chartash
- Department for Biomedical Informatics and Data Science, Yale School of Medicine, New Haven, CT, United States
- School of Medicine, University College Dublin, National University of Ireland, Dublin, Ireland
| | - Donald Wright
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, United States
- Department for Biomedical Informatics and Data Science, Yale School of Medicine, New Haven, CT, United States
| | - Monisha Dilip
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, United States
| | - Rohit B Sangal
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, United States
| | - Richard Andrew Taylor
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, United States
- Department for Biomedical Informatics and Data Science, Yale School of Medicine, New Haven, CT, United States
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Datta S, R. Valiquette C, Somogyi R. Understanding the Appropriate and Beneficial Use of Before and After Photos in Breast Surgery: A North American Survey. Plast Surg (Oakv) 2024; 32:404-412. [PMID: 39104944 PMCID: PMC11298139 DOI: 10.1177/22925503221146783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 10/31/2022] [Accepted: 11/06/2022] [Indexed: 08/07/2024] Open
Abstract
Introduction: Before and after photographs (BAPs) in breast surgery have been identified as important components of the informed consent process. Currently, there is limited consensus on the contents and presentation of BAPs. This study collected the opinions of prior and prospective patients on this topic. Methods: A survey, based on criteria identified by our previous nominal group technique (NGT) study, was designed to obtain patient perspectives on BAPs in breast surgery. Amazon Mechanical Turk, a validated crowd-sourcing tool, was used to identify and survey a group of 72 participants who indicated that they had undergone or were planning to undergo breast surgery. Likert items were analyzed using either chi-squared or Fisher's exact test. Results: Most respondents were cis-gendered-women (89%), Caucasian (83%), and between 31 and 41 years old (38%). Respondents agreed that BAPs are important to the consent process, for enabling patient-centered care, and should be presented in standardized sets. BAPs should be more accessible through different platforms, display multiple time points to show the healing process, and have multiple views including close-ups of scars. Photos should be unaltered except for de-identification, and have more diversity with regard to patient gender, age, skin color, and body mass index. These results align with results from our NGT study. Conclusion: Through this study we have identified many criteria that BAPs should meet according to prior and prospective breast surgery patients. Surgeons should think critically about how they present BAPs during the consent process to ensure effective patient-centered care.
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Affiliation(s)
- Shaishav Datta
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Chantal R. Valiquette
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Division of Plastic, Reconstructive & Aesthetic Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Ron Somogyi
- Division of Plastic, Reconstructive & Aesthetic Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada
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White AA, King AM, D’Addario AE, Brigham KB, Bradley JM, Gallagher TH, Mazor KM. Crowdsourced Feedback to Improve Resident Physician Error Disclosure Skills: A Randomized Clinical Trial. JAMA Netw Open 2024; 7:e2425923. [PMID: 39110461 PMCID: PMC11307134 DOI: 10.1001/jamanetworkopen.2024.25923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 06/06/2024] [Indexed: 08/10/2024] Open
Abstract
Importance Residents must prepare for effective communication with patients after medical errors. The video-based communication assessment (VCA) is software that plays video of a patient scenario, asks the physician to record what they would say, engages crowdsourced laypeople to rate audio recordings of physician responses, and presents feedback to physicians. Objective To evaluate the effectiveness of VCA feedback in resident error disclosure skill training. Design, Setting, and Participants This single-blinded, randomized clinical trial was conducted from July 2022 to May 2023 at 7 US internal medicine and family medicine residencies (10 total sites). Participants were second-year residents attending required teaching conferences. Data analysis was performed from July to December 2023. Intervention Residents completed 2 VCA cases at time 1 and were randomized to the intervention, an individual feedback report provided in the VCA application after 2 weeks, or to control, in which feedback was not provided until after time 2. Residents completed 2 additional VCA cases after 4 weeks (time 2). Main Outcomes and Measures Panels of crowdsourced laypeople rated recordings of residents disclosing simulated medical errors to create scores on a 5-point scale. Reports included learning points derived from layperson comments. Mean time 2 ratings were compared to test the hypothesis that residents who had access to feedback on their time 1 performance would score higher at time 2 than those without feedback access. Residents were surveyed about demographic characteristics, disclosure experience, and feedback use. The intervention's effect was examined using analysis of covariance. Results A total of 146 residents (87 [60.0%] aged 25-29 years; 60 female [41.0%]) completed the time 1 VCA, and 103 (70.5%) completed the time 2 VCA (53 randomized to intervention and 50 randomized to control); of those, 28 (54.9%) reported reviewing their feedback. Analysis of covariance found a significant main effect of feedback between intervention and control groups at time 2 (mean [SD] score, 3.26 [0.45] vs 3.14 [0.39]; difference, 0.12; 95% CI, 0.08-0.48; P = .01). In post hoc comparisons restricted to residents without prior disclosure experience, intervention residents scored higher than those in the control group at time 2 (mean [SD] score, 3.33 [0.43] vs 3.09 [0.44]; difference, 0.24; 95% CI, 0.01-0.48; P = .007). Worse performance at time 1 was associated with increased likelihood of dropping out before time 2 (odds ratio, 2.89; 95% CI, 1.06-7.84; P = .04). Conclusions and Relevance In this randomized clinical trial, self-directed review of crowdsourced feedback was associated with higher ratings of internal medicine and family medicine residents' error disclosure skill, particularly for those without real-life error disclosure experience, suggesting that such feedback may be an effective way for residency programs to address their requirement to prepare trainees for communicating with patients after medical harm. Trial Registration ClinicalTrials.gov Identifier: NCT06234085.
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Affiliation(s)
- Andrew A. White
- Department of Medicine, University of Washington School of Medicine, Seattle
| | - Ann M. King
- National Board of Medical Examiners, Philadelphia, Pennsylvania
| | | | - Karen Berg Brigham
- Collaborative for Accountability and Improvement, University of Washington School of Medicine, Seattle
| | - Joel M. Bradley
- Department of Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
- Department of Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | - Thomas H. Gallagher
- Department of Medicine, University of Washington School of Medicine, Seattle
- Department of Bioethics, University of Washington School of Medicine, Seattle
| | - Kathleen M. Mazor
- Department of Medicine, UMass Chan Medical School, Worcester, Massachusetts
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Dean RS, Hafen TJ, Braithwaite CL, Farley KX, LaPrade RF, Guettler JH, Bicos J. Patient Perception of Allograft Versus Autograft in ACL Reconstruction Using a Validated Online Survey Marketplace. Orthop J Sports Med 2024; 12:23259671241263853. [PMID: 39165330 PMCID: PMC11334250 DOI: 10.1177/23259671241263853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 02/02/2024] [Indexed: 08/22/2024] Open
Abstract
Background Little is known regarding the opinions of the general population on anterior cruciate ligament (ACL) graft options. Purpose To evaluate the general population's perception of the use of allografts versus autografts in ACL reconstruction using a previously validated online marketplace platform. Methods A prospective 34-question survey was distributed via the online marketplace. After collecting baseline demographics, participant preferences for ACL reconstruction with an allograft or autograft were established. All respondents completed a preeducation survey, reviewed an evidence-based education sheet, and completed a posteducation survey to assess their understanding. Upon completion, participants were asked which graft they would prefer. Participants were then asked if they would be willing to change their preference based on surgeon recommendation. Finally, participants were asked to rank the factors from the education sheet that were most influential. Study Design Cross-sectional study. Results There were 491 participants that completed the survey (mean age, 39.9 years [range, 19-72 years]; 244 male, 241 female, and 6 nonbinary/third-gender participants). Before reading the education sheet, 276 (56%) reported no graft preferences, 146 (30%) preferred autograft, and 69 (14%) preferred allograft. After reading the provided sheet, 226 (46%) participants preferred autograft, 185 (38%) preferred allograft, and 80 (16%) had no preference. The mean score on the preeducation test was 45%, and the mean score on the posteducation test was significantly greater (61%; P < .01). Overall, 345 participants (83.9%) stated they would change their preference for autograft or allograft if their surgeon recommended it. Surgeon preference (n = 330; 67%), educational information provided (n = 117; 24%), and previous knowledge (n = 44; 9%) were the most important factors for making graft selections. The mean ages of the participants selecting each graft type before and after education were as follows: allograft (37.8 ± 10.1 vs 40.6 ± 11.8 years; P = .05), autograft (38 ± 11.5 vs 39.5 ± 10.1 years; P = .21), and no preference (41.5 ± 11.2 vs 39.4 ± 11.8 years; P = .16). Conclusion Education resulted in a greater number of individuals' reporting a preference in graft type (either allograft or autograft) compared with preinformation questioning. In addition, 83.9% of the participants were willing to switch their graft choice if recommended by their surgeon.
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Affiliation(s)
- Robert S. Dean
- Department of Orthopaedics, Corewell Health William Beaumont University Hospital, Royal Oak, Michigan, USA
| | - Tanner J. Hafen
- William Beaumont School of Medicine, Oakland University, Auburn Hills, Michigan, USA
| | - Collin L. Braithwaite
- William Beaumont School of Medicine, Oakland University, Auburn Hills, Michigan, USA
| | - Kevin X. Farley
- Department of Orthopaedics, Corewell Health William Beaumont University Hospital, Royal Oak, Michigan, USA
| | | | - Joseph H. Guettler
- Department of Orthopaedics, Corewell Health William Beaumont University Hospital, Royal Oak, Michigan, USA
| | - James Bicos
- Department of Orthopaedics, Corewell Health William Beaumont University Hospital, Royal Oak, Michigan, USA
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Kuzmik A, Liu Y, Cuffee Y, Kong L, Sciamanna CN, Rovniak LS. Friend Social Network Size Moderates the Association Between Age and Physical Activity Across Adulthood. INTERNATIONAL JOURNAL OF EXERCISE SCIENCE 2024; 17:1068-1082. [PMID: 39257546 PMCID: PMC11385292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 09/12/2024]
Abstract
Both physical activity and social network size decline as people age. However, limited research has examined if social network size and contact frequency differentially influence physical activity across the adult lifespan. This study aimed to assess if these social network characteristics moderated the relationship between age and physical activity level across adulthood. Multiple regression analyses were conducted to examine the main-effect association between age, past-week physical activity, and past-year physical activity, as well as the moderating effect of social network characteristics (i.e., friend network size, friend contact frequency, relative network size, and relative contact frequency) on age-physical activity associations. The results revealed that friend network size had moderated associations between age and past-week physical activity (β = -7.03; p = .025, f2 = 0.13) and past-year physical activity (β = -585.52; p = .017, f2 = 0.15). Specifically, adults who were older and had smaller friend networks performed more minutes of moderate-vigorous physical activity (MVPA) over the past week and past year; on the other hand, adults who were younger and had larger friend networks performed more minutes of MVPA over the past week and past year. Relative network size, friend contact frequency, and relative contact frequency did not moderate the relationship between age and past-week physical activity and past-year physical activity. These findings suggested that building friend networks throughout adulthood may help promote active living across the adult lifespan.
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Affiliation(s)
- Ashley Kuzmik
- Ross and Carol Nese College of Nursing, Pennsylvania State University, PA, USA
| | - Yin Liu
- Department of Human Development and Family Sciences, Utah State University, UT, USA
| | | | - Lan Kong
- Departments of Medicine and Public Health Sciences, College of Medicine, Pennsylvania State University, PA, USA
| | - Christopher N Sciamanna
- Departments of Medicine and Public Health Sciences, College of Medicine, Pennsylvania State University, PA, USA
| | - Liza S Rovniak
- Departments of Medicine and Public Health Sciences, College of Medicine, Pennsylvania State University, PA, USA
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Niu Z, Heckman CJ. Associations of Social Factors and Self-Efficacy with Skin-Self Examination Intentions Among Hispanics at Risk for Skin Cancer and Their Preferences for Digital Interventions. CYBERPSYCHOLOGY, BEHAVIOR AND SOCIAL NETWORKING 2024. [PMID: 39083402 DOI: 10.1089/cyber.2023.0704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/02/2024]
Abstract
Skin cancer ranks as the most prevalent cancer in the United States. Over the past two decades, the incidence of melanoma, the deadliest form of skin cancer, among Hispanics has risen by 20%. Melanoma mortality rates are higher in Hispanics than in non-Hispanic Whites (NHW). Early detection of melanoma via skin self-examination may lead to diagnosis of melanoma at an earlier stage, when they are thinner, less invasive, and more easily treatable, resulting in improved survival rates. Given the gap in research addressing culturally relevant factors related to skin cancer prevention and detection among Hispanics and informed by the Preventive Health Model, this study tested the associations between social and normative factors and self-efficacy with thorough skin self-examination (TSSE) intentions and queried participants about their preferences for skin cancer-related interventions. Among respondents (n = 79), 55.7% were female (n = 44), and 89.9% held a college or higher degree (n = 71). Self-efficacy fully mediated the effects of descriptive norms, injunctive norms, and provider-patient communication on TSSE intentions among Hispanics. On average, respondents demonstrated considerable interest in participating in a skin cancer-related behavioral intervention using a mobile application (75.6%) and/or using WhatsApp (71.8%). These preliminary findings provide new insights for development of future digital skin cancer intervention programs among Hispanics targeting social factors, including social norms and provider-patient communication, and utilizing preferred digital tools.
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Affiliation(s)
- Zhaomeng Niu
- Department of Health Informatics, Rutgers School of Health Professions, New Brunswick, NJ, USA
| | - Carolyn J Heckman
- Department of Medicine, Robert Wood Johnson Medical School, Rutgers Cancer Institute, New Brunswick, NJ, USA
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12
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Parikh HB, Ewing B, Tseng CC, Yoshida R, Kulber DA, Kuschner SH. Orthopaedic Surgery and Indusry: What our Potential Patients Believe. J Am Acad Orthop Surg 2024:00124635-990000000-01047. [PMID: 39018577 DOI: 10.5435/jaaos-d-24-00164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 05/23/2024] [Indexed: 07/19/2024] Open
Abstract
PURPOSE Physician and surgeon involvement in industry has received considerable attention in recent decades. In this study, we outline the perspective of the general US population regarding (1) disclosure, (2) ownership, and (3) compensation between physicians/surgeons and industry. We hypothesize that the general population would be largely supportive of the physician/surgeon-industry relationship. METHODS An online, survey-based, descriptive study was conducted through a crowdsourcing platform, Amazon Mechanical Turk. Survey respondents were presented with a seven-item questionnaire inquiring about the physician/surgeon and industry relationship. An "attention check" question was included; those who failed this question were excluded. Descriptive statistics were used to assess the data and a McNemar chi-squared test for paired, dichotomous data. RESULTS A total of 993 respondents were included. Survey responses are summarized in Table 1. 70.6% of respondents stated that it was "important" or "extremely important" to disclose that the patient be informed whether implants used in surgery had been developed by the operating surgeon. 71.1% of respondents reported that it was "important" or "extremely important" to disclose partial ownership within industry. Seventy-one percent of respondents stated it was "important" or "extremely important" to disclose royalty payments pertaining to surgical implants. 95.6% of respondents suggested that it was acceptable for surgeons to accept free airfare and lodging, and 95.2% of respondents stated that it was acceptable for the surgeon to be compensated for time away from practice to learn about new equipment. DISCUSSION In our survey of 993 respondents, we found that relationships with industry are considered acceptable if appropriate disclosure is given to patients. We also found that although respondents suggested that physicians and surgeons may be influenced by a free meal, compensation for trips to try new equipment and time spent away from practice is considered appropriate. LEVEL OF EVIDENCE 2c, Ecological studies.
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Affiliation(s)
- Harin B Parikh
- From the Department of Hand Surgery, Cedars-Sinai Medical Center (Parikh, Yoshida, Kulber, and Kuschner), the Department of Orthopaedic Surgery, Cedars-Sinai Medical Center (Ewing), and the Department of Outpatient Rehabilitation, University of Southern California, Los Angeles, CA (Tseng)
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13
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Valentine L, Weidman AA, Stearns SA, Dennis D, Alvarez AH, Foppiani J, Lin SJ. Rhinoplasty Preferences: Can the Public Detect Prior Surgery on Social Media? Aesthetic Plast Surg 2024; 48:2423-2431. [PMID: 38286896 DOI: 10.1007/s00266-023-03791-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 12/04/2023] [Indexed: 01/31/2024]
Abstract
BACKGROUND The creation of postoperative rhinoplasty results that appear natural and proportional to the face are crucial for patient satisfaction. The purpose of this study was to assess the public's ability to detect a post-rhinoplasty result and preference of preoperative and postoperative rhinoplasty outcomes. METHODS A survey was distributed using the Amazon Mechanical Turk online platform showing nine preoperative and postoperative rhinoplasty patients. Participants rated aesthetic appearance, identified areas of abnormality, and stated whether they believed the patient had undergone prior rhinoplasty. RESULTS A total of 456 responses were included. On a scale of 1-5 with 5 being the most aesthetically pleasing, the highest rated nose was a postoperative patient without visible deformities (3.95, SD 1.07) followed by the postoperative patient with a resultant bulbous tip (3.48, SD 0.96). The lowest ranking noses were the prior rhinoplasty with resultant saddle nose deformity (3.02, SD 1.19) and the prior rhinoplasty with nasal trapezoid deformity (2.95, SD 1.04). The public was able to correctly determine if patients had prior rhinoplasty surgery only if there were resultant defects. When respondents believed that the patient had undergone prior rhinoplasty, their average rating was lower than those who believed they had not undergone surgery (3.74/5 vs. 4.15/5, p < 0.0001). CONCLUSIONS The belief that someone had previously undergone rhinoplasty led the public to rate the aesthetic appearance of the nose lower. To provide optimal results following rhinoplasty, surgeons may therefore seek to provide a natural, "un-operated" look. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 . Differences for nasal aesthetic preferences exist and vary based on geographic region The public is unable to discern if a patient previously underwent rhinoplasty if the result does not show a postoperative defect, such as a dorsal hump, over-rotated tip, or mid-vault collapse Oppositely, the public can generally tell if patients have undergone rhinoplasty surgery if a postoperative deformity is present The belief that someone had rhinoplasty surgery negatively impacts the attractiveness ranking of the nose, even without any postoperative defects present.
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Affiliation(s)
- Lauren Valentine
- Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis Street Suite 5A, Boston, MA, 02215, USA
| | - Allan A Weidman
- Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis Street Suite 5A, Boston, MA, 02215, USA
| | - Stephen A Stearns
- Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis Street Suite 5A, Boston, MA, 02215, USA
| | - Daniella Dennis
- University of Connecticut School of Medicine, Farmington, CT, USA
| | - Angelica Hernandez Alvarez
- Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis Street Suite 5A, Boston, MA, 02215, USA
| | - Jose Foppiani
- Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis Street Suite 5A, Boston, MA, 02215, USA
| | - Samuel J Lin
- Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis Street Suite 5A, Boston, MA, 02215, USA.
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Song Y, Luximon Y. When Trustworthiness Meets Face: Facial Design for Social Robots. SENSORS (BASEL, SWITZERLAND) 2024; 24:4215. [PMID: 39000993 PMCID: PMC11244564 DOI: 10.3390/s24134215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 06/23/2024] [Accepted: 06/26/2024] [Indexed: 07/16/2024]
Abstract
As a technical application in artificial intelligence, a social robot is one of the branches of robotic studies that emphasizes socially communicating and interacting with human beings. Although both robot and behavior research have realized the significance of social robot design for its market success and related emotional benefit to users, the specific design of the eye and mouth shape of a social robot in eliciting trustworthiness has received only limited attention. In order to address this research gap, our study conducted a 2 (eye shape) × 3 (mouth shape) full factorial between-subject experiment. A total of 211 participants were recruited and randomly assigned to the six scenarios in the study. After exposure to the stimuli, perceived trustworthiness and robot attitude were measured accordingly. The results showed that round eyes (vs. narrow eyes) and an upturned-shape mouth or neutral mouth (vs. downturned-shape mouth) for social robots could significantly improve people's trustworthiness and attitude towards social robots. The effect of eye and mouth shape on robot attitude are all mediated by the perceived trustworthiness. Trustworthy human facial features could be applied to the robot's face, eliciting a similar trustworthiness perception and attitude. In addition to empirical contributions to HRI, this finding could shed light on the design practice for a trustworthy-looking social robot.
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Affiliation(s)
- Yao Song
- College of Literature and Journalism, Sichuan University, Chengdu 610065, China;
- Digital Convergence Laboratory of Chinese Cultural Inheritance and Global Communication, Sichuan University, Chengdu 610065, China
- School of Design, The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - Yan Luximon
- School of Design, The Hong Kong Polytechnic University, Hong Kong 999077, China
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15
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Foot H, Chan AHY, Horne R. Development and validation of the BMQ-AIR ©: a screening tool for assessing patients' treatment beliefs about switching to anti-inflammatory reliever (AIR) therapy. Front Pharmacol 2024; 15:1351851. [PMID: 39005938 PMCID: PMC11239962 DOI: 10.3389/fphar.2024.1351851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 05/30/2024] [Indexed: 07/16/2024] Open
Abstract
Introduction Despite anti-inflammatory reliever (AIR) therapy now being the preferred treatment choice across all severities of asthma, many patients are still "attached" to their short-acting beta2-agonist (SABA) reliever, believing this to be the best way to control their asthma. To encourage individuals to switch to AIR, it is important to first identify the beliefs that patients hold about AIR. Objective The aim of this paper was to describe the initial development and validation of the BMQ-AIR©, a six-item screening tool which assesses and identifies patients' treatment beliefs about switching to AIR therapy. Methods Statements were identified from the primary literature that assessed patients' perceptions of AIR therapy and adapted from the Beliefs about Medicines Questionnaire (BMQ). Internal reliability was examined using Cronbach's alpha coefficient. Construct validity was evaluated by comparing scores on BMQ-AIR© with a validated measure of medication adherence and SABA beliefs. Results A total of 446 participants completed the online survey. The BMQ-AIR© contained two subscales with three items each. Both the Necessity and Concerns subscales demonstrated good internal reliability, with Cronbach's α-values of 0.70 and 0.69, respectively. Both subscales were negatively correlated with self-report inhaled corticosteroid adherence (Necessity: r = -0.28, p < 0.0001; Concerns: r = -0.28, p < 0.0001) and positively correlated with SRQ scores (Necessity: r = 0.51, p < 0.0001; Concerns: r = 0.44, p < 0.0001). Conclusion Preliminary findings indicate that BMQ-AIR© demonstrates satisfactory reliability and validity. BMQ-AIR© is a promising tool that may help tailor interventions to an individual's specific beliefs and barriers to switching to better support individuals in stopping SABA and initiating AIR therapy.
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Affiliation(s)
- Holly Foot
- School of Pharmacy, The University of Queensland, Brisbane, QLD, Australia
- School of Pharmacy, The University of Auckland, Auckland, New Zealand
| | - Amy Hai Yan Chan
- School of Pharmacy, The University of Auckland, Auckland, New Zealand
- Centre of Behavioural Medicine, School of Pharmacy, University College London, London, United Kingdom
| | - Rob Horne
- Centre of Behavioural Medicine, School of Pharmacy, University College London, London, United Kingdom
- International Primary Care Respiratory Group, London, United Kingdom
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Irish LA, Christensen Pacella KA, Nation MB, Barnes RD. Engagement in binge eating and fasting associated with poorer sleep quality in an online sample of adults. J Eat Disord 2024; 12:76. [PMID: 38858793 PMCID: PMC11165844 DOI: 10.1186/s40337-024-01028-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 05/23/2024] [Indexed: 06/12/2024] Open
Abstract
OBJECTIVES Both disordered eating and disturbed sleep represent significant threats to mental health. Accumulating evidence suggests that disordered eating behaviors and sleep problems co-occur. A majority of current research, however, has focused on these behaviors as components of eating disorder diagnoses, rather than investigating the independent associations of transdiagnostic disordered eating behaviors and sleep. The present study sought to examine fasting, binge eating, self-induced vomiting, laxative or diuretic misuse, and driven exercise as predictors of sleep quality complaints. METHOD An online sample of 648 U.S. adults completed the Eating Disorder Examination - Questionnaire, the Pittsburgh Sleep Quality Index, and the Patient Health Care Questionnaire-2 as part of a larger parent study. RESULTS Results of a hierarchical linear regression revealed that, collectively, disordered eating behaviors predicted worse sleep quality [R2 = 0.30, F(7, 640) = 31.21, p < .001], and that both binge eating and fasting, but not other compensatory behaviors, accounted for unique variance in sleep quality after controlling for BMI and depression. CONCLUSIONS Overall, findings suggest that transdiagnostic disordered eating behaviors are associated with sleep quality complaints. Improved understanding of the specific relationships between individual eating behaviors and sleep characteristics can help refine the identification of individuals at high risk for sleep disturbance and address the potential reciprocal influence of sleep quality on disordered eating behaviors.
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Affiliation(s)
- Leah A Irish
- Department of Psychology, North Dakota State University, Fargo, ND, USA
- Center for Biobehavioral Research, Sanford Research-North, Fargo, ND, USA
| | | | - Maegan B Nation
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Rachel D Barnes
- Health Psychology General Internal Medicine, University of Minnesota Medical School, MMC 741, 420 Delaware Street SE, Minneapolis, MN, 55455, USA.
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Marquard J, Austin R, Rajamani S. Design of patient-facing immunization visualizations affects task performance: an experimental comparison of 4 electronic visualizations. J Am Med Inform Assoc 2024:ocae125. [PMID: 38833256 DOI: 10.1093/jamia/ocae125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 04/29/2024] [Accepted: 05/20/2024] [Indexed: 06/06/2024] Open
Abstract
OBJECTIVE This study experimentally evaluated how well lay individuals could interpret and use 4 types of electronic health record (EHR) patient-facing immunization visualizations. MATERIALS AND METHODS Participants (n = 69) completed the study using a secure online survey platform. Participants viewed the same immunization information in 1 of 4 EHR-based immunization visualizations: 2 different patient portals (Epic MyChart and eClinicWorks), a downloadable EHR record, and a clinic-generated electronic letter (eLetter). Participants completed a common task, created a standard vaccine schedule form, and answered questions about their perceived workload, subjective numeracy and health literacy, demographic variables, and familiarity with the task. RESULTS The design of the immunization visualization significantly affected both task performance measures (time taken to complete the task and number of correct dates). In particular, those using Epic MyChart took significantly longer to complete the task than those using eLetter or eClinicWorks. Those using Epic MyChart entered fewer correct dates than those using the eLetter or eClinicWorks. There were no systematic statistically significant differences in task performance measures based on the numeracy, health literacy, demographic, and experience-related questions we asked. DISCUSSION The 4 immunization visualizations had unique design elements that likely contributed to these performance differences. CONCLUSION Based on our findings, we provide practical guidance for the design of immunization visualizations, and future studies. Future research should focus on understanding the contexts of use and design elements that make tables an effective type of health data visualization.
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Affiliation(s)
- Jenna Marquard
- School of Nursing, University of Minnesota, Minneapolis, MN 55455, United States
- Institute for Health Informatics, University of Minnesota, Minneapolis, MN 55455, United States
| | - Robin Austin
- School of Nursing, University of Minnesota, Minneapolis, MN 55455, United States
| | - Sripriya Rajamani
- School of Nursing, University of Minnesota, Minneapolis, MN 55455, United States
- Institute for Health Informatics, University of Minnesota, Minneapolis, MN 55455, United States
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Zvolensky MJ, Robison JH, Ayers ZS, Senger AR, Clausen BK, Businelle MS, Gallagher MW. Anxiety sensitivity and COVID-19 mental health, fatigue, and well-being: a longitudinal examination among adults from the United States during March-October 2020. Cogn Behav Ther 2024:1-19. [PMID: 38828649 DOI: 10.1080/16506073.2024.2360054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 05/17/2024] [Indexed: 06/05/2024]
Abstract
There is widespread empirical evidence that the COVID-19 pandemic contributed to elevated risk of mental and physical health symptoms and decreased quality of life. The present investigation sought to examine if individual differences in anxiety sensitivity was associated with mental health, psychosomatic, and well-being among a sample of US adults during a 6-month period early in the COVID-19 pandemic. Employing longitudinal research methodology, we tested the hypothesis that the anxiety sensitivity global factor would be related to increased risk of anxiety, depression, fatigue, and lower well-being. Secondary analyses evaluated the lower order anxiety sensitivity factors for the same criterion variables. The sample consisted of 778 participants with an average age of 37.96 (SD = 11.81; range 18-73). Results indicated that, as hypothesized, anxiety sensitivity was associated with increased risk for more severe anxiety, depression, fatigue, and lesser well-being; the observed effects of anxiety sensitivity were relatively robust and evident in adjusted models that controlled for numerous theoretically and clinically relevant factors (e.g. perceived health status). Overall, these results suggest that pandemic functioning could likely be improved via interventions that target elevated anxiety sensitivity as a vulnerability factor for a broad range of aversive psychosomatic symptoms and personal well-being.
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Affiliation(s)
- Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, TX, USA
- Department of Behavioral Science, Anderson Cancer Center, The University of Texas MD, Houston, TX, USA
- HEALTH Institute, University of Houston, Houston, TX, USA
| | | | - Zachary S Ayers
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Amy R Senger
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Bryce K Clausen
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Michael S Businelle
- HEALTH Institute, University of Houston, Houston, TX, USA
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Matthew W Gallagher
- Department of Psychology, University of Houston, Houston, TX, USA
- HEALTH Institute, University of Houston, Houston, TX, USA
- Texas Institute for Measurement, Evaluation, and Statistics, University of Houston, Houston, TX, USA
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Kim D, Russell BS, Park CL, Fendrich M. Emotion dysregulation and family functioning moderate family caregiving burden during the pandemic. Palliat Support Care 2024; 22:451-459. [PMID: 37997433 DOI: 10.1017/s1478951523001712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023]
Abstract
OBJECTIVES Since the onset of COVID-19 pandemic, additional risk factors affecting family caregivers' mental health have arisen. Therefore, personal stress coping strategies and family dynamics became important factors in reducing the impact of the pandemic on family caregivers' mental health. The present research aimed to estimate the association between COVID-19 stressors and family caregiving burden. Moreover, moderating effects of emotion dysregulation and family functioning on this association were investigated. METHODS This study analyzed data collected in April 2021 from 154 family caregivers (Mage = 38.79, SDage = 9.36, range = 22-64) recruited through Amazon's Mechanical Turk (MTurk). The impact of COVID-19 stressors on family caregiving burden was tested, and moderating impacts of emotion dysregulation and family functioning were also investigated. RESULTS Both COVID-19 stress exposure and stress appraisal were positively associated with family caregiving burden. Emotion dysregulation and problematic family functioning were also positively associated with family caregiving burden. A significant moderating effect of emotion dysregulation was found, such that family caregivers with higher emotion dysregulation were likely to feel more caregiving burden when they experienced more COVID-19 stressors. SIGNIFICANCE OF RESULTS The current research highlighted the role of emotion regulation in reducing the negative impact of COVID-19 stressors on family caregiving burden. The research also emphasizes the need for intervention programs to improve emotion regulation strategies to decrease family caregiving burden during the pandemic.
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Affiliation(s)
- Dahee Kim
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Beth S Russell
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Crystal L Park
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Michael Fendrich
- School of Social Work, University of Connecticut, Hartford, Connecticut, USA
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Kim EJ, Foppiani J, Alvarez AH, Valentine L, Weidman AA, Bustos VP, Lin SJ, Lee BT. The Impact of Health Literacy on Trust in Online Plastic Surgery Content: A Nationwide Analysis. J Surg Res 2024; 298:300-306. [PMID: 38640615 DOI: 10.1016/j.jss.2024.03.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 02/14/2024] [Accepted: 03/21/2024] [Indexed: 04/21/2024]
Abstract
INTRODUCTION On most online platforms, just about anyone can disseminate plastic surgery (PS) content regardless of their educational or professional background. This study examines the general public's perceptions of the accuracy of online PS content and the factors that contribute to the discernment of credible information. METHODS The Amazon Mechanical Turk crowdsourcing platform was used to survey adults in the United States. The survey assessed respondent demographics, health literacy (HL), and perceptions of online PS content accuracy. T-tests, Chi-square tests, and post hoc analyses with Bonferroni corrections assessed differences between HL groups. Multivariate linear regressions assessed associations between sociodemographic variables and perceptions of online content. RESULTS In total, 428 (92.0%) of 465 complete responses were analyzed. The median age of respondents was 32 y (interquartile range: 29-40). Online sources were predominantly perceived to have a high degree of accuracy, with mean scores of various platforms ranging from 3.8 to 4.5 (1 = not accurate at all; 5 = extremely accurate). The low HL group perceived social media sites and review sites to be more accurate than the high HL respondents, particularly for Reddit (P = 0.004), Pinterest (P = 0.040), and Snapchat (P = 0.002). CONCLUSIONS There is a concerning relationship between low HL and the perceptions of the accuracy of online PS sources. This study underscores the need for education campaigns, the development of trustworthy online resources, and initiatives to improve HL. By fostering a more informed public, individuals seeking PS can make better informed decisions.
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Affiliation(s)
- Erin J Kim
- Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Jose Foppiani
- Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Angelica Hernandez Alvarez
- Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Lauren Valentine
- Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Allan A Weidman
- Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Valeria P Bustos
- Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Samuel J Lin
- Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
| | - Bernard T Lee
- Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
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Pollet TV, Bovet J, Buhaenko R, Cornelissen PL, Tovée MJ. Sample characteristics for quantitative analyses in Body Image: Issues of generalisability. Body Image 2024; 49:101714. [PMID: 38744196 DOI: 10.1016/j.bodyim.2024.101714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 04/02/2024] [Accepted: 04/09/2024] [Indexed: 05/16/2024]
Abstract
Psychological research frequently encounters criticism regarding the representativeness of the samples under study, highlighting concerns about the external validity of the obtained results. Here, we conducted a comprehensive survey of all the quantitative samples from the journal Body Image for 2021 (n = 149 samples). Our primary objective was to examine the extent to which the sampled populations deviated from the population at large, which could potentially compromise the generalizability of findings. We identified that a substantial number of these samples came from student populations (n = 44) and the majority were from the United States, United Kingdom, and Australia. Only a small number of samples (n = 9) employed direct measurements of body mass index (BMI), while the majority relied on self-reported data (n = 93). For a subset of samples in the journal, which were drawn from the general population, we compared whether these differed from population reference values in terms of age and BMI. Using Monte Carlo simulations, we found that samples tended to be younger and score lower on BMI than reference values obtained from the broader population. Samples drawn from female university students also tended to be lower on BMI than age-matched reference samples. We discuss the implications of our findings and make recommendations on sampling and inference. We conclude that a clearer specification of the parameters or conditions under which findings are expected to generalise has the potential to enhance the overall rigor and validity of this field of research.
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Roter DL, Lowe C, Bugayong M, Dobs AS. Cancer care partners' behavioral intention to use autonomy enhancing communication skills during accompanied visits after online skill training. PATIENT EDUCATION AND COUNSELING 2024; 123:108176. [PMID: 38422948 DOI: 10.1016/j.pec.2024.108176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 12/19/2023] [Accepted: 01/25/2024] [Indexed: 03/02/2024]
Abstract
OBJECTIVE The study objective is to evaluate an adaptation of the LEAPS skill framework for cancer care partners (CPs) focusing on autonomy enhancing skills and assessed by strong behavioral intention (SBI) to use these skills METHOD: Cancer CPs were recruited through public platforms to view and rate 4 LEAPS cancer-specific narratives and 52 skill demonstration videos, indicate SBI to use demonstrated skills and provide information on skill-related measures. RESULTS Half of CPs expressed SBI to use an average of 6.5 of 13 LEAPS skills which did not vary by LEAPS communication domains or examples used to demonstrate skills. Significant predictors of SBI include positive ratings of program narratives and past use of LEAPS-related behaviors in the communication domain of shared decision making (SDM). CONCLUSION CPs indicated SBIs to use multiple autonomy enhancing skills and positively rated program videos after exposure to the brief LEAPS training program. PRACTICE IMPLICATIONS The brevity of the LEAPS training videos make it possible for users to view an individual cancer-specific narrative and 13 skill demonstrations in roughly 6 min. This ultra-brief training can benefit care partners and the patients they accompany by increasing the likelihood that autonomy enhancing skills are used during accompanied visits.
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Affiliation(s)
- Debra L Roter
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Chenery Lowe
- Center for Biomedical Ethics, Stanford University, Palo Alto, CA, USA
| | - Marielle Bugayong
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Adrian S Dobs
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
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Seiter CR, Johnson ZD. Death walks into a bar: Humor and profanity in advance care planning messages. DEATH STUDIES 2024:1-9. [PMID: 38698573 DOI: 10.1080/07481187.2024.2341873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
Although scholars note advantages and disadvantages to using humor and profanity, influential leaders in the Death Positive Movement (DPM) use both message features to motivate end-of-life (EOL) advance care planning (ACP). Through the lens of expectancy violations theory (EVT), this study examined relationships between perceived humor, profanity in messages, trait profanity use in receivers, perceived offensiveness, perceived speaker effectiveness, and perceived message effectiveness. Participants (N = 604) were randomly exposed to a podcast about ACP containing clean humor, profane humor, or no humor. Results indicated that profanity and perceived humor were positively related to offensiveness, and offensiveness was negatively related to perceived speaker and message effectiveness. When perceived as non-offensive, perceived humor was positively related to perceived speaker and message effectiveness. Surprisingly, profane messages offended profane receivers more than they offended less-profane receivers. These results suggest that to be maximally effective, ACP motivators should use humor cautiously and avoid profanity.
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Affiliation(s)
- Christian R Seiter
- Department of Human Communication Studies, California State University, Fullerton, California, USA
| | - Zac D Johnson
- Department of Human Communication Studies, California State University, Fullerton, California, USA
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Rezwan SK, Puthumana JS, Brandacher G, Cooney CM. Crowdsourcing Attitudes and Beliefs About Upper Extremity Donation in the United States. Cureus 2024; 16:e59746. [PMID: 38841001 PMCID: PMC11151185 DOI: 10.7759/cureus.59746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2024] [Indexed: 06/07/2024] Open
Abstract
Introduction To date, upper extremity transplantation (UET) is the most frequently performed vascularized composite allotransplantation (VCA). Perceptions regarding upper extremity donation among Americans, particularly in veterans and service members (VSMs), are largely unknown. Materials and methods We administered a one-time survey to United States (US)-resident Amazon Mechanical Turk (MTurk) workers aged ≥18 years. Descriptive statistics were used to summarize study data; frequencies and percentages were calculated for categorical variables analyzed by Fischer's exact test and using a two-tailed test assessing the statistical significance of p<0.05. Results A total of 860 respondents completed the study survey. Among these, 529 (61.5%) reported willingness to donate an upper extremity, 152 (17.7%) were undecided, and 179 (20.8%) were unwilling. A significantly higher proportion of those willing to donate were female (66.7%, p=0.009), non-Hispanic (63.9%, p=0.000), White (64.0%, p=0.004), non-religious (71.3%, p=0.001), not a VSM (62.8%, p=0.000), or non-amputees (62.9%, p=0.000). Conclusions Our survey found that being female, non-Hispanic, White, non-religious, non-VSM, or non-amputee was significantly associated with donation willingness. These findings may help guide VCA programs, organ procurement organizations, and researchers in efforts to develop targeted educational materials to broaden the public's knowledge and awareness of VCA donation to further benefit all patients in need of or desiring transplantation.
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Affiliation(s)
- Siam K Rezwan
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Joseph S Puthumana
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Gerald Brandacher
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Carisa M Cooney
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, USA
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Rezwan SK, Aravind P, Puthumana JS, Brandacher G, Cooney CM. Crowdsourcing Opinions and Awareness of Upper Extremity Transplantation in the United States. Cureus 2024; 16:e60941. [PMID: 38910738 PMCID: PMC11193538 DOI: 10.7759/cureus.60941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2024] [Indexed: 06/25/2024] Open
Abstract
Introduction As of 2008, the United States had 41,000 people living with upper extremity amputation. This number is projected to reach 300,000 by 2050. Human upper extremity transplantation (HUET) may become a more common treatment option with the potential to significantly improve the quality of life for certain amputees. Awareness and opinions regarding HUET among Americans, particularly in Veterans/Service Members (VSM) affiliates, are largely unknown. Materials and methods We administered a survey on Amazon Mechanical Turk (MTurk) workers. Eligible participants were US citizens aged ≥18 years; MTurk worker selection targeted workers who self-reported being a VSM. We used descriptive statistics to summarize study findings and Fisher's exact and Wilcoxon's rank-sum tests for between-group comparisons. Results The survey was completed by 764 individuals, 604 (79.1%) of whom reported being aware of HUET. Among those familiar versus unfamiliar, a significantly higher proportion were aged ≤35 years (n=385, 64.0% vs. n=86, 53.7%; p=0.017), employed (n=523, 86.6% vs. n=114, 71.3%; p<0.001), and aware of their religion's stance on organ/tissue donation (n=341, 54.5% vs. n=62, 38.8%; p<0.001). Amputees and/or respondents related to an amputee were more likely to be aware of HUET than individuals who were amputation naive (n=211, 90.6% vs. n=393, 74.0%, respectively; p<0.001), as were individuals with a personal or familial military affiliation (n=286, 85.4% with vs. n=318, 74.1% with no affiliation; p<0.001). The most reported HUET information sources were digital media (n=157, 31.2%) and internet (n=137, 27.2%). Conclusions Our survey of MTurk workers found greater awareness of HUET among individuals with a VSM or amputee connection. Our additional findings that the internet and academic sources, such as journals or reputable medical publications, were respondents' preferred sources of HUET information emphasize the importance of vascularized composite allotransplantation (VCA) centers' involvement in creating accurate and accessible content to help educate the public about this treatment.
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Affiliation(s)
- Siam K Rezwan
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Pathik Aravind
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Joseph S Puthumana
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Gerald Brandacher
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Carisa M Cooney
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, USA
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Fliss MD, Lao J, Behne F, Brinkley-Rubinstein L. Few Prison Systems Release Individual Death Data: Death in Custody Reporting Act Completeness, Speed, and Compliance. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2024; 30:424-428. [PMID: 38603750 DOI: 10.1097/phh.0000000000001893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
The United States has one of the largest incarcerated populations per capita. Prisons are dangerous environments, with high in-prison and postrelease mortality. The Death in Custody Reporting Acts (DCRAs) of 2000 and 2013 require deaths of people in correctional custody or caused by law enforcement to be reported to the Bureau of Justice Assistance. These deaths must be reported within 3 months of the death and include 10 required fields (eg, age, cause of death). There is no public reporting requirement. Our Third City Mortality project tracks near-real-time data about individual deaths released publicly and prison system metadata, including data completeness and release speed, across (N = 54) US state, federal (N = 2; Bureau of Prisons, Immigration and Customs Enforcement), Washington, District of Columbia, and Puerto Rico prison systems. Twenty-one (38%) systems release no individual death data; 13 systems release incomplete data slower than 1 year; 19 release timely, but incomplete, death data; and only one system (Iowa) releases complete and timely data. Incomplete, untimely, public prison mortality data limit protective community responses and epidemiology.
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Affiliation(s)
- Mike Dolan Fliss
- Author Affiliations: Population Health Department, Duke University, Durham, North Carolina (Drs Fliss and Brinkley-Rubinstein and Mr Behne); UNC Injury Prevention Research Center (Dr Fliss) and Gillings School of Global Public Health (Mr Behne), The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; and Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts (Ms Lao)
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Diniz SB, Meer E, Nesemann JM, Jackson NJ, Rootman DB. Head rotation and the perception of eyelid height and contour. BMJ Open Ophthalmol 2024; 9:e001557. [PMID: 38575344 PMCID: PMC11002378 DOI: 10.1136/bmjophth-2023-001557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 03/05/2024] [Indexed: 04/06/2024] Open
Abstract
PURPOSE Effective visual perceptual processing is one of the many components of surgical competence. Human face identification is most efficient when viewed upright. However, it is not yet clear how this perception sensitivity impacts eyelid symmetry. This study investigates surgeons' and laypeople's accuracy and efficiency in perceiving eyelid asymmetry from different spatial perspectives. METHODS A prospective psychometric experiment was conducted where oculoplastic surgeons were recruited from the American Society of Ophthalmic Plastic and Reconstructive Surgery and the Brazilian Oculoplastic Surgery Society, and control participants were recruited via crowdsourcing (Amazon's Mechanical Turk). Standard illustrations of the human face with varying degrees of eyelid abnormality, laterality, gender and rotation were presented to participants who were asked to judge whether the eyelids were symmetric or asymmetric. RESULTS The survey was completed by 75 oculoplastic surgeons (49.33% male; mean age of 46.9±10.7) and 192 lay individuals (54.6% male; mean age 34.6±11.3 years). Among oculoplastic surgeons, deviation from upright was significantly associated with increased reaction time and decreased proportion correct (OR per 45° for peak 0.68, 95% CI 0.60 to 0.77, p<0.001; OR per 45° for ptosis 0.52, 95% CI 0.32 to 0.87, p=0.012; OR per 180° for aggregate responses 0.56, 95% CI 0.51 to 0.61, p<0.001). Oculoplastic surgeons demonstrated increasing accuracy and decreasing reaction time with additional trials for both peak and ptosis. CONCLUSION Oculoplastic surgeons perceive eyelid asymmetries more accurately and can better compensate for inverted sensory information. However, accuracy increases and reaction time decreases with additional trials, suggesting trainability and potential for improvement in inversion disability.
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Affiliation(s)
- Stefania B Diniz
- Department of Orbital and Ophthalmic Plastic Surgery, University of California, Los Angeles, California, USA
| | - Elana Meer
- Department of Ophthalmology, University of California, San Francisco, California, USA
| | - John M Nesemann
- Department of Ophthalmology, University of California, San Francisco, California, USA
| | - Nicholas J Jackson
- Statistics Core, University of California David Geffen School of Medicine, Los Angeles, California, USA
| | - Daniel B Rootman
- Department of Orbital and Ophthalmic Plastic Surgery, University of California, Los Angeles, California, USA
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Curran T, Seiter JS, Elwood RE, Lindsay MC. Negative Social Exchanges During the Pandemic, Loneliness, and the Mediating Role of Stress and Feeling Misunderstood Among People at High-Risk for COVID-19 Related Complications. HEALTH COMMUNICATION 2024:1-8. [PMID: 38515233 DOI: 10.1080/10410236.2024.2332004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
The goal of this study was to investigate the links between social interactions and mental health for people who are high-risk for COVID-19 complications. Specifically, we tested the relationships between negative social exchanges during the pandemic and loneliness through two mediators: stress and feeling misunderstood about one's health status. Data were collected via Amazon's MTurk from participants (N = 271) who self-identified as being high-risk for COVID-19. The results from our model showed both a direct association between negative social interactions and loneliness, and an indirect link between these variables through stress. Overall, these results highlight the importance of understanding social interactions for people who are at high-risk for COVID-19 and their mental well-being. The results and implications are discussed.
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Affiliation(s)
| | - John S Seiter
- Department of Communication Studies and Philosophy, Utah State University
| | - Rebecca E Elwood
- Department of Communication Studies and Philosophy, Utah State University
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Bradley MS, Hetzel-Riggin MD, Knight JC, Murillo A, Zyczynski H, Shelton CR. Online Search Strategies and Results From a Crowdsourced Survey on Asymptomatic Bacteriuria. UROGYNECOLOGY (PHILADELPHIA, PA.) 2024:02273501-990000000-00191. [PMID: 38498773 DOI: 10.1097/spv.0000000000001500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
IMPORTANCE Despite the prevalence of asymptomatic bacteriuria (ASB), what proportion of the population is aware of this condition and the quality of internet resources are currently unknown. OBJECTIVE This study aimed to use an online crowdsourcing platform to explore general knowledge and internet search strategies, along with the quality of information, on ASB. STUDY DESIGN An online survey was administered through a crowdsourcing platform to women 50 years or older via Qualtrics, which is a sophisticated online survey tool. Participants completed a survey on ASB, and participants were asked how they would search the internet for information both on urinary test results and on ASB. Outcomes included survey responses, and qualitative data were coded and analyzed thematically. χ2 Testing and regression modeling were used to look for variables associated with concern for ASB. RESULTS There were a total of 518 participants who passed attention check qualifications, and only 45 respondents (8.7%) had heard of ASB. Many were concerned about progress to a worsening infection (n = 387 [77.6%]). When controlling for confounders, education beyond a college degree was not associated with a lower concern for ASB when compared with those with a high school education or less (adjusted odds ratio, 0.63; 95% confidence interval, 0.25-1.55; P = 0.31). Medical providers were the target audience for a majority of the websites, and many of the patient-facing results were of poor quality. CONCLUSIONS Our national survey of women demonstrated a prevalent knowledge deficit surrounding ASB. We must seek to create high-quality, readily available, patient-facing information to increase awareness of ASB, allay concerns, and increase antibiotic stewardship.
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Affiliation(s)
- Megan S Bradley
- From the Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Women's Hospital, University of Pittsburgh Medical Center
| | | | | | - Ashley Murillo
- From the Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Women's Hospital, University of Pittsburgh Medical Center
| | - Halina Zyczynski
- From the Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Women's Hospital, University of Pittsburgh Medical Center
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Davies RL, Rice K, Rock AJ. Development and validation of the Informal Supporter Readiness Inventory (ISRI). PLoS One 2024; 19:e0296770. [PMID: 38466646 PMCID: PMC10927096 DOI: 10.1371/journal.pone.0296770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 12/18/2023] [Indexed: 03/13/2024] Open
Abstract
OBJECTIVE This article outlines the development and validation of the Informal Supporter Readiness Inventory (ISRI), based on the model developed by the present authors in (Davies, 2023). This scale assesses the readiness of informal supporters to intervene or provide support in situations of intimate partner violence (IPV). METHODS The research followed a three-phased procedure of item development, scale development, and scale evaluation; adhering to best practice guidelines for psychometric development and validation. This process provided empirical substantiation for the domains of the Model of Informal Supporter Readiness (Davies, 2023). RESULTS The 57-item ISRI incorporates four primary factors: normative, individual, goodman-emotional, and situational-assessment. These factors demonstrated robust internal consistency and factor structures. Additionally, the ISRI evidenced strong test-retest reliability, and both convergent and divergent validity. Although aligning closely with the Model of Informal Supporter Readiness, the scale revealed a nuanced bifurcation of situational factors into situational-emotional and situational-assessment. DISCUSSION The ISRI offers an important advancement in IPV research by highlighting the multifaceted nature of informal supporter intervention. The findings have several implications, from tailoring individualised supportive interventions to strengthening support networks and empowering survivors. The present study's findings underscore the potential of adopting a social network-oriented approach to interventions in IPV scenarios. Applications for research and practice are discussed.
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Affiliation(s)
- Ryan L. Davies
- School of Psychology, University of New England, Armidale, New South Wales, Australia
| | - Kylie Rice
- School of Psychology, University of New England, Armidale, New South Wales, Australia
| | - Adam J. Rock
- School of Psychology, University of New England, Armidale, New South Wales, Australia
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Nadratowski A, Shoots-Reinhard B, Shafer A, Detweiler-Bedell J, Detweiler-Bedell B, Leachman S, Peters E. Evidence-Based Communication to Increase Melanoma Knowledge and Skin Checks. JID INNOVATIONS 2024; 4:100253. [PMID: 38328593 PMCID: PMC10847376 DOI: 10.1016/j.xjidi.2023.100253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 11/03/2023] [Accepted: 11/17/2023] [Indexed: 02/09/2024] Open
Abstract
Rates of melanoma-the deadliest form of skin cancer-have increased. Early detection can save lives, and patients have a critical role to play in checking their skin. We aim to identify health communication messages that best educate the public and increase intentions toward skin checks. After viewing messages intended to increase melanoma knowledge, participants correctly identified a greater proportion (74.6 vs 70.4%) of moles (mean number = 17.9, 95% confidence interval [CI] = 17.5-18.3 vs 16.9, 95% CI = 16.6-17.3; P < .001, partial eta-squared = 0.03) and had knowledge of more melanoma warning signs (mean number = 5.8, 95% CI = 5.7-5.8 vs 5.6, 95% CI = 5.5-5.7, P = .01, partial eta-squared = 0.02). After viewing messages intended to increase self-confidence in checking their skin accurately, they were also more likely to report greater intentions to do a skin check on a scale of 1-5 (mean number = 3.8, 95% CI = 3.7-3.9 vs 3.6, 95% CI = 3.4-3.7, P = .005, partial eta-squared = 0.02). Online melanoma messages aimed at increasing both melanoma knowledge and skin-check confidence may be most effective in improving the accuracy of skin self-examinations and intentions to do them.
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Affiliation(s)
- Ariel Nadratowski
- Center for Science Communication Research, School of Journalism and Communication, University of Oregon, Eugene, Oregon, USA
| | - Brittany Shoots-Reinhard
- Center for Science Communication Research, School of Journalism and Communication, University of Oregon, Eugene, Oregon, USA
- Department of Psychology, College of Arts and Sciences, The Ohio State University, Columbus, Ohio, USA
| | - Autumn Shafer
- Center for Science Communication Research, School of Journalism and Communication, University of Oregon, Eugene, Oregon, USA
| | | | | | - Sancy Leachman
- Department of Dermatology, Oregon Health & Science University, Portland, Oregon, USA
| | - Ellen Peters
- Center for Science Communication Research, School of Journalism and Communication, University of Oregon, Eugene, Oregon, USA
- Department of Psychology, College of Arts and Sciences, University of Oregon, Eugene, Oregon, USA
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Law KC, Wee JY, O'Connell K, Moreira N, Preston O, Rogers ML, Anestis JC. The impact of different neurobehavioral symptoms on suicidal ideation and perceived likelihood of future suicidality. J Psychiatr Res 2024; 171:134-141. [PMID: 38280241 DOI: 10.1016/j.jpsychires.2024.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/01/2023] [Accepted: 01/05/2024] [Indexed: 01/29/2024]
Abstract
Existing literature suggests that psychological and functional impairment, independent of head injury severity, can increase suicide risk. This study explores the impacts of self-perceived dysfunction within four neurobehavioral symptom clusters-vestibular (e.g., dizziness, balance), somatosensory (e.g., headaches, nausea, vision), affective (e.g., anxious, irritable mood), and cognitive (e.g., concentration, memory, indecision)-on current suicidal ideation and the perceived likelihood of future suicidal ideation and attempts. Community participants (n = 309; Mage = 36.88; 51.6% female; 79.6% White) completed the Neurobehavioral Symptom Inventory (NSI) and the Self-Injurious Thoughts and Behaviors-Short Form (SITBI-SF). Quantile regression analysis was used to explore the effects of the four neurobehavioral symptom clusters at different levels of suicidal ideation intensity, perceived likelihood of future suicidal ideation, and self-perceived likelihood of future suicide attempt. Controlling for past head injuries and suicide attempts, affective symptoms were significantly associated with a moderate and high average intensity of current suicidal ideation. Somatosensory symptoms were significantly associated with a moderate perceived likelihood of future suicidal ideation. Finally, vestibular symptoms were significantly associated with a moderate perceived likelihood of a future suicide attempt. These findings highlight the critical need to consider a broader spectrum of symptoms, including chronic physical symptoms, when assessing suicide risk. Furthermore, they underscore the need to expand beyond affective symptoms as an explanation for increased suicidality and examine additional mechanisms through which chronic physical symptoms can increase suicide risk.
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Affiliation(s)
| | | | | | | | - Olivia Preston
- University of Florida College of Medicine - Jacksonvile, USA
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33
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Anderson BR, Herman PM, Hays RD. Predictors of Pain Management Strategies in Adults with Low-Back Pain: A Secondary Analysis of Amazon Mechanical Turk Survey Data. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2024; 30:297-305. [PMID: 37646759 PMCID: PMC10954603 DOI: 10.1089/jicm.2023.0233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Objective: To evaluate the associations between baseline demographics, health conditions, pain management strategies, and health-related quality-of-life (HRQoL) measures with pain management strategies at 3-month follow-up in respondents reporting current low-back pain (LBP). Study design: Cohort study of survey data collected from adults with LBP sampled from Amazon Mechanical Turk crowdsourcing panel. Methods: Demographics, health conditions, and the Patient-Reported Outcomes Measurement Information System (PROMIS)-10 were included in the baseline survey. Respondents reporting LBP completed a more comprehensive survey inquiring about pain management strategies and several HRQoL measures. Bivariate then multivariate logistic regression estimated odds ratios (ORs) with 95% confidence intervals (CIs) for the association between baseline characteristics and pain management utilization at 3-month follow-up. Model fit statistics were evaluated to assess the predictive value. Results: The final cohort included 717 respondents with completed surveys. The most prevalent pain management strategy at follow-up was other care (n = 474), followed by no care (n = 94), conservative care only (n = 76), medical care only (n = 51), and medical and conservative care combined (n = 22). The conservative care only group had higher (better) mental and physical health PROMIS-10 scores as opposed to the medical care only and combination care groups, which had lower (worse) physical health scores. In multivariate models, estimated ORs (95% CIs) for the association between baseline and follow-up pain management ranged from 4.6 (2.7-7.8) for conservative care only to 16.8 (6.9-40.7) for medical care only. Additional significant baseline predictors included age, income, education, workman's compensation claim, Oswestry Disability Index score, and Global Chronic Pain Scale grade. Conclusions: This study provides important information regarding the association between patient characteristics, HRQoL measures, and LBP-related pain management utilization.
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Affiliation(s)
- Brian R. Anderson
- Palmer Center for Chiropractic Research, Palmer College of Chiropractic, Davenport, IA, USA
| | - Patricia M. Herman
- RAND Center for Collaborative Research in Complementary and Integrative Health, RAND Corporation, Santa Monica, CA, USA
| | - Ron D. Hays
- Department of Medicine, UCLA Division of General Internal Medicine & Health Services Research, Los Angeles, CA, USA
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Pucciarelli DM, Ramasubramani R, Trautmann CH. Associations Between Psychopathological Symptom Severity Amid the Pandemic and the Childhood Sociodemographic Environment. Cureus 2024; 16:e56458. [PMID: 38638738 PMCID: PMC11024765 DOI: 10.7759/cureus.56458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2024] [Indexed: 04/20/2024] Open
Abstract
It is well-documented that childhood socioeconomic status (SES) is associated with various health conditions in adulthood. Here, we examine the extent to which childhood SES is associated with COVID-19 pandemic anxiety and depression. Participants (n = 212), recruited from Amazon Mechanical Turk, were assessed for depression and anxiety in February 2022 for both the current context and retrospective self-perceived early pandemic depression and anxiety (April 2020). Participants also reported childhood SES and current demographics. Consistent with predated findings, we show a strong, positive correlation between depression and anxiety under both conditions. Paternal unemployment in childhood was associated with increased anxiety, while maternal occupation was not. High household education in childhood was generally associated with greater anxiety and depression, similar to past studies examining education levels and depression. However, the shift from high school to post-secondary degrees (trade school and associate's) was associated with decreased anxiety and depression, which may reflect "essential work" careers, therefore indicating a dualism. Growing up in crowded, de-individualized spaces was associated with lower anxiety and depression, suggesting better conditioning for the imposition of COVID-19 quarantines. Pandemic-related unemployment was associated with an increase in anxiety and depression. Strong political views, regardless of ideology, were associated with increased anxiety. Finally, participants in our cohort perceived their mental health to be worse in the early pandemic for anxiety and depression, up 6.6% and 7.9%, respectively. Our work suggests a complex relationship between SES, demographics, and anxiety and depression during the pandemic. These findings emphasize the importance of exploring the dynamics between early SES and mental health in adulthood, particularly during extended societal stressors.
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Seiter CR, Zhao X, Rossheim ME. Valence of YouTube Comments and College Student Reactions Towards Electronic Nicotine Product Counter-Marketing Messages. HEALTH COMMUNICATION 2024; 39:592-602. [PMID: 36794383 DOI: 10.1080/10410236.2023.2177795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Advertisements promoting and discouraging electronic nicotine products (ENPs) are widespread on social media. User interaction is a hallmark feature of social media sites. This study examined how user-comment valence (i.e. positive versus negative comments) influences attitudes toward counter-marketing ads, and determinants of ENP abstinence according to the theory of planned behavior (TPB). College students were randomly assigned to one of three conditions, a positive comment condition (n = 121), in which they were shown a YouTube comment section with eight positive comments and two negative comments; a negative comment condition (n = 126), in which they were shown a YouTube comment section with eight negative and two positive comments; and a control condition (n = 128). Then, all groups were shown a YouTube video advocating for ENP abstinence and completed measures about their attitudes toward the ad (Aad), attitudes toward ENP abstinence, injunctive and descriptive norms about ENP abstinence, perceived behavioral control (PBC) toward ENP abstinence, and intention to abstain from ENPs. Results indicated that exposure to negative comments yielded significantly less favorable Aad when compared to the positive condition, but no difference in Aad was observed between the negative and control conditions, or between the positive and control conditions. Further, there were no differences for any determinants of ENP abstinence. Additionally, Aad mediated the effects of negative comments on attitudes toward ENP abstinence, injunctive norms and descriptive norms about ENP abstinence, and behavioral intention. Findings indicate that negative user comments depress attitudes toward counter-persuasion ads targeting ENP use.
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Affiliation(s)
- Christian R Seiter
- Department of Human Communication Studies, California State University, Fullerton
| | - Xiaoquan Zhao
- Department of Communication, George Mason University
| | - Matthew E Rossheim
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center
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Salinas KZ, Saran S, Saulnier K, Hoglen B, Houser KR, Krebs NM, Kaynak Ö, Bordner CR, Yingst JM, Foulds J, Allen SI, Hobkirk AL. A Comparison of Mental Health Symptoms among Adults Who Vape Nicotine, Cannabis, or Both. Subst Use Misuse 2024; 59:601-607. [PMID: 38115560 DOI: 10.1080/10826084.2023.2294956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
OBJECTIVES Dual use of combustible cannabis and nicotine is related to worse mental health symptoms (MHS); however, little is known about MHS among those who vape cannabis and nicotine. The current study aimed to determine if dual use of cannabis and nicotine vapes is associated with worse MHS compared to single use and to identify correlates of MHS for dual users. METHODS We used Amazon Mechanical Turk to survey adults (N = 492) who used nicotine or cannabis vapes in the past 30 days on stress, anxiety, depression, vape use behaviors and sociodemographic information. We conducted hierarchical linear regressions to compare MHS between dual vs. single substance vape use and to identify correlates of MHS, including sociodemographic variables and vape use characteristics. RESULTS The final sample was 37.6% female, 87.6% White, and 11% Hispanic/Latinx with a mean age of 34.15 years. After controlling for sociodemographic characteristics and combustible product use, dual users had significantly higher mean MHS severity than single users. For dual users, younger age and being married were associated with higher symptoms of depression and stress. Holding a medical cannabis card was associated with higher anxiety symptoms. CONCLUSION The findings suggest that dual use of cannabis and nicotine vapes is associated with worse MHS severity compared to single substance use.
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Affiliation(s)
- Kalin Z Salinas
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Savreen Saran
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Kevin Saulnier
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Brianna Hoglen
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Kenneth R Houser
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Nicolle M Krebs
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Övgϋ Kaynak
- School of Behavioral Sciences & Education, Penn State Harrisburg, Middletown, Pennsylvania, USA
| | - Candace R Bordner
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Jessica M Yingst
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Jonathan Foulds
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, Pennsylvania, USA
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Sophia I Allen
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Andrea L Hobkirk
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, Pennsylvania, USA
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA
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Ananda RA, Gwini SM, Long KM, Lai JH, Chen G, Russell GM, Stowasser M, Fuller PJ, Yang J. Diagnostic Delay and Disease Burden in Primary Aldosteronism: An International Patient Survey. Hypertension 2024; 81:348-360. [PMID: 38095087 DOI: 10.1161/hypertensionaha.123.21965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 11/14/2023] [Indexed: 01/19/2024]
Abstract
BACKGROUND Primary aldosteronism (PA) is a common but underdiagnosed cause of hypertension. Many patients experience preventable end-organ injury due to delayed or missed diagnosis but data on the experience of patients are limited. METHODS We evaluated the lived experience of PA and determines factors associated with diagnostic delay through an international anonymous online cross-sectional survey, codesigned by researchers and PA consumers. We distributed the survey through academic medical centers, Amazon Mechanical Turk, Twitter, PA patient advocacy groups, and hypertension support groups on Facebook between March 21 and June 5, 2022. RESULTS Of 684 eligible respondents, 66.5% were women. Diagnostic delay (defined as ≥5 years between the diagnosis of hypertension and PA) was reported in 35.6%. Delay was more likely in women than in men (odds ratio, 1.55 [95% CI, 1.10-2.20]) and respondents with ≥3 comorbidities versus none (odds ratio, 1.77 [95% CI, 1.05-3.02]), ≥10 symptoms versus none (odds ratio, 2.73 [95% CI, 1.74-4.44]), and on ≥4 antihypertensive medications versus none (odds ratio, 18.23 [95% CI, 6.24-77.72]). Three-quarters of patients (74.4%) experienced reduced symptom burden following targeted PA treatment. Quality of life improved in 62.3% of patients, and greater improvement was associated with being a woman (odds ratio, 1.42, [95% CI, 1.02-1.97]), receiving adrenalectomy (odds ratio, 2.36 [95% CI, 1.67-3.35]), and taking fewer antihypertensive medications following diagnosis (odds ratio, 5.28 [95% CI, 3.55-7.90]). CONCLUSIONS One-third of patients with PA experienced prolonged diagnostic delays. Targeted treatment led to reduced symptom burden and improved quality of life. Gender differences in diagnostic delay and symptom burden are prominent. These findings suggest that routine screening for PA at the onset of hypertension may reduce diagnostic delay and facilitate timely diagnosis.
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Affiliation(s)
- Roshan A Ananda
- Centre for Endocrinology and Metabolism, Hudson Institute of Medical Research, Clayton, VIC, Australia (R.A.A., J.H.L., P.J.F., J.Y.)
- School of Public Health, Imperial College London, United Kingdom (R.A.A.)
| | - Stella May Gwini
- School of Public Health and Preventive Medicine Monash University, Melbourne, VIC, Australia (S.M.G.)
- Department of Biostatistics, University Hospital Geelong, Barwon Health, VIC, Australia (S.M.G.)
| | - Katrina M Long
- National Centre for Healthy Ageing, Frankston, VIC, Australia (K.M.L.)
| | - Jordan H Lai
- Centre for Endocrinology and Metabolism, Hudson Institute of Medical Research, Clayton, VIC, Australia (R.A.A., J.H.L., P.J.F., J.Y.)
| | - Gang Chen
- School of Primary and Allied Health Care (K.M.L.), Centre for Health Economics, Monash Business School (G.C.), Monash University, Frankston, VIC, Australia
| | - Grant M Russell
- Department of General Practice (G.M.R.), Monash University, Frankston, VIC, Australia
| | - Michael Stowasser
- Endocrine Hypertension Research Centre, University of Queensland, Brisbane, QLD, Australia (M.S.)
| | - Peter J Fuller
- Centre for Endocrinology and Metabolism, Hudson Institute of Medical Research, Clayton, VIC, Australia (R.A.A., J.H.L., P.J.F., J.Y.)
- Department of Endocrinology, Monash Health, Clayton, VIC, Australia (P.J.F., J.Y.)
| | - Jun Yang
- Centre for Endocrinology and Metabolism, Hudson Institute of Medical Research, Clayton, VIC, Australia (R.A.A., J.H.L., P.J.F., J.Y.)
- Department of Endocrinology, Monash Health, Clayton, VIC, Australia (P.J.F., J.Y.)
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Fox KR, Kameoka AM, Raidoo S, Soon R, Tschann M, Fontanilla T, Kaneshiro B. Patient Barriers to Discontinuing Long-Acting Reversible Contraception. Matern Child Health J 2024; 28:192-197. [PMID: 38158476 DOI: 10.1007/s10995-023-03878-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVES To describe how frequently a national sample of patients with experience discontinuing or desiring discontinuation of long-acting reversible contraception (LARC) experienced barriers to discontinuation. METHODS We conducted an online survey of individuals ages 18 to 50 in the United States who had previously used and discontinued or attempted to discontinue LARC. We recruited respondents using the Amazon platform MTurk. Respondents provided demographic information and answered questions regarding their experience discontinuing LARC, including reasons removal was deferred or denied. We analyzed frequency of types of barriers encountered and compared these by demographic factors. RESULTS Of the 376 surveys analyzed, 99 (26%) described experiencing at least one barrier to removal. Barriers were disproportionately reported by those who had public health insurance, a history of abortion, and a history of birth compared to those who did not report barriers to removal. They also more frequently identified as Latinx, Asian, or Middle Eastern. Most barriers were provider-driven and potentially modifiable. CONCLUSIONS FOR PRACTICE Barriers to LARC discontinuation are common and may be provider- or systems-driven. Providers should be mindful of biases in their counseling and practices to avoid contributing to these barriers.
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Affiliation(s)
- Kacie R Fox
- Department of Obstetrics, Gynecology & Women's Health, John A. Burns School of Medicine, University of Hawaii, 1319 Punahou St. #824, Honolulu, HI, 96826, USA
| | - Alyssa M Kameoka
- Department of Obstetrics, Gynecology & Women's Health, John A. Burns School of Medicine, University of Hawaii, 1319 Punahou St. #824, Honolulu, HI, 96826, USA.
| | - Shandhini Raidoo
- Department of Obstetrics, Gynecology & Women's Health, John A. Burns School of Medicine, University of Hawaii, 1319 Punahou St. #824, Honolulu, HI, 96826, USA
| | - Reni Soon
- Department of Obstetrics, Gynecology & Women's Health, John A. Burns School of Medicine, University of Hawaii, 1319 Punahou St. #824, Honolulu, HI, 96826, USA
| | - Mary Tschann
- Department of Obstetrics, Gynecology & Women's Health, John A. Burns School of Medicine, University of Hawaii, 1319 Punahou St. #824, Honolulu, HI, 96826, USA
| | - Tiana Fontanilla
- Department of Obstetrics, Gynecology & Women's Health, John A. Burns School of Medicine, University of Hawaii, 1319 Punahou St. #824, Honolulu, HI, 96826, USA
| | - Bliss Kaneshiro
- Department of Obstetrics, Gynecology & Women's Health, John A. Burns School of Medicine, University of Hawaii, 1319 Punahou St. #824, Honolulu, HI, 96826, USA
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Atoloye AT, Akinsola O, Murillo M. Examining Factors Associated with the Use of Community Food Resources: An Application of the Andersen Model to Inform Future Interventions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:76. [PMID: 38248540 PMCID: PMC10815130 DOI: 10.3390/ijerph21010076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 12/31/2023] [Accepted: 01/05/2024] [Indexed: 01/23/2024]
Abstract
The role of the food environment in shaping nutrition and health has gained substantial attention from policymakers, public health researchers, and advocacy groups. To promote equities in food access and nutrition outcomes, understanding factors linked with the utilization of local community food resources is crucial. Using Andersen's service utilization model, we explained how adults use their neighborhood food resources. In a cross-sectional study design, an online survey was conducted in REDCap Version 13.4.0 via the Amazon Mechanical Turk (MTurk) involving 1830 adults with a mean age of 37.9 ± 12.1 years. Participants answered questions on predisposing, enabling, and need factors that influence their use of different community food resources. The predisposing factors that were statistically significant included age, family size, marital status, race, and ethnicity. The enabling factors included travel time, travel mode, income, and shopping decision motivators (such as being able to use Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) vouchers, delivery services, great sales, and coupons). Food security and community food resources need for lower food price were the significant need factors. However, these factors vary by the types of food resources. In conclusion, enhancing the utilization of community-based food access initiatives and programs among underserved families requires consideration of family composition, racial and ethnic diversity, and transportation access.
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Affiliation(s)
- Abiodun T. Atoloye
- Department of Nutrition, Dietetics, and Food Sciences, Utah State University, Logan, UT 84322, USA
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Sahker E, Furukawa TA, Luo Y, Ferreira ML, Okazaki K, Chevance A, Markham S, Ede R, Leucht S, Cipriani A, Salanti G. Estimating the smallest worthwhile difference of antidepressants: a cross-sectional survey. BMJ MENTAL HEALTH 2024; 27:e300919. [PMID: 38191234 PMCID: PMC10806871 DOI: 10.1136/bmjment-2023-300919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 11/11/2023] [Indexed: 01/10/2024]
Abstract
BACKGROUND Approximately 30% of patients experience substantial improvement in depression after 2 months without treatment, and 45% with antidepressants. The smallest worthwhile difference (SWD) refers to an intervention's smallest beneficial effect over a comparison patients deem worthwhile given treatment burdens (harms, expenses and inconveniences), but is undetermined for antidepressants. OBJECTIVE Estimating the SWD of commonly prescribed antidepressants for depression compared to no treatment. METHODS The SWD was estimated as a patient-required difference in response rates between antidepressants and no treatment after 2 months. An online cross-sectional survey using Prolific, MQ Mental Health and Amazon Mechanical Turk crowdsourcing services in the UK and USA between October 2022 and January 2023 garnered participants (N=935) that were a mean age of 44.1 (SD=13.9) and 66% women (n=617). FINDINGS Of 935 participants, 124 reported moderate-to-severe depressive symptoms but were not in treatment, 390 were in treatment and 495 reported absent-to-mild symptoms with or without treatment experiences. The median SWD was a 20% (IQR=10-30%) difference in response rates for people with moderate-to-severe depressive symptoms, not in treatment, and willing to consider antidepressants, and 25% (IQR=10-35%) for the full sample. CONCLUSIONS Our observed SWDs mean that the current 15% antidepressant benefit over no treatment was sufficient for one in three people to accept antidepressants given the burdens, but two in three expected greater treatment benefits. IMPLICATIONS While a minority may be satisfied with the best currently available antidepressants, more effective and/or less burdensome medications are needed, with more attention given to patient perspectives.
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Affiliation(s)
- Ethan Sahker
- Department of Health Promotion and Human Behavior, Graduate School of Medicine / School of Public Health, Kyoto University, Kyoto, Japan
- Population Health and Policy Research Unit, Medical Education Center, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Toshi A Furukawa
- Department of Health Promotion and Human Behavior, Graduate School of Medicine / School of Public Health, Kyoto University, Kyoto, Japan
| | - Yan Luo
- Department of Health Promotion and Human Behavior, Graduate School of Medicine / School of Public Health, Kyoto University, Kyoto, Japan
- Population Health and Policy Research Unit, Medical Education Center, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Manuela L Ferreira
- The University of Sydney, Sydney Musculoskeletal Health and The Kolling Institute, School of Health Sciences, Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | | | - Astrid Chevance
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France
- Centre d'Epidémiologie Clinique, AP-HP, Hôpital Hôtel Dieu, Paris, France
| | - Sarah Markham
- Patient and Public Involvement (PPI) Group, Oxford Precision Psychiatry Lab, NIHR Oxford Health Biomedical Research Centre, University of Oxford, Oxford, UK
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College, London, UK
| | - Roger Ede
- Patient and Public Involvement (PPI) Group, Oxford Precision Psychiatry Lab, NIHR Oxford Health Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Stefan Leucht
- Department of Psychiatry and Psychotherapy, Technical University of Munich, School of Medicine, München, Germany
| | - Andrea Cipriani
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Precision Psychiatry Lab, NIHR Oxford Health Biomedical Research Centre, Oxford, UK
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Georgia Salanti
- Institute of Social and Preventive Medicine and Clinical Trials, University of Bern, Bern, Switzerland
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Quach WT, Hennessy C, Lindsell CJ, Langerman A. Public Perceptions and Informational Needs Regarding Surgical Residents. JOURNAL OF SURGICAL EDUCATION 2024; 81:37-47. [PMID: 37852873 PMCID: PMC10842999 DOI: 10.1016/j.jsurg.2023.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 07/15/2023] [Accepted: 09/10/2023] [Indexed: 10/20/2023]
Abstract
OBJECTIVE Identify what topics are of most interest to patients regarding surgical residents. DESIGN Survey of general public describing a hypothetical surgery and then assessing comfort level with resident involvement in surgery, reactions to disclosure statements regarding resident involvement, and desires for additional information. This data was used to produce an amended statement about surgical residents and their involvement in a hypothetical surgery to determine the impact of increased information on participant comfort. SETTING Online survey via Mechanical Turk. PARTICIPANTS Our sample was broadly representative of the United States based on race and age, but with higher education level than United States census data. RESULTS Using a combination of hierarchical clustering, weighted averages, and VAS scoring, questions that were most highly valued by participants were related to what the resident will be doing in the operation and the impact of resident involvement. Participants who had a past negative experience with residents assigned higher importance to all questions, even those that may be seen as not clinically relevant. Increasing the amount of proactively provided information did not have a significant effect on comfort (p = 0.219) when compared to our baseline statement, except with those who reported past negative experience with residents (p = 0.039). CONCLUSIONS These results demonstrate that the majority of potential patients want to know specific details about the residents' skills, what they will be doing in their surgery, and the impact of their participation. Surgeons should be attuned to patients with past negative experiences, who may desire more information. Additional information alone may not be sufficient to comfort some patients, and future research should consider information delivery styles and interpersonal effects on patient comfort level.
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Affiliation(s)
- William T Quach
- Vanderbilt University School of Medicine, Nashville, Tennessee; Surgical Ethics Program, VUMC Center for Biomedical Ethics and Society, Nashville, Tennessee
| | - Cassandra Hennessy
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - Alexander Langerman
- Surgical Ethics Program, VUMC Center for Biomedical Ethics and Society, Nashville, Tennessee; Vanderbilt University Medical Center, Department of Otolaryngology - Head and Neck Surgery, Nashville, Tennessee.
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Yang Z, Li K, Gan H, Huang Z, Shi M, Zhou R. An Alzheimer's Disease classification network based on MRI utilizing diffusion maps for multi-scale feature fusion in graph convolution. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2024; 21:1554-1572. [PMID: 38303477 DOI: 10.3934/mbe.2024067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
Graph convolutional networks (GCN) have been widely utilized in Alzheimer's disease (AD) classification research due to its ability to automatically learn robust and powerful feature representations. Inter-patient relationships are effectively captured by constructing patients magnetic resonance imaging (MRI) data as graph data, where nodes represent individuals and edges denote the relationships between them. However, the performance of GCNs might be constrained by the construction of the graph adjacency matrix, thereby leading to learned features potentially overlooking intrinsic correlations among patients, which ultimately causes inaccurate disease classifications. To address this issue, we propose an Alzheimer's disease Classification network based on MRI utilizing diffusion maps for multi-scale feature fusion in graph convolution. This method aims to tackle the problem of features neglecting intrinsic relationships among patients while integrating features from diffusion mapping with different neighbor counts to better represent patients and achieve an accurate AD classification. Initially, the diffusion maps method conducts diffusion information in the feature space, thus breaking free from the constraints of diffusion based on the adjacency matrix. Subsequently, the diffusion features with different neighbor counts are merged, and a self-attention mechanism is employed to adaptively adjust the weights of diffusion features at different scales, thereby comprehensively and accurately capturing patient characteristics. Finally, metric learning techniques enhance the similarity of node features within the same category in the graph structure and bring node features of different categories more distant from each other. This study aims to enhance the classification accuracy of AD, by providing an effective tool for early diagnosis and intervention. It offers valuable information for clinical decisions and personalized treatment. Experimentation on the publicly accessible Alzheimer's disease neuroimaging initiative (ADNI) dataset validated our method's competitive performance across various AD-related classification tasks. Compared to existing methodologies, our approach captures patient characteristics more effectively and demonstrates superior generalization capabilities.
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Affiliation(s)
- Zhi Yang
- School of Computer Science, Hubei University of Technology, Wuhan 430068, China
| | - Kang Li
- School of Computer Science, Hubei University of Technology, Wuhan 430068, China
| | - Haitao Gan
- School of Computer Science, Hubei University of Technology, Wuhan 430068, China
| | - Zhongwei Huang
- School of Computer Science, Hubei University of Technology, Wuhan 430068, China
| | - Ming Shi
- School of Computer Science, Hubei University of Technology, Wuhan 430068, China
| | - Ran Zhou
- School of Computer Science, Hubei University of Technology, Wuhan 430068, China
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Elmer NA, Veeramani A, Hassell N, Comer C, Manstein S, Shiah E, Bustos V, Lin SJ. In the Age of Social Media, How Does the Public Choose a Plastic Surgeon? A Crowdsourcing Analysis of Major Deciding Factors. Plast Reconstr Surg 2024; 153:194e-203e. [PMID: 37075258 DOI: 10.1097/prs.0000000000010571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
BACKGROUND Patients consider many factors when selecting a plastic surgeon. Previous studies have demonstrated the importance of board certification and reputation in this decision. Despite this, there is a paucity of knowledge on the role that cost of procedure, social media, and surgeon training have on the decision-making process. METHODS The authors' study used a population-based survey administered by Amazon Mechanical Turk. Adults 18 years and older and residing in the United States were asked to rank the importance of 36 factors from 0 (least important) to 10 (most important) when selecting a plastic surgeon. RESULTS A total of 369 responses were analyzed. The mean age of respondents was 36.9 years (SD, 10.9 years), and 174 participants (47.2%) were female. Of those surveyed, 216 (55.0%) had previously undergone plastic surgery, and all respondents were considering plastic surgery either at the time of survey or in the future. The most common first step for respondents in identifying a plastic surgeon was a web-based search (32.2%). The top three most important factors in selecting a plastic surgeon were surgeon's experience with the desired procedure (7.48), surgeon's board certification (7.38), and surgeon's years in practice (7.36). The three least important factors were the surgeon's race (5.43), number of social media posts (5.62), and television appearances (5.64). CONCLUSIONS The authors' survey provides insight into the role that different elements play in the decision of selecting a plastic surgeon in the United States. Understanding how patients select a plastic surgeon can help surgeons optimize these elements in their practices.
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Affiliation(s)
- Nicholas A Elmer
- From the Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School
| | - Anamika Veeramani
- From the Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School
| | - Natalie Hassell
- From the Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School
| | - Carly Comer
- From the Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School
| | - Samuel Manstein
- From the Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School
| | - Eric Shiah
- From the Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School
| | - Valeria Bustos
- From the Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School
| | - Samuel J Lin
- From the Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School
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Katz E, Edelstein B. Psychometric Properties of the Wake Forest Physician Trust Scale with Older Adults. Int J Aging Hum Dev 2023:914150231218929. [PMID: 38105230 DOI: 10.1177/00914150231218929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Background: Trust is an integral part of the patient-physician relationship. None of the current measures of patient-physician trust has been validated with a sample of older adults. Age-appropriate samples are needed to support the use of assessment instruments and accurate interpretation of assessment results. The purpose of the study was to examine the psychometric properties of the Wake Forest Physician Trust Scale (WFPTS) with a sample of older adults. Methods: Internal consistency and convergent and discriminant validity evidence were examined. One hundred and sixty-one English-speaking, community-dwelling older adults participated. Results: Reliability evidence is strong based on coefficient alpha and average inter-item correlations. Convergent validity evidence is strong, with significant, moderate to strong correlations with measures of related constructs. Discriminant validity evidence is strong. Discussion: The results of this study provide support for the psychometric properties of the WFPTS with older adults. Future directions for research with this instrument are discussed.
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Affiliation(s)
- Emma Katz
- Department of Psychology, West Virginia University, Morgantown, WV, USA
| | - Barry Edelstein
- Department of Psychology, West Virginia University, Morgantown, WV, USA
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Kim ACH, Du J, Andrew DPS. Social media consumption and depressive symptoms during the COVID-19 lockdown: the mediating effect of physical activity. Front Psychiatry 2023; 14:1120230. [PMID: 38130287 PMCID: PMC10733509 DOI: 10.3389/fpsyt.2023.1120230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 11/22/2023] [Indexed: 12/23/2023] Open
Abstract
Introduction Social media platforms played a critical role during the COVID-19 pandemic. This study aimed to explore: (1) the changes in social media consumption patterns, physical activity levels/sedentary behavior, and depressive symptoms, and (2) how the changes in social media consumption patterns predict the changes in depressive symptoms while investigating the mediating role of changes in physical activity levels/sedentary behavior between before, and after the COVID-19 lockdown among U.S. adults with different age clusters. Methods A total of 695 U.S. participants completed an online questionnaire via MTurk, and participants were asked to recall their social media consumption patterns, physical activity/sedentary behavior, depressive symptoms in January and May of 2020 while covariates included non-physical activity health behavior including diet quality, alcohol consumption, smoking, and sleep quality. Results The results of Bayesian significance testing of changes showed that the older participants tended to spend more time with content-focused social media platforms during the lockdown. While significantly increased sitting time was reported by all age clusters, no significant changes were found in activity levels. Additionally, the middle-aged and older participants reported significantly higher depressive symptoms. The findings of a multigroup structural analysis showed the significant mediating effect of moderate-to-vigorous physical activity on the relationship between changes in social media consumption and depressive symptoms. Discussion This study highlights the need for targeting specific social media platforms for older adults and the importance of moderate-to-vigorous physical activity to alleviate the mental health issues resulting from social media consumption. The result of this study also highlights the need for sport-based intervention programs in the future and the need for more social media campaigns at the institution/organization levels established by public health stakeholders and policy makers to promote physical activity and maximize population perception and reach during the pandemic.
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Affiliation(s)
- Amy Chan Hyung Kim
- Department of Sport Management, Center for Sport, Health, and Equitable Development (cSHED), Florida State University, Tallahassee, FL, United States
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Alsoof D, Kasthuri V, McDonald C, Cusano J, Anderson G, Diebo BG, Kuris E, Daniels AH. How much are patients willing to pay for spine surgery? An evaluation of attitudes toward out-of-pocket expenses and cost-reducing measures. Spine J 2023; 23:1886-1893. [PMID: 37619868 DOI: 10.1016/j.spinee.2023.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 08/14/2023] [Accepted: 08/16/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND CONTEXT With rising healthcare expenditures in the United States, patients and providers are searching to maintain quality while reducing costs. PURPOSE The aim of this study was to investigate patient willingness to pay for anterior cervical discectomy and fusion (ACDF), degenerative lumbar spinal fusions (LF), and adult spine deformity (ASD) surgery. STUDY DESIGN/SETTING A survey was developed and distributed to anonymous respondents through Amazon Mechanical Turk (MTurk). METHODS The survey introduced 3 procedures: ACDF, LF, and ASD surgery. Respondents were asked sequentially if they would pay at each increasing price option. Respondents were then presented with various cost-saving methods and asked to select the options that made them most uncomfortable, even if those would save them out-of-pocket costs. RESULTS In total, 979 of 1,172 total responses (84%) were retained for analysis. The average age was 36.2 years and 44% of participants reported a household income of $50,000 to 100,000. A total of 63% used Medicare and 13% used Medicaid. A total of 40% stated they had high levels of financial stress. A total of 30.1% of participants were willing to undergo an ACDF, 30.3% were willing to undergo a LF, and 29.6% were willing to undergo ASD surgery for the cost of $3,000 (p=.98). Regression demonstrated that for ACDF surgery, a $100 increase in price resulted in a 2.1% decrease in willingness to pay. This is comparable to degenerative LF surgery (1.8% decrease), and ASD surgery (2%). When asked which cost-saving measures participants were least comfortable with for ACDF surgery, 60% stated "Use of the older generation implants/devices" (LF: 51%, ASD: 60%,), 61% stated "Having the surgery performed at a community hospital instead of at a major academic center" (LF: 49%, ASD: 56%), and 55% stated "Administration of anesthesia by a nurse anesthetist" (LF: 48.01%, ASD: 55%). Conversely, 36% of ACDF patients were uncomfortable with a "Video/telephone postoperative visit" to cut costs (LF: 51%, ASD: 39%). CONCLUSIONS Patients are unwilling to contribute larger copays for adult spinal deformity correction than for ACDF and degenerative lumbar spine surgery, despite significantly higher procedural costs and case complexity/invasiveness. Patients were most uncomfortable forfeiting newer generation implants, receiving the operation at a community rather than an academic center, and receiving care by physician extenders. Conversely, patients were more willing to convert postoperative visits to telehealth and forgo neuromonitoring, indicating a potentially poor understanding of which cost-saving measures may be implemented without increasing the risk of complications.
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Affiliation(s)
- Daniel Alsoof
- Department of Orthopedics, Brown University Warren Alpert Medical School, 1 Kettle Point Ave, East Providence, RI 02914, USA
| | - Viknesh Kasthuri
- The Warren Alpert Medical School of Brown University, 222 Richmond St, East Providence, RI 02903, USA
| | - Christopher McDonald
- Department of Orthopedics, Brown University Warren Alpert Medical School, 1 Kettle Point Ave, East Providence, RI 02914, USA
| | - Joseph Cusano
- Department of Orthopedics, Brown University Warren Alpert Medical School, 1 Kettle Point Ave, East Providence, RI 02914, USA
| | - George Anderson
- The Warren Alpert Medical School of Brown University, 222 Richmond St, East Providence, RI 02903, USA
| | - Bassel G Diebo
- Department of Orthopedics, Brown University Warren Alpert Medical School, 1 Kettle Point Ave, East Providence, RI 02914, USA
| | - Eren Kuris
- Department of Orthopedics, Brown University Warren Alpert Medical School, 1 Kettle Point Ave, East Providence, RI 02914, USA
| | - Alan H Daniels
- Department of Orthopedics, Brown University Warren Alpert Medical School, 1 Kettle Point Ave, East Providence, RI 02914, USA.
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Esmaeilzadeh P. Older Adults' Perceptions About Using Intelligent Toilet Seats Beyond Traditional Care: Web-Based Interview Survey. JMIR Mhealth Uhealth 2023; 11:e46430. [PMID: 38039065 PMCID: PMC10724815 DOI: 10.2196/46430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 10/19/2023] [Accepted: 11/06/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND In contemporary society, age tech (age technology) represents a significant advancement in health care aimed at enhancing patient engagement, ensuring sustained independence, and promoting quality of life for older people. One innovative form of age tech is the intelligent toilet seat, which is designed to collect, analyze, and provide insights based on toileting logs and excreta data. Understanding how older people perceive and interact with such technology can offer invaluable insights to researchers, technology developers, and vendors. OBJECTIVE This study examined older adults' perspectives regarding the use of intelligent toilet seats. Through a qualitative methodology, this research aims to unearth the nuances of older people's opinions, shedding light on their preferences, concerns, and potential barriers to adoption. METHODS Data were collected using a web-based interview survey distributed on Amazon Mechanical Turk. The analyzed data set comprised 174 US-based individuals aged ≥65 years who voluntarily participated in this study. The qualitative data were carefully analyzed using NVivo (Lumivero) based on detailed content analysis, ensuring that emerging themes were coded and classified based on the conceptual similarities in the respondents' narratives. RESULTS The analysis revealed 5 dominant themes encompassing the opinions of aging adults. The perceived benefits and advantages of using the intelligent toilet seat were grouped into 3 primary themes: health-related benefits including the potential for early disease detection, continuous health monitoring, and seamless connection to health care insights. Technology-related advantages include the noninvasive nature of smart toilet seats and leveraging unique and innovative data collection and analysis technology. Use-related benefits include ease of use, potential for multiple users, and cost reduction owing to the reduced need for frequent clinical visits. Conversely, the concerns and perceived risks were classified into 2 significant themes: psychological concerns, which included concerns about embarrassment and aging-related stereotypes, and the potential emotional impact of constant health monitoring. Technical performance risks include concerns centered on privacy and security, device reliability, data accuracy, potential malfunctions, and the implications of false positives or negatives. CONCLUSIONS The decision of older adults to incorporate intelligent toilet seats into their daily lives depends on myriad factors. Although the potential health and technological benefits are evident, valid concerns that need to be addressed remain. To foster widespread adoption, it is imperative to enhance the advantages while simultaneously addressing and mitigating the identified risks. This balanced approach will pave the way for a more holistic integration of smart health care devices into the routines of the older population, ensuring that they reap the full benefits of age tech advancements.
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Affiliation(s)
- Pouyan Esmaeilzadeh
- Department of Information Systems and Business Analytics, College of Business, Florida International University, Miami, FL, United States
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Barnes RD, Palmer B, Hanson SK, Lawson JL. Sleep is the best medicine: assessing sleep, disordered eating, and weight-related functioning. Eat Weight Disord 2023; 28:98. [PMID: 37991644 PMCID: PMC10665232 DOI: 10.1007/s40519-023-01610-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 09/21/2023] [Indexed: 11/23/2023] Open
Abstract
Sleep quality is linked to disordered eating, obesity, depression, and weight-related functioning. Most research, however, has focused on clinical populations. The current study investigated relationships between sleep quality, disordered eating, and patterns of functioning in a community sample to better understand relationships among modifiable health behaviors. Participants (N = 648) recruited from Amazon Mechanical Turk completed assessments of eating, depression, weight-related functioning, and sleep. Self-reported height and weight were used to calculate body mass index (M = 27.3, SD = 6.9). Participants were on average 37.6 years (SD = 12.3), primarily female (65.4%), and White, not Hispanic (72.7%). Over half of participants endorsed poor sleep quality, and average sleep scores were above the clinical cutoff for poor sleep quality. Sleep scores were significantly positively correlated with disordered eating, depression, and weight-related functioning, even after adjusting for age, body mass index, and sex. Multivariate regression models predicting weight-related functioning and depression showed that both sleep quality and disordered eating independently predicted depression. Sleep quality did not independently predict weight-related functioning; however, disordered eating did. To the best of our knowledge, this is the first study to assess sleep behaviors, disordered eating, and weight-related functioning in a community sample of weight diverse participants. Results indicate that most participants endorsed poor sleep quality, which was associated with disordered eating patterns, including binge eating and poorer weight-related functioning, even after controlling for body mass index, highlighting that this relationship exists across the weight spectrum. These results speak to the importance of health behavior assessment and intervention within nonclinical samples.Level of evidence Level III: evidence obtained from well-designed cohort or case-control analytic studies.
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Affiliation(s)
- Rachel D Barnes
- Division of Geriatrics, Palliative and Primary Care, University of Minnesota Medical School, MMC 741, 420 Delaware Street SE, Minneapolis, MN, 55455, USA.
| | - Brooke Palmer
- Division of Geriatrics, Palliative and Primary Care, University of Minnesota Medical School, MMC 741, 420 Delaware Street SE, Minneapolis, MN, 55455, USA
| | - Sheila K Hanson
- Department of Psychology, School of Entrepreneurship and Management, University of North Dakota, Grand Forks, ND, USA
| | - Jessica L Lawson
- VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
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Anil Kumar Vaidhyam S, Huang KT. Social Determinants of Health and Patients' Technology Acceptance of Telehealth During the COVID-19 Pandemic: Pilot Survey. JMIR Hum Factors 2023; 10:e47982. [PMID: 37934556 PMCID: PMC10631497 DOI: 10.2196/47982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 09/05/2023] [Accepted: 09/23/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND Telehealth has been widely adopted by patients during the COVID-19 pandemic. Many social determinants of health influence the adoption. OBJECTIVE This pilot study aimed to understand the social determinants of patients' adoption of telehealth in the context of the pandemic. METHODS A survey methodology was used to capture data from 215 participants using Amazon Mechanical Turk. The study was guided by the technology acceptance model and the social determinants of health framework. The questionnaire included technology acceptance model variables (eg, perceived usefulness [PU] and perceived ease of use [PEOU]), social determinants (eg, access to health care, socioeconomic status, education, and health literacy), and demographic information (eg, age, sex, race, and ethnicity). A series of ordinary least squares regressions were conducted to analyze the data using SPSS Statistics (IBM Corp). RESULTS The results showed that social determinant factors-safe neighborhood and built environment (P=.01) and economic stability (P=.05)-are predictors of the PEOU of telehealth adoption at a statistically significant or marginally statistically significant level. Furthermore, a moderated mediation model (PROCESS model 85) was used to analyze the effects of COVID-19 on the neighborhood, built environment, and economic stability. PEOU and PU significantly positively affected users' intention to use technology for both variables. CONCLUSIONS This study draws attention to 2 research frameworks that address unequal access to health technologies. It also adds empirical evidence to telehealth research on the adoption of patient technology. Finally, regarding practical implications, this study will provide government agencies, health care organizations, and health care companies with a better perspective of patients' digital health use. This will further guide them in designing better technology by considering factors such as social determinants of health.
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Affiliation(s)
- Sneha Anil Kumar Vaidhyam
- Department of Information Culture and Data Stewardship, School of Computing and Information, University of Pittsburgh, Pittsburgh, PA, United States
| | - Kuo-Ting Huang
- Department of Information Culture and Data Stewardship, School of Computing and Information, University of Pittsburgh, Pittsburgh, PA, United States
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Park CL, Wilt JA, Russell BS, Fendrich M. Does perceived post-traumatic growth during the COVID-19 pandemic reflect actual positive changes? ANXIETY, STRESS, AND COPING 2023; 36:661-673. [PMID: 36592338 PMCID: PMC10314967 DOI: 10.1080/10615806.2022.2157821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 11/29/2022] [Accepted: 12/03/2022] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND OBJECTIVES People commonly report positive changes following stressful experiences (perceived posttraumatic growth; PPTG), yet whether PPTG validly reflects positive changes remains unestablished. DESIGN AND METHODS We tested the extent to which COVID-19 pandemic-related PPTG relates to positive changes in corresponding psychosocial resources in a national US sample participating in a five wave study (T1-T5), focusing here on T2-T5: ns = 712-860. We examined correlations between resource change (both latent and observed difference scores) and PPTG at each occasion and conducted structural equation models to separate occasion-specific and stable (traitlike) PPTG variance. We related changes in resources to occasion-specific and stable PPTG components. RESULTS Associations between change scores and occasion-specific PPTG were sparse, providing limited evidence of PPTG validity. Associations between change scores and stable PPTG tended to be positive and stronger than associations for occasion-specific PPTG. DISCUSSION Perceptions of growth were largely unrelated to experienced positive changes and thus appear to be largely illusory. However, a personality-like tendency to believe one grows from stressful experiences relates more strongly to actual resource growth. These results suggest that people are not accurate reporters of positive changes they experience and that interventions aimed at promoting post-traumatic growth may be premature.
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Affiliation(s)
- Crystal L Park
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - Joshua A Wilt
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
- Department of Psychology, Case Western Reserve University, Cleveland, OH, USA
| | - Beth S Russell
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA
| | - Michael Fendrich
- School of Social Work, University of Connecticut, Hartford, CT, USA
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