Tag: nevin manimala

Med Care. 2022 Oct 12. doi: 10.1097/MLR.0000000000001785. Online ahead of print.

ABSTRACT

BACKGROUND: The Center for Medicare and Medicaid Innovation revised the comprehensive Care for Joint Replacement (CJR) program, a mandatory 90-day bundled payment for lower extremity joint replacement, in December 2017, retaining 34 of the original 67 metropolitan statistical areas with higher volume and historic episode payments.

OBJECTIVES: We describe differences in costs, quality, and patient selection between hospitals that continued to participate compared with those that withdrew from CJR before and after the implementation of CJR.

RESEARCH DESIGN: We used a triple difference approach to compare the magnitude of the policy effect for elective admissions between hospitals that were retained in the CJR revision or not, before and after the implementation of CJR, and compared with hospitals in nonparticipant metropolitan statistical areas.

SUBJECTS: 694,275 Medicare beneficiaries undergoing elective lower extremity joint replacement from January 1, 2013 to August 31, 2017.

MEASURES: The treatment effect heterogeneity of CJR.

RESULTS: Hospitals retained in the CJR policy revision had a greater reduction in 90-day episode-of-care cost compared with those that were allowed to discontinue (-$846, 95% CI: -$1,338, -$435) and had greater cost reductions in the more recent year (2017). We also found evidence that retained CJR hospitals disproportionately reduced treating patients who were older than 85 years.

CONCLUSIONS: Hospitals that continued to participate in CJR after the policy revision achieved a greater cost reduction. However, the cost reductions were partly attributed to avoiding potential higher-cost patients, suggesting that a bundled payment policy might induce disparities in care delivery.

PMID:36223537 | DOI:10.1097/MLR.0000000000001785

J Clin Psychol. 2022 Oct 12. doi: 10.1002/jclp.23450. Online ahead of print.

ABSTRACT

OBJECTIVE: Nonsuicidal self-injury (NSSI) frequently functions to regulate shame-based emotions and cognitions in the context of interpersonal stress. The present study sought to examine how sleep quality (SQ) may influence this process in a laboratory setting.

METHODS: Participants included 72 adults (M_age = 24.28; 36 with a lifetime history of NSSI) who completed a self-report measure of prior month SQ and engaged in a modified Trier social stress task (TSST). State shame ratings were collected immediately before and following the TSST, as well as 5 min post-TSST, to allow for the measurement of shame reactivity and recovery.

RESULTS: No significant results emerged for NSSI history and SQ as statistical predictors of shame reactivity. However, NSSI history was significantly associated with heightened shame intensity during the recovery period of the task, and this was moderated by SQ. Simple slopes analyses revealed a conditional effect whereby poorer SQ (1SD above the mean) was associated with greater intensity of shame during recovery, but only for those with a history of NSSI.

CONCLUSION: Poor SQ may contribute to worrisome emotional responses to daytime stressors in those at risk for NSSI.

PMID:36223526 | DOI:10.1002/jclp.23450

J Public Health Manag Pract. 2022 Oct 12. doi: 10.1097/PHH.0000000000001659. Online ahead of print.

ABSTRACT

CONTEXT: Big Cities Health Coalition member health departments (BCHC HDs) serve more than 61 million people across their jurisdictions, nearly 20% of the US population. As such, they have particular challenges and opportunities in how they do their work. This article focuses on BCHC HDs that participated in the 2021 Public Health Workforce Interests and Needs Survey (PH WINS) and describes workplace perceptions, training needs, COVID-19 efforts, and well-being.

OBJECTIVE: To describe key characteristics of the governmental public health workforce among BCHC HDs, including demographics, perceptions, and needs.

DESIGN: Using a subsample of data from the 2021 PH WINS that included 29 BCHC HDs, descriptive statistics on many of the topics covered by the 2021 PH WINS were analyzed and compared with the 2017 PH WINS.

SETTING: Twenty-nine BCHC HDs in cities across the United States.

PARTICIPANTS: In total, 7922 of 29 661 staff members (response rate of 27%) from participating BCHC HDs.

RESULTS: Most BCHC HD respondents self-identified as a woman (76%, 95% confidence interval [CI]: 75%-77%), and as Black, Indigenous, and people of color (69%, 95% CI: 68%-70%), similar to findings from the 2017 PH WINS (75%, 95% CI: 74%-76%; 67%, 95% CI: 66%-69%, respectively). Most respondents believe that their organization prioritizes diversity, equity, and inclusion (70%, 95% CI: 69%-72%). Thirty percent (95% CI: 29%-32%) intend to leave their organizations within 1 year, and 18% (95% CI: 17%-19%) plan to retire within 5 years. Staff connect their work with agency goals and priorities (86%, 95% CI: 85%-87%) and are determined to give their best effort every day (91%, 95% CI: 90%-91%).

CONCLUSION: As the need for an all-encompassing focus on COVID-19 lessons, BCHC HDs should continue to focus on prioritizing staff retention, enhancing communication between senior staff and employees, and fostering an environment where innovation and creativity are rewarded.

PMID:36223507 | DOI:10.1097/PHH.0000000000001659

J Public Health Manag Pract. 2022 Oct 11. doi: 10.1097/PHH.0000000000001633. Online ahead of print.

ABSTRACT

OBJECTIVE: In response to calls to achieve racial equity, racism has been declared as a public health crisis. Diversity, equity, and inclusion (DEI) is an approach public health organizations are pursuing to address racial inequities in health. However, public health workforce perceptions about organizational commitment to DEI have not yet been assessed. Using a nationally representative survey of public health practitioners, we examine how perceptions about supervisors’ and managers’ commitment to DEI and their ability to support a diverse workforce relate to perceptions of organizational culture around DEI.

METHODS: Data from the 2021 Public Health Workforce Interests and Needs Survey (PH WINS) to examine the relationship between public health employees’ perceptions about their organization’s commitment to DEI and factors related to those perceptions. PH WINS received 44 732 responses (35% response rate). We calculated descriptive statistics and constructed a logistic regression model to assess these relationships.

RESULTS: Findings show that most public health employees perceive that their organizations are committed to DEI; however, perceptions about commitment to DEI vary by race, ethnicity, gender identity, and organizational setting. Across all settings, White respondents were more likely to agree with the statement, “My organization prioritizes diversity, equity, and inclusion” (range, 70%-75%), than Black/African American (range, 55%-65%) and Hispanic/Latino respondents (range, 62.5%-72.5%). Perception that supervisors worked well with individuals with diverse backgrounds had an adjusted odds ratio (AOR) of 5.37 (P < .001); organizational satisfaction had an AOR of 4.45 (P < .001). Compared with White staff, all other racial and ethnic groups had lower AOR of reporting their organizations prioritized DEI, with Black/African American staff being the lowest (AOR = 0.55), followed by Hispanic/Latino staff (AOR = 0.71) and all other staff (AOR = 0.82).

CONCLUSIONS: These differences suggest that there are opportunities for organizational DEI commitment to marginalized public health staff to further support DEI and racial equity efforts. Building a diverse public health workforce pipeline will not be sufficient to achieve health equity if staff perceive that their organization does not prioritize DEI.

PMID:36223514 | DOI:10.1097/PHH.0000000000001633

J Chem Inf Model. 2022 Oct 12. doi: 10.1021/acs.jcim.2c00977. Online ahead of print.

ABSTRACT

Ester hydrolysis is of wide biomedical interest, spanning from the green synthesis of pharmaceuticals to biomaterials’ development. Existing peptide-based catalysts exhibit low catalytic efficiency compared to natural enzymes, due to the conformational heterogeneity of peptides. Moreover, there is lack of understanding of the correlation between the primary sequence and catalytic function. For this purpose, we statistically analyzed 22 EC 3.1 hydrolases with known catalytic triads, characterized by unique and well-defined mechanisms. The aim was to identify patterns at the sequence level that will better inform the creation of short peptides containing important information for catalysis, based on the catalytic triad, oxyanion holes and the triad residues microenvironments. Moreover, fragmentation schemes of the primary sequence of selected enzymes alongside the study of their amino acid frequencies, composition, and physicochemical properties are proposed. The results showed highly conserved catalytic sites with distinct positional patterns and chemical microenvironments that favor catalysis and revealed variations in catalytic site composition that could be useful for the design of minimalistic catalysts.

PMID:36223497 | DOI:10.1021/acs.jcim.2c00977

Sci Adv. 2022 Oct 14;8(41):eabo6872. doi: 10.1126/sciadv.abo6872. Epub 2022 Oct 12.

ABSTRACT

Planning for adaptation to climate change requires accurate climate projections. Recent studies have shown that the uncertainty in global mean surface temperature projections can be considerably reduced using historical observations. However, the transposition of these new results to the local scale is not yet available. Here, we adapt an innovative statistical method that combines the latest generation of climate model simulations, global observations, and local observations to reduce uncertainty in local temperature projections. By taking advantage of the tight links between local and global temperature, we can derive the local implications of global constraints. The model uncertainty is reduced by 30% up to 70% at any location worldwide, allowing to substantially improve the quantification of risks associated with future climate change. A rigorous evaluation of these results within a perfect model framework indicates a robust skill, leading to a high confidence in our constrained climate projections.

PMID:36223474 | DOI:10.1126/sciadv.abo6872

PLoS One. 2022 Oct 12;17(10):e0275933. doi: 10.1371/journal.pone.0275933. eCollection 2022.

ABSTRACT

BACKGROUND: Antenatal care (ANC) is imperative to decreasing adverse pregnancy outcomes and their related maternal mortality. However, in sub-Saharan Africa, increases in ANC coverage have not correlated well with improved maternal and fetal outcomes suggesting the quality of ANC received could be the missing link. This study assessed ANC quality and its effect on adverse pregnancy outcomes among women who delivered at Komfo Anokye Teaching Hospital.

METHODS: A cross-sectional study was conducted among women who delivered at Komfo Anokye Teaching Hospital within the study period. Women were selected through systematic sampling and interviewed using a pretested structured questionnaire as well as review of their medical records. Data were collected on their sociodemographic and reproductive characteristics, care provided during ANC and delivery outcomes. Categorical variables were compared using the χ2 test. Factors associated with quality of ANC and adverse pregnancy outcomes were assessed using univariate and multivariate logistic regression to generate crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs). Statistical analyses were performed using SPSS and GraphPad Prism. P-values of < 0.05 were considered statistically significant.

RESULTS: 950 women were recruited into the study with mean age of 30.39±5.57 years. Less than one-tenth (7.6%) of the women received good quality ANC, 63.4% had average quality ANC, and 29.0% received poor quality ANC. Increasing educational level and initiating ANC in the first trimester [aOR 0.2; 95%CI 0.08-0.68; p<0.001] increased the odds of receiving good quality ANC while being unemployed decreased the odds of receiving good quality ANC [aOR 0.3; 95% CI 0.12-0.65; p = 0.003]. Receiving poor and average quality of ANC were significantly associated with increased likelihood of developing anaemia during pregnancy, preeclampsia with severe features or delivering a low birth weight baby.

CONCLUSION: Most women did not receive good quality ANC. High quality ANC should be provided while the women are encouraged to comply with the recommendations during ANC.

PMID:36223426 | DOI:10.1371/journal.pone.0275933

PLoS One. 2022 Oct 12;17(10):e0274972. doi: 10.1371/journal.pone.0274972. eCollection 2022.

ABSTRACT

PURPOSE: To explore the wider determinant factor of citizens’ spirituality, health engagement, health belief model, and attitudes towards vaccines toward acceptance and willingness to pay for a Coronavirus disease 2019 (COVID-19) vaccination.

METHODS: A community-based cross-sectional online investigation with convenience sampling was utilized to recruit 1423 citizens from 18 districts across Indonesia between December 14, 2020 and January 17, 2021. Descriptive statistics, One-way analysis of variance, Pearson correlation, Independent t-tests, and multiple linear regression were examined.

RESULTS: Spirituality, health engagement and attitude toward vaccines, as well as health beliefs constructs (all scores of perceived benefits and barriers) were significant key factors of acceptance of vaccines. Interestingly, the spirituality, attitude toward vaccine, and health beliefs constructs including perceived susceptibility, and benefits indicated a significantly higher willingness.

CONCLUSIONS: Results demonstrated the utility of spirituality, health engagement, health belief model, and attitudes towards vaccines in understanding acceptance and willingness to pay for a vaccine. Specifically, a key obstacle to the acceptance of and willingness to pay COVID-19 vaccination included a high score of the perceived barrier construct. Moreover, the acceptance of and willingness to pay could be impaired by worries about the side-effects of a COVID-19 vaccination.

PMID:36223417 | DOI:10.1371/journal.pone.0274972

J Cardiopulm Rehabil Prev. 2022 Oct 10. doi: 10.1097/HCR.0000000000000726. Online ahead of print.

ABSTRACT

PURPOSE: The objective of this investigation was to determine whether chronic obstructive pulmonary disease (COPD) patients with high blood eosinophil (EOS) counts had better improvement in 6-min walk test (6MWT) after pulmonary rehabilitation (PR).

METHODS: Fifty COPD patients were randomly assigned to either the rehabilitation group (RG) or the control group (CG). Patients in the RG (8 wk PR + routine medication) and the CG (routine medication) were followed for 32 wk. According to the blood EOS level, the RG was divided into an EOS ≥ 200 cells/μL group and EOS < 200 cells/μL group. The 6MWT distance, Borg Scale, and COPD Assessment Test (CAT) were evaluated before intervention and 8 wk and 32 wk later.

RESULTS: After the 8-wk intervention, 37 patients (19 RG/18 CG) completed the study. At 8-wk and 32-wk follow-up from baseline, a statistically significant difference was found between these two groups in the 6MWT, Borg Scale, and CAT. Compared with baseline, the 6MWT in the RG increased 49.1 ± 40.2 m (95% CI, 29.7-68.5, P < .001) at 8 wk and 60.8 ± 42.1 m (95% CI, 40.5-81.6, P < .001) at 32 wk. In addition, the improvement of 6MWT in the EOS ≥ 200 cells/μL RG group was higher than that in the EOS < 200 cells/μL group (40.1 ± 17.6 m, 95% CI, 36.8-43.4; P = .036) at 32-wk follow-up from baseline.

CONCLUSION: An 8-wk PR can improve the exercise capacity of COPD patients, and the benefits persistent for 24 wk. The improvement in the 6MWT was more significant in COPD patients with a high blood EOS count.

PMID:36223406 | DOI:10.1097/HCR.0000000000000726

PLoS One. 2022 Oct 12;17(10):e0275829. doi: 10.1371/journal.pone.0275829. eCollection 2022.

ABSTRACT

Gynandropsis gynandra (spider plant) is an African traditional leafy vegetable rich in minerals, vitamins and health-promoting compounds with potential for health promotion, micronutrients supplementation and income generation for stakeholders, including pharmaceutical companies. However, information on biomass productivity is limited and consequently constrains breeders’ ability to select high-yielding genotypes and end-users to make decisions on suitable cultivation and production systems. This study aimed to assess the phenotypic variability in biomass and related traits in a collection of G. gynandra advanced lines to select elite genotypes for improved cultivar development. Seventy-one advanced lines selected from accessions originating from Asia, West Africa, East Africa and Southern Africa were evaluated over two years with two replicates in a greenhouse using a 9 x 8 alpha lattice design. Significant statistical differences were observed among lines and genotype origins for all fourteen biomass and related traits. The results revealed three clusters, with each cluster dominated by lines derived from accessions from Asia (Cluster 1), West Africa (Cluster 2), and East/Southern Africa (Cluster 3). The West African and East/Southern African groups were comparable in biomass productivity and superior to the Asian group. Specifically, the West African group had a low number of long primary branches, high dry matter content and flowered early. The East/Southern African group was characterized by broad leaves, late flowering, a high number of short primary branches and medium dry matter content and was a candidate for cultivar release. The maintenance of lines’ membership to their group of origin strengthens the hypothesis of geographical signature in cleome diversity and genetic driver of the observed variation. High genetic variance, broad-sense heritability and genetic gains showed the potential to improve biomass yield and related traits. Significant and positive correlations among biomass per plant, plant height, stem diameter and leaf size showed the potential of simultaneous and direct selection for farmers’ desired traits. The present results provide insights into the diversity of spider plant genotypes for biomass productivity and represent key resources for further improvement in the species.

PMID:36223403 | DOI:10.1371/journal.pone.0275829