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Vergel N. An HIV long-term survivor and activist's perspective on HIV cure-related research - Nelson vergel. HIV Res Clin Pract 2024; 25:2328408. [PMID: 38520134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2024]
Affiliation(s)
- Nelson Vergel
- Director, Program for Wellness Restoration, Houston, Texas
- Community Member, Delaney AIDS Research Enterprise (DARE), Houston, Texas
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Su X, Sun L. Prevalence and associated factors of abortion among women with severe mental disorders. J Affect Disord 2024; 355:432-439. [PMID: 38548200 DOI: 10.1016/j.jad.2024.03.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 02/23/2024] [Accepted: 03/23/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND Abortion behaviors among individuals with mental disorders presented major obstacles to women's health. However, few studies reported the prevalence and associated factors of abortion among women with severe mental disorders in China. Consequently, this study aims to investigate the prevalence of abortion among female patients in rural communities and identify potential health risks. METHOD This was a cross-sectional study of 276 women aged 18 years and older with severe mental disorders in rural areas of Shandong Province, China. The pregnancy history, abortion history and socio-demographic characteristics of women were investigated by questionnaire. Logistic regression analysis was employed to examine the associated factors for different abortion behaviors. RESULT The study showed that 82.61 % (228/276) of patients had a pregnancy history. Among the patients with a pregnancy history, 43.42 % (99/228) reported having had at least one abortion, and 15.79 % (36/228) had more than one. In the other side, 31.58 % (72/228) of them experienced spontaneous abortion, while 12.72 % (29/228) experienced induced abortion. Age at first gestation (aOR 0.80, 95 % CI 0.70-0.90) and age at last gestation (aOR 1.17, 95 % CI 1.07-1.27) were both associated with abortion. Anxiety was related to spontaneous (aOR 1.08, 95 % CI 1.02-1.15) and repeat abortions (aOR 1.10, 95 % CI 1.01-1.19). In addition, religion (aOR 10.47, 95 % CI 2.81-39.01), number of children≥2 (aOR 0.18, 95 % CI 0.04-0.77), and family functioning (aOR 1.31, 95 % CI 1.06-1.63) were associated with induced abortion. CONCLUSION Women with severe mental disorders in rural regions have notably higher rates of abortion compared to the general female population, particularly for spontaneous abortions. Gestational age and anxiety of pregnant patients deserve attention and preventive measures to avoid the outcomes of abortion.
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Affiliation(s)
- Xiaoying Su
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; National Health Commission of China (NHC), Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan 250012, China
| | - Long Sun
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; National Health Commission of China (NHC), Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan 250012, China.
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Wang C, Wang Q, Liu M, Tang S, Huang X, Huang C. Effectiveness of psychological interventions among community-dwelling older adults with subthreshold depression: A systematic review and meta-analysis. J Affect Disord 2024; 354:368-375. [PMID: 38479506 DOI: 10.1016/j.jad.2024.03.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 02/22/2024] [Accepted: 03/09/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND Little is known about the effectiveness of psychological interventions among older adults with subthreshold depression in the community. This systematic review and meta-analysis aimed to examine the effectiveness of psychological interventions on depressive symptoms, anxiety symptoms and quality of life. METHODS We searched five databases from inception to 20th September 2022 and included RCTs that evaluated the effectiveness of psychological interventions among older adults with subthreshold depression in the community. Standardized mean difference (SMD) and 95 % confidence intervals (CI) were used to calculate the effect sizes of treatment outcomes in the meta-analysis, using RevMan 5.4.1 and Stata 16.0. RESULTS This meta-analysis included thirteen RCT studies involving 2079 participants. Psychological interventions could significantly reduce depressive symptoms (post-intervention time: SMD = -0.58, 95 % CI = -0.76 to -0.40; follow-up time: SMD = -0.31, 95 % CI = -0.41 to -0.22) and anxiety symptoms (post-intervention time: SMD = -0.33, 95 % CI = -0.49 to -0.17; follow-up time: SMD = -0.24, 95 % CI = -0.36 to -0.12) and improve quality of life (post-intervention time: SMD = 0.30, 95 % CI = 0.05 to 0.55; follow-up time: SMD = 0.15, 95 % CI = 0.01 to 0.28). CONCLUSION Evidence suggests that psychological interventions could significantly reduce depressive symptoms and anxiety symptoms, and improve quality of life among community-dwelling older adults with subthreshold depression.
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Affiliation(s)
- Chunyu Wang
- School of Nursing, University of California, Los Angeles, CA 90024, USA
| | - Qing Wang
- Xiangya School of Nursing, Central South University, Changsha, Hunan 410013, China
| | - Minhui Liu
- School of Nursing, Ningxia Medical University, Yinchuan, Ningxia 750101, China
| | - Siyuan Tang
- Xiangya School of Nursing, Central South University, Changsha, Hunan 410013, China
| | - Xiaoting Huang
- Xiangya School of Nursing, Central South University, Changsha, Hunan 410013, China.
| | - Chongmei Huang
- School of Nursing, Ningxia Medical University, Yinchuan, Ningxia 750101, China.
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Febvre C, Goldblatt C, El-Sabaawi R. Thermal performance of ecosystems: Modeling how physiological responses to temperature scale up in communities. J Theor Biol 2024; 585:111792. [PMID: 38513968 DOI: 10.1016/j.jtbi.2024.111792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 02/20/2024] [Accepted: 03/10/2024] [Indexed: 03/23/2024]
Abstract
Understanding how ecosystems respond to their environmental temperature is a major challenge. Thermodynamic constraints on species' metabolic rates are expected to affect ecosystem characteristics, but species interactions and interspecific variation in physiological thermal response curves (TRC) may obscure ecosystem-level responses to temperature. As a result, macroecological patterns related to temperature are still poorly understood. We investigate how physiological TRC scale up to ecosystem-level thermal responses by modifying the Tangled Nature (TaNa) model, a stochastic network model of ecology and evolution. We include new parameterizations that make reproduction, death, and mutation temperature-dependent. We find that ecosystem survival probability depends on how the minimum fitness required for species survival varies with temperature. The thermal response of ecosystem survival probability is the only ecosystem property that is sensitive to interspecific variation in TRC. Species richness scales up directly from the TRC of mutation rate, and average species population sizes are inversely related to mutation rate, with Species Abundance Distributions (SADs) exhibiting more rare species in warmer temperatures. Interactions between species are also inversely related to mutation, with positive interactions occurring more frequently in colder temperatures. The abundance of surviving ecosystems is not sensitive to temperature. This work helps clarify the specific relationships between physiological responses to temperature and ecosystem-level repercussions when species are interacting and adapting to their thermal environments.
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Affiliation(s)
- Camille Febvre
- School of Earth & Ocean Sciences, University of Victoria, 3600 Finnerty Road, Victoria, BC, Canada; Department of Biology, University of Victoria, 3600 Finnerty Road, Victoria, BC, Canada.
| | - Colin Goldblatt
- School of Earth & Ocean Sciences, University of Victoria, 3600 Finnerty Road, Victoria, BC, Canada
| | - Rana El-Sabaawi
- Department of Biology, University of Victoria, 3600 Finnerty Road, Victoria, BC, Canada
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Rommerskirch-Manietta M, Bergmann JM, Manietta C, Purwins D, Van Haitsma K, Abbott KM, Roes M. Exploration of the Content and Structure of Preferences for Leisure Activities of People Receiving Adult Day Services Using Concept Mapping. Gerontologist 2024; 64:gnad142. [PMID: 37870248 PMCID: PMC11020227 DOI: 10.1093/geront/gnad142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Indexed: 10/24/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Providing preferred leisure activities appears to be an important approach to support and empower people receiving adult day services (ADS) allowing them to age in place. To provide the conceptualization for a preference instrument, we actively involved people receiving ADS in exploring the content and structure of their preferences for leisure activities. RESEARCH DESIGN AND METHODS We chose a concept mapping methodology and involved 16 people receiving ADS. We systematically reviewed the literature and conducted semistructured interviews to generate a set of 80 preferences. Analysis of structuring these preferences resulted in a 3-dimensional cube with 12 clusters. A graphical representation was then interpreted, and the clusters were labeled. RESULTS Our conceptualization divides preferences for leisure activities into the following: 1. Take a trip, 2. Revel in memories and catch up on the news (most important), 3. Do something for yourself and come to rest, 4. Play intelligence and parlor games, 5. Make/produce and try something alone or in a group, 6. Keep fit and cheer others on in sports (least important), 7. Learn, educate, and share knowledge, 8. Have contact with other people, 9. Attend at entertainment, cultural, and amusement events, 10. Enjoy music, your homeland, or other countries, 11. Engage in outdoor activities, and 12. Get involved, offer support, and provide companionship. DISCUSSION AND IMPLICATIONS Our results may lead to the development of instruments and thus opens the field for further research and theory building on preferences for leisure activities of people receiving ADS.
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Affiliation(s)
- Mike Rommerskirch-Manietta
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Witten, North Rhine-Westphalia, Germany
- Faculty of Health, School of Nursing Science, Witten/Herdecke University, Witten, North Rhine-Westphalia, Germany
| | - Johannes M Bergmann
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Witten, North Rhine-Westphalia, Germany
- Faculty of Health, School of Nursing Science, Witten/Herdecke University, Witten, North Rhine-Westphalia, Germany
| | - Christina Manietta
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Witten, North Rhine-Westphalia, Germany
- Faculty of Health, School of Nursing Science, Witten/Herdecke University, Witten, North Rhine-Westphalia, Germany
| | - Daniel Purwins
- Diakonie Osnabrück, Stadt und Land GmbH, Osnabrück, Lower Saxony, Germany
| | - Kimberly Van Haitsma
- College of Nursing, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Katherine M Abbott
- Department of Sociology and Gerontology, Miami University, Oxford, Ohio, USA
- Scripps Gerontology Center, Miami University, Oxford, Ohio, USA
| | - Martina Roes
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Witten, North Rhine-Westphalia, Germany
- Faculty of Health, School of Nursing Science, Witten/Herdecke University, Witten, North Rhine-Westphalia, Germany
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Zhao Y, Li J. Opportunities and challenges of integrating artificial intelligence in China's elderly care services. Sci Rep 2024; 14:9254. [PMID: 38649405 PMCID: PMC11035568 DOI: 10.1038/s41598-024-60067-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 04/18/2024] [Indexed: 04/25/2024] Open
Abstract
The challenge of elderly care presents a formidable task, demanding the collective attention of governmental bodies and diverse sectors of society. The integration of Artificial Intelligence (AI) into the research and development of Social Elderly Care Service (ECS) has emerged as a dominant trend, holding substantial importance in the establishment of an efficient ECS system. This study aims to serve as a comprehensive reference for the advancement of China's ECS system, achieved through the harmonious integration of a social ECS system with AI capabilities. This paper introduces the fundamental theory of AI, delving into the intricacies of the greyscale model of AI. Furthermore, it provides an overview of the current landscape of elderly care and elder care institutions, offering scientific data and insights to propel further research on AI development and system construction. Through an analysis of the existing research status, the study identifies prevalent issues within the AI-ECS integration, emphasizing pivotal factors influencing the construction of a robust social ECS system. To address these concerns, the study puts forth specific and viable policy recommendations. Notably, the questionnaire's statistics underscore that 83% of the elderly populace would opt for AI-driven solutions in selecting intelligent products, thereby underscoring the pivotal role of AI within the social ECS system. The challenges facing elderly care systems, including demographic shifts, resource constraints, and evolving societal norms, demand innovative solutions for providing efficient and effective care. This study addresses these challenges by exploring the integration of Artificial Intelligence (AI) into Social Elderly Care Services (ECS) in China. By delving into the theory of AI and assessing the existing research status, the study identifies key issues in AI-ECS integration and proposes viable policy recommendations. Insights from stakeholder surveys further highlight the importance of AI-driven solutions in meeting the needs of the elderly population.
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Affiliation(s)
- Yongyan Zhao
- School of Humanities and Law, Harbin University, Heilongjiang, 150086, China
| | - Jian Li
- School of Innovation and Entrepreneurship, Harbin University, Heilongjiang, 150086, China.
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Ohta R, Nitta T, Shimizu A, Sano C. Role of family medicine physicians in providing nutrition support to older patients admitted to orthopedics departments: a grounded theory approach. BMC Prim Care 2024; 25:121. [PMID: 38641569 PMCID: PMC11027398 DOI: 10.1186/s12875-024-02379-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 04/09/2024] [Indexed: 04/21/2024]
Abstract
BACKGROUND Care of older adults requires comprehensive management and control of systemic diseases, which can be effectively managed by family physicians. Complicated medical conditions in older patients admitted to orthopedic departments (orthopedic patients) necessitate interprofessional collaboration. Nutrition is one of the essential components of management involved in improving the systemic condition of older patients. Nutrition support teams play an important role in nutrition management and can be supported by family physicians. However, the role of family physicians in nutrition support teams is not well documented. This study aimed to investigate the role of family physicians in supporting nutrition management in orthopedic patients. METHODS This qualitative study was conducted between January and June 2023 using constructivist grounded theory methodology. Eight family medicine physicians, three orthopedic surgeons, two nurses, two pharmacists, four rehabilitation therapists, four nutritionists, and one laboratory technician working in Japanese rural hospitals participated in the research. Data collection was performed through ethnography and semi-structured interviews. The analysis was performed iteratively during the study. RESULTS Using a grounded theory approach, four theories were developed regarding family physicians' role in providing nutrition support to orthopedic patients: hierarchical and relational limitation, delay of onset and detection of the need for geriatric care in orthopedic patients, providing effective family medicine in hospitals, and comprehensive management through the nutrition support team. CONCLUSIONS The inclusion of family physicians in nutrition support teams can help with early detection of the rapid deterioration of orthopedic patients' conditions, and comprehensive management can be provided by nutrition support teams. In rural primary care settings, family physicians play a vital role in providing geriatric care in community hospitals in collaboration with specialists. Family medicine in hospitals should be investigated in other settings for better geriatric care and to drive mutual learning among healthcare professionals.
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Affiliation(s)
- Ryuichi Ohta
- Community Care, Unnan City Hospital, 96-1 Iida, Daito-cho, Unnan, Shimane, 699-1221, Japan.
| | - Tachiko Nitta
- Community Care, Unnan City Hospital, 96-1 Iida, Daito-cho, Unnan, Shimane, 699-1221, Japan
| | - Akiko Shimizu
- Community Care, Unnan City Hospital, 96-1 Iida, Daito-cho, Unnan, Shimane, 699-1221, Japan
| | - Chiaki Sano
- Department of Community Medicine Management, Faculty of Medicine, Shimane University, 89-1 Enya cho, Izumo, Shimane, 693-8501, Japan
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Diciolla NS, Rebelo P, Rodrigues G, Grave AS, Dias C, Gomes M, Santos ES, Pereira Z, Pereira L, Marques A. Validation of "CENTR(AR)" walking trails: Different field criteria do not lead to different physical activity intensities in people with COPD. Heart Lung 2024; 67:26-32. [PMID: 38640848 DOI: 10.1016/j.hrtlng.2024.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 04/10/2024] [Accepted: 04/10/2024] [Indexed: 04/21/2024]
Abstract
BACKGROUND Validating walking trails is essential to promote physical activity (PA) safely and confidently in people with COPD. OBJECTIVES We aimed to validate predetermined light, moderate, and vigorous intensities of walking trails in people with COPD. METHODS This cross-sectional study included individuals with COPD walking in predetermined light, moderate and vigorous intensity trails. Activity intensity and volume outcomes were collected. Dyspnoea and fatigue (modified Borg scale), energy expenditure (EE, Sensewear), heart rate (HR, HR monitor), time spent in different PA intensities, and cadence (ActiGraph) were recorded and used to classify PA intensity. RESULTS Twenty people with COPD [71(7) years, 80 % male, FEV1%predicted 65.6(11.6)] were included. Fatigue differed significantly between light and moderate [3.0(2.0;4.0) vs 3.4(2.5;4.5), p = 0.01], but not vigorous (3.5[2.5-4.0]) tracks. Dyspnoea [2.3(1.5) vs 2.7(1.6) vs 2.6(1.4)], EE [5.1(0.8) vs 4.9(0.5) vs 4.6(0.8) METs], HR [92.5(11.1) vs 93.7(18.6) vs 95.4(15.0) beats/min] and cadence [115.1(104.0;120.3) vs 104.7(99.6;117.6) vs 111.2(99.9;118.5) steps/min] were similar across trails (p > 0.05). Time spent in light and moderate PA, EE volume, walking time, and step count increased along with the proposed intensity levels (p < 0.01). Walking trails were categorised as moderate intensity in most participants. CONCLUSION Walking trails were safe and valid for practising moderate-intensity PA in people with COPD. Participants adjusted their physiological responses and perceived symptoms to match a moderate intensity.
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Affiliation(s)
- Nicola S Diciolla
- Physiotherapy in Women's Health Research Group - FPSM, Department of Nursing and Physiotherapy, University of Alcalá, Alcalá de Henares, Madrid, Spain; Respiratory Rehabilitation and Research Laboratory - Lab3R, School of Health Sciences (ESSUA), and Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal.
| | - Patrícia Rebelo
- Respiratory Rehabilitation and Research Laboratory - Lab3R, School of Health Sciences (ESSUA), and Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal.
| | - Guilherme Rodrigues
- Respiratory Rehabilitation and Research Laboratory - Lab3R, School of Health Sciences (ESSUA), and Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal.
| | - Ana Sofia Grave
- Respiratory Rehabilitation and Research Laboratory - Lab3R, School of Health Sciences (ESSUA), and Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal.
| | - Cíntia Dias
- Respiratory Rehabilitation and Research Laboratory - Lab3R, School of Health Sciences (ESSUA), and Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal.
| | - Maria Gomes
- Respiratory Rehabilitation and Research Laboratory - Lab3R, School of Health Sciences (ESSUA), and Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal.
| | - E Samuel Santos
- Respiratory Rehabilitation and Research Laboratory - Lab3R, School of Health Sciences (ESSUA), and Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal.
| | - Zulmira Pereira
- Cosmonível Company - Topography, Cartography and Cadaster, Porto, Portugal.
| | - Luísa Pereira
- Águeda School of Technology and Management - ESTGA, University of Aveiro, Aveiro, Portugal.
| | - Alda Marques
- Respiratory Rehabilitation and Research Laboratory - Lab3R, School of Health Sciences (ESSUA), and Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal.
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Prosnier L. Zooplankton as a model to study the effects of anthropogenic sounds on aquatic ecosystems. Sci Total Environ 2024; 928:172489. [PMID: 38621539 DOI: 10.1016/j.scitotenv.2024.172489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 03/23/2024] [Accepted: 04/12/2024] [Indexed: 04/17/2024]
Abstract
There is a growing interest in the impact of acoustic pollution on aquatic ecosystems. Currently, research has primarily focused on hearing species, particularly fishes and mammals. However, species from lower trophic levels, including many invertebrates, are less studied despite their ecological significance. Among these taxa, studies examining the effects of sound on holozooplankton are extremely rare. This literature review examines the effects of sound on both marine and freshwater zooplankton. It highlights two differences: the few used organisms and the types of sound source. Marine studies focus on the effects of very intense acute sound on copepods, while freshwater studies focus on less intense chronic sound on cladocerans. But, in both, various negative effects are reported. The effects of sound remain largely unknown, although previous studies have shown that zooplankton can detect vibrations using mechanoreceptors. The perception of their environment can be affected by sounds, potentially causing stress. Limited research suggests that sound may affect the physiology, behaviour, and fitness of zooplankton. Following this review, I highlight the potential to use methods from ecology, ecotoxicology, and parasitology to study the effects of sound at the individual level, including changes in physiology, development, survival, and behaviour. Responses to sound, which could alter species interactions and population dynamics, are expected to have larger-scale implications with bottom-up effects, such as changes in food web dynamics and ecosystem functioning. To improve the study of the effect of sound, to better use zooplankton as biological models and as bioindicators, researchers need to better understand how they perceive their acoustic environment. Consequently, an important challenge is the measurement of particle motion to establish useable dose-response relationships and particle motion soundscapes.
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Affiliation(s)
- Loïc Prosnier
- Faculté des Sciences et Techniques, University of Saint Etienne, Saint-Etienne, France; France Travail, Saint-Etienne, France.
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Fazid S, Haq ZU, Gillani BH, Khan AJ, Khan MN, Khan A, Garzon C, Habib I, Tanimoune M, Ihtesham Y, Heald AH. Effectiveness of locally produced ready-to-use supplementary foods on the prevention of stunting in children aged 6-23 months: a community-based trial from Pakistan. Br J Nutr 2024; 131:1189-1195. [PMID: 38012887 PMCID: PMC10918516 DOI: 10.1017/s0007114523002702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 10/31/2023] [Accepted: 11/17/2023] [Indexed: 11/29/2023]
Abstract
Undernutrition is a major public health problem in developing countries. Around 40·2 % of children are stunted in Pakistan. This longitudinal study aimed to assess the effectiveness of locally produced ready-to-use supplementary foods in the prevention of stunting by detecting change in of children in intervention v. control arm against the 2006 WHO growth reference. A community-based non-randomised cluster-controlled trial was conducted from January 2018 to December 2020 in the district of Kurram, Khyber Pakhtunkhwa, Pakistan. A total of 80 clusters (each cluster comprising ≈ 250-300 households) were defined in the catchment population of twelve health facilities. Children aged 6-18 months were recruited n 1680. The intervention included a daily ration of 50 g - locally produced ready-to-use-supplementary food (Wawa-Mum). The main outcome of this study was a change in length for age z-score (LAZ) v. WHO growth standards. Comparison between the interventions was by t test and ANOVA. Cox proportional hazard models were used to assess the association between stunting occurrence and the utilisation of locally produced supplement. Out of the total 1680, fifty-one out of the total 1680, 51·1 out of the total 1680 and 51·1 % (n 859) were male. Mean age 13·9 months (sd + 859) were male. Mean age 13·9 months (sd + -4·4). At baseline, 36·9 % (n 618) were stunted. In the intervention group, mean LAZ score significantly increased from -1·13(2·2 sd) at baseline to -0·93(1·8 sd) at 6-month follow-up (P value 0·01) compared with the control group. The incidence rate of stunting in the intervention arm was 1·3 v. 3·4 per person year in the control arm. The control group had a significantly increased likelihood of stunting (Hazard Ratio (HR) 1·7, 95 % CI 1·46, 2·05, P value < 0·001) v. the intervention group. Locally produced ready-to-use supplementary food is an effective intervention for reducing stunting in children below 2 years of age. This can be provided as part of a malnutrition prevention package to overcome the alarming rates of stunting in Pakistan.
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Affiliation(s)
- Sheraz Fazid
- Institute of Public Health & Social Sciences, Khyber Medical University, Peshawar, Pakistan
| | - Zia Ul Haq
- Institute of Public Health & Social Sciences, Khyber Medical University, Peshawar, Pakistan
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | | | - Abdul Jalil Khan
- Institute of Public Health & Social Sciences, Khyber Medical University, Peshawar, Pakistan
| | - Muhammad Naseem Khan
- Department of Popualtion Medicine, College of Medicine, Qatar University, Doha, Qatar
| | - Aslam Khan
- Institute of Basic Medical Sciences, Khyber Medical University, Peshawar, Pakistan
| | | | | | | | | | - Adrian H. Heald
- Department of Diabetes and Endocrinology, Salford Royal Hospital, Salford, UK
- The School of Medicine, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
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Xu Z, Xu X, Sun L, Guo Z, Lai J, Kang L, Li J. Effectiveness of personalized meal recommendation in improving dietary behaviors of Chinese community-dwelling elders: study protocol for a cluster randomized controlled trial. Trials 2024; 25:252. [PMID: 38605376 PMCID: PMC11007920 DOI: 10.1186/s13063-023-07865-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 12/08/2023] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND Inappropriate eating behaviors, particularly a lack of food diversity and poor diet quality, have a significant impact on the prognosis of certain chronic conditions and exacerbate these conditions in the community-dwelling elderly population. Current dietary interventions for the elderly have not adequately considered the nutritional needs associated with multiple chronic conditions and personal dietary preferences of elderly individuals. A personalized recommendation system has been recognized as a promising approach to address this gap. However, its effectiveness as a component of an elderly-targeted dietary intervention in real-world settings remains unknown. Additionally, it is unclear whether this intervention approach will be user-friendly for the elderly. Therefore, this study aims to examine the effectiveness of a personalized meal recommendation system designed to improve dietary behavior in community-dwelling elders. The implementation process in terms of System usability and satisfaction will also be assessed. METHODS The trial has been designed as a 6-month, non-blinded, parallel two-arm trial. One hundred fifty community-dwelling elders who meet the eligibility criteria will be enrolled. Subjects will be allocated to either the intervention group, receiving personalized meal recommendations and access to corresponding food provided as one component of the intervention, as well as health education on elder nutrition topics, or the control group, which will receive nutritional health education lectures. Outcomes will be measured at three time points: baseline at 0 months, 3 months, and 6 months. The primary outcomes will include dietary diversity (DDS) and diet quality (CDGI-E) of enrolled community-dwelling elders, representing their dietary behavior improvement, along with dietary behavior adherence to recommended meals. Secondary outcomes will measure the perceived acceptability and usability of the personalized meal recommendation system for the intervention group. Exploratory outcomes will include changes in the nutritional status and anthropometric measurements of the community-dwelling elders. DISCUSSION This study aims to examine the effectiveness, acceptability, and usability of a personalized meal recommendation system as a data-driven dietary intervention to benefit community-dwelling elders. The successful implementation will inform the future development and integration of digital health strategies in daily nutrition support for the elderly. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR2300074912. Registered on August 20, 2023, https://www.chictr.org.cn/showproj.html?proj=127583.
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Affiliation(s)
- Zidu Xu
- School of Nursing, Columbia University, New York, NY, USA.
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, 3rd Yabao Road, Beijing, 100020, Chaoyang District, China.
| | - Xiaowei Xu
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, 3rd Yabao Road, Beijing, 100020, Chaoyang District, China
| | - Lianglong Sun
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, 3rd Yabao Road, Beijing, 100020, Chaoyang District, China
| | - Zhen Guo
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, 3rd Yabao Road, Beijing, 100020, Chaoyang District, China
| | - Jianqiang Lai
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing, China
| | - Lin Kang
- Department of Geriatrics, Peking Union Medical College Hospital, Beijing, China
| | - Jiao Li
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, 3rd Yabao Road, Beijing, 100020, Chaoyang District, China.
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12
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Rommerskirch-Manietta M, Manietta C, Hoffmann-Hoffrichter AL, Purwins D, Van Haitsma K, Abbott KM, Roes M. The PELI-D II Study: Development and Preliminary Validation of the Preferences for Leisure Activities Inventory (P-LAI) for Adult Day Services. Clin Gerontol 2024:1-14. [PMID: 38594970 DOI: 10.1080/07317115.2024.2341110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
OBJECTIVES The current study aimed to develop and preliminarily validate an initial version of an instrument to assess the leisure activity preferences of people receiving adult day services (ADS). METHODS Based on previously conducted concept mapping steps, we identified 12 clusters of preferences for leisure activities. We adopted the structure of the Preferences for Everyday Living Inventory and phrased our cluster labels as questions to develop a first draft of the Preferences for Leisure Activities Inventory (P-LAI). We conducted cognitive interviews (n = 8) to revise, preliminarily validate, and preliminarily finalize the P-LAI. RESULTS The draft of the P-LAI included 25 questions. Based on the results of the cognitive interviews, the number of questions was reduced to 21, three questions were rephrased, and evidence to support the preliminary validity of the P-LAI based on the response processes was provided. CONCLUSIONS The P-LAI is the first instrument to assess preferences for leisure activities in the ADS environment. CLINICAL IMPLICATIONS The preliminary results of the P-LAI allow ADS providers and healthcare professionals to assess the preferences for leisure activities of people who receive ADS in a structured way. Based on these results, preference-based services can be designed and planned, and the person-centered philosophy of care can be further operationalized in the ADS environment.
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Affiliation(s)
- Mike Rommerskirch-Manietta
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Witten, Germany
- Faculty of Health, School of Nursing Science, Witten/Herdecke University, Witten, Germany
| | - Christina Manietta
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Witten, Germany
- Faculty of Health, School of Nursing Science, Witten/Herdecke University, Witten, Germany
| | - Anna Louisa Hoffmann-Hoffrichter
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Witten, Germany
- Faculty of Health, School of Nursing Science, Witten/Herdecke University, Witten, Germany
| | - Daniel Purwins
- Diakonie Osnabrück, Stadt und Land gGmbh, Osnabrück, Germany
| | - Kimberly Van Haitsma
- College of Nursing, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Katherine M Abbott
- Department of Sociology and Gerontology, Miami University, Oxford, Ohio, USA
- Scripps Gerontology Center, Miami University, Oxford, Ohio, USA
| | - Martina Roes
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Witten, Germany
- Faculty of Health, School of Nursing Science, Witten/Herdecke University, Witten, Germany
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13
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Gertz AM, Smith M, Thomas D, Ti A, Vamos C, Bohn J. A qualitative study to explore experiences of anti-racism teaching in medical residency programs across the United States and subsequent creation of the SPOC (Support - Pipeline - Outcomes - Community) Model to guide future curricula design. BMC Med Educ 2024; 24:382. [PMID: 38589833 PMCID: PMC11003050 DOI: 10.1186/s12909-024-05305-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 03/13/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND Racism contributes to health disparities and is a serious threat to public health. Teaching physicians about racism, how to address it in medical practice, and developing high quality and sustainable curricula are essential to combating racism. OBJECTIVE This study aimed to (1) describe the experience of racism and anti-racism teaching in residency programs, and elicit recommendations from key informants, and (2) use these data and formative research to develop recommendations for other residencies creating, implementing, and evaluating anti-racism curricula in their own programs. METHODS From May to July 2023, 20 faculty and residents were recruited via convenience sampling for key informant interviews conducted via Microsoft Teams. Interviews were audio recorded, transcribed, and coded. An initial list of themes was developed using theoretical frameworks, and then refined using a grounded-theory approach. A brief online optional anonymous demographic survey was sent to participants in August of 2023. RESULTS: Eighty percent (20/25) of participants approached were interviewed. Seventy-five percent (15/20) answered a brief optional demographic survey. Seven themes emerged: (1) Racism in medicine is ubiquitous; (2) Anti-racism teaching in medicine varies widely; (3) Sustainability strategies should be multifaceted and include recruitment, resource allocation, and outcome measures; (4) Resources are widely available and accessible if one knows where to look; (5) Outcomes and metrics of success should include resident- faculty-, patient- community-, and system-focused outcomes; (6) Curricular strategies should be multilayered, longitudinal, and woven into the curriculum; and (7) Self-reflection and discomfort are necessary parts of the process. CONCLUSIONS: This study is one of the first to qualitatively examine perspectives of key stakeholders invested in anti-racism teaching for residents. The Support - Pipeline - Outcomes - Community (SPOC) Model, that was developed using information collected during this study, can be used in the future as a guide for others working to design and implement sustainable and high quality anti-racism curricula for residents.
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Affiliation(s)
- Alida M Gertz
- Wellstar Douglas Family Medicine Residency Program, Douglasville, GA, USA.
- College of Public Health, University of South Florida, Tampa, USA.
| | - Michele Smith
- Wellstar Douglas Family Medicine Residency Program, Douglasville, GA, USA
| | - Davon Thomas
- Wellstar Douglas Family Medicine Residency Program, Douglasville, GA, USA
| | - Angeline Ti
- Wellstar Douglas Family Medicine Residency Program, Douglasville, GA, USA
| | - Cheryl Vamos
- College of Public Health, University of South Florida, Tampa, USA
| | - Joe Bohn
- College of Public Health, University of South Florida, Tampa, USA
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14
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Walker BK, Fisco Becker D, Williams GJ, Kilfoyle AK, Smith SG, Kozachuk A. Regional reef fish assemblage maps provide baseline biogeography for tropicalization monitoring. Sci Rep 2024; 14:7893. [PMID: 38570549 PMCID: PMC10991435 DOI: 10.1038/s41598-024-58185-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 03/26/2024] [Indexed: 04/05/2024] Open
Abstract
The Anthropocene rise in global temperatures is facilitating the expansion of tropical species into historically non-native subtropical locales, including coral reef fish. This redistribution of species, known as tropicalization, has serious consequences for economic development, livelihoods, food security, human health, and culture. Measuring the tropicalization of subtropical reef fish assemblages is difficult due to expansive species ranges, temporal distribution shifts with the movement of isotherms, and many dynamic density-dependent factors affecting occurrence and density. Therefore, in locales where tropical and subtropical species co-occur, detecting tropicalization changes relies on regional analyses of the relative densities and occurrence of species. This study provides a baseline for monitoring reef fish tropicalization by utilizing extensive monitoring data from a pivotal location in southeast Florida along a known transition between tropical and subtropical ecotones to define regional reef fish assemblages and use benthic habitat maps to spatially represent their zoogeography. Assemblages varied significantly by ecoregion, habitat depth, habitat type, and topographic relief. Generally, the southern assemblages had higher occurrences and densities of tropical species, whereas the northern assemblages had a higher occurrence and density of subtropical species. A total of 108 species were exclusive to regions south of the Bahamas Fracture Zone (BFZ) (South Palm Beach, Deerfield, Broward-Miami) and 35 were exclusive to the north (North Palm Beach, Martin), supporting the BFZ as a pivotal location that affects the coastal biogeographic extent of tropical marine species in eastern North America. Future tropicalization of reef fish assemblages are expected to be evident in temporal deviance of percent occurrence and/or relative species densities between baseline assemblages, where the poleward expansion of tropical species is expected to show the homogenization of assemblage regions as adjacent regions become more similar or the regional boundaries expand poleward. Ecoregions, habitat depth, habitat type, and relief should be incorporated into the stratification and analyses of reef fish surveys to statistically determine assemblage differences across the seascape, including those from tropicalization.
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Affiliation(s)
- Brian K Walker
- GIS and Spatial Ecology Lab, Halmos College of Arts and Sciences, Nova Southeastern University, 8000 North Ocean Drive, Dania Beach, FL, 33004, USA.
| | - Dana Fisco Becker
- GIS and Spatial Ecology Lab, Halmos College of Arts and Sciences, Nova Southeastern University, 8000 North Ocean Drive, Dania Beach, FL, 33004, USA
| | - Gareth J Williams
- School of Ocean Sciences, Bangor University, Menai Bridge, Anglesey, LL59 5AB, UK
| | - Audie K Kilfoyle
- Resilient Environment Department, Broward County Florida, 115 S Andrews Ave, Room 329-H, Fort Lauderdale, FL, 33301, USA
| | - Steven G Smith
- Cooperative Institute for Marine and Atmospheric Studies, University of Miami's Rosenstiel School of Marine, Atmospheric, and Earth Science, 4600 Rickenbacker Causeway, Miami, FL, 33149, USA
| | - Allie Kozachuk
- GIS and Spatial Ecology Lab, Halmos College of Arts and Sciences, Nova Southeastern University, 8000 North Ocean Drive, Dania Beach, FL, 33004, USA
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15
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Davis A, Knudsen HK, Walker DM, Chassler D, Lunze K, Westgate PM, Oga E, Rodriguez S, Tan S, Holloway J, Walsh SL, Oser CB, Lefebvre RC, Fanucchi LC, Glasgow L, McAlearney AS, Surratt HL, Konstan MW, Huang TTK, LeBaron P, Nakayima J, Stein MD, Rudorf M, Nouvong M, Kinnard EN, El-Bassel N, Tilley J, Macoubray A, Savitzky C, Farmer A, Beers D, Salsberry P, Huerta TR. Effects of the Communities that Heal (CTH) intervention on perceived opioid-related community stigma in the HEALing Communities Study: results of a multi-site, community-level, cluster-randomized trial. Lancet Reg Health Am 2024; 32:100710. [PMID: 38510790 PMCID: PMC10950860 DOI: 10.1016/j.lana.2024.100710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 02/11/2024] [Accepted: 02/20/2024] [Indexed: 03/22/2024]
Abstract
Background Community stigma against people with opioid use disorder (OUD) and intervention stigma (e.g., toward naloxone) exacerbate the opioid overdose crisis. We examined the effects of the Communities that HEAL (CTH) intervention on perceived opioid-related community stigma by stakeholders in the HEALing Communities Study (HCS). Methods We collected three surveys from community coalition members in 66 communities across four states participating in HCS. Communities were randomized into Intervention (Wave 1) or Wait-list Control (Wave 2) arms. We conducted multilevel linear mixed models to compare changes in primary outcomes of community stigma toward people treated for OUD, naloxone, and medication for opioid use disorder (MOUD) by arm from time 1 (before the start of the intervention) to time 3 (end of the intervention period in the Intervention arm). Findings Intervention stakeholders reported a larger decrease in perceived community stigma toward people treated for OUD (adjusted mean change (AMC) -3.20 [95% C.I. -4.43, -1.98]) and toward MOUD (AMC -0.33 [95% C.I. -0.56, -0.09]) than stakeholders in Wait-list Control communities (AMC -0.18 [95% C.I. -1.38, 1.02], p = 0.0007 and AMC 0.11 [95% C.I. -0.09, 0.31], p = 0.0066). The relationship between intervention status and change in stigma toward MOUD was moderated by rural-urban status (urban AMC -0.59 [95% CI, -0.87, -0.32], rural AMC not sig.) and state. The difference in stigma toward naloxone between Intervention and Wait-list Control stakeholders was not statistically significant (p = 0.18). Interpretation The CTH intervention decreased stakeholder perceptions of community stigma toward people treated for OUD and stigma toward MOUD. Implementing the CTH intervention in other communities could decrease OUD stigma across diverse settings nationally. Funding US National Institute on Drug Abuse.
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Affiliation(s)
- Alissa Davis
- Columbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY, 10027, USA
| | - Hannah K. Knudsen
- Department of Behavioral Science and Center on Drug & Alcohol Research, University of Kentucky, 845 Angliana Avenue, Lexington, KY, 40508, USA
| | - Daniel M. Walker
- CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking College of Medicine, The Ohio State University, 700 Ackerman Rd., Suite 4000, Columbus, OH, 43202, USA
- Department of Family and Community Medicine, College of Medicine, The Ohio State University, 700 Ackerman Rd., Suite 5000, Columbus, OH, 43202, USA
| | - Deborah Chassler
- Boston University School of Social Work, 264-270 Bay State Road, Boston, MA, 02215, USA
| | - Karsten Lunze
- Boston University Chobanian & Avedisian School of Medicine/Boston Medical Center, Department of Medicine, 801 Massachusetts Ave., Boston, MA, 02118, USA
| | - Philip M. Westgate
- Department of Biostatistics, College of Public Health, University of Kentucky, 760 Press Avenue, Lexington, KY, 40536, USA
| | - Emmanuel Oga
- RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC, 27709, USA
| | - Sandra Rodriguez
- Columbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY, 10027, USA
| | - Sylvia Tan
- RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC, 27709, USA
| | - JaNae Holloway
- RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC, 27709, USA
| | - Sharon L. Walsh
- Department of Behavioral Science and Center on Drug & Alcohol Research, University of Kentucky, 845 Angliana Avenue, Lexington, KY, 40508, USA
| | - Carrie B. Oser
- Department of Sociology, Center on Drug and Alcohol Research, Center for Health Equity Transformation, University of Kentucky, 1531 Patterson Office Tower, Lexington, KY, 40506, USA
| | - R. Craig Lefebvre
- RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC, 27709, USA
| | - Laura C. Fanucchi
- Department of Medicine, Center on Drug and Alcohol Research, University of Kentucky, 845 Angliana Ave, Lexington, KY, 40508, USA
| | - LaShawn Glasgow
- RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC, 27709, USA
| | - Ann Scheck McAlearney
- CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking College of Medicine, The Ohio State University, 700 Ackerman Rd., Suite 4000, Columbus, OH, 43202, USA
- Department of Family and Community Medicine, College of Medicine, The Ohio State University, 700 Ackerman Rd., Suite 5000, Columbus, OH, 43202, USA
| | - Hilary L. Surratt
- Department of Behavioral Science and Center on Drug & Alcohol Research, University of Kentucky, 845 Angliana Avenue, Lexington, KY, 40508, USA
| | - Michael W. Konstan
- Case Western Reserve University School of Medicine, 10900 Euclid Avenue, Cleveland, OH, 44106, USA
| | - Terry T.-K. Huang
- Center for Systems and Community Design and NYU-CUNY Prevention Research Center, Graduate School of Public Health & Health Policy, City University of New York, 55 W. 125 Street, Room 803, New York, NY, 10027, USA
| | - Patricia LeBaron
- RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC, 27709, USA
| | - Julie Nakayima
- Department of Behavioral Science and Center on Drug & Alcohol Research, University of Kentucky, 845 Angliana Avenue, Lexington, KY, 40508, USA
| | - Michael D. Stein
- Department of Health Law, Policy and Management, Boston University School of Public Health, 715 Albany Street, Boston, MA, 02118, USA
| | - Maria Rudorf
- Boston Medical Center, Section of General Internal Medicine, 801 Massachusetts Avenue, Boston, MA, 02118, USA
| | - Monica Nouvong
- Boston Medical Center, Section of General Internal Medicine, 801 Massachusetts Avenue, Boston, MA, 02118, USA
| | - Elizabeth N. Kinnard
- Boston Medical Center, Section of General Internal Medicine, 801 Massachusetts Avenue, Boston, MA, 02118, USA
| | - Nabila El-Bassel
- Columbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY, 10027, USA
| | - Jess Tilley
- New England Drug Users Union, 36 Bedford Terrace, Suite 2, Northampton, MA, 01060, USA
| | - Aaron Macoubray
- RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC, 27709, USA
| | - Caroline Savitzky
- Boston Medical Center, Section of Infectious Diseases, 801 Massachusetts Ave., Boston, MA, 02118, USA
| | - Amy Farmer
- The Ohio State University College of Medicine, HEALing Communities Research, 530 W. Spring St., Suite 275, Columbus, OH, 43215, USA
| | - Donna Beers
- Boston Medical Center, Section of General Internal Medicine, 801 Massachusetts Avenue, Boston, MA, 02118, USA
| | - Pamela Salsberry
- The Ohio State University College of Public Health, 1841 Neil Ave., Columbus, OH, 43210, USA
| | - Timothy R. Huerta
- CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking College of Medicine, The Ohio State University, 700 Ackerman Rd., Suite 4000, Columbus, OH, 43202, USA
- Department of Family and Community Medicine, College of Medicine, The Ohio State University, 700 Ackerman Rd., Suite 5000, Columbus, OH, 43202, USA
- Department of Biomedical Informatics, College of Medicine, The Ohio State University, 1585 Neil Ave, Columbus, OH, 43210, USA
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Hochstetler E, Taweh O, Mistry AJ, Metz P. Worcester Refugee Assistance Project: An Example of Strengths-Based, Community-Based, Culturally Sensitive Care. Child Adolesc Psychiatr Clin N Am 2024; 33:263-276. [PMID: 38395510 DOI: 10.1016/j.chc.2023.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
Refugee populations are diverse and can present with a variety of unique and complex circumstances. The purpose of this article is to examine an organization that provides care to refugee youth, the ways in which this is accomplished, and a few of the challenges that have been faced. Specifically, the work of this organization will be examined using a Systems of Care philosophy to demonstrate how using these concepts can assist in providing sensitive, high-quality care.
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Affiliation(s)
- Emily Hochstetler
- University of Massachusetts, T.H. Chan School of Medicine, 55 Lake Avenue North, Worcester, MA 01655, USA.
| | - Omar Taweh
- University of Massachusetts, T.H. Chan School of Medicine, 55 Lake Avenue North, Worcester, MA 01655, USA
| | - Anushay J Mistry
- Children's Hospital Los Angeles, 4650 Sunset Boulevard, Los Angeles, CA 90027, USA
| | - Peter Metz
- University of Massachusetts, T.H. Chan School of Medicine, 55 Lake Avenue North, Worcester, MA 01655, USA
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17
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Scarnati K, Esser K, Sahloff EG, Duggan J. The Role of Community Pharmacies in Providing Access to HIV Post-exposure Prophylaxis (PEP). J Community Health 2024; 49:222-228. [PMID: 37759138 DOI: 10.1007/s10900-023-01281-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2023] [Indexed: 09/29/2023]
Abstract
HIV affects an estimated 1.2 million individuals in the United States and is disproportionately concentrated among African Americans, Latinos, and people of multiple races. Post-exposure prophylaxis (PEP) substantially decreases HIV transmission when started within 72 h after exposure, but problems of accessibility have hindered its widespread usage in communities at risk for HIV infection. Pharmacy-initiated PEP access was first permitted in New York City in 2017, allowing pharmacists to provide a 7-day supply of PEP without a prescription for consumers at high risk for HIV infection. It was expected that the broad reach and accessibility of community pharmacies would increase timely access to PEP for all individuals, especially those who already face significant barriers to accessing the healthcare system. Since then, eleven other states have followed suit and expanded the scope of outpatient pharmacy practice in order to increase the availability of HIV PEP but prescribing laws in over 75% of the US have not been changed. Much of the existing literature on HIV prevention focuses on PrEP access barriers with limited information on PEP access in the US. In this paper, we review the current status of pharmacist-initiated PEP in the US as part of the End the HIV Epidemic (EHE) initiative.
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Affiliation(s)
- Kaylee Scarnati
- Division of Infectious Disease/Department of Internal Medicine, University of Toledo, College of Medicine and Life Sciences, Toledo, USA
| | - Katherine Esser
- Division of Infectious Disease/Department of Internal Medicine, University of Toledo, College of Medicine and Life Sciences, Toledo, USA
| | - Eric G Sahloff
- Department of Pharmacy Practice, University of Toledo, College of Pharmacy and Pharmaceutical Sciences, Toledo, USA.
| | - Joan Duggan
- Division of Infectious Disease/Department of Internal Medicine, University of Toledo, College of Medicine and Life Sciences, Toledo, USA
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Awaad R, Hussein A, Durrani Z, Shareef S. The Development of a Novel Suicide Postvention Healing Model for Muslim Communities in the United States of America. J Relig Health 2024; 63:1002-1016. [PMID: 38006521 DOI: 10.1007/s10943-023-01949-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/30/2023] [Indexed: 11/27/2023]
Abstract
Suicide among American Muslims is understudied, despite recent research highlighting increased suicide attempts among this population. While suicide is forbidden in Islam, formal guidelines for addressing and responding to suicide within Muslim communities did not exist until recently. The Stanford Muslim Mental Health and Islamic Psychology Lab has responded to a number of suicides in Muslim communities across North America and implemented an original model for suicide response and community healing. This approach incorporates Islamic principles and values to create a culturally and religiously congruent response to suicide that can support loss survivors and steer impacted communities toward healing. The Muslim Postvention Community Healing session described in this paper aims to provide a safe space for individuals impacted by suicide to come together and process their emotions, while also using Islamic teachings to guide the healing process. This unique model has the potential to serve as a valuable resource for Muslim communities across North America, and beyond, in addressing and responding to suicide.
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Affiliation(s)
- Rania Awaad
- Muslim Mental Health and Islamic Psychology Lab, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
- Maristan, San Francisco Bay Area, Hayward, CA, USA.
| | - Anwar Hussein
- Department of Psychology, The University of Akron, 290 E Buchtel Ave, Akron, OH, 44325, USA
| | - Zuha Durrani
- Department of Psychiatry, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada
| | - Sana Shareef
- Department of Bioethics, School of Professional Studies, Columbia University, 2970 Broadway, New York, NY, 10027, USA
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Reagan L, Laguerre R, Todd S, Gallagher C. The Feasibility and Acceptability of a Diabetes Survival Skills Intervention for Persons Transitioning from Prison to the Community. J Racial Ethn Health Disparities 2024; 11:1014-1023. [PMID: 37154888 PMCID: PMC10166023 DOI: 10.1007/s40615-023-01581-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 03/25/2023] [Accepted: 03/27/2023] [Indexed: 05/10/2023]
Abstract
Community evidenced-based diabetes self-management education (DSME) models have not been examined for feasibility, acceptability, or effectiveness among persons transitioning from prison to the community to independent diabetes self-management (DSM). In a non-equivalent control group design with repeated measures, we examined the feasibility, acceptability, and preliminary effect of a 6-week, 1-h per week Diabetes Survival Skills (DSS) intervention on diabetes knowledge, distress, self-efficacy, and outcome expectancy for transitioning incarcerated males. Of the 92 participants (84% T2D, 83% using insulin, 40% Black, 20% White, 30% Latino, 66% high school or less, mean age 47.3 years, 84% length of incarceration ≤4 years ), 41 completed the study (22 control/19 intervention [TX]). One-way repeated measures ANOVAs revealed significant changes in diabetes knowledge within each group (C, p = .002; TX, p = .027) at all time points; however, a two-way repeated measures ANOVA showed no differences between groups. Additionally, both groups showed improvement in diabetes-related distress and outcome expectancy with the treatment group experiencing greater and sustained improvement at the 12-week time point. Analysis of focus group data (Krippendorf) revealed acceptance of and enthusiasm for the DSS training and low literacy education materials, the need for skill demonstration, and ongoing support throughout incarceration and before release. Our results highlight the complexity of working with incarcerated populations. After most of the sessions, we observed some information sharing between the intervention and the control groups on what they did in their respective sessions. Due to high attrition, the power to detect effects was limited. Yet, results suggest that the intervention is feasible and acceptable with an increased sample size and refined recruitment procedure. NCT05510531, 8/19/2022, retrospectively, registered.
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Affiliation(s)
- Louise Reagan
- University of Connecticut School of Nursing, 231 Glenbrook Road, Storrs, CT, U-4026, USA.
| | - Rick Laguerre
- Department of Psychological Sciences, University of Connecticut, Storrs, USA
- Department of Psychology, Montclair State University, Montclair, NJ, USA
| | - Sarah Todd
- University of Connecticut School of Nursing, 231 Glenbrook Road, Storrs, CT, U-4026, USA
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Awaad R, Durrani Z, Quadri Y, Sifat MS, Hussein A, Kouser T, El-Gabalawy O, Rajeh N, Shareef S. Developing a Suicide Crisis Response Team in America: An Islamic Perspective. J Relig Health 2024; 63:985-1001. [PMID: 38245908 DOI: 10.1007/s10943-023-01993-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/20/2023] [Indexed: 01/23/2024]
Abstract
Suicide is a critical public health issue in the United States, recognized as the tenth leading cause of death across all age groups (Centers for Disease Control and Prevention, 2020). Despite the Islamic prohibition on suicide, suicidal ideation and suicide mortality persist among Muslim populations. Recent data suggest that U.S. Muslim adults are particularly vulnerable, with a higher attempt history compared to respondents from other faith traditions. While the underlying reasons for this vulnerability are unclear, it is evident that culturally and religiously congruent mental health services can be utilized to steer suicide prevention, intervention, and postvention in Muslim communities across the United States. However, the development of Suicide Response toolkits specific to Muslim populations is currently limited. As a result, Muslim communities lack a detailed framework to appropriately respond in the event of a suicide tragedy. This paper aims to fill this gap in the literature by providing structured guidelines for the formation of a Crisis Response Team (CRT) through an Islamic lens. The CRT comprises of a group of individuals who are strategically positioned to respond to a suicide tragedy. Ideally, the team will include religious leaders, mental health professionals, healthcare providers, social workers, and community leaders. The proposed guidelines are designed to be culturally and religiously congruent and take into account the unique cultural and religious factors that influence Muslim communities' responses to suicide. By equipping key personnel in Muslim communities with the resources to intervene in an emergent situation, provide support to those affected, and mobilize community members to assist in prevention efforts, this model can help save lives and prevent future suicide tragedies in Muslim communities across the United States.
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Affiliation(s)
- Rania Awaad
- Department of Psychiatry and Behavioral Sciences, Muslim Mental Health and Islamic Psychology Lab, Stanford University School of Medicine, 401 Quarry Rd Ste 2114, MC 5723, Stanford, CA, 94305, USA.
- Maristan, 340 Annette Lane, Hayward, CA, 94541, USA.
| | - Zuha Durrani
- Department of Psychiatry, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada
| | - Yasmeen Quadri
- School of Medicine, Stanford University, 291 Campus Drive, Stanford, CA, 94305-5101, USA
| | - Munjireen S Sifat
- Department of Behavioral and Community Health, University of Maryland School of Public Health, College Park, MD, USA
- Health Promotion Research Center, University of Oklahoma Health Science Center, Oklahoma City, OK, USA
| | - Anwar Hussein
- Department of Psychology, The University of Akron, 290 E Buchtel Ave, Akron, OH, 44325, USA
| | - Taimur Kouser
- School of Medicine, Stanford University, 291 Campus Drive, Stanford, CA, 94305-5101, USA
| | - Osama El-Gabalawy
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Neshwa Rajeh
- Department of Professional Studies, Northwestern University, 633 Clark Street, Evanston, IL, 60208, USA
| | - Sana Shareef
- School of Professional Studies, Department of Bioethics, Columbia University, 2970 Broadway, New York, NY, 10027, USA
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Shimada H, Doi T, Tsutsumimoto K, Makino K, Harada K, Tomida K, Morikawa M, Arai H. Combined impact of physical frailty and social isolation on use of long-term care insurance in Japan: A longitudinal observational study. Maturitas 2024; 182:107921. [PMID: 38295504 DOI: 10.1016/j.maturitas.2024.107921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 01/07/2024] [Accepted: 01/17/2024] [Indexed: 02/02/2024]
Abstract
OBJECTIVES The combined effect of physical frailty and social isolation on the need to make use of long-term care insurance (LTCI) among older adults remains unknown. Thus this study investigates the association between physical frailty, social isolation, and the use of LTCI among older adults in Japan. STUDY DESIGN This is a prospective observational study. MAIN OUTCOME MEASURES Physical frailty is defined as limitations in strength, mobility, and physical activity, as well as exhaustion and weight loss. People with one or two indicators were categorized as pre-frail. Participants with a score of 1 point or more on the social isolation scale were defined as being socially isolated. Participants were followed up monthly for two years to check whether incident certification of care had been required. RESULTS Data on 4576 community-dwelling independent older adults (mean age, 73.9 ± 5.5 years, 2032 men, 2544 women) were analyzed. A time-dependent Cox proportional hazards regression model showed that individuals with pre-frailty without social isolation (hazard ratio [HR] 2.02, 95 % confidence interval [CI] 1.40-2.91), pre-frailty with social isolation (HR 2.36, 95 % CI 1.62-3.43), frailty without social isolation (HR 2.98, 95 % CI 1.83-4.85), and frailty with social isolation (HR 3.19, 95 % CI 2.07-4.91) had significantly higher risks of needing to make use of LTCI than those with no frailty and without social isolation. This higher risk was non-significant among individuals with no frailty and social isolation (HR 1.28, 95 % CI 0.78-2.10). CONCLUSION Combined frailty and social isolation among older adults should be addressed to prevent adverse health outcomes, including use of LTCI.
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Affiliation(s)
- Hiroyuki Shimada
- Department of Preventive Gerontology, Centre for Gerontology and Social Science, National Centre for Geriatrics and Gerontology, Obu, Japan.
| | - Takehiko Doi
- Department of Preventive Gerontology, Centre for Gerontology and Social Science, National Centre for Geriatrics and Gerontology, Obu, Japan
| | - Kota Tsutsumimoto
- Department of Preventive Gerontology, Centre for Gerontology and Social Science, National Centre for Geriatrics and Gerontology, Obu, Japan
| | - Keitaro Makino
- Department of Preventive Gerontology, Centre for Gerontology and Social Science, National Centre for Geriatrics and Gerontology, Obu, Japan
| | - Kenji Harada
- Department of Preventive Gerontology, Centre for Gerontology and Social Science, National Centre for Geriatrics and Gerontology, Obu, Japan
| | - Kouki Tomida
- Department of Preventive Gerontology, Centre for Gerontology and Social Science, National Centre for Geriatrics and Gerontology, Obu, Japan
| | - Masanori Morikawa
- Department of Preventive Gerontology, Centre for Gerontology and Social Science, National Centre for Geriatrics and Gerontology, Obu, Japan
| | - Hidenori Arai
- Centre for Gerontology and Social Science, National Centre for Geriatrics and Gerontology, Obu, Japan
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22
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Xu L, Chen Y, Chen S, Wang G, Fu Y, Cai J, Yang X, Wu S, Miao C, Hong J. Relationship between resting heart rate and long-term outcomes in stabilized patients with myocardial infarction: A prospective community-based cohort study. Int J Cardiol 2024; 400:131811. [PMID: 38278489 DOI: 10.1016/j.ijcard.2024.131811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 01/11/2024] [Accepted: 01/22/2024] [Indexed: 01/28/2024]
Abstract
BACKGROUND Resting heart rate (RHR) during hospitalization has been shown to be associated with adverse outcomes in patients with myocardial infarction (MI). This study aimed to evaluate the long-term prognostic effect of RHR during the stable phase after MI in post-MI patients. METHODS Patients who had prior or new-onset MI and RHR measurements during the stable period after MI between 2006 and 2018 in the community-based Kailuan Study were enrolled. RHR was divided into four groups based on quartiles. Cox regression analysis was used to analyze the association of RHR with primary composite outcome of all-cause death, hospitalization for heart failure (HF), stroke, and recurrent MI and its components. RESULTS A total of 4447 post-MI patients were included. During a median follow-up of 7.5 years, 1813 patients (40.8%) developed primary outcomes. Compared to RHR ≤67 bpm, patients with 72 < RHR ≤80 bpm and RHR >80 bpm had increased risks of primary outcome, with adjusted hazard ratios (95% confidence intervals) of 1.23 (1.08-1.40) and 1.35 (1.18-1.55), respectively. The risk of primary outcome increased by 12% (1.07-1.17) for each 10-bpm increase in RHR. Similar results were observed in all-cause death and hospitalization for HF. Restricted cubic splines revealed a linear relationship between RHR and primary outcome, all-cause death, and hospitalization for HF (P for nonlinearity >0.05). CONCLUSIONS RHR during the stable phase after MI was an independent predictor for primary outcome and all-cause death in post-MI patients, and RHR >72 bpm was associated with increased risk for primary outcome and all-cause death.
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Affiliation(s)
- Lina Xu
- Department of Critical Care Medicine, Shanghai General Hospital of Nanjing Medical University, Shanghai, China
| | - Yonggang Chen
- Department of Cardiology, Tangshan Central Hospital, Tangshan, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Guodong Wang
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Yu Fu
- Department of Emergency and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jingyi Cai
- Department of Emergency and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xinying Yang
- Department of Cardiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China.
| | - Congliang Miao
- Department of Emergency and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Jiang Hong
- Department of Critical Care Medicine, Shanghai General Hospital of Nanjing Medical University, Shanghai, China.
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Morikawa M, Harada K, Kurita S, Nishijima C, Fujii K, Kakita D, Yamashiro Y, Takayanagi N, Sudo M, Shimada H. Estimating the Effect of Engagement in Community-Based Going-Out Program on Incidence Disability in Older Adults. J Am Med Dir Assoc 2024:S1525-8610(24)00164-6. [PMID: 38569560 DOI: 10.1016/j.jamda.2024.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 02/14/2024] [Accepted: 02/20/2024] [Indexed: 04/05/2024]
Abstract
OBJECTIVES Although going out has been reported to be associated with the incidence of disability, few studies have investigated the effect of community-based programs to promote going out on the incidence of disability. This study aimed to estimate the effects of a program fostering going-out on the incidence of disability in community-dwelling older adults. DESIGN Longitudinal, observational study. SETTING AND PARTICIPANTS Nonengaged (n = 1086) and engaged older adults (n = 1086) enrolled in the National Center for Geriatrics and Gerontology Study of Geriatric Syndrome by using a one-to-one nearest neighbor propensity score-matching scheme. METHODS After the baseline assessments, participants in the community-based going-out program received a specialized physical activity tracker, monitored their daily physical activity, and received personalized feedback on going out to community facilities with a system for reading the device for 12 months. Disability onset was defined as a new case of long-term care under the public insurance certification in Japan within 48 months of program completion. The absolute risk reduction and the number needed to treat for the incidence of disability were calculated for the nonengaged and engaged groups. Cox proportional hazard regression analysis, using inverse probability weighting was used to obtain the hazard ratio. RESULTS Disabilities occurred in 112 individuals in the matched nonengaged group and 51 individuals in the engaged group. The absolute risk reduction was 5.67% (95% CI 3.46%-7.88%). The number needed to treat was 18 (95% CI 13-29). The hazard ratio, with the nonengaged group as the reference, was 0.49 (95% CI 0.36-0.67). CONCLUSIONS AND IMPLICATIONS This longitudinal observational study suggested that a community-based program could prevent 1 disability in every 18 participants. This program does not require a professional instructor, only the distribution of devices and system installation, and it could be beneficial as a population-based approach to preventing disabilities.
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Affiliation(s)
- Masanori Morikawa
- Department of Preventive Geronotology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan; Japan Society for the Promotion of Science, Chiyoda-ku, Tokyo, Japan.
| | - Kenji Harada
- Department of Preventive Geronotology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Satoshi Kurita
- Department of Preventive Geronotology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Chiharu Nishijima
- Department of Preventive Geronotology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Kazuya Fujii
- Department of Preventive Geronotology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Daisuke Kakita
- Department of Preventive Geronotology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Yukari Yamashiro
- Tokyo Research Laboratories, Kao Corporation, Sumida-Ku, Tokyo, Japan
| | - Naoto Takayanagi
- Tokyo Research Laboratories, Kao Corporation, Sumida-Ku, Tokyo, Japan
| | - Motoki Sudo
- Tokyo Research Laboratories, Kao Corporation, Sumida-Ku, Tokyo, Japan
| | - Hiroyuki Shimada
- Department of Preventive Geronotology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
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Claisse C, Durrant AC, Branley-Bell D, Sillence E, Glascott A, Cameron A. 'Chugging along, plugging in and out of it': Understanding a place-based approach for community-based support of mental health recovery. Soc Sci Med 2024; 348:116823. [PMID: 38579629 DOI: 10.1016/j.socscimed.2024.116823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 03/14/2024] [Accepted: 03/21/2024] [Indexed: 04/07/2024]
Abstract
Community-based Mental Health (MH) organisations in the United Kingdom (UK) are facing challenges for sustaining in-person service delivery. Without empirical evidence that demonstrates the value of a place-based approach for MH recovery, and the types of resources needed to build nurturing spaces for peer support, community-based MH organisations will struggle to maintain their physical spaces. We present empirical insights from a case study involving interviews with 20 students accessing peer support services at the Recovery College Collective, a community-based MH organisation located in the North East of England. The interview study aims to evidence how a place-based approach can afford MH recovery. We draw from discourses on place-making and interpret our interview findings through an established framework that highlights four mechanisms through which place impacts recovery: place for doing, being, becoming and belonging. We use this framework to structure our findings and highlight key qualities of place for establishing and maintaining MH recovery. Our contribution is two-fold: we address a gap in the literature by providing empirical understandings of how place influences MH recovery, whilst extending previous research by considering the role that place plays in community-based organisations. This is timely because of the challenges faced in securing in-person service delivery post-pandemic, and a shift towards remote service provision models. We highlight key implications: (i) Accessing a physical place dedicated to MH support is vital for people who do not have anywhere else to go and are socially isolated due to their health conditions; (ii) Connecting through peer-to-peer interaction is an integral part of the recovery process, and learning from people with lived experience can inform a place-based approach that best suit their needs; and (iii) Recognising the value of place for MH support, and the resources needed for peer support delivery in the community, will help secure places that our research participants described as lifesaving.
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Affiliation(s)
- Caroline Claisse
- Open Lab, School of Computing, Newcastle University, Newcastle Upon Tyne, UK.
| | - Abigail C Durrant
- Open Lab, School of Computing, Newcastle University, Newcastle Upon Tyne, UK.
| | - Dawn Branley-Bell
- Department of Psychology, PaCT Lab, Northumbria University, Newcastle Upon Tyne, UK.
| | - Elizabeth Sillence
- Department of Psychology, PaCT Lab, Northumbria University, Newcastle Upon Tyne, UK.
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Sfriso AA, Juhmani AS, Tomio Y, Sfriso A, Rizzolio F, Adeel M, Wahsha M, Munari C, Mistri M. Microplastic accumulation and ecological impacts on benthic invertebrates: Insights from a microcosm experiment. Mar Pollut Bull 2024; 202:116231. [PMID: 38554685 DOI: 10.1016/j.marpolbul.2024.116231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 03/02/2024] [Accepted: 03/03/2024] [Indexed: 04/02/2024]
Abstract
Microplastic (MP) pollution poses a global concern, especially for benthic invertebrates. This one-month study investigated the accumulation of small MP polymers (polypropylene and polyester resin, 3-500 μm, 250 μg L-1) in benthic invertebrates and on one alga species. Results revealed species-specific preferences for MP size and type, driven by ingestion, adhesion, or avoidance behaviours. Polyester resin accumulated in Mytilus galloprovincialis, Chamelea gallina, Hexaplex trunculus, and Paranemonia cinerea, while polypropylene accumulated on Ulva rigida. Over time, MP accumulation decreased in count but not size, averaging 6.2 ± 5.0 particles per individual after a month. MP were mainly found inside of the organisms, especially in the gut, gills, and gonads and externally adherent MP ranged from 11 to 35 % of the total. Biochemical energy assessments after two weeks of MP exposure indicated energy gains for water column species but energy loss for sediment-associated species, highlighting the susceptibility of infaunal benthic communities to MP contamination.
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Affiliation(s)
- Andrea Augusto Sfriso
- Department of Chemical, Pharmaceutical and Agricultural Sciences, University of Ferrara, Via Fossato di Mortara 17, 44121 Ferrara, Italy.
| | - Abdul-Salam Juhmani
- Department of Biology and Biotechnology, Faculty of Science, The Hashemite University, Zarqa 13133, Jordan
| | - Yari Tomio
- Department of Environmental Sciences, Informatics and Statistics, Ca'Foscari University of Venice, Via Torino, 155, 30170 Venezia-Mestre, Italy
| | - Adriano Sfriso
- Department of Environmental Sciences, Informatics and Statistics, Ca'Foscari University of Venice, Via Torino, 155, 30170 Venezia-Mestre, Italy
| | - Flavio Rizzolio
- Department of Molecular Sciences and Nanosystems, Ca'Foscari University of Venice, Via Torino 155, 30170 Venezia-Mestre, Italy
| | - Muhammed Adeel
- Department of Molecular Sciences and Nanosystems, Ca'Foscari University of Venice, Via Torino 155, 30170 Venezia-Mestre, Italy
| | - Mohammad Wahsha
- Marine Science Station, The University of Jordan, Aqaba Branch, Aqaba 77110, Jordan
| | - Cristina Munari
- Department of Chemical, Pharmaceutical and Agricultural Sciences, University of Ferrara, Via Fossato di Mortara 17, 44121 Ferrara, Italy
| | - Michele Mistri
- Department of Chemical, Pharmaceutical and Agricultural Sciences, University of Ferrara, Via Fossato di Mortara 17, 44121 Ferrara, Italy
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Oni TO, Okunlola DA. Contextual determinants of generational continuation of female genital mutilation among women of reproductive age in nigeria: analysis of the 2018 demographic and health survey. Reprod Health 2024; 21:39. [PMID: 38532404 DOI: 10.1186/s12978-024-01778-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 03/21/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND Female genital mutilation (FGM) has negative health implications and has long been recognised as violating sexual rights. Despite the huge efforts expended on eradicating FGM, generational continuation of the practice, i.e. the act of mutilated women also mutilating their daughters, persists in Nigeria. This study investigated the individual, household, and community factors associated with generational continuation of FGM among women in Nigeria. METHODS The study analysed data from the 2018 Nigeria Demographic and Health Survey (NDHS). A weighted sample of 3835 women with FGM history and who had given birth to female children was analysed. Models were estimated using mixed-effects multilevel logistic regression with Stata 16.0. RESULTS The results showed that 40.0% of women continued FGM for their daughters. Regional prevalence of FGM continuation ranged from 14.9% in the South-South (the lowest) to 64.3% in the North-West (the highest). Women aged 15-24 years (uaOR = 0.40; 95% CI:0.28-0.57) and rich (uaOR = 0.44; 95% CI:0.35-0.56) had the least likelihood of generational continuation of FGM. In communities with low proportions of women unexposed to the media, the likelihood of FGM continuation was significantly higher (uaOR = 1.85; 95% CI:1.35-2.53). Generational continuation of FGM was significantly lower in communities with moderate proportions of uneducated mothers (aOR = 0.6; 95% CI:0.42-0.86). CONCLUSION FGM continuation was high in Nigeria, and it was most common among older and poor mothers and in communities with large proportions of uneducated women and those unexposed to the media. Existing National Policy and Plan on FGM elimination should be strengthened to target these characteristics.
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Affiliation(s)
- Tosin Olajide Oni
- Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Nigeria.
| | - David Aduragbemi Okunlola
- Department of Sociology, College of Social Sciences and Public Policy, Florida State University, Tallahassee, Florida, USA
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Bouilloud M, Galan M, Pradel J, Loiseau A, Ferrero J, Gallet R, Roche B, Charbonnel N. Exploring the potential effects of forest urbanization on the interplay between small mammal communities and their gut microbiota. Anim Microbiome 2024; 6:16. [PMID: 38528597 DOI: 10.1186/s42523-024-00301-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 03/06/2024] [Indexed: 03/27/2024] Open
Abstract
Urbanization significantly impacts wild populations, favoring urban dweller species over those that are unable to adapt to rapid changes. These differential adaptative abilities could be mediated by the microbiome, which may modulate the host phenotype rapidly through a high degree of flexibility. Conversely, under anthropic perturbations, the microbiota of some species could be disrupted, resulting in dysbiosis and negative impacts on host fitness. The links between the impact of urbanization on host communities and their gut microbiota (GM) have only been scarcely explored. In this study, we tested the hypothesis that the bacterial composition of the GM could play a role in host adaptation to urban environments. We described the GM of several species of small terrestrial mammals sampled in forested areas along a gradient of urbanization, using a 16S metabarcoding approach. We tested whether urbanization led to changes in small mammal communities and in their GM, considering the presence and abundance of bacterial taxa and their putative functions. This enabled to decipher the processes underlying these changes. We found potential impacts of urbanization on small mammal communities and their GM. The urban dweller species had a lower bacterial taxonomic diversity but a higher functional diversity and a different composition compared to urban adapter species. Their GM assembly was mostly governed by stochastic effects, potentially indicating dysbiosis. Selection processes and an overabundance of functions were detected that could be associated with adaptation to urban environments despite dysbiosis. In urban adapter species, the GM functional diversity and composition remained relatively stable along the urbanization gradient. This observation can be explained by functional redundancy, where certain taxa express the same function. This could favor the adaptation of urban adapter species in various environments, including urban settings. We can therefore assume that there are feedbacks between the gut microbiota and host species within communities, enabling rapid adaptation.
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Affiliation(s)
- Marie Bouilloud
- CBGP, IRD, CIRAD, INRAE, Institut Agro, Univ Montpellier, Montpellier, France.
- Centre de Biologie pour la Gestion des Populations, 750 Avenue Agropolis, 34988, Montferrier sur Lez, France.
| | - Maxime Galan
- CBGP, IRD, CIRAD, INRAE, Institut Agro, Univ Montpellier, Montpellier, France
| | - Julien Pradel
- CBGP, IRD, CIRAD, INRAE, Institut Agro, Univ Montpellier, Montpellier, France
| | - Anne Loiseau
- CBGP, IRD, CIRAD, INRAE, Institut Agro, Univ Montpellier, Montpellier, France
| | - Julien Ferrero
- CBGP, IRD, CIRAD, INRAE, Institut Agro, Univ Montpellier, Montpellier, France
| | - Romain Gallet
- CBGP, IRD, CIRAD, INRAE, Institut Agro, Univ Montpellier, Montpellier, France
| | - Benjamin Roche
- MIVEGEC, IRD, CNRS, Univ Montpellier, Montpellier, France
| | - Nathalie Charbonnel
- CBGP, IRD, CIRAD, INRAE, Institut Agro, Univ Montpellier, Montpellier, France
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Middleton G, Johnson BJ, Dutch D, Trost SG, Byrne R, Christian HE, Henry A, Terranova CO, Williams KE, Chai LK, Brookes DSK, Simon K, Golley RK. A great way to bring up health behaviour topics at playgroup: a qualitative evaluation of the Healthy Conversations @ Playgroup program. BMC Public Health 2024; 24:890. [PMID: 38528500 PMCID: PMC10962158 DOI: 10.1186/s12889-024-17703-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 01/08/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND The early years is a critical stage to establish optimal nutrition and movement behaviours. Community playgroups are a relaxed environment for parents with a focus on social connection and supporting parents in their role as 'First Teachers'. Playgroups are therefore an opportunistic setting to promote health behaviours in the early years. To support parents with young children around healthy lifestyle behaviours, the Healthy Conversations @ Playgroup program was delivered in urban and regional areas, across three Australian jurisdictions between 2021-2023. OBJECTIVE This qualitative evaluation aimed to understand how the Healthy Conversations @ Playgroup program was experienced by parents, playgroup coordinators and peer facilitators. DESIGN Semi-structured virtual interviews and focus groups were conducted with parents, playgroup coordinators (i.e., person responsible for coordinating the playgroup) and peer facilitators (i.e., trained facilitator for the program) that participated in the Healthy Conversations @ Playgroup study. Transcripts were analysed following a thematic analysis approach. RESULTS Twenty-eight playgroup parents, coordinators or peer facilitators participated in one of 8 focus groups or 5 interviews. Four themes were developed: Program strengths and challenges; Setting strengths and challenges; Factors that impact program delivery; Participant's suggestions for future program delivery. CONCLUSIONS The Healthy Conversations @ Playgroup program was valued by parents, providing validation and normalisation of parenting practices, and fostering a shared experience of parenting. Playgroups are a convenient setting for families to attend. The dynamic and distracting nature of the playgroup setting were carefully considered when designing the program. Strategies to further enhance program engagement could include use of coordinator or parent champions, tailored delivery, and extending the reach to other family members. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12621000055808, registered 22 January 2021, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380890.
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Affiliation(s)
- Georgia Middleton
- Flinders University, College of Nursing and Health Sciences, Caring Futures Institute, Adelaide, SA, Australia
| | - Brittany J Johnson
- Flinders University, College of Nursing and Health Sciences, Caring Futures Institute, Adelaide, SA, Australia.
| | - Dimity Dutch
- Flinders University, College of Nursing and Health Sciences, Caring Futures Institute, Adelaide, SA, Australia
| | - Stewart G Trost
- School of Human Movement and Nutrition Sciences, The University of Queensland Australia, Brisbane, QLD, Australia
| | - Rebecca Byrne
- Faculty of Health, School of Exercise and Nutrition Science, Queensland University of Technology, Brisbane, QLD, Australia
| | - Hayley E Christian
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
- School of Population and Global Health, The University of Western Australia, Perth, WA, Australia
| | - Anna Henry
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Caroline O Terranova
- Faculty of Health, School of Exercise and Nutrition Science, Queensland University of Technology, Brisbane, QLD, Australia
| | - Kate E Williams
- Centre for Child and Family Studies, School of Early Childhood and Inclusive Education, Queensland University of Technology, Brisbane, QLD, Australia
| | - Li Kheng Chai
- Faculty of Health, School of Exercise and Nutrition Science, Queensland University of Technology, Brisbane, QLD, Australia
- Health and Wellbeing Queensland, Queensland Government, Brisbane, QLD, Australia
| | - Denise S K Brookes
- Faculty of Health, School of Exercise and Nutrition Science, Queensland University of Technology, Brisbane, QLD, Australia
| | - Kate Simon
- Faculty of Health, School of Exercise and Nutrition Science, Queensland University of Technology, Brisbane, QLD, Australia
| | - Rebecca K Golley
- Flinders University, College of Nursing and Health Sciences, Caring Futures Institute, Adelaide, SA, Australia.
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Zuo C, Yang X, Wu X, Fan R, Liu J, Xiang H, Li Y, Zhao X, Liu X, Liu Y. Medication non-adherence and self-inflicted violence behaviors among 185,800 patients with schizophrenia in the community: a 12-year cohort study. BMC Med 2024; 22:136. [PMID: 38523268 PMCID: PMC10962179 DOI: 10.1186/s12916-024-03354-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 03/13/2024] [Indexed: 03/26/2024] Open
Abstract
BACKGROUND Despite the importance of medication adherence in treatment effectiveness, little is known about the association between medication non-adherence and self-inflicted violence behaviors. We aimed to assess whether medication non-adherence increased the risk of self-inflicted violence behaviors among schizophrenics in communities (hypothesis 1) and whether the dose-response relationship existed (hypothesis 2). METHODS This 12-year cohort study in western China recruited 292,667 community-dwelling schizophrenics. The proportion of regular medication (PRM) was calculated by dividing the time of "regular adherence" by the total time of antipsychotic treatment during follow-up period as an indicator of medication adherence. For hypothesis 1, medication adherence was designated as a binary variable with a threshold of 0.8 (PRM); for hypothesis 2, medication adherence was specified as five-category and continuous variables, respectively. Inverse probability weighting and mixed effects Cox proportional hazards models were conducted for confounders control and survival analyses. RESULTS One hundred eighty-five thousand eight hundred participants were eligible for the final analyses, with a mean age of 47.49 years (SD 14.55 years), of whom 53.6% were female. For hypothesis 1, the medication non-adherence group (PRM < 0.8) had a lower risk of suicide (HR, 0.527, 95% CI, 0.447-0.620), an increased risk of NSSI (HR, 1.229, 95% CI, 1.088-1.388), and non-significant risk of attempted suicide compared with adherence group (PRM ≥ 0.8). For hypothesis 2, the lowest medication adherence (PRM < 0.2) was associated with increased risks of suicide attempt (HR, 1.614, 95% CI, 1.412-1.845), NSSI (HR, 1.873, 95% CI, 1.649-2.126), and a decreased risk of suicide (HR, 0.593, 95% CI, 0.490-0.719). The other non-adherence groups had lower risks for all three self-inflicted violence behaviors. The associations between medication adherence in continuous-variable and three outcomes were consistent with the categorical medication adherence results. CONCLUSIONS Almost no medication taken as prescribed was associated with an increased risk of suicide attempt and NSSI. However, medication adherence did not appear to prevent completed suicide. Besides, patients with moderate adherence had a lower incidence of suicide attempt and NSSI. These findings highlight the need for a more detailed portrayal of medication adherence and the need to be vigilant for suicide intent in schizophrenics with good medication adherence who may be overlooked previously.
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Affiliation(s)
- Chuanlong Zuo
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.17, Section 3, Renmin South Road, Chengdu, Sichuan, 610041, China
| | - Xianmei Yang
- Sichuan Mental Health Center, The Third Hospital of Mianyang, No. 190, Jiannan East Road, Mianyang, Sichuan, 621000, China
| | - Xiangrui Wu
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.17, Section 3, Renmin South Road, Chengdu, Sichuan, 610041, China
| | - Ruoxin Fan
- Sichuan Mental Health Center, The Third Hospital of Mianyang, No. 190, Jiannan East Road, Mianyang, Sichuan, 621000, China
| | - Jun Liu
- Sichuan Mental Health Center, The Third Hospital of Mianyang, No. 190, Jiannan East Road, Mianyang, Sichuan, 621000, China
| | - Hu Xiang
- Sichuan Mental Health Center, The Third Hospital of Mianyang, No. 190, Jiannan East Road, Mianyang, Sichuan, 621000, China
| | - Yang Li
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.17, Section 3, Renmin South Road, Chengdu, Sichuan, 610041, China
| | - Xing Zhao
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.17, Section 3, Renmin South Road, Chengdu, Sichuan, 610041, China
| | - Xiang Liu
- Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.17, Section 3, Renmin South Road, Chengdu, Sichuan, 610041, China.
| | - Yuanyuan Liu
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.17, Section 3, Renmin South Road, Chengdu, Sichuan, 610041, China.
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Keates N, Martin F, Waldock KE. Autistic People's Perspectives on Functioning Labels and Associated Reasons, and Community Connectedness. J Autism Dev Disord 2024:10.1007/s10803-024-06316-3. [PMID: 38507152 DOI: 10.1007/s10803-024-06316-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2024] [Indexed: 03/22/2024]
Abstract
PURPOSE Functioning labels have been used in relation to autistic people and differentiating between support needs. The main purpose of our study was to identify perspectives regarding language about being autistic. In regard to themselves and functioning. Furthermore, we investigated the influential factor of community connectedness on use of language acceptability and functioning labels. METHODS 516 autistic respondents completed our survey. We asked about demographic characteristics, how respondents would like autistic people to be termed in the survey, and their acceptability (person with autism, Aspergers, disorder, conditions, living with autism, autistic). We also asked about respondents? Autistic Community Connectedness, acknowledging the implicit nature of language and identity (Stets & Serpe in New directions in identity theory and research, Oxford University Press, 2016). The main focus of our survey was whether or not to use functioning labels, and the supporting rationale. RESULTS Qualitative study using Merleau-Ponty's hermeneutic phenomenology as a philosophical framework. Data collection took place between 2020 and 2021 in a southern Spanish province. A total of 22 in-depth interviews were conducted using open-ended questions until data saturation was reached. RESULTS 97% of respondents stated that they find the term 'autistic' acceptable. Respondents who did see merit in using functioning labels to describe autistic people also reported not necessarily using them about themselves. Community membership was found to impact the participants' language preferences to describe the support needs of autistic people, including the use of functioning labels. CONCLUSION The proposed best option for language preferences is not to find consensus but instead, opt for the optimal choice that people find the least offensive or disagreeable. This means using identity-first language and not using functioning labels.
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Affiliation(s)
- Nathan Keates
- University of Sunderland in London, 197 Marsh Wall, Docklands, London, E14 9SG, UK.
| | - Farradeh Martin
- School of History, University of Kent, Canterbury, Kent, CT2 7NZ, UK
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O'Halloran SA, Hayward J, Valdivia Cabrera M, Felmingham T, Fraser P, Needham C, Poorter J, Creighton D, Johnstone M, Nichols M, Allender S. The common drivers of children and young people's health and wellbeing across 13 local government areas: a systems view. BMC Public Health 2024; 24:847. [PMID: 38504205 PMCID: PMC10949822 DOI: 10.1186/s12889-024-18354-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 03/13/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND System dynamics approaches, including group model building (GMB) and causal loop diagrams (CLDs), can be used to document complex public health problems from a community perspective. This paper aims to apply Social Network Analysis (SNA) methods to combine multiple CLDs created by local communities into a summary CLD, to identify common drivers of the health and wellbeing of children and young people. METHODS Thirteen community CLDs regarding children and young people health and wellbeing were merged into one diagram involving three steps: (1) combining variable names; (2) CLD merging, where multiple CLDs were combined into one CLD with a set of unique variables and connections; (3) paring, where the Decision-Making Trial and Evaluation Laboratory (DEMATEL) method was used to generate a cut-point to reduce the number of variables and connections and to rank the overall importance of each variable in the merged CLD. RESULTS Combining variable names resulted in 290 variables across the 13 CLDS. A total of 1,042 causal links were identified in the merged CLD. The DEMATEL analysis of the merged CLD identified 23 common variables with a net importance between 1.0 and 4.5 R + C values and 57 causal links. The variables with the highest net importance were 'mental health' and 'social connection & support' classified as high net receivers of influence within the system. CONCLUSIONS Combining large CLDs into a simple diagram represents a generalisable model of the drivers of complex health problems.
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Affiliation(s)
- Siobhan A O'Halloran
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, VIC, 3220, Australia.
| | - Joshua Hayward
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, VIC, 3220, Australia
| | - Melissa Valdivia Cabrera
- Institute for Intelligent Systems Research and Innovation, Deakin University, 75 Pigdons Rd, Waurn Ponds, VIC, 3216, Australia
| | - Tiana Felmingham
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, VIC, 3220, Australia
| | - Penny Fraser
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, VIC, 3220, Australia
| | - Cindy Needham
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, VIC, 3220, Australia
| | - Jaimie Poorter
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, VIC, 3220, Australia
| | - Doug Creighton
- Institute for Intelligent Systems Research and Innovation, Deakin University, 75 Pigdons Rd, Waurn Ponds, VIC, 3216, Australia
| | - Michael Johnstone
- Institute for Intelligent Systems Research and Innovation, Deakin University, 75 Pigdons Rd, Waurn Ponds, VIC, 3216, Australia
| | - Melanie Nichols
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, VIC, 3220, Australia
| | - Steven Allender
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, VIC, 3220, Australia
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Eime R, Harvey J, Charity M. Australian sport and physical activity behaviours pre, during and post-COVID-19. BMC Public Health 2024; 24:834. [PMID: 38500087 PMCID: PMC10946170 DOI: 10.1186/s12889-024-18245-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 03/01/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Globally, COVID-19 and associated restrictions impacted negatively on recreational physical activity (RPA). Participation in community sport was significantly impacted with cancelled training and competitions. Whilst team and club-based sport participation declined during COVID-19 restrictions, participation in some physical activities actually increased, particularly individual and online activities and outdoor activities not requiring facilities. AIM The aim of this study is to investigate changes in the patterns of participation in club-based sport, informal sport and other RPA in Australia from pre, during and post-COVID-19 restrictions. Further, these participation patterns are broken down by gender, age and region of residence. METHODS Two longitudinal waves of an online survey were conducted in mid-2020 and mid-2021. The first wave also captured retrospective pre-COVID19 (2019) data. Two sections of the survey dealt respectively with two 'settings' of RPA: organised club sport, and less structured sport and recreational physical activity (designated 'other RPA'). For each year 2019-2021 each individual was categorized as participating (Yes/No) in each of club sport and other RPA. For each setting, the proportions of each pattern of participation were tabulated, and the results for the demographic cohorts were compared. RESULTS A total of 1,138 Australians aged 13 years and above completed both waves of the survey. Overall, there were considerable differences between the patterns of club sport and other RPA. Most individuals who participated in other RPA (69%) were able to and did participate continuously throughout the COVID-19 pandemic. However, and not surprisingly, the club-sport participants were forced to drop out in 2020 during COVID-19 restrictions, and less than half reported returning to play post-COVID-19 restrictions. Less than a quarter of sports club participants were able to continue to play throughout COVID-19 and beyond. Significantly more males returned to playing sport 51% than females 44%. CONCLUSION Participation in community club-based sport has been significantly negatively impacted by COVID-19, more so than participation in some other recreational sport and physical activities. Further, fewer females than males returned to playing community sport, and priority and specific attention should be given to understanding why women and girls have not returned to playing community club-based sport.
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Affiliation(s)
- Rochelle Eime
- Physical Activity and Sport Insights, Research and Innovation, Federation University, Ballarat, Australia.
| | - Jack Harvey
- Physical Activity and Sport Insights, Research and Innovation, Federation University, Ballarat, Australia
| | - Melanie Charity
- Physical Activity and Sport Insights, Research and Innovation, Federation University, Ballarat, Australia
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Wang J, Liang X, Qiu Q, Yan F, Fang Y, Shen C, Wang H, Chen Y, Xiao S, Yue L, Li X. Cognitive trajectories in older adults and the role of depressive symptoms: A 7-year follow-up study. Asian J Psychiatr 2024; 95:104007. [PMID: 38520944 DOI: 10.1016/j.ajp.2024.104007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 01/06/2024] [Accepted: 03/16/2024] [Indexed: 03/25/2024]
Abstract
OBJECTIVES To examine different trajectories of cognitive changes in elderly adults and explore the mediating role of depressive symptoms. DESIGN A 7-year, community-based, prospective cohort study. SETTING The downtown neighborhood of Shanghai, China. PARTICIPANTS A cohort of 394 older adults, with an average age of 71.8 years, was recruited in 2015 and has been reassessed every two years until 2021. METHODS Latent Class Growth Analysis was used to model aging trajectories and Linear Mixed-Effect Models for Repeated Measures were used to estimate the least squares mean changes of cognition between subjects with depression (DEP+) and without (DEP-) across all visits. RESULTS Three cognitive trajectories were identified: the "successful aging" (SA) trajectory had the best and most consistent performance (n=229, 55.9%); the "normal aging" (NA) trajectory showed lower but stable cognition (n=141, 37.3%); while the "cognitive decline" (CD) trajectory displayed poor and declining cognition (n=24, 6.8%). Depressive symptoms were found to be influential across all trajectories. In the CD trajectory, the MoCA scores of the DEP+ group increased in within-group comparisons and were significantly higher than those of the DEP- group at visits 1 and 3 in between-group comparisons. A similar trend was observed in the NA trajectory, though it did not reach statistical significance. CONCLUSIONS Our research suggests that mild and decreasing depressive symptoms can be a reversible factor that might slow down the irreversible cognitive decline in the elderly. Therefore, we suggest that even mild depressive symptoms in the elderly should be monitored and detected.
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Affiliation(s)
- Jianjun Wang
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai 200030, China; Department of Neurology and Psychology, Shenzhen Traditional Chinese Medicine Hospital, The Fourth Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen 518000, China
| | - Xiao Liang
- Shanghai Xuhui District Mental Health Center, Shanghai 200232, China
| | - Qi Qiu
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Feng Yan
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Yuan Fang
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Changyi Shen
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Huijuan Wang
- Shanghai Jingan District Mental Health Center, Shanghai 200040, China
| | - Yuming Chen
- Shanghai Jingan District Mental Health Center, Shanghai 200040, China
| | - Shifu Xiao
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Ling Yue
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai 200030, China.
| | - Xia Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai 200030, China.
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Tan JY, Poitras Pratt Y, Danyluk P. 'First, do no harm': systematic program evaluation of an equine veterinary service-learning initiative with Indigenous communities in Canada. BMC Med Educ 2024; 24:287. [PMID: 38486267 PMCID: PMC10941546 DOI: 10.1186/s12909-024-05234-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 02/27/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND Veterinary students have historically lacked meaningful experiential learning opportunities in equine medicine. At the same time, there are barriers to accessing veterinary care in Indigenous communities stemming from colonial injustices. In 2018-2019, a partnership was initiated where University of Calgary students began to provide equine veterinary services to Indigenous communities. As the first-documented equine veterinary service-learning initiative in Indigenous communities embedded in a veterinary curriculum, the purpose of the study is to systematically evaluate the program for its potential impact as part of a formative process for improvement. METHODS Multiple parties in the program were engaged in a convergent, parallel, mixed-methods systematic program evaluation to explore the main program outcomes: (1) equine veterinary care; (2) clinical experiential student education; (3) cultural training of veterinary professionals and students; and (4) education of community members. The hypothesis was that ethical development using the "first, do no harm principle" would lead to benefits including a healthy horse population, a technically and culturally competent veterinary community, and an educated horse clientele. RESULTS The program had a positive impact on accessibility to veterinary care and self-reported improvement in veterinary and cultural competency. In addition to the hypothesized program outcomes, additional program outcomes and effects were identified, including reciprocal learning and relationship building with the Indigenous community, leading to trust and equity-building. The students learned from both the in-community programming as well as the Indigenous community members they worked with. CONCLUSION Program evaluation of an equine service-learning initiative in Indigenous communities reveals multiple and profound impacts including improved patient health status, wider scope of veterinary and cultural learning, strengthened relationships, and reciprocal learning with partnering Indigenous communities.
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Lim GP, Appalasamy JR, Ahmad B, Quek KF, Ramadas A. Peer-led lifestyle interventions for the primary prevention of cardiovascular disease in community: a systematic review of randomised controlled trials. BMC Public Health 2024; 24:812. [PMID: 38486215 PMCID: PMC10941612 DOI: 10.1186/s12889-024-18328-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 03/11/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Peer-led lifestyle interventions have gained recognition as effective approaches for managing and preventing chronic diseases. However, there remains a critical knowledge gap regarding the impact and effectiveness of peer-led interventions specifically in the primary prevention of cardiovascular disease (CVD). Our systematic review aims to synthesise the available evidence and evaluate the impact of peer-led lifestyle interventions, providing invaluable insights that can guide the development of peer-led strategies for preventing CVD. METHODS Systematic database searches were conducted on Ovid Medline, Embase, Cochrane Centre for Controlled Trials, PubMed and Scopus to source peer-reviewed articles published between 2013 and 2023. Reference lists of the included publications were also manually searched. RESULTS Fourteen unique randomised controlled trials were identified, of which three were pilot studies. Most of the interventions were conducted among individuals at moderate to high risk of CVD and lasted for a year. There is a variety of components in intervention delivery, including group discussions and individual counselling. Peer leader training mostly covered intervention delivery, communication, and research-specific skills. Systolic blood pressure showed the most promising CVD-related improvement, while mixed results were found for several other dietary and lifestyle behavioural outcomes. CONCLUSION Peer-led lifestyle interventions have shown varying effectiveness in cardiovascular health outcomes. The competencies and roles of peer leaders were identified to guide future intervention development with a more comprehensive approach to the primary prevention of CVD.
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Affiliation(s)
- Geok Pei Lim
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | | | - Badariah Ahmad
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - Kia Fatt Quek
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - Amutha Ramadas
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia.
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AbuKoura R, Checchi F, Abdalla O, Ibrahim O, Hemeadan AT, Eldirdiri AAA, Mohamed DI, Ahmed A, Ahmed AE, Abdelmagid N, Pepe P, Dahab M. Population mortality before and during the COVID-19 epidemic in two Sudanese settings: a key informant study. BMC Public Health 2024; 24:701. [PMID: 38443885 PMCID: PMC10916139 DOI: 10.1186/s12889-023-17298-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 11/22/2023] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Population mortality is an important metric that sums information from different public health risk factors into a single indicator of health. However, the impact of COVID-19 on population mortality in low-income and crisis-affected countries like Sudan remains difficult to measure. Using a community-led approach, we estimated excess mortality during the COVID-19 epidemic in two Sudanese communities. METHODS Three sets of key informants in two study locations, identified by community-based research teams, were administered a standardised questionnaire to list all known decedents from January 2017 to February 2021. Based on key variables, we linked the records before analysing the data using a capture-recapture statistical technique that models the overlap among lists to estimate the true number of deaths. RESULTS We estimated that deaths per day were 5.5 times higher between March 2020 and February 2021 compared to the pre-pandemic period in East Gezira, while in El Obeid City, the rate was 1.6 times higher. CONCLUSION This study suggests that using a community-led capture-recapture methodology to measure excess mortality is a feasible approach in Sudan and similar settings. Deploying similar community-led estimation methodologies should be considered wherever crises and weak health infrastructure prevent an accurate and timely real-time understanding of epidemics' mortality impact in real-time.
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Affiliation(s)
- Rahaf AbuKoura
- London School of Hygiene and Tropical Medicine, Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London, UK.
- Sudan COVID-19 Research Group, Khartoum, Sudan.
| | - Francesco Checchi
- London School of Hygiene and Tropical Medicine, Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London, UK
| | | | | | | | | | | | - Aljaile Ahmed
- Y-Peer, Khartoum, Sudan
- Sudan COVID-19 Research Group, Khartoum, Sudan
| | | | - Nada Abdelmagid
- London School of Hygiene and Tropical Medicine, Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London, UK
- Sudan COVID-19 Research Group, Khartoum, Sudan
| | | | - Maysoon Dahab
- London School of Hygiene and Tropical Medicine, Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London, UK
- Sudan COVID-19 Research Group, Khartoum, Sudan
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Ng MSN, So WKW, Choi KC, Akingbade O, Chan WCH, Chan HYL, Chan CWH. Social capital for carers of patients with advanced organ failure: a qualitative exploration of stakeholders' perspectives. BMC Public Health 2024; 24:670. [PMID: 38429719 PMCID: PMC10908001 DOI: 10.1186/s12889-024-18213-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 02/26/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Carers of patients with advanced organ failure (AOF) experience a tremendous caregiving burden. Social capital utilizes the internal strength of a community to support its members and may provide carers with comprehensive support. This study aimed to identify the different sources of social capital that can support carers of patients with AOF from the perspectives of stakeholders. METHOD A descriptive qualitative study was conducted in community settings from April 2021 to May 2022. Stakeholders from medical social work departments, self-help groups, and non-governmental organizations were recruited, while some community members were invited through online media platforms. Individual semi-structured interviews were conducted using an interview guide. Interview transcripts were analyzed using a qualitative description approach. In total, 98 stakeholders, including 25 carers, 25 patients, 24 professionals, and 24 community members, were recruited using purposive and snowball sampling. RESULTS Six categories about social capital for carers emerged, namely, carer attributes, the community, social care services, healthcare services, information, and policies. While the attributes of carers and their relationships with care recipients had a significant influence on caregiving, support from different groups in the community, such as neighbors and employers, was valued. Good communication of information about caregiving and social services was emphasized as being helpful by carers and other stakeholders. While carers presented a need for various healthcare and social care services, several features of these services, including their person-centeredness and proactive reach, were deemed useful. At the societal level, policies and research on comprehensive supportive services are warranted. The different sources of social capital constitute a multi-layer support system in the community. CONCLUSION Carers can utilize personal attributes, interpersonal relationships, community resources, and societal contexts to enhance their caregiving. While this system can serve as a framework for building carer-friendly communities, interventions may be required to strengthen some aspects of social capital.
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Affiliation(s)
- Marques Shek Nam Ng
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China.
| | - Winnie Kwok Wei So
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
| | - Kai Chow Choi
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
| | | | - Wallace Chi Ho Chan
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne, UK
| | - Helen Yue Lai Chan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
| | - Carmen Wing Han Chan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
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Fletcher CME, Woolford D, Gladigau J, Gunn KM. A 'Vocal Locals' social network campaign is associated with increased frequency of conversations about mental health and improved engagement in wellbeing-promoting activities in an Australian farming community. BMC Public Health 2024; 24:673. [PMID: 38431599 PMCID: PMC10909292 DOI: 10.1186/s12889-024-18193-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 02/23/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND Farmers face numerous barriers to accessing professional mental health services and instead report a preference for informal support systems, such as lay or peer networks. Farmers also experience barriers to investing time in maintaining or improving their wellbeing, stemming from sociocultural norms and attitudes that are widespread in agricultural communities. The Vocal Locals social network campaign is an ifarmwell initiative that aims to promote conversations about wellbeing and challenge attitudes and behaviours that contribute to farmers' poor mental health. METHODS The Vocal Locals campaign was underpinned by the socio-ecological model which explains human behaviour as stemming from interactions between the individual, their closest social circle, the community, and broader society. The campaign ran in Loxton, South Australia, from June to August 2022. Ten community members (8/10 farmers) became 'Vocal Locals' and were supported to share 'calls-to-action' to encourage people in their social networks to engage in wellbeing-promoting activities. A broader communications campaign reinforced key messages and amplified Vocal Locals' activities in the community. The intrapersonal and community-level impacts of the campaign were evaluated via pre- and post-campaign surveys of Vocal Locals and community members respectively. RESULTS Vocal Locals reported significantly lower psychological distress (p = .014), and higher positive mental wellbeing (p = .011), levels of general mental health knowledge (p = .022), and confidence helping someone with poor mental health (p = .004) following the intervention. However, changes in stigmatising beliefs about mental illness, confidence recognising poor mental health, and confidence and comfort speaking to others about mental health were non-significant. Community members who were familiar with the campaign reported having significantly more wellbeing-related conversations post-campaign compared to before (p = .015). Respondents also reported being more comfortable speaking to others about mental health or wellbeing (p = .001) and engaging more in activities to maintain or improve their wellbeing (p = .012) following the campaign. CONCLUSIONS The Vocal Locals social network campaign is an example of how science and community can be brought together to achieve meaningful outcomes. The campaign may serve as a model for others who wish to challenge attitudinal or knowledge-related barriers to help-seeking and improve engagement in wellbeing-promoting activities in difficult-to-reach communities.
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Affiliation(s)
- Chloe M E Fletcher
- IIMPACT in Health, Department of Rural Health, Allied Health and Human Performance, University of South Australia, Adelaide, SA, 5000, Australia
| | - Dale Woolford
- IIMPACT in Health, Department of Rural Health, Allied Health and Human Performance, University of South Australia, Adelaide, SA, 5000, Australia
| | - John Gladigau
- Gladigau Enterprises Pty Ltd, Loxton, SA, 5333, Australia
| | - Kate M Gunn
- IIMPACT in Health, Department of Rural Health, Allied Health and Human Performance, University of South Australia, Adelaide, SA, 5000, Australia.
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Morgan KA, Paton S, Patten A, Tucker S, Walker K. Community-based exercise goals of persons with spinal cord injury: Interpreted using the International Classification of Functioning, Disability, and Health. J Spinal Cord Med 2024; 47:229-238. [PMID: 34698620 PMCID: PMC10885771 DOI: 10.1080/10790268.2021.1970896] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE To identify goals for exercising among community-dwelling persons with spinal cord injury (PwSCI). DESIGN Qualitative descriptive study. SETTING Community-based exercise facility for persons with a disability. PARTICIPANTS Fifty-five PwSCI identified their exercise goals prior to participation in a community-based exercise intervention. INTERVENTIONS None. OUTCOME MEASURES A modified version of the Canadian Occupational Performance Measure was used to ask about exercise goals. The International Classification of Functioning, Disability, and Health (ICF) was used to code the goals for themes. RESULTS The participants were predominantly male (76%) and Black (56%) with thoracic-level injury (51%) and a mean age of 39.44 (standard deviation [SD] 13.62). A total of 231 goals (mean 4.2 goals per participant; SD 1.25) were identified. Participants rated their performance and satisfaction with their goals as 4.256 (SD 1.55) and 3.57 (SD 1.67), respectively. Participants most frequently reported goals related to endurance, muscle strengthening, weight loss, activities of daily living, transferring, and home and community mobility. The most commonly reported goals fell into five ICF domains: Functions of Cardiovascular, Hematological, Immunological, and Respiratory Systems; Neuromusculoskeletal and Movement-Related Functions; Structures Related to Movement; Mobility; and Self-Care. CONCLUSION PwSCI have goals they would like to achieve through participation in exercise. The goals are multifaceted and encompass improving health and fitness as well as improving performance in everyday activities such as transferring and mobility. Identifying themes of goals for PwSCI to achieve through exercise is an important step in developing programs and interventions needed to support PwSCI living in the community.
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Affiliation(s)
- Kerri A. Morgan
- Washington University in St. Louis, School of Medicine, St. Louis, Missouri, USA
| | - Samantha Paton
- Washington University in St. Louis, School of Medicine, St. Louis, Missouri, USA
| | - Anna Patten
- Washington University in St. Louis, School of Medicine, St. Louis, Missouri, USA
| | - Susan Tucker
- Washington University in St. Louis, School of Medicine, St. Louis, Missouri, USA
| | - Kimberly Walker
- Washington University in St. Louis, School of Medicine, St. Louis, Missouri, USA
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Maximiano-Barreto MA, Leal LR, Pessoa RMDP, Bomfim AJDL, Morais DD, Luchesi BM, Chagas MHN. Factors associated with happiness among community-dwelling older adults: a systematic review. Geriatr Nurs 2024; 56:124-137. [PMID: 38340433 DOI: 10.1016/j.gerinurse.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 01/12/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVES To identify factors associated with self-reported happiness among community-dwelling older adults. METHODS A systematic review of the literature was conducted. Searches were conducted in the PsycInfo, Web of Science, Scopus and Pubmed databases for relevant articles published in English, Spanish or Portuguese using the following search strategy and Boolean operators: (happiness*) AND (elder* OR (old adult*)). No restriction was imposed with regards to year of publication. This review was registered in PROSPERO (CRD42018107302). RESULTS Forty-six articles met the eligibility criteria and were included in the review. Economic, social and health-related factors were associated with happiness among community-dwelling older adults. The sociodemographic characteristics of older adults, such as the female sex, being married, an older age, a higher level of schooling and having a religion, were also associated with happiness. CONCLUSIONS The articles included in the present systematic review demonstrate that social, economic and health-related aspects have an association with happiness in community-dwelling older adults.
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Affiliation(s)
| | - Lívio Rodrigues Leal
- Research Group on Mental Health, Cognition and Aging, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Rebeca Mendes de Paula Pessoa
- Research Group on Mental Health, Cognition and Aging, Federal University of São Carlos, São Carlos, SP, Brazil; Department of Neuroscience and Behavior, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Ana Julia de Lima Bomfim
- Research Group on Mental Health, Cognition and Aging, Federal University of São Carlos, São Carlos, SP, Brazil; Department of Neuroscience and Behavior, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Daiene de Morais
- Research Group on Mental Health, Cognition and Aging, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Bruna Moretti Luchesi
- Research Group on Mental Health, Cognition and Aging, Federal University of São Carlos, São Carlos, SP, Brazil; Três Lagoas Campus, Federal University of Mato Grosso do Sul, Três Lagoas, MS, Brazil
| | - Marcos Hortes Nisihara Chagas
- Research Group on Mental Health, Cognition and Aging, Federal University of São Carlos, São Carlos, SP, Brazil; Department of Neuroscience and Behavior, University of São Paulo, Ribeirão Preto, SP, Brazil
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Sanford JR, DeBowes RM. Top Veterinary Practice Issues that Negatively Affect Culture, Retention, and Performance. Vet Clin North Am Small Anim Pract 2024; 54:423-440. [PMID: 37951765 DOI: 10.1016/j.cvsm.2023.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
With over 70 years of experience and having consulted with nearly 2000 veterinary hospitals in the United States and abroad, this top 10 list has been consistent through the years with some different approaches since the pandemic. Beyond consulting and advising, we teach practice management for veterinary students at Washington State University (Rick) and University of Georgia (Jeff). As a part of the 4th year curriculum, we conduct on-site evaluations for practices where the veterinary students observe appointments, interpret practice and financial data, and make recommendations for improvement to the owners. From these reports, often over 100 pages long and from debrief meetings with owners, we offer the following as our list of the TOP 10challenges we see in practices today. For each issue, we identify the issue, describe common findings, and then suggest some changes that practices can institute to either treat or avoid these issues for their practices.
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Affiliation(s)
- Jeffrey R Sanford
- University of Georgia College of Veterinary Medicine, Office of Academic Affairs, 501 D.W. Brooks Drive, Athens, GA 30602, USA.
| | - Richard M DeBowes
- Clinical Communication, Leadership and Practice Management, Washington State College of Veterinary Medicine, PO Box 647010, Pullman, WA 99164-7010, USA
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Kim SM, Lewis JP. Protective Factors in the Context of Successful Aging in Urban-Dwelling Alaska Native Elders. J Cross Cult Gerontol 2024; 39:53-71. [PMID: 38112906 DOI: 10.1007/s10823-023-09493-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2023] [Indexed: 12/21/2023]
Abstract
Successful aging in rural Alaska communities has been established as a characteristic best described by reaching "Eldership," conveying reverence and respect from the community and implying leadership responsibilities. Most Alaska Native (AN) Elders believe that aging successfully or aging well happens within their home communities. However, limited rural resources lead Elders to relocate to urban settings. While protective factors supporting aging well in rural communities have been established, little is known about which factors support aging well after relocation to an urban setting. This exploratory, qualitative, community-based participatory research study explored AN Elder's (ages 48-84) experiences comparing successful aging within four rural Alaska communities and of Elders who relocated from a rural to an urban community. Thirteen rural-based Elders and 12 urban-based Elders semi-structured interviews were compared to explore how successful aging was experienced similarly and differently in rural and urban settings. To age well in urban Alaska, access to health care services, family, and community engagement were essential. The main challenges for urban Elders involved establishing a sense of community, intergenerational involvement, and the ability to continue traditional ways of living. This research identified challenges, similarities, and differences in aging well in an urban community. The findings of this study inform practices, services, and policies to improve existing urban services and initiate needed urban services to foster successful aging after relocation from remote rural areas into urban communities in Alaska.
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Affiliation(s)
- Steffi M Kim
- University of Alaska Anchorage, 3211 Providence Drive, Anchorage, AK, 99508, USA.
| | - Jordan P Lewis
- University of Minnesota Medical School, Duluth campus, Memory Keepers Medical Discovery Team - Health Equity, 624 E. 1st. Street, Suite 201, Duluth, MN, 55805, USA
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Kabagenyi A, Wasswa R, Kayemba V. Multilevel mixed effects analysis of individual and community factors associated with unmet need for contraception among married women in four East African countries. SSM Popul Health 2024; 25:101602. [PMID: 38375320 PMCID: PMC10875291 DOI: 10.1016/j.ssmph.2024.101602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 01/03/2024] [Accepted: 01/03/2024] [Indexed: 02/21/2024] Open
Abstract
Background Despite the use of contraceptives being an expression of a woman's reproductive control, the prevalence of unmet need remains high and a public concern among married women in East Africa. However, limited literature has explored the associated factors in the region. We live in age of leaving no one behind unfortunately many women still have unmet for family planning todate. This study therefore intends to examine the individual and community level factors associated with unmet need for contraception among married women in Burundi, Rwanda, Tanzania and Uganda. Methods The study utilizes data from the four recent demographic and health surveys for Burundi, Rwanda, Tanzania and Uganda. Analyses were conducted using multilevel mixed effects logistic regressions with random community and country level effects. Results are reported using predictive probabilities and margins. Results This study revealed that: 20%, 22%, 28% and 33% of the married women in Tanzania, Uganda, Rwanda and Burundi respectively had unmet need for contraception. Younger women, and those: without formal education, from the poorest households, had ever experienced child loss, whose husbands desire more children than them, and have no access to family planning messages faced a higher probability of unmet need for contraception. This was also true for women living in communities with low usage of modern contraception and those in communities where there is an increasing number of children per woman. Conclusions The findings reiterate the need for family planning efforts to focus on younger women. Additionally, improved education, economic empowerment, calls for spousal involvement in family planning matters, support for those with child loss, and comprehensive awareness initiatives remain vital to tackling unmet need for contraception.
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Affiliation(s)
- Allen Kabagenyi
- Department of Population Studies, School of Statistics & Planning, College of Business and Management Sciences, Makerere University, Kampala, Uganda
| | - Ronald Wasswa
- Department of Health Policy, Planning and Management, Makerere University School of Public Health, New Mulago Complex, Kampala, Uganda
- Center of Excellence for Maternal and Newborn Health, Makerere University School of Public Health, New Mulago Complex, Makerere University, Kampala, Uganda
| | - Vincent Kayemba
- Department of Population Studies, School of Statistics & Planning, College of Business and Management Sciences, Makerere University, Kampala, Uganda
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Bunting SR, Wang G, Yu R, Hazra A. Availability of Testing for Sexually Transmitted Infections and HIV in U.S. Outpatient Mental Healthcare Settings. AIDS Behav 2024; 28:1029-1038. [PMID: 37882953 DOI: 10.1007/s10461-023-04211-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2023] [Indexed: 10/27/2023]
Abstract
People with mental illnesses experience higher incidence of sexually transmitted illnesses (STIs) and HIV, and estimates show fewer than 50% have received testing. The purpose of this study was to examine the prevalence of STI/HIV testing among United States outpatient mental healthcare service providers. Data from the National Mental Health Services Survey (NMHSS) was used to determine the rates of STI and HIV testing amongst 9,267 outpatient mental healthcare service providers in the U.S. Regression analyses were used to assess whether the likelihood a service provider offered STI or HIV testing was associated with service provider characteristics (facility type, services offered, accepted payments) and state-level incidence of STIs and HIV. We found 7.79% and 6.64% of outpatient mental healthcare service providers provided STI and HIV testing, respectively, with lowest rates in community mental health centers and partial hospitalization facilities. Providing dual-diagnosis for severe mental illness and substance use disorders was an independent predictor of STI testing (aOR = 2.17, [1.72-2.75] and HIV testing (aOR = 2.61, [2.07-3.30]. Higher state-level incidence of STIs and HIV were associated with higher rates of STI testing (β = 0.28, p = .047) and HIV testing (β = 0.48, p < .001). Preventing STIs and HIV among patients living with mental illness is a key priority of multiple national initiatives. Despite this, fewer than 10% of outpatient mental healthcare service providers responding to the NMHSS offered STI and HIV testing. Existing service co-delivery models may be one promising method for implementing STI/HIV testing within outpatient mental health settings.
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Affiliation(s)
- Samuel R Bunting
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago Medicine, Chicago, IL, USA.
| | - Gary Wang
- Pritzker School of Medicine, The University of Chicago, Chicago, IL, USA
| | - Roger Yu
- Pritzker School of Medicine, The University of Chicago, Chicago, IL, USA
| | - Aniruddha Hazra
- Section of Infectious Disease and Global Health, Department of Medicine, The University of Chicago Medicine, Chicago, IL, USA
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Xin RKW, Yee TW, Qin WZ, Kaiyee L, Mohammed AH, Blebil A, Dujaili J, Hassan BA, Lim A. Community pharmacists' knowledge, attitudes, and practices regarding counselling on vitamins and dietary supplements in Malaysia: A study on complementary medicines. Explor Res Clin Soc Pharm 2024; 13:100410. [PMID: 38389828 PMCID: PMC10882583 DOI: 10.1016/j.rcsop.2024.100410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 12/14/2023] [Accepted: 01/19/2024] [Indexed: 02/24/2024] Open
Abstract
Background The utilization of vitamins and dietary supplements (DSs) among consumers in Malaysia has seen a notable increase. However, there is limited research available on how pharmacists in Eastern countries manage the provision of these products. Objective This study aims to assess the knowledge, attitudes, and practices of community pharmacists in Malaysia regarding the provision of counselling services on vitamins and DSs. The findings will inform education strategies in this area. Methods A cross-sectional quantitative study was conducted from February to April 2022 using a validated online-based questionnaire. The survey was distributed to community pharmacists across Malaysia through social media channels. t-test and ANOVA test were used for data analysis. Results Among the 260 participants, 73.5% were categorized as having average product knowledge. Key concerns included a lack of knowledge about the indications of new products and when to discontinue their use. Regarding dosing in specific patient groups, 33.5% of pharmacists only occasionally consulted references and primarily relied on product labels. Furthermore, 29% of pharmacists believed it was unnecessary to refer patients to doctors when they experienced ongoing symptoms while taking vitamins or DSs. Interestingly, 44.6% of pharmacists believed there was a correlation between the efficacy of vitamins and their price, often recommending more expensive brands despite similar content. Conclusion There is an opportunity to enhance the knowledge of pharmacists in Malaysia regarding vitamins and DSs. Education interventions should focus on areas such as dosing for specific patient groups, when to discontinue products, understanding new products, evidence-based efficacy of products for specific conditions, and providing a framework for appropriate referral to support pharmacists in their practice.
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Affiliation(s)
- Rosamund Koo Wei Xin
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Subang Jaya, Selangor, Malaysia
| | - Tan Wai Yee
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Subang Jaya, Selangor, Malaysia
| | - Wong Zi Qin
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Subang Jaya, Selangor, Malaysia
| | - Lau Kaiyee
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Subang Jaya, Selangor, Malaysia
| | - Ali Haider Mohammed
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Subang Jaya, Selangor, Malaysia
- Department of Pharmacy, Al Rafidain University College, Baghdad 10001, Iraq
| | - Ali Blebil
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Subang Jaya, Selangor, Malaysia
- Department of Pharmacy, Al Rafidain University College, Baghdad 10001, Iraq
| | - Juman Dujaili
- Swansea University Medical School, Swansea University, Swansea, UK
- Department of Pharmacy, Al Rafidain University College, Baghdad 10001, Iraq
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Subang Jaya, Selangor, Malaysia
| | | | - Angelina Lim
- Faculty of Pharmacy and Pharmaceutical Sciences Monash University, Victoria, Australia
- Murdoch Childrens Research Institute, Royal Children's Hospital, Victoria, Australia
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Krieger B, Moser A, Morgenthaler T, Beurskens AJHM, Piškur B. Parents' Perceptions: Environments and the Contextual Strategies of Parents to Support the Participation of Children and Adolescents with Autism Spectrum Disorder-A Descriptive Population-Based Study from Switzerland. J Autism Dev Disord 2024; 54:871-893. [PMID: 36538129 PMCID: PMC9765345 DOI: 10.1007/s10803-022-05826-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2022] [Indexed: 12/24/2022]
Abstract
Environments have a modifying effect on the participation of children and adolescents with autism spectrum disorder (ASD) in all areas of life. This cross-sectional study investigated parental perspectives on supportive or hindering environments and the daily contextual strategies parents used to enhance their children's participation. Qualitative and quantitative data gathered from 115 parents from German-speaking Switzerland using the participation and environment measure-child and youth (PEM-CY) were analyzed. Results revealed 45 environmental supports and barriers at home, at school, and in the community. Contextual strategies were identified in combination with people, activities, time, objects, and places. Parental perspectives on participation and their contextual strategies should be considered in environmental-based interventions to support the participation of children and adolescents with ASD.
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Affiliation(s)
- Beate Krieger
- School of Health Sciences, ZHAW Zurich University of Applied Sciences, Katharina Sulzer Platz 9, 8401, Winterthur, Switzerland.
- Department of Family Medicine, School Caphri, Maastricht University, Maastricht, The Netherlands.
| | - Albine Moser
- Department of Family Medicine, School Caphri, Maastricht University, Maastricht, The Netherlands
- Research Centre for Autonomy and Participation for People With Chronic Illness, Zuyd University of Applied Sciences, Heerlen, The Netherlands
| | - Thomas Morgenthaler
- School of Health Sciences, ZHAW Zurich University of Applied Sciences, Katharina Sulzer Platz 9, 8401, Winterthur, Switzerland
| | - Anna J H M Beurskens
- Department of Family Medicine, School Caphri, Maastricht University, Maastricht, The Netherlands
| | - Barbara Piškur
- Research Centre for Autonomy and Participation for People With Chronic Illness, Zuyd University of Applied Sciences, Heerlen, The Netherlands
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Kim J, Bae YH, Ho SH, Lee H, Park H. Feasibility and outcomes of a community-based, mobile health system-monitored lifestyle intervention in chronic stroke: A pilot study. Technol Health Care 2024:THC230857. [PMID: 38517811 DOI: 10.3233/thc-230857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2024]
Abstract
BACKGROUND People with disabilities face challenges in daily life during the COVID-19 pandemic, including limited access to care, exposure to lifestyle-related diseases, and difficulties in regular exercise. Therefore, it is important to establish health safety nets using Information and Communication Technology (ICT) in communities. OBJECTIVE This study aimed to develop an m-Health-based personalized lifestyle intervention algorithm targeting high-risk groups of lifestyle-related diseases (including hypertension, diabetes, and obesity) among people with hemiplegic disabilities, and to verify its feasibility. METHODS Six people at a high risk of lifestyle-related diseases participated in an 8-week lifestyle intervention using a wearable device and the S-Health program. The self-health management areas included walking, moderate-intensity exercise, weight, blood pressure, blood sugar, diet, calorie intake, heart rate, sobriety, no smoking. Health, physical, psychological, and social changes were measured before and after the study. RESULTS The intervention had a positive impact on the participants' health, with statistically significant differences found in fasting blood glucose, highest systolic blood pressure, grip strength, and motor function assessment. Quality of life, health-related quality of life, and self-efficacy improved post-intervention. CONCLUSION Our findings can be used as preliminary evidence for establishing m-Health-based health safety net systems for people with disabilities who live in communities.
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McGee K, d'Elbée M, Dekova R, Sande LA, Dube L, Masuku S, Dlamini M, Mangenah C, Mwenge L, Johnson C, Hatzold K, Neuman M, Meyer-Rath G, Terris-Prestholt F. Costs of distributing HIV self-testing kits in Eswatini through community and workplace models. BMC Infect Dis 2024; 22:976. [PMID: 38424538 PMCID: PMC10902928 DOI: 10.1186/s12879-023-08694-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 10/10/2023] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND This study evaluates the implementation and running costs of an HIV self-testing (HIVST) distribution program in Eswatini. HIVST kits were delivered through community-based and workplace models using primary and secondary distribution. Primary clients could self-test onsite or offsite. This study presents total running economic costs of kit distribution per model between April 2019 and March 2020, and estimates average cost per HIVST kit distributed, per client self-tested, per client self-tested reactive, per client confirmed positive, and per client initiating antiretroviral therapy (ART). METHODS Distribution data and follow-up phone interviews were analysed to estimate implementation outcomes. Results were presented for each step of the care cascade using best-case and worst-case scenarios. A top-down incremental cost-analysis was conducted from the provider perspective using project expenditures. Sensitivity and scenario analyses explored effects of economic and epidemiological parameters on average costs. RESULTS Nineteen thousand one hundred fifty-five HIVST kits were distributed to 13,031 individuals over a 12-month period, averaging 1.5 kits per recipient. 83% and 17% of kits were distributed via the community and workplace models, respectively. Clients reached via the workplace model were less likely to opt for onsite testing than clients in the community model (8% vs 29%). 6% of onsite workplace testers tested reactive compared to 2% of onsite community testers. Best-case scenario estimated 17,458 (91%) clients self-tested, 633 (4%) received reactive-test results, 606 (96%) linked to confirmatory testing, and 505 (83%) initiated ART. Personnel and HIVST kits represented 60% and 32% of total costs, respectively. Average costs were: per kit distributed US$17.23, per client tested US$18.91, per client with a reactive test US$521.54, per client confirmed positive US$550.83, and per client initiating ART US$708.60. Lower rates for testing, reactivity, and linkage to care in the worst-case scenario resulted in higher average costs along the treatment cascade. CONCLUSION This study fills a significant evidence gap regarding costs of HIVST provision along the client care cascade in Eswatini. Workplace and community-based distribution of HIVST accompanied with effective linkage to care strategies can support countries to reach cascade objectives.
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Affiliation(s)
- Kathleen McGee
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.
| | - Marc d'Elbée
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Linda A Sande
- Malawi Liverpool Wellcome Trust Research Programme, Blantyre, Malawi
| | | | - Sanele Masuku
- Population Services International, Mbabane, Eswatini
| | | | - Collin Mangenah
- Centre for Sexual Health and HIV/AIDS Research, Harare, Zimbabwe
| | | | - Cheryl Johnson
- World Health Organisation, Global HIV, Hepatitis and STI Programmes, Geneva, Switzerland
| | - Karin Hatzold
- Population Services International, Cape Town, South Africa
| | - Melissa Neuman
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Gesine Meyer-Rath
- Center for Global Heath and Development, Boston University School of Public Health, Boston, USA
- Health Economics and Epidemiology Research Office, Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Fern Terris-Prestholt
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
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Suratana S, Boonchiang W, Apidechkul T, Naksen W, Mulikaburt T, Chomsri P, Matrakul M. A Community-Based Reproductive Health Care Model Effectively Enhances Reproductive Health Among Lahu Women in Northern Thailand. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01959-5. [PMID: 38421508 DOI: 10.1007/s40615-024-01959-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 02/04/2024] [Accepted: 02/21/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Inadequate and delayed access to sexual and reproductive health services among the Hill Tribe population can be attributed to the intersection of socioeconomic challenges and distinct cultural practices. To address this limitation and create a tailored model capable of addressing it, this study assesses the effectiveness of the Community-Based Reproductive Health Care Model (CRHC) in enhancing reproductive health knowledge, attitudes, and practices among Lahu women, a prominent hill tribe population in Northern Thailand. METHODS Implementing the CRHC model includes training programs for community influencers and subsequent education for Lahu women using culturally adapted courses. The effectiveness of the model is assessed through pre-test and post-test comparisons of knowledge, attitudes, and practices related to reproductive health care and analyzed using paired t-tests and repeated ANOVA. RESULTS The scores for knowledge, attitudes, and practices among Lahu women changed from 8.92 ± 2.02, 52.99 ± 5.54, and 27.76 ± 6.67 to 10.47 ± 2.32 (p < 0.001), 56.61 ± 5.54 (p < 0.001), and 29.47 ± 6.76 (p = 0.030), respectively. Significant improvements are observed in these areas, particularly in maternal health practices among pregnant Lahu women (n = 11). This study additionally evaluates the model's impact on the healthcare system by analyzing changes in government performance indexes, showing increased access to high-quality antenatal care and contraceptive usage. This study highlights the challenges faced by hill tribe populations in accessing healthcare, emphasizing the need for tailored reproductive health education and the importance of addressing health insurance barriers. CONCLUSION The CRHC model's success illustrates the potential of community-based, culturally sensitive interventions in improving reproductive health outcomes, providing valuable insights for similar interventions in other indigenous or marginalized communities.
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Affiliation(s)
- Soontaree Suratana
- Faculty of Public Health, Chiang Mai University, 239 Huay Kaew Road, Muang District, Chiang Mai, 52000, Thailand
- School of Health Science, Mae Fah Luang University, Chiang Rai, 57100, Thailand
| | - Waraporn Boonchiang
- Faculty of Public Health, Chiang Mai University, 239 Huay Kaew Road, Muang District, Chiang Mai, 52000, Thailand.
| | - Tawatchai Apidechkul
- School of Health Science, Mae Fah Luang University, Chiang Rai, 57100, Thailand
- Center of Excellence for Hill-Tribe Health Research, Mae Fah Luang University, Chiang Rai, 57100, Thailand
| | - Warangkana Naksen
- Faculty of Public Health, Chiang Mai University, 239 Huay Kaew Road, Muang District, Chiang Mai, 52000, Thailand
| | | | - Pimpisa Chomsri
- School of Nursing, Mae Fah Luang University, Chiang Rai, 57100, Thailand
| | - Mullika Matrakul
- School of Nursing, Mae Fah Luang University, Chiang Rai, 57100, Thailand
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50
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Shimokihara S, Ikeda Y, Matsuda F, Tabira T. Association of mobile device proficiency and subjective cognitive complaints with financial management ability among community-dwelling older adults: a population-based cross-sectional study. Aging Clin Exp Res 2024; 36:44. [PMID: 38367133 PMCID: PMC10874308 DOI: 10.1007/s40520-024-02697-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 01/03/2024] [Indexed: 02/19/2024]
Abstract
BACKGROUND Mobile devices have been used by many older adults and have the potential to assist individuals with subjective cognitive complaints (SCCs) in daily living tasks. Financial management is one of the most complex daily activity for older adults, as it is easily impaired in the prodromal stage of dementia and cognitive impairment. AIM To investigate financial management ability among older adults from SCCs and mobile device proficiency. METHODS A self-administered questionnaire was sent to 529 participants who were ≥ 65 years and regularly use mobile devices. Participants were divided into four groups based on SCC prevalence and scores of the Mobile Device Proficiency Questionnaire (MDPQ-16). Financial management abilities were compared between groups using the Process Analysis of Daily Activities for Dementia subscale. Regression model and crosstabulation table were used to investigate associations in detail. RESULTS A significant difference in financial management ability was observed among the four groups (p < 0.001), with the dual impairment group showed significantly lower than the robust and SCC groups (p < 0.001). Educational history, sex, and MDPQ-16 score were significantly associated with participants' financial management ability (p ≤ 0.01). The proportion of participants who could use ATMs and electronic money independently was significantly lower among those with low proficiency in mobile devices (LPM), regardless of SCC (p < 0.05). CONCLUSION The LPM group showed an impaired ability to manage their finances, particularly in situations where they would use information devices. Therefore, healthcare professionals should assess not only the SCC but also their proficiency with mobile devices to predict their impairment in activities of daily living.
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Affiliation(s)
- Suguru Shimokihara
- Graduate School of Health Sciences, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 890-8544, Japan.
- Research Fellowship for Young Scientists, Japan Society for the Promotion of Science, 5-3-1, Kojimachi, Chiyoda-Ku, Tokyo, 102-0083, Japan.
| | - Yuriko Ikeda
- Department of Occupational Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Fumiyo Matsuda
- Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Takayuki Tabira
- Department of Occupational Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 890-8544, Japan
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