Tag: nevin manimala

J Holist Nurs. 2023 May 1:8980101231170482. doi: 10.1177/08980101231170482. Online ahead of print.

ABSTRACT

Purpose: To evaluate effectiveness of chairside yoga therapy on perceptions of fatigue, pain, nausea, anxiety, and distress among oncology patients concurrently receiving outpatient cancer infusion therapy. Design: This prospective pilot study used pre-/post-survey design in convenience sample of cancer patients in outpatient setting. Methods: Researchers developed and administered the Outpatient Cancer Symptom Assessment Scale (OCSAS) comprised of cancer- or treatment-related symptoms commonly reported in the oncology population (nausea, pain, fatigue, anxiety, and distress). Following IRB approval, symptoms were rated using Likert scale of 0 (not present) to 10 (severe) before and after chairside yoga therapy delivered concurrently with outpatient infusions. Qualitative data was collected related to patients’ overall infusion experience. Findings: Participants (n = 82) reported positive patient experiences and statistically less pain (p < 0.001), fatigue (p < 0.001), anxiety (p < 0.001), and distress (p < 0.001) following the yoga intervention compared to baseline. Nausea was not significantly impacted by the yoga intervention. Conclusions: Yoga therapy received concurrently during outpatient cancer infusion is consistent with a holistic and integrative approach to care for the oncology population. Yoga therapy offers promise for reducing symptoms which negatively impact quality of life, including pain, fatigue, anxiety, and distress. Qualitative data suggests patients’ overall infusion experience was enhanced with yoga therapy.

PMID:37128683 | DOI:10.1177/08980101231170482

J Telemed Telecare. 2023 May 1:1357633X231171315. doi: 10.1177/1357633X231171315. Online ahead of print.

NO ABSTRACT

PMID:37128677 | DOI:10.1177/1357633X231171315

Health Expect. 2023 May 1. doi: 10.1111/hex.13771. Online ahead of print.

ABSTRACT

BACKGROUND: The COVID-19 pandemic brought rapid and major changes to research, and those wishing to carry out Patient and Public Involvement (PPI) activities faced challenges, such as restrictions on movement and contact, illness, bereavement and risks to potential participants. Some researchers moved PPI to online settings during this time but remote consultations raise, as well as address, a number of challenges. It is important to learn from PPI undertaken in this period as face-to-face consultation may no longer be the dominant method for PPI.

METHODS: UK stay-at-home measures announced in March 2020 necessitated immediate revisions to the intended face-to-face methods of PPI consultation for the ESORT Study, which evaluated emergency surgery for patients with common acute conditions. PPI plans and methods were modified to all components being online. We describe and reflect on: initial plans and adaptation; recruitment; training and preparation; implementation, contextualisation and interpretation. Through first-hand accounts we show how the PPI processes were developed, experienced and viewed by different partners in the process.

DISCUSSION AND CONCLUSIONS: While concerns have been expressed about the possible limiting effects of forgoing face-to-face contact with PPI partners, we found important benefits from the altered dynamic of the online PPI environment. There were increased opportunities for participation which might encourage the involvement of a broader demographic, and unexpected benefits in that the online platform seemed to have a ‘democratising’ effect on the meetings, to the benefit of the PPI processes and outcomes. Other studies may however find that their particular research context raises particular challenges for the use of online methods, especially in relation to representation and inclusion, as new barriers to participation may be raised. It is important that methodological challenges are addressed, and researchers provide detailed examples of novel methods for discussion and empirical study.

PATIENT AND PUBLIC CONTRIBUTION: We report a process which involved people with lived experience of emergency conditions and members of the public. A patient member was involved in the design and implementation, and two patients with lived experience contributed to the manuscript.

PMID:37128669 | DOI:10.1111/hex.13771

Health Expect. 2023 May 1. doi: 10.1111/hex.13773. Online ahead of print.

ABSTRACT

INTRODUCTION: Mental health problems are a considerable public health issue and spending time in nature has been promoted as a way to access a range of psychological benefits leading to the development of nature-based interventions for people with severe and enduring mental health problems. Less, however, is understood about the potential benefits and efficacy of day-to-day routine access to outdoor green and blue spaces for mental health service users.

METHODS: Using a mixed-methods design between April and October 2021, we explored the benefits and barriers to spending time outdoors with a purposive sample of mental health service users (N = 11) using qualitative interviews and an online general population survey (N = 1791). Qualitative evidence highlighted the restorative benefits of nature and identified a number of barriers associated with fears around personal safety, social anxiety, fatigue and lack of motivation. COVID-19 had also restricted access to green and blue spaces. Having social contact and support encouraged people to spend time outdoors. In the quantitative survey, self-report and standardised measures (the Patient Health Questionnaire and the Warwick-Edinburgh Wellbeing Scale) were used to assess past and current mental wellbeing.

FINDINGS: Statistically significant differences were found between wellbeing and the use of green and blue spaces. Those with mental health problems spent time outdoors because they: felt guilty; wanted to reduce their anxiety; or rely on someone for encouragement. Those without mental health problems endorsed more positively framed reasons including relaxation, improving physical health or getting exercise. Barriers for people with mental health problems involved safety concerns, feeling anxious and having a poor self-image. These findings give insight into motivations for an outdoor activity to help inform the design of public mental health interventions.

CONCLUSION: Further work is required to improve access and safety to promote the benefits of green and blue spaces for everyone.

PATIENT OR PUBLIC CONTRIBUTION: The research team included expert experienced researchers with a mental health service provider (Praxis Care) and they were involved in the development of the research idea, funding application, design, data collection, analysis, writing up and dissemination activities.

PMID:37128668 | DOI:10.1111/hex.13773

Expert Rev Cardiovasc Ther. 2023 May 1:1-10. doi: 10.1080/14779072.2023.2207009. Online ahead of print.

ABSTRACT

OBJECTIVES: This umbrella review aims to quality assess published meta-analyses, conduct a de-novo meta-analysis of the available randomized control trials (RCTs), and test the hypothesis that there is a long-term difference in mortality between OSR and EVAR.

METHODS: A systematic search was conducted in MEDLINE and EMBASE’s bibliographic databases (June 2022). Data were extracted using standardized extraction forms. The methodological quality of publications was assessed using the ROBIS tool. Data were analyzed with ‘one-stage’ and ‘two-stage’ approaches.

RESULTS: According to two-stage analysis, EVAR has significantly favorable mortality for up to four years (increasing evidence). Subsequently, until the longest available time period, there is no difference between EVAR and OSR; all the results are statistically non-significant.In one stage analysis, the Cox model demonstrated a non-significant (weak evidence) hazard ratio of 1.03 (95% confidence interval [CI]: 0.94-1.12) in favor of OSR. The best-fitting parametric model (generalized gamma), leads to an hazard ratio of 0.97 (95% CI: 0.93-1.01) in favor of EVAR, with the results approaching significance (weak evidence).

CONCLUSION: The results of this umbrella systematic review and meta-analysis failed to demonstrate any difference in long-term mortality following planned EVAR, compared with OSR of infrarenal AAA.

PMID:37128666 | DOI:10.1080/14779072.2023.2207009

J Med Internet Res. 2023 May 1;25:e43006. doi: 10.2196/43006.

ABSTRACT

BACKGROUND: The proliferation of mobile health (mHealth) applications is partly driven by the advancements in sensing and communication technologies, as well as the integration of artificial intelligence techniques. Data collected from mHealth applications, for example, on sensor devices carried by patients, can be mined and analyzed using artificial intelligence-based solutions to facilitate remote and (near) real-time decision-making in health care settings. However, such data often sit in data silos, and patients are often concerned about the privacy implications of sharing their raw data. Federated learning (FL) is a potential solution, as it allows multiple data owners to collaboratively train a machine learning model without requiring access to each other’s raw data.

OBJECTIVE: The goal of this scoping review is to gain an understanding of FL and its potential in dealing with sensitive and heterogeneous data in mHealth applications. Through this review, various stakeholders, such as health care providers, practitioners, and policy makers, can gain insight into the limitations and challenges associated with using FL in mHealth and make informed decisions when considering implementing FL-based solutions.

METHODS: We conducted a scoping review following the guidelines of PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews). We searched 7 commonly used databases. The included studies were analyzed and summarized to identify the possible real-world applications and associated challenges of using FL in mHealth settings.

RESULTS: A total of 1095 articles were retrieved during the database search, and 26 articles that met the inclusion criteria were included in the review. The analysis of these articles revealed 2 main application areas for FL in mHealth, that is, remote monitoring and diagnostic and treatment support. More specifically, FL was found to be commonly used for monitoring self-care ability, health status, and disease progression, as well as in diagnosis and treatment support of diseases. The review also identified several challenges (eg, expensive communication, statistical heterogeneity, and system heterogeneity) and potential solutions (eg, compression schemes, model personalization, and active sampling).

CONCLUSIONS: This scoping review has highlighted the potential of FL as a privacy-preserving approach in mHealth applications and identified the technical limitations associated with its use. The challenges and opportunities outlined in this review can inform the research agenda for future studies in this field, to overcome these limitations and further advance the use of FL in mHealth.

PMID:37126398 | DOI:10.2196/43006

JAMA Netw Open. 2023 May 1;6(5):e2311012. doi: 10.1001/jamanetworkopen.2023.11012.

ABSTRACT

IMPORTANCE: Women often experience physiological and functional changes in their health during midlife. Identifying women who have clinically important improvements in physical health and function and evaluating the factors associated with these improvements can identify intervention targets at midlife.

OBJECTIVE: To identify factors associated with improvements in physical health and function among women during midlife.

DESIGN, SETTING, AND PARTICIPANTS: Participants were part of the Study of Women’s Health Across the Nation (SWAN), a diverse cohort of US women early in midlife, and followed up annually for up to 21 years between 1996 and 2017. Analyses were based on visit 8 (2004-2006) through visit 15 (2015-2017). Statistical analysis was conducted from October 2021 to March 2023.

EXPOSURES: Sociodemographic indicators, health status measures, and comorbidities measured at visit 8.

MAIN OUTCOMES AND MEASURES: The main outcome was a clinically important (≥5 points) improvement in the physical component score (PCS) of the 36-item Short-Form Health Survey between visit 8 and visit 15.

RESULTS: Of the 1807 women (at visit 8: mean [SD] age, 54.5 [2.7] years; 898 [50%] White participants) in SWAN who qualified for analysis, 265 (15%) experienced a clinically important improvement in PCS over a median of 11.1 years (IQR, 10.9-11.4 years). Factors associated with improvement in PCS included no financial strain (odds ratio [OR], 1.73; 95% CI, 1.18-2.52), no sleep disturbances (OR, 1.43; 95% CI, 1.05-1.96), no osteoarthritis (OR, 1.42; 95% CI, 1.01-1.99), and having a higher physical activity score (OR, 1.17; 95% CI, 1.00-1.37) as assessed at visit 8. Women who had a higher PCS at visit 8 (OR, 0.84; 95% CI, 0.83-0.86), who had a higher body mass index (OR, 0.95; 95% CI, 0.93-0.97), or who were taking more medications (OR, 0.93; 95% CI, 0.88-0.98) had lower odds of an improved PCS.

CONCLUSIONS AND RELEVANCE: This cohort study of women in midlife suggests that approximately 15% of women experienced clinically important improvements in health and function over an 11-year period. Several potentially modifiable factors associated with improvements may inform women of variables to target for future interventions.

PMID:37126345 | DOI:10.1001/jamanetworkopen.2023.11012

JAMA Neurol. 2023 May 1. doi: 10.1001/jamaneurol.2023.0932. Online ahead of print.

ABSTRACT

IMPORTANCE: Although it has been postulated that chronic inflammation caused by rheumatoid arthritis (RA) contributes to the development of Parkinson disease (PD), the association between these 2 conditions has yet to be determined.

OBJECTIVE: To evaluate the association between RA and subsequent PD risk.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study used the Korean National Health Insurance Service database to collect population-based, nationally representative data on patients with RA enrolled from 2010 to 2017 and followed up until 2019 (median follow-up, 4.3 [IQR, 2.6-6.4] years after a 1-year lag). A total of 119 788 patients who were first diagnosed with RA (83 064 with seropositive RA [SPRA], 36 724 with seronegative RA [SNRA]) were identified during the study period and included those who underwent a national health checkup within 2 years before the RA diagnosis date (64 457 patients). After applying exclusion criteria (eg, age <40 years, other rheumatic diseases, previous PD), 54 680 patients (39 010 with SPRA, 15 670 with SNRA) were included. A 1:5 age- and sex-matched control group of patients without RA was also included for a total control population of 273 400.

EXPOSURES: Rheumatoid arthritis as defined using International Classification of Diseases, Tenth Revision codes M05 for SPRA and M06 (except M06.1 and M06.4) for SNRA; prescription of any disease-modifying antirheumatic drug; and enrollment in the Korean Rare and Intractable Diseases program.

MAIN OUTCOMES AND MEASURES: The main outcome was newly diagnosed PD. Data were analyzed from May 10 through August 1, 2022, using Cox proportional hazards regression analyses.

RESULTS: From the 328 080 individuals analyzed (mean [SD] age, 58.6 [10.1] years; 74.9% female and 25.1% male), 1093 developed PD (803 controls and 290 with RA). Participants with RA had a 1.74-fold higher risk of PD vs controls (95% CI, 1.52-1.99). An increased risk of PD was found in patients with SPRA (adjusted hazard ratio [aHR], 1.95; 95% CI, 1.68-2.26) but not in patients with SNRA (aHR, 1.20; 95% CI, 0.91-1.57). Compared with the SNRA group, those with SPRA had a higher risk of PD (aHR, 1.61; 95% CI, 1.20-2.16). There was no significant interaction between covariates on risk of PD.

CONCLUSIONS AND RELEVANCE: In this study, RA was associated with an increased risk of PD, and seropositivity of RA conferred an augmented risk of PD. The findings suggest that physicians should be aware of the elevated risk of PD in patients with RA and promptly refer patients to a neurologist at onset of early motor symptoms of PD without synovitis.

PMID:37126341 | DOI:10.1001/jamaneurol.2023.0932

Opt Lett. 2023 May 1;48(9):2492-2495. doi: 10.1364/OL.491408.

ABSTRACT

Standard surface specifications for mid-spatial frequency (MSF) errors do not capture complex surface topography and often lose critical information by making simplifying assumptions about surface distribution and statistics. As a result, it is challenging to link surface specifications with optical performance. In this work, we present use of the pupil-difference probability distribution (PDPD) moments to assess general MSF surface errors and show how the PDPD moments relate to the relative modulation.

PMID:37126307 | DOI:10.1364/OL.491408

Opt Lett. 2023 May 1;48(9):2413-2416. doi: 10.1364/OL.488885.

ABSTRACT

We introduce an efficient approach to simultaneously tailor the spatial profile and the degree of coherence (DOC) of partially coherent light by devising its statistical properties in the spatial frequency domain. The relationship between the beam profile and the DOC in the source plane and the correlation function and power spectrum in the spatial frequency domain is analyzed in detail. This approach enables us to generate partially coherent sources with spatially uniform or non-uniform coherence states, and the source profiles are controlled. The condition for switching two coherence states is given through two theoretical examples. Furthermore, we validate our approach in experiment through generating two kinds of spatially non-uniform correlated sources with controllable beam profiles. The experimental results agree well with our theoretical analysis.

PMID:37126286 | DOI:10.1364/OL.488885