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Gc K, Mahalingam K, Gupta V, Angmo D, Gupta S, Dada T. Stress and Allostatic Load in Patients With Primary Open Angle Glaucoma. J Glaucoma 2024; 33:87-93. [PMID: 37974317 DOI: 10.1097/ijg.0000000000002332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 10/15/2023] [Indexed: 11/19/2023]
Abstract
PRCIS This study evaluated the allostatic load (AL) in primary open angle glaucoma (POAG) patients and reported that the AL score was significantly higher in glaucoma patients compared with age-matched controls. PURPOSE To evaluate the AL in patients with POAG. METHODS This case-control study comprised 50 POAG (glaucoma patients) and 50 age-matched controls without glaucoma (controls). AL was estimated based on 13 variables: systolic blood pressure (BP), diastolic BP, homocysteine, triglycerides, total cholesterol, high-density lipoprotein, low-density lipoprotein, body mass index, serum cortisol, glycosylated hemoglobin, albumin, creatinine clearance, and C-reactive protein. High-risk thresholds were determined based on biological cutoffs of each biomarker. One point was assigned for each biomarker reading above cutoff and were summated to obtain AL score; score ≥4 was considered high. RESULTS Mean age of glaucoma patients was 60.82±6.26 and 60.14±6.72 years in controls ( P =0.602). All components of AL score (except C-reactive protein) had higher values in glaucoma patients. There was a statistically significant difference in homocysteine ( P =0.001), total cholesterol ( P =0.037), high-density lipoprotein ( P =0.005), and glycosylated hemoglobin ( P =0.003). Mean AL score was 4.68±2.09 in glaucoma patients and 3.32±1.34 in controls ( P <0.001). There was significant association of high AL score with older age ( P =0.006), low socioeconomic status ( P =0.020), and glaucoma severity ( P =0.001). Negative correlation was seen between AL and retinal nerve fiber layer thickness (Right Eye: r =-0.37, P <0.001; Left Eye: r =-0.298, P <0.001) and visual field mean deviation (Right Eye: r =-0.469, P <0.001; Left Eye: r =-0.520, P <0.001). CONCLUSIONS Glaucoma patients exhibited allostatic overload indicating physiological dysregulation to chronic stress although additional research is required to establish causality. A holistic approach with lifestyle modifications to reduce chronic stress should be an integral part of managing glaucoma patients as it would serve both to possibly reduce or prevent disease progression and improve overall health outcomes.
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Affiliation(s)
- Kiran Gc
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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Karimi N, Opie R, Crawford D, O'Connell S, Ball K. Digitally Delivered Interventions to Improve Nutrition Behaviors Among Resource-Poor and Ethnic Minority Groups With Type 2 Diabetes: Systematic Review. J Med Internet Res 2024; 26:e42595. [PMID: 38300694 PMCID: PMC10870209 DOI: 10.2196/42595] [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: 09/10/2022] [Revised: 06/22/2023] [Accepted: 07/30/2023] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Resource-poor individuals, such as those with a low income, are disproportionately affected by diabetes and unhealthy eating patterns that contribute to poor disease self-management and prognosis. Digitally delivered interventions have the potential to address some of the barriers to healthy eating experienced by this group. However, little is known about their effectiveness in disadvantaged populations. OBJECTIVE This systematic review is conducted to assess the effectiveness of digitally delivered interventions in improving nutritional behaviors and nutrition-related health outcomes among disadvantaged people with type 2 diabetes (T2D). METHODS MEDLINE complete, Global Health, Embase, CINAHL complete, Informit Health, IEEE Xplore, and Applied Science and Technology Source databases were searched for studies published between 1990 and 2022 on digitally delivered nutrition interventions for disadvantaged people with T2D. Two reviewers independently assessed the studies for eligibility and determined the study quality using the Cochrane Risk-of-Bias Assessment Tool. The Behavioral Change Technique Taxonomy V1 was used to identify behavior change techniques used in the design of interventions. RESULTS Of the 2434 identified records, 10 (0.4%), comprising 947 participants, met the eligibility criteria and were included in the review. A total of 2 digital platforms, web and messaging services (eg, SMS text messaging interventions or multimedia messaging service), were used to deliver interventions. Substantial improvements in dietary behaviors were reported in 5 (50%) of the 10 studies, representing improvements in healthier food choices or increases in dietary knowledge and skills or self-efficacy. Of the 10 studies, 7 (70%) examined changes in blood glucose levels, of which 4 (57%) out of 7 achieved significant decreases in hemoglobin A1C levels ranging from 0.3% to 1.8%. The most frequently identified behavior change techniques across all studies were instruction on how to perform the behavior, information about health consequences, and social support. CONCLUSIONS This review provided some support for the efficacy of digitally delivered interventions in improving healthy eating behaviors in disadvantaged people with T2D, an essential dietary prerequisite for changes in clinical metabolic parameters. Further research is needed into how disadvantaged people with T2D may benefit more from digital approaches and to identify the specific features of effective digital interventions for supporting healthy behaviors among disadvantaged populations. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42020149844; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=149844.
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Affiliation(s)
- Nazgol Karimi
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
| | - Rachelle Opie
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
| | - David Crawford
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
| | - Stella O'Connell
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
| | - Kylie Ball
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
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Kapiriri L, Essue BM, Velez CM, Julia A, Elysee N, Bernardo A, Marion D, Susan G, Ieystn W. Was priority setting included in the Canadian COVID-19 pandemic planning and preparedness? A comparative analysis of COVID-19 pandemic plans from Eight provinces and Three territories. Health Policy 2023; 133:104817. [PMID: 37150048 PMCID: PMC10074731 DOI: 10.1016/j.healthpol.2023.104817] [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: 07/12/2022] [Revised: 03/16/2023] [Accepted: 04/04/2023] [Indexed: 04/08/2023]
Abstract
Background Variation in priorities during pandemic planning among the federal, provincial and territorial jurisdictions are thought to have impacted Canada's ability to effectively control the spread of the COVID-19 virus, and protect the most vulnerable. The potential influence of diverse and divergent political, cultural, and behavioural factors, regarding inclusion of priority setting (PS) in pandemic preparedness planning across the country is not well understood. This study aimed to examine how the Canadian federal, provincial and territorial COVID-19 pandemic preparedness planning documents integrated PS. Methods A documentary analysis of the federal, eight provincial, three territorial COVID-19 preparedness and response plans. We assessed the degree to which the documented PS processes fulfilled established quality requirements of effective PS using the Kapiriri & Martin framework. Results While the federal plan included most of the parameters of effective PS, the provinces and territories reflected few. The lack of obligation for the provinces and territories to emulate the federal plan is one of the possible reasons for the varying inclusion of these parameters. The parameters included did not vary systematically with the jurisdiction's context. Conclusion Provinces could consider using the framework of the federal plan and the WHO guidelines to guide future pandemic planning. Regular evaluation of the instituted PS would provide a mechanism through which lessons can be harnessed and improvement strategies developed. Future studies should describe and evaluate what PS mechanisms were implemented.
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Affiliation(s)
- Lydia Kapiriri
- Department of Health, Aging and Society, McMaster University, 1280 Main street West, Hamilton, Ontario, Canada.
| | - Beverley M Essue
- Institute of Health Policy, Management and Evaluation, University of Toronto, Canada
| | - Claudia M Velez
- Department of Health, Aging & Society, McMaster University, 1280 Main Street West, KTH-226, Hamilton, Ontario L8S 4M4, Canada; Faculty of Medicine, University of Antioquia, Cra 51d #62-29, Medellín, Antioquia, Colombia
| | - Abelson Julia
- Health Policy Program, McMaster University, 1280 Main Street West, L8S 4M4, Hamilton, Ontario, Canada
| | - Nouvet Elysee
- School of Health Studies, Western University, 1151 Richmond Street, London, Ontario N6A 3K7, Canada
| | - Aguilera Bernardo
- Facultad de Medicina y Ciencia, Universidad San Sebastian, Providencia, Santiago
| | - Danis Marion
- Section on Ethics and Health Policy, National Institutes of Health, 10 Center Drive, Bethesda, MD 20892, USA
| | - Goold Susan
- Internal Medicine and Health Management and Policy, Center for Bioethics and social sciences in medicine, University of Michigan, 2800 Plymouth Road, Bldg. 14, G016, Ann Arbor, MI 48109-2800, USA
| | - Williams Ieystn
- School of Social Policy, HSMC, Park House, University of Birmingham, Edgbaston, Birmingham B15 2RT, UK
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Chen X, McMaughan DJ, Li M, Kreps GL, Ariati J, Han H, Rhoads KE, Mahaffey CC, Miller BM. Trust in and Use of COVID-19 Information Sources Differs by Health Literacy among College Students. Healthcare (Basel) 2023; 11:healthcare11060831. [PMID: 36981488 PMCID: PMC10048640 DOI: 10.3390/healthcare11060831] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 03/02/2023] [Accepted: 03/08/2023] [Indexed: 03/14/2023] Open
Abstract
People’s health information-seeking behaviors differ by their health literacy levels. This study assessed the relationship between health literacy and college students’ levels of trust in and use of a range of health information sources of COVID-19. We collected data from August to December 2020 among college students (n = 763) through an online survey. We used a health literacy measure containing three self-reported survey questions, developed by the CDC. We assessed the extent to which participants trusted and used any of the sixteen different sources of information about COVID-19. Respondents reported high levels of trusting and using COVID-19 information from the CDC, health care providers, the WHO, state/county/city health departments, and official government websites when compared to other sources. After controlling for demographic characteristics (i.e., gender, age, race, ethnicity, and income), those who reported having lower health literacy were significantly less likely to trust and use COVID-19 information from these health authorities when compared to participants who reported having higher health literacy. Students with lower self-reported health literacy indicated not trusting or using official health authority sources for COVID-19 information. Relying on low-quality information sources could create and reinforce people’s misperceptions regarding the virus, leading to low compliance with COVID-19-related public health measures and poor health outcomes.
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Affiliation(s)
- Xuewei Chen
- School of Community Health Sciences, Counseling and Counseling Psychology, Oklahoma State University, Stillwater, OK 74078, USA; (D.J.M.); (H.H.); (K.E.R.)
- Correspondence:
| | - Darcy Jones McMaughan
- School of Community Health Sciences, Counseling and Counseling Psychology, Oklahoma State University, Stillwater, OK 74078, USA; (D.J.M.); (H.H.); (K.E.R.)
| | - Ming Li
- Department of Health Sciences, Towson University, Towson, MD 21252, USA;
| | - Gary L. Kreps
- Center for Health and Risk Communication, George Mason University, Fairfax, VA 22030, USA;
| | - Jati Ariati
- School of Educational Foundation, Leadership, and Aviation, Oklahoma State University, Stillwater, OK 74078, USA;
- Department of Psychology, Universitas Diponegoro, Semarang 50275, Indonesia
| | - Ho Han
- School of Community Health Sciences, Counseling and Counseling Psychology, Oklahoma State University, Stillwater, OK 74078, USA; (D.J.M.); (H.H.); (K.E.R.)
| | - Kelley E. Rhoads
- School of Community Health Sciences, Counseling and Counseling Psychology, Oklahoma State University, Stillwater, OK 74078, USA; (D.J.M.); (H.H.); (K.E.R.)
| | - Carlos C. Mahaffey
- College of Health and Human Sciences, Purdue University, West Lafayette, IN 47906, USA;
| | - Bridget M. Miller
- Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA;
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Bajos N, Spire A, Silberzan L, Sireyjol A, Jusot F, Meyer L, Franck JE, Warszawski J. When Lack of Trust in the Government and in Scientists Reinforces Social Inequalities in Vaccination Against COVID-19. Front Public Health 2022; 10:908152. [PMID: 35937246 PMCID: PMC9346080 DOI: 10.3389/fpubh.2022.908152] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 06/08/2022] [Indexed: 11/13/2022] Open
Abstract
Objective To assess whether lack of trust in the government and scientists reinforces social and racial inequalities in vaccination practices. Design A follow-up of the EpiCov random population-based cohort survey. Setting In July 2021, in France. Participants Eighty-thousand nine hundred and seventy-one participants aged 18 years and more. Main Outcome Measures Adjusted odds ratios of COVID-19 vaccination status (received at least one dose/ intends to get vaccinated/ does not know whether to get vaccinated/refuses vaccination) were assessed using multinomial regressions to test associations with social and trust factors and to study how these two factors interacted with each other. Results In all, 72.2% were vaccinated at the time of the survey. The population of unvaccinated people was younger, less educated, had lower incomes, and more often belonged to racially minoritized groups, as compared to vaccinated people. Lack of trust in the government and scientists to curb the spread of the epidemic were the factors most associated with refusing to be vaccinated: OR = 8.86 (7.13 to 11.00) for the government and OR = 9.07 (7.71 to 10.07) for scientists, compared to vaccinated people. Lack of trust was more prevalent among the poorest which consequently reinforced social inequalities in vaccination. The poorest 10% who did not trust the government reached an OR of 16.2 (11.9 to 22.0) for refusing to be vaccinated compared to the richest 10% who did. Conclusion There is a need to develop depoliticised outreach programmes targeted at the most socially disadvantaged groups, and to design vaccination strategies conceived with people from different social and racial backgrounds to enable them to make fully informed choices.
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Affiliation(s)
- Nathalie Bajos
- Institut de Recherche Interdisciplinaire sur les Enjeux Sociaux (IRIS), Institut National de la Santé et de la Recherche Médicale (INSERM)/École des Hautes Études en Sciences Sociales (EHESS), Aubervilliers, France
| | - Alexis Spire
- Institut de Recherche Interdisciplinaire sur les Enjeux Sociaux (IRIS), Centre National de la Recherche Scientifique (CNRS), Aubervilliers, France
| | - Léna Silberzan
- Institut de Recherche Interdisciplinaire sur les Enjeux Sociaux (IRIS), Institut National de la Santé et de la Recherche Médicale (INSERM), Aubervilliers, France
| | - Antoine Sireyjol
- Institut de Recherche Interdisciplinaire sur les Enjeux Sociaux (IRIS), Institut National de la Santé et de la Recherche Médicale (INSERM), Aubervilliers, France
| | - Florence Jusot
- Laboratoire d'Économie et Gestion des Organisations de Santé, Université Paris Dauphine, Paris, France
| | - Laurence Meyer
- Centre de Recherche en Epidémiologie et Santé des Population, Institut National de la Santé et de la Recherche Médicale, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Jeanna-Eve Franck
- Institut de Recherche Interdisciplinaire sur les Enjeux Sociaux (IRIS), Institut National de la Santé et de la Recherche Médicale (INSERM), Aubervilliers, France
| | - Josiane Warszawski
- Centre de Recherche en Epidémiologie et Santé des Population, Institut National de la Santé et de la Recherche Médicale, Université Paris-Saclay, Le Kremlin-Bicêtre, France
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Harewood J, Rosenfield M. Defining race and ethnicity in Optometry. Ophthalmic Physiol Opt 2021; 41:659-662. [PMID: 34137060 DOI: 10.1111/opo.12846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Flanagan D, Gaebler D, Bart-Plange ELB, Msall ME. Addressing disparities among children with cerebral palsy: Optimizing enablement, functioning, and participation. J Pediatr Rehabil Med 2021; 14:153-159. [PMID: 34092660 DOI: 10.3233/prm-210015] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE Recognizing health disparities among children with cerebral palsy (CP) is necessary for understanding potential risk factors for CP and for implementing early and effective preventative and intervention treatments. However, there is currently little and conflicting evidence regarding the direct impact of contextual factors such as socioeconomic status (SES) for children with CP in the United States. These contextual factors include the complex social determinants of health on prematurity, comprehensive informed obstetric management for minority and vulnerable populations, and cumulative adversity disproportionately experienced by children, by gender, minority status, immigration, poverty, and structural racism. METHODS This study presents results from a review of health disparities among children with CP, using registry and population surveillance data from Australia, Canada, Scandinavia, the United Kingdom, Ireland, Turkey, and the United States. RESULTS The review confirmed that there are significant health disparities among children with CP, both in terms of prevalence and severity, based on factors such as SES, neighborhood disadvantage, maternal education, gender, and minority status. CONCLUSION Strategies need to be implemented in the United States to promote enablement and functioning among children with CP who face additional health disparities. This requires a greater understanding of population groups at increased risk, comprehensive assessment and care for young children with motor delays, and systematic population counts of children and adults with CP using registries and systems of neurodevelopmental surveillance across health, education, and community rehabilitation. These efforts also require sensitivity to structural and persistent racism, stigma, trauma-informed care, and culturally sensitive community engagement. Additional efforts are also required to improve outcomes over the life course for individuals living a life with CP from a framework of enablement, self-direction, equity and social justice.
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Affiliation(s)
- Deirdre Flanagan
- University of Chicago Comer Children's Hospital, Section of Developmental and Behavioral Pediatrics, Chicago, IL, USA
| | | | - Emma-Lorraine B Bart-Plange
- University of Chicago Comer Children's Hospital, Section of Developmental and Behavioral Pediatrics, Chicago, IL, USA
| | - Michael E Msall
- University of Chicago Comer Children's Hospital, Section of Developmental and Behavioral Pediatrics, Chicago, IL, USA
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